PHASE 2 – SURVEY

SECTION 1: What would be the roles of the new peak?

A Way Ahead Queensland (AWAQ) agrees that the four roles outlined in the
discussion paper constitute activities that could enhance the experience of
consumers within the mental health sector and within the community in general.
The roles outlined ion the discussion paper are:
• To advocate for change through the provision of national independent
advice, Including to government, on issues and policies affecting the lives
of people with mental illness;
• To provide national leadership on mental health consumer engagement
and participation;
• To provide national leadership on mental health consumer organisation
and service development; and
• To engage the community in promoting a positive understanding of people
with mental illness and their lived experience.

AWAQ also considers that the body should have a central role in ensuring that
there is balance within the body of research undertaken in mental health.
Although there is some research undertaken in Australia and overseas into the
effectiveness of peer run services, often indicating improved outcomes compared
with traditional mental health services based on the medical model, the volume of
this research is dwarfed by research into medications and into treatment models
favoured by the mainstream mental health sector. Most people would agree that
it is preferable to base interventions and fund services on the basis of evidence
that they are effective, although this has not always been the case in psychiatry.
However, unless research into consumer determined support and consumer run
services is sponsored, commissioned and promoted, mental health services will
continue to be skewed towards an expensive system that many consumers find
unpleasant and ineffective and avoid engaging with, often to their own detriment
and that of the community in general.

AWAQ also considers that a central role of the new body should be to foster
connection and communication between consumers, and to act as a conduit of
information between consumers and decision makers in order that decision
makers are informed of the range of views and experiences of mental health
consumers at the grass roots level, and consumers are informed of the
deliberations and decisions made about them and their lives.

SECTION 2: What would be its key areas of work?

Again, AWAQ considers that the areas of work outlined in the discussion paper
represent most of the spheres that we consider important. However, we consider
it is vital that the proposed new body regularly and frequently actively engage in
informing consumers and seeking their views. It is only by functional participation
in these processes that consumers will ultimately benefit from such a body. And if
consumers are not going to benefit, there is no point in the existence of such a
body.

SECTION 3: What would it be a peak of?

AWAQ considers that, at this time, the only viable model of those outlined,
namely a peak of peaks, a peak of individuals, a peak of organisations or a
hybrid model, is the hybrid model, because of the scarcity of genuine consumer
organizations. In our view, a genuine consumer organisation is one where all full
members are consumers and the governance structure comprises consumers
(with the possible exception of a small minority of identified positions for people
with specific expertise). In this context, a consumer is:
• A person who has a lived experience of mental distress;
• This lived experience has had a serious impact of the person’s life and
social roles; and
• The person identifies as a consumer.

It will not necessarily continue to be the case that there are very few genuine
consumer organisations, particularly as we believe that the proposed new body
should foster and assist the development of genuine consumer organisations and
the connections between them. At some time in the future, therefore, we believe
that the proposed new body should review its structure and activities to ensure
that they are responding to the needs of consumers within the contemporary
context.

SECTION 4: Where does it fit in?

Ideally, the proposed new body should be the apex of a pyramid which has as its
foundations individual consumers, who then feed into local, then regional then
state networks, and ultimately to the national body. The federal nature of
Australia, and the disparate funding responsibilities of State and Commonwealth
agencies might make this difficult. But it is nonetheless the case that there needs
to be consistency and coherence between State and Commonwealth activities in
mental health, and a high degree of complementarity between them. The
National Mental Health Strategy is an initiative of the Council of Australian
Governments, and so the National Mental Health Working Group might be a
forum within which ways to achieve this might be canvassed.

The various types of organisations suggested in the discussion paper as

potential partners is a reasonable list, provided that they are considered as
organisations with which strategic alliances around particular issues might be
formed and not as members of the proposed national consumer body, since few
of the organisations named are consumer organisations. AWAQ considers that
the mental health related faculties of educational institutions might also have a
role to play, since they have a dominant influence on the culture of the future
mental health workforce.
SECTION 5: What is a viable organisational framework?
At the consultation in Brisbane, it was made clear that the organizational
framework is still being developed, so there seems to be no point in commenting
on the one included in the discussion paper, other than to say that we hope that
members will have a more central role than appears to be the case in the
diagram on page 20.

SECTION 6: What sort of legal entity would work best?

AWAQ does not consider that an organisation auspiced by another organisation
gives sufficient independence and autonomy to adequately represent the
interests and voices of consumers.

The discussion paper does not give details of the differences in cost and
administrative burden between establishing as an incorporated organisation or a
company limited by guarantee. Nor does it substantiate the assertions made
about each form of governance. We do not, therefore, feel that we could make an
informed choice between these two options.

SECTION 7: How could it ensure good governance?

AWAQ believes that the Board of the proposed new national consumer
organisation should comprise consumers who understand the role of governing
an organisation, are committed to doing so effectively and are able to make
themselves available to complete the considerable volume of work that is
involved in the role they are undertaking. Being a Board member involves much
more than participation in a number of meetings. Board members have to
understand, with advice, the complexities of governance; the sector in which they
are operating, both historically and developmentally; and the environment within
which that sector is placed. Just as importantly, they have to actively seek the
views of their constituency, and faithfully represent those views, as well as
ensure that their constituency is kept informed of developments that concern
them.

The suggestion that there be Board places reserved for people with specific
expertise is worthy of consideration, however AWAQ does not believe that the
organisation would need to go beyond the community of consumers in order to
find people with the required expertise.

Another suggestion worth considering is that of having proxy Board members

who can replace appointed Board members when they are not able to attend to
the business of the organisation as a consequence of illness. At the consultation
in Brisbane it was declared that there were legal problems with this. If those legal
problems are related to establishing as a company limited by guarantee, then
perhaps that should be a factor in deciding what kind of legal structure to adopt.

With regard to nomination for and appointment to the board, AWAQ believes that
there should be merit-based selection process where people who nominate for
appointment to the Board submit applications based on key selection criteria,
showing demonstrated competencies. These applications should be scrutinized
and tested by an independent body. The National Service User Network in
England has an Appointments Committee comprising members who are not on
the Board and not nominating for it, but with demonstrated skill in selection
processes. Such a Committee could also be responsible for regular appraisal of
Board members.

If there were more qualified candidates than positions available, then perhaps the
final selection could be made by a postal ballot of members, overseen by an
independent returning officer.

The emphasis in the discussion paper on training of Board members is

supported, although the engagement of a management consultant to brief each
Board member prior to every meeting might prove to be expensive, and have the
organisation using more resources to support its governance structure than its
members.

SECTION 8: How would it get the work done?

The suggestions in the discussion paper are, in general, supported by AWAQ.
However the proposal to rotate Board meetings through each state is likely to
prove expensive and draw heavily on organisational resources. It might also
lead to dissatisfaction unless the various regions within states are also given the
opportunity. Considering the size of Australia, and the difficulty of travel to some
remote areas, it is likely to take several terms of Board membership to complete
one rotation. Consideration could be given to making teleconference
arrangements with, for example, state government agencies in various regions
throughout the country, which would make it possible for more people to take
part more frequently in forums.

SECTION 9: How would the new peak make sure it does the best it can?
AWAQ supports the suggestions in the discussion paper.

SECTION 10: What are the options for the establishment phase?
AWAQ supports the suggestions in the discussion paper.

SECTION 11: What resourcing would be required?

Resourcing should be sufficient to adequately provide for the work of the
organisation, including, most importantly, frequent and regular contact with
members by direct and general methods.