Written by Dr Alicia King – Central Clinical School, Monash University

The sharing of lived experience by mental health service staff in roles not designated as Lived Experience (hereafter referred to as “professionals”) has long been a contentious but poorly described phenomenon (see Figure 1). Recently completed doctoral research by Alicia King has identified conditions that support sharing by professionals with lived experience and their colleagues in designated roles (hereafter referred to as “peer workers”). The research involved interviews with 33 staff in a range of roles (e.g., clinicians, support workers, peer workers, line managers and supervisors), and analysis of relevant policies and procedures, from two Victorian mental health services, a specialist mental health service and a community mental health support service. The project was supervised by Professor Lisa Brophy and Associate Professor Tracy Fortune (La Trobe University), Lived Experience academic, Dr Louise Byrne (RMIT), and a research advisory group comprised of 50% Lived Experience membership.

The research revealed perceived organisational and supervisor support, and an individual preference for being open, contributed to the likelihood staff would share their lived experience with colleagues and supervisors (see Figure 2). Staff with lived experience all privately shared this experience with trusted confidantes, but only some felt confident to share more openly with their teams. The only factor that consistently predicted open sharing was supervisor support for sharing as a resource for team reflection and growth, a concept described in the organisational psychology literature as psychological safety. Sharing privately and openly resulted in improved wellbeing and mutual support but only open sharing was associated a sense of authenticity in the workplace.

Conversely, stigma beliefs expressed by colleagues and past experiences of discrimination discouraged staff with lived experience from sharing openly (see Figure 3). These beliefs were subtly reinforced by helper responses from supervisors to those experiencing current challenges. Helper responses mimic relationships between service users and providers in that they involve the one-way provision of support in a private setting, which has the potential to limit other avenues of support and create a sense of being a “burden” to their manager. Traditional professional boundaries limiting the sharing of personal information, were reinforced by use of terms like “disclosure” in organisational documents. In team climates of interpersonal fear, professionals with lived experience favoured silence over speaking up for service users, while peer workers experienced being “shut down,” “brushed aside” and “ignored.”

These findings have significant implications for the implementation of workforce related reforms recommended by the Royal Commission into Victoria’s Mental Health System. If the lived and living experience staff across the mental health workforce is not acknowledged and valued, we risk replicating the “us and them” divide between staff and service users that has historically caused so much harm.

The final project report summarises the findings and recommendations of most interest to those working within mental health services. The thesis and publications from this research are also available at: https://www.researchgate.net/profile/Alicia-King-4. For updates on future publications follow Dr King on Twitter @AliciaJeanKing or LinkedIn: www.linkedin.com/in/aliciajeanking

About the writer

Since qualifying as an occupational therapist in 2001, Alicia has worked in public and private mental health services, and in teaching roles. More recently, her interest in lived-experience as a resource for improving service responses has led her to undertake doctoral studies exploring the sharing of lived-experience by mental health professionals in the workplace. She has previously undertaken research capturing service users’ experiences of innovative and lived-experience informed services for the University of Melbourne and La Trobe University and now brings this expertise to her role with the Monash University research team based within the Melbourne Sexual Health Centre.