The markedly lower life expectancy for people with long-term mental health issues compared to the general population has been well researched in recent years. Policies and guidelines on a clinical level are being implemented. What does this mean for the front line? It is the aim of this presentation to explore some of the complex and challenging implications this can have for people delivering non-clinical support services. An ageing client group presenting with comorbid physical problems can become vulnerable to losing their rights as independent individuals. Often, the informed opinion of the front line support worker is not considered and decisions are sometimes made without taking the client’s mental state into account. On the other hand, a client’s choice is not always an informed one and mistaken by support staff as being the only way forward in order to advocate for this client. In this presentation, a service model will be introduced and discussed which incorporates ideas for best practice around maintaining clients’ right to privacy versus the need for information on physical health of client. The presentation will show the advantages of training on how to effectively communicate with clinicians and explore the idea of a trained GP liaison person as an innovative way forward.

Language has been described as the ‘road map of a culture’. By reflecting culture, the language used in classroom education has a significant impact on the attitudes and behaviours of mental health workers. Organisation-wide training - in particular mandatory training, acts as a cultural vector by socialising staff to ‘the way we think and do things around here’. This paper critiques the language embedded in a mandatory aggression management training program for mental health staff, and considers the roadmap it provides. The language is held up against best practice recovery-oriented and trauma-informed language and principles. The outcome, and how it influences mental health staff in their roles, is discussed. We argue that changing culture requires the conscious implementation of a new roadmap. Translating best practice principles into reality requires more than just educating mental health clinicians about recovery-oriented and trauma-informed principles; it requires that these principles be built into mental health training and education from the ground up. This paper describes our attempt to inspire a new cultural roadmap by rebuilding a mandatory aggression management training program using the language and principles of recovery-oriented and trauma-informed care.

Key words: Language, culture, mental health, education

Learning objectives:
Participants will:
1.Recognise the relationship between language, education, attitudes and culture.
2.Understand the impact that building best practice language and principles into mandatory education can have on mental health service culture and practice.


References:
ASCA (2012). Practice Guidelines for Treatment of Complex Trauma and Trauma Informed Care and Service Delivery. http://www.asca.org.au/Health-Professionals/Resources-Complex-Trauma.aspx

Commonwealth of Australia (2013. A national framework for recovery-oriented mental health services: guide for practitioners and providers: Guide for practitioners and providers. http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-pubs-n-recovgde

Neami National is a non-government mental health organisation which provides a range of services nationally characterised by the provision of the Collaborative Recovery Model. The development and management of a clinical governance framework within a non-government mental health organisation is not common and sets a new precedent for consideration within the sector. While Neami only currently delivers a limited range and volume of clinical services, the implementation of a clinical governance framework ensures the organisation safeguards high standards of health care, continuously improves the quality of services and delivers clinical services in alignment with organisation values. Partnering with clinical agencies, directly providing clinical services to consumers and employing staff in clinical roles is now a reality for Neami National and it is anticipated will feature strongly in the future growth of the organisation.

The activities encompassed by clinical governance are not new. The challenge for Neami is to remain true to recovery oriented service provision whilst delivering perceived traditional clinical mental health services. Neami’s clinical governance framework is therefore being developed in close alignment with our existing values and strategic direction and in direct consultation with key clinical partner agencies. The process of implementation will involve a whole of organisation approach to training, development and leadership within management, clinical effectiveness and risk management. In addition to focusing on risk and clinical effectiveness, Neami’s clinical governance systems will also place a high emphasis on leadership, culture and the consumer experience. A focus on such areas will enable the organisation to continue supporting high quality service delivery and consumer outcomes.