Last week’s #CroakeyGO #NavigatingHealth event attracted nearly 100 people to join us in navigating some of the pathways (and hearing about many of the mazes) in mental health.
Sponsored by the North Western Melbourne Primary Health Network, we stopped off at hospital, general practice and community settings in inner city Fitzroy and Carlton, walking on Wurundjeri land in Narm/Melbourne.
See our main wrap from the event, published earlier this week.
Along the way, we broadcast presentations from each of the stopping points (the Victorian Aboriginal Health Service, St Vincent’s Hospital’s Safe Haven café, drummond street services, and Carlton Family Medical) and interviews with participants and staff members.
Many were broadcast live via Twitter’s Periscope app where, to date, they have clocked a total of 4,635 views.
Some of the critical messages included the need for safe health care for many groups who are at risk in mainstream services and the mental health system as a whole, the impact of trauma, poverty and disadvantage, and the critical role of diverse workforces, including those with lived experience of mental health issues.
Many also reflected on the process of walking journalism, including Lara Kaput, an advocate for people harmed by discrimination and abuse by religious institutions, who said:
I love the idea of being physical while we talk, rather than sitting around a desk.”
You can watch all our videos and interviews below (in mostly chronological order). Here’s the route we took:
“Wominjeka”: Welcome to Country
Uncle Colin Hunter welcomed #CroakeyGO #NavigatingHealth to the traditional lands of the Wurundjeri people of the Kulin nation. He said:
“The Wurundjeri people welcome everyone to the land today. The Wurundjeri people want you to look after and protect the land as they did before.”
Uncle Colin urged participants to “get on the internet” and read about the remarkable self-determination of the Coranderrk mission, where his grandmother was born.
The story includes the 1881 Parliamentary Coranderrk Inquiry, the only occasion in 19th century Victoria when an official commission was appointed to address Aboriginal peoples’ calls for land and self-determination, and one of the few times that Aboriginal witnesses were called to give evidence on matters concerning their own lives and interests. There’s more here.
“People were literally dying rather than seeking help”
Alan Brown, a Gunditjmara man and former CEO and chair of the Victorian Aboriginal Health Services (VAHS), talked about the development of Aboriginal community controlled health in Victoria, steered by Auntie Alma Thorpe, from its “very humble beginnings” asserting the right and need for health care to be safe.
“A group of Aboriginal people decided that, even though they were two kilometres from St Vincent’s Hospital, the mainstream services might as well have been on the moon in terms of access and equity for Aboriginal people,” he said.
“Don’t come just when you’re sick”
Lionel Austin, Manager of the Preventative Health Unit at the Victorian Aboriginal Health Service (VAHS) outlined VAHS’ focus on physical, mental, social, emotional, spiritual, family and financial wellbeing. The service helps to address issues with fines and Centrelink, as well as gambling.
In the interview below with Croakey, Austin expands on this work, and how the Deadly Choices program has forged a strong association with the Essendon Football Club and The Long Walk, inspired by Indigenous AFL star Michael Long’s walk to Canberra to get Aboriginal and Torres Strait Islander issues on the national agenda. That’s helped to boost Health Check numbers at VAHS by 68 percent in recent years, he said.
On walking as a disruptive intervention for health
Public health journalist and Croakey managing editor Dr Melissa Sweet welcomed participants and introduced the Croakey team at the event, which was sponsored by the North Western Melbourne Primary Health Network (NWMPHN). She said:
“It’s a big deal, I think, to have a health service sponsoring an open journalism event like this, I think it really speaks to the culture of the organisation that they’re willing to do this.”
You can read about the philosophy of #CroakeyGO on the power of walking as a disruptive intervention for health here.
In #CroakeyGO tradition, we did quick vox pops with our participants to ask who they were, what had brought them to the event and what their main concerns or interests were in mental health. Because we had nearly 100 people attending, we split into groups (NB, some participants did not wish to be filmed). Watch our introductions on the playlist below and here are some keywords that came up:
autism, PHNs, media portrayal of mental health, training, access, inequity, poverty, cultural care, LGBTIQ health, community, NDIS, consumers, engagement, walking journalism, patient journeys, PHNs, gambling, employment, and Aboriginal and Torres Strait Islander (including Dr Tess Ryan @TessRyan: “I’m here to rant about everything basically!”)
“Active mindfulness”: Dr Tess Ryan
Melbourne based academic and writer, Dr Tess Ryan, a Biripi woman, talked about the importance to her of art and storytelling, as a practice for mental health and also as a communication tool.
Watch out for a follow up story coming soon at Croakey.
An ‘epidemic of loneliness’
Fran Timmins, Director of Nursing, Mental Health, at St Vincent’s Health Melbourne introduced the Safe Haven Café pilot model, which aims to provide a safe and therapeutic alternative to the Emergency Department, operating after-hours on Friday and weekends, for people experiencing mental health concerns.
An evaluation has produced three key findings:
1. The café has helped save resources in the Emergency Department, by reducing presentations.
2. People attending the café have a better experience of the overall health system as a result.
3. It created a sense of social connectedness.
Timmins said that last finding was unexpected and profound:
To translate that: in health terms we don’t deal in loneliness, because we deal in clinical issues, but the world at the moment is experiencing an epidemic of loneliness.”
Creating a Safe Haven
“The intention is to ensure there is an alternate space rather than traditional emergency type services for people after hours so they can get some social support, connections, and therapeutic needs met without having to present at an ED which not always equipped or able to meet mental health concerns.”
St Vincent’s Hospital clinician Benjamin Taylor and peer worker Jono Gamilis talk about their work at the Safe Haven Café.
Poverty and disadvantage and mental health are intimately linked
“When we discuss mental health, we need to also discuss poverty and disadvantage and vice versa. We can’t look at either of them in isolation.”
Ryan Sheales from the Victorian Council of Social Service (VCOSS) talked about the need to address the social determinants in mental health, including for the Federal Government to #RaiseTheRate of Newstart and on the need to address silos between community and health services, as well as prevention and early intervention. He said:
The first responders to our mental health challenges can’t be emergency services, they must be community services.”
VCOSS CEO Emma King recently gave evidence to the Royal Commission into the Victorian Mental Health System. You can read the transcript (Friday 29 July, community resilience session) or the VCOSS submission.
On #gambling #racism #culturalsafety #isolation
In Melbourne’s beautiful Carlton Gardens, Victorian Upper House MP Fiona Patten and health academic Dr Ruth DeSouza talked about mental health issues on their minds. They ranged from racism and cultural safety to gambling and the impact of loneliness and isolation.
Croakey has published articles by DeSouza in the past on clinical, technical, and ethical issues posed by wearable technologies (a relevant point at #CroakeyGO #NavigatingHealth for those of us who were clocking our steps on the day) and on busting myths about cultural safety.
Patten, who was re-elected as leader of the Reason party to the Upper House last year, has played a big role in many important public health issues in the state, including voluntary assisted dying, drug injection rooms, safe abortion access, and spent convictions.
She talked here of frustration at the refusal of governments to stem “low roller” gambling, highlighting its risks in a community where so many are at risk of isolation and loneliness.
Connecting disability, mental health and autism
#CroakeyGO participant Mel Spencer is a cofounder of Different Journeys, which provides support and social connections for autistic people and their families.
She shared her concerns about gaps in services and support, and the stigma experienced by people with Autism Spectrum Disorder (ASD) and their supporters.
“Those who don’t come in the door”
Karen Field, CEO of drummond street services, talked about how the origins of the organisation – a public outcry over the death of a ‘destitute’ man who could not get treatment because the hospital was full – informs its work today. She said:
That sets up a range of ways about how you think about people walking in the door and also the people that don’t walk in the door and aren’t getting the services.”
Field also responded to questions from participants, including around faith and sexuality from former Jehova’s Witness member Lara Kaput. See below for an interview with Kaput about the concerns and interest she brought to the event.
Watch also this interview below with Field (right), and her drummond street colleagues, Jemma Mead, General Manager of the Western Region, and Bexx Djentuh-Davis, who is a Senior Youth Development Practitioner, and a Ghanian/Maori (Tainui, Ngati Maniapoto) woman from Aotearoa/New Zealand.
Importance of a diverse workforce
Amuna Abdella from drummond street talked about the importance of a diverse workforce, including people with lived experience. She gave a recent example of how just seeing her outside the service one day recently had encouraged three woman to access health and other service supports that they may otherwise not have.
Abdella welcomes that most organisations speak in their mission statements about the importance of inclusion and being accessible, “but you need to do that in a very practical way”, she said.
There (may be) money for interpreters, it’s much better to have people from the same background (as clients) working for your organisation.”
Impact of racism on mental health
Josh Power from the Lowitja Institute, Australia’s National Institute for Aboriginal and Torres Strait Islander Health Research, showcased two pieces of Indigenous health research on mental health.
One was research into the mental health impacts for Victorian Aboriginal communities of experiencing racism, including in health settings. Nearly one-third of people in the study reported being a target of racist names, jokes or teasing, or hearing comments that relied on stereotypes of Aboriginal Australians when they were seeking health care.
Power also talked about the Healing the past by nurturing the future project, community-based participatory research for Aboriginal and Torres Strait Islander parents, which aims to break the cycle of intergenerational trauma.
Bearing witness on “religious harm”
Former Jehova’s Witness member Lara Kaput, who co-founded the Say Sorry campaign to highlight “religious harm” to sections of the community, was a very engaged participant at #CroakeyGO #NavigatingHealth. In this interview she talked about the mental health impacts of discrimination of LGBTIQ people by religious organisations and the impacts of institutional child sex abuse.
The Royal Commission into Institutional Child Sexual Abuse reported that 70 survivors had informed in private hearings about abuse in the Jehovah’s Witnesses and recommended major changes in the way that victims were able to report offences within the faith organisation.
See also another brief interview with Kaput about her role, and her experience of the #CroakeyGO.
Decolonisation and pathologisation
Claire Bostock and Ari Dunphy work in drummond street’s queerspace services, which provide a safe and supportive space for the health and well-being of LGBTIQ+ communities.
Asked what major change they would like to see in mental health, Bostock nominated decolonisation and filling in the gaps between ‘youth’ and ‘adult’ services that leave many people struggling through the transition. For Ari, it’s about greater autonomy and self determination for transgender people. They said:
For me, the pathologisation of trans people is a really big issue, as well the controlling nature that the mental health sector has around trans people’s ability to make decisions about their own body and presentation. I see a lot of people going through that process who require counselling to cope with what’s supposed to be a therapeutic process.”
Feeling “judged” by the mental health system
Another group of drummond street staff talked about their roles, including in the Redress programs for people who have experienced child sexual abuse in institutions and those affected by the process of the Royal Commission into Institutional Responses to Child Sexual Abuse.
Like so many others on the #CroakeyGO #NavigatingHealth trail, their work involves addressing significant backgrounds of trauma, and the need to be able to manage multiple support systems and needs, including housing and homelessness, identity issues, drug and alcohol support, and the NDIS. Stigma and harm from within the health sector is also an issue:
I feel a lot of mental health clinicians need a bit more understanding around complex PTSD….some don’t understand the impact on survivors of child institutional sex abuse. (Survivors) feel judged by the mental health system.”
Trialling ‘care navigators’ at GPs
The event also highlighted some of the innovative work being done by the North Western Melbourne Primary Health Network.
In this interview, Liezl Oliver introduced the Link-Me trial, being run with the University of Melbourne, which is exploring whether a specific role (care navigators) can help patients with severe complex mental health needs in care planning with their GP.
“No wrong doors”
At our final stop at Carlton Family Medical, GP Associate Prof Ralph Audehm talked to #CroakeyGO #NavigatingHealth participants about the many difficulties in accessing proper mental health care for many groups of his patients.
He highlighted issues for asylum seekers, international students, women and/or couples undergoing IVF, and barriers including professional silos, out of pocket costs and Medicare funding processes.
Audehm urged a “no wrong doors” approach, detailing many individual cases where his patients have been unable to get the support they need, or go through many doors to get there, causing stress for them and GPs trying to support them.
Social prescribing: non-medical pathways to health
In another interview highlighting new approaches being trialled by the NWMPHN, Sarah O’Leary, Director of Integrated Care at the PHN, talked about its emerging work in “social prescribing” which aims to set up networks and information for GPs to refer patients to a range of non-medical services offered by community-based organisations.
“Connect with reality on the ground … and walk!”
“Fantastic wonderful large turnout, really engaging, people and services right along the route.”
North Western Melbourne PHN CEO Professor Christopher Carter summed up #CroakeyGO #NavigatingHealth and how it will change his practice in this interview with Croakey’s Dr Melissa Sweet.
One of his takeaways from the event, and the insights gained from visiting the four key health services along the three hour route?
We don’t know what we don’t know.”
Takeaways from #CroakeyGO #NavigatingHealth
Finally, a group of #CroakeyGO #NavigatingHealth participants shared brief insights on their key messages from the day.
We thank them all, the North Western Melbourne Primary Health Network, and the services that opened their doors to us along the way, for their participation and for sharing their stories.