In March 2020 life changed for Victorians as we went into lockdown. With the start of the pandemic and resulting disruption to people’s lives across the world we were required to work from home.
At the forefront of my mind was staff wellbeing and being able to continue to provide services to people at risk of or subject to compulsory treatment. Outside of a pandemic, consumers tell us they often feel powerless as basic decisions we all take for granted are removed from them, including what they eat, where they go and what treatment they access for their experience of mental health issues or distress.
We were fortunate as Victoria Legal Aid’s technology allowed us to continue providing our phone services and to pivot to online delivery of our outposts within mental health services. Assisting consumers in-person has always been an integral part of the IMHA model, especially to build and maintain relationships with clinical staff and workers in mental health units. These relationships are critical to supporting our ability to provide services, and consumers involved in IMHAs three-year independent evaluation by RMIT found this was important to them.
While the initial switch to online was a shock, we slowly worked through with individual services to continue outposts. At times this could be a bit chaotic, with some services able to facilitate virtual outposts with a laptop or iPad while others were still reliant on limited phones for patients.
Consumers experience of the pandemic
Unfortunately, the experiences of people on compulsory treatment orders in mental health units and in the community during the pandemic, have mostly been invisible to the public. Yet their wellbeing has been significantly impacted. Consumers in inpatient units told us they were scared as staff were in full PPE, that they may be exposed to COVID-19 in the ward and that distancing wasn’t possible in many communal areas. Some consumers were also distressed as they could not have people visit them or have leave due to new restrictions.
On Christmas Eve 2020 I was covering IMHA’s phone line and spoke to a consumer who was in an inpatient unit. She was extremely distressed as her requests to visit her two children on Christmas Day, had been denied. I contacted the service to discuss her concerns and was told that due to COVID-19 risk no consumers could be given leave, nor could her children visit her in the ward. This no-leave policy had been implemented in the service since the beginning of the lockdowns in March and had not changed as restrictions eased for the wider community. I escalated the matter, but it could not be responded to until the next working day. This sat with me for many days as I spent Christmas Day with my daughter and several family members.
As the result of advocacy from IMHA, some services made welcome changes and moved to manage COVID-19 risk while respecting the rights of consumers, allowing them to do what other Victorians could, such as exercise outside the unit. The Department of Health also provided more resources such as phones and other technology in inpatient units so that consumers had increased communication options.
Meeting the change and challenge of 202 1
We continue to respond to the uncertain impact of COVID-19. This year, during lockdowns we have been able to attend some services in person, where a consumer would otherwise not get an advocacy service. We have also had weeks of being able to return to in-person outposts.
We have also been able to continue our consumer advisory group – Speaking from Experience (SFE), whose expertise influenced and shaped our advocacy to the Royal Commission into Victoria’s mental health system (RCVMHS) and played a role in highlighting the vital importance of non-legal advocacy for consumers around Victoria. We were so pleased to see, as part of the royal commission’s final report, that access to services like IMHA will be resourced to reach everyone who needs them, through the creation of an ‘opt-out’ system for non-legal advocacy.
There is no doubt that the ongoing uncertainty and changes will continue to mean we need to be able to adapt and work closely with consumers, mental health services, policy makers, oversight and safeguard bodies. The experiences of the last 18 months have shown that by working collaboratively, we can continue to ensure that consumers remain at the centre of our work despite a challenging environment.
Reviewed 26 November 2021