Cath Roper

Changing Attitudes: The Role of a Consumer Academic in the Education of Postgraduate Psychiatric Nursing Students.

Consumer participation in health care is increasingly becoming an expectation within mental health services. Consumer involvement in the education of mental health professionals, including nurses is considered crucial to achieving this aim. This article describes the impact of a mental health consumer academic on the attitudes of postgraduate psychiatric nursing students towards consumer participation. A questionnaire was administered to students before (n = 25) and following (n = 19) exposure to the teaching of the consumer academic. Comparison of results suggests that support for consumer participation increases after exposure to the consumer academic reinforcing the value of mental health consumers in psychiatric nursing education.

Consumer participation in mental health research: articulating a model to guide practice

Objective: Consumer involvement in mental health research is considered both a right and a benefit, despite the identified barriers to forming effective collaborative relationships. The purpose of this paper is to examine the literature relating to consumer involvement in mental health research with a view to articulating a model to guide this process. Method: A qualitative review of the relevant literature was undertaken. Literature referring to consumer roles in research was accessed and reviewed with the aim of articulating the benefits of, and barriers to, consumer participation in research. Results: The literature has identified a number of important benefits and some significant barriers to consumer involvement in mental health research. However, a clear model to articulate definitions of involvement is lacking. Four distinct levels of involvement were articulated. Conclusions: The identification of clearly defined models for consumer involvement in mental health research is important in order to facilitate collaboration and avoid tokenism. Research is required in order to determine the applicability of these models within actual research projects.

Promoting genuine consumer participation in mental health education: A consumer academic role

Mental health policy reform in Australia has led to the expectation of increased consumer participation not only in all aspects of service delivery, but also in the education and training of mental health professionals. The aim of this paper is to explore the development and introduction of a role for a consumer of mental health services within an academic institution, including achievements of the role and the principles contributing to successful implementation. The consumer academic position was successfully implemented and has proved a valuable role. The success of the role was considered to be dependent on the following factors: partnership and commitment, support, scope and autonomy. In conclusion, a consumer can play a valuable role within an academic institution. However, success will depend upon a number of important environmental factors that promote the independence of the consumer voice.

The myth of representation: The case for consumer leadership

Abstract Australian government policy now embodies a clear expectation that consumers should be participants in all aspects of mental health services. A number of barriers have been identified as inhibiting the realisation of this goal, with the negative attitudes of professional staff being recognised as a major factor. A more pervasive barrier with the potential to minimise the positive developments in consumer participation is the issue of representation. It has been claimed that consumers who are actively involved in participatory roles are not necessarily representative of the broader population of mental health consumers. The paucity of literature makes this argument difficult to either defend or refute, although there is limited research evidence to suggest that the views of active consumers may indeed be similar to those who do not choose to have involvement. The aim of this paper is to consider the implications of engaging in debate about the extent to which consumer advocates might represent a broader group. In particular the potential consequences of this argument include: silencing activism; questioning the legitimacy of consumer roles; and, discriminatory expectations of consumers. These issues are discussed with the aim of establishing the need to use the term consumer leadership to describe participation which is aimed at the systemic level.

Promoting consumer participation through the implementation of a consumer academic position

Consumer participation in mental health care is increasingly becoming an expectation. A review of the literature suggests that the negative attitudes of mental health professionals towards people diagnosed with mental illness constitutes a significant barrier to the realization of this goal. The education of health professionals has been identified as a major strategy for reducing the negatively of such attitudes, and to promoting a more participatory relationship between consumer and provider. This paper describes the process of the development and implementation of an academic role for a consumer of mental health services in teaching psychiatric nursing students. A personal case study by the consumer academic is provided to illustrate the process of this collaborative venture. This paper contributes to the development of framework to guide the implementation of similar positions.

Attitudes towards seclusion and restraint in mental health settings: findings from a large, community-based survey of consumers, carers and mental health professionals

Aims. There are growing calls to reduce, and where possible eliminate, the use of seclusion and restraint in mental health settings, but the attitudes and beliefs of consumers, carers and mental health professionals towards these practices are not well understood. The aim of this study was to compare the attitudes of mental health service consumers, carers and mental health professionals towards seclusion and restraint in mental health settings. In particular, it aimed to explore beliefs regarding whether elimination of seclusion and restraint was desirable and possible. Methods. In 2014, an online survey was developed and widely advertised in Australia via the National Mental Health Commission and through mental health networks. The survey adopted a mixed-methods design, including both quantitative and qualitative questions concerning participants’ demographic details, the use of seclusion and restraint in practice and their views on strategies for reducing and eliminating these practices. Results. In total 1150 survey responses were analysed. A large majority of participants believed that seclusion and restraint practices were likely to cause harm, breach human rights, compromise trust and potentially cause or trigger past trauma. Consumers were more likely than professionals to view these practices as harmful. The vast majority of participants believed that it was both desirable and feasible to eliminate mechanical restraint. Many participants, particularly professionals, believed that seclusion and some forms of restraint were likely to produce some benefits, including increasing consumer safety, increasing the safety of staff and others and setting behavioural boundaries. Conclusions. There was strong agreement across participant groups that the use of seclusion and restraint is harmful, breaches human rights and compromises the therapeutic relationship and trust between mental health service providers and those who experience these restrictive practices. However, some benefits were also identified, particularly by professionals. Participants had mixed views regarding the feasibility and desirability of eliminating these practices.

Consumer perspective employment in the psychiatric service system: a Victorian view on safety issues

Abstract Opportunities for consumers to explore our employment within the psychiatric service system are urgently needed. This article raises issues and dilemmas concerning un/safety and consumer perspective employment, for ongoing debate and discussion. I identify as a psychiatric service receiver and use the word ‘we’ generally to refer only to consumers, not to ‘people in general’. The word ‘consumer’ as described here refers to someone who has received a psychiatric service. The Mental Health Statement of Rights and Responsibilities defines ‘consumer’ as: A person making use of, or being significantly affected by a mental health service (Australian Health Ministers, 1991, p16).

Consumers’ and their supporters’ perspectives on barriers and strategies to reducing seclusion and restraint in mental health settings

Objective This paper examines the perspectives of consumers and their supporters regarding the use of seclusion and restraint in mental health settings. Methods Five focus groups for consumers and five focus groups for supporters were conducted in four Australian cities and in one rural location. The 66 participants were asked about strategies to reduce or eliminate the use of seclusion and restraint in mental health settings. Results All participants supported the reduction of the use of seclusion and restraint. Barriers to reducing these practices related to the environment, the effects of drug and alcohol issues, lack of a human rights focus and poor recognition of trauma, stigma and discrimination. Strategies for reducing or eliminating seclusion and restraint included workforce development, environmental and cultural changes. Conclusions Participants clearly identified that the status quo needs to change and conveyed urgency for action. Participants suggested that the involvement of supporters and a range of consumer roles are integral to reducing the use of seclusion and restraint. The findings support the current policy emphasis of working towards the elimination of these practices. What is known about the topic? Mental health policies across many jurisdictions support the reduction and elimination of restraint and seclusion. Evidence suggests those subjected to restraint and seclusion largely experience a range of harmful consequences. No studies focus on the views of supporters of consumers regarding the reduction and elimination of seclusion and restraint, whereas the views of consumers appear in a minority of international studies. What does this paper add? The research enabled an opportunity to hear from people who have been personally affected by and/or have lived experience of these coercive practices. Participants identified local reforms that can uphold the human rights of consumers. They suggested practices to increase accountability, peer support and family involvement, areas that have not been analysed in depth in any of the seclusion and restraint literature. What are the implications for practitioners? This paper will give healthcare services a deeper insight into how to reduce or eliminate restraint or seclusion from the perspective of those with lived experience.

When equality is not really equal: affirmative action and consumer participation

Consumer participation in mental health service planning and delivery is now authorised through Australian government policy. While strategies have been implemented to foster opportunities for participation, they have rarely been evaluated for their effectiveness. Furthermore, the inadequacy of these strategies to support policy implementation has been criticised in the literature and identified as a major obstacle to genuine and effective consumer participation in mental health care. This paper argues that there is an urgent need for affirmative action in order to overcome the current and historical discrimination that prevents consumers from active participation.

Identifying the ‘right patient’: Nurse and consumer perspectives on verifying patient identity during medication administration

Accurate verification of patient identity during medication administration is an important component of medication administration practice. In medical and surgical inpatient settings, the use of identification aids, such as wristbands, is common. In many psychiatric inpatient units in Victoria, Australia, however, standardized identification aids are not used. The present paper outlines the findings of a qualitative research project that employed focus groups to examine mental health nurse and mental health consumer perspectives on the identification of patients during routine medication administration in psychiatric inpatient units. The study identified a range of different methods currently employed to verify patient identity, including technical methods, such as wristband and photographs, and interpersonal methods, such as patient recognition. There were marked similarities in the perspectives of mental health nurses and mental health consumers regarding their opinions and preferences. Technical aids were seen as important, but not as a replacement for the therapeutic nurse-patient encounter.