# Empathy Increased in Rural and Remote Health and Social Care Workers by Participation in the Hearing Voices That Are Distressing Simulation Workshop

## TL;DR

A simulation workshop increased empathy among rural health workers for people who hear distressing voices, improving understanding and communication.

## Contribution

A simulation-based workshop was shown to significantly enhance empathy in non-specialist rural health workers toward voice-hearers.

## Key findings

- Empathy scores increased significantly after the workshop (p's < 0.001).
- Participants gained a deeper understanding of how distressing voices affect daily life and concentration.
- The training is especially valuable for generalist workers in rural areas with limited resources.

## Abstract

Evidence suggests that health care workers are often uncomfortable talking with people about hearing voices, despite recommendations that voice‐hearers be provided with opportunities to freely discuss their experiences. Moreover, in rural and remote Australia, workforce shortages mean that a broader range of workers, often non‐specialists, are providing services for people with complex mental health presentations. Improving the skills of this non‐specialist workforce is therefore an important endeavour. The Hearing Voices that are Distressing (HVD) simulation workshop was originally developed by voice‐hearers and provides participants with first‐hand experience of what it might be like to hear voices that are distressing. HVD simulation workshops were delivered by a mental health academic, a mental health clinician, and a person with lived experience to 62 health and social care workers in rural South Australia. Mixed methods were used to examine the impact of the workshop on participants' level of empathy for people who hear distressing voices. The revised Kiersma‐Chen Empathy Scale assessed changes in empathy, and post‐simulation reflective group discussions were qualitatively analysed. Statistically significant increases in empathy were reported following participation in the simulation (p's < 0.001). Participants reflected that having practical experience helped them develop deeper understanding of the impact hearing distressing voices has on a person's day‐to‐day life; how they may be preoccupied with their internal world; impacting their concentration and engagement with others. Results indicated that this training would be highly valuable for health and social care workers, and particularly generalist workers in rural settings where resources are stretched.