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Being Trauma Informed:A consumer perspective
So you want to change the world7 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 advocateLived experience of mental ill healthChildhood & Intergenerational TraumaLover, Mother, Nana, Sister, Daughter,
Boss, Colleague and FriendA ‘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.
ParticipationParticipation 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 VisionFor all people with a lived experience
of mental illness to participate as valued citizens in the communities
they choose.
Trauma and Mental IllnessMany people with a lived experience of mental
illness have experienced traumaPhysical, psychological and emotional trauma Multiple kinds of adversity and life
experiences Interpersonal violenceIntergenerational trauma
Social TraumaTrauma associated with marginalisation and
discriminationPerpetuating traumatic relationships Social marginalisation – homelessness, poverty,
disengagementLoss of childrenLoss of family support, friends, jobTrauma in Criminal Justice system
Trauma in ‘Treatment’
Hospital Culture
Hospitals are machinesMoving people throughEmptying bedsKeeping orderNot very human
(Bridgett Hamilton – University of Melbourne)
Treatments hindering recoveryInvoluntary treatment and CTOsSeclusion and RestraintMedicationStigma and fearPatronising, caring and maternalistic approachesDiagnostic and prognosis assumptions Limiting information – jargon, closed files, clearly talking about someone in sight but out of earshot
Trauma experienced in treatmentMH Legislation can be a form of structural violenceCan create non-autonomous beingsCan lead to 'real world' violence Patient can not refuse/ choose treatmentIf there is no clear pathway back to autonomy it can
lead to lifelong dependenceLoss of freedom of movementBodily integrity violatedNo 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. 160-180.
Involuntary treatment has a high moral cost
We need to see, consider, discuss and count this cost
Challenge the culture for recoveryQuestion unhelpful or harmful talk / practice / cultureRemember consumers are people not conditionsMedication has its place but being treated like a person can work wondersReally, really listenWork on developing trust and relationshipsBe aware of the power imbalance – name it
Other workers can learn a lot from peer workersBelieve that recovery is possibleBe InterestedListenTake the time to develop relationships of trust and mutual esteemHang 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 CollaborationEmpowerment
Trauma Informed Practice (TiP)Trauma-informed culture helps staff and
consumers make better recoveriesReduces risk of:
Re-traumatisationSecondary trauma or Vicarious trauma
Improves relationships – experience of difference: affirmation, recognition
Walking in another’s shoes
Consumer focused TiP
Create safety, build trust and relationshipsBe aware of possible experiences of traumaMeet people where they are at – ‘inappropriate’
behaviour may be appropriate in context Don’t dwell on the details of trauma – don’t
enforce disclosurePeople will tell their story when they are readyCelebrate resilience
Reverence of Lived Experience
Respect EsteemHigh RegardAdmirationAwe
Ways of connecting with BEING
Become a memberEmail: [email protected] Facebook: https://www.facebook.com/nswcagTwitter: @BeingMHV
