ARCVic Philosophy
1. Heeding the Voice of Experience
People who have a mental disorder live moment by moment, day by day, with the impact of their disorder upon their behaviours, feelings, cognitions, development and identity. They suffer mental and emotional pain, and struggle with unwanted consequences upon their family and social lives, and their academic and occupational functioning. Times spent with professional helpers are a minimal part of the entirety of their lives. In between these times they learn to live with their disorder. They learn to adapt their needs and expectations to the demands of their disorder. They learn to struggle through and survive times of despair and deep loneliness. Every day they deal with other's reactions to their problems and often suffer under the added load of feelings of anger, guilt and confusion. They try to manage to fulfil their roles in their family and society while enduring daily battles with bewildering and terrifying symptoms. Sometimes they seem to fail and fall. Many times they seem to be just hanging on - surviving. And then there are times when unharnessed capacities and strengths are forged - they discover new ways of thinking, of managing their difficulties, of facing their fears - enabling them to live a better quality of life and begin their journey to recovery.
Can we face these people, and their experience of living with their mental disorder, and imagine that we do not need to learn from them?
The core of ARCVic's philosophy is that the experience and knowledge of people with a mental disorder must be valued, heeded and included in the development and delivery of mental health support and clinical services. We offer them respect and dignity, when we work together with them as partners in their recovery. We empower them to discover their inner capacities and strengths, when we provide opportunities for them to exert control and choice.
ARCVic aims to incorporate the perspectives and experiences of people with anxiety disorders in the development, delivery and management of its services. ARCVic also seeks to promote the 'voice of experience' of people with anxiety disorders to other mental health and primary care services, and facilitate a provider/consumer partnership that builds mutual trust and respect.
2. Creating Community : A Place To Belong
Health care policies, service developments and treatment advances aimed at recovery, normalisation and destigmatisation may benefit consumers in many ways, and yet, the essential fact of the mental disorder cannot be ameliorated. The condition of having a mental illness is intrinsically an isolating experience, and sufferers feel deeply a sense of difference and separateness from the rest of the community. Chronic and frightening symptoms reinforce this sense of alienation, which may eventually become entrenched by perpetuating avoidance behaviours and social isolation. Feelings of shame and worthlessness are common responses to the sense of being unacceptably different, and people will often expend enormous energy and effort in hiding their disorder from their work colleagues, employers, friends, family members, and even from health professionals who are involved in their care.
Isolation is fertile ground for the growth of depression, desperation, anger and fear, and can insidiously militate against a person's capacity to utilise beneficial treatments and health or welfare services.
ARCVic is a community created to respond directly and explicitly to this need, and contains the key components required for effective expiation of this need - that is, the joining of a group of people with a common condition and needs, whose purpose is to draw upon the support, caring, resources and skills of all group members, for the benefit of all - thus providing a model and an experience of a unified community, engendering inclusion and empowerment.
For people with an anxiety disorder, ARCVic is one place in the midst of their confusion and fear, where they know they belong. In this place their mental and emotional difficulties are understood, accepted and validated. They find a community of people whose 'difference' is just the same as theirs and whose experiences of coping and recovery offer unprecedented hope. ARCVic provides a safe place for people, where they can express their views and feelings, gaining a greater insight into their needs and symptoms, and not be judged in the process.
Clinical and research evidence strongly suggests that people with a mental illness who have good support and social networks have a better chance of recovery, and are less likely to relapse, than people who are isolated and lack opportunities to improve their level of social functioning.
3. Building Expertise and Skills - Specialist Quality Services
The specialist focus of ARCVic is a vital component of its capacity to provide 'a place to belong'. The nature and impact of OCD, psychosis, bipolar disorder, anorexia nervosa and borderline personality disorder, are as different from each other as epilepsy, cancer and multiple sclerosis. A support service covering all mental illnesses could not provide the unique qualities of a specialist service that promote recovery for consumers.
The needs of people with anxiety disorders are significantly determined by the particular symptoms and disabilities they experience. The services provided by ARCVic have been developed by people with anxiety disorders and their carers, and therefore are appropriate and effective in meeting these needs. People with severe anxiety disorders are often housebound, or extremely restricted in their capacity to engage in normal routine activities - such as driving, using public transport or facilities, interacting with people and so on. ARCVic's services are designed to assist and support people who are restricted in this way - through the HelpLine, Telephone Networks, local Support Groups, home delivery of resources, advocacy and promoting professional expertise across all regions of Victoria.
It is important to note that anxiety disorders are associated with high levels of insight in sufferers, leading to intense feelings of shame and embarrassment. It is very common for people with anxiety disorders to keep their problems secret from family, friends, work colleagues and health professionals. ARCVic ensures that these people are able to obtain help in a confidential and safe environment, and are provided with support and assistance to obtain appropriate professional help. Further, the current limited availability of treatment services for anxiety disorders in the public and private mental health system means that for many people with anxiety disorders ARCVic's services are their only source of assistance.
Support and recovery services, including support groups, self help groups, social groups, telephone counselling, telelink groups, recovery groups, outreach and one-to-one support, offered by ARCVic contribute to the recovery of people with mental illnesses. The specialised knowledge, expertise and experience which is available to all who participate in these services, are essential factors contributing to the successful achievement of the objectives of primary health services and the National Mental Health Plan - ie. promoting independence and well-being in community settings, and encouraging healthy behaviours and self-reliance.
ARCVic is a centre of expertise through which specialist knowledge and experience relating to anxiety disorders and associated disabilities, can be collected and dissemminated. Education, training and consultation for professionals and workers in primary care and mental health services are considered by ARCVic to be a fundamental responsibility of the organisation.
4. Ensuring Representation, Access & Standards
The most important factor that ensures representation, access and standards is the establishment and development of a funded state-wide organisation which is recognised and supported by government, primary care and mental health services. Principally, ARCVic acts as a representative for its target group (for the purposes of advocacy, lobbying, health promotion and education) at a state-wide level. This level of representation has greater power and effect than any small, locally based group could achieve. The resources of a state-wide organisation ensures that services are accessible to all consumers in the State (not just in those areas where a viable local group has been able to develop), and is able to regulate the standards of all regional groups and services within its auspice. A funded state-wide organisation is accountable for quality through formal service agreements which regulate appropriate standards. The experience of ARCVic and its accumulating expertise in providing consumer-managed support services, has led to the firm view that a central (state-wide), accountable (legally and ethically), professionally staffed office, is essential to ensure the integrity, quality and viability of a network of consumer-managed support services throughout the State. Locally run independent support groups contain little or no protection for consumers. The style, structure and content will be largely determined by the values, experiences and opinions of the convenor(s), and there may be no mechanisms for ethical or financial accountability. Its members - particularly those who are emotionally and mentally vulnerable, will have no recourse if their rights and welfare are undermined or exploited.
Support groups which are auspiced by a State-wide organisation are able to utilise all the resources of the central body - including written material to disseminate to their local communities, training, and financial and management support. The local groups do not become isolated, and are able to seek advice and assistance for any difficulties which arise. ARCVic is able to support its regional groups and branches to become a dynamic part of their local communities - to make connections with mental health centres, psychiatric services in hospitals, community and welfare organisations, general practitioners and local businesses. In this way, ARCVic's support groups and services are able to respond to the needs of people with anxiety disorders in their region, and work effectively and cooperatively with other local health services.
5. Promoting Recovery in a Community Setting
Community support and self-help services play a vital role in promoting the emotional, mental and social well-being of people with a mental illness and their carers. At the most fundamental level, these services help consumers to rebuild a sense of worth and confidence, and gain new knowledge and understanding which relieves feelings of guilt and fear. The benefits of such changes in self-esteem and attitude, to consumers' capacity for coping and recovery are obvious. In essence, the positive effects upon service users springs from the common bond of a shared condition, but the dynamics of the groups and the consumer-management ethic (including volunteerism) contribute to well-being at many levels. Within an environment which is geared to promote attitudes and feelings (towards self and others) of understanding, acceptance, honesty and positive regard - trust, hope and courage are rediscovered by people, enabling them to take charge of their journey to recovery, and try a range of self-help strategies and professional treatments that previously seemed too difficult to face.
ARCVic is designed to offer services that promote choice and are responsive to a range of needs - in that consumers and carers can choose to use the services at whatever level is appropriate to them. Often the services literally act as a lifeline for the most severe and chronic sufferers - many of these people are unable to be effectively helped by current treatments, and must find some way of living with severe anxiety symptoms and depression. These consumers contact with ARCVic is critical in helping them to keep going from day to day, and they are able to find some relief from their mental and emotional pain by being able to talk openly to others who understand. The self-help networks and support groups provide a way of empowering people to help themselves. Effective groups help members to achieve recovery through mutual support, and by encouraging members to confront fears and to focus and work upon the recovery process, rather than their difficulties and distress. The groups enable social skills and self-confidence to be developed or regained, and provide opportunities for members to develop a range of other skills (for example - public speaking, group leadership skills, committee and management skills, office skills and other voluntary roles), which improve self-esteem as well as opening up employment and educational possibilities.
ARCVic's services offer cost-effective support in the community setting and contribute greatly to reduced health care costs - through appropriate referrals, making available a range of community supports and resources to foster self-management skills, and providing support and accurate information to encourage maintenance of appropriate treatment. As a result of these services encouraging consumers to take an active role in their own support and recovery, and contribute to the care of others, many social costs and problems are also alleviated.
6. Effective Consumer-Management
The objectives of the mental health system to promote consumer involvement in service provision, and to provide services that support consumers within their local community, are most clearly achieved through a consumer managed organisation. The genesis and growth of self-help groups arise from consumers' motivation and efforts to take care of themselves and others who share their difficulties. Their willingness to assume these roles and participate actively in their recovery provide a timely model of hope and optimism to all service providers and consumers who are involved in the mental health system.
The Committee of Management of ARCVic primarily includes people with anxiety disorders, family members and carers. This ensures that they are actively engaged in the planning, development and management of services. Committee members and service users are encouraged and supported to take on voluntary positions in the organisation in areas of service delivery. In this way, the organisation promotes self-help from its core into all of its activities, and actuates the belief that each person has strengths, skills and knowledge that contribute to his or her recovery, and can be shared to strengthen and support their community networks. Volunteers are also able to closely monitor the needs of users, and evaluate the effectiveness and appropriateness of the services on an on-going basis. The role of consumers in management and service provision is supported by a professionally staffed central office, and complemented by the involvement of interested health professionals.
7. Promoting Partnerships between Support, Primary Care and Mental Health Services
Feelings of worthlessness and powerlessness - which are generally a part of the experience of mental disorders, are compounded through social stigma and a psychiatric system which has struggled to respond to the complex needs of sufferers. The focus of clinical services on treatment, must be balanced by an equal emphasis on management of the social and emotional impact of psychiatric disorders upon sufferers and carers. A mental health system which does not provide this balance, will ultimately fail to help a large number of people with chronic mental illnesses. Without access to support services and networks, their needs for understanding, acceptance, support and self-empowerment will not be met.
ARCVic seeks to extend reliance from external aids and professional authorities, to include self and community reliance. Community support and self-help services are not an alternative to professional or medical help, but rather a vital component in the process of recovery. ARCVic's purpose is to find and foster the inner strength and spark of hope that lies within each person with an anxiety disorder, and to provide a supportive and understanding community in which this strength and hope will flourish. In this way, a healing and recovery process is initiated, and many barriers, which could have interfered with successful professional treatment, are broken down. From this point, ARCVic can help to facilitate access to primary care and mental health services, and support people with mental illnesses to stick with, sometimes long and difficult treatment programs.
Partnerships between ARCVic and primary care and mental health services are based on recognition of the importance of a combined approach to recovery that makes both partners stronger, and provides a powerful force for effectively helping people with a mental illness and their carers.
by Kathryn I'Anson, Director, ARCVic
for the ARCVic Committee of Management,
December 2000