Introduction by Croakey: The World Health Organization (WHO) recently released its largest report on global mental health since 2001. It found that while some advances in mental healthcare and policies have been made in the past two decades, urgent transformation is required.
“Mental health conditions continue to exact a heavy toll on people’s lives, while mental health systems and services remain ill-equipped to meet people’s needs,” the report states.
The report made three key recommendations: deepening the value and commitment given to mental health; reshaping environments that influence mental health; and strengthening mental healthcare by changing where, how and by whom mental healthcare is delivered and received.
Empowering the voices of those with lived experience of mental illness is one guiding principle of the WHO’s Comprehensive Mental Health Action Plan 2013-2030, referred to in the World Mental Health Report.
Given stigma and discrimination are common against people with mental illness, it is important to ensure laws enable the consumer workforce, those with lived experience, to be safe at work.
The consumer workforce will be a critical aspect of change in Australia’s mental healthcare system, and “have a range of rights and protections that should secure them a safe workplace,” according to Simon Katterl, a consumer workforce member and mental health consultant, who provides an overview of Australia’s consumer workforce laws below.
Simon Katterl writes:
Do you feel safe bringing “your whole self” to work? This is a question that human resource teams across Australia are asking their staff.
Recent reports such as those on ABC’s 7.30 TV program reveal widespread racism and suggest many people do not.
This question of self and safety at work is crucial in the mental health sector.
Australia’s mental health system is undergoing structural and cultural changes.
Expanding the “consumer workforce” – a broad set of roles that require a person to use their lived experience of mental health issues and/or having used the mental health system in their work – is one critical aspect of this change.
As a person with lived experience of mental health issues myself and a member of the consumer workforce, I know this question needs to be urgently asked and answered in Victoria.
Having worked in these roles, handled complaints about mental health services, written on discrimination law, and provided supervision to the consumer workforce, I can say that many would answer the “whole self” question in the negative.
Review of consumer workforce laws
It is important to note that consumer workforce members have a range of rights and protections that should secure them a safe workplace. That is why I recently reviewed laws affecting the consumer workforce (behind paywall here).
A starting point for any consumer worker should be employment law, which governs their pay, protections against adverse actions taken against them (for example, speaking up about a workplace issue) or being unfairly dismissed.
Unfortunately, on many occasions, I have personally seen how consumer workforce members’ employment is placed in jeopardy for speaking up about workplace issues.
Note: Consumer workers may want to reach out to an employment or industrial relations lawyer, their union or the Fair Work Ombudsman if they have concerns.
Work health and safety laws exist in all states and territories and place a duty on managers and workplaces to eliminate “psychological hazards”, including bullying, exclusion or poor or uncertain work conditions.
And yet these remain a feature of people’s experiences, as one worker reported in a recent study by Edan and colleagues:
I have felt isolated in my role for the last five years as being the only peer support worker. Now that they have increased the lived experience team, I have moved across to this team and am feeling supported.”
Psychological hazards can also reflect witnessing the poor treatment of consumers, which is particularly traumatic for consumer workers who have also been in the system. One consumer said in a 2020 report about ‘co-producing safe, inclusive workplaces for consumer mental health workers’:
But then when I was on the ward I was like oh my God I can’t believe the language they use, I can’t believe they walk out into the office area and like bitch about a consumer in the most disrespectful way possible in front of a room full of people.”
Note: Consumer workers may want to reach out to their work safety regulator (for example, Safe Work NSW or WorkSafe Vic) if they have concerns or have been harmed.
Anti-discrimination (or sometimes termed “equal opportunity”) laws protect against someone being unfairly treated based on a protected attribute, such as a mental health diagnosis (but also, race, gender, sexual orientation and union membership, for example).
The law generally protects against “direct” and “indirect” discrimination. The former (direct), for example, prevents employers from directly or explicitly treating a staff member with mental health issues less favourably based on those mental health issues.
The latter (indirect), for example, means that even “neutral” looking rules, conditions or practices of the workplace can be unlawful if they disadvantage people with mental health issues.
They also require employers to make “reasonable adjustments” to the workplace so that people with mental health issues enjoy the same workplace standards as those without.
Despite these protections, the Royal Commission into Victoria’s Mental Health System found that consumer workers are commonly experiencing discrimination in the workplace (as reported on pages 535-536).
A common example is a belief that peer workers are less capable because of their experiences of mental health issues (when in fact it may be those experiences that are the advantage!).
This often results in their exclusion and marginalisation in key aspects of the workplace.
Note: Consumer workers with concerns may want to contact their local Legal Aid or their local human rights and equal opportunity regulator (for an overview of these laws, see here).
How do we explain the gap between the law and the consumer workforce’s lived experience of the law? One component are the power imbalances between consumer and non-consumer workforces, as noted by the Royal Commission on page 17:
Complex power imbalances rooted in professional, historical, social and statutory hierarchies continue to influence the opportunities available for people with lived experience of mental illness or psychological distress to lead, shape and participate in Victoria’s mental health system.”
Such findings are resisted or contested by non-lived experience workforce members who characterise often seek to erase such power imbalances, in much the same way that other beneficiaries of power imbalances do regarding race or gender in the workplace.
A fairer workplace for consumer workers will undoubtedly require greater reflection on, and commitment to, acknowledging and eliminating these power imbalances.
What is also glaring is that these laws are remaining under- or un-enforced. Workplace health and safety regulators must take a more active role in identifying the unique psychological hazards posed by discrimination and power imbalances in the workplace, and ensure workplaces take preventative steps to address this.
Working closely with the consumer workforce will be crucial. Part of this will require support from unions who assist the consumer workforce on industrial relations matters.
Paul Healy, Victorian Secretary of the Health and Community Services Union, was asked for comment for this article, and said, “all lived experience workers have a right to be safe at work. To be free of bullying, harassment and in a culture free of fear and working for the best outcomes for consumers and families.”
Further industrial activity and action may be required to make these aspirations a reality.
Finally, the obvious caveat is that these laws and their enforcement must be a component of a broader multifaceted strategy to improve work conditions, including better organisational readiness for consumer workforce members, education of the non-consumer workforce and greater representation of consumer workforce members in executive and leadership roles.
Undertaking such changes is not only crucial to improving the workplace for consumer workers, but to creating better mental health services for Australians.
About the author:
Simon Katterl is a consumer workforce member who has worked in community development, advocacy, regulation, and law reform. Simon’s work is grounded in his lived experience of mental health issues, as well as his studies in law, politics, psychology and regulation.
Simon previously worked for the Victorian Equal Opportunity and Human Rights Commission, the Mental Health Complaints Commissioner, Victoria Legal Aid, RMIT University, Griffith University and the University of Melbourne.
He now provides consultancy to several agencies, including the Royal Commission into Victoria’s Mental Health System. Simon’s research has focused on human rights breaches within mental health systems and the shortcomings of regulatory oversight processes.
Please see Croakey’s extensive archive of articles on discrimination.