Local branch of an international movement
Mental Health First Aid is now running in sixteen countries around the world. Australia is the birthplace of MHFA.
In 2000, Betty Kitchener and Professor Tony Jorm began writing a MHFA manual and an accompanying course, with the aim to improve the mental health literacy of members of the Australian community. Since then, the MHFA Training and Research Program has been developed, evaluated and disseminated nationally and internationally. This Program includes a 5-day Instructor Training Course to accredit suitable candidates to become MHFA Instructors who deliver the 12-hour MHFA course to their communities. This 12-hour course is designed to give members of the public some skills to help someone developing a mental health problem or in a mental health crisis situation. The philosophy behind the course is that mental health crises, such as suicidal and self-harming actions, may be avoided through early intervention with people developing mental disorders. If crises do arise, then members of the public can take action to reduce the harms that could result.
http://www.mhfa.com.au/
MHFA is revised regularly to keep up-to-date with developments in mental health as well as listening to feedback from course participants and instructors. One key spin-off of the course (and not originally anticipated) is that people have found it to be a safe and confidential space where personal mental health issues can be shared if they so choose.
In 2008 the Royal Society for Public Health (RSPH) announced support for training and qualifications in Mental Health First Aid. Together with NMHDU (National Mental Health Development Unit) RSPH is developing a national qualification in Mental Health First Aid and is also accrediting the national training programme for the MHFA course instructors.
Wednesday 31 March 2010
Saturday 27 March 2010
Mainstream isn't Therapy
Mainstream isn't therapy
Mainstream isn't therapy. The road back into mainstream life for someone with a 'severe and enduring' mental health diagnosis does not require a therapeutic relationship. It requires the individual's genuine desire to access the mainstream world based on personal goals, passions and motivation.
People with mental health conditions are taking the road back to mainstream every day. Sometimes they achieve this entirely through their own efforts, sometimes with the skills of a bridge builder. The bridge builder's role is not to set up a therapeutic relationship. It is simply to help the client identify which area or areas of mainstream life he or she wishes to prioritise.
The most effective way to start the conversation about mainstream is by having the conversation in a mainstream setting. If a client wishes to access a place where he or she can record and produce music, the meeting can take place in a mainstream music studio. If a client wishes to access a course in flower arranging, the meeting can be in an adult education venue. If a client wishes to return to their faith, the meeting can take place in a mosque, temple, church or wherever the client's chosen faith venue happens to be.
The journey of recovery into what Dr. Pat Deegan calls 'valued social roles' can only start effectively by setting out from and within a place where social roles cohere and are realised. These can be places situated anywhere in the mainstream community and not in special settings.
The client's relationship with the social inclusion bridge builder lasts for as long as the client requests some support in order to access mainstream goals. As such, it is not an ongoing therapeutic relationship.
Mainstream isn't therapy. The road back into mainstream life for someone with a 'severe and enduring' mental health diagnosis does not require a therapeutic relationship. It requires the individual's genuine desire to access the mainstream world based on personal goals, passions and motivation.
People with mental health conditions are taking the road back to mainstream every day. Sometimes they achieve this entirely through their own efforts, sometimes with the skills of a bridge builder. The bridge builder's role is not to set up a therapeutic relationship. It is simply to help the client identify which area or areas of mainstream life he or she wishes to prioritise.
The most effective way to start the conversation about mainstream is by having the conversation in a mainstream setting. If a client wishes to access a place where he or she can record and produce music, the meeting can take place in a mainstream music studio. If a client wishes to access a course in flower arranging, the meeting can be in an adult education venue. If a client wishes to return to their faith, the meeting can take place in a mosque, temple, church or wherever the client's chosen faith venue happens to be.
The journey of recovery into what Dr. Pat Deegan calls 'valued social roles' can only start effectively by setting out from and within a place where social roles cohere and are realised. These can be places situated anywhere in the mainstream community and not in special settings.
The client's relationship with the social inclusion bridge builder lasts for as long as the client requests some support in order to access mainstream goals. As such, it is not an ongoing therapeutic relationship.
Monday 22 March 2010
Broken Recovery II
In a previous post I wrote:
'Dr. Pat Deegan visualises recovery and the return to mainstream life as crucial moments in an individual's journey through mental illness. It is a return that can often be blighted by low expectations, both by the service user and by his or her professional team. Even carers and family members can contribute to damaging an individual's recovery.'
The reasons why a recovery might be 'broken', protracted, delayed, postponed or put on hold indefinitely, are many. The return to mainstream is part of a crucial moment in the mental health survivor's journey. The moment is that space where the mental health survivor moves from being a patient into perceiving his or her ability to be a decision-maker. For Deegan the decision was to refuse the health profession's signposting her to 'a career in mental health'. Instead she chose to follow an inner calling to become someone who could learn to develop what she calls 'a valued social role'. The valued social role was to train to become a doctor and to work from the inspirational thought she phrases as 'I am going to become Dr. Deegan and change the mental health system from within so that no-one ever gets hurt in it again.'
'Dr. Pat Deegan visualises recovery and the return to mainstream life as crucial moments in an individual's journey through mental illness. It is a return that can often be blighted by low expectations, both by the service user and by his or her professional team. Even carers and family members can contribute to damaging an individual's recovery.'
The reasons why a recovery might be 'broken', protracted, delayed, postponed or put on hold indefinitely, are many. The return to mainstream is part of a crucial moment in the mental health survivor's journey. The moment is that space where the mental health survivor moves from being a patient into perceiving his or her ability to be a decision-maker. For Deegan the decision was to refuse the health profession's signposting her to 'a career in mental health'. Instead she chose to follow an inner calling to become someone who could learn to develop what she calls 'a valued social role'. The valued social role was to train to become a doctor and to work from the inspirational thought she phrases as 'I am going to become Dr. Deegan and change the mental health system from within so that no-one ever gets hurt in it again.'
Friday 12 March 2010
Access to Mainstream
Access to Mainstream
In a recent editorial, Big Issue magazine founder John Bird states that the purpose of the Big Issue is to enable homeless people to access the marketplace.
For a homeless person, becoming a Big Issue salesperson creates a position in the marketplace, perhaps for the first time.
John Bird's explanation of the rationale behind the Big Issue is analagous to the reasons for exclusion from mainstream experienced by many people with mental health conditions.
As a person who has not only experienced homelessness but who is also a businessman, Bird's prioritises the activities of selling and distribution. These are methods through which a homeless person can access mainstream. Bird doesn't discuss breaking down barriers, addressing stigma or seeking support. He is keen to stress that the purpose of purchasing a Big Issue is not to give charity or even sympathy. The purpose is commercial empowerment for the individual salesperson.
For people with severe and enduring mental health conditions, a similar disempowering process has taken place which not only denies access to the marketplace but to any kind of mainstream opportunity. Sometimes the process has taken place over many years.
A Big Issue seller is a valued salesperson on the basis of their motivation. He or she becomes a sole trader or franchisee under an umbrella organisation.
For someone with a 'severe and enduring' diagnosis the journey into or back into what Pat Deegan calls a 'valued social role' can be impaired by the same system which has organised support. Access to mainstream can be discouraged by years of grounding in the process that Deegan calls 'a career in mental health'.
A career in mental health can mean a life on benefits, a life in residential support, a life of incapacity, a career of inertia. For people with mental health conditions it can be their clinical diagnosis which become the key determinant of identity. Yet the factors which determine an active social role for someone with a mental health condition are no different from anyone else's. Our identities are determined by the things we are passionate about, our aspirations, our goals, our dreams and our key priorities.
Meaningful involvement in mainstream for people with a mental health diagnosis begins to take place when individuals are allowed to measure themselves in terms of their goals. The world of mainstream does not necessarily discriminate or stigmatise and even where it does, this may not be the main obstacle.
In a recent editorial, Big Issue magazine founder John Bird states that the purpose of the Big Issue is to enable homeless people to access the marketplace.
For a homeless person, becoming a Big Issue salesperson creates a position in the marketplace, perhaps for the first time.
John Bird's explanation of the rationale behind the Big Issue is analagous to the reasons for exclusion from mainstream experienced by many people with mental health conditions.
As a person who has not only experienced homelessness but who is also a businessman, Bird's prioritises the activities of selling and distribution. These are methods through which a homeless person can access mainstream. Bird doesn't discuss breaking down barriers, addressing stigma or seeking support. He is keen to stress that the purpose of purchasing a Big Issue is not to give charity or even sympathy. The purpose is commercial empowerment for the individual salesperson.
For people with severe and enduring mental health conditions, a similar disempowering process has taken place which not only denies access to the marketplace but to any kind of mainstream opportunity. Sometimes the process has taken place over many years.
A Big Issue seller is a valued salesperson on the basis of their motivation. He or she becomes a sole trader or franchisee under an umbrella organisation.
For someone with a 'severe and enduring' diagnosis the journey into or back into what Pat Deegan calls a 'valued social role' can be impaired by the same system which has organised support. Access to mainstream can be discouraged by years of grounding in the process that Deegan calls 'a career in mental health'.
A career in mental health can mean a life on benefits, a life in residential support, a life of incapacity, a career of inertia. For people with mental health conditions it can be their clinical diagnosis which become the key determinant of identity. Yet the factors which determine an active social role for someone with a mental health condition are no different from anyone else's. Our identities are determined by the things we are passionate about, our aspirations, our goals, our dreams and our key priorities.
Meaningful involvement in mainstream for people with a mental health diagnosis begins to take place when individuals are allowed to measure themselves in terms of their goals. The world of mainstream does not necessarily discriminate or stigmatise and even where it does, this may not be the main obstacle.
Wednesday 3 March 2010
Is anti-stigma the new stigma?
Anti-stigma the new Stigma?
The 'Time to Change' campaign challenges stigma and discrimination against people with mental health conditions. Time to Change is helping groups and individuals organise activities which actively cooperate in challenging discriminatory attitudes and behaviours.
Challenging discrimination is achieved primarily through engaging in mainstream as a contributor, a consumer or a provider. Many people with mental health conditions access mainstream activities, making their own choices as to whether to disclose or not. The greatest impact in challenging mainstream can be achieved by prioritising individual goals and aspirations. Support is also available to access mainstream from mental health organisations and bridge builders or through personalisation and direct payments.
'Time to Change' seems to insist that all people with mental health conditions wish to disclose as part of their eligibility for mainstream life. In a recent campaign video the broadcaster and service user Stephen Fry asserts that stigma and the attitudes of society in general are the main roadblocks that hinder the self-development of people with mental health conditions.
But many individuals with mental health diagnoses are accessing mainstream life without stigma, whether they choose to disclose or not. Disclosure is really up to the individual and far from discouraging service users to use mainstream, many organisations are open to all and are accessed by people with mental health conditions every day of the week. These are not simply voluntary organisations or groups limited to the health or charity sectors. These are consumer providers of all kinds - art galleries, libraries, recording studios, performance venues, gyms, sports centres, retail outlets and many more. To assert these these organisations are discriminating simply isn't fair on these groups, nor is it a realistic assessment.
Where people with mental health conditions may lose out is in having the initial confidence to set on the journey back to mainstream. This is particularly true of those who have been in secondary care and who may have become habituated to the life that Pat Deegan calls 'a career in mental health'. Dr. Deegan is referring to the lack of hope, aspiration and goals that can set in with a long-term condition.
People who play football who happen to have mental health conditions are footballers. They aren't required to be 'positive mental health footballers'. People who play guitar who happen to have mental health conditions are guitarists, not mental health guitarists. People who are arts tutors who have a mental health condition are arts tutors. By continuing to tag mental health on mainstream activities and aspirations there is a danger of recycling stigma and not allowing people to move into valued social roles.
Could anti-stigma be the new stigma?
The 'Time to Change' campaign challenges stigma and discrimination against people with mental health conditions. Time to Change is helping groups and individuals organise activities which actively cooperate in challenging discriminatory attitudes and behaviours.
Challenging discrimination is achieved primarily through engaging in mainstream as a contributor, a consumer or a provider. Many people with mental health conditions access mainstream activities, making their own choices as to whether to disclose or not. The greatest impact in challenging mainstream can be achieved by prioritising individual goals and aspirations. Support is also available to access mainstream from mental health organisations and bridge builders or through personalisation and direct payments.
'Time to Change' seems to insist that all people with mental health conditions wish to disclose as part of their eligibility for mainstream life. In a recent campaign video the broadcaster and service user Stephen Fry asserts that stigma and the attitudes of society in general are the main roadblocks that hinder the self-development of people with mental health conditions.
But many individuals with mental health diagnoses are accessing mainstream life without stigma, whether they choose to disclose or not. Disclosure is really up to the individual and far from discouraging service users to use mainstream, many organisations are open to all and are accessed by people with mental health conditions every day of the week. These are not simply voluntary organisations or groups limited to the health or charity sectors. These are consumer providers of all kinds - art galleries, libraries, recording studios, performance venues, gyms, sports centres, retail outlets and many more. To assert these these organisations are discriminating simply isn't fair on these groups, nor is it a realistic assessment.
Where people with mental health conditions may lose out is in having the initial confidence to set on the journey back to mainstream. This is particularly true of those who have been in secondary care and who may have become habituated to the life that Pat Deegan calls 'a career in mental health'. Dr. Deegan is referring to the lack of hope, aspiration and goals that can set in with a long-term condition.
People who play football who happen to have mental health conditions are footballers. They aren't required to be 'positive mental health footballers'. People who play guitar who happen to have mental health conditions are guitarists, not mental health guitarists. People who are arts tutors who have a mental health condition are arts tutors. By continuing to tag mental health on mainstream activities and aspirations there is a danger of recycling stigma and not allowing people to move into valued social roles.
Could anti-stigma be the new stigma?
Monday 1 March 2010
Do Care and Support hinder Recovery?
Care and support are not the only models or frameworks for mental health recovery. The establishing or re-establishing of what Dr. Pat Deegan refers to as 'valued social roles' can be held back by a mental health system that often encourages the client to choose 'a career in mental health' (Pat Deegan).
A career in mental health means living longterm on benefits and longterm marginalisation from mainstream life. A career in mental health will identify symptoms, diagnoses, medication and team support but will often leave out aspirations, goals, priorities.
Where access to mainstream is encouraged, it can often be through projects or programmes which take place in special settings or are designed for people with mental health conditions. So the marginalisation continues.
A genuine return to mainstream can only take place in mainstream. This is where the role of the bridge builder comes in. A client who has worked with a mainstream bridge builder identifies goals and priorities for him or herself. It is the bridge builder's job to signpost or link the client up with mainstream venues appropriate to the client's life choices. The amount of support a client may request from there on is determined only by the client not by the bridge builder.
A career in mental health means living longterm on benefits and longterm marginalisation from mainstream life. A career in mental health will identify symptoms, diagnoses, medication and team support but will often leave out aspirations, goals, priorities.
Where access to mainstream is encouraged, it can often be through projects or programmes which take place in special settings or are designed for people with mental health conditions. So the marginalisation continues.
A genuine return to mainstream can only take place in mainstream. This is where the role of the bridge builder comes in. A client who has worked with a mainstream bridge builder identifies goals and priorities for him or herself. It is the bridge builder's job to signpost or link the client up with mainstream venues appropriate to the client's life choices. The amount of support a client may request from there on is determined only by the client not by the bridge builder.
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