'I am more than my diagnosis': Amplifying the voice of consumers in the design and delivery of mental health services.

OBJECTIVE: In line with the Australian Government's Vision 2030, this research foregrounds consumer experiences of recovery to inform the (co)design and delivery of mental health services for people living with complex needs and/or a severe and persistent mental health condition. SETTING: The research takes a specialist focus on the regional setting, with data collected from client experiences within Western NSW, Australia, in the context of the National Disability Insurance Scheme (NDIS) implementation and inclusion of psycho-social disability within the NDIS service environment. PARTICIPANTS: Thirty-seven people aged 19-70 years living with complex needs and/or a diagnosis of a severe and persistent mental health condition were recruited from services where they had a care plan or where they were members of a consumer reference group for recovery-oriented services. DESIGN: A tripartite framework integrating recovery oriented, trauma-informed and collective impact approaches for a qualitative, arts-based (photovoice) study. RESULTS: In areas of the mental health service system that had not yet applied a personalised understanding of recovery or embraced trauma-informed practice there were a range of issues and gaps in service delivery relating to authentic relationships, belonging and connection, service cultures, trauma-informed care, and workforce investment. CONCLUSION: Clinical and non-clinical services need to ensure consistent person-centred and trauma-informed practice is implemented throughout the mental health service system to meet the needs of the consumer. An eight-point checklist serves as the basis for services to reflect on how they are working with consumers and to support the review of systems and clinical governance frameworks.

Forming relationships through group art-making: An exploration with neurodivergent people living in regional Australia.

ISSUES ADDRESSED: Neurodivergent people have a strong history of raw creative expression in the arts, however they also have a history of being segregated from society. This segregation has obstructed pathways to building the connections that maintain both mental and physical health. This research sought to illuminate how group art-making impacts relationship formation with neurodivergent people in regional Australia. METHOD: The study included nine participants with intellectual disability and one with an acquired brain injury who regularly attend art-making workshops, along with eight of their chosen arts advocates. A single iterative case-study design was employed using participatory action research (PAR) methodology. Methods included: three participant think aloud (T/A) groups, nine researcher observations, and nine third-party interviews. The data were thematically analysed then triangulated using three different sources. RESULTS: Making art in a group can form enriched relationships with (a) the artwork; (b) the self; (c) others; and (d) community. Facilitation supported how these relationships formed. The relationships increased agency, belonging and wellbeing. CONCLUSION: These connections mitigate the numerous effects of marginalisation. Art-making has the capacity to enrich the health and wellbeing of neurodivergent populations. SO WHAT?: Art-making groups can provide a space that interrupts the isolation and social exclusion experienced by neurodivergent people. Art workshops offer both an emancipatory space to create where sense of self and relationships with others are enhanced, and an opportunity to reach beyond the studio to connect with communities. These rich connections contribute to better health outcomes for neurodivergent people, thus enhance the wellbeing of their communities.

"Living the life I want": A framework for planning engagement with people with intellectual disability and complex support needs.

BACKGROUND: Self-determination involves autonomy, agency, choice and control. This study investigated how these aspects of self-determination relate to engaging people with intellectual disability and complex support needs in setting goals and making plans. METHOD: Body mapping was used to understand the planning experiences of 30 adults with intellectual disability and complex support needs. Each participant created two body maps using a guided group-based process. Visual and text data were thematically analysed and a framework for planning engagement developed. RESULTS: The framework identifies the centrality of having a well-developed sense of self which includes insight, motivation and agency, and which is shaped by contextual barriers and facilitators and influenced by helpful and unhelpful support. CONCLUSIONS: A well-developed sense of self and ability to harness resources and people is fundamental to the ability of individuals with intellectual disability and complex support needs articulating goals, identifying aspirations, and attaining valued outcomes.