Consumer participation and

the Lived Experience

Workforce

Matthew Halpin

Coordinator Lived Experience Workforce

Program

Central Adelaide Local Health Network

Partnering with Consumers and Carers

> “The most beautiful people we have

known are those who have known defeat,

known struggle, known loss and have

found their way out of the depths. These

persons have an appreciation, sensitivity

and an understanding of life that fills them

with compassion, gentleness and a deep

loving concern. Beautiful people do not

just happen” – Elizabeth Kubler-Ross

Our Commitment

> Central Adelaide Mental Health Directorate is

committed to providing the best possible care first

time, every time in the right place delivered by the

right person. To achieve this consumers are

central to everything we do and our goal is to build

effective partnerships with consumer and carers

across all levels of our service.

> Consumer are central in the way we care, in the

way we deliver our service and in the way we

make decisions

> “Our consumers are the most important people in

our health service, they are the purpose of our

work”

Lived Experience Liaison

Groups

> Advisory and consultation groups who has a proactive

role in partnering with the service

> Two groups across Central Adelaide in the east and

west

> Reports directly to Service Manager in each area

including providing an advisory role on the development

of policies, procedures across each sector

> Chaired by a consumer or carer member

> Service managers, a team manger, a team leader,

consumer liaison office and coordinator lived

experience workforce are part of the membership

> All service consultations also go through this groups

> Monthly service KPI’s are presented

> Consumer and carer members provide feedback from

the community

Consumer and Carer Auditing

> CALHN Mental health directorate has sponsored a

project utilising consumers and carers as customer’s

auditors within our service

> Mental Health Care Plans focus of audits

> Consumers and Carers recruited via EOI process

including application and interview

> Auditors provided introductory training on auditing and

mental health care plans and use their lived experience

of mental health care plans to assist in reviewing

> Auditors use purpose developed audit tools to review

quality of care plans developed to review each section

of the mental health care plan

> Reviewed a sample from each team which are

deidentified to maintain consumers confidentiality

Lived Experience Education

> Consumer are employed as co facilitators in education

programs utilising their lived experience to assist in training

clinical staff

> Consumers educators also regularly provide sessions to the

university sector

> Areas of training include

• Working with consumer with Borderline Personality

Disorder

• Trauma informed care

• Self harm

• Working with consumer with complex needs

• Working within a recovery framework

• Consumer engagement

• Consumers experience of care

• Role of lived experience staff

Other areas of participation

> Membership of executive committee's

• Involved at every level

• Attend strategic planning days

• Influence on policy, service development and

opportunity raise consumer and carer views,

issues or concerns at the executive level.

> Membership on working parties who develop and

implement policy with CALHN Mental Health

> Leading the development of consumer and care

resources

> CALHN Consumer Advocates Council

Benefits and Support

> Lived experience members and workforce report that

participation and contributing to the service has a benefit on

their own recovery

> Empowers consumers and carers

> Provides an opportunity to contribute and assist in developing

the services they use

> Provides clinical staff with a greater understanding of what it’s

like living with or caring for someone with an illness

> Positively influences service culture leading to a more recovery

focused service

> Consumer and carer representatives are offered and provided

support and mentoring from the coordinator lived experience

workforce.

> The leadership team meets with representatives regularly and

are very supportive of the representatives

The Lived Experience Workforce

Peer Work within Mental

Health Services

• The introduction of employees with a lived experience of mental illness, either as a consumer of MHS (peer specialist) or as a carer of a consumer (carer consultant), notably adds value to the professionally trained workforce. The roles and presence of the lived experience staff members compliment the clinical roles of professional staff, and their presence on inpatient wards and in the community teams creates an environment which importantly contributes to reducing the stigma associated with mental illness, and which therefore significantly improves outcomes for consumers.

• ‘Peer Support: Social and emotional support, frequently coupled with practical support, provided by people who have experienced mental health problems to others sharing a similar mental health condition. Peer support aims to bring about a desired social or personal change. (National Mental Health Policy 2008)’

• ‘Peer support workers are emerging as new components of the workforce, and should be supported in this context to reach their full potential. (2008)’

History of Lived experience workforce in

Mental Health Services

• 1998

• the first of the lived experience workforce (peer specialists) were

employed

• 2006 • the program expanded and employed one peer specialist and one

carer consultant for every 20 beds across the Central and Northern

regions.

• 2009

• new positions were introduced to CRC’s and ICC’s in each region.

• Over the next few years there was a number changes in the

project coordination

• There was a number of resignations and staffing levels fell.

• 2010

• new Senior Peer Specialist was appointed and original Carer

Connect Coordinator returned to the role

History of Lived experience workforce in

Mental Health Services

• 2010

• A large recruitment commenced filling all vacancies

• Regular bi monthly Lived Experience Workforce training days were

introduced

• Monthly group supervision and staff meetings were introduced

• Regular individual lived experience supervision was introduced

• 2011

• An evaluation of the Lived Experience Workforce was commenced

• Southern Peer Specialists were included in the state-wide program

• Additional Carer Consultants were recruited to southern and older

person service

• 2013

• Coordination for the Peer Specialist and Carer Consultant

workforce was rolled into the Senior Peer Specialist role.

• In 2014

• this role was redeveloped to become Coordinator Lived

Experience Workforce Program

Where the Lived Experience Workforce is

now employed with Metro LHN’s

> Inpatient Units

> All Intermediate care centres

> All Community rehabilitation centres

> All psychosocial day programs

> New roles will soon be recruited to for eastern

community mental health service and Royal Adelaide

Hospital Emergency Department

What is Peer Work?

• The role is to provide support and education to consumers

about their mental health and how to manage this.

• Peer specialists provide education and support to consumers

living with a mental illness including;

what living with a mental illness means

Understanding the role of treatment and the clinical

team

recognising early warnings signs

understanding triggers

Helping consumers set goals and work out steps to

achieves these.

Provide positive role modelling on living with a mental

illness

Develop relapse prevention plans or care plans (with

the treating team)

What is the Carer Consultants

role?

• In the Carer Consultant context“Lived Experience”

means caring for someone who has a mental illness

(often a family member)

• The Carer Consultant utilises their “Lived Experience”

to assist and support families in the following ways:

• Understanding mental illness

• Understanding the role of the clinical team

• Communicating with the clinical team

• Linking into supports and community service that

are available to carers

• Supporting the carer to look after themselves and

how this can help the person they care for including

respite

•

‘Sometime if you need to climb the biggest

mountain it is easier if you know someone

has been on that journey before you.

Where does the Peer role fit

into the Recovery model?

The peer role models recovery to consumers and carers,

demonstrating that work, study and a happy and fulfilling

personal life is possible with a Mental Illness.

Peer Specialists and carer consultants are people who have

experienced the highs and lows of mental illness and have

learnt how to achieve their goals and support their families

regardless of the possible limitations of mental illness.

Being a Peer Specialist isn’t about being completely “cured”

its about modelling recovery and helping consumers begin

their own journey of Recovery

• Peer work is not a clinical role, it is not a peer workers role to

provide clinical assessment or advice

• It is not a peer work role to be a therapist

• Peer specialist and carer consultants are part of the multi-d

team and help provide another perspective for both consumers

and staff.

Lived Experience

Recovery is possible,

authentic and peer work role

models recovery

Similar experience, a shared level of understanding and mutuality.

Its Knowing, walking along

side, sitting with distress and its

challenging.

Its about not expecting and its not directive or prescriptive.

Lived Experience workforce in SA Public Mental Health

services; what we have learned, what we have

achieved and future directions

> CALHN conducted a research study “Lived Experience

Workforce in SA Public Mental Health services” lead by

Coordinator Lived Experience Workforce.

> Aim to evaluate the lived experience roles from a

consumers, carers, clinical staff, managers view and

LE staff view

> Included purpose developed surveys for each group

and additional focus groups for LE staff and Managers

> Published by CALHN in 2014

> Sample size

• clinical staff (n=58),

• consumer (n=29),

• LEW staff (n=12),

• Carers (n= 5)

• Managers (n= 13)

Lived Experience workforce in SA Public Mental Health

services; what we have learned, what we have

achieved and future directions

> Consumers

>

Statement M SD N (%) who

rated item as

good or very

good

The peer specialist helped increase my understanding

of the symptoms I experience.

4.32 .77 15 (53.6%)

The peer specialist shared their positive coping

strategies with me.

4.24 .79 15 (51.72%)

The peer specialist helped me to identify my own

coping strategies.

4.00 .67 24 (85.7%)

The peer specialist increased my sense of hope for

recovery.

4.46 .64 26 (92.9%)

The peer specialist helped me in feeling supported. 4.45 .83 25 (86.2%)

The peer specialist encouraged me in managing my

own symptoms.

4.11 .80 22 (81.5%)

The peer specialist helped me connect with

community resources.

3.96 1.14 20 (71.4%)

Lived Experience workforce in SA Public Mental Health

services; what we have learned, what we have

achieved and future directions

> Carers

How good was the carer consultant at ... M SD

Assisting you to learn about the hospital system. 5.00 .00

Explaining the Well Ways program. 5.00 .00

Helping you feel supported. 5.00 .00

Increasing your sense of hope for your relatives or friends recovery. 5.00 .00

Reducing distress by sharing their coping strategies. 4.67 .58

Helping you identify and build upon your personal coping strengths in

your caring role.

4.67 .58

Lived Experience workforce in SA Public Mental Health

services; what we have learned, what we have

achieved and future directions

Statement M SD

The lived experience orientation program adequately prepared me for

my role within the acute/rehabilitation unit settings.

3.75 .75

As part of my role I receive ongoing training and development: this

enhances my skills, knowledge and abilities to carry out my role.

3.83 1.19

I am well supported within my role by the unit I work on and from the

program as a whole.

4.50 .67

As a lived experience staff I am valued as a member of the

multidisciplinary team within the units where I work.

4.17 .84

As lived experience staff my role is understood by the clinical team,

consumers and carers within the units I work.

3.58 .90

Benefits from Lived

Experience staff

> “Improved communications between clinicians

and consumers”

> “A vital part of our team”

> “Yes peer specialist assist in bringing

communication gaps, particularly in breaking

down the Us & Them mentality that is present in

a lot of inpatient settings”

> “The positions are integral now within the mental

health service workforce”

> “There has been a greater understanding

from staff working in units about the

obstacles that both consumers and carers

face in the real world dealing with MH

issue.”

> “The transition of 20 long term

consumers to Burnside Housing and

Support Program (HASP) could not occur

without input from these staff.”

Recommendations

Recommendation 1: Role clarity

> Increase education at a local level via

regular in-services and at a service level

with all orientation and staff training✔

> Develop print based advertising on the

LEW ✔

> Further develop the LEW role, the hours

and days they work (in progress)

> Further develop LEW specific policies

and procedures (in progress)

Recommendations

Recommendation 2: Training and development for the

LEW

> Review of ongoing training and development programs

✔

> Develop an orientation program specific to the LEW ✔

> Develop an orientation and training manual for LEW

staff (in progress)

> Use evidence based training and ongoing evaluation of

training to review the effectiveness in supporting role

development ✔

> To further improve the training and development

delivered to lived experience staff Central Adelaide

Mental Health has partnered with the Mental Health

Coalition of South Australia to deliver quarterly

professional development to lived experience

workforces across both SA Health and the non

government sector of mental health in South Australia.

Recommendations Recommendation 3: Staff resourcing and job and person

specifications

> Review the current 0.5 FTE positions for LE staff to

determine if services are adequately resourced

(ongoing)

> Review the current job and person specifications ✔

> Explore further career development opportunities for

LEW staff

> Involve supervisors and program coordinators to

manage the selection process for new LEW staff ✔

> Develop a casual pool of LEW staff to cover absences

> Fill LEW staff vacancies as soon as possible to provide

an ongoing service to consumers and carers with

minimal interruptions ✔

> Involve LE staff in in-services and unit based

development of policies, procedures and local work

instructions ✔

Recommendations

Recommendation 4: Supervision and line management

> Implement lived experience specific supervision and

mentoring ✔

> Review and develop specific LEW supervision

framework

> Utilise more experienced peer specialists and carer

consultants to provide training and support to new staff

✔

> Develop procedural guidelines for documentation and

supervision ✔

> Enhance support offered to LEW staff when required,

within a defined support structure ✔

> Enhance program management support from the

coordinators of the lived experience program and

enhance partnerships with the supervisors/line

managers of LEW staff ✔