Hearing and believing people with lived experience of compulsory mental health treatment

Key points

• We worked with 16 people with lived and living experience of compulsory mental health treatment in Victoria to share their stories as part of the review into compulsory treatment and decision-making laws and broader mental health and wellbeing reform.
• These stories of the lasting adverse impacts of compulsory treatment reinforce the findings from the Royal Commission into Victoria’s Mental Health System that the system remains broken.
• Among many common themes was a call to reform Victoria’s approach to mental health treatment so that it is rights and recovery focused, and provides more holistic models of treatment that support mental health and wellbeing.

In their own words, 16 people have told their stories of compulsory mental health treatment and their hopes for change.

Their experiences should inform ongoing mental health and wellbeing reform across Victoria, including regarding compulsory treatment.

The Being believed, being heard report brings these stories together and highlights common themes and issues from their experiences.

Many spoke of the lasting adverse impacts of compulsory treatment in their lives and how their voices were ignored.

‘The stories are incredibly moving and they brought me to tears,’ said Senior Consumer Consultant Wanda Bennetts.

‘They lay bare the trauma and inhumanity of what can happen when systems and legislation impact so heavily on the lives of people.

‘As we continue the journey of mental health and wellbeing reform in this state, it is vital we recognise and hear consumer voices.

‘Lived experience expertise should be centred in all reform activities, including partnering with lived experience experts for all reform work.’

Opening the report’s online launch event in front of several hundred attendees, Minister for Mental Health Ingrid Stitt said the government was committed to transforming the system so that treatment and support is compassionate, respectful and responsive.

‘This starts with making sure that consumers are meaningful partners in decision making and ensuring consumer rights and preferences are upheld at every level of our system,’ she said.

‘Hearing your voices – as we have in this report – is vital to our vision.

‘We will continue to work alongside you to build a more supportive and responsive mental health system.’

Experiences of compulsory treatment

In Victoria, hundreds of people are on compulsory treatment orders every day.

Victoria has disproportionately high rates of compulsory treatment orders, including for specific groups such as First Nations and culturally and linguistically diverse consumers. Victoria also has some of the highest rates of community treatment orders in Australia and the world.

The Royal Commission into Victoria’s Mental Health System found that the number of orders in Victoria had continued to rise despite the stated intention of the Mental Health Act 2014 to make compulsory treatment a last resort.

‘Healing doesn’t happen in a non-conducive environment when you don’t have agreement in together planning goals in life resolutions. If you do not have the person’s permission to receive treatment, you are invading their personal privacy and right to feel safe and protected.’ – Jessica (not her real name)

The lived experience experts we spoke to were clear about knowing what works for them and what supports and services they want and need.

Commonly, their experiences of compulsory treatment harmed rather than helped them.

Priority issues and themes as identified by participants include:

• compulsory treatment making things worse, not better, with an emphasis by health practitioners on medical treatment (medication, electroconvulsive treatment or neurosurgery) over holistic care models
• low confidence in the effective use of supported decision-making mechanisms, like the Second Psychiatric Opinion Service and advance statements of preferences
• concerns about misdiagnosis leading to mistreatment, with limited understanding or consideration of the impact of disability, chronic pain, drug addiction and other life factors on their mental health
• negative experiences of first responders and emergency departments
• experiences of coercion and control, including people ‘agreeing’ to voluntary treatment solely because they felt it was the only way to avoid compulsory treatment
• failure to provide accessible, inclusive and safe environments for personal recovery in healthcare settings for people with disability, LGBTIQA+ people, women, First Nations peoples and those from culturally diverse backgrounds
• a lack of access to information about treatment or consumer rights.

Expanding non-legal advocacy to support consumer rights

One of the significant changes of the Mental Health and Wellbeing Act 2022 (Vic) which came into effect last year was to improve understanding of consumer rights and amplify the consumer’s voice in their assessment, treatment and recovery through non-legal advocacy.

Under the new laws, every person placed on a compulsory order in Victoria is now given access to Independent Mental Health Advocacy (IMHA).

An IMHA advocate can help them understand their rights, express their views and preferences, seek legal help and other services they want, and/or make decisions about their assessment, treatment and care.

IMHA is independent from hospitals and mental health services and works with thousands of consumers each year to have their say.

We acknowledge that consumer voices are integral to reforming the mental health system to centre rights, supported decision-making and recovery.

We prioritise consumer-led work through our lived experience advisory group, Speaking from Experience, and we partner with lived and living experience experts to co-design, co-produce and/or co-deliver services, resources and education.

Hopes for change

In our submission to the review of compulsory treatment criteria, we highlighted the steps that can be taken now to radically reduce the use and duration of compulsory treatment and promote a rights-respecting system.

The system should centre consumers’ will, preferences and personal recovery, with supported decision-making as the primary approach.

The Being believed, being heard report also collates participants’ solutions for mental health and wellbeing reform, including increasing access to services consumers need and want, without having to be on a compulsory treatment order to receive them.

‘The irony now is that I fought to voluntarily get into a public youth mental health service. I had no idea that it would lead me to being stuck in the system for over a decade and being traumatised by my experiences.’ – Cyan (not their real name)

Participants called for strengthened protections for mental health consumers against abuse, mistreatment and coercion, improved experiences of mental health services and improved accountability mechanisms to ensure any reforms are implemented effectively.

‘We all want this report and consumer leadership more broadly to lead to change,’ said Wanda.

‘It isn’t enough to just read the stories, we want to see meaningful systemic change so others do not have to go through the same experiences.’

Media enquiries

Contact Senior Communications Adviser Crys Ja on Crys.Ja@vla.vic.gov.au or 0457 483 780.

More information

Read Being believed, being heard

Learn more about our advocacy on mental health reform

Read Your story, your say – stories from 34 people to the royal commission

We note the language and themes in the Being believed, being heard report reflect the views expressed by a diverse community of lived experience experts. Victoria Legal Aid's views are expressed in our submission to the review of compulsory treatment criteria and alignment of decision-making laws.