Authors: William Campos, Nicola Hancock, Justin Scanlan, Andrew Povolny, Anne Honey, Grenville Rose, Helen Glover, Mark Orr, Sumathi Govindasamy, Naseem Ahmadpour, Yidan Cao, Lorraine Smith, Dr Chris Groot, Elise Carrotte, Fincina Hopgood, Lisa Phillips, Melinda Benson, Gayle McNaught, Elizabeth Paton, Jane Dewing & Anne Richards
Event: 2023 The MHS conference - Adelaide
Subject: Language, Stigma & Recovery
Type of resource: Conference Presentations and Papers
Presentation 1: Prevention & Recovery: Key to better choices, care and outcome for Mental health in Australia.
The key to more effective Mental Health Care in Australia is the transition of care between Hospital and Community and home. How well we support care of individual during the transition between services will have an enormous benefit to not only the individual, but their family and the broader community.
People with acute or severe levels of distress who will, at times require specialist intervention and present to hospital for treatment. It is this group where prevention and early intervention in the community supported by a lived experience workforce can provide the most benefit, as the provision of quality care can significantly amplify better outcomes for individuals and their families over the long term.
The additional interplay between face-to-face services and online service has demonstrated that there are benefits to continuity of care, which can enhance coordination of care and improve outcome for people with mental health needs. This includes a step-up and step-down services with a focus on support provided by lived experience workforce, can enhance the clinical outcomes already established by traditional treatments.
There is evidence that such coordinated, community-based services provide a long-term return on investment for hospitals, health districts and government, with a reduction of individuals requiring hospital admission and /or readmissions, as well as supporting people in recovery and staying well longer.
People with complex and enduring mental health conditions, (as well as their carers and families), should have the choice of a consistent and coordinated transition of care from hospital to home.
By including people with a lived experience as a support network and peer workforce to assist with transitional care will enhance the day-to-day nuances of living with a mental health condition and importantly enhance the treatment and care.
1) Top understand people with long term and enduring mental illness, benefits from a transition of care, to support long term stability of the individual & family/ carer.
2) Outline the benefits of having a Lived experience Peer workforce to complement the treatment process from Hospital to home
Fowler, D., French, P., Banerjee, R. et al. Prevention and treatment of long-term social disability amongst young people with emerging severe mental illness with social recovery therapy (The PRODIGY Trial): study protocol for a randomised controlled trial. Trials 18, 315 (2017). https://doi.org/10.1186/s13063-017-2062-9
Reoennfeldt, h & Byrne, L (2021) Skin in the game: The professionalization of lived experience roles in mental health. International Journal of Mental Health Nursing Vol 30, (1) October 2021, 1445-1455 https://doi.org/10.1111/inm.12898
Presentation 2: A Co-Designed App to Support the Right to Greater Self Determination in Mental Health Recovery?
Authors: Nicola Hancock, Justin Scanlan, Andrew Povolny, Anne Honey, Grenville Rose, Helen Glover, Mark Orr, Sumathi Govindasamy, Naseem Ahmadpour, Yidan Cao & Lorraine Smith
The Recovery Assessment Scale – Domains and Stages (RAS-DS) is a co-developed recovery-focused tool with two specific objectives: 1. as a self-report outcome measure, and 2. to maximise self-determination in recovery-focused planning, a fundamental right of people accessing mental health services. Evidence has demonstrated the sound measurement properties of RAS-DS, resulting in the instrument being used as an outcome measure in over 26 countries. However, the second and potentially more impactful objective remains challenging for many.
This presentation will report on an in progress, 3-year funded, co-design project being conducted in partnership by The University of Sydney, Flourish Australia, and Helen Glover’s Enlightened Consultancy. Phase 1 of the project involves an iterative co-design and testing process. Through this process we are developing a digitised RAS-DS resource (Driv-R – DRIVing my own mental health Recovery App) to support the right to self-determination. Co-designing Driv-R helps ensure it aligns with the needs and priorities of service users and mental health staff alike.
Our co-design team includes both lived experience partners and staff allies. Our research team’s strength is its diversity. We are a team of researchers with lived and living expertise of mental health recovery, service provision, co-design and e-design expertise.
Participants will learn about Recovery Assessment Scale – Domains and Stages (RAS-DS) and the project team’s experiences and learnings around co-design.
RAS-DS is widely used. This project supports a more rights-based and recovery-oriented approach to its use - supporting people to take greater leadership in their mental health recovery planning.
Hancock, N., Scanlan, J.N., Honey, A., Bundy, A.C. & O’Shea, K. (2015). Recovery Assessment Scale – Domains & Stages (RAS-DS): Feasibility and measurement capacity. Australian and New Zealand Journal of Psychiatry. DOI: 10.1177/0004867414564084.
Hancock, N., Scanlan, J.N., Kightley, M. Harris, A. (2020). Recovery Assessment Scale – Domains and Stages (RAS-DS): measurement capacity, relevance, acceptability and feasibility of use with young people. Early Intervention in Psychiatry 14(2)179-187. DOI: 10.1111/eip.12842
Presentation 3On the Same Wavelength: development and evaluation of a new podcast about stigma and discrimination.
Authors: Dr Chris Groot, Elise Carrotte, Fincina Hopgood & Lisa Phillips
Podcasts are a popular medium for sharing narratives from people with lived experience, and show promise for engaging and educating audiences. On the Same Wavelength is a new podcast produced in collaboration between SANE and the Melbourne School of Psychological Sciences at the University of Melbourne. This podcast aims to reduce listeners’ stigmatising attitudes towards people living with complex mental health issues.
Unique to this podcast is the research which informed its development, including a co-design study. A Co-Design Committee was established with Peer Ambassadors, healthcare professionals, media professionals, and workplace mental health champions. Through this co-design process, On the Same Wavelength was created, with each of the six episodes focusing on life domains where stigma and discrimination are common. Guests speak about the profound impact of stigma and discrimination on their lives, their right to be treated with equity, and positive changes they wish to see. The impact of listening to the podcast will be determined through a randomised controlled trial, assessing listeners’ attitudes and discriminatory intentions before and after listening to the podcast.
This presentation will overview early findings from the randomised controlled trial, and discuss implications for individuals and organisations producing lived experience-based podcasts in the future.
Delegates will learn about how formative and impact research designs can be applied to podcasts, and understand important considerations for sharing stories about mental health-related stigma and discrimination in this format.
Carrotte, E.R., Hopgood, F., Blanchard, M., Groot, C., & Phillips, L. (forthcoming) A new podcast to reduce stigma against people living with complex mental health issues: a co-design study. JMIR Formative Research.
Walsh, D.A.B., & Foster, J.L.H. (2021) A call to action: a critical review of mental health related anti-stigma campaigns. Frontiers in Public Health, 8: 1–15.
Presentation 4: The Language of Stigma: Language guidance for communicating about mental health issues and suicide.
Authors: Melinda Benson, Gayle McNaught & Elizabeth Paton
The words we use to describe mental health issues or suicide play a crucial role in shaping public perceptions and contributing to stigma experienced by individuals with a lived experience and their families.
Stigma is a complex social process and human rights issue, leading to discrimination and exclusion from societal opportunities like employment and relationships.1 Exposure to public stigma, for example, can reinforce shame and self-stigma, impact help-seeking behaviours and impede long-term recovery. Those with lived experience of mental health issues say living surrounded by stigma can be harder than dealing with the condition itself.2
This presentation outlines new language guidelines with best-practice advice for communicating about mental health and wellbeing, mental health issues, suicide, self-harm, alcohol and other drug use and disordered eating. Across the development of Our Words Matter, people with lived and living experience were consulted alongside clinical experts and professional communicators to establish a consensus on language.
The project aims to reduce the harm caused by poor communication, including stigma, social exclusion, barriers to help-seeking, and suicidal behaviour. Language that empowers and supports those impacted by mental health issues or suicide moves us towards a more inclusive, understanding society.
Participants will be able to identify: 1. Impact of an individual’s language use on stigma; 2. the challenges and opportunities for clinicians in focusing on the language they use; 3. areas where they can make language changes; 4. guidelines and resources available to support them to communicate safely and sensitively.
1 Thornicroft G, et. al. The Lancet Commission on ending stigma and discrimination in mental health. The Lancet Commissions 2022 https://doi.org/10.1016/S0140-6736(22)01470-2
2 Cameron Solnordal and SANE StigmaWatch. What’s the impact of Stigma? https://www.sane.org/get-involved/advocacy/stigmawatch
Presentation 5Real life stories – Promoting Recovery
Authors: Jane Dewing & Anne Richards
Social connections, a sense of belonging, taking control, getting a job, or finding other meaningful roles, can all contribute to recovery for individuals’ participating in mental health services. The aim of this presentation is to share real life stories from a community psychosocial rehabilitation program, that for almost 30 years has had a focus on recovery and occupation (the things we need to do, want to do and have to do as part of everyday life). There are varied reasons why individuals attend psychosocial rehabilitation programs. The incentive for many is the opportunity to re- connect and to regain confidence in social settings. Working from this starting point, the dreams, goals, and aspirations of individuals can be identified, shared, and achieved.
This presentation will explore the process and principles that guide this program including the use of meaningful and purposeful occupation, collaborative goal setting, identification of strengths and values, taking action and coaching to make change. It will also explore agency for change; including choice and control, promoting confidence in abilities, the value of sharing experiences and being heard. We will also introduce the concepts of occupational identity and formulation as a new lens for working in this space.
Exploring real life stories that demonstrate principles and processes that act as agents for change, in a community psychosocial rehabilitation program.
It will have a focus on recovery in the context of mental health
Parkinson, S & Brooks, R, 2021 A Guide to the Formulation of Plans and Goals in Occupational Therapy, Routledge.
Hancock, N, Scanlon, J.N, Bundy, AC & Honey, A, 2019, Recovery Assessment Scale Domains and stages (RAS-DS) Manual version 3, Sydney, University Of Sydney.