A conversation with Tim on ‘Not Before Time’

Earlier this week a range of lived experience advocates released Not Before Time: Lived Experience-Led Justice and Repair. The report – which advises the Victorian Minister for Mental Health – outlines the different ways that governments and mental health systems should acknowledge harm caused by mental health and associated systems.

I wanted to speak with Tim Heffernan (he/him) who, alongside Kerry Hawkins (she/her), helped facilitate the Reference Group that decided on the recommendations in the report (you can read more about the process on the website or full report). Tim has been a consumer leader working as a peer worker, consultant and government official for decades.

So, Tim, what was it like being part of the project and co-facilitating the Reference Group?

It felt like I was part of something important, historic and needed. The project moved all of us into feelings, memories and places that were at times both confronting and liberating. Our discussions that took place over many meetings and in safe spaces between the meetings, reinforced our unique, individual experiences of the mental health system as consumers and carers.

The members of the reference group were all sensitive, intelligent, collaborative and compassionate in their approach to this work, even when seemingly intractable issues arose. As I mentioned before the experience of harm from the mental health system is deeply personal and there is a difference between being directly and personally harmed by coercion, violence and involuntary treatment, and being the carer or family supporting and witnessing these human rights violations.

I think the reference group navigated these difficulties and differences as human beings acknowledging and respecting the experiences of each other. When people needed to leave the group we always honored their choice while retaining the wisdom and insights that they had left us with. I admire each person who began this process as part of the reference group and I was honored to co-Chair with my friend the amazing Kerry Hawkins. I have known Kerry since we attended Boston University’s Global Leadership Institute in 2013 and her leadership, intellect and reformist advocacy always fuel my passion in this often-difficult mental health space.

The opportunity to support you Simon in this process has been important to me as well. Few people with a personal lived experience of mental health issues have developed their voice and ways of working as well as you have. Thank you for inviting me in to the Acknowledgement of Harm project Simon!

Consumers and survivors have long spoken about harms in the mental health system. What do you think are the least understood parts of this conversation in the general community?

For many people these harms have been out of sight and out of mind, and the general community seems to accept that. When the mental health system moved out of the institutions and into the community in the 70’s and 80’s there was still a perceived community need to keep consumers and survivors as somehow separate and invisible. Notions of dangerousness, perpetuated in film, television and the print media always presented a distorted, inaccurate, yet popular view of us. Coercion, physical and chemical control, limitations on, and infringements of, our human rights were legislated into Mental Health Acts. Harm is justified because it is legislated.

I think the general community don’t really understand that these harms are not necessary, that we do have human rights that are not recognised in mental health legislation and that we are still abused in mental health services through their ‘treatment and care’.

We covered a lot of different ways to acknowledge harm in the system – public apologies, restorative justice processes, reparations, guarantees of non-repetition. Are there options that stand out to you?

For a long time, I have believed that the intractable differences between the traditional mental health professions and people with personal lived experience of mental health issues would only ever be dealt with through a process of truth and reconciliation and because acute mental health services have always been the responsibility of the states, it is appropriate that Victoria, following the Royal Commission should deal with the individual and collective experiences of compulsory treatment that harmed people and stripped away our human rights. All people should have the opportunity to speak their truth and in the spirit of this restorative justice approach there needs to be an opportunity for forgiveness and reconciliation, an opportunity to go forward with the knowledge of past harms.

This moving forward can be strengthened by a sincere and generous apology from government and from professions that have caused harm in the past. If the apology is sincere then I don’t personally see the need for any guarantees of non-repetition as I see this as being implicit in the saying sorry. Nor do I see the need for reparations. Following the truth telling, reconciliation and apology what is need is the true co-design of services that are established in the spirit of these processes. These will be radically different from the traditional services that have caused harm, and often they will be run by, led by, and staffed by people with personal lived experience.

It makes sense to seek the truth and to understand the processes of reconciliation before a formal apology.

Why do you think acknowledgements of harm are necessary around mental health?

We cannot move forward, away from the flawed biomedical system of mental health issues without an acknowledgement of the harm that that the system has caused to the very people it sought to help. People have always been stigmatised by diagnoses that implied they were flawed and less than human. Abuse of people’s human rights has been sanctioned by making compulsory treatment and medication lawful.

Personally, the harm of seclusion and restraint that I experienced as a young man continues to haunt me. The processes of healing from trauma can only begin with an acknowledgment of the harmful practices that caused it.

You’re unlucky enough not to live in the self-assessed best state in the country – Victoria. So, what opportunities do you think this report provides the rest of Australia?

I love ripples, Simon! This pebble thrown into the national pond will spread and so other states and territories will also need to acknowledge past harms so that they too can move ahead. I do hope that the Victorian Government will follow through on their intent and vision in commissioning this incredible group of people to set out the best option for an acknowledgement. If they do, they will be remembered as true leaders in mental health and the work of the Royal Commission will be embedded and amplified through this restorative, healing acknowledgement.

Do you have any final reflections or requests?

Just for us to remember that the acknowledgement of harm recommendations do not seek to blame the people who work in mental health. They simply ask for a recognition of past and current practices that harm, so that we say sorry, come together and learn how to look out for each other in the future.