Overview

Title
Substance Use Treatment Program in a forensic hospital for people with mental health issues

Agencies
University of Sydney Matilda Centre and the Justice Health and Forensic Mental Health Network 

Project overview
Update a UK Substance Use Treatment Program (SUTP) manual with the perspective and language of Australians with lived experience of mental illness, by collaborating with a range of peer workers with lived experience of mental health issues and caring, family and kinship groups.

Lived Experience Framework: Actions to achieve change

  • Culture and approach: the value of lived experience of people with mental health issues and caring, families and kinship groups is recognised across services and communities
  • Quality improvement: organisations are safe, empathetic, curious, and continually learning and improving
  • Capacity building: sponsor the development of tools to implement the Lived Experience Framework across mental health and social services.

Challenge

Incorporate lived experience of people with mental health issues in a forensic setting into a redesigned manual for a Substance Use Treatment Program prior to pilot-testing in NSW.

The University of Sydney

Response

The project redesigned the manual for a Substance Use Treatment Program to incorporate lived experience of people with mental illness. This was a collaboration of two peer workers (one Aboriginal) a senior social worker at the forensic hospital and researchers. Consultations held at the hospital produced a strengths-based language revision to the manual, prior to a SUTP pilot study.

The project was run in several stages in mid-2019:  

1. Reviewed literature of University of Sydney and Corrective Services NSW libraries on the lived experience of individuals in inpatient mental health settings, to inform project collaborations

 

2. The peer worker (former forensic mental health patient) and a researcher on treatment design and service delivery presented a lived experience of mental illness to University researchers

3. Consultations between researchers, a forensic hospital peer consultant, a peer worker and Aboriginal peer worker, a NSW Consumer Advisory Group member, a former forensic mental health patient, who is a support worker and advocate for NSW mental health patients

4. A report on the project to the NSW Mental Health Commission, prior to test.

Evaluation process

  • Evaluation of qualitative and quantitative data from participants pre- and post-SUTP program are being analysed for publication in an academic journal and a Masters thesis in 2020
  • Analysis of the data may indicate the acceptability, feasibility and preliminary efficacy of the SUTP program. 

Outcomes

  • Localised content incorporating lived experience of people with mental health issues was developed and implemented into the SUTP manual at the Forensic Hospital, Long Bay, with localised language and references from a lived experience of mental health issues perspective 
  • The SUTP manual explains supports for people with drug, alcohol and mental health issues
  • A ‘Language Matters’ guide (by the Network of Alcohol and Other Drugs Agency) was suggested and has been included at the front of the SUTP manual
  • A need for inclusion of voices of people with lived experience of mental health issues in a forensic hospital setting has been listened to and acknowledged.
  • Lived experience was embedded into the design of a forensic group intervention.

Key learnings for the organisers:

  • The Aboriginal peer worker’s feedback helped make questions more open and helped develop a holistic recovery approach: e.g. use of the word ‘connecting’ to build human connections
  • The manual needed better coverage of how substances affect people already living with a mental illness: as a result, examples were added of some impacts of substance use on people living with mental health issues
  • Social support was improved by including examples from peer workers and a peer consultant
  • Embed co-ownership of SUTP development with peer workers and family consultants
  • Ensure SUTP content is developed in collaboration with people with lived experience of mental health issues and caring, families and kinship groups.

Benefits facilitated by the project co-design:

  • Access: the Principal Investigator’s employment access (in the Justice Health & Forensic Mental Health Network) and relationships with forensic staff facilitated forensic unit access for researchers, which enabled work to stay on track for completion in June 2019.

Challenges to the project:

  • Individual interview information collection was labour-intensive (compared to a focus group)
  • It was difficulty to conduct a focus group with the forensic hospital peer consultant and the peer worker who each worked part-time on different days.

Project benefits for other organisations or settings:

  • Scheduling of participants can be critical and could help in data gathering
  • Holding a focus group of researchers and all peer workers/consultants may be more time-efficient to gather qualitative data than hosting individual interviews.

Next steps

  1. Collect qualitative and quantitative data from participants (prior to and after participation in the SUTP, which begins use in late 2019).
  2. Data analysis of the SUTP (acceptability, feasibility and preliminary efficacy)
  3. Publication in an academic journal and as a Masters thesis by mid-2020.

References 
1.    University of Sydney Matilda Centre Lived Experience Framework Project report.