Follow up to the Inquiry

During the Inquiry into Mental Health and Workforce Participation, myself and a few colleagues talked at Parliament House and we were asked some great questions. I love being asked great questions, it shows that the other person was really listening and engaged with you. And then I get all excited and my brain buzzes as I try to engage back and come up with good, useful responses framed in a way that will make sense. Between the nerves and the excitement, it’s a bit like skydiving! We ended up sending in a letter with a more detailed reply afterwards to make sure we’d really answered everything. I thought I’d share the gist of some of this with you.

Q: What would have helped you to access education or employment when you initially became unwell?
A. For myself, I really needed targeted support on campus at university that was geared to assist people with mental illness and multiple disabilities. One of the difficulties with the disability sector is that it often operates on a limited framework, assuming only one condition per person. For people like me with difficulties in more than area, support can be limited and fragmented. The kind of support I have needed on campus is a safe place to retreat to – be that a quiet room, a group meeting area, a small cafe or space in the library. For me it needs to be small, quiet, out of the way, open all hours and easy to get to. Libraries have traditionally been my safe haven, but uni libraries are very large and confusing and I tend to get lost in them!

I also needed someone I could talk to who was willing to provide emotional support while I oriented myself and became more comfortable on campus. I struggle in new environments and with lots of strangers around. The counselling I accessed during my time at uni was unsuitable. The counsellor was extremely anxious about my mental illness, geared for short term goal-oriented counselling, and outraged that I was just seeking emotional support from them. A better understanding of the nature of mental illness would have been very helpful.

Similarly, making more disability friendly the other pathways back to work and study would have been very helpful, such as volunteering and short courses. Helping people like me to feel useful, connected and to find a road back to our study and work goals is crucial.

Another thing that’s often overlooked is that good mental health is built upon a foundation of stability and security. Mental illness can arise from major life challenges, and can create major life challenges. Many people with severe mental illnesses also face complex issues such as homelessness, family breakdown and domestic violence, isolation, drug and alcohol issues, and physical disability. All these contribute to instability and make maintaining work or study extremely difficult. It may not seem intuitive to support employment for people with a mental illness by providing services such as appropriate housing, but this kind of foundational, practical support is key to creating the kind of life where day to day survival is less consuming, so there is time for the pursuit of education and work goals.

Making it easier to link into services would have been incredibly helpful. As a young person I was given no information about my mental illness, local services available to me, and I had no idea there were things I could do to improve my mental health. My doctor or the university could have provided this kind of information, or a referral helpline could allow people to find out about services in their area. Making support services more friendly and accessible would also help. I was initially extremely afraid of the mental health system and deeply intimidated by the labels. It took a mixture of courage, exhausted indifference, and desperation for me to be willing to walk into buildings with words like “Mental Illness” on them. Many of the services available are also very restricted in the kind of support they provide and who they accept as clients. Many services provide support based on the label of your condition, for those of us with poorly funded conditions or rare ones, we can really struggle to find anyone to look out for us. Even if you can access a service, growing older, moving house into a new postcode, getting a new diagnosis, or becoming homeless can all see you become ineligible and exited from the system. Flexible and tenacious support is key. Had I been linked to a PHaMs worker back then, things may have been very different.

Reducing fear and stigma in the community will also make it easier for people with mental illnesses to seek early help and stay engaged. School aged education about mental illness, self care, early warning signs, and hope for recovery could help students struggling with emerging mental illnesses to recognise their condition, know where to go for help, and feel more comfortable about doing so. The opportunity to connect with Peer Workers who have come through mental illness can help enormously to encourage people that a mental illness is not the end of the world.

Q. What can the Government do to encourage employers to employ people with a mental illness?
A. Far more powerful than telling the business world how they should be including people with mental illnesses in their workforce is to model how it can be done. This would normalise the practice and show commitment to meaningful inclusion. There are already people within Government departments who are managing a mental illness, and they could be approached as a resource to develop policies around the employment of people with a mental illness. If the Government leads the way by supporting people with a mental illness within their own workforce, other organisations and employers are more likely to follow this example.

FaHCSIA has models such as PhaMs that require Peer Workers, so having experienced a mental illness is a prerequisite of the position. The Government could ensure that current and future models be designed to have the same requirements, for example respite services, community based mental health programs, Centrelink, or Medicare. Include Peer Work positions in service agreements, then follow up, review and support organisations to implement them.

Education, training, and ongoing support for employers about managing a workforce containing people with a mental illness will help to reduce some of the fears that employers have. An example of this is the Remind Education Program. Ideally, this kind of training should be provided by people with a mental illness themselves – this will reduce stigma and create jobs directly for those individuals. A helpline for employers may be an appropriate format for providing ongoing support.

Peer Workers play a crucial role in raising awareness and reducing stigma. Peer Work positions value the ‘on the job training’ of people who have learned to manage a mental illness, so that it in some way stacks up when compared with people who have theoretical training. The Peer Work Program can be supported as a pilot model for the employment of people with a mental illness. This model can then be expanded to be used for the employment of people with a mental illness in any role.

Lastly, creating safety nets so that people with a mental illness can manage episodes of illness without losing their jobs or having crucial tasks left undone will promote employer confidence and employee security. For example, having a disability employment support who make a staff member available to fill the individuals role should they become unwell. Less pressure on staff with a mental illness can lead to greater productivity.

Q. What are the risks to Peer Workers? For example, are they similar to those faced by Peer Workers in the Drug and Alcohol sector?

A. I found this a really interesting question. The risks to the health of Peer Workers in the field of Mental Health are very different to those faced by recovered addicts/alcoholics who work in the Drug and Alcohol sector. The development of a mental illness is quite different from the addiction model. There is nothing ‘tempting’ about spending time with people with a mental illness. I’m also not aware of any evidence that spending time as a peer with people with a mental illness will in any way make someone more vulnerable to mental illness or a decline in their mental well-being. That certainly hasn’t been my experience, on the contrary, being part of my groups has been of tremendous benefit to me!

Having said that, Peer Workers do have risks to manage. Some of these are simply the kind that anyone in the workforce has, such as coping with life stressors or balancing work and family responsibilities. There are also some issues that are particularly relevant to anyone working in the mental health sector, such as the possibility of burn out, and the importance of minimising vicarious traumatisation. Lastly there are some issues specific to the role of Peer Worker. Peer Workers have a ‘foot in both worlds’ as it were, partly staff and partly consumers within the mental health system. Membership to more than group in this way can be stressful, particularly at times when those groups are in conflict and each is demanding the exclusive loyalty of the Peer Worker. As the role is relatively new, sometimes Peer Workers work under unclear job descriptions, experience workplaces that don’t model good mental health practices, or struggle with a lack of support from management. Sometimes Peer Workers can be under extra pressure to prove they are managing their mental illness. Boundary issues can be difficult to negotiate, and some Peer Workers have lacked access to relevant training and support.

My experience has been that Peer Workers often report that their work is part of their recovery journey rather than a risk to it. In work environments that are supportive and well matched to their skill set, Peer Workers can flourish. The opportunity for employment and the chance to give something back is a meaningful part of the recovery process. Peer Workers can also appreciate the transformation of experiences that have previously been a liability into an asset.

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