University of South Australia releases spotlight report on person-centred and consumer directed mental health care

The project was developed to provide understanding of how the concepts of person-centred and consumer directed mental health care are evident in mental health care settings. One aim was to hear from consumers, carers, mental health practitioners and policy makers about their experience and views. This was important because these concepts are influential in general health care, aged care and disability sectors, yet there hasn’t been a significant body of Australian academic work in interpreting them in a contemporary mental health and suicide prevention context. A further aim was to promote discussion and action about the different tensions and barriers involved in achieving these levels of care. We see this work as vital given that many consumers, carers, and service leaders report mixed, difficult or harmful experiences in care systems.

We did a targeted invite to a broad range of peak bodies, organisations and services. It was important we talked to people across diverse groups and service settings. We spoke to 50 people, through nine focus groups and 15 interviews, and they provided very rich information and experience. We then undertook thematic analysis of key messages, concepts, as well as barriers, issues and ways forward. From here we undertook a co-design process with 20 participants to develop our findings on what ‘system level shifts’ are needed.

Through thematic analysis and codesign we developed detailed expectations on how person-centred care and consumer directed care are understood from lived experience and provider viewpoints. We also identified many key tensions and challenges for ensuring services and practitioners can consistently deliver on these expectations. These included issues such as paternalism, medical model limits, power imbalances, experiences of coercion and risk aversion, service inflexibility, lack of practitioner resources and time, lack of pathways for people experiencing complex issues, limited service information, and stigma and stereotyping.

Our findings and codesign work on shifts highlight eight areas for action. These are focused on:

• Promoting practitioner education and training
• Improving service leadership and structures, including lived experience leadership
• Reform of mental health legislation for human rights
• Improving ‘upstream’ supports and developing crisis response centres
• Funding lived experience peer navigation, and peer supports programs across specialist services and community.