S67: LEAD & PANEL PRESENTATIONS: Citizenship, Equity and Social Justice

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By December 15, 2022 No Comments

Authors: Emma Tseris, Scarlett Franks, Eva Bright Hart, Fay Jackson, Megan Paull, Penny Bartholomew, Julie Millard, Muhamad Hidayat, Sharon Lawn, Eimear Muir-Cochrane, Candice Oster, Mark Tayar

Year: 2022

Event: 2022 TheMHS Conference

Subject: peer work, CALD, diversity, human rights, research

Type of resource: Conference Presentations and Papers

Abstract: LEAD PRESENTATION: "My voice was discounted": Women's experiences of resisting injustice within involuntary mental health treatment contexts
Emma Tseris, Scarlett Franks, Eva Bright Hart

This presentation will report on a qualitative action research study exploring women’s experiences of compulsory mental health treatment in Australia. In-depth interviews with women, family/friends, and mental health workers reveal substantial gendered harms experienced by women within involuntary mental health treatment settings. Themes emerging in the study include: involuntary treatment replicates the dynamics and tactics of gendered violence; treatment involves profound deprivation and losses, with potential implications across the life course; mental health services disrupt and undermine mothering; and recovery is found outside of coercive mental health systems. The study reveals the heightened harms experienced by women within involuntary mental health contexts, as well as women’s strategic resistances to psychiatric oppression. It demonstrates the relevance of attending to gender, in order to develop a deeper understanding of women’s experiences of intersecting oppressions within involuntary mental health settings. The study shows that it is necessary to challenge the medicalisation of women's distress, and to centre women's voices in creating alternatives to coercion.

PANEL PRESENTATION: Focus on Social Citizenship
Fay Jackson, Megan Paull, Penny Bartholomew

Flourish Australia provides services with a focus on recovery and are trauma informed. However, we have also developed a strong focus on social citizenship. Our Social Citizenship Framework emerged out of a deeply co-designed process including people accessing our services, staff from all levels, Aboriginal Elders, people from CALD, LGBTI and asylum seeker communities, people from justice systems, youth, elderly and representatives from peak bodies.

Our co-designers recognised a strong need for people to feel included and valued in their communities at all times, including while experiencing voices, visions, sensations and beliefs that others do not experience. Our Social Citizenship Framework focuses on strong community engagement and human rights including the right for people with active mental health challenges to be responsible and valued members of families, neighbourhoods and communities.

Just as many physical disability advocates take the view that individuals are only disabled by communities which do not have attitudes, built environments and equipment that ensure natural inclusivity of people with disabilities; Flourish Australia is advocating for and working in an ethos which aims at leading communities to recognise their responsibility to provide naturally inclusive environments, communities, workplaces, educational institutions, clubs, and services for people with psychosocial disabilities, trauma and mental health issues.

PANEL PRESENTATION: Navigating Complexity - Mental Health Challenges in the Oceania Region
Julie Millard

Oceania covers an area of 8,971,000 square kilometres, and is situated in the Indian, Southern and Pacific Oceans. It includes Australia, Fiji, Kiribati, Marshall Islands, Micronesia, Nauru, New Zealand, Palau, Papua New Guinea, Samoa, Solomon Islands, Tonga, Tuvalu and Vanuatu.

The World Federation for Mental Health (WFMH) is an international volunteer membership organisation founded in 1948 to advance globally the promotion of mental health, prevention of mental illness and emotional disorders, and enhance treatment and care.

Climate change, COVID-19 pandemic, rising sea levels and natural disasters are having a profound impact on the mental health of populations in the region. Mental health services are under resourced in many Pacific nations, with limited research on what works in responding to each specific population’s needs.

The presentation will discuss mental health challenges for the Oceania region, and the work of the Oceania Mental Health Advisory Committee in the building of connections and sharing of resources to address the complexity of mental health challenges in the region.

PANEL PRESENTATION: A graveyard of the living; the physical conditions of life for persons in pasung
Muhamad Hidayat, Sharon Lawn, Eimear Muir-Cochrane, Candice Oster

Indonesia has among the highest rates of Pasung in the world. This widespread significant human rights issue (Hidayat et al 2020) is the phenomenon of restraint of people with mental illness in the home, usually by their family, in the absence of more compassionate and competent institutions to treat them or any formal system of evidence-based mental health care beyond the short-term support provided by large psychiatric institutions. Many people in Pasung live in deplorable conditions, yet there has been little research into the issue. Identifying the negative effects of community forcible seclusion and restraint is a difficult task that raises ethical, legal, and methodological concerns. The main objective of this photograph analysis is to look for the effects of seclusion and restraint on mentally ill people at home. This study analysed 135 photos of people in Pasung, to gain detailed insights into diversity of pasung characteristics such as geographical area, gender, age, family condition, influences of stigma and cultural beliefs, pasung type, and photos that conveyed content, context, and meaning related to Pasung for the person, their family, and the community. Lessons for how we address stigma and care for people with severe mental illness more broadly are indicated.

PANEL PRESENTATION: Peer work within systems of involuntary treatment: Past consumers with Stockholm Syndrome?
Mark Tayar

Peer Workers are most often employed in public health systems and survive an ongoing process of recovery. Public health systems may have required an involuntarily admission for consumers who later become Peer Workers. Peer Workers employed by public health systems must somehow reconcile their employment with their trauma of past hospital stays and sometimes difficult experiences involving clinical staff. ‘Stockholm syndrome’ is a non-diagnostic term used to describe the positive bond some kidnap victims develop with their captor (Namnyak et al 2008). This paper discusses Stockholm syndrome as a metaphor for the experience of Peer Workers now working within the systems that detained them involuntarily. Inpatient admissions can be highly beneficial to some consumers and may lead to a motivation to help co-consumers through a career change. Still, memories of locked wards and primary or secondary trauma within these wards can haunt Peer Workers while they are working. Stockholm syndrome has been applied to intimate partner violence, human trafficking, and international relations (see Adorjan et al 2012) and may be useful as a metaphor to both critique and improve the transition from consumer to Peer Worker. Through narrative inquiry with vignettes and ethnographic participant observation, this paper demonstrates the competing logics of the psychiatric survivor movement and clinically-oriented peer work. Stockholm syndrome is highly flawed as a coping mechanism and will accompany retraumatisation of Peer Workers unless there is ongoing training and empathetic supervision. These tensions are compounded in the case of a relapse of symptoms where readmission or community treatment occurs. Such a relapse may be triggered or amplified by workplace retraumatisation which undermines even the currently robust resilience of the lived experience workforce.

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