This submission by cohealth was informed by the organisation’s consumer advisory groups’. The submission provided a considerations which included increased consumer participation through co-design mechanisms, face to face meetings and more communication about the nature of reform processes.
This submission has been prepared by cohealth at the request of cohealth consumer advisory group committee members.
cohealth consumer advisory groups’ members met on Tuesday, 26 August 2014 to discuss service changes resulting from the Mental Health Community Support Services (MHCSS) and Alcohol and Other Drug (AOD) reform process. The discussion was hosted by cohealth in response to requests from its consumer advisory group members, who represent diverse and marginalised communities in Inner North, North and Western Metropolitan Melbourne. The members were eager to present consumer perspectives on the lessons learnt from the recent recommissioning to the Community Sector Reform Council (CSRC) and the Hon Mary Wooldridge.
In attendance were representatives with a lived experience of a mental health condition and/or alcohol and other drug experience, as well as carers and family members. Attendees were from across North West Metropolitan Melbourne, including Footscray, Whittlesea and Fitzroy. The majority of the participants live in public housing estates. The cultural backgrounds of participants included Australian born and people of Asian and African cultural backgrounds. Interpreters were engaged to support the conversation.
Broader participation was invited from consumers, carers and consumer consultants however short notice and previous commitments led to numerous apologies. Those who did attend also felt that a lack of background knowledge about the reform among the general community may have impacted on prospective attendees’ impression of the consultation’s relevance.
Key reflections from the cohealth staff and consumer consultants who hosted the discussion included:
The group focussed on the following issues:
Attendees reported they had only learned about the changes to MHCSS and AOD as a result of their participation in cohealth consumer advisory committees. They reported they had little knowledge of how the changes would affect them and the services they receive. Attendees asked questions about how people with mental health conditions would receive information about the change of services.
If I didn’t attend the CLAP [Consumer Liaison and Participation group] I wouldn’t know about any of this.
Furthermore, attendees reported they were not given enough time to prepare an informed response for this submission. One attendee highlighted:
They need to give us time to put this feedback together. We’re only just learning about the changes now. We don’t have time to form our opinions.
One attendee advised:
We don’t adjust to change very well. We should be supported, kept informed of anything that affects us.
There was lengthy discussion emphasising the need for clear communication and information from the commencement of any reform process. The need for this information to be available through a variety of mechanisms was also seen as important. More specifically, communication and information that is accessible for people of different language and cultural backgrounds was highlighted.
A number of participants reported that information about available services was best delivered by face-to-face discussions at existing community meetings and forums. They stated that providing a website with information is not useful for many people with languages other than English. As stated:
Many people can’t access the website. If you don’t speak English or homeless…
Attendees reported that dissemination of information via local community radio, local newspapers, presentations with community groups across a broad range of languages and cultural backgrounds was necessary to reach people who use and need services. Examples included language specific newspapers such as Vietnamese and Arabic newspapers, and language specific channels such as SBS, 3AA and 927.
Providing opportunities for consumers to contribute to the process
Attendees advised that as people with a lived experience of mental health, alcohol and/or other drug conditions, they would like to be able to inform the government and non-government sectors on what works well, particularly how they would like to access and be involved in consultation processes for the services.
All attendees reiterated the value of working together with the government and non-government sectors in ways that promote transparency and trust through reform processes. The need for processes that embed consumer participation from the commencement of any reform process were highlighted:
We want to participate. We want to know what services are in our community and how to access them. We want to be able to tell other community members about these services.
The discussion progressed to the need for stronger links and involvement of service users to be embedded in change processes that affect them.
The discussion group recommended that the CSRC and government be more aware of the time required to inform and involve consumers. They discussed how short timelines further excluded rather than involved consumer voice in communication between community and government.
If they genuinely want our input, why not have people like us on the board or whatever from the beginning of the process?
Making the system work for vulnerable people
The importance of simplicity from a consumer and carer perspective was noted:
We don’t want the process to be complicated. We don’t like going through different channels.
Some attendees reported that they did not feel comfortable to use the telephone to make a request for mental health services. They reported they would like face-to-face, local community connection with workers they knew and trusted, with their carer or family member present if they chose. They also highlighted the right to have access to an interpreter and the additional complexity that a lack of language skills in addition to a mental health condition brings to effective access of services. As highlighted by one attendee:
It’s a fearful thing calling up someone you don’t know. I don’t feel safe.
Another attendee said:
People should be able to walk into their local community health centre and have a face-to-face discussion.
There was some discussion about the need for services to be accessible and work for everyone. There were also numerous questions from attendees about the various phone numbers across the regions; cost of the phone call; information materials available for community in community languages; availability of interpreters; availability of a triage system; support for recovery; possibility of home visits and call backs; and the process that would follow the initial phone call. The attendees’ focus on this access information indicated to the hosts that it may be valuable to have follow-up consultations about the reform process and user experience once communities are aware of and using the new systems.
Attendees highlighted the importance of a strong connection and partnership between the government and non-government sector, with local workers and agencies being conduits to effective and inclusive consumer engagement processes.