Authors: Rick Corney, Jacqueline Keevins, Suzie Forell, Sarah O'Connor, Lisa Mcdonald, Trisha Haynes, Leanne Stimpson
Event: 2022 TheMHS Conference
Subject: co-design, legal, systems
Type of resource: Conference Presentations and Papers
Abstract: PANEL PRESENTATION: Outside four walls, thinking outside the square: co-design with clients of Corrections and mental health.
Rick Corney, Jacqueline Keevins
People in the criminal justice system commonly experience poor mental health and barriers to treatment . In Victoria, Ballarat Community Health provides mental health treatment for adults on Correctional Orders. However, this highly marginalised group are typically court-ordered to comply with multiple expectations, proving difficult to engage. We therefore undertook a project of discovery to design a service with less barriers to participation. This required genuine co-design methodology to involve people unused to being consulted. Guided by The Australian Centre for Social Innovation, we accumulated wisdom from clients, colleagues, and service system partners to shape our service model.
The project had major implications for our service and the project participants. A key learning outcome was that:
“if we want people to change, then we have to change”.
This project epitomises the Conference theme. Our shared Corrections and mental health clients navigate lives of complexity and difficulty that represent a serious barrier to engagement. They experienced the service system as fractured and unfriendly, providing a blueprint for a different and better alternative. The presenters navigated this journey through our own lenses of professional and lived experience.
PANEL PRESENTATION: Seeing legal needs in mental health settings: practitioner strengths and challenges
Suzie Forell, Sarah O'Connor
People in contact with mental health services often experience the impact of adverse social conditions. These can manifest as legal issues, for which the solutions lie beyond the mental health system. So what does it look like for mental health practitioners to support people who have health harming legal issues, such as spiralling debt, unstable housing, discrimination, family breakdown and family violence or criminal law issues? What are practitioner strengths and challenges, and how to we improve service capability to respond to complex intersecting need?
This presentation reports a baseline survey conducted with mental health clinicians and peer support workers across Australia to understand the types of legal need their consumers experience, their strengths and the challenges they face in responding to these issues.
The survey is being undertaken to inform the design and development of health justice partnerships in a selection of Neami National services. Health justice partnerships bring legal help into health care settings and teams to broaden the range of skills, knowledge, tools and connections available to address complex and intersecting health and legal issues.
PANEL PRESENTATION: Legal Systems Influence on Therapy & Therapeutic Alliance for Sexual Violence & Domestic Violence Clients
Legal systems impact therapeutic practice where a client has disclosed sexual and/or domestic violence. Practitioners regularly have case notes subpoenaed for Family Court or Criminal Court, often they are weaponised against their client. In this context is therapy a safe and confidential space for clients and is it ethical to say so? What of the therapeutic alliance? The danger of the practitioner being discredited for believing a client?
Tentative research on being exposed to this problem via lived experience. As a practitioner I contemplated it, listened to women whose lives were being impacted by legal systems, similar patterns emerged. Practitioners unaware of how their case notes would be used against their client in legal systems and client's blindsided on the stand or by legal systems, years too late. Australia has a significant problem with believing women and children who experience violence.(Ref) Is it not an ethical and a protective measure for practitioners to learn and incorporate parts of the law to augment their case notes to better support the client?
I believe yes. Case notes can be an integral way for systems to change to take away bias, and steadfast a cultural shift in courts, especially if done universally.
PANEL PRESENTATION: “Take a walk in my shoes” - Transfer of Care from custody to community.
Trisha Haynes, Leanne Stimpson
Integrated Care in partnership with the Justice Health and Forensic Mental Health Network, developed a model of care for custodial clients with complex health and social care needs to provide multi-disciplinary, cross sectorial coordinated care post-release into Western NSW.
Our Model focuses a comprehensive holistic person centered approach which promotes physical and psychosocial wellbeing and aligns with NSW Value Based Health Care.
The project has shown a reduction in ED presentations and recidivism. Individuals reported feeling trusted, included and having an understanding of their health and social care plans and pathways. Individuals had improved social inclusion which minimised the effects of mental health. Families, Carers and providers reported a better experience of care, with increased satisfaction from key stakeholders delivering the care. Delivering a person-centred and team based care approach, enhanced access and engagement with primary care services, improving health literacy and breaking down institutionalised stigma.
The strong partnerships created between Justice Health, Forensic Mental Health and Western NSW LHD continues to identify at risk custodial clients, providing positive outcomes. The continuum of care into the community supports individuals to break the cycle of institutionalisation, reducing stigmatisation by delivering supported integration into their community.