After being diagnosed with psychosis in the 90s, Matthew Ball was hospitalised and treated with medication and electroshock therapy. In 2017, Matthew was recognised by the Australian College of Mental Health Nurses as the best mental health nurse in the country. Quite a jump! In addition to being a qualified nurse, Matthew is also a psychotherapist, counsellor, educator and consultant, and he’s dedicated his life to encouraging people to realise that they are the key to their own recovery. Matthew was happy to tell us all about his journey…
I became an accredited mental health nurse in 2009 and completed my Master’s in Nursing in 2017. I also studied counselling and psychotherapy between 2001 and 2006. Like most students, I faced the challenge of finding a balance between work, study and family. When I enrolled at Uni in the UK, however, there was a small speedbump when I ticked a box on my form confirming that I’d experienced mental health issues in the past. Even though it had been 6 years since I’d seen a psychiatrist, the Uni wanted me to make an appointment to see one before the start of the term. I refused, and thankfully nobody bothered to follow this up. Another time, my class was doing a study about suicide, and the lecturer said to me, in front of the whole class, “Matt, if this is difficult for you, please say so, as I know you’ve had suicide attempts.” It wasn’t the most helpful thing to say!
When I was an in-patient, I didn’t find the medical model treatments all that effective. The psychotropic medication may have been of some value, but it did NOT get rid of the psychosis (voices, visions, beliefs). The ECT wasn’t helpful, either. While I enjoyed the tea and toast they give you afterwards, I take the view that ECT is being administered without a reasonable understanding of how it works, and that means it can be very harmful. It’s also spoken about in terms that leave you feeling powerless (used as “a last resort treatment”, that sort of thing).
You do NOT have to be rid of all symptoms in order to achieve your goals. If we decided to see symptoms as meaningful results from our life events, or as a part of a person’s journey, perhaps we’d be able to better understand what these experiences represent. For instance, a symptom could just be your body’s survival mechanisms (say, a trauma informed approach) kicking in. “Total remission” is the language of the biomedical model, and for many of us such a term can actually disempower. The biggest hurdle facing people with a lived experience is how the established medical model of illness and diagnosis tells us that we absolutely require an outside clinician if we want to have any chance at recovery. This focus can damage how we see our own powers of resilience and self-betterment. Not being the arbiter of our own recovery journey is very disheartening and can hold people in “the illness trap”.
I don’t think that a mental health diagnosis on its own is a positive thing. Having a “straight answer” by being diagnosed won’t help, because it’s not actually a straight answer. I think that for some people a diagnosis can be useful at times, but after its limited value has been spent we can find ourselves disempowered and confused as to what else we are allowed to explore with forced treatment based on a largely hypothetical diagnostic process. The chemical imbalance stuff is nonsense, and our journeys are complex things that evolve and change as we work through them. As the clinical path is enforced as through it was evidence-based, this makes it a real problem. But if a person finds value in giving what they’re experiencing a clinical name, then that’s good, because value and meaning can come in many different forms. But do I think diagnosis is crucial to recovery? No.
We should try to make sense of – and find meaning in – people’s psychosis and voice-hearing. It’s not difficult if the attitude of both parties is right and we are able to put aside the majority of the medical model. It’s about listening and being with a person to understand their personal journey, rather than labelling, oppressing and directing. It works in supporting a person to make autonomous paths in their life instead of having professionals leading the way. Of course, a person has to work hard to find their path, but this is true of all lives, I guess.
The alternative is to listen to people and value their perspective. Labels are only required because public services and non-government organisations operate on targets. They’re about processing human beings like numbers. I’m not against a label if someone values it and they are supported to know the alternatives so they have genuine choice. The diagnostic system is not about individuals making a choice.
Takes one to know one?
I believe there is a power dynamic that often exists between mental health professionals and the individuals who access the system that they run. My history may have given me a natural empathy, though I don’t believe that a lived experience is an essential requisite if somebody wants to gain this level of understanding. Due to my history, most days I take some time to reflect on the limited differences between people who have been labelled with a “mental illness” and myself. If you work in the mental health system and you’ve had a lived experience, this can give you an insight that the average mental health professional doesn’t have, but I think there’s a lot more lived experience among nurses and other clinical staff than is talked about. If we decided to accept that a lived experience can be a positive attribute in this line of work, we might encourage these staff members to step forward and own it. I also think this is true of other professions.
If you want to help somebody who is unwell, start by walking beside them and accepting that they perceive reality in a way that may be very different to the way you see it. Do NOT try to prove they are in need of this-or-that style of treatment, or get into arguments about why they are wrong. It is, of course, legitimate to hold a different view, but accepting that they see reality in their own way is vital. This can nurture future opportunities to support them on their recovery journey, and this has the potential to be life changing.
We should be discussing how mental distress can be an opportunity to learn. Listening to a person without discounting their reality can have a powerful impact. This doesn’t necessarily have to be the traditional staff/client relationship. Working towards understanding our experiences can make mental distress a part of our journey towards a good life, rather than a dreadful ordeal.
As these kinds of experiences can be isolating, we all need to be provided with the space, freedom and respect to find and construct our own support networks. All of our support people need to accept that whoever we decide to bring into our network is up to us. This is at the heart of all genuine person-centered recovery approaches. My goal is to encourage conversations about recovery and empowering entire networks.
My biggest professional struggle is that if I genuinely want to put the person (and their supporters) at the centre of their journey, I’ll potentially face opposition. Many professionals and peer workers within the system still use the age-old diagnostic model rather than listening to the broader experiences of the individual. By challenging this, I am sometimes labelled as “anti” or dangerous. I’ve had a psychiatrist write defamatory (and inaccurate) statements about me to their colleagues because I took a person-centred and humane position on the way somebody in distress perceived things. This is a prime example of the vulnerability of the dominant biomedical discourse, as it is based in an often well-intentioned – but misguided – power imbalance, rather than on good evidence. Many of my opponents tend to focus more on defending a professional position than on a person’s lived reality of mental distress.
Although I won Mental Health Nurse of the Year through the Australian College of Mental Health Nurses, I still found it a little embarrassing when an ABC News article described me as the “best”!
I had to meet certain criteria to win, such as demonstrating that I’d gone beyond what is required in my role as a nurse and truly value the impact I have in the lives of others. I think that I was awarded this honour for the breadth of the work I do, but particularly for bringing the “Hearing Voices” approach into the public mental health system. To date, I’ve delivered this training to 120 mental health professionals, including peer workers, support workers, mental health nurses, social workers, occupational therapists, psychologists and even psychiatrists. To date, we’ve shared an alternative understanding (and approach) of dealing with realities that would normally be labelled as psychosis to over 250 individuals and families. The Australian College of Mental Health Nurses also recognised the work I’ve been fortunate to facilitate in the Aboriginal clinic, which was a great opportunity to gain a cultural understanding of mental health in the Indigenous community.
I was nominated for the award by three people: Dr Christine Palmer, who is a wonderful nurse, Suze Hutchison, a peer consultant in SA, and Dr Kath Moores, an outstanding psychologist. The decision to make me Mental Health Nurse of the Year was made by the President of the ACMHN, a lived experience rep, an Australian College of Nursing rep and one other person.
I feel very grateful for what I’ve learned from my trip through the system, and it is very important for me to remember the beautiful people I’ve met along the way. I have a strong hope that there will be a widespread shift towards more humane ways of being, as well as being in relationships with people in distress.
“Mental health patient becomes Australia’s best mental health nurse,” Brett Williamson, ABC Radio Adelaide