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Final Consultation Paper Draft Framework for the NSW Mental Health Consumer Workforce -2-

The NSW Consumer Advisory Group – Mental Health Inc. (NSW CAG) is the

peak, independent, statewide organisation representing the views of mental

health consumers at a policy level, working to support and achieve systemic

change. NSW CAG’s vision is for all mental health consumers to be able to

participate meaningfully in society and to experience fair access to quality and

recovery services which reflect their needs.

The Consumer Workers’ Forum (CWF) Organising Committee is made up

of the experience and expertise of consumer workers. The CWF

Organising Committee operates to ensure the efficient, effective and

transparent management of the Annual Consumer Workers’ Forum. Part

of the work of the CWF Organising Committee is to ensure that they work

in consultation with consumer workers, developing best practice for

consumer workers in NSW.

Referencing this document

This document has been developed over two years of research and

consultation with all relevant stakeholders and in particular with consumer

workers. Due to the importance of input from local and relevant

stakeholders in the development of this Framework, NSW CAG strongly

recommends that other jurisdictions duplicate similar consultation process

to develop a Framework owned and relevant to their jurisdiction rather

than duplicate this document. If you would like to reference this document

do so in the following way: The Final Consultation Paper Draft Framework

for the NSW Health Consumer Workforce (NSW Consumer Advisory

Group – Mental Health Inc. 2011)

Written by Karen Oakley, Executive and Policy Advisor (2011)

The NSW Consumer Advisory Group – Mental Health Inc. Suite 501 80 William Street East Sydney, NSW 2011 Telephone: (02) 9332 0200 Fax: (02) 9332 0299 Email: [email protected]

NSW CAG & NSW CWF funded by NSW Department of Health


Contents

Introduction ......................................................................................................... 4

The Framework for the NSW Mental Health Consumer Workforce ................ 6

The Job ............................................................................................................. 9

a. The Roles within the Consumer Workforce and their Situation within the Mental Health System in NSW ..................................................................... 10

b. Position Descriptions Incorporating Position Titles, Role Purpose, Responsibilities, Minimum Training and Experience .................................... 19

c. Remuneration .......................................................................................... 22

Support and Development ............................................................................... 23

a. Line Management .................................................................................... 25

b. Professional Supervision and Mentoring .................................................. 28

c. Professional Development and Best Practice Training ............................ 28

d. Workplace Accommodations ................................................................... 38

The System ..................................................................................................... 40

a. Establishing Champions .......................................................................... 41

b. Training and Education of All Staff about the Consumer Workforce ........ 41

c. Policies, Procedures and Systems ........................................................... 43

The Profession ................................................................................................ 46

a. Code of Professional Standards .............................................................. 47

b. Evaluation of the Workforce ..................................................................... 48

Recommendations and Future Directions ...................................................... 48

References......................................................................................................... 51

Appendices ........................................................................................................ 53


Introduction

This paper presents the draft Framework for the NSW Mental Health Consumer

Workforce for public mental health services for final consultation. The draft

Framework is based on consultations conducted between 2009 and 2011 with

consumer workers, Area Health Executive, NSW Health, service staff and

consumers throughout NSW. The finalised Framework, resulting from the final

consultation round with this paper will be presented to NSW Health in a final

report, which will also include the background to the project and, the project’s

method.

The final consultation process will involve the following consultations throughout

November and December 2011:

- Consumer workers throughout NSW at the Consumer Workers’ Annual

Forum on 18th November 2011

- Consumer Workers not at Forum via email

- Consumer Sub-Committee to the Mental Health Program Council via email

and meeting

- Consumers in NSW via consumer workers, NSW CAG’s Network NSW,

NSW CAG’s consultations

- Area Executive via emails

- LHD Executive via emails

- NSW Health via meetings

Feedback from this consultation process will be collated and incorporated as best

as possible to reflect the overall views of key stakeholders. Where there are

discrepancies in views, this will be noted in the report. The final report will then

be presented to the Consumer Workers’ Forum Organising Committee and the

Consumer Sub Committee for their support and recommendations, and finally

submitted to NSW Health by 31st March 2011.


Feedback on the draft Framework can be provided via the following mechanisms:

1. Consultation questions and comments can be completed online at:

https://www.surveymonkey.com/s/THE_JOB

https://www.surveymonkey.com/s/SUPPORT_AND_DEVELOPME

NT

https://www.surveymonkey.com/s/THE_SYSTEM

https://www.surveymonkey.com/s/THE_PROFESSION

https://www.surveymonkey.com/s/THE_WHOLE_FRAMEWORK

2. Notes and comments can be

a. Emailed to: [email protected]

b. Faxed to: C/-Consumer Worker Draft Framework (02) 9332 0299

c. Mailed to: C/- Consumer Worker Draft Framework, NSW Consumer

Advisory Group – Mental Health Inc. Suite 501, 80 William St East

Sydney NSW 2011

3. Consultation questions and comments can be answered on a Word

version of the consultation questions available via NSW CAG’s website

and returned as above

4. Notes and comments can be made on a printed version of this

consultation paper and returned as above

Feedback on this consultation paper is due by close of business Friday 20th

January 2012.


The Framework for the NSW Mental Health Consumer Workforce

Mental health consumer workers are people with the lived experience of mental

illness, employed in specific designated roles by mental health services to use

the skills and knowledge acquired from the personal experience of mental illness

and using mental health services, as part of the mental health service team.

The Framework for the NSW Mental Health Consumer Workforce, “the

Framework”, is designed to guide workforce development for consumer workers

within public mental health services in NSW, through providing a consistent,

statewide approach and promoting the professionalism of the consumer

workforce, and its standing as a legitimate and defined workforce. To do this, the

Framework has four components:

1. The Job

2. Support and Development

3. The System

4. The Profession

Each of these components articulates the critical aspects which are required to

ensure a clearly defined and sustainable workforce. The Framework depicted in

Figure 1 on page 8. Each of the components is individually presented within this

paper. The Framework addresses workforce development as requiring capacity

building and strategies at the levels of the individual worker, the mental health

system or organisational level and at the professional level.

The Framework presents the consumer workforce as an integral component of

the NSW public mental health system, at all levels of the system. While one aim

of the Framework is to bring a consistent, statewide approach to the consumer

workforce in NSW, the Framework is also designed to be flexible to specific local

needs.


While the Framework is designed specifically for the consumer workforce in

public mental health services in NSW, it can be adapted for use in private and

non-government or community managed sectors and other jurisdictions both

within Australia and internationally.

The Framework will necessarily require changes to the current consumer

workforce structure and functioning within NSW. As has been identified through

the literature review into the consumer workforce and in consultations throughout

stages 1 and 2 of the CWF project, consumer workers, Area Health Executive,

service staff, NSW Health and researchers all concur that change is required to

progress the workforce and to ensure that it is a meaningful component of the

mental health system and service structure. An implementation plan for this

framework will be drafted and presented to NSW Health concurrently with the

final project report. Consultations on the implementation plan will occur in the

early part of 2012.

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The first component of the Framework is “The Job”. As shown in Figure 2 on

page 9, this examines the roles and positions of the consumer workforce and

their placement within the mental health system. This component is critical for

building a shared understanding throughout the different workforces within the

mental health system, and throughout the state, of the role and purpose of the

consumer workforce, and each of the positions within this workforce. It is also

necessary for ensuring a consistent approach to recruitment to positions, that

people employed within roles have the skills and knowledge to perform their role,

and equitability in terms of remuneration, both within the consumer workforce,

and in relation to the rest of the mental health workforce.

a. The Roles within the Consumer Workforce and their Situation within the Mental Health System in NSW

Critical to understanding the roles of the consumer workforce is understanding its

purpose. Essentially, the purpose of the consumer workforce is to use the skills

and knowledge acquired from the personal experience of mental illness and

using mental health services to:

Inform service development and delivery, including related policy

development and implementation;

Provide a role model, and support from the shared experience of mental

illness and using services for consumers;

Promote consumer participation at all levels of the service from

involvement in individual treatment to involvement in the policy direction

of services and at local health district (LHD) and state levels; and

Support consumers to navigate the mental health system, including

ensuring that their rights are upheld.

This results in three critical functions of the consumer workforce:

Individual advocacy

Systemic advocacy or representation

Peer support

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Table 1. The functions of the consumer workforce and recommended position titles.

Function Recommended Title

Coordination and Management

Consumer Worker Manager (at LHD level)

Consumer Worker Coordinator (at service level)

Individual Advocacy Individual Consumer Advocate or Individual Consumer Advisor

Systemic Advocacy and Representation

Consumer Representative

Peer Support Peer Support Worker

The location of positions within the system

To coordinate the consumer workforce across the LHD, a Consumer Worker

Manager is required at LHD level. As a result of the responsibilities of this role it

is recommended that this position sits alongside other senior executive for mental

health within the LHD, reporting directly to the LHD Director for Mental Health or

equivalent. This will enable the strategic progression and coordination of the

consumer workforce within the LHD, as well as representation of consumers at

strategic levels.

A Consumer Worker Coordinator at service level is recommended where there

are a number of consumer workers operating at a service. The ideal situation is

for a Consumer Worker Coordinator at all services, however it is recognised that

this is not practical. An option is for one Consumer Worker Coordinator to

oversee consumers employed at a number of services. This role is responsible

for coordinating the activities of the consumer workers at the service level, and

providing direct line management for these consumer workers. The Consumer

Worker Coordinator would need to report both to the team leader, Nursing Unit

Manager (NUM), or director of the service about operational and day to day

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matters, as well as the Consumer Worker Manager – LHD. This position needs to

be situated alongside other management positions within the service, reporting

directly to the team leader/NUM/service director consistent with other managers.

Where no Consumer Worker Coordinator is employed at the local service level,

the consumer workers employed at the local service will need to report both to

the team leader or Nursing Unit Manager (NUM) or director of services or other

designated person of the service about day to day matters, and to the Consumer

Worker Manager – LHD for aspects related to the strategic direction of the

consumer workforce activities, and for performance support, development and

personnel matters. This dual line management system is recommended as a

result of the expression that consumer workers should be directly managed by

another consumer worker, and the practical requirements of direct management.

A strong relationship will need to be maintained between the Consumer Worker

Manager – LHD and designated person at the service to ensure the agreed work

and activities of the consumer worker, to ensure that they are consistent with the

strategic directions of the consumer workforce for the LHD, and within the roles

and responsibilities of the consumer worker, and to jointly ensure the

performance of the consumer worker. This is discussed in greater depth in the

sectiona. Line Management under Support and Development on page 25.

The three other consumer worker positions, Individual Consumer

Advocate/Advisor, Consumer Representative and Peer Support Worker, operate

predominantly at a local service level. However, Consumer Representatives may

also be required to undertake some representational roles at LHD level, such as

sitting on LHD committees, as negotiated by the Consumer Worker Manager –

LHD and Consumer Worker Coordinator – Mental Health Service/s or designated

operational manager of the consumer workers at local service level. Consumer

workers in these positions may be engaged to undertake the role across more

than one service, with clarity provided around the number of hours they are to

spend with each service, and their line management arrangements.

Figure 4 on page 15 depicts the structure of the consumer workforce in NSW.

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It has been noted that structuring the consumer workforce in this way provides a career pathway for consumer workers. Number of positions required for each role Recommendations are presented about the number of positions required for

each role in Table 2 on page 17. While the recommendation is for a minimum of

one Peer Support Worker available to each service, it is further recommended

that expansion of the Peer Support Worker positions within mental health

services be a priority. This recommendation is based on the views expressed

during consultation.

Determining number of hours for each position In determining the number of hours for each position the following need to be

taken in to consideration:

Time for:

Performing all aspects of the role

Undertaking administrative requirements such as reporting and

responding to emails

Preparation time, for example preparation of group activities,

planning for events and coordinating them, reading for a meeting

Team meetings

Meetings with the line manager

Mentoring and professional supervision (recommendation of

minimum of monthly – see b. Professional Supervision and

Mentoring, page 28)

Professional development activities

Travel between services, and to and from any meetings

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Noting the above, and also taking into account requirements for eligibility for the

Disability Support Pension, it is recommended that the minimum number of hours

for each position, and for each consumer worker employed is 14 hours per week.

Some positions, as noted in Table 2 may be undertaken in a casual employment

capacity or as a volunteer. In such circumstances, the minimum of 14 hours per

week does not apply, however the positions may be adapted so that they can be

successfully undertaken. The number of hours for casual and volunteer positions

must still be sufficient for all responsibilities of the position to be undertaken with

the provision of supervision and support, and for casual roles, also professional

development, incorporated.

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Table 2. Recommendations about the roles of the consumer workforce in terms of location within the system and recommended minimum numbers Role Location within system Recommendation re

minimum numbers Other comments

Consumer Worker Manager – LHD

LHD mental health, senior management/executive Associated with consumer, carer and consumer participation initiatives

1 full time per LHD May also undertake role of coordination of consumer participation initiatives and policies

Consumer Worker Coordinator – Mental Health Service/s

Individual mental health service Role may coordinate across more than one mental health service

1 part time or full time - where more than 2 consumer workers at a community or inpatient service

Services may join to share one Consumer Coordinator

Individual Consumer Advocate/Advisor

Individual mental health service

1 part time or full time per inpatient and community service Position may be casual, permanent part time, or temporary part time

Number of hours to be determined based on size of consumer population using service; large community services and hospitals with several units may require more than one person; for smaller services an individual worker may cover more than one unit or service Considerations need to be given to demographics of people using service to ensure that Consumer Advocate meets cultural and age needs

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Consumer Representative Individual mental health service; may also provide some representation at LHD level

1 part time or full time per inpatient and community service Position may be casual, permanent part time, temporary part time, or volunteer

Number of hours to be determined based on size of consumer population using service; large community services and hospitals with several units may require more than one person; for smaller services an individual worker may cover more than one unit

Peer Support Worker Individual mental health service

1 part time or full time per inpatient and community service Position may be casual, permanent part time, temporary part time, or volunteer

Number of hours to be determined based on size of consumer population using service; large community services and hospitals with several units may require more than one person; for smaller services an individual worker may cover more than one unit Considerations need to be given to demographics of people using service to ensure that Peer Support Worker meets cultural and age needs

THE JOB


b. Position Descriptions Incorporating Position Titles, Role Purpose, Responsibilities, Minimum Training and Experience

Clear position descriptions, outlining the purpose of each role, responsibilities

and the knowledge, skills and experience required to perform the role are critical

to overcome the role confusion experienced by many consumer workers and

other mental health staff. Template position descriptions for each of the identified

roles are provided in Appendices A to E.

Merging functions into one position

Each of the four different functions and their related positions require different

skill sets. For this reason, and to assist with enhancing clarity about the roles and

responsibilities of each consumer worker, it is recommended that the roles

remain as individual positions. However, the position of Consumer Worker

Coordinator – Mental Health Service/s may also undertake some of the functions

of individual advocacy, representation and systemic advocacy and peer support.

This should be reflected in their position description, and in the selection criteria

for the position.

Further, it is noted that some consumer workers may hold multiple skill sets and

therefore the service may wish to create a position which combines some of the

functions into one position. In creating a merged position from the consumer

worker functions, there is a risk that service staff will view the position as

multifunctional and thus continue one of the current challenges of lack of clarity

about the role of consumer workers. This may result in unreasonable

expectations of the worker, which may result in increased workloads, additional

duties being required of the consumer worker, and the potential for the worker to

be unclear as to their role (Dixon, 1994). To overcome this, it is critical that

minimum expectations for aspects of all positions to be undertaken, incorporating

the responsibilities and tasks included, are clearly defined within a position

description, and that this is clearly articulated to all staff responsible for the

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management of the position. To achieve this, the template position descriptions

presented in the appendices will require updating.

When functions are merged into one position, it is critical that the number of

hours allocated to that position per week is sufficient to enable the fulfilment of all

aspects of the position.

Further, while some have suggested that the title “Consumer Consultant” be

applied to combined positions, it is recommended that less ambiguous titles be

applied to clearly articulate the role the worker is to undertake. Table 3 presents

recommended titles for positions where functions are merged.

Table 3. Recommended titles for positions where functions are merged

Functions to be merged Recommended title Individual advocacy and peer support

Individual Consumer Advocate/Advisor and Peer Support Worker

Individual advocacy and systemic advocacy/representation

Individual Consumer Advocate/Advisor and Consumer Representative

Systemic advocacy/representation and peer support

Consumer Representative and Peer Support Worker

Individual advocacy, systemic advocacy/representation and peer support

Individual and Systems Consumer Advocate/Advisor and Peer Support Worker

Minimum Training and Experience As with all roles in any workforce, it is critical to ensure that the person employed

to undertake the role has the skills, knowledge and capabilities to undertake all

components of the role. This must be first and foremost in creating and merging

roles, and in the recruitment process. The template position descriptions in the

appendices outline the key skills and experience that is required for each

position.

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However, it is also noted that requiring people to have the outlined skills and

experience to be eligible to apply for the role may limit the opportunities for

consumers to take up consumer worker roles, as well as limit the recruitment

pool for services. Therefore, the service may choose to recruit people who do not

have the experience or training but who are willing to obtain these. In so doing,

the service needs to take responsibility for providing the required training and

experience. The following caveats are therefore recommended for adoption:

1. Where the service employs someone without the experience or training

required the service is responsible for providing this training, via formal

courses and on the job coaching and mentoring, and opportunities to

practice this skill within the first 3-6 months of the person being in the

role. The service includes that in the probationary review period

demonstration of the satisfactory acquisition of the knowledge and skill

is required to remain in the role.

2. Where someone is employed without experience, they may be required

to work alongside another worker in some areas until they are

considered to have sufficiently displayed the ability to competently

perform the role. This is particularly relevant for areas of work which

require a greater level of skill such as supporting a consumer in

attending a Tribunal hearing.

3. Where the service employs someone without the experience or training

required, they may be engaged at a lower level of pay than someone

with the experience and training, and progress in pay levels with the

demonstration of skill, and with the acquisition of experience.

Discussion about the role of Consumer Worker Manager – LHD

It has been noted that the role of Consumer Worker Manager – LHD is critical to

furthering the consumer workforce and consumer participation at LHD level, and

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that ideally this person needs to be a consumer. However some have raised that

it may be difficult to find a person who has the required skills and training to

undertake a such a strategic management role who is also prepared to disclose

that they are a mental health consumer. In such cases, it is recommended that:

1. Attempts have been made to find a person who has the skills and

experiences to undertake the role and is prepared to disclose that they

are a mental health consumer

2. Where a consumer with the appropriate skills and knowledge is not

found:

a. A person who is not a consumer who has the skills and knowledge

and is committed to consumer participation and the consumer

workforce may be recruited to the role; and

b. A person who is prepared to disclose that they are a mental health

consumer and who has the ability to be trained up to the role is

recruited in a traineeship type position.

c. Remuneration

During the consultation process, consumer workers expressed an interest in

developing a specific Consumer Worker Award to cover the conditions of

employment and remuneration for the consumer workforce. However, to make

this feasible, there would need to be considerable growth in the size of the

consumer workforce.

Given the current size of the consumer workforce and the awards available, it is

recommended that the Health Education Officers (HEO) (State) Award be applied

to consumer workers undertaking the roles of Individual Consumer

Advocate/Advisor, Consumer Representative and Peer Support Worker. As

stipulated under the HEO Award, where a consumer worker holds a tertiary

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qualification they should be remunerated under the Graduate level of the Award.

It is further recommended that consumer workers be supported to obtain the

qualifications required to progress to the Graduate level of the Award.

It is recommended that consumer workers performing the roles of Consumer

Worker Manager – LHD and Consumer Worker Coordinator - Mental Health

Service/s should be remunerated under the Health Managers (State) Award.

These awards outline the starting rates of pay for employees, and determinations

about annual pay increases. They further outline the conditions of employment.

Table 4. Recommended Industrial Award for each consumer worker role Role Recommended Award

Consumer Worker Manager – LHD

Health Managers Award


Health Managers Award


Health Education Officers (HEO) Award (Graduate level where qualifications held)

Consumer Representative Health Education Officers (HEO) Award (Graduate level where qualifications held)

Peer Support Worker Health Education Officers (HEO) Award (Graduate level where qualifications held)

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The second component of the Framework is “Support and development”. As

shown in Figure 5 on page 24, this considers four aspects required to adequately

support the consumer workforce and ensure the ongoing development of the

individuals employed within it: line management, professional supervision and

mentoring, professional development and best practice training, and workplace

accommodations. Each of these elements is critical for all staff, and all

workforces. However, by explicitly seeking people with a mental illness in

designated roles, there is an additional responsibility to ensure, within the

workplace, the individual’s wellbeing and safety in relation to their mental illness.

Detailed below are the recommendations specific to supporting the consumer

workforce.

a. Line Management

As with all positions, it is essential that each consumer worker is clear about who

their direct line manager is. The line manager is responsible for allocating

workloads and responsibilities, performance management, ensuring adherence

to codes of conduct and professional standards and other policies and

procedures, addressing staff training and development needs, dealing with

administrative matters including leave requests and accrued leave entitlements,

monitoring of health and safety within the workplace, and dealing with operational

issues and questions related to the role.

Recommendations have been made about the undertaking of line management

in the sections a. The Roles within the Consumer Workforce and their Situation

within the Mental Health System in NSW and b. Position Descriptions

Incorporating Position Titles, Role Purpose, Responsibilities, Minimum Training

and Experience above under the Framework component of The Job. Specifically,

it is recommended that the line management arrangements outlined in Table 5

are in place.

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Table 5. Recommended line management arrangements

Position Line Management Recommendation Consumer Worker Manager – LHD

LHD Director for Mental Health or other Executive position


1. Day to day operational matters – Director of services or NUM or Team Leader or other delegated position at the service

2. Strategic direction and personnel matters – Consumer Worker Manager - LHD

Individual Consumer Advocate/Advisor, Consumer Representative and Peer Support Worker

Consumer Worker Coordinator – Mental Health Service/s. Where there is no such position at a service: 1. Day to day operational matters –

Director of services or NUM or Team Leader or other delegated position at the service

2. Strategic direction and personnel matters – Consumer Worker Manager - LHD

For positions which have two line management reporting arrangements in place,

clear guidelines and protocols need to be put in place to clarify responsibilities. It

is recommended that the Consumer Worker Manager – LHD and the local

service position to whom the consumer workers will report on a daily basis clarify

the arrangements, build a strong working relationship and have regular, at least

monthly contact. They should further agree on the responsibilities and activities

of each of the consumer worker positions and the workloads to be assigned.

Recruitment to consumer worker positions should be done jointly as should

induction and orientation, and annual performance appraisals. The Consumer

Worker Manager – LHD should be informed about any performance or

behavioural issues and involved in any processes relating to these, and informed

of any unplanned leave of the consumer worker.

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It is recommended that the Consumer Worker Manager – LHD has responsibility

for:

Ensuring that the consumer workers are working in line with the strategic

direction of the consumer workforce for the LHD

Personnel matters including rates of pay, requests for leave (to also be

negotiated with the line manager at the local service)

Arranging support and professional development activities

Ensuring that the consumer workers are working in line with codes of

conduct, professional standards and other policies and procedures

Providing regular, at least monthly meetings with all consumer workers at

the service and other networking opportunities across the LHD. Where

there is only one consumer worker at the service, more regular meetings

may be required one on one to ensure support is provided

Broad level occupational health and safety (OH&S) matters, including

arrangements of workplace adjustments and planning in the event of

illness

Issues related to the workplace and the role

It is recommended that the local line manager has responsibility for:

Allocation of workloads (after discussion with the Consumer Worker

Manager – LHD), and overseeing their completion

Day to day OH&S matters

Approval of timesheets

Ensuring resources are available to undertake the role

Provision of advice regarding immediate concerns and problems

A report on activities for the month should be provided by the consumer worker to

both managers, but this should be the same report to avoid duplication of work.

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b. Professional Supervision and Mentoring

In addition to line management, the importance of professional supervision is

widely recognised as part of good practice in ensuring an efficient, effective and

consistent delivery of services, and as a mechanism to support workers (Milne,

2007; NSW Department of Health, 2006b; WA Country Health Services and

Combined Universities Centre for Rural Health, 2009; Wagner, Keane, McLeod,

& Bishop, 2008). Such professional supervision is part of regular practice for

many professionals and workers within the health and mental health field (Fone,

2006; Kirk, Eaton, & Auty, 2000; Mills, Francis, & Bonner, 2005; Milne, 2007;

NSW Department of Health, 2006b; Wagner, et al., 2008). Throughout the CWF

project, the need for regular, formalised professional supervision for consumer

workers has been identified.

The following outlines the purpose and structure of such supervision as well as

the requirements of supervisors. As there is little research and guidelines which

relate specifically to the provision of professional supervision to consumer

workers, it is recommended that future work be undertaken to develop these

guidelines and a training package for consumer worker supervisors.

1. Purpose of supervision

The purpose of supervision for consumer workers is to provide a formalised

structure to:

Reflect upon and review current working practices

Examine and explore strategies in working with particular consumers

or situations, where this can be undertaken in a confidential context

Debrief on any work-related issue

Explore new practices related to consumer workers, including new

ideas and perspectives

Monitor and support the consumer worker’s wellbeing and coping

capacity in relation to their work

Problem solve

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Explore career development opportunities

(Mills, et al., 2005; Milne, 2007; NSW Department of Health, 2006b;

WA Country Health Service and Combined Universities Centre for

Rural Health, 2009)

Group supervision provides the additional purposes of:

Providing opportunities for consumer workers to come together as a group

to explore work practices and share new developments and ideas

Creating a shared vision for the consumer workers in a region and a

cohesive workforce

Providing peer support for consumer workers

(NSW Department of Health, 2006b; WA Country Health Service

and Combined Universities Centre for Rural Health, 2009)

2. Structure of supervision and minimum requirements Supervision can be provided to individual consumer workers and to groups of

consumer workers. It is recommended that all consumer workers receive

professional supervision on a monthly basis, and that individual supervision be

provided on at least a quarterly basis.

Consumer workers should also be able to have access to supervision when

needed and to organise additional supervisions ad hoc depending on their

workloads and any stressors they may be experiencing during their employment.

While it is preferable that supervision is provided face to face, the geographic

realities of NSW may not make this a possibility in all instances. The use of tele-

supervision may be required. Specific training of supervisors would be required to

ensure that this is used effectively and that an effective relationship between the

consumer worker and supervisor is still achieved.

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3. Supervisors Supervision is a highly skilled practice, and thus should be performed by

someone with the relevant training and experience. While the majority of

professions consider that supervision should be provided by a senior member of

a profession (eg. Fone, 2006; Kirk, et al., 2000; Milne, 2007), during

consultations consumer workers have identified the need for flexibility in selecting

a supervisor, so that it may be a consumer worker who has greater experience,

skills or knowledge as well as training and experience in providing supervision, or

another mental health professional. Some consumer workers expressed that they

would prefer their professional supervisor to be someone external to their place

of work, while others have indicated that they would prefer someone within the

same service. This indicates the importance of consumer workers being involved

in selecting who will provide their professional supervision. This is further

emphasised by the need for the consumer worker and supervisor to establish a

purposeful relationship where trust is critical (WA Country Health Service and

Combined Universities Centre for Rural Health, 2009).

Therefore the following should be applied in the appointment of a professional

supervisor:

a) Agreement in collaboration with the consumer worker

b) The supervisor has the following experience and training:

i. Experience and training in the provision of professional supervision

ii. Either experience as a consumer worker or a sound knowledge of

the purpose, roles, responsibilities and requirements of consumer

workers and experience in working in the mental health system

c) The development of a contract between the service and the supervisor

outlining what is expected of supervisors

d) The development of a supervision agreement between each consumer

worker and supervisor which includes periods at which review will be

undertaken, the regularity of meetings, priorities for supervision and such

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Different supervisors may be appointed for individual and group supervision as

required.

In addition to formal supervision, informal supervision via mechanisms such as

mentoring are also regularly utilised as mechanisms to provide support to

workers, and a means of up-skilling (Fone, 2006; Kirk, et al., 2000; Mills, et al.,

2005). Mentoring is different from supervision in that it is about the provision of

advice, support and guidance in an non-judgemental and non-evaluative way,

whereas formal supervision may have aspects of evaluation and determining

correct from incorrect practice (Fone, 2006). Mentoring is a further useful

component that should be built into the consumer worker’s support structures,

particularly at the beginning of their employment, and when seeking to build their

skill set or taking on new duties or responsibilities. Again, the consumer worker

should be involved in determining who provides this mentoring in collaboration

with their line manager and the Consumer Worker Manager. Additionally,

consumer workers should be able to avail the services of the Employment

Assistance Programs (EAP) offered by services.

c. Professional Development and Best Practice Training

i. Professional Development Professional development encompasses a range of activities which include:

Networking with other consumer workers at meetings, conferences,

workshops, training and other fora

Formal training

Informal training including mentoring, coaching, on the job training, online

tutorials and courses

Conference attendance

Induction and orientation processes

Supervision (which has been explored above)

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Professional development occurs at the individual level and the group or

workforce level. Recommendations for this development at both levels are made

below.

Individual consumer worker professional development

All consumer workers should have access to professional development to

ensure the opportunity for the enhancement of skills and knowledge, to

improve work performance and to access avenues for career

advancement. These opportunities should be the same as for all other staff

within the service. It is recommended that a budget be allocated for the

provision of professional development for consumer workers at a local

level.

Each consumer worker should have a professional development plan which is

developed upon commencement, reviewed at least quarterly and refreshed as

required and at minimum on an annual basis with the annual performance

review. This plan should be specific to the individual’s needs and their current

position, as well as take into consideration career aspirations. The way in which

professional development needs are addressed, for example through formal

qualifications, informal training and such, should be determined by the

professional development need and the individual’s learning style and

preferences.

During consultations, a range of training areas were highlighted as critical during

the induction and orientation period for all consumer workers. These are detailed

in Box 1.

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The development of the consumer workforce

To enable the consumer workforce to work more cohesively, and for individual

consumer workers to feel part of an integrated team, it is essential that

networking opportunities be provided at local, LHD and state levels. At local

levels, this is the responsibility of Consumer Coordinators and line managers,

and where there is no Consumer Worker Coordinator, and at LHD levels, this is

the responsibility of the Consumer Worker Manager. It is recommended that, at a

minimum, consumer workers within an LHD have the opportunity to come

together on a quarterly basis. However, where there are consumer workers who

are working alone, a more regular basis is recommended.

To coordinate networking at a state level, as well as to progress the ongoing

statewide professional development of the consumer workforce, and a cohesive

approach and vision for the consumer workforce throughout the state, it is

recommended that a State Consumer Workforce Coordinator be appointed. This

role would ideally be fulfilled by a consumer who had previously worked as a

consumer worker, however may also be undertaken by a person with a

comprehensive understanding of the consumer workforce as well as workforce

development. This role may be placed either within NSW Health or NSW CAG,

and would essentially connect to key strategic and policy setting areas at a state

level including Program Council, Clinical Advisory Council, Workforce

Development committees, the Chronic and Continuing Care, Recovery and

Rehabilitation Working Group, and other program and project initiatives that

critically involve the consumer workforce and consumer participation initiatives.

The relationship of the State Consumer Workforce Coordinator to consumer

workers is depicted in Figure 6 on page 35.

As part of their responsibilities for ensuring statewide development and

networking opportunities, it is recommended that the State Consumer Workforce

Coordinator organises, in collaboration with the Consumer Managers of each

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LHD the annual Consumer Workers’ Forum. It is further recommended that they

arrange for annual or, depending on need, biannual state inductions for

consumer workers which consider the following areas:

The role of the consumer worker

The mental health system in NSW

Key state policies

NSW Mental Health Plan

National Mental Health Plan

NSW Mental Health Legislation and how this applies to the

consumer workforce

Rights and responsibilities across the state for consumers

National Mental Health Standards

The State Consumer Workforce Coordinator also has a role in developing policy

and procedure at a state level related to the consumer workforce, providing

support to LHDs in building the capacity of services and staff to work effectively

with consumer workers, arranging regular meetings of the Consumer Managers

of each LHD to ensure a consistent vision for the consumer workforce, and other

such developmental activities.

ii. Best practice training

As with all staff, it is essential that training is tailored to the needs of the

workforce and individual. There are a range of mechanisms by which training can

be delivered including:

Formal qualifications

Formal short courses

Informal short courses

Group training or classroom settings

Individual, one on one training

Workshops

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Verbal delivery of information

Workbooks and other written material

Online training such as online tutorials, webinars etc

Critically, all training should apply the principles of adult learning (eg. Merriam,

Caffarella, & Baumgartner, 2006), ensuring that the training is goal oriented,

relevant, practical, recognising the individual’s experience and knowledge and

respectful (Lieb, 1991). The training should be appropriate to the individual’s

learning style and preferences.

It is also imperative that all training, including mandatory or mainstream training

provided to all health staff is relevant for consumer workers. This includes

ensuring that:

The level of training is appropriate for consumer workers, taking into

account their role, skill level and prior experience, and

The type of training is appropriate and focussed on topics that are

relevant to the role of consumer workers.

During consultations, it was discussed that the training developed for consumer

workers should also incorporate the consumer worker perspective. This includes

addressing how the training is relevant for consumer workers, how consumer

workers will benefit from the training and education provided, and how consumer

workers can implement the training and education they are involved in within the

mental health service environment, relevant to their roles and responsibilities.

Consumer workers were also keen for structures to be put in place to pass on the

knowledge and skills learnt during a professional development activity to other

consumers, and recommended that this be incorporated as a regular component

of networking meetings of consumer workers at local and LHD levels.

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d. Workplace Accommodations and Adjustments

The federal Disability Discrimination Act 1992 and the NSW Anti-Discrimination

Act 1977 require that workplaces make work-related reasonable adjustments to

enable employees with a disability to perform their work. While the term

“reasonable” is ambiguous, the legislation notes that it is not discrimination for

the workplace to not make adjustments, decline or dismiss from employment in

the situation where the person is unable to perform the inherent requirements of

the role even if adjustments were to be made or where “unjustifiable hardship”

would be encountered by the employer.

Workplace accommodations or adjustments for the consumer workforce need to

be tailored to the individual and to the needs of the service and role. They may

include flexible work hours, flexibility in leave for sick leave or appointments, the

ability to reduce work hours at times, changing the place where the worker

undertakes administrative work, the provision of an environment that enables

concentration, and so forth. Some adjustments, for example if hours are

renegotiated, or the role description is adjusted, may require formal

documentation such as a change to the contract, an Individual Flexibility

Agreement, or other such file note, which should be written, signed by both

parties and filed in the employee’s personnel file.

It is recommended that discussions about any required workplace adjustments

occur at the commencement of the role. This should be reviewed on a regular

basis, at least yearly but preferably on a six monthly basis, and at other times as

required.

It has also been suggested that during discussions about workplace adjustments,

discussion can also occur about what will happen in the event that the consumer

worker becomes unwell, including where they will seek treatment. This is

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important given the recommendation that consumer workers are not treated in

the same service in which they work.

Agreed adjustments and plans for illness should be documented, signed by both

parties and a copy placed on the employee’s personnel file. All staff involved in

the direct supervision of the employee should be provided with a copy of the

document. Agreement should be reached between the direct supervisor and the

employee concerned as to who is able to access their specific plans, as well as

the arrangements to be made when the direct supervisor is on leave.

Appendix F provides a template, called the Workplace Adjustment

Implementation Plan (or WAIP), which can be used to guide these discussions.

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The third component of the Framework is “The System”. As depicted in Figure 7

on page 40, this is about building the capacity of the whole mental health system

to enable cohesive relationships between consumer workers and other staff

within the mental health service system as well as ensuring the most effective

use of the consumer workforce within the system.

a. Establishing Champions

Throughout the project, the importance of champions and leadership direction

supporting and championing consumer workers has been emphasised as critical

to successful workforce integration within the mental health system and with

other staff. Champions for consumer workers, who have a firm belief in, and

promote the value and contribution of consumer workers to the mental health

system and the recovery journey of consumers, facilitate and promote the

acceptance of the workforce, and provide support to consumer workers are

needed at state, LHD and local service levels. It has been emphasised that these

champions are needed not just within the consumer workforce itself, but also

outside it from executive, management and other staff. It is recommended that

champions be identified at state levels, within each LHD including at executive

and management levels, and within each local service where consumer workers

are either currently employed or volunteer, or where there are plans to

incorporate a consumer workforce.

b. Training and Education of All Staff about the Consumer Workforce

Building the capacity of staff and services to fully integrate a consumer workforce

is critical to ensuring a clear and shared understanding of the:

Roles and purpose of the consumer workers, including the roles and

responsibilities they are to perform and the boundaries of the role

Expectations of the workers

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Benefits of consumer workers for the service and for consumers’ recovery

journeys

Philosophy of the consumer workforce, including its Code of Professional

Standards

Way in which consumer workers work with other members of the team

Specific training of managers of the consumer workforce is also needed to

ensure that managers have the information and skills to fully support consumer

workers. This training would incorporate information on the specific policies and

procedures that may apply to the workforce, professional development,

supervision, workplace flexibility and workplace accommodations and

adjustments policies and processes. This training also needs to emphasise the

importance of networking of consumer workers with each other as a mechanism

of support.

It is recommended that the development of programs to train and educate staff

about the role of the consumer workforce and their important contribution to

mental health services and the recovery journey of consumers is undertaken at a

state level, and rolled out throughout NSW. It is further recommended that a

mentor and support program for managers and champions of the consumer

workforce is developed and implemented at a state level to provide support,

information and advice to employers and the services to enable full integration of

the consumer workforce and to optimise the impact of the workforce. It is

recommended that to commence this process, investigation of the work

performed by Baptist Care South Australia and the Mental Illness Fellowship of

South Australia is undertaken (Baptist Care South Australia and the Mental

Illness Fellowship of South Australia, 2009; Biedrzycki, 2008). It is recommended

that the State Consumer Workforce Coordinator be engaged in coordinating this

work to ensure consistency with the vision for the consumer workforce.

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c. Policies, Procedures and Systems

Consumer workers, and managers and executive at state, Area, and local service

level have all identified the need for the development of policies and procedures

to support the effective implementation of this Framework and to ensure that

consumer workers and their managers have clear guidelines and support. These

policies and procedures may need to be developed at state, LHD or local service

levels. Box 2 outlines the key policy, guidelines and statements that have been

identified as being required.

In some cases, the development of new policies may not be required, but current

policies and procedures may just need to be adjusted or emphasised. Indeed,

some have noted that some policies do exist but that management are reluctant

to enforce them because of concerns about claims of prejudicial treatment of

consumer workers because of their mental illness. In particular, this has been

identified in relation to policies regarding an employee who becomes sick. As

with all employees if an employee is considered to be too unwell to perform some

or all of their duties, the direct manager can confine the employee’s duties or can

send them home and require them to take sick leave. This applies equally to

physical and mental ill health, and to consumer designated and non-consumer

designated positions alike. This is an important policy to ensure the quality of

services to consumers, the safety of consumers, and the health and safety of the

employee concerned and other employees. Further, clarity is needed around the

limitations to providing flexibility for extended periods of sick leave. While it is

important that the service supports consumer workers by providing flexibility for

sick leave, by means such as use of annual leave, taking sick leave at half pay,

using time in lieu for sick leave as negotiated and agreed upon, taking unpaid

leave, there is also a need for the service to have limitations to the length of

extended leave of an employee. This is needed to ensure that the provision of

the service can continue and to minimise additional stress and pressure placed

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A policy area considered in need of elaboration is the receipt of treatment at a

service where a person is also an employee. There are four critical components

to consider here:

Protection of the consumer worker’s privacy, dignity and respect as a

colleague and worker

Protecting the consumer worker’s privacy, dignity and respect from the

perspective of consumers of the service

Minimising dual relationships between staff and with consumers

The practicalities of geographical location

Where practical, a consumer worker, as with any employee should not receive

treatment from the service in which they are employed or from any member of

the service team and staff of the service in which they are employed. This

includes that a consumer worker should, where practical, not be admitted to an

inpatient service, or be a consumer at a community service where they are also a

member of staff or where they deliver services as a consumer worker. It is

recognised that where consumer workers operate in remote locations of NSW,

there may be limited opportunities for seeking treatment and services. In such

cases where it is not possible to avoid the receipt of services by a follow member

of staff or at a service where the consumer worker operates, it is critical that

mechanisms be put in place to ensure clear boundaries in relationships, and the

protection of the consumer worker’s privacy, dignity and respect as a consumer

worker.

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The final component of the Framework is “The Profession”. Depicted in Figure 8

on page 46, this includes the establishment of a code of professional standards

for the whole consumer workforce as well as building an evaluation base to both

establish the evidence base for the mental health consumer workforce as well as

to ensure the workforce’s ongoing quality improvement and development.

a. Code of Professional Standards

During the first stage of the Consumer Workers’ Forum Project, consumer

workers identified that they needed a code of professional standards developed

for the workforce. It was considered that such a code would set out clear

guidelines regarding professional conduct for all consumer workers, promoting a

consistent approach to the workforce and assist in the promotion of the consumer

workforce as a professional, legitimate workforce.

The Code of Professional Standards for the NSW Mental Health Consumer

Workforce (the Code) in Appendix G was developed through consultations with,

and input from current and former NSW consumer workers. It sets out the basic

values, ethical responsibilities, professional responsibilities and guidelines for

forming relationships for the mental health consumer workforce, thereby setting

minimum expectations and standards for ethical behaviour for the workforce. The

Code does not replace the codes of conduct of services, however sits alongside

them.

Unlike other professions with professional codes of conduct or standards, the

consumer workforce does not have an independent and overarching accrediting

or registration body which monitors the behaviour and practice of its aligned

workers. Until the consumer workforce reaches a critical mass which would

legitimate the development of such a body, it is recommended that the Code of

Professional Standards for the NSW Mental Health Consumer Workforce be

incorporated into the agreements that consumer workers make upon

commencement in the role, in line with other such documents as the service’s

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code of conduct, and be enforced and monitored by the consumer worker’s line

manager and the Consumer Worker Manager, and be discussed during

professional supervision.

b. Evaluation of the Workforce

There are two components to workforce evaluation. One is the evaluation of the

efficacy of the services provided, and the experience of services by consumers

as part of continuous quality improvement. The second is the evaluation of the

efficacy of the services in order to develop an evidence base for the workforce

which is required when seeking funding and resources. The different purposes of

the evaluations require different methodologies.

Evaluation as part of continuous quality improvement

Continuous quality improvement is a regular part of health service delivery (eg.

NSW Health, 1999). It involves a cycle of evaluating the services being provided,

developing strategies to improve the services, implementing the strategies and

then checking via re-evaluation to determine whether the strategies implemented

have effected the desired change. This cycle is ongoing, indicating the

continuous nature of quality improvement which emphasises that even when

services are considered to being delivered well, improvements are always

possible (Chowanec, 1994; Kahan & Goodstadt, 1999). A specific program of

evaluating the services provided by consumer workers needs to be integrated

into the broader continuous quality improvement process of the mental health

system, and at state, LHD and local service levels. Critically, consumers need to

be central to the evaluation of the services provided by consumer workers in

considering their experience of the service they receive from consumer workers

and how they consider it needs improving. Others including carers, family

members and friends of the consumer, colleagues, management, executive and

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consumer workers themselves should be involved in this evaluation and

continuous quality improvement process.

It is recommended that the State Consumer Workforce Coordinator develops a

program for such evaluation at state level, in conjunction with the Consumer

Worker Managers at each LHD and others involved in the continuous quality

improvement processes for the state’s mental health system. This will further

enable Consumer Worker Managers to work with their LHD continuous quality

improvement coordinators and others to implement LHD programs, and with local

services to develop local programs that complement the state processes. Such

continuous quality improvement has a clear relationship to the professional

development of individual workers and the workforce as a whole, including the

surrounding processes including performance reviews, work plans, professional

development plans, professional supervision, and the provision of professional

development and networking opportunities. It further aligns to annual planning for

services and the regular review processes that occur at all levels to consider the

effectiveness of programs and to further their development.

Evaluation to build the evidence base

In conducting the literature review for this project, (NSW Consumer Advisory

Group – Mental Health Inc., 2010, see

http://nswcag.org.au/files//our_work/cwf_literature_review_final.pdf), it was

identified that there is a paucity of literature published which evaluates the work

of consumer workers in terms of their efficacy in promoting the recovery and

supporting the recovery journeys of consumers. While outcome focussed

research, whereby outcomes are based on reductions of symptomology are not

advocated for, it is recognised that such research is used as the basis for

justifying funding to being allocated to workforces and treatments. This research

is also lacking for the consumer workforce.

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Developing a literature base for the consumer workforce which evaluates its

effectiveness in promoting a recovery orientation to service delivery and assisting

consumers on their recovery journey is necessary to:

Assist in promoting the value of the workforce to other members of the

mental health team and consumers

Advocate for funding allocation to the consumer workforce

Determine best practice for consumer workers in how they deliver their

services and work with consumers

Assist in determining the number of hours required on a per capita basis of

the number of consumers at the service for each of the different roles of

consumer workers

It is recommended that a research program for the evaluation of the consumer

workforce is developed, based upon the agreed understanding of the role and

purpose of the workforce as articulated in this Framework. Such a program

needs to be a collaboration between consumer workers, consumers,

management, executive, the State Consumer Workforce Coordinator, and

qualified researchers.

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Recommendations and Future Directions

Based on the findings of the CWF project, the following recommendations are

made to NSW Health for the development of the mental health consumer

workforce:

1. The Framework for the NSW Mental Health Consumer Workforce

including the Code of Professional Standards articulate in this document

be approved and adopted by NSW Health.

2. A State Consumer Workforce Coordinator be engaged on an ongoing

basis to implement the Framework and to ensure the ongoing professional

development of the consumer workforce.

3. The Framework be implemented at state, LHD and local service levels

(refer to draft implementation plan*). This implementation will require the

support of project funds to develop and implement a range of resources

including, but not limited to: a. Training and support to build the capacity of LHDs and local

services to support consumer workers, including mentoring and

networking programs; b. Policy and procedures;

c. Professional development and networking of consumer workers

including the annual Consumer Workers’ Forum, and state

induction and orientation for new consumer workers;

d. Standards and training for consumer worker professional

supervisors; and

e. Guidelines on the minimum number of consumer worker hours for

each of the roles identified in the Framework based on a per capita

head of consumers at a service (this will require research).

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4. NSW representatives continue to be involved in the development of a

national curriculum for peer workers to ensure that it meets the needs of

the mental health consumer workforce in NSW.

5. A gap analysis of current training available for the various roles of

consumer workers be commissioned and new training developed and/or

current training for consumer workers be refined to ensure consistency

with the Framework and the accepted purpose and roles of consumer

workers in the NSW mental health system articulated within this

Framework.

6. A methodology for the evaluation of the mental health consumer workforce

be developed, and the evaluation commissioned, in collaboration with

consumers, consumer workers, the State Consumer Workforce

Coordinator and researchers.

*Note the draft implementation plan for the Framework for the NSW Mental

Health Consumer Workforce will be available for consultation in early 2012.

Provide your feedback on THE WHOLE FRAMEWORK at

https://www.surveymonkey.com/s/THE_WHOLE_FRAMEWORK

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References

Baptist Care South Australia and Mental Illness Fellowship of South Australia

(2009). Employer tool kit: Employing peer workers in your organisation. South Australia: Baptist Care (SA) Inc. and Mental Illness Fellowship SA Inc. (MIFSA).

Biedrzycki, K. (2008). Endpoint report: Baptist Community Services peer support

project evaluation. South Australia: South Australia Community Health Research Unit.

Chowanec, G.D, (1994). Continuous quality improvement: Conceptual

foundations and application to mental health care. Hospital and Community Psychiatry, 45(8), 789-793.

Dixon, L., Krauss, N. & Lehman, A. (1994). Consumers as Service Providers:

The promise and challenge. Community Mental Health Journal, 30(6), 615-625.

Fone, S. (2006). Effective supervision for Occupational Therapists: The

development and implementation of an information package. Australian Journal of Occupational Therapy, 53(4), 277-283.

Kahan, B. & Goodstadt, M. (1999). Continuous quality improvement and health

promotion: Can CQI lead to better outcomes? Health Promotion International,14(1), 83-91.

Kirk, S.F.L., Eaton, J., & Auty, L. (2000). Dieticians and supervision: should we

be doing more? Journal of Human Nutrition and Dietetics, 13, 317-322. Lieb, S. (1991). Principles of adult learning. Accessed 22nd October 2011, at

http://www2.honolulu.hawaii.edu/facdev/guidebk/teachtip/adults-2.htm. Merriam, S.B., Caffarella, R.S., & Baumgartner, L.M. (2006). Learning in

adulthood: A comprehensive guide, 3rd ed. Indianapolis: Jossey-Bass. Mills, J.E., Francis, K.L., & Bonner, A. (2005). Mentoring, clinical supervision and

preceptoring: clarifying the conceptual definitions for Australian rural nurses: A review of the literature. Rural and Remote Health, 5, 410 (Online).

Milne, D (2007). An empirical definition of clinical supervision, British Journal of

Clinical Psychology, 46, 437-447. NSW Consumer Advisory Group – Mental Health Inc. (2010). Literature Review

on the Mental Health Consumer Workforce. Accessed 29 October 2010 from http://nswcag.org.au/files//our_work/cwf_literature_review_final.pdf.


NSW Department of Health (2006). NSW Drug and Alcohol clinical supervision

guidelines. North Sydney: NSW Department of Health. NSW Health (1999). A famework for managing the quality of health services in

New South Wales. Sydney: NSW Department of Health. Wagner, S., Keane, S., McLeod, B., & Bishop, M. (2008). A Report: Clinical

supervision for allied health professionals in rural NSW. Dubbo, NSW: NSW Institute of Rural Clinical Services and Teaching.

WA Country Health Services and Combined Universities Centre for Rural Health

(2009). Foundations to supervision. Western Australia: Government of Western Australia Department of Health


Appendices

Appendix A: Template Position Description Consumer Worker Manager – Local

Health District

Appendix B: Template Position Description Consumer Worker Coordinator –

Mental Health Service/s

Appendix C: Template Position Description - Individual Consumer

Advocate/Advisor

Appendix D: Template Position Description- Consumer Representative

Appendix E: Template Position Description Peer Support Worker

Appendix F: Workplace Adjustment Implementation Plan

Appendix G: Code of Professional Standards for the NSW Mental Health

Consumer Workforce


Appendix A: Template Position Description

Consumer Worker Manager – Local Health District

Position Overview

Mental health consumer workers are people with the lived experience of mental illness, employed in consumer designated roles within various capacities. The workforce is seen as vital in the support and advice they offer to mental health services on a range of issues in NSW as well as in the support they provide to consumers.

The Consumer Manager – LHD is situated within the LHD Executive team to coordinate the consumer workforce and its activities within the LHD. The role has clear connections with the Consumer, Carer and Community Participation Manager in promoting and facilitating consumer participation within the LHD.

Roles and Responsibilities

• Provision of line management for Consumer Coordinators – Mental Health Services within their LHD, and Consumer Advocates, Representatives and Peer Support Workers where there is no Consumer Coordinator - Mental Health Service; this includes coordination and allocation of roles and responsibilities, performance management, support, ensuring that support mechanisms including professional supervision and mentorship and professional development are made available and accessed

• Facilitating the networking of Consumer Workers within the LHD

• Management and maintenance of the LHD consumer worker budget (if applicable)

• Coordination of and building linkages with wider groups of consumer networks within the LHD to enhance consumer participation

• Preparation and coordination of consumer participation events within the LHD (e.g. Mental Health Month)

• Forming partnerships with professional mental health staff in the development of programs


• Reporting on consumer service issues to the mental health executive and senior meetings and working with them to develop strategic plans to manage these issues

• Facilitation of pathways for consumer participation in service planning, delivery and review, including MH-CoPES

• Driving the implementation of consumer identified gaps in service provision via MH-CoPES

• Participating in the strategic planning and direction of the LHD, representing the views of consumers and consumer workers, including through participation in the development of LHD policy and procedure, LHD executive committees including quality improvement, risk and safety, clinical governance, and meetings of the executive

• Representing the views and needs of consumer workers to LHD executive

• Participating in statewide networking of LHD Consumer Managers (LHD) and all consumer workers

• Provision of reports regarding consumer workforce activities as required to LHD executive

• Assistance with accreditation at LHD level

• Contribute to orientation and induction procedures and other staff education

Reporting Relationships

Reports to:

LHD Director for Mental Health

Direct reports:

Consumer Coordinators – Mental Health Services Individual Consumer Advocates, Consumer Representatives, Peer

Support Workers at service level where there is no Mental Health Service Consumer Coordinator


Other relationships:

LHD mental health executive, including manager for consumer, carer and community participation, manager for quality improvement, manager for workforce development, manager for promotion and prevention, manager for rehabilitation programs, director of mental health programs

Team leaders and Nursing Unit Managers in all services where Consumer Workers are employed

State Consumer Workforce Coordinator NSW Consumer Advisory Group – Mental Health Inc. Consumers

Budgetary Responsibilities:

LHD Consumer Workforce budget

Remuneration:

At appropriate level of NSW Health Managers Award

Selection Criteria

1. The personal, lived experience of mental illness 2. Qualifications in management or working towards same 3. Demonstrated experience in staff supervision and the provision of

strategic leadership 4. Demonstrated ability to manage a budget and resources 5. Demonstrated sound written and verbal communication skills, including

report writing, facilitating groups, and presentation skills 6. Demonstrated ability to build effective partnerships and work cooperatively

with others, including other management staff, service staff, consumer networks, consumer workers, consumers

7. Demonstrated ability to advocate on behalf of consumers and consumer workers in a cooperative manner

8. Demonstrated ability to plan and facilitate consumer participation activities 9. Demonstrated knowledge of the following:

a. Consumer participation principles and practice b. Mental Health Act 2007 c. Rights and responsibilities for consumers d. State and national mental health policies e. Recovery oriented service provision principles and practice


f. The issues related to the mental health consumer workforce

Notes re Consumer Worker Manager - LHD

It is noted that the Consumer Worker Manager – LHD may also encompass the

role of coordinator of consumer participation for the LHD. The position description

would need to be updated to reflect this.


Appendix B: Template Position Description

Consumer Coordinator– Mental Health Service/s

Position Overview


The Consumer Coordinator – Mental Health Service/s is situated within the mental health service to coordinate the consumer workforce and its activities within the mental health service/s.


• Provision of line management for consumer workers, including Consumer Advocates, Representatives and Peer Support Workers in the service/s; this includes coordination and allocation of roles and responsibilities, performance management, support, ensuring that support mechanisms including professional supervision and mentorship and professional development are made available and accessed

• Facilitating the networking of Consumer Workers within the service • Management and maintenance of the service consumer worker budget (if

applicable) • Coordination of and building linkages with consumer networks within the

service/s to enhance consumer participation • Preparation and coordination of consumer participation events within the

service (e.g. Mental Health Month) • Forming partnerships with professional mental health staff in the

development of programs within the service/s


• Reporting on consumer service issues to the service management team and to the Consumer Manager - LHD and working with them to develop plans to manage these issues

• Facilitation of pathways for consumer participation in service planning,

delivery and review, including MH-CoPES • Collaboration with staff to implement consumer identified gaps in service

provision via MH-CoPES • Participating in the strategic planning and direction of the service/s,

representing the views of consumers and consumer workers, including through participation in the development of service policy and procedure, service committees including quality improvement, risk and safety, clinical governance, and meetings of the management team

• Representing the views and needs of consumer workers to the service

management • Participating in LHD networking of Consumer Coordinators (Mental Health

Service/s) and all consumer workers • Provision of reports regarding consumer workforce activities as required to

service management and the Consumer Manager (LHD) • Assistance with accreditation at service level • Contribute to orientation and induction procedures and other staff

education


Reports to:

• Daily operational: Team Leader/Nursing Unit Manager/Other designated • Line management: Consumer Worker Manager - LHD

Direct reports:

• Individual Consumer Advocates, Consumer Representatives, Peer Support Workers at the service/s



• Service management, including quality improvement, promotion and prevention, rehabilitation program coordinator

• Consumers • Other consumer workers


Service/s Consumer Workforce budget (where applicable)

Remuneration:

At appropriate level of NSW Health Managers Award

Selection Criteria

1. The personal, lived experience of mental illness 2. Qualifications in management or working towards same 3. Demonstrated experience in staff supervision and the provision of

leadership 4. Demonstrated ability to manage a budget and resources 5. Demonstrated sound written and verbal communication skills, including

report writing, facilitating groups, and presentation skills 6. Demonstrated ability to build effective partnerships and work

cooperatively with others, including other management staff, service staff, consumer networks, consumer workers, consumers

7. Demonstrated ability to advocate on behalf of consumers and consumer workers in a cooperative manner

8. Demonstrated ability to plan and facilitate consumer participation activities

9. Demonstrated knowledge of the following: a. Consumer participation principles and practice b. Mental Health Act 2007 c. Rights and responsibilities for consumers d. State and national mental health policies e. Recovery oriented service provision principles and practice f. The issues related to the mental health consumer workforce


Notes regarding Consumer Worker Coordinator – Mental Health Service/s

It is noted that the Consumer Worker Coordinator – Mental Health Services may

also undertake components of the roles of Individual Consumer

Advocate/Advisor, Consumer Representative, or Peer Support Worker. The

position description would need to be amended to reflect this.


Appendix C: Template Position Description


Position Overview


The Individual Consumer Advocate/Advisor is situated within the mental health service to provide individual advocacy to consumers in relation to their rights and service needs, and to provide support when the consumer is going through the processes under the Mental Health Act.


• Where requested by the consumer, provide representation and support to consumers when they are attending Mental Health Review Tribunal hearings, Guardianship Tribunal hearings and other meetings/hearings

• Where requested by the consumer, attend clinical case reviews and case conferences within the mental health service to provide support and representation for the consumer

• Where requested by the consumer, support the consumer in making complaints

• Where requested by the consumer, assist consumers in their dealings with services such as Centrelink, the Housing Department and other external services

• Where requested by the consumer, advocate for and with the consumer to access the services that they require, and where appropriate, working with other service staff to secure these services

• Work to build the capacity of consumers so that they are able to advocate for themselves


• Contribute to the MH-CoPES Framework by assisting consumers to

complete Questionnaires, distribution of the outcomes of the MH-CoPES Questionnaires, participating in and facilitating mechanisms for consumers to participate in the Action and Change process

• Assist in the service’s accreditation process

• Production of reports to management on activities as required


Reports to:

Where available: Consumer Worker Coordinator - Mental Health Service/s

Where this position is not available:

• Daily operational: Team Leader/Nursing Unit Manager or other designated role

• Line management: Consumer Worker Manager - LHD

Direct reports:

• Nil Other relationships:

• Service staff • Consumers • Other consumer workers


Nil

Remuneration:

At appropriate level of NSW Health Education Officers Award (to be at Graduate level where the incumbent has the appropriate qualifications)


Selection Criteria

1. The personal, lived experience of mental illness 2. Training and education in providing individual advocacy or willingness

to undertake this training* 3. Demonstrated experience in individual advocacy for people from

disadvantaged backgrounds or willingness and ability to acquire this skill*

4. Demonstrated sound written and verbal communication skills, including report writing

5. Demonstrated ability to build effective partnerships and work cooperatively with others, including service staff, consumer networks, consumer workers, consumers

6. Demonstrated ability to advocate on behalf of consumers and to represent their views and needs or willingness and ability to acquire this skill*

7. Demonstrated ability to build the capacity of consumers to be able to self advocate or willingness and ability to acquire this skill*

8. Demonstrated ability to work effectively and cooperatively, both independently and within a team

9. Demonstrated effective problem solving and negotiation skills 10. Demonstrated sound knowledge of the following:

a. Consumer participation principles and practice b. Mental Health Act 2007 c. Rights and responsibilities for consumers d. State and national mental health policies e. Recovery oriented service provision principles and practice

* Where the applicant does not have the current experience or knowledge they need to demonstrate via their application how they have in previous situations been able to acquire knowledge, skill sets and experience

* Where the service employs someone without the experience or training required the service is responsible for providing this training, via formal courses and on the job coaching and mentoring, and opportunities to practice this skill within the first 3-6 months of the person being in the role. The service includes that in the probationary review period demonstration of the satisfactory acquisition of the knowledge and skill is required to remain in the role.

* Where someone is employed without experience, they may be required to work alongside another worker in some areas until they are considered to have sufficiently displayed the ability to competently perform the role. This is


particularly relevant for areas of work which require a greater level of skill such as supporting a consumer in attending a Tribunal hearing.

* Where the service employs someone without the experience or training required, they may be engaged at a lower level of pay than someone with the experience and training, and progress in pay levels with the demonstration of skill, and with the acquisition of experience


Appendix D: Template Position Description


Position Overview


The Consumer Representative is situated within the mental health service to provide systemic advocacy for consumers and to ensure a strong consumer voice working within mental health services to ensure that consumers are adequately represented. At times, the Consumer Representative may also be required to provide representation at LHD level.


• Facilitate consultations with consumers to gather consumer input into a wide range of issues concerning mental health consumers, including service planning, policy, development and evaluation

• Provide consumer feedback on policies, procedures, and service directions for mental health services at service and where required, LHD level

• Represent the consumer perspective at service level management, and where required, the LHD Mental Health Executive , including through the engagement in committees at service, and where required, LHD level, to ensure the consumer voice is represented

• Provide education to staff and consumers within the mental health service and people in the community about various issues from the consumer perspective (e.g. recovery)

• Conduct presentations at TAFE, university and in the community providing the consumer perspective


• Contribute to the development and delivery of training programs to consumers and carers

• Work closely with other consumer workers to provide a collective knowledge of consumer issues in service development

• Participate on committees that have higher level input into policy decision making and strategic direction for the mental health service to represent the consumer perspective

• Prepare monthly reports on issues that may be of a systemic level for the mental health service that they are employed by

• Take appropriate action on issues that may be of a systemic level, as required

• Contribute to the MH-CoPES Framework by assisting consumers to complete Questionnaires, distribution of the outcomes of the MH-CoPES Questionnaires, participating in and facilitating mechanisms for consumers to participate in the Action and Change process




Reports to:





Direct reports:

• Nil





Nil

Remuneration:


Selection Criteria

1. The personal, lived experience of mental illness 2. Training and education in providing systemic advocacy and

representation or willingness to undertake this training* 3. Demonstrated experience in systemic advocacy and representation or

willingness and ability to acquire this skill* 4. Demonstrated sound written and verbal communication skills, including

report writing, presentation skills 5. Demonstrated ability to build effective partnerships and work

cooperatively with others, including service staff, consumer networks, consumer workers, consumers

6. Demonstrated ability to advocate on behalf of consumers and to represent their views and needs or willingness and ability to acquire this skill*


8. Demonstrated experience in developing, implementing and facilitating consumer advocacy activities at a systemic level or willingness and ability to acquire this skill*

9. Demonstrated experience in facilitating consultations with individuals and groups or willingness and ability to acquire this eskill*

10. Demonstrated experience in feeding outcomes and information back to consumers


11. Demonstrated ability to represent views beyond and potentially conflicting with one’s own views

12. Demonstrated experience in working as a member of committees or willingness and ability to acquire this skill*

13. Demonstrated knowledge of the following: a. Consumer participation principles and practice b. Rights and responsibilities for consumers c. State and national mental health policies d. Recovery oriented service provision principles and practice



* Where someone is employed without experience, they may be required to work alongside another worker in some areas until they are considered to have sufficiently displayed the ability to competently perform the role.



Appendix E: Template Position Description

Peer Support Worker Position Overview


The Peer Support Worker is situated within the mental health service to provide support to consumers at an individual and group level. The role is focussed on developing empathic relationships based on the common ground of the lived experience of mental illness, and to provide hope, encouragement and information as the Peer Support Worker walks alongside consumers on their recovery journey.


• Advertising upcoming events within the service and in the community for mental health consumers, their carers, friends, relatives and the general community

• Running and coordinating programs and activities of a peer support nature

• Organising and helping to facilitate recovery groups and workshops within inpatient and/or community services

• Providing activities that are appropriate for the consumers within the service. This includes ensuring that the activities and programs are culturally and age appropriate and reflective of the demographics of the service

• Organising and conducting consumer feedback groups in inpatient and/or community facilities

• Developing and implementing activity based sessions as a mechanism for information provision and support


• Providing support to the consumer during their recovery journey through

acting as a role model for consumers, providing hope, encouraging and empowering a person during their recovery journey

• Providing information about community resources and services

• Assisting consumers during the discharge process from hospital

• Organising referrals to appropriate peer support services for consumers following discharge

• Checking in with consumers following discharge to provide any ongoing support where appropriate

• Assisting consumers in developing their treatment plans, relapse plans and wellness plans, alongside the mental health clinical staff

• Providing information for consumers on: employment; rights and responsibilities; and, other areas where requested

• Contribute to the MH-CoPES Framework by assisting consumers to complete Questionnaires, distribution of the outcomes of the MH-CoPES Questionnaires, participating in and facilitating mechanisms for consumers to participate in the Action and Change process




Reports to:






Direct reports:

• Nil



Budgetary Responsibilities

Nil

Remuneration:


Selection Criteria

1. The personal, lived experience of mental illness 2. Training and education in peer support work, including facilitation of

groups, or willingness to undertake this training* 3. Demonstrated experience in developing and implementing peer

support programs at individual and group levels or willingness and ability to acquire this skill*

4. Demonstrated good written and verbal communication skills, including report writing, presentation skills

5. Demonstrated ability to build effective partnerships and work cooperatively with others, including service staff, consumer networks, consumer workers, consumers


7. Demonstrated experience in facilitating peer support groups or willingness and ability to acquire this skill*

8. Demonstrated knowledge of the following: a. Consumer participation principles and practice b. Rights and responsibilities for consumers


c. Recovery oriented service provision principles and practice



* Where someone is employed without experience, they may be required to work alongside another worker in some areas until they are considered to have sufficiently displayed the ability to competently perform the role.



Appendix F: Workplace Adjustment Implementation Plan

Prior to discussing workplace adjustment needs of employees, first consider:

1. The core components of the role that cannot be altered and the skills

required for these

2. The skills of the employee

The following provides a guide for the discussion. It is recommended that any

decisions be transferred to an action plan.

Guide for discussion

It is important to explain that the purpose of this plan is to support the employee

in performing their role to the best of their ability. It should be explained that as

the employer, the service has a responsibility to make reasonable adjustments to

the workplace to assist people to perform their role, and also has the

responsibility for ensuring the physical and emotional wellbeing and safety of

staff. During discussions, clarification and agreement should be reached about

who has access to the plan, and the arrangements for if the direct supervisor is

on leave.

This plan is designed to consider the employee’s current needs and how the

employer can accommodate these. It is also to plan for possible future needs that

may be identified based on the individual’s work and health history.

It is also important during the discussion to be clear on what the workplace can

provide and what is outside the bounds of the workplace to provide, and thus

what is the individual’s responsibility. (For example the boundaries between

workplace support and personal counselling should be discussed).


It is noted that the below is a guideline for the discussion to form a Workplace

Adjustment Implementation Plan. While it is recommended that discussion is held

around all aspects, it may be agreed that a plan for the specific area is not

required. There may be other aspects that also need to be discussed and

included in the Plan depending on the role and the individual; these can be

included.

Workplace adjustments and other considerations

1. How can we best support you to perform to your ability within this role?

2. How can we best support you to ensure your wellbeing while at work and

in this role?

3. What challenges do you see that this role may present you with? How can

we help you overcome these? (eg is there anything in the position

description you may have difficulty doing?)

4. Is there any specific equipment you need to be able to perform your job?

(eg hearing assistances, enlarged computer screens etc)

5. Are there any changes we need to make to the physical work environment

to ensure you have access to the building and all areas you need to go?

(eg heights of handles for doors, wheelchair access etc)

6. Are there any specific things you need in an office to be able to work well?

(eg quiet place – to assist with concentration)

7. Are there any changes that we need to make to the hours you work? (eg

start time, finish time, total hours per week, additional breaks, days per

week, flexibility for appointments, flexibility around sick leave)

8. Are there any things that you are aware of that might trigger your mental

illness that you think you might encounter in this job? How can we assist

you so that you are not impacted? (eg are there things of the job that need

to be avoided (eg particular places, specific conversations etc); or if they

are encountered what support is needed?)

9. If the employee currently uses services connected to their place of

employment – what strategies shall we put in place to ensure that your

professional relationships are maintained with staff and that your


therapeutic/treatment relationships are also maintained? (NB It is

recommended that consumer workers do not work in a service where they

are currently receiving treatment, however in some rural and remote

regions this may not be possible)

10. What strategies should we put in place if someone who you are friends

with comes into this service? (NB It is recommended that consumer

workers do not work with people with whom they have a personal

relationship)

Planning for the future

1. What would you like us to do if we notice you are becoming unwell?

2. How might we know that you are becoming unwell?

3. Is there anyone you would like us to contact if you become unwell? When

would you like us to contact them?

4. If we think you need to be admitted to a hospital, what is your preference

for place? (NB It is recommended that consumer workers are not treated

in services where they work. This may require transfer to another LHD.

This should be discussed. However in some rural and remote regions this

may not be possible and where this is the case, a discussion should ensue

about what strategies need to be put in place to ensure professional

credibility and relationships are maintained whilst also ensuring

therapeutic and treatment relationships)

5. Discuss what occurs if the person needs to be on leave for an illness for a

period longer than that for which they have accrued sick leave.

6. Discuss when the plan should be activated by management and how it is

best for this to occur. Also discuss that the employee can request that their

plan be activated.


Action Plan

Workplace Adjustments and Other Requirements

Requirement Action to be taken Responsibility Review

Plan for future health care needs

1. Indications that the employee is becoming unwell:

………………………………………………………………………………………

………………………………………………………………………………………

………………………………………………………………………………………

………………………………………………………………………………………

………………………………………………………………………………………

In the event of illness the following is to be implemented:

1. The following actions will be taken by the supervisor when they notice the

employee becoming unwell: …………………………………….

2. The following people should be contacted when it is recognised the

employee is becoming unwell

Name:………………………………………………….

Relationship to employee: …………………………………..

Contact details: ………………………………………………..

When they should be contacted: …………………………………

…………………………………………………………………………

3. If treatment is required in an inpatient facility, it is preferred that this is

……………………………………………………. Hospital


4. The following arrangements will be implemented if extended sick leave is

required:

………………………………………………………………………………………

………………………………………………………………………………………

………………………………………………………………………………………

………………………………………………………………………………………

………………………………………………………………………………………

5. It is agreed that the employee’s supervisor can activate this plan (such as

contacting people etc) in the following ways and at the following times:

………………………………………………………………………………………

………………………………………………………………………………………

………………………………………………………………………………………

………………………………………………………………………………………

6. Other actions to be taken or things to be considered:

………………………………………………………………………………………

………………………………………………………………………………………

………………………………………………………………………………………

………………………………………………………………………………………

It is agreed that this plan can be shared with the following people and positions:

………………………………………………………………………………………………

……………………………………………………………………………………………

Documents related to this Action Plan:

(eg any Individual Flexibility Arrangements, contractual changes etc)

………………………………………………………………………………………………

………………………………………………………………………………………………

Signature of employee: ……………………………………………

Date: …………………………………

Signature of supervisor: …………………………………………..

Date: …………………………………


Appendix G: Code of Professional Standards for the NSW Mental Health Consumer Workforce


Code of Professional Standards for the NSW Mental Health Consumer Workforce

NSW Mental Health Consumer Workforce Draft Version – for endorsement by the Mental Health Program Council (November 2011) Based on revisions from consultations


Contents

Introduction ......................................................................................................... 84

Consumer Workforce Values .............................................................................. 86

Human Values ................................................................................................. 86

Consumer Focus ............................................................................................. 87

Integrity and Honesty ...................................................................................... 88

Rights and Needs of Others ............................................................................ 89

Recovery Framework ...................................................................................... 89

Professional Responsibilities .............................................................................. 91

Ethical Responsibilities ....................................................................................... 95

Relationships .................................................................................................... 100

References ....................................................................................................... 108


Code of Professional Standards for the NSW Mental Health Consumer Workforce

Introduction

Mental health consumer workers are people with the lived experience of mental

illness, employed in specific designated roles by mental health services to use

the skills, and knowledge acquired from the personal experience of mental illness

and using mental health services, as part of the mental health service team.

The mental health consumer workforce in NSW was founded on the recognised

need for increased consumer participation, support, advocacy, rights and

protection within mental health services. The NSW Mental Health State Plan,

NSW: A new direction for mental health outlines that the NSW mental health

consumer workforce has become a significant element in a broader mental health

participation strategy (NSW Department of Health, 2006).

The consumer workforce undertakes key roles within mental health services

including providing peer support, representing the consumer voice within mental

health services and the community, and providing individual and systemic

advocacy for mental health consumers. It has been recognised that to progress

the unification of the consumer workforce in NSW public mental health services,

a Code of Professional Standards is required.

The Code of Professional Standards (the Code) is intended to act as a

guideline for consumer workers in NSW as they carry out work in line with their

professional practice. It is encouraged that all consumer workers are mindful of

the Code and demonstrate an understanding of the values, ethics and

responsibilities of the Code and act in accordance with its contents.


The Code sets out the basic values, ethical responsibilities, professional

responsibilities and guidelines for forming professional relationships for the

mental health consumer workforce. The principles outlined throughout the Code

will help to promote:

The professional practice of consumer workers in NSW;

Minimum expectations and requirements for the consumer workforce; and,

A minimum standard for ethical behaviour.

The Code was developed through consultations with and input by current and

former NSW consumer workers.

This Code sets out the following:

Consumer Workforce Values;

Ethical Responsibilities;

Professional Responsibilities; and,

Relationships.

The Code should be used to assist consumer workers in identifying the ideals

and purpose of the consumer workforce profession, to identify the professional

obligations of consumer workers, and identify what constitutes ethical behaviour

for consumer workers. The Code sets out standards which seek to protect the

profession, individual consumer workers and mental health consumers who

receive the services of the consumer workforce.

The Code should be read in conjunction with other codes of conduct and

standards specified by the service which the consumer worker is employed by.


Consumer Workforce Values

Through the provision of quality mental health services to consumers in NSW,

consumer workers operate under five key values. These are:

Human Values

Consumer Focus

Integrity and Honesty

Rights and Needs of Others

Recovery Framework

In performing the key range of tasks and duties in line with the work expected

from the consumer workforce, these values underpin the approach taken by

consumer workers as they provide essential services to mental health consumers

in NSW. Each value is governed by a series of principles that provides guidance

and structure to the work performed by consumer workers. The adoption of these

values provides an ethical structure for the consumer workforce profession.

Human Values

Consumer workers should be respectful of Human Values, ensuring that

everyone is treated equally, with dignity, respect and understanding at all times.

Consumer workers should ensure that they:

Are respectful of all consumers within the service and in the wider

community

Treat all people equally

Are understanding of all people

Value the rights of each consumer

Provide compassion, hope and consideration to all consumers

Trust in the consumer and provide dignity of risk to enable the consumer

to take risks to progress in their recovery


Set boundaries for confidentiality with consumers, in accordance with the

employer’s guidelines, mandatory reporting responsibilities, duty of care,

Occupational Health and Safety legislations, and act within these at all

times

Value and validate the consumer voice

Promote social inclusion and all opportunities for consumers to participate

in their treatment, within the service and as valued members of the

community

Works in a manner consistent with the National Mental Health Standards

(Australian Government, 2010)

Consumer Focus

Each consumer worker should provide a Consumer Focus in their work. Due to

their lived experience of mental illness, consumer workers are, at times, able to

relate to consumers on a level that other service staff may not be able to. A

consumer focus is about ensuring that the views and opinions of the individual

consumer or the group of consumers is the core focus of the work undertake, as

well as about drawing on the consumer worker’s own personal experience as a

consumer to enable a more empathic relationship. This consumer focus needs

to be applied in both individual, one on one work as well as when representing

consumers in setting such as committees and in education they provide for

service staff, consumers and the community.


Are able to relate to all consumers they work with

Provide a non-prejudicial environment for consumers

Provide a safe environment for consumers to talk with the consumer

worker and to express emotions, thoughts and feelings

Speak respectfully with the consumer and in terms that they are able to

understand

Actively listen so that the consumer feels listened to and respected


Are good role models for all consumers and lead by example

Consumer workers will work to represent the:

Individual: this will be achieved through:

o Reflecting the consumer’s perspective, view and wishes to others

o Truly representing the consumer’s voice in all settings

Community: this will be achieved through:

o Truly representing the voice of all consumers in all settings

o Remaining in constant contact with consumers through developing

appropriate relationships (defined in the Code) with consumers

within the inpatient setting, in community mental health services

and in the wider community

o Remaining in constant contact with other consumer workers to

ensure awareness of broader issues that may need to be

represented to the mental health service, the government and other

stakeholders within the community


Every consumer worker should ensure Integrity and Honesty in their work at all

times.

In order to demonstrate this consumer workers should ensure that they:

Are honest at all times with themselves, with the service and with the

consumer

Provide a non-judgemental environment for the consumer and for other

consumer workers

Are respectful of other mental health staff

Are respectful to other consumer workers, valuing their opinions and

practice

Behave at all times with dignity and respect for their profession

Promote and demonstrate clear understanding of the values of the

consumer workforce


Aim to provide an impartial service for consumers, without imposing their

own views and opinions

Provide the consumer privacy at all times where appropriate


In working with consumers, other mental health service staff and other consumer

workers, each individual should ensure that they uphold the Rights and Needs

of Others.

In order to demonstrate this consumer workers should ensure that they:

Provide a high level of commitment to the work that they perform

Have an awareness and respect for diverse religious and cultural factors

Promote advocacy, social justice and fairness for consumers within the

mental health service and in the wider community

Advocate for consumers on their behalf or through encouraging

consumers to advocate for themselves and their own rights Ensure that

they are, at all times, truly representative of the consumers who they are

working with and representing

Acknowledge the right for consumers to experience inclusion and

participation in: the community; political and public life; cultural life,

recreation, leisure and sport; and, the least restrictive environment

Recovery Framework

Recovery for people living with a mental illness is often described as a journey

that is unique for each individual. It involves living a meaningful life, having hope

for the future, managing the illness, fostering self determination, being able to

participate in the community and sustain meaningful relationships (Andreson,

Oades & Caputi, 2003). Recovery in this sense is not necessarily about cure of

symptoms; rather it is about people living meaningful lives in the presence or

absence of symptoms.


For consumer workers working with mental health consumers on a daily basis, it

is important to work within a Recovery Framework. This involves providing

services that seek to maximise consumers’ control over their treatment and care

preferences and goals for the future at every opportunity, irrespective of where a

person may be in their journey. To work within a recovery framework, consumer

workers need to listen to the consumer’s views, and help them identify and work

towards their aspirations.


Acknowledge and demonstrate that recovery is a process

See beyond a person’s illness to consider the whole person, their interests

and broader context of their life

View a person’s life situation holistically for a deeper understanding of the

consumer

Focus on the consumer’s strengths rather than their deficits

Encourage that consumers maintain healthy/supportive relationships with

family and social networks

Understand that it is human to have faults, and that relapse may occur.

Consumer workers need to recognise that relapse of mental illness is not

always a failure of care, treatment or service provision. Relapse can be

seen as an opportunity to develop resilience and insight. Relapse into

symptoms does not mean that a person is no longer on their recovery

journey

Convey to the consumer, mental health service staff and within the

community that it is possible for the consumer to live a meaningful life in

the community with the presence or absence of symptoms


Professional Responsibilities

There are minimum expectations that should be fulfilled at all times when

carrying out the professional responsibilities of a consumer worker. The following

responsibilities and minimum expectations are based on the five core values for

the workforce.

Human Value

Consumer workers will:

Demonstrate good active listening skills when communicating with

consumers

Develop sound social skills when engaging with consumers, providing an

environment that is open and safe for consumers

Be respectful and non-judgemental of a person’s gender, age, culture,

ethnicity, religious beliefs and sexual orientation

Demonstrate a positive attitude towards consumers, encouraging their

growth and promoting recovery

Consumer Focus


Remain in communication with consumers on the ground to remain a true

representative of the mental health consumer

Not allow their own beliefs, views and opinions to interfere with their

representational or advocacy duties

Build relationships with consumers through communicating in a simple and

clear manner; working without prejudice or stigma; and conveying a

genuine emphatic relationship with consumers

Have a basic knowledge of mental illness and disorders

Remain abreast of issues relating to consumes within their services and

Local Health District by working alongside mental health service staff and

other consumer workers


Provide an equal representation of all consumers within their mental

health service and Local Health District

Promote and develop the self advocacy skills of consumers

Ensure that employment status, the views of government, the service or

service staff, and the needs of the service or service staff do not interfere

with their advocacy and representational duties

Declare any conflicts of interest where personal perspectives, employment

situation or any other factors affect the ability to objectively and adequately

represent the consumer view and/or advocate for the consumer



Strive to be consistent and reliable in their role at all times

Demonstrate a strong work ethic

Demonstrate a sound knowledge of the mental health system and other

systems as they relate to mental health (including legal and social)

Develop a working knowledge on the NSW Mental Health Act 2007 and

the National Mental Health Standards (Australian Government, 2010)

Continue to operate in a professional manner at all times

Engage in regular training and supervision to ensure integrity and honesty

is maintained during employment

Engage in their work, refraining from any behaviour that may damage the

reputation of the consumer workforce profession

Not engage in any task or duty without ensuring that they have the

appropriate education and training to perform the task, and that the task is

consistent with their position

Engage in reflective practice

Adhere to all legal requirements including those relating to privacy,

confidentiality, Occupational Health and Safety (OH&S), mandatory

reporting, and any other applicable legislations




Work with a high level of commitment to the consumer workforce

profession

Work to prevent and eliminate negative discrimination on the grounds of a

person’s gender, age, culture, ethnicity, religious beliefs and sexual

orientation Work to advocate for the rights of consumers, and where

appropriate, empower consumers to advocate for themselves

Inform mental health services and service staff about matters relevant to

consumers to contribute to better conditions and mental health service

environments

Strive to ensure that consumers are informed on all relevant matters

(including, but not limited to: rights and responsibilities; the NSW Mental

Health Act 2007; community mental health services; and, peer support

services)

Are aware of local networks and support groups that the consumer may

find useful and informs consumers of these

Recovery Framework

Consumer Workers will:

Work with their supervisors to ensure that they have a comprehensive

understanding and knowledge of the recovery philosophy

Acknowledge that they are on their own individual recovery journey

Work within a recovery framework when performing their tasks and duties

within the mental health service

Actively encourage consumer engagement in:

o Making decisions about their own treatment, care and services

o Taking responsibility for their own recovery

o The centre of the planning processes around their own treatment

and care

o Creating and maintaining their own care and recovery plans


o Identifying and documenting early warning signs of their illness

o Identifying and documenting strategies for staying well

o Creating and maintaining crisis and relapse prevention plans

o Working towards self management of illness

o Involving carers and family

o Moving towards their identified goals

o Connecting with peer groups and support networks

o Evaluating and providing feedback about the service

o Improving the service


Ethical Responsibilities

Each consumer worker is expected to adhere to certain standards of ethical

behaviour during their employment. When carrying out their roles and

responsibilities, the consumer worker is responsible at all times to the:

1. Consumer

2. Workplace

3. Wider Community

4. Profession, and

5. Themself

The ethical responsibilities that consumer workers operate under aim to provide

the profession with a minimum standard for their conduct at work, and assist in

guiding the work carried out by members of the workforce. These ethical

responsibilities should be used during supervision sessions to ensure that

consumer workers are operating at the minimum standard, providing a

benchmark for the assessment of professional behaviour.

1. Consumer

The consumer worker should ensure that they:

Do not talk about a consumer outside of work or to others where they may

be breaching confidentiality and the consumer’s trust

Do not act as a counsellor for the consumer, but refers the consumer,

through recommendation to the consumer, to an appropriate member of

the mental health service for counselling

Are fair in all dealings with the consumer

Do not make promises to a consumer (to avoid jeopardising relationships

if a promise cannot be met)

Work within a recovery framework with the consumer

Are non-judgemental at all times and work without prejudice

Do no inflict physical or emotional harm to self, consumers or staff

Empower the consumer to self advocate


Empower the consumer during their recovery journey

Provide professional support to the consumer within the bounds of the

Code

Are non-discriminative and foster an environment that discourages

stigmatising attitudes

Are accountable to the consumer – this includes ensuring that it is the

consumer’s views that are represented not the consumer worker’s, the

service’s or any others

Are aware of what constitutes professional boundaries in their relationship

with mental health consumers (as laid out in the Code) and act within

these boundaries

Secure the safety of consumers by immediately referring consumers (by

recommendation to the consumer) to a relevant staff member if required,

and in circumstances where there is imminent risk, involves a suitable

member of the mental health service staff

Inform consumers of what information consumer workers pass on to other

mental health staff about the consumer

Do not record any information about a consumer in any format other than

that specified by the service

Do not provide the consumer with their personal contact details

2. Workplace


Work alongside multi-disciplinary teams where relevant when performing

their roles and responsibilities, recognising and adhering to the specific

role that the consumer worker has

Demonstrate respect for other mental health staff

Strive to be consistent in their conduct at work, throughout their

employment


Identify conflicts of interest between the Code, their role and requirements

and any aspects of the job they are asked to undertake, and advise the

appropriate service manager or supervisor and seek a resolution

Identify conflicts of interest between personal beliefs, the Code, and their

employment status and any requests from the consumer for advocacy

and/or representation. Advising the appropriate service manager or

supervisor and where appropriate the consumer to seek a resolution

Abide by other codes of conduct or standards, policies and guidelines as

required by the service they are employed by

Identify and bring to the immediate attention of management and seek to

resolve any contention between the Code for consumer workers and

those of the service

Adhere to all legal requirements including those relating to privacy,

confidentially, Occupational Health and Safety (OH&S) and mandatory

reporting, and other applicable legislations

Act in accordance with service policy and protocol to immediately report to

their direct supervisor and, where required, to emergency services

o Any disclosure or threat of harm from consumers to self, others or

property (including any abuse or neglect)

o Any disclosed actual or consideration of illegal activity by the

consumer

o Any incidents

A consumer worker may become unwell and temporarily may not be able to

perform their roles and responsibilities during their employment. The consumer

worker should ensure that they are aware of the services policy and procedural

guidelines which operate in such situations, and develop a plan with their

supervisor such as the Workplace Adjustment Implementation Plan, for

implementation in the event that they become unwell during their employment.


3. Wider Community


Are committed to social justice and dignity and act on these principles

Are true representatives of the consumer voice

Act in a professional manner when representing the mental health service

and the consumer perspective

4. Profession


Act in a professional manner at all times

Are conscientious and diligent

Are reliable

Respect other consumer workers and the differing views and opinions that

they may hold

Carry out the work of the consumer worker to the best of their abilities at

all times

5. Themself


Are respectful of themselves

Are aware of their limitations and work to their strengths – this may involve

acknowledging any limitations they have in supervision, and seeking

training, mentoring and other support to address these

Develop a wellness plan to assist in maintaining their mental health

Are aware of their own feelings, thoughts, opinions and views so that

these do not impact in any way on their dealings with consumers or when

representing the consumer

Develop clarity of what details about their experience of living with mental

illness they are willing to share within their position and not exceed these

Undertake ongoing professional development including

supervision/mentoring, training and other development opportunities


Have adequate formal and informal support

Take care of themself

Have self awareness


Relationships

It is important that the relationships consumer workers form with other people

during their employment do not cross professional boundaries and ensure the

integrity of the workforce. Consumer workers also need to ensure an

engagement with those whom they work with and represent. Certain guidelines

need to be put into place that can assist consumer workers in building and

maintaining professional relationships with:

1. Consumers

2. Colleagues

o Other consumer workers

o Other mental health service staff

3. The wider community, and

4. The NSW Consumer Advisory Group – Mental Health Inc. (NSW CAG)

5. Others including carers and family of consumers

When forming professional relationships with people, consumer workers need to

ensure that ethnical boundaries around the relationship are defined, and that

appropriate time is allowed to develop the relationship. Relationships need to be

founded on trust and mutual respect, with the consumer worker aware of what

compromises a beneficial relationship in a recovery-oriented environment.

1. Consumers

When working with consumers, the consumer worker should ensure that they

define their role at the outset. This includes a discussion of the boundaries of the

relationship, and an articulation of the services that the consumer worker

provides to the consumer. The consumer worker needs to ensure that they

develop a good working relationship with consumers, whilst also developing and

respecting boundaries between themselves and the consumers with whom they

work.


Consumer workers should also ensure that they are aware of how their

relationship may hinder their own or the consumer’s recovery.

Boundaries between consumer workers and consumers

Although the consumer workforce is different from other workforces, in that it is

established as primarily a peer workforce, the following must be considered

concerning the boundaries of relationships between consumer workers and

consumers:

The best interests and needs of the consumer must be at the forefront of

all dealings with the consumer

The consumer worker is employed to undertake a role as defined by their

position description

The consumer worker is required to act within their professional role

In relationships with professionals, including consumer workers,

consumers may reveal information, say things and act in ways they would

not want known about in a personal relationship

There is a power differential between the consumer worker, in their

professional position, and the consumer in their service receiver position

The consumer worker needs to maintain objectivity at all times in their

work

During periods of illness, people are vulnerable

During periods of illness, people may reveal information, make decisions

and act in ways that they would not want others to know about when they

are well

A personal relationship with one consumer may present a conflict of

interest in working with other consumers

A personal relationship with a consumer may present a conflict of interest

between the requirement of the consumer as a friend and their

requirements as a service receiver

Consumer workers should always:


Be accepting

Be supportive of the consumer

Be a good role model

Be encouraging

Build good rapport with the consumers they come into contact with

Be polite

Be courteous

Be friendly

Be approachable

Act professionally

Be appropriate in the way that they interact with consumers

Guidelines for setting boundaries in relationships

Guidelines need to be maintained to ensure that consumer workers avoid dual

relationships and recognise professional and personal boundaries between

themselves and the consumer. This will maintain clarity of the consumer worker

role, avoid conflicts of interest or unrealistic expectations arising and avoid

breach of actual or perceived physical and mental safety of consumers and

consumer workers, any of which can hamper the consumer’s recovery journey.

These guidelines will also ensure the consumer worker can adhere to all aspects

of the Code as laid out under Consumer Workforce Values, Ethical

Responsibilities, Professional Responsibilities and Relationships.

Consumer workers should:

Avoid any kind of personal relationship (defined as sharing time or

providing additional support outside of professional interactions and their

position description; this includes the development of friendships and

intimate relationships) with a consumer who is seeking or receiving

treatment from the service in which they work


Not engage in sexual relationships with a consumer until at least two years

have passed since the professional relationship ended between the

consumer worker and consumer

Not receive gratuities or other remuneration from a consumer. It is

acceptable to receive small tokens of appreciation from consumers (such

as a card, chocolates or flowers) however if such gifts are aiming to

influence decisions or actions, they must be declined. Acceptance of any

gifts must be reported to the direct manager

Not give or lend money or other goods to a consumer

Alert their direct manager and relevant staff members of the wider team if

the consumer worker has a current or has had a past personal relationship

with the consumer (this includes friends, family members, partners,

neighbours) – where practical have another consumer worker engage with

the consumer

Not provide additional services (outside of those laid out in the Code and

their position description) to the consumer

Not socialise with the consumer who is seeking or receiving treatment

from the service in which they work

Not share personal contact details with the consumer

2. Colleagues

a. Other consumer workers

Consumer workers should work to ensure that they form professional

relationships with other consumer workers. These relationships should be based

on equality, respect, respect for difference and working towards a common goal.

In their relationships with co-workers, consumer workers should ensure that the

values, ethics and standards of the Code and the consumer workforce are

upheld and should seek to respectfully and professionally address breaches.

Consumer workers should always:

Be accepting


Be supportive of fellow consumer workers

Be a good role model

Be encouraging

Be polite

Be courteous

Be friendly

Be approachable

Act professionally

Address differences respectfully, and addressing the issue and not the

individual

b. Other mental health service staff

Consumer workers should work to form professional relationships with other

mental health service staff within the service that they are employed by. In their

dealings with other mental health service staff, consumer workers will act

professionally at all times within the boundaries laid out in the Code. These

relationships should be based on respect, respect for difference and working

towards a common goal.

Guidelines need to be maintained to ensure respectful relationships are formed

between consumer workers and their colleagues. Consumer workers should:

Report any discriminatory or stigmatising behaviour they may experience

from other mental health service staff or other consumer workers

Recognise and respect different views and opinions that are held by other

staff

When a consumer worker becomes unwell during their employment

In order to avoid dual relationships with staff members, it is recommended that

consumer workers do not work in services where they currently or have

previously sought treatment. Such a situation places the consumer worker in the

situation of being a service recipient from other staff, while also being their


colleagues. Conversely it puts other service staff in the position of being a service

deliverer and colleague to the consumer worker.

In any situation where a mental health service is provided, the following occur:

Personal information is disclosed that the consumer worker may not

ordinarily disclose to colleagues

The power differential will change from one of equal colleagues to service

provider and consumer

The service provider may be aware of decisions and actions of the

consumer worker, and may have experienced behaviour from the

consumer worker that the consumer worker would not wish a colleague to

be aware of

The consumer worker may feel vulnerable and exposed in their

interactions with staff (ex-colleagues)

The consumer workers return to work may be hampered

Any of the above may hamper the consumer workers recovery journey

Even in situations where there has not been a treatment relationship between the

service provider and consumer within the last 2 years, this information remains. It

is therefore recommended that consumer workers do not work in services where

they have previously received a service.

However, given the geographic limitations that are posed by rural and remote

regions, it may not be possible for a consumer worker to work in a service where

they have not previously received a service. In such situations, the consumer

worker should alert their direct supervisor when they have previously received

treatment or support from the service, or where they are working alongside a staff

member they have received treatment from in the past and develop a

collaborative strategy to minimise any impact of the dual relationship.


When a consumer worker becomes unwell during their employment it is

recommended that they receive treatment in a service where they are not

employed and/or which they do not engage with as part of their work. Where this

cannot be achieved, the consumer worker will work collaboratively with their

supervisor prior to returning to work to develop a strategy to minimise the impact

of any dual relationship.

3. Wider Community

Consumer workers should ensure that they develop networks in the community.

This contributes to a greater knowledge of services that exist outside the mental

health environment that consumer workers can link consumers to. Consumer

workers should also work to ensure that they remain professional at all times

when representing the service or providing the consumer perspective within

networks.

Consumer workers should ensure that they have an understanding and

knowledge of the Community Managed Organisations (CMOs or Non-

Government Organisations) within the Local Health Network and surrounds.

4. NSW CAG

As advocates for mental health consumers, it is important that consumer workers

develop a working relationship with NSW Consumer Advisory Group Mental

Health Inc. (NSW CAG). NSW CAG is the statewide peak body representing

mental health consumers to the state government. This relationship will ensure a

pathway for systemic issues to be raised at state government levels, and at times

at national levels. This will also provide for flow of information to consumer

workers about the mental health system and participation opportunities for

consumers.

To ensure this relationship, consumer workers should:


Develop professional working relationships between the service and NSW

CAG

Have an understanding of the work conducted by NSW CAG

Feed any statewide and systemic advocacy issues into NSW CAG

Encourage mental health consumers to input into NSW CAG and have

their say on the mental health system

Disseminate information to consumers from NSW CAG about the mental

health system and opportunities for participation

5. Others

The principles outlined above should be followed when forming

relationships and engaging with others including family members and

carers. Consumer workers should always ensure that the consumer is their

focus and that the views of the consumer are their priority for any

advocacy.


References

Andresen, R., Oades, L, & Caputi, P. (2003). The Experience of Recovery from Schizophrenia: Towards an Empirically-Validated Stage Model. Australian and New Zealand Journal of Psychiatry, 37(5), 586-594

Australian Government (2010). National standards for mental health services 2010. Canberra: Commonwealth of Australia.

NSW Department of Health (2006). NSW: A new direction for mental health.

North Sydney: Mental Health and Drug and Alcohol Office. Mental Health Act 2007 accessible from

http://www.legislation.nsw.gov.au/viewtop/inforce/act+8+2007+FIRST+0+N/

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