Disability Support Workers' Qualities Go Under Our Consumer Microscope...and Humanity is the Active Ingredient!
 

Prepared by Allan Pinches and Sue Robertson.


Few occupations place such a premium on a worker's human qualities, personal development processes and self awareness as is required for a good psychiatric disability support worker.

In this job, it really matters what kind of person you are -- in a job that salvages lives and is essentially about facilitating processes to assist people with psychiatric disability to reclaim, restore, enhance and actualise their innate human potential. Complex issues are often involved such as early sexual abuse, family trauma and violence, family breakdown, suicides of close ones, drug and alcohol abuse, domestic violence, homelessness, unemployment, poverty, developmental delays and many other difficult life passages such as divorce, separation, or rejection. A kind of panoramic view of society's problems. Many of these issues lead people to become mental health consumers.
 
The exacting vocation of disability support worker demands a complex "juggling act" of professional skills, as well as excellent personal qualities. It requires knowledge of psychology and clinical factors; psychosocial rehabilitation theory and practice; human relations and counselling skills; creative thinking; flexibility; responsiveness; a genuinely positive approach; ability to negotiate conflict and crises; and endurance and good stress management, so as to be fairly relaxed aimid chaotic and often emotionally demanding environments.
 
As if this were not enough, the personal qualities needed are very stringent and tend to be based on hard won self knowledge and awareness gained through life experience, learning from difficulties and personal development efforts, perhaps rather more than theoretical knowledge. The rest of this article is devoted to these often hard to pin down qualities.
 
As longtime consumers we have had much helpful guidance, support and friendship from disability support workers over the years, and more recently as consumer advocates/ reps have enjoyed much discussion with workers and consumers about how services can be improved -- ideally aiming to:

All of these discussions have been hot topics at Neami Inc, where we are among six consumer reps on the committee of management and much effort is being made to improve the quality and responsiveness of services. It is actually very important to articulate these things as an organisation and encourage consumer input and codifying core values and strategies.
 
Naturally, a great deal of the success of such a progressive agenda depends on having the highest quality of staff with the right personal qualities to make such perhaps idealistic goals become a reality in disability support, residential and employment-related programs. Good personal qualities should also be a major selection criteria for clinical case managers, nurses, doctors etc.
 
We also welcome the gradually emerging trend for ex-consumers to seek training and work in the disability support field and would support some affirmative action approaches to facilitate the employment of these "pioneers."
 
At absolute "bedrock" a caring disposition is a vital quality for this job, coupled with the skills to follow through in a practical way which empowers consumers. For the right person this can be an exciting, rewarding, inspiring, enriching and satisfying career which is also very socially beneficial.
 
Genuine friendliness in workers is also highly valued by consumers, and while there are necessary boundaries in this work, these should be applied with sensitivity and discretion.
 
Absolute sincerity in a worker is indispensable. After all, consumers, weary of the "System" are often experts at detecting crap, insincerity, false jollity which actually masks closedness, patronising attitudes and talk, "Mr Fixits" who impose quick solutions, babysitters, sanity "dispensers" on legs, self-appointed role models, people identifying with "charity" thinking, religious proselytisers, judgemental types, and other thankfully rare specimens who should be encouraged to stay well away from this important work.
 
Implicit in this is a sort of emerging "Golden Rule" of disability support work that a worker's ongoing personal development and life processes are TOTALLY linked with his or her work. We are talking about a "shared journey" of understanding and personal growth. Consumer empowerment often means the worker consciously eschewing the temptation to wear the "expert's" hat, instead encouraging consumers to tune in to their own solutions, listen to, learn from and value each other, and ultimately determine their own destinies.
 
There's a very poignant quote from a wise Aboriginal woman activist and elder who was meeting a newly arrived social worker and said the following:
 
"If you have come here to 'help' me, you are wasting your time. But if your struggle for liberation is bound up with mine, then maybe we can work together."
 
I think this is so relevant to disability support work, just as it is to many community endeavours, because the scope of the work is much more than so-called "helping" of those less fortunate. In so many ways workers and clients can relate as "fellow travellers" with a whole world to explore and so many people and things to learn about. A fascination for life and a constantly renewing sense of hope can also be shared emerging qualities, which go a long way to promoting wellbeing of clients and workers alike.
 
A good support worker will be aware of these processes and will constantly be reflecting upon their own experiences, in ways that highlight consumers' experiences as being essentially about common, normal and difficult passages in life, which may have temporarily swamped the person beyond their immediate capacity to cope. Problems can escalate further over time if there isn't appropriate personal support and therapeutic work on the issues. Labels and diagnoses tend to lose relevance or meaning, and the context is a more holistic social one, in disability support practices.
 
Being aware of these processes goes a long way towards developing true empathy for clients and a "levelling" between worker and client, so necessary for beneficial work. For too long mental health consumers in the System have been trapped in rigid, stigmatising "us and them" regimes, which depersonalised and disempowered us. We seemed to be regarded as sick sub-humans, rather than real people, with lives beyond the illness. We were bruised, battered and broken by system which didn't care, and in many cases it was not until we were lucky enough to find a disability support key worker at a day centre or supported housing service, who seemed to really care and gave us loving support that we really got back onto our feet.
 
Consumer often talk about the healing power of love and how there is just not enough love in the world, and a glaring, impoverishing lack of any real sense of community in our modern world. The very word "love" has become debased and devalued in these cynical times, in which it has become a product, something to do with sex, something seemingly becoming an endangered quality in marriages and families. Materialism and greed are tearing up the social and family quilt. Consumers often face not only lovelessness, but also poverty, lack of meaningful role in society and a cruel stigma, that ironically can be at its strongest in families of origin.
 
Support workers should not shy away from the concept of love, and its efficacy for consumers.
 
One consumer interviewed for the "Rites of Passage" consultation of the Northern Area Consumer Consultants Project, was a rather shy and lonely middle aged bachelor. He subsequently passed away of natural causes, never fully realising just how many consumers and staff at the clinic held genuine affection and love for him. He had this to say:
 
"Everyone, no matter who they are has something to offer society. I believe everyone deserves a bit of love, no matter who they are, rich or poor, sick or well...because love goes a long way."
 
If consumers seem a bit "different" we must all understand the effects of past long hospitalisations, debilitating megadoses of medication, some drastic effects of the medical model, which many consumers find too narrow and disempowering and the cumulative damage on consumers of a system whose methods can be harsh and failing to treat people as humans. Some doctors' blinkered faith in medication as a the only panacea, excluding any real interest in or consideration of the significant contents of our life journeys, disempower us, wither our spirits, rob us of hope, and tend to gravitate against recovery.
 
It is important for a support worker to be a good listener, with the patience to hear long, painful stories -- knowing this is very healing in itself -- and the ability to reflect back key emerging themes to the client, help generate options, and to exercise restraint when tempted to jump in too quickly with possible solutions without enough attention to detail or process. It is remarkable just how often consumers, when encouraged, can generate their own unique and creative responses or solutions to problems. This says a lot about the nature of consumers, but also a lot about the nature of problems:

As consumers working through issues we have established that:

Open mindedness, a ready acceptance of people "where they are at" and a democratic world view according equality to all people, are qualities many consumers really appreciate in a worker, which really assist the processes at hand. Workers will have their likes and dislikes, but must maintain a positive regard for all consumers, perhaps using the social requirement of "appropriateness" as a reference point to talk around with any difficult clients.
 
Disability support workers will also meet consumers they like, admire and respect for their courage, spiritual insight, grasp on profound truths and their often hard-won wisdom. This kind of personal enrichment is an important resource for workers, so their energy and enthusiasm become sustainable and renewable resources. The people you see growing and evolving, partly under your influence, will give you energy to deal with the more mundane or frustrating aspects of the work.
 

The difficult area of spirituality
 
Spirituality is inevitably both a "minefield" and a source of strength and inspiration to many mental health consumers.

This demands creative responses from support workers, case managers or doctors, who may be required to help reverse some of the damage of some consumers' over-identification with the "dark shadow side" of religion, sometimes arising our of early traumatic religious "abuse" experienced in families of origin.

Some consumers become fixated on concepts such as fundamentalist "hellfire and brimstone" scenarios, eternal damnation and the threat of a terrible Doomsday at any time now, or may feel compelled to "take up their own cross" and try to function in a harsh secular world while living out roles of religious figures. This is not conducive to a smooth passage through life, to say the least.

Some people become extremely depressed because of a delusion "bubble" bursting, as they return to a more everyday type of consciousness, but find the world and its problems all too horrible compared to the shining heavenly utopias of their former "waking dreams" that doctors call delusions. Some sufferers can spend years "trapped between worlds."

There are sometimes mishaps in spiritual searching, and the mental wellbeing helper needs to constantly highlight concepts such as:

•    the need for having proper instruction from a recognised teacher, in spiritual learning. Not just books, which can be a haphazard way to learn;

•    preparing the mind and body for spiritual experiences;

•    the need to remain "grounded" while following spiritual or meditation practices, to avoid "spinning out" or losing touch with the common world; and,

•    the concept of the need to strive for balance in all things, as a way of flowing with, rather than against, the basic tendency of nature and all natural systems to seek to return toa state of balance.

Indeed these imperatives are important in the healing process itself..

People going through mental suffering need a lot of very sensitive support and gentle guidance. It is important for workers to try to help the person reduce the damage of "afflicted spirituality," and start to heal, without interfering with destroying the underlying good and unifying aspects spirituality can offer.

This is very tricky, and may involve a gentle, long-term process involving a progressive re-orientation to approximated "consensus" reality and encouragement that the (so-called) "real" world is not such a bad place really, and try to instill hope that the person WILL gradually re-acclimatise to the everyday world. (Not that anyone would want recoverers to turn around and imitate the many desensitised and numb "normals" who calmly munch on their dinners while the world continues its orgy of death and destruction on the nightly TV news.)

A useful frame of reference for support workers is a very wide and generic version of spirituality that recognises and respects the diversity, and often individual flavour of religious beliefs.

It is possible to work with concepts such as;

•    an often eclectic comparative religion studies and mythology;

•    the Universe;

•    a Higher Power, which can reside both within and without;

•    the importance of respect for others and other creatures.

•    nature's bountiful beauty, healing powers, wholeness, and imperative to seek balance.

•    notions of the common good as defined by traditional and International conventions;

•    the practical and pragmatic good outcomes of right actions, as well as ethical benefits;

•    the need many people have for a personal God and creator who loves them and has promised     them Heaven after this life, if they live good faithful lives.

•    Another key idea is philosophical stance of believing in the essential goodness and nobility of the human spirit, at its best.

Folk stories and fables, or having creatively facilitated "story telling" sessions about our lives or our ancestor's lives, or even an imaginary life we would like to have, can also be very rewarding for consumers. Such approaches tend to stimulate individuation processes and reinforce ego strength, which are often weakened in mental health consumers.
 
Finally, on a very idealistic but also attainable note, workers who possess, develop and creatively employ the qualities outlined in this article -- and there are so many more we could have mentioned -- can effectively and enduringly assist consumers by assisting us to find many ways of creating pathways within ourselves, illuminated by a growing awareness and self-knowledge, bringing us back to our own, often hard-won but bountiful, inner resources.
 
This is true empowerment and avoids any undue dependancy problems. It is like a psychosocial version of the aid agency maxim that if you give a man a fish today, he will be hungry tomorrow; but if you show him how to catch fish, he will be fed for life.
 
 


 
*Allan Pinches is a former metropolitan journalist who currently works as a Consumer Consultant for the Northern Area Mental Health Services. He is a consumer member of the Neami Inc and Richmond Fellowship of Victoria boards. He is currently the Vice-President of Neami Inc, and regularly writes articles for mental health publications in print and on the Internet.
 

Sue Robertson, BA, (Monash.) is a pioneering Neami Inc consumer, who has served on the organisation's board as a consumer member for five years. In addition to committee work and her active participation in the life and development of Neami's Catch 23 Day Program in Thornbury, Sue has been extensively involved in staff selection processes for Neami.