Academic journal article Advances in Mental Health

Consumer and Carer Consultants in Mental Health: The Formation of Their Role Identity

Academic journal article Advances in Mental Health

Consumer and Carer Consultants in Mental Health: The Formation of Their Role Identity

Article excerpt

Mental health services throughout the world have undergone significant policy reform over the past two decades, and Australia is no exception (Parham, 2005; World Health Organization, 2009). Part of this reform has seen the increasing involvement of carers and consumers in the planning, delivery and review of mental health services, and is now a key component of the Federal Government's Mental Health Strategy (Commonwealth of Australia, 2009). One way in which consumers and carers are involved in mental health services is through employment as consultants. Consumer and carer consultants (CCCs) have been engaged in public mental health services in Australia since the first National Mental Health Plan was released in the early 1990s (Commonwealth of Australia, 1992). The most recent Australian figures (for 2004-2005) show a total of 55.3 full-time equivalent consumer consultants and 13.5 carer consultants employed across 252 mental health service organisations (Commonwealth of Australia, 2007, p. 61). While more recent figures are not available, it is likely that this figure will have increased over the past 5 years.

Carer consultants are defined as 'work[ing] with mental health staff in developing service responsiveness to the needs of carers and families' (Commonwealth of Australia, 2009, p. 84). Consumer consultants are 'employed to advise on and facilitate service responsiveness to people with mental health problems or mental illness and the inclusion of their perspective in all aspects of planning, delivery and evaluation of mental health and other relevant services' (Commonwealth of Australia, 2009, p. 84). CCCs are not direct service providers, but work in partnership with mental health staff and occupy diverse roles including:

* building relationships with individual consumers and carers and communicating their needs to health professional staff;

* investigating and advocating areas for improvement to local services, policy and procedures;

* participating in the selection of staff employed in the local services;

* advocating consumer and carer perspectives in the evaluation of local services; and

* contributing to training programs for service delivery staff (Commonwealth of Australia, 2007, p. 61).

Underpinning the CCC role 'is a view that such participation can empower and inform consumers and carers, destigmatise mental illness and ultimately improve mental health outcomes by promoting a recovery orientation in service delivery' (Commonwealth of Australia, 2007, p. 59). The notion of 'recovery' was introduced by consumer advocacy groups in America in the early 1990's and is now identified as a key priority of the Australian National Mental Health Plan (Commonwealth of Australia, 2009, p. 28). Recovery in relation to mental illness is an ongoing process aimed at achieving quality of life within the limitations of the illness. It is variously defined but generally involves the following: a spirit of unquenchable hope; the ability to define oneself apart from the illness; the ability to cope with symptoms; empowerment; and the ability to establish meaningful social connections (Adams, 2010; Andresen, Carputi, & Oades, 2010; O'Connor & Delaney, 2007).

While consumer participation at all levels (i.e., policy development, service planning, service delivery and evaluation) is a cornerstone of policy, a plethora of commentators and researchers have observed that the rhetoric of Australia's mental health policy has not transpired into action (Casey, 2006; Goodwin & Happell, 2006; Hickie & McGorry, 2007; Kidd, Kenny, & Endacott, 2007; McAllister & Walsh, 2004; Roper & Happell, 2007; Thornicroft & Tansella, 2005; Whiteford & Buckingham, 2005). Implementation at state and territory level is variable and reliant on 'champions' (Parham, 2005). This has certainly been the case in relation to the involvement of CCCs in mental health service provision, where significant variation has been evident in the employment of CCCs across states and organisations (Commonwealth of Australia, 2007). …

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