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Standing Committee on Education and Employment
07/06/2011
Mental health and workforce participation

GRIFFITH, Mr Deiniol, Team Leader, Peer Work Project, Mental Illness Fellowship South Australia

THIELE, Ms Lisa, Sessional Education Worker, Mental Illness Fellowship of South Australia

[13:30]

CHAIR: Welcome. Although the committee does not require you to give evidence under oath, I should advise you that the hearing is a legal proceeding of the parliament and therefore has the same standing as proceedings of the respective houses. Do you have any comments to make about the capacity in which you appear?

Ms Thiele : I am a graduate of the peer work program.

CHAIR: I invite you to make an opening statement, and you can both say something and then perhaps we will go to questions.

Mr Griffith : Thank you for having us here, it is fantastic. Hopefully, today, I am looking to share a little bit about what the project is and what we do, and provide some insight and provoke some questions from you guys. Given the previous talk, there were some good conversations, so I want to keep some of that momentum going. I will tell you a little bit about what the peer work project is and then hand over to Lisa and she can share some of her experiences.

The peer work project is a collaborative project between Baptist Care SA and us, MIFSA. We have been running it for about six years now and, essentially, what we do is train and support individuals to become peer workers—and I will share a little bit more about the concept of peer work in a second—as well as train and support organisations to employ peer workers. From our mindset, a peer worker is someone that has a lived experience of mental health, that is at a stage where they are living well and want to start to draw on those experiences in a way that will benefit and help others.

We have two sorts of areas of peer work that people are employed in within South Australia. One is where the peer work or the lived experience is an essential criterion in their job and person specifications; and the other area is where the lived experience is utilised but is not necessarily a requirement of the job and person specification. For example, within the PHaMS teams an identified peer worker is someone who, in their job and person spec, must have lived experience. They have also got people on that team who identify with lived experience, are drawing from that and utilising that within their work, but it is not an essential criterion of their role. So that is what peer workers are. There are many and varied roles: they go from consumer consultancy through to community support and volunteer roles, so a wide range of opportunities and job titles. Essentially, a peer workers is someone utilising their lived experience within their work.

The peer work project is, like I said, a collaborative project that has been running for six years now. It has grown to a point where we are sharing a lot of our work and training with interstate organisations, so we are helping to promote that more on a national scale. In the training, the main port of call is an introduction to the peer work course, which is where a lot of the people start. They come through and we offer a variety of other supports, including extra professional and personal development mentoring—one-to-one mentoring, group mentoring—and support to gain employment and while they are employed. Regarding the work we do with organisations, we assist organisations to employ peer workers. We provide information, help to get some peer work culture into their organisations, raise awareness of peer work culture among other employees, assist with things like job and person specifications, role development, recruitment and essentially anything that is tailored to the needs of the organisations. That gives you a bit of an idea about some of the stuff we do. I would like to provide the opportunity for you guys to ask questions about things, such as some perspectives from our peer mentors as well as the graduates from the course—which Lisa will be able to do as well—issues relating to employers and their feelings and thoughts about graduates, tools utilised by employers and peer workers and where peer work might be heading in the future, and how it might affect the mainstream workforce. These are some of the things that you might like to ask questions about. I will hand over to Lisa.

Ms Thiele : The change in my health happened in my first year of university. I was studying for an economics degree and an accident turned my life around. I subsequently had 20 years of social isolation. After many frustrating hospital experiences, I came to a team at Flinders Private Hospital where there was a collaborative approach. I had a team of people in different areas, psychiatrists, nurses, occupational therapists, people from the craft room and peer workers. As a team they introduced to me ideas which I had thought were out of my league. In those years of being isolated from the community, I had lost hope for change in my life. I had lost belief in myself.

I had people who were introducing ideas—what were my goals; what did I want to do?—and they believed that I could do things again that I never thought possible and that I could live independently again. I had a guardian at this stage who also held great belief in me. The respect that these people held for me and the belief that they held the candle for me, when I could not light it myself, led to no end of change for me in starting to see that there could be a life further than the life I could see.

When I left the hospital I had a time when I was able to be a volunteer for two years. It was during this time that I was offered suggestions of further study I could do. I went back to study at Hamilton Adult College, doing computer training and cooking and sewing subjects. I did a certificate 4 at TAFE for non-clinical mental health. Along the way I got a lot of guidance from counsellors and lecturers.

The Peer Work Project at MIFSA was quite a turning point for me. If you like, I can speak more on this in your question time. I found that this course helped me reduce the stigma I felt on myself. There is a lot of stigma out there—unknown information about mental illness. I held a stigma, though, to myself. It was not just those around me who did not understand me. I felt I could not share my past with anybody because it was just far too embarrassing. I got a lot of support from the team at MIFSA through education—there was a lot of education training available to me. There was one-on-one mentoring; there was guidance in applying for jobs—just confidence building with goal setting.

I would also like to mention the path that I have now undertaken, apart from the education work I am doing with MIFSA, which came about through a course in public speaking, which MIFSA organised. I did not expect to be on this path again. However, having people suggest to me the gifts and talents I had, and having people believe in me, opened doorways that I would not have thought of trying to turn the handle to.

As part of my educational sessions of work, I now also have a job at Adelaide University in wheat research. I did achieve my economics degree and I have my mental health studies. I then ended up in wheat research and I also have a position as a youth and young adults coordinator at my church. Something that has been of great assistance is to have my employers wanting to help me, even with finances towards further study. So I am now in a position where I can study in leadership and teamwork training, and mentoring training, which is something my organisation sees the benefits of studying, helping me to further myself. May I just add that at my interviews I was never backwards in coming forwards about my history. I turned it into a positive and a building block for my life. I built strong roots of faith and resilience in my life and I also developed tools to be able to see into other people's lives—things that other people could not see. I will leave it at that for now.

CHAIR: Thank you very much, that is wonderful to hear and I think you have actually picked up on a topic that we had not heard much about, which is the self stigma. I think you have highlighted the impact that had on you but also your journey about how you got over that and the assistance that people gave you along the way, so I appreciate that very much. One question I did want to ask, which is one of the questions you suggested, is about how employers are reacting to the peer support program—how they take it on, how they use it. That sort of discussion would be really helpful because we have heard certainly today about the importance of educating employers. They are a huge part of the solution, so it would be great to hear that side from you.

Mr Griffith : We have been working in this field for the last six years. Right at the start of this project was the time when what was then CNAHS, or Central North Adelaide Health Services, were looking to introduce peer specialists on to the wards at the hospitals. We worked quite closely with them at the time. We have been involved in that sort of thing for a while. Before I go further into that, the idea and the talk about disclosure is a big one in mainstream workforces, but when you talk about peer work that issue of disclosure essentially is mute, because that is the whole point of coming in there. You are coming in already telling them, 'Yes, I want to be a peer worker.' It makes for an interesting conversation around the difference behind disclosure within peer work and also mainstream work. One of the biggest things that we still come up against today is that fear. Sometimes it is a rational fear and sometimes it is an irrational fear of what could happen.

If you look back to the time when the peer specialists were coming on board, there were some interesting radio articles that highlighted some of these sorts of fears like, 'Do we give them the key?' 'Can we trust them to do medications?' 'Are they allowed to write case notes?'—all these sorts of fears that just did not really incorporate them into the team. There are still those fears: 'What happens if I become unwell?' or 'What happens if they become unwell?'—around boundaries issues. These are fears that are there and talked about in a peer work context, but they are actually issues that are across the board in any workplace. We try to normalise some of those fears in terms of: these are issues that you are faced with getting anyone on board. If someone comes along and they do have any sort of health injuries they need to manage, for example, physical health, if they are in a wheelchair there are things around that you need to look into. Or someone might be allergic to things. There is a whole lot of leniency and flexibility in the workforce already that you just need to tie in to the fact that mental health is part of that. I think some of that comes back to a lack of understanding and a lack of education for employers. Even with getting peer workers on board, there is still that lack of understanding. It is a slow process to implement a new position into an organisation, but there are similar things within a peer workforce and within a mainstream workforce. There are some flyers and information in that pamphlet that Natasha and Fiona handed around. There is some information in there that I will be drawing from. I have also sent electronic copies through to Deborah as well.

CHAIR: I have a question for Lisa and then I will hand over to colleagues. Self-stigmatisation was obviously one of the many barriers you faced, and having people around you who believed in you was really important. You mentioned that you sort of 'checked out' after the first year of uni—for 20 years, I think you said.

Ms Thiele : I was out of circulation for a period of 20 years.

CHAIR: Was there anything that could have helped? We have been talking about early intervention; what could have happened differently to maybe help you regain some meaning earlier than that?

Ms Thiele : If the medical profession had guided me towards a team such as MIFSA or if there had been education for my family so they knew more about what I was actually experiencing, then perhaps I would not have felt so alone. The more alone I felt, the more I cut myself off. The less information there was for me to get access to so I could learn what was happening to me, the more I retreated into myself. I believe that, when I was in hospital in the earlier stages, if I had had a peer worker walking alongside me explaining that what I was going through was quite normal and staff members who had explained to me a little more what I was experiencing, that would have been of great help to me.

CHAIR: So a focus on helping you understand it and being there for you, not just for your illness, would have made a big difference. Am I hearing you correctly?

Ms Thiele : Yes.

CHAIR: Thank you. I will hand over to Mr Symon.

Mr SYMON: Thank you. How are peer workers funded? We have spoken a lot about how good it is to get them into places, but what funding does MIFSA get to enable the funding of those peer workers? Is it enough? Can you put more in or have you reached your limits?

Mr Griffith : Our project is not responsible for filling peer worker positions, so we do not put peer workers in organisations. We are just funded to train and support both organisations and individuals to grow that concept. Essentially, it is up to the individual organisation to find the funding to create a new position itself or, over time, create a community support worker position and turn that into a peer worker position. It is about organisations coming up with their own funding. That is always an issue, especially when organisations approach us and say, 'We really want to get a peer worker on board'—especially non-government organisations—but they do not have any extra funding they can access to create new positions.

Mr SYMON: I take it there is no funding stream for that.

Mr Griffith : No, there is no funding stream that I am aware of. The CNAHS, as a sign of their commitment to getting peer workers or peer specialists on board, took something like one per cent out of the budgets of some of their existing programs to be able to then fund the 10 consumer specialist or peer worker positions at the time. Other organisations have, essentially, sourced more funding. They have gone for short-term grants to get someone on board, which is not necessarily the ideal way to do it but it is a way they do it. There is also sessional type work. For example, we are able to provide organisations with trained and skilled peer workers to sit on interview panels or to talk at forums—things along those lines. They then invoice us for that short-term capacity and we pay the individual. As it sits at the moment, there is no extra funding for people to access peer worker support. It is about how each organisation manages its own budget and finances and then the commitment it makes to creating those positions within its own workforce.

Mr SYMON: Outside of the mainly NGO space that you have just described, are there large private employers that also operate or want to operate like that?

Mr Griffith : Not as many as we would like.

Mr SYMON: Do you have any examples?

Mr Griffith : Being mindful of the fact that we have really been working only within the mental health sector at this point in time, with dreams and aspirations of getting into that main workforce, a lot of the larger organisations that are doing things in that area that we are aware of have what would essentially be a position around maintaining mental wellness within the workplace; they are not necessarily staffed by peer workers. For example, they may have a wellbeing officer who will access services like ours—the training, community education and stuff that we provide through MIFSA. They will come in to do those talks and things such as resilience building, deep breathing and relaxation.

Mr SYMON: But it is not lived experience; it is passed on.

Mr Griffith : Yes, it is a specific position, so it is not incorporated in that aspect. But the concept of peer work is utilised by a variety of means anyway. You have your mentoring capacity, with people who have been involved in, say, the fireys or another position for a longer time mentoring the new people, so they are drawing from lived experience there. Again, you look at things like the drug and alcohol sector, where they are using people who have identified with that lived experience of being a drug user or HIV-positive. So it is used in the NGO sectors a lot. As far as the corporate or big business stuff goes, it is essentially drawing from people who have been through the system and have been involved in that organisation for a period of time; they come back and have those mentor-type positions rather than a lived experience in mental health, for example.

Mr SYMON: What do you think it would take from government to encourage employers to pick up in that area? As you say, they are already doing it in many other areas without thinking about it.

Mr Griffith : I suppose it is raising that awareness. It is that encouragement and awareness-raising from the government to say that one in five are going to have an issue with this, and they say that over a lifetime one in two will have some negative effect on their mental health. So it is about raising that awareness and building that resilience amongst staff and providing opportunities for the people who experience mental illness to have that conversation with their employers. It is about normalising it: raising awareness, reducing stigma and providing opportunity. It is very much a case of saying that it is out there: 'If you do not want people to get sick, help them to not get sick; that is your workforce across the board.' Everyone has stresses in their lives. Everyone has events or something. Build resilience. That is the biggest part. People need to learn to deal with stress. One of the biggest things I find with peer workers is that they are more equipped to deal with stress. While stress may very well play a bigger part in their lives, they are aware of it; they have been living with this for five, 20 or 30 years. They are more equipped to deal with stress. They have an understanding of how their body works, what is good for them and how they get around situations. A lot of that comes from managerial support or friends and family—those sorts of things. It is very much about normalising the idea—anti-stigma campaigns and those sorts of things. Talk about it across the board; do not isolate it. Do not say 'mental illness' and 'mental health'. Isolate it so that it is a holistic approach; it is everyone saying, 'I am learning how to do that.'

Mr RAMSEY: I wish I had had time to ask this question of the previous witness. Do you have a regional focus at all? I noticed that MIFSA has an office at least in Port Lincoln and some kind of south-east focus in Mount Gambier.

Mr Griffith : Yes, as you are aware, MIFSA itself has those sites. We are also part of a national body, the Mental Illness Fellowship of Australia, which spans a national area. The best part of having a collaborative project is that Baptistcare also have a lot of diverse programs and locations. We have peer workers in places such as Berri and those sorts of areas, which focus on sites that we are engaged in. One of the problems with regional areas is the lack of support. When we first started this program, we were doing some training in the country areas. We would go out and do peer work training or an introduction peer work course in those areas. But without that organisational support—without someone there to help the peer workers to look in the right places or organisations to create positions—you are not able to do it. Again, it comes down to being able to access support in those areas. You need organisational support. The imperative part of peer working positions in those areas is that organisational support. We do have focus, I suppose, and plans to help how we would support or grow that regional area. Because, again, I suppose as with everything in those areas, access to services, the small community stuff, the people not wanting necessarily to put themselves out there and say, 'Yes, I've got a mental illness', because they see them down the street every day and all those sorts of things as well. So you have that smaller community issue as well. But what we struggled with mostly was organisational support for peer work positions in those areas. And just access to resources.

Mr RAMSEY: I have not heard of anything like this happening on my patch. I may well be corrected later on.

Mr Griffith : From my understanding, what we do is one of the only, if not the only, projects of its type in Australia. A lot of places will have peer work support, and they will support peer workers in their specific area. So, places will support consumers across the board, but there is nowhere that has a specific base that says, 'We support organisations and individuals' in the whole peer work sort of concept. So you will not find too many of them. Hopefully we are starting to develop and draw on that, because we sort of do train the trainer and we have supported other organisations to do peer work training in different sites across Australia. But there is nothing exactly like this project, which I think is something that is needed to just keep that momentum going in an area.

Mr RAMSEY: Right, thank you.

Ms O'NEILL: You act as an employer, really, of people who have mental illnesses. That is pretty clearly identified.

Mr GRIFFIN: Yes.

Ms O'NEILL: So how do you manage the impact of the episodic nature of mental illness as an employer?

Mr Griffith : It is not just the peer work project in particular, but MIFSA as a whole has, as I think Natasha pointed out, 75 per cent of individuals identifying with being a person with lived experience. I suppose one of the biggest parts for me and I think across our organisation is that you find the right person for the job. You get the right person and you work with them on their needs. It is very similar to the way that we work with individuals anyway, I think. You have flexibility. We have had flexibility for years in workplaces where you are able to do those sorts of things. And again, the focus is on resilience. It is resilience, understanding and prevention, I suppose. It is an understanding that yes, you might get sick, and yes, you have a job role, but there are ways to work around that.

Ms O'NEILL: This is the area, I think, that is a whole knowledge base that you have that you now take for granted. And the rest of the world is saying, 'You could do that?' We do not even know what we cannot do. But you have decided to forget, because you have improved the practices. I am really keen to actually find out how, practically, when you have this expertise in managing the episodic nature, how you make your workplace a successful workplace?

Mr Griffith : Yes, as I said, you get the right people for the job. You are flexible, I know—

Ms O'NEILL: What does that mean?

Mr Griffith : Well, I suppose, through Natasha and our management, it is understanding that people have situations. So if someone needs to go pick their child up from school at 3.30, but they are working full time, you would not necessarily offer them a full-time position or if they are doing four days a week, you might stretch out to five days they so they can drop their children off, go pick their child up. It is having flexibility in work hours and work times. It is having a sound understanding of the roles we have and the positions to fill. It is about what we need to get done and how we go about doing it. So, you need to have conversations with people and make it safe for people to have conversations with you. Especially from a supervisory and management level, staff need to have an understanding that they can talk to you.

One of the things in particular, is that we encourage peer workers in particular to utilise the Ulysses agreement. It is a relatively simple document. You will have it in your folders that were handed around previously. It really is about opening up that conversation between an employer and an employee, saying: 'Yes, I obviously identify with having a mental illness. These are some of my early warning signs, this is how I control it and this is what I want you to do if you start noticing these things.' Because it is very much about prevention, and the individual taking control and management having an understanding that they can talk about these issues. As I said, we do provide that flexibility. You can do your work hours. If you struggle to get up in the morning, you can start at 10 and finish at six. It is very much about being flexible. I suppose it is something that we take into account. I do know that management worked very hard in setting up the culture that we have. We started as a group of concerned individuals coming together, so it is very grassroots. We have grown from understanding that people need different things at different times in their lives, and you just adapt in the way that you manage your program. As long as you are meeting your outcomes and you are getting positive feedback, and the roles are being fulfilled and the jobs are being done, it is just what you do; you just make the changes as needed.

Ms O'NEILL: It sounds like the best HR practice actually in action.

Mr Griffith : I would like to think so, and I definitely know that management would like to think so—and it is, very much. On that, we will be able to put something more together, maybe, if you are interested in that sort of stuff.

Ms O'NEILL: Thank you.

Mr Griffith : Or if there are any more specific questions, maybe get them sent through and we can address them a bit more in depth for you, because there are a lot of practices there—for peer work we go to organisations and try to normalise it. If your child gets sick, you leave, or if you get sick or pregnant there are ways and flexibilities in the workforce that you need to know about—how to use them and have the understanding that jobs will get done and work will happen.

Ms O'NEILL: One of the things with peer support, especially from my understanding from a drug recovery perspective, is that it can be very risky for people who are in recovery from drug and alcohol addiction to actually go out and do peer modelling. How do you manage the risks to yourself? You spoke about how fantastic it was to be teaching somebody and decreasing your own—what did you say?—stigma reduction which came through that. But what about the other side of setting yourself up almost as a role model in your peer management, which increases the risk of danger to your mental health and wellbeing?

Ms Teeley : I ensure that I have regular visits with my medical team. They know how I am going because I am seeing them so regularly that they will see early warning signs. I have a team of people around me, a support network within family and friends and within the workplace, and I am regularly communicating with them about how I am going and what my goals are. If I am travelling forward, or not travelling forward, they will notice this. I also have an approach that I want to look after myself holistically and there is quite a list of things that I have in place to ensure that I will keep myself well. So if I am adhering to this range of things that will help me stay balanced. Does that answer the question?

Ms O'NEILL: Yes. I think it does, because it sounds like you have the connections around you that would prevent you from getting to a point where it is dangerous for you to be out there with your peers. And perhaps because you are leading with your peers there is more of an incentive for you to keep plugged in to the supports.

Mr Griffith : And it is very much around that training as well—training and support to know how to draw from your experience. It is not just, 'I have got lived experience; I can be a peer worker;' it is about how you utilise that, and different people use it in different ways.

Ms Teeley : I am attending further training sessions and keeping myself educated and further developing my skills continually.

Ms O'NEILL: Thank you.

CHAIR: Thank you very much. Unfortunately we have run out of time. We could talk about this all day, I think. We really appreciate the information that you have given and hearing how you are using this to assist employees and change the attitudes of employers, which is something that we have heard is really critical to getting people back into the workplace. We have heard the message that it is not just about the jobseeker; it is about the employer as well and ensuring that they are making the necessary flexibilities and starting to see it as a positive. It is not just about the stuff they have got to do but about starting to value it as well. I think we have certainly heard that message. So we really appreciate you and Lisa for providing your individual experience in such an articulate way.

Turning to where we go from here, we will do a report that will be tabled in the parliament with recommendations to government, and the information you have provided here today will be part of making that report. You will be sent a copy of the transcript of your evidence to which you can make corrections of grammar and fact. Thank you again.