What can the lived experience workforce learn from gender equality and…regulation?
Regulation, gender equality and lived experience. These are policy areas that hang out at parties…but they should! I have been one to write about and explore how regulation can play an important role in reducing and eliminating coercion from the mental health system. But it also has a role in dealing with deep structural inequities grounded in ideological divisions when it relates to the lived and living experience workforce in mental health settings.
In 2021 I was fortunate to interview Dr Niki Vincent from the Victorian Gender Equality Commission as part of a podcast (episode #11) I used to host, From Rules to Reality: How Regulation Shapes, or Fails to Shape, Our Daily Lives. I already viewed regulation as having a crucial role in human rights issues across the mental health system, but I left the interview convinced of the value that regulation could play to addressing another area: the conditions under which the lived and living workforce operate.
What is the lived and living workforce?
The lived and living workforce (LLEW) refers to a broad set of roles that are designated for people with lived experience of mental health issues, alcohol and other drug issues, or as a family member or supporter of these groups. These roles form part of disciplines that are grounded in lived experience community-based knowledge and practice, often as resistance from oppressive mental health systems. The Victorian Government recently commissioned and released discipline frameworks for these different LLEW disciplines, including for:
Similar frameworks have been developed nationally.
What are some of the challenges the LLEW face?
These workforces face a great number of compounding and intersecting forms of injustice and inequality. Unequal pay, poor workplace conditions and a lack of respect for their discipline (Edan et al, 2021; Ainsworth et al, 2020). There remain a lack of developed career pathways and undefined scopes of practice that leave new LLEW members susceptible to poor work conditions or capture by the systems they often joined to reform or challenge.
As has been written on many occasions, hierarchies within mental health workplace settings can replicate the experiences that people experienced within the mental health system. The Royal Commission into Victoria’s Mental Health System (2021) acknowledged that:
Complex power imbalances rooted in professional, historical, social and statutory hierarchies continue to influence the opportunities available for people with lived experience of mental illness or psychological distress to lead, shape and participate in Victoria’s mental health system
These challenges are likely to grow and come into focus with the growth in these workforces (David et al 2024).
What does the law currently do to protect the rights of the LLEW?
The LLEW exist in a web of interconnected legal arrangements, including:
occupational health and safety law,
equal opportunity law,
tort law, and
employment law (Katterl, 2022).
These laws focus individual workers’ claims against discrimination (e.g. equal opportunity laws) as well as broader psychological safety and other duties on employers (occupational health and safety and employment law). These laws have varying promise to address the issues raised above.
For example, there are significant limitations to the use of equal opportunity laws for systemic change in general: the reliance on complaints based approaches has shown to only have a minimal impact on awareness and the ultimate elimination of discrimination against marginalised communities (Allen, 2021). Equal opportunity laws also fail to address the needs of the LLEW because it is often not discrimination based on “mental health” or as a “carer” that is the issue, but rather a broader marginalisation of the knowledge that springs from these community-based identities and knowledge bases, and the exercise of power within old power structures.
More positive signs might come from the informed exploration of occupational health and safety laws. Though uptake and implementation of psychosocial standards within a LLEW context has been limited, mportant establishment work has been started by lived experience leaders (Gullestrup, 2025). This still, however, may fail to deal with broader structural inequities such as around pay and around the value ascribed to different LLEW disciplines.
In effect, the law as it stands lacks a proactive, systemic and workforce-specific approach to addressing inequality (in its many forms) in public mental health services. This problem has many dimensions, one of which is failed regulation.
How did the Victorian Government seek to address this regarding gender inequality in the workplace?
Similar issues were confronted in Victoria prior to the establishment of the Gender Equality Act 2020 (Vic) (GEA). This legislation was largely borne of the failures of equal opportunity laws (Equal Opportunity Act 2010) to address entrenched inequality and discrimination within workplaces. The reliance on complaints-only mechanisms, paired with the lack of proactive regulation and data-driven approaches meant that there was little shift being seen in gender equality despite broad goodwill.
Enter the GEA. The primary objective of the legislation is to promote gender equality and improve the status of women; to identify and eliminate the systemic causes of inequality in workplaces and communities; to redress the disadvantages faced by women; and to promote the human rights of women under Victorian and international law.
The GEA seeks to do so through a sophisticated regulatory regime that monitors and gives effect to the rights of women (trans and cis). This regulatory regime include concrete requirements on public sector bodies (this does not extend to the private sector) to:
Promote gender equality
Conduct gender impact assessments
Undertake a workplace gender equality audit
Create a gender equality action plan, and
Report on that progress (What You Need to Do to Comply with the Gender Equality Act, 2023).
To give effect to these duties the GEA creates a Public Sector Gender Equality Commissioner with powers to compel information and enforce compliance with the GEA. The value of the GEA is that it has identified the points of inequity between genders, identified evidence-based approaches to addressing those inequities, and created a regulatory infrastructure (including the Commissioner) to drive change.
A key part of the regulatory approach is “informational regulation” (the use of information to drive positive outcomes), whereby data is publicly available (New Data on Gender Equality, 2023), showing regular progress by public sector bodies and holding those accountable who are falling behind.
How could this assist the LLEW?
This regulatory model could begin to address inequities faced by the LLEW in the mental health sector that current laws don't cover. A regulatory framework for the LLEW needs:
A clear understanding of the inequities and harms the LEWW faces compared to non-LEWW.
Identification of where these inequities are most severe for LEWW members.
Evidence-based, LEWW-led strategies to tackle these issues.
Drawing on identified inequities, a regulatory regime could focus on:
Pay disparities between LEWW and non-LEWW in public mental health services.
The makeup of LEWW and non-LEWW in public mental health services.
Experiences of stigma and discrimination at work.
Recruitment and promotion of LEWW members.
Work segregation for LEWW and non-LEWW roles.
Leave, flexibility, and reasonable adjustments.
These areas can drive change across public mental health services. A regulatory body could require services to:
Promote equality for the LEWW based on key indicators.
Conduct impact assessments and readiness frameworks.
Audit their performance against these indicators.
Develop a LEWW equality action plan.
Report progress publicly and to the regulator.
This process could bring about significant, systemic change for the lived experience workforce. These are calls that I have been making for close to four years. It is up to the sector to take these issues up in a funded way to explore and operationalise them in more detail.
References
Allen, D. (2021). An evaluation of the mechanisms designed to promote substantive equality in the’Equal Opportunity Act 2010’(Vic). Melbourne University Law Review, 44(2), 459–501.
Ainsworth, S., Alvarez-Varquez, S., Edan, V., Johnson, B., Roper, C., Sellick, K., Smale, K., & Switserloot, J. (2020). Leading the Change: Co-producing safe, inclusive workplaces for consumer mental health workers. VMIAC & University of Melbourne. https://socialequity.unimelb.edu.au/__data/assets/pdf_file/0005/3532820/Leading-the-Change-Report-2020.pdf
David, C., Stojanovska, D., Nipperess, S., Lambert, C., Walters, C., Petrakis, M., Alvarez, A., Wyder, M., Casaceli, L., & Gor, D. (2024). Setting priorities for mental health family carer research and advocacy in Australia. International Journal of Care and Caring, 1(aop), 1–7.
Edan, V., Sellick, K., Ainsworth, S., Alvarez-Varquez, S., Johnson, B., Smale, K., ... & Roper, C. (2021). Employed but not included: The case of consumer-workers in mental health care services. The International Journal of Human Resource Management, 32(15), 3272-3301.
Gullestrup, J. (Director). (2025, March 26). Workshop Psychosocial Hazards Experienced by the Lived Experience Workforce (QLEWN Conference) [Video recording]. https://www.youtube.com/watch?v=6j-uR5mJB_c
Katterl, S. (2022). Examining the workplace rights of mental health consumer workers. Australian Health Review, Advanced online publication. https://doi.org/10.1071/AH21311
State of Victoria. (2021). Royal Commission into Victoria’s Mental Health System, Volume 3: Promoting inclusion and addressing inequities (No. Parliamentary Paper no. 202, Session 2018-2021 (document 4 of 6)). State of Victoria. https://finalreport.rcvmhs.vic.gov.au/download-report/
New data on gender equality. (2025, February 27). https://www.genderequalitycommission.vic.gov.au/new-data-gender-equality
What you need to do to comply with the Gender Equality Act. (2023, April 27). https://www.genderequalitycommission.vic.gov.au/what-you-need-to-do-to-comply
