Being Trauma Informed: A consumer perspective So you want to change the world 7 May 2015 The value of Consumer Engagement PHOTO: “Larissa” by Alexandra Crosby is licensed under CC BY-NC-SA 2.0

Acknowledgements The Traditional Owners of the land on which we meet People with a lived experience of mental illness and the people who love us

Who am I  Academic and advocate  Lived experience of mental ill health  Childhood & Intergenerational Trauma  Lover, Mother, Nana, Sister, Daughter, Boss, Colleague and Friend  A ‘carer’  CEO of consumer peak

NSW Consumer Advisory Group – Mental Health Inc. trading as BEING is the independent, state-wide organisation for people with a lived experience of mental illness (consumers). We work with consumers to achieve and support systemic change.

Participation Participation is a fundamental human right as enshrined in Article 25 of the International Covenant on Civil and Political Rights (ICCPR). Participation of consumers results in better services, more effective public policy and facilitates individual recovery.

Being’s Vision For all people with a lived experience of mental illness to participate as valued citizens in the communities they choose.

Trauma and Mental Illness Many people with a lived experience of mental illness have experienced trauma Physical, psychological and emotional trauma Multiple kinds of adversity and life experiences Interpersonal violence Intergenerational trauma

Social Trauma Trauma associated with marginalisation and discrimination Perpetuating traumatic relationships Social marginalisation – homelessness, poverty, disengagement Loss of children Loss of family support, friends, job Trauma in Criminal Justice system

Trauma in ‘Treatment’

Hospital Culture Hospitals are machines Moving people through Emptying beds Keeping order Not very human (Bridgett Hamilton – University of Melbourne)

Treatments hindering recovery Involuntary treatment and CTOs Seclusion and Restraint Medication Stigma and fear Patronising, caring and maternalistic approaches Diagnostic and prognosis assumptions Limiting information – jargon, closed files, clearly talking about someone in sight but out of earshot

Trauma experienced in treatment MH Legislation can be a form of structural violence Can create non-autonomous beings Can lead to 'real world' violence Patient can not refuse/ choose treatment If there is no clear pathway back to autonomy it can lead to lifelong dependence Loss of freedom of movement Bodily integrity violated No way of securing own treatment preferences (Cath Roper – Consumer Academic University of Melbourne)

Dirty Hands The hard decisions can leave us with ‘Dirty Hands’ Michael Walzer, “Political Action: The Problem of Dirty Hands,” Philosophy and Public Affairs, Vol. 2, No. 2 (Winter, 1973), pp Involuntary treatment has a high moral cost We need to see, consider, discuss and count this cost

Challenge the culture for recovery Question unhelpful or harmful talk / practice / culture Remember consumers are people not conditions Medication has its place but being treated like a person can work wonders Really, really listen Work on developing trust and relationships Be aware of the power imbalance – name it

Other workers can learn a lot from peer workers Believe that recovery is possible Be Interested Listen Take the time to develop relationships of trust and mutual esteem Hang out in the consumers space

Get out of the Goldfish Bowl P

to ‘drive’ own recovery choice being related to as a person recovery orientated services environments conducive to recovery access to assistance when required What people want to facilitate their recovery

Principles of TiP Core principles of trauma-informed practice are: Safety Trustworthiness Choice Collaboration Empowerment

Trauma Informed Practice (TiP) Trauma-informed culture helps staff and consumers make better recoveries Reduces risk of: Re-traumatisation Secondary trauma or Vicarious trauma Improves relationships – experience of difference: affirmation, recognition Walking in another’s shoes

Consumer focused TiP Create safety, build trust and relationships Be aware of possible experiences of trauma Meet people where they are at – ‘inappropriate’ behaviour may be appropriate in context Don’t dwell on the details of trauma – don’t enforce disclosure People will tell their story when they are ready Celebrate resilience

Reverence of Lived Experience Respect Esteem High Regard Admiration Awe

Ways of connecting with BEING Become a member Facebook:

THANK YOU Dr Peri O’Shea Phone: Website: