MENTAL HEALTH REFORM
Primary health symposium
A discussion on the role of the Primary Health Networks within the context on national mental health reform.
- Chris carter - CEO, North Western Melbourne PHN
- Lyn Morgain - CEO, cohealth
- Jason Trethowan - CEO, Western Victoria PHN
Mansfield Mater – utilising rural community resources to benefit the social connections of those living with mental illness.
Mansfield Mates is an innovative project aimed at utilising community volunteers in assisting those experiencing mental health difficulties in the Mansfield region. The project aims to reconnect participants with their community in the areas of social inclusion and day time activity. The project was developed as a way of directly responding to the voices of consumers and carers who were concerned by the limited resources within the current mental health sector for rural communities. The Mansfield Mates project is community looking after community and signifying the positive impact of social connections for people with mental illness. The project provides a better opportunity for community members to gain knowledge and understanding of mental health difficulties and therefore reducing stigma.
In reviewing support services/systems in the Mansfield region, evidence identified that people with a mental illness had unmet needs in the areas of social connectedness, companionship and day time activities. This evidence in indicative of many rural and remote communities and is not restricted to the service options of mental health supports specifically. The service system has little to no capacity to offer supports that are flexible and not restricted to 9-5 Monday to Friday. This led to the development of a steering committee to co-design the pilot project with the goal to overcome the restrictive support capacity within the region’s resources.
Robert McDonald – Support Facilitator, Hume Partners in Recovery (MI Fellowship)
Renee Leary – Project Officer, Mansfield Mates
Delivering carer support through an integrated local community strategy.
The Macedon Ranges has an unique geographic and demographic profile. Less than one hour from both Melbourne and Bendigo, it is a semi-rural area with about 40,000 inhabitants. It sits neither inside the greater Melbourne catchment nor that of greater Bendigo. It is tantalisingly close to being included in key mental health service areas, but die to its position is excluded from many direct resources and outreach services other Victorians take for granted.
This level of uncertainty re access to services is a major stressor to local carers. At the same time as caring for a family member with mental illness, carers are navigating through the complexities of the mental health system, unsure of what is available to them. There are a number of agencies who do cover the Ranges region, however the lack of a coordinated approach from those service providers also means that carers who look for support are unaware of who is the appropriate agency for their specific situation.
Ps My Family Matters (PSMFM) was formed in response to these issues. The lived experience of two local mothers identified the need to offer carers assistance in navigating the system within the framework of a peer support program.
This presentation will outline how PSMFM established a 3 pillar strategy, focused on peer support, assistance in accessing services/benefits and community home support. This strategy was developed to be both sustainable over time and replicable in other communities who share similar challenges to those experienced in the Ranges.
Since its inception in mid-2014, PSMFM has impacted on over 150 families in the Ranges region. Recent funding support from Bendigo Health and Macedon Ranges Health has enabled PSMFM to appoint a services coordinator. A volunteer training program has been established and PSMFM now offers a team of peer support volunteers, all with lived experience of caring for someone with mental health issues.
Michael Hamer – Vice President, PS My Family Matters.
PS My Family Matters is a Macedon Ranges based charity offering support to those caring for family members and loved ones with a mental illness.
Michael has extensive non-profit experience having served on the boards of the Alzheimer’s Association, lifeworks and the Eating Disorders Foundation of Victoria.
In his professional life Michael works as an independent leadership coach and facilitator. His experience also includes 20 years working for an international advertising agency.
He is currently undertaking a Master’s program in Psychotherapy and Councelling with the Australian College of Applied Psychology. Michael lives in the Macedon Ranges and is married with two children.
Creation of co-located ‘Partners in Recovery’ Support Facilitator role with Mind Australia and Bendigo and District Aboriginal Cooperative (BDAC).
Mind Australia, Bendigo and District Aboriginal Cooperative (BDAC) and the Murray Primary Health Network's Partners in Recovery (PIR) program have developed an innovative partnership to provide specialised support services to Aboriginal clients with severe and persistent mental ill-health in the Greater Bendigo and Dja Dja Wurrung region. Aboriginal engagement has always been a goal of the Murray Primary Health Network, which has a specific Aboriginal and Torres Strait Islander engagement portfolio. This program addresses some of the unmet need around severe and persistent mental ill-health that exists within our local Aboriginal communities.
In response to community consultation and an identified gap in local services for Aboriginal people with severe mental ill-health, the three service providers successfully collaborated to design an integrated model to engage a PIR Support Facilitator to be co-located between Mind Australia and BDAC.
This innovative program has allowed the three partners to strengthen their own service provisions while meeting the local Aboriginal people where they are and supporting the creation of strong linkages between Aboriginal people and mental health support services. PIR offers an ideal bridge for people connecting with mental health services, by getting multiple sectors, services and supports they may come into contact with (and could benefit from) to work in a more collaborative, coordinated and integrated way.
The focus of the Support Facilitator's role is to provide services to clients, families and carers and teams in line with Mind Australia’s Model of Recovery Orientated Practice and according to the values of Mind Australia.
By providing a service that their existing mental health support services were unable to meet, this role also enhances BDAC’s vision of striving to achieve better health outcomes through a holistic approach for Aboriginal people of the Dja Dja Wurrung area.
After 14 months of negotiation and consultation the Support Facilitator commenced work in November 2015 and is co-located in Mind Australia's Bendigo office and BDAC, providing specialist services to Aboriginal people and their families who may have experienced barriers to accessing mainstream mental health services. It also provides a secondary consult and support role to the various teams at BDAC, and supports the development of culturally sensitive practices in Mind Australia's services across the catchment.
Already we are seeing an increase in the number of enquiries and referrals of Aboriginal people and their families to PIR. The Support Facilitator is also working closely with staff from both agencies to increase their collective knowledge and wisdom by sharing ideas and assisting with continued connection between the two agencies (and by extension the community).
This successful collaboration is an example of best practice of service providers working together to meet the needs of their community. The development of an MOU has not only formalised this process, but allowed for the continued encouragement of collaboration between the three agencies. This partnership also provides a framework that can be replicated in other communities to establish and build integrated services within their own regions.
Nicola Cairns - Partners in Recovery Support Facilitator, Mind Australia
Nicola joined Mind Australia's Partners in Recovery team in november 2015. a qualified social worker, trainer and passionate advocate for regional Australia, Nicola has extensive experience working across Indigenous communities in South West Queensland.
Bill Dower - Quality and Infrastructure Manager, Bendigo and District Aboriginal Coooperative
Bill is a qualified social worker with 30 years experience working across a range of sectors. This includes extensive work in dsability and not for porift mental health services. Over the past seven years much of this work has been with and for Aboriginal Community Controlled Health Organisatioins fostering partnerships.
From participant to peer worker.
The efficacy of peer work in improving recovery outcomes has been established, the term peer work covers a wide range of meanings and roles, yet the employment of peer workers may raise challenges (Carter T and Repper J 2011, A Review of the Literature on Peer Support in Mental Health Services, Journal of Mental Health). Specific training courses for peer workers are a recent development and effective resources to support peer workers can be absent in regional Australia (Health Workforce Australia 2014, Mental Health Peer Workforce Study). Peer worker roles can be ambiguous in scope and definition and peer workers, without previous experience of human service work, may struggle to make the transition from participant to employee.
This co-presentation by a peer worker and their supervisor considers the employment of a peer worker in northern Tasmania. It reflects on the transition of a person from being a participant in a rehabilitation and recovery service to becoming an employed peer worker. It offers insights from a peer and supervisor perspective of how best to support and develop peer workers. It will be suggested that a bi-directional relational process, characterised by willingness in both sides to learn and develop, provides a means to assist the transition from participant to peer worker.
Harvey Baker-Dowdell - Peer Worker, MI Fellowship
Harvey Baker-Dowdell is an International Peer Worker, with lived experience of mental illness for much of his life. Harvey has transitioned from receiving support in his recovery at the service, into paid employment where he shares his experiences and insights about his recovery into mental illness.
David Wilkes - Senior Program Worker, MI Fellowship
David Wilkes is a social worker, from a family with intergenerational mental illness, employed as a Senior Program Worker, with responsibility for mentoring and training staff. He is passionate about helping people with mental illness fulfil their potential.
Providing a peer support network for AOD and mental health peer workers and advisors in the eastern metropolitan region.
The Eastern Peer Support Network (EPSN) is a project designed to bring together peer advisors, workers and people with lived experience of mental health and/or AoD issues to meet on a monthly basis.
The EPSN is peer led and has approximately 40 participants at monthly meetings which are hosted by Eastern Melbourne Region service providers.
The EPSN’s aim is to identify, pilot and evaluate an appropriate peer support network model and regional approach to peer networking, workforce development and training.
Information gathered throughout the project will contribute to the development of effective methods of peer engagement in the workforce which in turn will assist organisatins with the planning and provision of services. The primary focus of the recommendations will be how organisations can grow and better support the peer worksforce in the EMR. Recommendations will be provided to participating organisations at the conclusion of the project in June 2016.
Joel Robbins – Partners in Recovery Manager, Eastern Melbourne PHN
Paula Kelly – Project Worker, Peer Worker, Eastern Health
Engaging the multicultural mental health community through using applied creative art, promoting mental health and reducing stigma simultaneously via the 4c art project implemented by the victorian cald consumer / carer advisory group.
This presentation will highlight work undertaken by the Victorian Culturally and Linguistically Diverse (CALD) Consumer / Carer Advisory Group called the ‘4C Art Project’. The Project aims to reduce stigma, promote vital dialogue alleviating isolation, encourage social networks to develop and positive attitudes / behaviours / mindsets around mental illnesses, with intent to focus primarily on wellbeing of the participants.
The Project is named ‘4C Art Project’ symbolising the four pillars that the project aimed to achieve, namely: Collaboration, Culture, Collectiveness and Connections. These four pillars were not only the Project’s aims, but also initiated a starting point for the project to develop. It gave a sense of purpose / interest from the migrant communities to participate.
Needless to say, Culturally Responsive Practices / Cultural Safety were also driving concepts that were part of the project. Having people from different cultural backgrounds meant that the project required a culturally relevant and safe way of engagement. This in itself not only removed fear / shame to participate, but allowed people to accept each other. In fact, it provided an opportunity for people to engage together as a micro community which otherwise would not have been possible to achieve.
The 4C Art Project is used to illustrate the use of Art as a health promotion tool with communities with emphasis on the migrant communities who lack many of these initiatives, or are struggling to engage due to their level of English/MH proficiency. The role of the community engagement within mental health services will also be explained.
Building capacity for people and services both formally and informally in the migrant communities of today has also allowed recovery and wellness to easily be established, as well as encouraged these communities to empower themselves and explore other options beyond the 4C Art Project.
Evan Bichara - CALD Mental Health Consumer Advocate, Victorian Transcultural Mental Health
Evan Bichara arrived in Australia with his family of Greek-Egyptian background at the age of six. His promising academic career received a setback when he developed a mental illness in the first year of science at the University of Melbourne.
He maintained, however, a profound determination to heal himself and contribute to others. Unusually, Evan found a means of achieving this through sport. His love for soccer and young people led him to coaching junior teams up to state championship level, eventually becoming a referee for Soccer Australia. Assisting his local Greek Orthodox Church also helped him on his long journey to heal his mind, body & soul.
Evan is now a tireless consumer advocate for those who have his condition – supporting individuals in crisis, building awareness in ethnic communities and advising government. His disability has become the means for expressing his passion to make a difference to the lives of other Australians.
RIGHTS AND ADVOCACY
Independent Mental Health Advocacy: using advocacy to increase consumer choice and control in the public mental health system.
The Mental Health Act 2014 (Vic) (The Act) contains a set of reforms to the mental health system that represent a shift towards a more consumer focused, recovery orientated model of care. One of the key concepts underpinning The Act is the idea that consumers have a right to exercise choice and control over their mental health treatment and recovery.
To ensure consumers are provided with assistance to exercise this right, the Act contains a number of supported decision making mechanisms. In addition to the provisions set out in the Act, the government committed to funding a new independent mental health advocacy service for Victoria to support consumers who are subject to compulsory treatment. Independent Mental Health Advocacy (IMHA) began delivering services on the 31 August 2015 to people subject to compulsory treatment in Victoria.
The service is based on the recognition that compulsory treatment under the Act is an inherently disempowering process that places restrictions on people’s human rights. The provision of advocacy to consumers subject to compulsory treatment to support them to make or participate in decisions about their mental health treatment is one way of trying to ensure that this group of consumers retain a degree of choice and control over their care.
It is a model that works. In 2007 the UK introduced an Independent Mental Health Advocacy service for people subject to compulsory treatment (also known as IMHA) which has been comprehensively evaluated. The evaluation found that the provision of IMHA advocacy was key for ensuring that consumers subject to a treatment order ‘had a voice’ .
Liz Carr, Senior Advocate, IMHA
Liz Carr was previously the Acting CEO of VMIAC. She has over 15 years' experience as a mental health consumer advocate across both metropolitan and regional/rural Victoria. Previous roles include community development, administrative and editing work across a range of industries.
Wanda Bennetts, Senior Consumer Consultant, IMHA
Wanda Bennetts has worked in a variety of consumer perspective roles since January 2001 including consumer consultant, consumer educator and consumer researcher. Wanda’s paper “Real Lives, Real Jobs’ is about her passion for progressing consumer workforce issues. Wanda works as the senior consumer consultant for IMHA and also does freelance work.
Positive change in reducing seclusion and restraint in New Zealand.
Te Pou O te Whakaaro Nui has been working with a number of District Health Boards over the past eight years to reduce the incidence of seclusion and restraint in acute adult mental health inpatient units. This work has also been supported by the Ministry of Health.
Reducing and working to eliminate seclusion and restraint is highlighted as a priority action in Rising to the Challenge: Mental Health and Addiction Service Development Plan 2012-2017. This plan is the key national policy document for mental health and addiction services in New Zealand. Seclusion data is reported annually in the Director of Mental Health’s Annual Report. The policy context will be discussed in the presentation.
The New Zealand Six Core Strategies© checklist is a proven way for mental health and addiction services to reduce seclusion and restraint events. These strategies are:
- Leadership towards organisational change
- Using data to inform practice
- Workforce Development
- Use of seclusion and restraint reduction tools
- Service user/consumer roles in inpatient units
- Debriefing techniques
The original Six Core Strategies© were developed in the USA by the National Association of State Mental Health Program Directors Medical Directors Council (NASMHPD), and are evidence based approaches effective in reducing seclusion and restraint.
The New Zealand Six Core Strategies© checklist was developed by Te Pou to help services in New Zealand implement the original strategies. The checklist is tailored for the New Zealand environment.
One of the key success factors has been the co-leadership of this work with a project lead and a service user lead. The service user voice is strong in this work, and was a critical voice when adapting the Six Core Strategies© for the New Zealand context. This continues to be the case.
This work also contributes to the theme of the Towards Recovery Conference relating to human rights. Seclusion is a human rights issue, and the approach Te Pou has taken in implementing Six Core Strategies© has shown a reduction in seclusion and restraint which in of itself is a positive outcome. The nature of the six strategies also requires change at an individual, system and organisational level. It also bodes well to the concept of transformation given the trauma associated with seclusion events, and with the decreased use of seclusion and restraint will reduce trauma experienced in units.
Angela Gruar – Manager Practice and Leadership, Te Pou O te Whakaaro Nui
Angela Gruar is Manager, Practice and Leadership at Te Pou O te Whakaaro Nui, which is the national mental health evidence based workforce development centre in New Zealand. Angela leads a team who are focused on working with services in respect to particular practice issues in both district health boards and non government organisations, This includes reducing seclusion and restraint in acute adult mental health inpatient units.
Angela has a Master of Arts (Hons) in Education, and has worked in the public sector prior to joining Te Pou in 2015.
Exploring the potential for alternatives to seclusion in Acute In-patient Services.
Restrictive interventions, such as seclusion, are experienced by people experiencing an acute mental health crisis as traumatic, and counter to recovery.
Objectives - To audit seclusion rates in one service in Melbourne, Australia, to investigate the use of seclusion, patient demographics, and opportunities to reduce seclusion use.
Methods - A cohort of admissions were examined across a 12 month period in January – December in 2013. Electronic and paper records were accessed and audited for 655 admissions.
Results - There were 198 seclusion events and 90 discreet patients who experienced seclusion. For those experiencing seclusion: two thirds were male; half were either homeless or had no fixed abode; 32% were case managed; and over 50% were unemployed or not in the workforce. The average time people experienced seclusion for was 12 hours, and the median and mode times were 4 hours.
Conclusion - By understanding seclusion interventions better, changes can be made to enhance practice. This exploratory research into seclusion has clarified who is most likely to experience seclusion, why, for how long, and suggests ways social workers can be catalysts in important reforms to protect and enhance the rights and wellbeing of marginalised members of our communities at their most vulnerable.
Background -: This data was collected while author was on final Social Work placement at an in-patient mental health service in late 2015. This data was gathered in order to provide a comparison point for future research to see if interventions, such as a pilot program utilising peer workers and reforms brought about from the new Mental Health Act (2014), had had any significant impact on seclusion rates. It was also hoped that by learning more about who gets secluded that this research could be used to advocate for such consumers who are over represented in the secluded population. This research was originally submitted as an honours thesis titled “Preserving Human Rights During an Acute Episode: Uncovering issues of masculinity, homelessness, social isolation and poverty through a quantitative analysis of mental health service seclusion events”, which, as the title suggests, had a strong leaning toward promoting recovery principles and comparing current practice with prevalent human rights law.
Jacinta Chavulak - Mental Health Support Worker, Uniting Care Prahran Mission
Jacinta Chavulak is currently working as a Mental Health Support Worker with Uniting Care Prahran Mission after completing a double degree of Arts (majoring in behavioural studies) and Social Work (with Honours). Jacinta has previously worked as a community support worker at St Mary’s House of Welcome after completing her first social work placement for this organisation. Jacinta is in the process of writing articles from this research for international mental health-focused journals and will be presenting her results at the International Social Work Conference on Health and Mental Health in Singapore later on in the year. Jacinta completed this research whilst on placement where she concurrently supported work completed for a pilot program utilising peer workers and assisted in collecting and reporting on consumer feedback for this program. Jacinta is a passionate advocate of recovery orientated practice within her current work and writing.
Transformative communities - The Mind Recovery College approach provides consumer choice and control through co-production and co-delivery.
The Mind Recovery College provides a range of educational courses for people with lived experience, friends, family carers, practitioners and the broader community. Co-production is central to the Recovery College, meaning all courses are co-developed and co-delivered in partnership with the aforementioned stakeholders, ensuring each course provides an opportunity to inform, challenge, and impart knowledge, wisdom, and personal experiences to support recovery.
This interactive session will demonstrate the merits of stakeholder collaboration through the activity of co-production.
A key component of the Mind Recovery College approach is to transform mental health services through organisational change. Recovery colleges value the expertise of lived experience and carers as much as the expertise of practitioners. The benefits of the model in supporting recovery have been widely documented in the UK and emerging research suggests that co-production can positively impact not only consumers, but organisations more broadly, in reinvigorating and rebuilding the way we do business. The Mind Recovery College won a National Disability Award in 2015 for Excellence in Choice and Control in Service Delivery.
The potential for the Recovery College approach to expedite lasting and sustainable recovery for long-term ‘clients’ of mental health services is exciting and profound. This speaks to the recognition that participation of people with lived experience in the process of knowledge formation - from production, delivery and evaluation of courses - provides a rich and meaningful plethora of understanding, enabling assumptions and bias to be challenged in the context of a learning environment.
Co-production is the mechanism that provides a more inclusive and transformational recovery platform. This shifting of consciousness is possible within the context of the college due to 5 key factors within the approach:
Facilitator - At least one facilitator has lived experience, is not an authority figure or expert, and is equipped to facilitate meaningful activities and conversations that are not confined by clinical language and expectation.
Content - The content for workshops is co-produced. Many people are part of the process in establishing themes, ideas, experiences that inform our courses in a more meaningful way. The way we communicate elicits more emotional and kinaesthetic components.
Students – Our participating students share vast lived experiences, are self-motivated (they choose to be here, feel safe and are able to have conversations and reflect and learn from each other). The Recovery College approach allows consumers, carers and practitioners to learn together without hierarchy or ‘experts’.
Environment – The Mind Recovery College is open, warm and welcoming. The campuses also provide access to resources and facilitators.
Activities - Many methods of facilitation are incorporated into the teaching; the sessions are not didactic, are more grounded in group-work, reflection, and incorporate activities that reinforce and challenge the learner.
This presentation provides a summary of how co-production contributes to choice and control and service transformation. The workshop will also include a demonstration of the co-production process that will give participants a firsthand experience of co-production at work.
Emma Higgins - Mind Recovery College
Emma Higgins- Has worked in the Mental Health Sector and Education for last 10 years. Emma has a diploma in Mental Health Sciences, Masters in Sociology and recently completed a Graduate Certificate in Family Therapy. Emma is passionate about recovery and her work is informed by her own personal experiences and a strong conviction that anything is possible if you hold hope, have support and hold dreams and goals to inspire you.
Courtney O’Connell - Mind Recovery College
Courtney O’Connell has experience of working in mental health services as an Occupational Therapist for the past 7 years. During this time Courtney has worked at a Recovery College in the UK which has helped develop her passion for Recovery Colleges and the exciting opportunity they offer to people. Courtney now works at the Mind Recovery College.
Learnings from a process evaluation of the Mind Recovery College.
The Mind Australia Recovery College (MRC) is an innovative service delivery model that uses a co-production and education-based approach to mental health service delivery. Based on the Recovery College model from the United Kingdom, the MRC gives people with lived experience of mental ill-health, their families and friends a space to both learn and teach skills to support recovery. The MRC has been in operation since 2014 and is currently in partnership with the Centre for Mental Health at the Melbourne School of Population and Global Health in conducting ongoing evaluation activities.
Aims; This presentation will present preliminary findings from an evaluation focused on the implementation of the MRC as well as early indications about a range of potential outcomes. This stage of the evaluation aimed to examine: (A) how Mind has adapted the Recovery College model; (B) the fidelity of the implementation of the MRC to Mind’s initial plan; (C) indicators about the effectiveness and impact of the MRC; and (D) the ‘active ingredients’ of the MRC Model in the short term.
Methods: These questions were addressed through a mixed methods design using a documentation review, a survey of stakeholders and a series of semi-structured interviews and focus groups with students, teachers, carers, family members and Mind staff at the Mind Recovery College.
Findings and reflections: Data is currently being gathered and analysed. We anticipate that findings from this phase of the evaluation will inform ongoing development of the College and assist to inform future evaluation efforts. We are keen to share ideas about the best approach to evaluation of a new innovative service like the MRC that reflects its core principles, particularly co-production, and the implications of preliminary findings.
Teresa Hall - Research Fellow, Global and Cultural Mental Health Unit, Melbourne School of Population and Global Health, Melbourne University
Teresa Hall is a Research Fellow at Melbourne School of Population and Global Health with a MSc Public Health from London School of Hygiene and Tropical Medicine. She has a particular interest in consumer-orientated mental health systems policy design, implementation and evaluation both in Australia and internationally. She has previously worked on the development of national guidelines for mental health in the criminal justice system in the UK, and the national mental health policy of Sri Lanka.
Developing a progressive mental health research and evaluation agenda through researcher, consumer & practitioner collaboration.
Traditionally, research ideas and questions have been driven by research institutions or academics and at times can be removed from the real issues facing people who experience mental health difficulties and the services employed to support them. As a growing organisation with an increasing number of staff and consumers to work with; Neami was often seen as a potential pool of ‘subjects’ by researchers.
In 2008 we asked ourselves the question “How do we as an organisation with a focus on service delivery, become a leading organisation in recovery focused evidence based research and evaluation”? We wanted to enact a research and evaluation agenda that could be used to address priority issues that lead to direct benefits for consumers.
A key factor that has driven Neami’s capacity to undertake research and evaluation activities has been the development of a Research and Evaluation Committee. The committee is made up of Neami staff, consumers, and external academics. Each of the members bring valuable expertise, knowledge and experiences which contribute to decisions regarding which projects to prioritise and undertake, or where projects may require improvements in design or process. Over time it has evolved to reflect a coproduction process where each of the members contribute to decisions and are able to learn from each other. As an innovation, it has proven to be successful in progressing Neami’s capacity to undertake research and evaluation projects that can advance knowledge and service delivery practices in the mental health field.
“I love the idea that what I contribute has an effect on how things are done”. (Consumer member)
“I have been so impressed by the breadth and depth of research and evaluation that Neami initiates and participates in, and also, how being on the committee has developed my own knowledge and skills.” (Staff member)
As a whole, the committee provides a vital function in ensuring quality and consistency is reflected in all of Neami’s research and evaluation activities. The members ensure all research is conducted in accordance with Neami values, ethical research practice, and National Health and Medical Research Council (NHMRC) guidelines consumer participation in research. Together they provide a frank and fearless review of project proposals, a willingness to offer informative advice and mentoring, and the ability to reflect on how their role can be refined to improve their contribution.
In this presentation we share:
- Committee member profiles and how these contribute to decisions made by the committee.
- The core functions of the committee and how these influence our research and evaluation activities.
- How the committee has evolved over time to enact a co-production approach.
- The benefits of engaging differing forms of expertise to further quality and relevance in research and evaluation.
Keren Wolsterncroft – Research Coordinator, Neami National
Keren Wolstencroft: Keren is research coordinator at Neami National and has a key role in ensuring research and evaluation activities participated in by Neami are enacted according to the oversight decisions of Neami’s Research and Evaluation Committee. She is a psychologist with a particular interest in research and practices that support health, wellbeing and a flourishing life.
Dave Peters: Dave is a consumer with a lived experience of recovery. He has an interest in using his experience to be a voice and advocate for the consumer perspective of how it might feel to participate in any research project, how data collection methods can be negative or misinterpreted, and how research translates into service improvements. During his time on the committee Dave has also been participated in a number of steering group roles related to mental health research and program design.
Bridget Roberts – Senior Consultant, clear Horizon
Bridget Roberts: Bridget is a senior consultant with Clear Horizon. She is an experience evaluator with a background in education, community development and health service provision. Bridget has conducted multiple policy, system and program evaluations for state and federal government departments in Australia and New Zealand. Bridget is experienced in conceptualising and designing mixed method evaluation projects, reviewing relevant literatures and documents and conducting a wide range of group and one-to-one consultations involving consumers, front-line and senior service providers and senior policy executives. She is an accomplished writer for varied audiences and a published author of over a dozen peer-reviewed articles.
MENTAL HEALTH REFORM
Partners in Recovery Symposium - an exploration of the future of the PIR program within the context of current reforms.
Partners in Recovery. Building towards the NDIS. National progress- local experience.
Partners in Recovery (PIR) has achieved remarkable outcomes in its first 3 years of operations. The NDIS has emerged during the same period as the largest health (disability) reform since Medicare in the 1970s. This presentation will compare the rolling out of the two initiatives so far and also raise some of the challenges as PIR starts to integrate into the NDIS over the next 3 years.
The presentation will compare and contrast the approaches of the two initiatives. While the content will focus on the PIRs’ experience there will be strong correlations between PIR practitioners and services experiences and those of the broader community mental health sector. The presentation will discuss the steps that have been taken and what still needs to done to assist people with mental health support needs to access the NDIS.
The speaker will gather the latest information available on the progress of the two initiatives; including numbers of mental health clients engaged in each, the current profiles of the client groups and the relationship to consumers and carers that each initiative is supporting. There will be a comparison of the operational models of each, and an emphasise of the impact that each has had or is likely to have on the service system also the public and political profile of each
There will be an examination of the key component of PIR, the Support Facilitator role and a discussion of how support coordination is likely to be incorporated into the NDIS model. The question as to how people with high and complex support issues might be supported within the NDIS model will also be considered.
There will also be a discussion of the language and emphasis of both approaches, contrasting the recovery and strength motivated approach of PIR and the mental health sector, to that of a deficit focussed and assessment of life time disability assigned within the NDIS model.
The speaker will then discuss the next step issues and what is likely to change in the delivery of PIR services to better integrate with the NDIS.
This presentation could act as a curtain raiser for the more detailed PIR presentations to follow, particularly the Flinders University National PIR Capacity building initiative, which looks at how , the national program was supported and how regions all over Australia were fostered to develop a cohesive national program, while addressing the needs of local populations and mental health systems.
Kieran Halloran – Partners in Recovery Manager, Northern Melbourne
Graham Panther - Mallee Family Care/Red Panther Consulting
Garth Boyh - Malle Family Care
Jenny Donnelly - Murray PHN
Tania Shelby-James - Flinders University
Demonstrating value in the coming service system: lessons from partners in recovery from the Lower Murray Region.
This is a time of great change for Australia’s mental health system. Most notably, the implementation of NDIS, and the sweeping reforms announced by the Commonwealth Government. In each case, there is a bold, ambitious vision for a more user-friendly system, as well as a great deal of debate about how it will all really work. In Victoria, other major recent changes include the recommissioning of community-based mental health services, and a new Mental Health Act.
While this churn has brought a measure of uncertainty and trepidation amongst the sector and the broader community, it has also opened up important conversations about how we meet the mental health needs of our community, and how we put these big ideas of recovery and consumer choice into action in meaningful ways.
Partners in Recovery is particularly well-placed to lead this conversation. The advent of PIR can itself be seen as a major development in the system, with the creation of a whole new form of mental health support, and the program’s system mandate to bring us closer to a recovery-oriented, truly client-centered service system.
PIR has also built up a strong working knowledge of the ins and outs of the system. The program operates at two levels – working directly with community members, and coordinating the system itself – which provides unique insights into the system’s strengths, weaknesses, and opportunities for improvement via the embedment of systems change work as core to the work of PIR.
Our project aims to capture that working knowledge. As the lead agency of Lower Murray PIR, Mallee Family Care is undertaking an evaluation, with a particular focus on possibilities for the future. In addition to a standard evaluation of PIR’s impact in the region, we are exploring the question of how PIR can demonstrate value in the coming funding environment – to funders, consumers, and other stakeholders. We will explore outcome measurement practices in the particular context of service coordination, with regard to likely future funding scenarios. Engagement with communities in and around Lower Murray, will explore the broader question of what people want out of the system in this region – hopes for the future system, common roadblocks to getting help, and types of support they would purchase under individualized funding if it were available.
Our approach is one of shared sense-making, working with our partners, funders, and the community to envision where the sector can go from here, and what PIR’s role in that may be. In this presentation, we will offer up our initial findings in the interests of contributing to the broader, ongoing conversation about future sector development.
Graham Panther – Red Panther
Graham Panther has over a decade's experience in the mental health sector as an evaluator, researcher, and innovator. Graham has worked on a number of ground-breaking projects, including New Zealand’s first Peer Support Services, and Australia’s first Recovery College. Graham’s consultancy, Redpanther, are currently evaluating multiple Partners in Recovery programs across Victoria.
The ‘learn as we go’ approach of Partners in Recovery fits nicely with Redpanther’s practical, partnership-based approach to evaluation. Graham believes that when it comes to mental wellbeing, no one has all the answers, so it pays to share what we've learned – whether in professional roles, messy life experiences, or both. He has a passion for getting people talking and listening to one another in new ways.
Kane Alderson - Partners in Recovery Team Leader – Lower Murray Region
Kane is the team leader of the Partners in Recovery Program for the Lower Murray region. Kane is a trained social worker and a passionate advocate for systems reform that will assist people with mental health issues, their families and carers. Kane’s work experience to date ensures he is well placed to speak broadly about how the systems interact, and provide commentary for the future landscape within this space.
Contributing to personal recovery through a monitoring and evaluation process.
Hume PIR have taken a non-traditional approach to evaluation and one that aims to enhance the recovery process for our participants and create opportunities for two-way feedback. We have chosen an interview approach that allows respondents to tell their own story. It has been important to us that respondents have the chance to explain their own experience and perceptions, without having to tick boxes. As such, our methodology is largely qualitative and driven by informal dialogue, not statistics. It has enabled us to gain rich insights into the impact of PIR, and allows our participants to control their contribution to the evaluation, putting respondents in the driver’s seat, and giving them the opportunity to qualify and substantiate aspects of their PIR experience.
Jenny Donnelly – Manager Hume PIR Program
Jenny has a background in community health, particularly in the area of health promotion, and has utilised the knowledge gain in that sphere to implement an effective strategy to engage consumers in monitoring and evaluation which is respectful of their participation and the information which they share, and which is extremely valuable in indentifying program/service outcomes.
Building capacity within the Partners in Recovery initiative
The national Partners in Recovery (PIR) initiative (funded by the Australian Government Department of Health) aims to advance and improve support for people with severe and persistent mental illness with complex needs through the effective coordination of services and supports across multiple sectors. The purpose of the PIR Capacity Building Project (CBP) is to increase the capacity of PIR organisations to deliver the PIR initiative by creating regular opportunities for national networking and information-sharing across the PIR network.
To achieve this, a number of activities and resources are being delivered, including:
- An annual national meeting and regular state and territory workshops
- A PIR web portal that provide resources and information and facilitates networking between PIR organisations
- Numerous training modules and webinars that cover specific activities and challenges relevant to PIR
- A national mentoring program and staff exchange program that facilitate ongoing networking
- A governance structure that enables the CBP to be responsive to stakeholder needs and challenges
A recent evaluation of the CBP indicated that the project has made a positive contribution to the staff involved in the implementation and ongoing delivery of PIR. There was excellent evidence from respondents that the CBP team had met its objective to increase the capacity of PIR staff to deliver PIR. Networking events such as the annual meeting and the state/territory workshops were the most highly-rated activities in the evaluation findings. The evaluation also indicated that without the CBP, the work of PIR staff would have been more difficult and staff have believe that the this impacted their work in several ways including
- Providing consistency and direction
- Decreasing isolation
- Providing new ideas
- Providing support when staff feel lost
- Opportunity to get new information and exchange ideas
- Better sharing and support
- Improved efficiency
The PIR Capacity Building Project provides essential support to the PIR program. The project is continuing to build momentum, evolve in response to emerging themes and key challenges and disseminate best practice approaches and innovative ideas to PIR organisations and their staff.
Associate Professor Tania Shelby-James - Manager PIR Capacity Building Project, Flinders University.
Tania is a health service researcher specialising in complex or chronic disease and capacity building and is passionate about ensuring high quality care for all people regardless of income or location. She has represented the research community on national committees for the Australian Government and is a member of the Scientific Working Committee of PC4, a national primary healthcare collaborative for palliative care. She has led projects exploring care coordination within primary care and ways in which patient centred care coordination can be delivered.
WELL BEING AND SPIRITUALITY
Co-designing a sustainable living program for people living with a mental illness.
In 2014-15, Neami National (NN) adopted a co-design approach to develop, implement and evaluate sustainability focus groups with consumer participants living with a mental illness. The co-design process and resulting focus groups aimed to collect consumer perspectives about the importance of various ecotherapy options (activities in green environments) on their recovery from a mental illness and ongoing wellbeing.
Green spaces present an opportunity for replenishing and improving many aspects of health and wellbeing including physical, spiritual, emotional, neurological and psychological health (Townsend & Weerasuriya, 2010). Some of the physical and mental health benefits from spending regular time in green spaces have included improvements in mood as well as lower levels of anxiety, sleep disturbances and stress. Physical health, fitness and immunity have also been shown to be linked to time spent being active in green spaces. Research has shown that people experience time in nature as calming and like a mental, physical and spiritual renewal or like a ‘mini holiday’ (Townsend & Weerasuriya, 2010; (Mind UK, 2007; University of Essex, 2013).
The NN consumer participants who took part in the focus groups placed highest value on:
- opportunities to connect with nature as a relaxation strategy and positive mood enhancer;
- skills to source, prepare and eat healthy, fresh and seasonal produce; and
- creating community and social opportunities around focused sustainable living activities such as gardening, cooking, outings into nature, mindfulness in nature, art in nature, conservation activities and exercise outdoors.
While community gardening opportunities have long been a part of many community mental health services, these findings indicate that consumers see ecotherapy activities as beyond just gardening and as important to their recovery and wellbeing. While the focus groups collected feedback from a small sample of 30 consumers, the information is a valuable resource to inform improvements in service delivery and practice at NN. Furthermore the co-design process was a valuable experience for Neami staff and consumers, resulting in improvements in the evaluation and planning of NN’s sustainable living programs.
Since September 2015, Neami has used the information gathered through this co-design process to develop opportunities for consumers to engage in ecotherapy activities as part of their recovery including a ‘Get active in nature’ program and resources for people to build their own mini garden box to install at their home.
- Townsend, M. & Weerasuriya R, (2010). Beyond Blue to Green: The benefits of contact with nature for mental health and well-being, Study conducted by Deakin University in collaboration with BeyondBlue.
- Mind UK (2007), Ecotherapy: the Green Agenda for Mental Health, accessed 1/11/2013, http://www.mind.org.uk/media/211252/Ecotherapy_The_green_agenda_for_mental_health_Executive_summary.pdf
- The Australian Centre for Social Innovation (2011), Co-designing thriving solutions, accessed 19/8/2014, tacsi.org.au/curriculum
- Mind UK (2013), EcoMinds Directory of Projects 2009-2013, accessed 1/11/2013, http://www.mind.org.uk/about-us/policies-issues/ecotherapy/
- Diamant E. and Waterhouse A. (2010), Gardening and Belonging: Reflections on how social and therapeutic horticulture may facilitate health, wellbeing and inclusion. British Journal of Occupational Therapy, pp84-88.
- University of Essex (2013), Ecominds effects on mental wellbeing: An evaluation for Mind, accessed 1/12/2014 http://www.mind.org.uk/media/354166/Ecominds-effects-on-mental-wellbeing-evaluation-report.pdf
Amy Piesse - Sustainability Officer, Neami National
Amy has worked at Neami National since 2011, initially as a Community Rehabilitation and Support Worker before her current role as a Sustainability Officer. Amy works with staff and consumers to implement sustainability initiatives across NN, including the Sustainable Living Program, which offers consumers opportunities to engage in sustainable living activities relevant to their personal recovery goals.
DOWNLOAD AMY'S PRESENTATION:
Meaning making and the Hope Factor: making space for spirituality.
The presentation will focus on the conference key concepts of hope & recovery, transformation and empowerment/rights with scope to contribute to staff and organisational development that directly impacts the quality and depth at which workers are able to engage with and support individual consumers and their carers.
I will present the findings of a pilot training program that ran in 2015. It introduced mental health staff in regional Victoria to concepts of spirituality and spiritual care and how this knowledge enhances the delivery of recovery orientated services and outcomes for consumers of mental health services.
By way of background information, this presentation will briefly consider the historical origins of the recovery movement and where it intersects with spiritual care philosophy. Both champion hope, choice, dignity & respect, inclusion and empowerment. These values, whether viewed from a recovery or spiritual care perspective underpin the things that give people meaning and purpose in life. And when we attend to this dimension of the person, we begin to connect more deeply, which in turn fosters trust and a greater capacity to work together in meaningful ways.
‘Meaning making’ is a process that a person naturally engages in when confronted with illness, trauma or change. How confidant and equipped do staff feel when called upon to engage in conversations that are spiritual in nature and support hope for the future? What stops us from connecting with people at this level? What personal, professional or systemic prejudices come into play?
Analysis of the data collected from pilot program which includes pre-training surveys, post training evaluations and survey monkey questionnaire distributed six months on from the training. The data resoundingly suggests that after some specific education into what has long been regarded a taboo area (especially in mental health), workers feel more confident to be with and initiate conversations that support their consumers to identify additional resources that aid their recovery. In one instance, the additional skills of the worker proved to be a game changer.
Recovery must consider the whole person including the spiritual dimension. It is not until the whole person and their needs are addressed that meaningful change is possible for people. We can no longer neglect the spiritual care needs of our consumers because we don’t feel comfortable or equipped to have these conversations. Our consumers want to experience this depth of connection when seeking support in their healing journey.
Jennifer Greenham – Mental Health Leader, Spiritual Health Victoria
Jennifer commenced in her role as Mental Health Leader at Spiritual Health Victoria in March 2015. She brings a wealth of experience working in both community, clinical and forensic mental health settings, in a variety of capacities over a 25 year period. Her work at SHV is supported by an Interfaith Ministry Ordination and units in Clinical Pastoral Education. Interfaith honors and celebrates all paths to the sacred and has been described as ‘spirituality without borders’. In her experience this speaks beautifully to the spiritual care needs of those with a lived experience of mental illness.
Jennifer is a Board Member of the Interfaith Centre of Melbourne and a volunteer Community Chaplain with the Victorian Council of Churches Emergency Ministry Program. Additionally she co-creates rites of passage ceremonies and rituals with and for people who increasingly identify themselves as ‘spiritual, but not religious’ from her private celebrancy business.
Pilot program with outside the locker room.
Bendigo Health Carer Support Services works closely with their local communities amongst rural isolated and socio demographically disadvantaged consumers. Within this work a need was identified to support young people with risk taking behaviours, anxiety and depression.
Young carers were identified as needing active role models (mentors) in their lives, and people suffering from mental illness needed support to reduce stigma and discrimination within small communities.
Key leaders, committee members and parents within local sporting clubs were challenged with their thoughts and beliefs in relation to mental illness. Carer Support services set out to change the culture and thinking of local football and netball clubs in Campaspe.
Living in rural isolated communities has many disadvantages when it comes to accessing services to support mental health and wellbeing. Education is required to reduce the stigma of people on our communities living with a mental illness and informing the communities of pathways to seek support.
Today’s youth are constantly challenged by internal and external pressures of social experimentation which can lead to the development of drug and alcohol abuse and other socially destructive behaviours.
A pilot program was developed in partnership with Goulbourn Murray AFL to target 13-25 year olds within 12 local football and netball clubs in the Shire of Campaspe region. The age group was targeted as the most vulnerable in our region with increased risk taking behaviours, social pressures, and drug and alcohol issues.
The program’s aim was to develop a collaborative network designed to foster and equip players as they transition from junior to senior ranking whilst promoting and encouraging strong social values within their local communities and everyday lives.
Juniors, delegates and community members were challenged on their personal beliefs of mental illness through three 2.5 hour workshops, which was facilitated by Outside the Locker Rooms Jake Edwards.
Each workshop was designed for the target group to interact with their peers, to achieve powerful and sustainable outcomes, including their thinking, practise, outcomes and options to determine the direction of the individual.
A local theatre company was engaged to perform a series of role plays including examples of eating disorders, drug overdose and body image. The group was encouraged to ask questions and discuss their thoughts on the scenarios that unfolded.
The third and final workshop was delivered by Justyna Kalka, a practising nutritionist. Justyna shares how her past experiences with eating disorders, depression and body image issues led her to what is now a true passion to inspire men and women of all ages to have self-confidence.
Evaluations have been compiled from 2300 youth attending the workshops. The importance of delivering these initiatives through sporting hubs in rural communities has proved an invaluable experience for all participants.
Julie Bright - Carer Support Worker, Bendigo Health
Julie Bright is a medication endorsed EN and has worked as an aged care nurse for over 15 years. For the last seven years Julie has worked as a Carer Support Worker and mental health project worker for Bendigo Health in the community. Julie believes if we can work in a collaborative approach with networks and service providers, our youth of today will be better equipped to tackle many young persons’ issues in today’s world.