To celebrate Speech Pathology week (25 – 31 August) we hear from Kathleen Fanning about her role at Monash Health
Can you tell us about your role at Monash health, the program you work in and what a normal day looks like for you?
Yes. My role at Monash Health is as the Speech Pathologist for the Forensic Mental Health in Community Health Program (FMHiCH). Beginning in 2018, we are a new program that has grown out of joint initiatives between the Health and Justice Departments, seeking to improve the Mental Health and Wellbeing of Community Based offenders. Our Program purpose is to support offenders living in the community, on either a Community Corrections Order (CCO) or Parole, to successfully complete their order. In the majority of cases, offenders have a Mental Health Treatment Condition which they must satisfy, of which some or all can be achieved via our Program. Referrals are through Corrections Victoria (CV) only. As a multidisciplinary team, we work closely with other Monash Health teams, CV, and the courts, in addition to numerous external providers, services and programs as required (e.g., SECADA, DHHS, Psychiatrists, Neuropsychologists, Victoria Police, Forensicare etc.). We service the Local Government Areas of Casey, Cardinia and Dandenong, and usually see clients at a Monash Health Community site. We frequently consult at the CV offices in Dandenong, Cranbourne and Pakenham, attend court, or facilitate various outreach appointments for clients as indicated.
A normal day for me includes between 2-5 client appointments, administration time, report/letter writing, session prep, staff meetings, case review and discussions, liaison with and beyond the team, in addition to research and refinement of my own role (being a new position) with associated resource development. I also regularly seek opportunities for collaboration and Program promotion to generate interest in Speech Pathology within the Mental Health and Justice sectors.
What major/new project or initiative is your team currently working on?
Our Psychiatric Nurse is championing a new women’s group, to complement the other groups we run. A number of our female clients may not be supported/safe/suitable to attend, for example, our Group Exercise Program or Psycho-Social Skills groups, which tend to be predominantly male offenders, leaving a number of women without tailored clinical space in group format.The focus of this group is predominantly positive interaction and engagement, which will be facilitated around casual activities and conversation. On suggestion from Speech Pathology we have called it Talk & Tea Tuesdays , commencing September 3 at 12pm at Thomas St, Dandenong.
What has your journey to Monash Health looked like?
I came to Speech Pathology through a combination of personal background, fascination with speech production, the way people interact and the International Phonetic Alphabet (IPA) through previous University coursework, and general interests in human behaviours and Healthcare.
I have been with Monash since December 2018 after working in public hospitals in Queensland and Victoria for the past few years. My previous clinical roles have been traditional Speech Pathology, working in the acute care wards through to community outreach. My days involved a lot of dysphagia (swallowing difficulties) and speech and language rehabilitation.
I was drawn to my current role because I was ready for a clinical change, but mostly because of long standing interests in Mental Health and communication, and how those interact alongside policy making and the Legal and Justice systems. This is where my family background comes into my choice of work. I have seen extreme failures in the Healthcare and Justice systems, which are devastating for families, made often due to miscommunication, and Speech Pathology has the capacity to assist, and ideally – prevent those occurring. Through individual assessment and treatment plans, in conjunction with high quality consultation, we can work to protect individuals, families and communities from avoidable hardship. I’ve always believed good communication is pivotal to healthy outcomes for all.
Can you tell us about the overall role speech pathologist play at Monash Health?
Certainly. Speech Pathologists study, diagnose and treat swallowing and communication disorders across the lifespan. Monash Health has a combination of inpatient, outpatient and community Speech Pathologists across 5 hospital, and multiple outpatient and community sites and programs in Melbourne.
Monash Speech Pathologists work with children and adults with neurological or physical insults, trauma, illness or disease, from birth to palliative care. We work with individuals, families and other stakeholders to deliver optimal treatment plans, often within multidisciplinary teams.
Based around hospital care, Monash has a number of specialist Speech Pathology services, which range from inpatient acute services to outpatient clinics including Videofluoroscopic Swallow Study (swallowing x-ray), cleft and facial anomalies, and Head and Neck surgery, Oncology, Tracheostomy, Laryngectomy and Voice.
Moving into more community based roles, Monash Health Community (MHC) Speech Pathologists provide services to babies, youth, families and adults that promote independence within social contexts. This ranges between transitional services from hospital based care (e.g., supporting patients going into aged or residential care), to preventative healthcare for babies, children and families. MCH Speech Pathology services are particularly important for diverse and vulnerable communities, those with reduced social supports, and for those who are at increased risk, often with the greatest needs. Services also include counselling, stakeholder consultation, education and goal directed treatment for individuals or groups in community centres or within the home.
In particular for Mental Health, Monash Speech Pathologists offer specialist consultation and differential diagnosis services for Psychiatry, in addition to assessment and treatment plans for individuals and educational and vocational direction.
What is the most rewarding part of your role?
The most rewarding part of my role relates to research and the possibilities I see for Speech Pathology in the future locally in MHC and in the Mental Health and Justice systems more broadly. I’m looking forward to being involved with Speech Pathology specific research, within our team, with our clients, over the next 12 months, currently in the early stages. We aren’t sure of the specifics just yet, but it is an exciting space and I hope to have some new practice avenues to share based on whatever those results turn out to be.
In addition, I hope to forward the position of Speech Pathology as it is seen by the Legal and Justice systems in particular, so we may be called upon over time much more frequently, in our capacity to comment on communication with greater weight and value placed on what we assess and the management we recommend. I particularly see this as important for the Judiciary, whereby decisions about offenders sentencing and monitoring are often made with Health Professionals reports taken into account. These are frequently done by Neuropsychologists and Forensic Psychologists. We know from research that up to and above 50% of our offending community members may have an undiagnosed communication impairment. Speech Pathologists are in the unique position of having the ability to analyse an offender’s communication in depth, and thereby generate a report specific to the nature of their communication, and explain the interplay with socio-emotional-behavioural factors. I believe our reports can become complementary to how the Justice system currently makes a number of its decisions – in point, for Sentencing and Judicial Monitoring.
The theme for speech pathology week 2019 is “Communicating with confidence” can you tell us what this means to you?
Communicating with confidence for me is about being true to yourself. Knowing who you are and being proud of that fact, regardless of where you came from and what challenges you may currently face. For our clients, it can be about acknowledging their behaviours/choices/life patterns, and addressing those in a way they can understand within the context of their life, in order to move forward.
A lot of our people come from traumatic backgrounds, they may have dual diagnoses and minimal social supports. For me, being able to give someone the ability to secure a most basic need through tailored therapy goals (for example, filling out a housing application), gives empowerment which may never have been had before and which many of us take for granted. The effect of this is that offenders then gain greater confidence and learnings in how to understand and express their own wants and needs in positive ways, and hopefully can begin engaging well in their communities, rather than continuing poor patterns with negative consequences for them and others.
Communicating with confidence is about identifying challenges through assessment, therapy and management that address all aspects of a human’s life – because communication sits alongside every basic human right, including food and shelter, and we need our systems to support that.
Are there any special moments in your career that stand out in particular?
Getting this job! And every wonderful person I’ve met and worked with in this position so far.
Every colleague and professional I’ve engaged with, for every case review, every training, to the Swinburne Centre for Forensic Behavioural Science, Willum Warrain Aboriginal Association, to Corrections Victoria, the Police, to the Magistrates Court in Dandenong – I have learnt and seen so much. Thank you to Monash and the Departments of Health and Justice for making this happen.
To every offender who has walked through my door so far, I say thank you – for teaching me something, about the world, about myself, about clinicians, healthcare, drugs, family violence, money, stalking, hate crimes, crimes of passion. The world of the underworld. I am lucky to be your Speech Pathologist.
Most importantly, thank you for showing me how we as a society can continually seek to understand and assist some of our most susceptible people. Because helping you is helping ourselves and enhancing our communities.
For information about Speech Pathology visit www.speechpathologyaustralia.org.au/week or https://mhinews.monashhealth.org/speech-pathology-week-2019/
Meet Monash Health Speech Pathologist Maria Kouspos: https://mhinews.monashhealth.org/meet-speech-pathologist-maria-kouspos/