Australian Government snubs OTs and Social Workers

As a person with autism, learning disabilities and mental health issues from a background of abuse and homelessness, a lot of my skills took years to acquire. I had had a lifetime of labels, Psych and Guidance, medicated by age 9, psychiatry since my teens. But it was a social worker who liased with my psychiatrist to get me – relatively illiterate, innumerate, itinerant and at risk – back into education. The psychiatrist took the credit but it was there I understood the very different jobs these people had in the area of mental health. The psychiatrist could medicate me, but the Social Worker had a more powerful medicine – practical plans and support to change, to save, a life.

It took me from age 15 to my 20s to acquire many self help and hard won independence skills;

how to reliably carry a house key and not lock myself out,

how to drive and remember where I was going and what time it was,

how to recognise which pieces of post were bills and how to pay them,

how to manage phone conversations with agencies and services,

how to shop and keep track of change, how to manage a payment card,

how to prepare food into a meal, how to tell a friend from someone who would exploit or abuse me.

I became an author. It was one of those one in a million chance things. My book was a bestseller and I found myself able to buy my own house and had an income to support myself.

Not understanding the difference between being loved and being owned and controlled, a very clever person wangled their way into my life and house. He encouraged me to let him touch me, to marry him, to buy an isolated property and then and over the next two years progressively wore down my confidence in my hard won self help skills. Under the guise of ´helping me´, ´caring about me´, he took over the keys to the house, all the finances, the driving, the cooking, all phone conversations, all shopping, my credit card, vetted all my friends and supports until they dwindled to none and insisted I not even walk to the letter box alone. The day after the second wedding anniversary he announced he was now entitled to half of everything I owned and was leaving.

I had spent two years without practicing my self help skills. Agoraphobic, isolated, disoriented, I didn´t need a psychiatrist or medication. I needed practical hands on help in the home and the community to pattern me back into my life skills. That help came in the form of an Occupational Therapist. She helped me get back my strategies and the life skills these supported, helped me get my confidence back and helped me put supports in place for the things I needed help with. Within three months I was running my life as an independent adult, able to commute from home out into the community, even joining in community activities and looking after a cat.

The Australian government is set to slash Medicare rebates for Occupational Therapy and Social Work under Mental Health plans. Mine and those like mine are the sorts of human stories the Australian Government seems to struggle to imagine. Yet it is the story of so many adults with special needs, those from backgrounds of trauma, homelessness, addiction, who don´t neatly fit the traditional ´psychiatric patient´ box and who, from time to time, will need support to keep their lives on track or get them back on track. Many of those people will be unable to access services if Medicare cover for those services is slashed.

I became a a teacher, an autism consultant, a lecturer, and work with families and with adults with a range of abilities and disabilities, including co-morbid psychiatric issues. A percentage of my clients will access the services of Social Workers and Occupational Therapists because they require something more holistic, more practical than a medication review, medication or further scrutiny of their psychiatric symptoms. They require a hands on approach which looks at their life in the context of their community, their social networks, their personhood. Whilst we have Medicare funding for such people to see Social Workers and Occupational Therapists, such people have a far better chance at equality and an integrated place in the community. Social Workers and Occupational Therapists are trained to think and work holistically, to see beyond the labels, the ´pathology´. Their service is designed to be humanising, egalitarian, to be an alternative to the ´them´ and ´us´ they may have found with Psychiatrists and psychologists.

People are not one size fits all. Our services should reflect that.

This funding slash isn´t set in stone yet. The decision will be reviewed in December 2010.

The question is, who will take the time to speak out.

Donna Williams, BA Hons, Dip Ed.

Author, autism consultant and public speaker.

http://www.donnawilliams.net