F LoC

To Whom It May Concern,

I have been advised by two peer workers within NSW Health, and a peer worker outside of NSWH to file a formal complaint about a series of incidents that have occurred within Campbelltown Safe Haven with Senior Peer Worker x.

·       Repeated breaches of privacy

·       Inappropriate use of information in guest notes

·       Challenging a guest on why they would want an anonymous MRN in light of the above

·       Language and jokes toward queer and gender-diverse guests that aren’t acceptable

·       Information being relayed to guests knowing that it’s information they shouldn’t have access to

1 –  The first concerning breaches of privacy is around a chat x and I were having to resolve a previous formal complaint where a peer worker (Tam: Liverpool) had chased after a guest as they were leaving and tried to shut the gate on them, preventing them from leaving. This was then followed up with Tam calling me after I’d left the center and said that if I didn’t come back later that afternoon to let them know I was safe they would have to call the police to do a welfare check. It was supposed to be a general chat to explain where things had ended up, but after getting through the details of that, x decided he wanted to chat about sensitive things disclosed to another peer worker. 

One of the issues here is that what was disclosed was incredibly sensitive and touched on what could be construed as *** *** within an already abusive relationship. x’s approach to this was to start with “I just wanted to talk about something I read in your notes”, and then went on to try and tell me that it wasn’t my fault and I didn’t deserve it. While I get where he may have been coming from, it’s an incredibly touchy (and for me, very triggering) conversation to begin with, and the idea that he thought this was something he could just bring up out of the blue during something that wasn’t a “one on one” was jarring.

Another issue with this is that it’s a topic he is unqualified to unpack as a peer worker as it is a subject that needs to be addressed in a setting with a psychologist or counsellor in the very real likelihood it would cause retraumatisation (surprise, it did).

Further, and I asked him this when I queried why he thought this was acceptable a week later, is why he thought as a cisgender male that this was anywhere near appropriate to approach sitting across from a transgender woman. My question to him on this was “would you, being male, have this conversation with a guest who was born biologically female?”. His response to this was to dodge the question altogether.

There were then comments made about how I was apparently stuck in my situation and wasn’t really making the effort to try and get myself out of it.

My situation isn’t just a case of “I’m depressed and suicidal”, it’s a combination of trauma, having had to wait months while I was in crisis to be able to access the proper services to be able to talk about and unpack this, complicated by every time I’ve had a suicide attempt it has been off the back of either a) introduction of new medication, or b) adjustment of medication doses, which has been repeatedly noted with my psychiatrist along this whole process, but he seems to think I’m just not engaging help-seeking skills when in crisis.

I also hadn’t had problems of this severity prior to the last six months of 2023, which lines up with the introduction of Mirtazapine when I was admitted to the Mental Health Short Stay Unit at Campbelltown Hospital initially. It got progressively worse since then with medication changes and adjustments. There’s zero consideration for the possibility that I’m having to deal with multiple problems at the same time and there’s no one main factor in why this is happening.

2 – It was because of point 1 that I requested an anonymous MRN so that information I had given wouldn’t be brought up the way it had been. x's initial response was to challenge me on why I would even need one. Part of my reasoning was that I was looking at doing an admission in a private clinic and didn’t necessarily want them to be able to have access to my notes from Safe Haven given the amount of information I had disclosed. When he said that private clinics don’t have access to records and notes kept on NSW Health systems, I expressed my other concern about guest privacy within SH.

The response to this was to indicate that I was being paranoid, but I would eventually get my anonymous MRN, and he announced to everyone that I would be recorded as AnonymousMac***.

3 – If this wasn’t enough, and to prove the point I was trying to make, after my most recent suicide attempt (on a Monday in the first week of December?) I had gone to Safe Haven, as this was what I agreed to do when I was discharged from ED. It was almost as soon as I had gotten in the door that x had said to me “I know I’m not supposed to know this, but I know that you were in ED on Monday”.

He then detailed a conversation he had with the SPOT clinician Phil about how that was where he got the information from and there was a discussion had about whether or not the situation where I had raised these complaints with x (the day previous) had possibly contributed to my presentation to ED and how that could have been approached differently. x stressed that he was convinced he did the right thing and that he wouldn’t have changed his approach to the whole situation.

The above also means he was entirely dishonest about the access to live data from ED that Safe Haven has. All workers have access to this through TZS laptops, they have the capability to go into a ’s notes and read what has happened. I understand recently that there was a directive given about how Peer Workers aren’t to go into a /guests file unless given permission to, but this isn’t good enough, because the repeated breaches of privacy have already occurred and damage has been done from this.

My response to this has been to specifically not talk to x beyond general chit chat and not engaging about anything that could remotely be an invitation to talk about anything previously mentioned in my notes, and indicate that I wouldn’t be able to do a “one on one” with him.

4 – Christmas Day, x decided that we needed to “make peace” and said that he was aware that I had spoken to a person within NSW Health and another support worker outside of Safe Haven about these concerns and was told that this absolutely warranted a formal complaint. The problem was with which way this should be approached: write a letter of complaint and give it to management at Safe Haven Campbelltown, send it further up the chain via the Mental Health Liaison Officer, or bring public attention to how people with mental health problems are treated within the public system. This time he said he was sorry for what had happened and if he could change the situation he would.

Of course, since my notes are supposed to be anonymous now, it was surprising to hear that this was information that I was being presented with. When I brought this up with another peer worker who I did have a “one on one” with, they did raise concerns they had with how other /guest records were just being accessed, read, and discussed. It was also highlighted during this conversation that Campbelltown SH is the only one that takes notes that are quite so detailed. There is only one Peer Worker that I’ve spoken to who has asked about the sort of information and things discussed I wanted recorded in my notes, which is honestly how it should be done unless there are indicators of something serious and falls under mandatory reporting requirements.

5 – Attitudes toward trans and gender diverse s/guests is pretty abysmal, to be honest. Sitting at the table in the main area of SH x has repeatedly brought up how before I started presenting at Safe Haven he had zero exposure to trans people within the community. This was followed up with his only references to trans people fell under his understanding of gay men who “went to Oxford Street back in the day and hung around public toilets in parks”.

While I do have a platform on social media where I have become a de-facto educator on trans issues, and that it falls within my field of advocacy and activism, it should not be my responsibility to educate about being trans when I am accessing a service like Safe Haven. It’s not a space I want to have to use and hear gay jokes, or racist jokes, and then have it backed up with “that’s just who I am, I tell it how it is”. It’s great that he is such a straight-forward person and his approach is to “tell it how it is”, but there’s a point where this only does more harm then good when dealing with people in crisis, possibly more-so when suicide is a factor.

6 – There are times I have presented to Safe Haven where I haven’t “looked” as female/feminine as I have at other times. This comes down to the issue of how much effort I have to put into presenting a certain way, and the way I am treated by x is almost dependent on how I’m presenting on the day. He’s made comments to the effect of “I see you’re very male today” or “you’re wearing male clothes” (my wardrobe consists almost exclusively of skinny jeans, and a range of tops bought from the women’s section or stores like City Chic, and this idea that I am suddenly male or female depending on my hair and makeup (or clothing) is really offensive).

Who I am as a person doesn’t change depending on how I present, and there’s an understanding with other Peer Workers around the idea that if I haven’t put effort into how I present too much, then it’s an indicator of where I’m at with my mental health. I’m not suddenly my deadname or detransitioned because I am too exhausted to do my makeup.

7 – I’m a guest or consumer at Safe Haven, I shouldn’t have to be advocating this hard for myself. I understand that the service has done a lot to try and link me in with outside services, but that I’m having to write this letter to address issues within the service while I’m in and out of crisis is unacceptable. What’s worse is that I have to include in this feedback and complaints from other Peer Workers because they aren’t confident it will even get addressed if they raise it within the service. A guest shouldn’t have to weigh up just how much of their visit is going to be geared towards navigating inter-staff issues against how much they are going to get out of accessing the service.

I’m aware that me studying to be a Mental Health Peer Support Worker gives me some insight and avenues for conversation with Peer Workers that isn’t normally present with other guests, but I’m torn between how much this is actually helping me, and how much this is work I’m having to do to bring attention to massive gaps in service and abuses of privacy.

I shouldn’t have to be in this position, but I’m doing it because Safe Haven is an important service in the community and I can’t deal with the idea of what happens if I don’t say anything. What happens if a guest comes in and the wrong thing is said and they are completely retraumatized as a result? It’s not something someone should have to even consider when accessing the service, but that was the position I found myself in.

Suggestions and possible ways forward:

·       Guest notes shouldn’t be treated as general reading material by peer workers. There is an expectation of privacy there that should be respected, especially if a guest has notes added from other services. I understand that access to these notes may help in talking to a /guest, but since Peer Workers aren’t clinicians, there’s no real reason for them to be digging through them.

·       Guests should be given explanation on exactly how their data is used, how it is accessed, why, and by whom.

·       Guest notes and what is recorded in them should be GUEST directed unless there’s something in there that requires mandatory reporting.

·       When a guest requests anonymity, it should be given without question. It’s not up to the Peer Worker or Senior Peer to decide who gets the right to invoke that. It’s written on the gate that you can request to be anonymous, and this shouldn’t be treated as some special information.

·       Trans and gender diverse people aren’t responsible for educating Peer Workers or the Senior Peer on the specifics of the trans community. We’re s/guests who use the service first and foremost. Some/most of us are happy to ask questions, but context and appropriateness is important.

·       If Safe Haven is advertised as a queer friendly and trans-inclusive space, then there is no reason gay jokes or anything relating trans women to gay men should be acceptable. One of the biggest problems the trans community faces from people who are hostile is that we’re just gay men who couldn’t deal with the stigma attached to homosexuality, so we transitioned so it was easier.

·       There needs to be space put between x and queer guests, or at the very least a way of educating him around things he can and can’t say. This isn’t just coming from the perspective of a guest, it’s been expressed that this is a problem from other peer workers.

·       A Peer Worker doesn’t get to decide whether a guest is doing enough to get themselves out of the situation they’ve found themselves in, especially knowing how hard people work at trying to access services and support both within and outside of NSW Health. We can all agree that the system is in crisis and it’s failing more and more people. There doesn’t need to be guilt put on a person for them not being able to access services or help.

For me, personally? I had to take out private health cover I can’t afford just to be able to keep myself safe while I was in crisis with an admission to a private clinic. I’m barely able to afford to pay my bills and eat as a result. This is completely unfair, especially when people are encouraged so strongly not to give in and take their own lives. We’re supposed to fight and stay…

For what?

My experience of the NSW mental health system has been horrifying. I can not understand how people manage to do this day in/day out. I don’t understand why Peer Workers are being used in places where properly qualified support people should be present. Don’t get me wrong, I think Peer Workers are amazing, and it’s something I am planning to do, but I also see firsthand the impact that doing this sort of work has on some people who are at times incredibly vulnerable themselves.

Everyone in this deserves better.

I’m happy to be contacted on 0434 *** *** for discussion about the above.