Mental illness education through stories of lived experience: validation review of the donoharm framework

The lived experience of people with mental illness is a powerful way to promote mental health literacy and reduce the stigma associated with mental illness. However, there is little guidance on how to do this safely. Mental Illness Education ACT is an Australian organisation that since 1993 has supported volunteer educators to share their individual stories of lived experience to school and community groups. In 2011, they developed the DoNOHarm Framework to assist volunteers to be able to talk about their experiences in a way that is safe for them and for their audience, a gap that they recognised in the field. This study reports a review of the Framework, considering the extent to which it is supported by the current literature and how it is being implemented and experienced by the volunteer educators. These research questions were addressed by a literature review and interviews with 14 volunteer educators and the staff that support them. The review of published literature over the past 10 years showed strong evidence for three of the six principles of the Framework: Context and Purpose, Recovery Empha-sis, and Safe Talking. Although the principle of Respectful and Inclusive Language is widely promoted in the mental health field, no recent studies investigated the benefits of this approach. Similarly, there was no recent research into the two principles of Limits to Helping and Self Care. The interviews revealed strong support for the Framework among volunteers. It was seen to be effective to protect the safety of both presenter and audience, ensure the relevance of the presentation, give educators confidence in their message and delivery, convey a hopeful message, and make certain that presentations were engaging for the audience. Overall, this review shows that the DoNO-Harm Framework fills an important gap for mental health education, with a sound evidence base where there is published evidence available.