Authors: Rob Warriner, Fay Jackson, Rania Omar, Ayesha Khan, Amie Verrall, Dr Mad Magladry, Larissa Fisher, Mark Loughhead, Kate Rhodes, Heather McIntyre, Dr. Laura Hayes & Nicholas Procter
Event: 2023 The MHS conference - Adelaide
Subject: Leaders at All Levels
Type of resource: Conference Presentations and Papers
Presentation 1: Re-imagining Mental Health.
Author: Rob Warriner
This presentation is heavily informed by “Reimagining Health”; a paper developed by Reform, a leading UK based “think tank”. The presentation aims to apply their thinking and recommendations to the mental health.
A high performing mental health system would be relentlessly focused on delivering the best outcomes for the communities they serve; providing timely, easy access to relevant, high quality treatment and support, and achieving value for taxpayers who fund them – all within the constraints of a sustainable budget.
Our mental health systems are currently falling short on each of these measures.
Recognition of social determinants of health should mean greater power and resources will need to flow to the public, social services and assets that keep us health – not just to the providers of treatment.
To achieve this we will need a model which can assess and act on partnering arrangements, where services are configured based on the broad health needs of the population, and where individuals and communities are incentivised and supported to play a lead role in boosting their health.
Reforming a complex system is not an easy task. The barriers to overcome in the mental health system are immense – this is even before we consider the mental health needs of the communities we serve.
This presentation will argue the need for more in depth and courageous consideration of the changes that need to happen – and how we can support these.
1) Delegates will be encouraged to reflect on a difference between reforming the mental health system and reforming our responses to poor mental health and wellbeing in the communities we serve.
2) Delegates will be encouraged to reflect upon how we connect with, support and utilise community resources and assets.
Reform, (2022) Reimagining Health. https://reform.uk/research/reimagining-health/
Presentation 2: Leaders of New Mental Health and Wellbeing Communities: New Leaders, Services, Attitudes and Outcomes.
Authors: Fay Jackson, Rania Omar, Ayesha Khan & Amie Verrall
Lived Experience leadership is a cornerstone of the values of Flourish Australia and an important contributor to protecting and promoting human rights in services. We are person-led by and for individuals and across the services. Flourish Australia is honoured to have people with lived-experience (LEx) in designated/non-designated roles across all levels of our service including the Board, Senior Executive, Middle managers, researchers, IT, Peer Workers, and the valued Community Advisory Council. Flourish encourages staff and people accessing services to take up leadership; to be the changes people with LEx have been telling services across Australia they need. We invite delegates to examine the phenomenon of reform and culture change: Does it always take so long? Must it be so challenging? We have experienced that it need not be as long or hard if everyone, including people accessing services, Peer Workers, families, staff at all levels, see themselves as leaders and change agents. We will explore how engaging people’s leadership potential and using the 3 Vital Behaviours in our Recovery Action Framework and our Social Citizenship Framework, led to cultural change and reform that took place at Flourish Australia comparatively quickly, painlessly, and with a sense of great achievement by all.
1. Taking a new approach to leadership.
2. The fastest way to achieve reforms are for people to recognize their leadership in bringing about reform. It encourages people with lived-experience, students, staff in clinical/non-clinical roles to share the burden, benefits beneficial services and communities by taking up leadership roles
Byrne, L., & Wykes, T. (2020). A role for lived experience mental health leadership in the age of COVID, Journal of Mental Health, 29(3), 243-246.
Flourish Australia (2023). Social Citizenship Framework. Unpublished.
Presentation 3: Keeping consumers at the centre of transition pathways when a service ends.
Authors: Dr Mad Magladry & Larissa Fisher
Discontinuation of care from a service can mean a loss of access to mental health supports, especially when consumers are not provided with the information, assistance and referral pathways needed to access alternatives. This threatens their rights and leaves them without access to medications, therapeutic care, and supports for social inclusion. While it is important that consumers have the ongoing care they require, addressing this issue requires a nuanced approach to avoid consumers being transitioned into alternative services that don’t meet their needs or that do not centre their perspectives. This presentation draws from Consumers of Mental Health WA’s systemic advocacy engagement with members about the lack of onward referral pathways when services cease, discussing the recent closure of group programs in WA. Our service data and consultation with consumers reveals a growing system-wide lack of transition pathways. However, it shows how Peer Workers in Peer Navigation can address this issue by co-developing transition pathways with consumers and service providers and facilitating continued access to supports that meet the needs of consumers. Peers Workers can identify gaps and strengthen service transition pathways, to ensure that consumers are supported to engage with the services that support their own definition of wellbeing.
This presentation will describe how Peer Workers can address the lack of transition pathways that enable continuation of support for consumers when a service ends by engaging them in program design and transition plans so that they are kept at the centre of their own care.
Presentation 4: What do we need to do to embed supported decision making?
Authors: Mark Loughhead & Kate Rhodes
This presentation begins by summarizing the findings of a recent spotlight report project which focused on improving sector understandings of person centred and consumer directed mental health care.
The focus narrows to the reports recommendations towards the importance of supported decision making as an approach which promotes human rights and assumptions of legal capacity for consumers with disability to make life or care based decisions. Whereas most mental health acts in Australia promote substitute decision making, which generates a focus on assessing consumer capacity and substituting decision making power to health professionals, embedding the approach of supported decision making promotes a consumers responsible autonomy and positions the role of helpers in providing supports to guide decisions accordingly. This stance aligns very well with key principles in the recovery, social model of disability and neurodiversity movements.
The presentation discusses the benefits of adopting this an approach as a key design feature in not only in legislation but in service culture and in the mental models that guide the education of health professionals. This identifies sites for change and action and the leadership of lived experience as an enabling force.
Participants will gain an improved understanding of different points of action and influence for embedding supported decision making in policy, service culture and professional practice.
Presentation 5: NDIS and the emergency department. What do people really think: A national survey.
Authors: Heather McIntyre, Dr. Laura Hayes, Mark Loughhead & Nicholas Procter
People on NDIS Psychosocial support plans may have limited supports available when facing a crisis. Often people seek help at Emergency Departments, where the medical model clashes with the mental health and social care philosophies. The person presenting is often in the centre of uncertainty. Difficulties in ED staff responding to complex needs may result in misunderstandings and/or misdiagnosis leaving the person feeling a sense of not being heard, misjudged and a sense of hopelessness.
This study, funded by MIND Australia as part of a PHD scholarship, describes consumers perspectives and will inform emergency department practitioners of alternative care pathways for to revise current practices.
Two concurrent national online mixed method surveys were conducted. 1) Clinicians working in the emergency department.
2) People with an NDIS psychosocial disability plan presenting to the emergency department.
Qualitative themes and quantitative descriptive statistics from qualitative data will be presented.
Recommendations for improved care pathways, supportive communication, continuity of care and follow-up after discharge from the emergency department will be presented.
Exploring lived experience perspectives and clinician experiences identifies important strategies and practices for improving care pathways for people using both ED and NDIS community supports.
1. Person centred care for people with a psychosocial disability when presenting to the emergency department
2. Presentation of phenomenological data from the ED clinician perspective
McIntyre, H, Reeves, V, Loughhead, M, Hayes, L and Procter, N 2022, ‘Communication pathways from the emergency department to community mental health services: A systematic review’, International Journal of Mental Health Nursing, 31, pp. 1282 - 1299. https://doi.org/10.1111/inm.13024
McIntyre H, Loughhead M, Hayes L, Procter NG 2021, ‘National Disability Insurance Scheme and the lived experience of people presenting to the Emergency Department: Protocol for a mixed methods study, Journal of Medical Internet Research - Research Protocol, vol. 10, iss. 11, e33268, pp. 1-8.