A grounded theory study of lived experience mental health practitioners within the wider workforce

For contemporary mental health policy to realise its commitment to enhance consumer participation and to promote the establishment of progressive mental health service delivery, progressing robust and effective roles for people with a lived experience of significant mental health challenges is essential. However, the emergent lived experience workforce in Australia faces a vast range of barriers including a lack of formal employment structures and awards, professional defensiveness from non-lived experience colleagues and stigma and discrimination in the workplace. Previously, there has been limited focused inquiry into the experience of employment for lived experience practitioners. The aim of this research is to provide a comprehensive exploration of the perspectives of lived experience practitioners of their employment within the mental health workforce, with a specific emphasis on factors that assist and inhibit the roles. Using a grounded theory approach, in-depth semi-structured interviews and focus groups were conducted. Lived experience practitioners employed in diverse roles within government, non-government and lived experience-run services from metropolitan, regional and rural settings across several states participated. Employing constant comparative analysis, the substantive theory Risk to self, resulting from stigma (seen and unseen) impacting on the LEP role emerged. Stigma, both seen and unseen was found to underlie and impact upon the LEP experience. As a result lived experience practitioners knowingly risked themselves and their own well-being within roles for the benefit of current mental health consumers. When workplaces were perceived as including greater supportive factors and were seen as less stigmatising, there was a correspondingly lower risk to LEP and greater consumer benefits. Conversely when more inhibiting factors existed, greater risk to LEP was posed and less consumer benefits occurred. For lived experience roles to evolve into full potentiality; to the benefit of mental health consumers and the well-being of LEP, the underlying stigma that is often ‘unseen’ must be recognised and addressed and supportive factors enhanced. The findings of this study will inform the on-going development of policy, service design and education of the professional and lived experience workforce, by identifying existing barriers, providing a framework to increase positive factors and ultimately contribute to a more collaborative, inclusive and therefore effective workplace culture for lived experience practitioners.