S06: Human Rights in Mental Health

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By October 19, 2023 No Comments

Authors: Sharon Lawn, Christine Kaine, De Backman-Hoyle, Shubhangi Kaushik, Rachel Barbara-May, Muriel Cummins, Mark Heeney, TJ Spencer, Shellie Braverman- Lichtman, Fay Jackson Luke Wrightson, Penny Bartholomew & J.A. Menzies

Year: 2023

Event: 2023 The MHS conference - Adelaide

Subject: Human Rights in Mental Health

Type of resource: Conference Presentations and Papers

Presentation 1: Why Addressing Loneliness and Mental Health is a Human Rights Imperative
Authors: Sharon Lawn, Christine Kaine & De Backman-Hoyle
The experience of loneliness is not new. Recognition of the intersection between loneliness and mental health is growing, particularly as more holistic understandings and responses to mental health challenges are called for in policy, practice, advocacy and communities.1,2
In this presentation, we examine why loneliness should be understood through a human rights lens. We will draw on the voices of people with lived experience of mental ill-health and loneliness who shared what loneliness means to them as part of a national survey conducted by Lived Experience Australia in 2022.
322 consumers, family carers and whānau completed the survey. Respondents overwhelmingly described having no-one, feeling invisible and disconnected, longing for connection, feeling misunderstood, disrespected and having no purpose or value to others. They emphasized how loneliness is a hard, hidden, harmful and how it intersects fundamentally with stigma, discrimination and shame, and will mental ill-health and poor physical health.
Results demonstrate how failing to ask about loneliness and take positive steps to address these fundamental drivers of loneliness is a failure to acknowledge the person’s human rights and citizenship. They also demonstrate the enormous strength and humanity respondents showed in the face of social exclusion, disconnection, isolation and loneliness.
Learning Objective
Delegates will learn about what loneliness means from a living and lived experience perspective. They will gain an understanding of how it intersects with core human rights concerns for people with mental ill-health and what is needed to improve their inclusion in community.
1. Meltzer, H., Bebbington, P., Dennis, M.S., Jenkins, R., McManus, S., Brugha, T.S. (2013) Feelings of loneliness among adults with mental disorder. Social Psychiatry and Social Epidemiology, 48, 5-13.
2. Świtaj, P., Grygiel, P., , M, Wciórka J. (2015) Experiences of discrimination and the feelings of loneliness in people with psychotic disorders: the mediating effects of self-esteem and support seeking. Comprehensive Psychiatry, 59, 73–79.

Presentation 2: Dialogue: An innovative human-centred and right-based approach to mental health care.
Authors: Shubhangi Kaushik & Rachel Barbara-May
In 2022, the Open Dialogue Centre embarked on a 35-day study-tour to learn about Open Dialogue and person-centred practices across the globe. The tour highlighted a shared set of values that were at the foundation of person-centred approaches.
•Truly ‘walking the walk’ of ‘no decision about me without me.’
•Recognition of the importance of an individual’s networks and community.
•Hope for, and a commitment to, individuals living fulfilled independent lives.
•Care, compassion, and respect for the workforce and supporting one another.
Learnings from study-tour:
•OD aligns with internationally recognised human-rights approaches.
•OD is an organisation wide intervention and can have a profound impact on workplace culture.
•OD highlights the importance of the workforce bringing humanity, openness, and vulnerability into their work. It supports better integration and respect for the peer workforce.
•OD drove significant improvement in workforce morale and satisfaction, and a reduction in the use of restrictive practices and involuntary treatment.
•OD resulted in improved engagement with services, reduction in chronicity, and reduced hospitalisation.
To support Australian efforts of reform, strong leadership and support is required to create a truly person-centred culture. Open Dialogue is a practical framework that can support organisations in achieving this.
Learning Objective
Open Dialogue provides a practical valued-led framework to embed human-centred and rights-based values, which requires a whole-of-service commitment to creating a culture that supports this.
Open Dialogue is an approach to mental health service delivery that can improve outcomes and transform the culture of services.
Mosse, D., Pocobello, R., Saunders, R., Seikkula, J., von Peter, S. (2023). Introduction: Open Dialogue around the world - implementation, outcomes, experiences and perspectives. Front Psycho, 13, 1093351.
Seikkula, J., & Olson, M.E. (2003). The open dialogue approach to acute psychosis: its poetics and micropolitics. Fam Process, 42(3), 403-18.

Presentation 3: Unmet Need & the Rights of People with Psychosocial Disability Living in Private Congregate Care
Authors: Muriel Cummins, Mark Heeney, TJ Spencer & Shellie Braverman- Lichtman
The PCC Alliance is comprised of a group of organizations working towards the goal of systemic recognition of the unmet needs of people with disability who live in PCC settings, including Supported Residential Services (SRS) in Victoria. PCC residences are privately operated businesses that provide accommodation and support with daily living, and retain many features of outdated institutional care.
The need for a safe place to call home
Many PCC residents experience psychosocial and complex disability. Substantial evidence indicates that PCC residents are at heightened risk of exploitation, violence, abuse and neglect. Currently, significant deficiencies in safeguarding structures create unacceptable risks for PCC residents. People with psychosocial disability who reside in PCC settings are falling through the gaps in safeguarding systems and lack opportunities to work towards life goals.
The potential for policy reform
The PCC alliance presents a growing body of evidence highlighting the urgency of multi-system policy and regulatory reform needed to ensure safer lives and equitable opportunities for people with psychosocial disability residing in PCC. This presentation includes consideration of the potential for the Disability Royal Commission final report; mental health reform in Victoria; and the NDIS Review to collectively create transformative change.
Learning Objective
• The key learning objective is to understand the urgent need and potential for policy reform to ensure safer lives and equitable opportunities for people with psychosocial disability who live in private congregate care or ‘group home’ settings.
Dearn, E., Ramcharan, P., Weller, P., Brophy, L. & Johnson, K. (2022) Supported residential services as a type of “total institution”: Implications for the National Disability Insurance Scheme (NDIS). Australian Journal of Social Issues, 00, 1–17. Available from: https://doi.org/10.1002/ajs4.233
McVilly, K., Ainsworth, S., Graham, L., Harrison, M., Sojo, V., Spivakovsky, C., Gale, L., Genat, A., Zirnsak, T. (2022). Outcomes associated with ‘inclusive’, ‘segregated’ and ‘integrated’ settings: Accommodation and community living, employment and education. A research report commissioned by the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability. University of Melbourne, Australia.

Presentation 4: Choice and Control: Friend or Foe
Author: Fay Jackson
‘Choice and control’ is an important part of people exercising their human rights, and a fundamental aspect of the NDIS. It is what people desire and expect to exercise once they receive an NDIS package. However, is the term understood? Does the term set greater expectations of what services can provide than what they can deliver? Is ‘Choice and Control’ being misused? Could it lead to a diminution of capability and the decline of NDIS sustainability? An expectation the supports someone wants must be delivered when and where they want, can overlook the fact that specialised mental health services are struggling to attract and keep staff since COVID-19, and unable to provide the number of qualified staff to provide the common services people require, let alone uncommon requests. This presentation outlines some of the issues caused by the expectations people have about being able to get exactly the kind of service they want, when, where how and by whom they want to provide these supports. It also asks whether having ‘choice and control’, without a clear understanding of what that means, may be leading towards a diminishment of capabilities in people who have NDIS packages, and the sustainability of NDIS.
Learning Objective
1. This presentation poses questions about the validity, efficacy, reality of the term ‘Choice and Control’ in NDIS service provision.
2. This presentation is relevant to the field of mental health because mental health services are struggling to meet the expectations of people with NDIS packages and the NDIS Commission.

Presentation 5: Let There Be Life; Let There Be Employment
Authors: Luke Wrightson, Penny Bartholomew & J.A. Menzies
Having a job can be one of the most rewarding experiences a person can have in their lives. This is no different for people with lived experience of mental health issues; in fact, the connection and reward involved in having a job can be more valuable for and valued by people with mental health issues. Employment and volunteering helps people feel a sense of belonging not only in their workplace but in the community and within themselves. Undertaking a role that utilizes a person’s strengths and capabilities and enables opportunities to learn and contribute can help people with mental health issues recognize that they are far more than the diagnosis they have been given. In this presentation, three people who are experts by experience, tell of the positive impact working has had in their lives. They hope to challenge services who provide NDIS supports to encourage people to utilize the Capacity Building elements of the NDIS a great deal more than they are currently utilized. They also hope to inspire all services to increase their focus on supporting people to achieve their social citizenship and human rights through employment Learning Objective
1. Delegates will hear from 3 people with lived-experience why employment is important for people with mental-health challenges.
2. This is relevant because NDIS providers, community and clinical public services need to do more to support people to claim human rights and social citizenship through supporting them to gain/sustain employment
Byrne, L., Roennfeldt, H. & O'Shea, P. (2017). Identifying barriers to change: The lived experience worker as a valued member of the mental health team: Summary. Brisbane: Queensland Government
Flourish Australia (2023). Social Citizenship Framework. Unpublished.
Rowe, M., Davidson, L., Recovering Citizenship: Yale Program for Recovery and Community Health, Yale School of Medicine, New Hoven, Connecticut, U.S.A., lsr J Psychiatry Relat Sci- Vo!. 53- Nol (2016)

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