Authors: Vrinda Edan, Lorna Downes
Event: 2017 TheMHS Conference
Subject: Lived Experience, Recovery,Trauma-informed care,Clinical Issues
Type of resource: Conference Presentations and Papers
Abstract: Nationally mental health services and health services in general are increasingly concerned about aggression management in services 1. Posters stating that violence will not be tolerated and public awareness campaigns highlighting the issue of occupational violence are becoming commonplace. Various forms of training have been developed in and across services to help staff manage aggression and ‘behaviours of concern’. Whilst there is no single definition of behaviours of concern or challenging behaviours (terms that are often used interchangeably in mental health services) typically they are defined as generally be any behaviour that is:
inappropriate, illegal, will affect a person’s access to community or health services, will harm the person or others or will result in property damage. (Community Services and Health Industry Skills Council 2015). Whist the definitions do not define the actor, that is, who is performing the behaviour, usually it is interpreted that the actor is a service user or possibly a family member/carer.
Whilst some training includes lived experience perspectives, the majority fail to highlight the issue of behaviours by service providers that are experienced by consumers and/or their families or by other service providers as inappropriate, affecting a person’s access to services, harmful or against organisation policy or even the law. In addition, although these kinds of training attempt to encourage participants to take a more open minded view in order to see the situational context of the person’s behaviour, this is usually overshadowed by issues of risk and risk management.2
Recovery oriented practice and trauma informed care require a paradigm shift in workers and systems. Where service providers are invested and passionate about implementing trauma informed and recovery oriented ways of thinking and working, they can find it difficult to challenge entrenched patterns of responding to behaviours and organisation culture.
Using examples of ‘behaviours of concern’ from established training, this highly interactive workshop uses humour and critical reflection to explore behaviours of concern from consumer and family/whanau/carer perspectives. Techniques used will include; small group work, open space technology, scenario based learning, and purposeful storytelling to enable participants to examine their responses to situations of power and powerlessness.
Learning Objective 1: Participants will take away skills in addressing situations in which they feel challenged in their experience of mental health services or in their workplace
Learning Objective 2: This workshop is relevant to mental health services because of the growing body of evidence that shows consumer and carers can be traumatised by their experience of mental health services.
1. Community Services and Health Industry Skills Council (2015) Knowledge Guide for CHC Community Services Training Package,
2. Victorian Government Department of Human Services, (2011) Preventing occupational violence. A policy framework including principles for managing weapons in Victorian health services. Melbourne, Victoria
3. B. Heckemann, A. Zeller, S. Hahn, T. Dassen, J.M.G.A. Schols, R.J.G. Halfens, The effect of aggression management training programmes for nursing staff and students working in an acute hospital setting. A narrative review of current literature, Nurse Education Today, Volume 35, Issue 1, January 2015, Pages 212-219.