Open Minds Submission Family and Community Development Committee Inquiry into Workforce Participation by People with a Mental Illness November 2011

Transcription

1 Open Minds Submission Family and Community Development Committee Inquiry into Workforce Participation by People with a Mental Illness November 2011 Prepared by Sally Gibson Maria Katsonis Co-convenors Open Minds P.O. Box Law Courts VIC 8010 e: info@vpsopenminds.com

2 1. Introduction Open Minds welcomes the opportunity to provide a submission to the Family and Community Development Committee Inquiry into the Workforce Participation of People with a Mental Illness. As a peer directed group for people with mental illness or caring for someone with mental illness, we fully understand the importance of employment and the work environment in supporting people with a mental illness, not just economically but also in contributing to self esteem and self worth. Employment provides an opportunity to regain a positive identity, including a sense of purpose and value, attributes that are often undermined by the experience of mental illness. For the individual, securing and sustaining employment enhances confidence and expands social networks. Being employed is also a key measure of social inclusion. Employment is important to recovery and often it as an unmet need. 1 Additionally, the workplace plays a crucial role in promoting positive mental health outcomes and maintaining mental well being. A supportive and inclusive workplace values people with mental illness and treats them equitably without fear of discrimination and stigma. This requires an organisational culture that takes a systemic approach to mental health in the workplace and creates an environment of trust and respect between managers, employees and colleagues. This submission is informed by an evaluation of Open Minds programs and a survey of Open Minds members. It incorporates direct quotes from managers and employees. The submission addresses two of the Inquiry s terms of reference: 1. identification of the barriers that people with mental illness experience in gaining and retaining employment. 2. the effectiveness of programs that aim to improve the workforce participation of people with mental illness. 2. About Open Minds Open Minds is a peer-directed group for Victorian Public Service (VPS) employees with mental illness or caring for someone with mental illness. Open Minds offers a range of programs for mental health consumers, carers and managers. This includes regular forums on mental illness, recovery and mental wellness. Open Minds also works to decrease the stigma of mental illness and provides a consumer and carers perspective on mental health issues in the workplace. It is the first whole-of-vps program to specifically target mental health issues in the workplace. Open Minds was launched in February 2010 and since its inception, it has been shaped by the lived experience of mental illness and caring. Maria Katsonis (Department of Premier and Cabinet) and Sally Gibson (Office of the Public Advocate) are the Open Minds Coconvenors. Maria is on the National Register of the Mental Health Council of Australia; a member of bluevoices, beyondblue s consumer and carer reference group; and the consumer representative on the Royal Australian GP College Psych Support Advisory Committee. Sally is on the Mind Australia Board; a member of Carers Victoria; Mind's Carer Advisory Group and SANE Australia s StigmaWatch. Open Minds is funded by VPS Departments and the Office of the Public Advocate provides financial auspicing. It currently operates on a volunteer basis and all funding is directed towards program activities. Open Minds has a Program Advisory Group that contributes to Submission to Inquiry into Workforce Participation by People with a Mental Illness Page 2

3 the development of programs and services with representatives from the Department of Justice, Metropolitan Fire Brigade and the Office of Disability. Current programs include: seminars and forums on mental health and wellbeing. Recent subjects have included The lived experience of mental illness, Let s talk about suicide, Building resilience, and Mindfulness. training for managers on managing mental health in the workplace which is delivered by beyondblue. roundtables for mental health consumers which seek to break down the isolation experienced by people with mental illness in the workplace and provide opportunities to share experiences. workshops for carers of people with mental illness. mental health first aid training. coordination of a whole of Victorian Public Service festival for Mental Health Week. People affected by mental illness can be divided into three broad tiers according to the severity of their illness as shown in Figure 1 below. 2 Figure 1: Three tiers of mental illness and prevalence in Victoria To date, the focus of Open Minds activities is on VPS employees in the first two tiers. This does not negate the experience of those in the third tier who have severe disability as they have the lowest likelihood of workforce participation (72 per cent compared to 46 per cent of those with a moderately severe psychiatric disability). Carers involved in Open Minds provide care across all three tiers. Submission to Inquiry into Workforce Participation by People with a Mental Illness Page 3

4 Open Minds has experienced rapid growth in response to the demand from consumers, carers and managers who are looking to do more than simply send staff to employee assistance programs. The comments below are from a survey conducted when Open Minds was being established to gain an understanding of interest and needs. A deeper understanding of the challenges facing people with mental health issues working in the VPS. Ideas and tools to make it safe for people to disclose in the VPS and a VPS wide initiative for the management of mental health. Understanding, resources, involvement in changing the perception of mental illness across government. Informed, educated and confident VPS managers who know a little about mental health and best practice in managing that in the workplace. Develop a work environment where mental health issues can be openly discussed and responded to positively to reach the best outcome for staff member and Department. In order to better understand the demand drivers and the impact of Open Minds programs, Open Minds commissioned The Nous Group to conduct an evaluation. The evaluation was partly funded by beyondblue who were interested in exploring the workplace effectiveness and advantages of a peer-directed model in engaging the workplace about mental health. The Nous Group completed the evaluation in February The evaluation found that Open Minds has had a positive impact on the attitudes, behaviour and well-being of many VPS employees. The strongest program impacts were greater understanding and awareness which contributed to stigma reduction. The majority of managers and colleagues who have been involved with the program identified changes in their own knowledge, attitudes and behaviour since attending an Open Minds activity as evidenced in the evaluation survey results below. 3 Change in behaviour Better understanding of what it is like to experience a mental illness or care for someone that does 90% Greater understanding of how mental illness may affect that person in the workplace 90% Felt more comfortable talking with their colleagues about mental health issues 82% Talked with colleagues about how their workplace can better support colleagues with a mental illness or colleagues caring for someone with a mental illness 59% Table 1: Affirmative responses to the question Since you attended an Open Minds activity, have you: Additionally Open Minds has enabled a substantial number of program participants to talk more confidently and openly with their colleagues about their mental health issues. Participants also reported feeling less isolated after becoming better connected to their peers and suitable support services. For many VPS employees, Open Minds has provided their first opportunity to talk about mental health in the workplace and seek assistance. Submission to Inquiry into Workforce Participation by People with a Mental Illness Page 4

5 I have never previously received any information or support around mental health issues, all the information and advice I have received has been through Open Minds. I feel better equipped to educate others (e.g. managers in my organisation) about how to effectively manage and support employees with mental health issues. Open Minds has also provided program participants with the opportunity to meet and connect with other people affected by mental health issues for first time. Building these new communities has resulted in a considerable number of people feeling less isolated and alone. I feel less alone because I know that there are others across the VPS who are experiencing similar things to what I have experienced. Peer support is an important element. Family/ carers of people with a mental illness can feel very isolated so meeting peers who are also impacted by mental illness reduces the feeling of isolation. Other survey respondents and focus group participants talked about how Open Minds has empowered them to discuss mental health issues in their workplace. [I have gained] the personal courage to speak more openly about my own experience, and learning from others in Open Minds. [I have gained] more confidence in dealing with my own mental health issues. Discussing it as something that exists in the world helps to objectify it, reducing the sense of it as an intractable problem that is intrinsic to myself. 3. Barriers people with mental illness experience in gaining and retaining employment 3.1 Nature of mental illness The statistics are well known: one in five Australians will experience a mental illness every year. 4 However that experience of mental illness will vary from individual to individual. For some, it might be a single episode with full recovery. For others, mental illness may be episodic in nature, coming and going throughout someone s life. It may even affect how a person functions over the course of a day. Similarly, treatment will vary and may involve medication, psychological counselling and lifestyle changes. Consequently every individual will also experience recovery differently. This too may be episodic in nature and recovery from mental illness has sometimes been likened to a dance as it can be two steps forward, one step back. The episodic nature of mental illness can be a barrier to employment especially if there is limited understanding and if workplaces take a one size fits all approach to how they deal with mental health in the workplace. Instead the emphasis should be on flexibility and a case management approach tailored to each individual s circumstances. Workplaces need to broaden their focus beyond return to work to plans to stay at work plans and assess how they can assist an employee with mental illness stay at work. Ideally these will be documented in mental health specific policies that are part of broader health and wellbeing strategies to create an inclusive and flexible workplace. Submission to Inquiry into Workforce Participation by People with a Mental Illness Page 5

6 3.2 Education and training Limited awareness and knowledge of mental health issues in the workplace is another barrier to gaining and retaining employment. A survey of 26,000 members of the Australian business community found that found that mental health training is infrequent amongst organisations with 83% of respondents stating they have not received any training to deal with mental illness in the work place. Additionally, 44% of respondents felt their organisation was not well equipped to effectively manage mental health issues in the workplace. 5 In particular, education and training is essential for managers and supervisors as they play a pivotal role in managing and supporting an employees return to work after an episode of mental illness. Managers without experience in managing employees with mental illness often can lack the confidence to initiate conversations with affected staff. Research conducted by SANE Australia found that an understanding and supportive employer is the most important factor in keeping a job. 6 Managers and supervisors also have a key role in liaising between employees, HR departments, occupational health practitioners and others who may be involved in employees return to work or when workplace adjustments are required. Training would include topics such as the different types of mental illnesses and their prevalence; warning signs and symptoms; how to support the recovery of employees with a mental illness; the impact of mental illness on concentration, memory, decision making and motivation; and actions that managers and supervisors can take to develop a mentally healthy workplace. Specialist mental health training is also relevant for HR and occupational health and safety practitioners as facilitating the return to work of employees with mental illness is not the same as a physical illness. While face to face training can be extremely beneficial, this has limited reach and wider educative opportunities also need consideration. For example in 2010, the Australian Human Rights Commission produced the publication: Workers with mental illness: a practical guide for managers. Available on the Commission s website, this provides managers with information on to how support employees with mental illness and how to develop and promote a safe and healthy work environment for all employees. There is scope to develop a similar VPS wide guide and also use the content for e-learning modules that could be accessed via intranets. The Open Minds evaluation demonstrated that Open Minds has been successful in in raising awareness of mental health issues among the VPS employees who have participated in program activities, including managers and colleagues of VPS employees affected by mental health issues. These activities have included the Open Minds presentations, seminars and events, managers training workshops and the mental health first aid training. I work in HR and we have implemented a few new things, at least partially inspired by what we have learned from Open Minds, including improving our Return to Work support for people with mental health issues and developing a mental health resource page for managers and employees on the Intranet. My training has certainly opened my mind to the impact it has on the workplace and how i can be of assistance without breaching privacy or offending individuals. I've found it great to understand better what some behaviours in others are and hopefully respond better. Submission to Inquiry into Workforce Participation by People with a Mental Illness Page 6

7 These changes in behaviour are validated by the perspectives of consumers and carers as seen in the table below: Change in behaviour Consumers Carers More understanding of what it is like to experience a mental illness or care for someone that does 71% 65% More comfortable talking about your mental illness or role as a carer 68% 68% More understanding of how a mental illness or obligations as a carer may affect your ability to do your job 64% 61% Has inquired about how they can better support your needs 42% 56% Table 2: Responses to the online survey question Since your colleagues and/or managers attended an Open Minds activity, have they 3.3. Stigma The stigma of mental illness is still a significant barrier to employment. Stigma can affect the workplace in two distinct ways: it can prevent employees from disclosing their mental illness due to fears of discrimination, negative stereotyping or adverse impacts on career prospects. it can influence employer perceptions of employees with mental illness and attitudes to attraction, recruitment and retention. While disclosing a mental illness is an individual decision, disclosure is necessary if access is needed to appropriate workplace support and adjustments. Without these supports, employees can struggle with work duties and this can lead to perceptions of poor work performance. Not disclosing can also lead to isolation which is compounded by the invisibility of mental illness. An employee s act of disclosure can also have positive spill over benefits as it can aid further understanding of mental illness in the workplace. It can help counter negative stereotypes and perceptions by demonstrating that people with a mental illness are able to work and that mental illness is a medical condition and not a behavioural issue or character flaw. Employees who disclose can also act as a role model and provide peer support for other employees. An employee with a mental illness is more likely to disclose when the workplace culture is supportive and there is tangible evidence of mental health literacy. A workplace can send signals about the value it places on mental health in the workplace. Positive signals include: mental health specific return to work policies and guidelines trained mental health first aid officers participation in events such as Mental Health Week and R U OK Day mental health awareness seminars and resources (eg information on intranets) mental health incorporated in organisation wide diversity and inclusion strategies mental health incorporated in organisation wide well-being strategies employee access to coaching and support through employee assistance or peer support programs supporting the participation of mental health consumers and carers in the development of workplace mental health policies and strategies. Submission to Inquiry into Workforce Participation by People with a Mental Illness Page 7

8 The visibility of Open Minds has been effective in addressing stigma as evidenced in the survey comments below: Open Minds has moved the topic from being one of taboo in the workplace to one that people can talk openly about with colleagues. [Open Minds] has changed perception of the nature of mental health issues. I can feel like I can talk more openly about these issues in the workplace. More proactive in managing my personal situation and comfortable with discussing mental illness issues. Amazed how some people have succeeded despite their mental illness. [Open Minds] provided the opportunity of making an impact on the workplace place in decreasing/removing stigma of mental illness. 4. Effectiveness of programs that aim to improve the workforce participation of people with mental illness, including best practice models As previously outlined, The Nous Group evaluation of Open Minds found that Open Minds had a positive impact on the attitudes, behaviour and well-being of many VPS employees. The evaluation also found that one of the unique features of Open Minds relative to other programs with similar objectives is the role of peer support and consumer/carer participation. Peer support is social and emotional support, which is mutually offered or provided by people having a mental health condition or caring for someone with a mental health condition to others sharing a similar condition or situation. It has been described as a system of giving and receiving help founded on key principles of respect, shared responsibility, and mutual agreement of what is helpful. 7 Peer support offers a range of benefits that are outside the scope of traditional models of service provision. These include: acceptance, empathy, and respect - those who have experienced mental illness directly or through their carer role have a basis for accepting and empathising with others with similar experiences. sharing what works, strategies for recovery and fostering hope - by telling their own stories of recovery, peers can provide encouragement and act as a role model to show that recovery is possible. empowerment and affirmation - peer support promotes a culture of health and ability rather than one of illness and disability. reducing isolation and promoting recovery for people with a mental illness. Consumer participation in program delivery is a unique feature of Open Minds. In a mental health setting, consumer participation draws on the lived experience of mental illness and first-hand perspectives given that people with mental illness have a unique understanding as a result of their experience. Consumer participation in the planning, development and delivery of mental health services has been increasingly acknowledged by the Commonwealth and the Victorian Governments. The Commonwealth is establishing a National Mental Health Consumer Organisation to ensure that the voice of mental health consumers is a central part of the Government s mental health reform. Similarly the Victorian Government s framework for strengthening consumer participation recognises that the voice of the consumer is fundamental for the delivery of effective and responsive services. 8 Submission to Inquiry into Workforce Participation by People with a Mental Illness Page 8

9 However the role of the consumer in workplace mental health programs is not as prominent. Open Minds has been cited as an example of a best practice model because of the role of consumer participation. This was acknowledged by beyondblue who co-funded the evaluation to assess the effectiveness and advantages of a peer-directed model in engaging the workplace in raising awareness about mental health. An example of consumer participation in Open Minds is the consumer session during the managers training. Rather than showing the usual video with actors playing a person with mental illness, the Open Minds training includes a Victorian public servant sharing their experience of mental illness and then participating in a question and answer session. This facilitates an open and honest discussion about the impacts of mental illness in the workplace, for both managers and employees. The consumer session consistently features as one of the highlights of the workshop as evidenced by the feedback below from the workshop evaluations: The consumer presentation was a wonderful insight and appreciated the openness and honesty. The consumer s presentation was extremely powerful and confronting. The workshop was fantastic and having a consumer present and be available for questions and discussions was extremely valuable. Consumer participation was also identified in the Open Minds evaluation as a critical success factor. It has given programs a level of credibility and authenticity in the eyes of Open Mind s intended target groups. [Open Minds] better understands the issues from a user perspective rather than often ill-informed expert point of view that further isolates. Because Open Minds is not affiliated with a particular department, it is seen as community owned. This has created a sense of inclusion and ownership among the participants involved with the program. Open Minds is VPS staff driven and this creates a safe, trusted environment for discussions on these topics. 5. Priority actions to improve outcomes With a workforce of 30,000 employees, the Victorian Public Service has an opportunity to position itself as an exemplar employer in workplace mental health. Drawing on the Canadian Workplace Mental Health Code of Best Practice 9, this involves mental health specific policies and programs that: are informed by the lived experience of mental health consumers and carers. educate employees about mental illness and the need to eliminate the stigma of mental illness. assist employees to acquire work-life skills that increase their mental resiliency. avoid workplace practices that increase distress. train managers and supervisors to recognise, manage and assist employees who are experiencing mental illness. encourage employees with mental illnesses to seek help. facilitate employees return to work after treatment with support that is tailored to the needs of the individual. Submission to Inquiry into Workforce Participation by People with a Mental Illness Page 9

10 support employees with a mental illness to stay at work support carers of people with a mental illness who can also face employment barriers. Finally, we would ask that the Committee recognise the role of consumer and carer participation in the recommendations put forward in the Committee s final report. References 1 Mental Illness Fellowship of Australia (2010). Mental illness and employment - challenges for the future. Accessed online 7 November 2011: pdf 2 Boston Consulting Group (2006). Improving mental health outcomes in Victoria: The next wave of reform. Accessed online 7 November 2011: nvictoria/$file/final%20report% pdf 3 The Nous Group (2011). Open Minds program evaluation. Accessed online 7 November 2011: 4 Department of Health (2011). Mental illness prevalence: fact sheet. Accessed online 7 November 2011: lness_prevalence.pdf 5 Beaton Consulting (2011). Mental health in the workplace. Accessed online 9 November 2011: 6 SANE Australia (2006): Research Bulletin No. 3: Employment and mental illness. Accessed online 9 November 2011: 7 Mead S, Hilton D, and Curtis, L. (2001). Peer support: a theoretical perspective. Plainfield, USA. 8 Department of Human Services (2005). Strengthening consumer participation in Victoria s public mental health services. Accessed online 9 November 2011: Business Roundtable For Workplace Mental Health. Code of Best Practices For Workplace Mental Health. Accessed online 9 November 2011: Submission to Inquiry into Workforce Participation by People with a Mental Illness Page 10