How can churches help establish restorative justice for mental health consumers?

From a talk by Allan Pinches,
Consumer Consultant in Mental Health,
Bachelor of Arts in Community Development (VU)

at a Commission for Mission forum at St Andrew’s Uniting Church on September 2, 2009 on Restorative Justice for people with mental health issues.

Hi, my name is Allan Pinches and I have been working as a Consumer Consultant in mental health services for about 14 years – in the interests of consumer participation and service improvement, planning and development of mental health services – and I have seen a lot of welcome change in that time.

I have first hand experience as a mental health service user, including clinical services and Psychiatric Disability Rehabilitation and Support Services (PDRSs) for several decades, have also served on two boards of management.

Since the deinstitutionalization of mental health services, which began in Victoria the late 1980s, and arising from the social change movements of the 1960s and 1970s, the so-called mental health consumer movement emerged.

The key principle of consumer participation is that consumers – that is, direct users of mental health and related services -- have an acknowledged right to have a say in the planning and development of those services, in the interests of service quality, to ensure services are a good “fit” with people’s expressed needs, and to safeguard consumers rights, to name a few key areas.

The consumer movement is in fact a very diverse range of groupings, broadly encompassing: selfidentified psychiatric survivors seeking radical changes or alternatives to psychiatry; consumer advocacy workers directly representing consumers making specific complaints about a service; systemic advocates working at policy and service system planning and development level; human rights-focused activists

who seek to hold services and government authorities to account on Australian or international human rights covenants; and Consumer Consultants working in local area services, often in quite modest projects towards changes in service models. Many sessional-paid casual Consumer Reps also make an indispensable but sometimes under-recognised contribution.

Consumer movement growing and developing

I have seen the consumer movement grow in size, scope and diversity, and this is exciting. The latest trend has been towards an expansion of roles and activities into consumer research, consumers as educators of mental health staff, internet based consumer education and clearing house services, consumer designed initiatives, peer support worker projects, and more.

As a member of this panel of speakers, I am glad to have the opportunity to talk about Mental Health and

Restorative Justice, to such a friendly and thoughtful audience. Church groups are often valuable supporters of consumers in their wish to be more fully involved in the life of the community and in seeking reform in the mental health system.

When the term Restorative Justice has been applied at today’s conference at St Andrews Uniting Church, Box Hill, in the gospel sense of “Jesus Christ restoring people into the fullness of life…” I believe this bears a strong resemblance to the “recovery paradigm” (or recovery-based systems of treatment and support) in mental health services, which is becoming more and more the best practice standard in the field.

The consumer movement has played a large role in bringing about these new recovery-based approaches, and this is acknowledged as one of its major achievements.

The progress of recovery-based approaches in mental health and related services can be attributed to the enormous efforts by many people who contributed to debates leading up to the deinstitutionalization process – where consumers were often strong advocates for change, with the support of many different groups across the community.

When we consider what has been achieved, it has been no less than a massive task of “turning around the ship” of mental health services – from a long and often terrible history of custodial treatment within institutions to a more enlightened system which includes more personalized recovery-based service delivery methods, mostly in the community. Much has been achieved, but there is more to be done.

These new recovery-based methods -- following the lead from campaigns of the consumer movement and their supporters in America and other places -- maintain that it is essential that the consumer’s needs and

wishes be incorporated into the planning and decision making for their treatment and support, and the relationship between a consumer and service key worker can often usefully be envisaged as a “shared journey.”

The more that the institutionalised walls are able to be dissolved away -- so that more people can be treated in the community while being included and participating in the life of the community in all sorts of ways -- the better the chances people have of moving forward in their recovery journey, and yes, becoming “…restored into the fullness of life.” While it may be that not all of the symptoms may go away, the quality of life and opportunities for healing and wholeness are increased greatly.

Spirituality often important to people with mental health issues

People with mental health issues often have a deep interest in matters of spirituality and religion, for a wide range of reasons. It seems true that spiritual matters and mental health are aspects of life which share some common places within each person’s being: namely those areas which relate to meaning and purpose…and questions about why is one here, whether there is a God, what does he expect of us, what should I to do with my life…how do I stand in relation to others…etc.

I believe from my experience and anecdotally from many others, that some people’s breakdowns or mental ill health can partly attributed to a particular sensitivity to the enormous problems of the modern world and often feeling overwhelmed or incensed about the injustices in society.

These include issues such as the growing gap between rich and poor; dominant materialistic values; work competition and life stress; apparent trends towards a “harder” and less community-minded social order; downward social pressures for some, limiting educational opportunities, creating poverty traps and unemployment; homelessness and housing stress; problems in relationships; outbreaks of senseless violence and burgeoning drug issues; governments and politicians seemingly unwilling or unable to go beyond populist policy formulations…and more. Many of these factors can make people sick…literally.

And regrettably, social stigma about mental illness, often stirred up by media misinformation and myths in popular culture and public opinion, tends to make it harder, or pose disincentives, for people with

mental health problems to access timely and appropriate mental health treatment, which could help them maintain their participation in the life of the community and maintain social and economic links. It is important that social inclusion be maintained to the utmost extent, for the sake of people’s mental health, practical coping and best chances for recovery.

People with mental health issues, I believe, often do have a lot of experience of society’s problems and difficulties -- which is precisely why I believe they should be carefully listened to as possible informants of social policy and reform. Mental health consumers often have good ideas for social change, and considerable wisdom and insight to offer. There is a need to go be able to listen beyond surface words, which may at first sound strange, and hear messages and meanings very possibly coming from a deep and reflective place.

I believe that one of the key take-home lessons from recovery-based approaches to mental health are that people are best assisted by engaging with them directly and equally as a people. It seems that one deepest fault-lines which contributed to many of the failings of the institution-based mental health system over a long period – also found in social stigma about mental illness – was the “us and them” mentality, which even if subconscious or unintended, effectively treated the patient/ mentally ill person as another, lesser, type of human being.

Holding the person and their problems at “arms length” is a virtual guarantee that treatment would not be effective and could be somewhat blind to the humanity and “wholeness” of the person. While such approaches are becoming less common in recent times, unfortunately, consumers say that occasional echoes linger on.

The person’s recovery journey often involves the re-kindling of their hopes and dreams. While talking about “dreams” sometimes sounds a bit “airy fairy” or sentimental to service provider staff, it seems to me that hope is the starting point – perhaps a kind of spark – for recovery, and it also strikes me that without the ability to dream, it is pretty hard to muster up the capacity to build hopes.

When the person has started to gather some hopes towards recovery, it is often useful to encourage them to start thinking about some things they might enjoy doing – perhaps following up on some interests they may have had earlier, or to explore some options for community participation, or assisted by a service worker, the consumer can develop some personally meaningful goals for action.

As a suggestion, I think it would be wonderful for many church groups and congregations to offer support and mutual friendship to one or two, or a small cluster of people with mental health problems, based on hope, recovery and the gospel notion of the justice of “being restored to the fullness of life…”

Thank you for your attention. I wish you well for the rest of the day.

Allan Pinches

Consumer Consultant for Mental Health
Bachelor of Arts in Community Development (VU)