The Australian and New Zealand Mental Health Association is an incorporated non government, not for profit organisation. The advisory board representatives have a wide background in Mental Health issues in Australia and New Zealand. We aim to EDUCATE professionals - ADVANCE knowledge for Carers and Consumers - ADVOCATE for improved services. Free to Join.
A Contributing Life: the 2012 National Report Card on Mental Health and Suicide Prevention - National Mental Health Commission
This first Report Card casts an independent eye over how we as a nation support the estimated 3.2 million Australians each year who live with a mental health difficulty, their families and support people, and how we provide and co-ordinate the services they need.
The 14th International Mental Health Conference will be in Queensland on the 5th and 6th of August 2013. Optional workshops will be held on
Wednesday the 7th of August. It will focus on a range of mental issues
including Depression, Schizophrenia, Bipolar Disorder and Dementia.
The Mental Health Council of Australia has released its annual report on mental health carers, 'Recognition and Respect: Report on Mental Health Carers 2012'.
The Report surveyed over 500 mental health carers and provides an insight into the lives of of people who regularly care for someone with a mental illness.
The 14th International Mental Health Conference"OPENING DOORS" will be held at Outrigger Inn, Surfers Paradise on Monday the 5th and Tuesday the 6th of August 2013. Optional workshops will be held on Wednesday the 7th of August. Call for Abstracts are now open.
Visit the website here
The conference will focus on a range of mental issues including Depression, Schizophrenia, Bipolar Disorder and Dementia.
The Australian
& New Zealand Mental Health Association would like to invite you to
attend the No 2 Bullying Conference which is being held at the Outrigger
Surfers Paradise on the Gold Coast from Wednesday 22nd to Friday 24th May 2013.
We are now accepting
abstracts for what will be a very significant event on such an important
topic. Please visit the conference
website http://www.no2bullying.org.auto submit your paper.
The theme for the Conference
is “Managing the Impacts of Bullying: Prevention, Policy and Practice",
the conference will examine bullying from School to Workplace and the new
phenomenon of Cyberspace.
The Bullying Conference program will
include material on:
·Building coping strategies for all parties involved
·Costs of bullying: Communities and Companies
·General health to Mental health: effects and
rehabilitation
The report was requested by the Australian Suicide Prevention Advisory Council (ASPAC) and funded by the Commonwealth Department of Health and Ageing. This report will assist the Council in their formation on advice to the Minister for Mental Health and Ageing.
The report was launched at the Australian Rural and Remote Mental Health Conference in Adelaide, you can download a copy here.
Left: Minister for Mental Health and Ageing, the Hon Mark Butler MP, and Dr Kairi Kolves, Senior Research Fellow AISRAP, at the launch of the report in Adelaide on Tuesday 20/11/12
Capacity building in rural and remote areas is hampered by the lack of availability of trained supervisors for clinical psychology and other mental health students in rural and remote locations.
Difficulties also exist with the current mental health workforce who are qualified to practice yet are unable to access a supervisor to provide the support required to deal with often complex and clinically challenging mental health issues.
Training to improve the quality of supervision and the number of appropriately trained supervisors has the potential to reduce burnout and declining retention rates.
The Codes and guidelines paper issued by the Psychology Board of Australia indicated that, under the National Accreditation rules which took effect in July 2010, there will be an increased emphasis on student supervision. More flexible rules will allow increases use of distance methods including teleconference quality video to assist training for those in remote settings. Notably, supervision will now be required for all practising psychologists, no longer just for students, thus the demand for supervision training is expected to increase significantly.
For the Mental Health Nursing profession, participation in clinical supervision is an essential requirement for completion of the Credentialing process, as specified by the Australian College of Mental Health Nurses, and is regarded as a benchmark to maintain standards of practice.
Outcomes from a program funded by the Department of Health and Ageing will be described including the development of a self-directed supported training syllabus to prepare mental health professionals for the role of clinical student supervision.
Psychiatric morbidity is linked to complex interactions
of social, environmental and biological factors. Social and biological factors
have been given comparatively better attention while environmental issues are
paid a partial consideration, especially when considering rural and remote
communities. Hence the role of basic environmental health in the development of
mental illness in rural and remote population is not understood.
This presentation will explore the link between mental
illness and basic environmental health issues affecting rural and remote
populations and introduce an environmental mental health checklist. Mental
health professionals have established the role of excessive and unrelenting day
to day stress in the development of psychiatric conditions such as depression
and anxieties. In rural and remote Australia many of the day to day stresses are
generated by issues associated with environmental health.
People living in rural and remote Australia have greater
environmental health stressors than the metropolitan population. Identifying
the link between these basic environmental health issues and development of
mental illness will lead to more effective and comprehensive psychological intervention.
The process of addressing these problems demands the need
for collaboration and partnership with various departments and community
service providers who traditionally played little or no role in mental health
care. For this to occur, mental health professionals need to extend mental health
assessment to include basic environmental factors. This
presentation highlights issues that need to be covered and introduces environmental
mental health assessment tools.
PUTTING PEOPLE FIRST: MENTAL HEALTH NEEDS AND INITIATIVES
IN AUSTRALIAN RURAL AND REMOTE COMMUNITIES.
Dr Gelaye Nadew and co-author Mrs Tania Wiley, Combined Universities Centre for Rural Health, University of WA will present this paper at the 4th Australian Rural and Remote Mental Health Conference in Adelaide from November 19th to 21st 2012
Advances in Neurobiology and Neuropsychotherapy in understanding the development of the young brain have demonstrated the need for early intervention to address childhood trauma and subsequent detrimental neural development.
The prevailing paradigms of psychopharmacological and cognitive based interventions as first line interventions for treatment of childhood trauma are confronted with a growing body of neurodevelopmental and neurobiological research that points toward the fundamental development of the right hemisphere during the last trimester pre natally and the first two years post natally.
Violation of basic needs (attachment, orientation and control, self-esteem enhancement and self-esteem protection and pleasure maximization and distress avoidance are explored in terms of neural development and developmental dysfunctions.
Since neurologist Paul MacLean postulated the Triune Brain Theory, research into neural development indicated the key functions of gene expression, synaptogenesis, neural plasticity, neural pruning and enriched environments and the detrimental effects of childhood trauma.
One of the most fundamental aspects of effective interventions (enriched environments) is the facilitation of secure attachment. Violation of secure attachment (especially in the very early stages of neural development) leads to the formation of protective (avoidance) neural loops - implicit memory systems which express especially in the limbic structures, right prefrontal cortex, anterior cingulate and orbito frontal areas.
The implications of these neural facilitations for therapeutic interventions are discussed. Specific reference is made to early intervention and challenges in rural and remote areas to provide effective service delivery. Specific strategies for early intervention are proposed.
In Australia the recent development of draft guidelines for the treatment of Borderline Personality Disorder (BPD) will set a standard for the provision of services for people with this disorder. It is therefore timely to review programs that are in place and consider how these programs fit with the proposed new national guidelines for the provision of comprehensive services informed by the recovery framework.
Dialectical Behaviour Therapy (DBT) is an evidence based treatment for BPD. Clients with this disorder have complex, multi-axial problems, are difficult to engage in treatment and intense transference and counter-transference issues can lead to clinician burnout.These problems are compounded when clinicians are working in isolated rural and remote areas.
This paper will describe the challenges and opportunities encountered in providing DBT treatment as part of community mental health services in a rural area. The DBT program has evolved over the past ten years to provide treatment for adults diagnosed with BPD as well as a DBT informed program for youth aged 14-24 years with emerging disorders of the self.
Clinical outcome data from both the adult and youth cohorts from the past three years of the program will be presented which shows reductions in service utilisation and improvements in quality of life. These outcomes indicate that DBT is a promising treatment that can be offered utilising the resources of a rural community mental health service.
Ms Rebecca Graham, Country Health SA LHN will speak at The 4th Australian Rural and Remote Mental Health Conference, in Adelaide on November 19th to 21st 2012 PUTTING PEOPLE FIRST: MENTAL HEALTH NEEDS AND INITIATIVES IN AUSTRALIAN RURAL AND REMOTE COMMUNITIES.
In April 2012 a couple of dozen psychiatrists, psychologists and mental health nurses left Cottesloe Beach in Perth riding motorcycles. Nine days later "Psychs on Bikes" arrived at Bondi Beach in Sydney.
The ride raised money for the Australasian Centre for Rural and Remote Mental Health and the riders developed an interest in trying to address the high suicide rate in rural areas (see www.psychsonbikes.com).
Renee Marie Petropoulos accompanied the ride and filmed its progress. The conference presentation is a preview of her documentary, some of which can be viewed at https://vimeo.com/44092061 (password is psych101).
Dr Joseph Dunn, Psychs on Bikes, will speak at the 4th Australian Rural and Remote Mental Health Conference in Adelaide on November 19th to 21st 2012. Visit the Conference website here
Dr Pieter Rossouw, University of Queensland will present at the 4th Australian Rural and Remote Mental Health Symposium to be held on the 19 - 21 November 2012, Adelaide, South Australia.
Advances in Neurobiology and Neuropsychotherapy in understanding the development of the young brain have demonstrated the need for early intervention to address childhood trauma and subsequent detrimental neural development.
The prevailing paradigms of psychopharmacological and cognitive based interventions as first line interventions for treatment of childhood trauma are confronted with a growing body of neurodevelopmental and neurobiological research that points toward the fundamental development of the right hemisphere during the last trimester pre natally and the first two years post-natally.
Violation of basic needs (attachment, orientation and control, self-esteem enhancement and self-esteem protection and pleasure maximization and distress avoidance are explored in terms of neural development and developmental dysfunctions.
Since neurologist Paul MacLean postulated the Triune Brain Theory, research into neural development indicated the key functions of gene expression, synaptogenesis, neural plasticity, neural pruning and enriched environments and the detrimental effects of childhood trauma. One of the most fundamental aspects of effective interventions (enriched environments) is the facilitation of secure attachment. Violation of secure attachment (especially in the very early stages of neural development) leads to the formation of protective (avoidance) neural loops - implicit memory systems which express especially in the limbic structures, right prefrontal cortex, anterior cingulate and orbito frontal areas.
The implications of these neural facilitations for therapeutic interventions are discussed. Specific reference is made to early intervention and challenges in rural and remote areas to provide effective service delivery. Specific strategies for early intervention are proposed.
The Drought Mental Health Assistance Package (DMHAP) in NSW was implemented (in 2007) as a response to the observed effects of the ongoing drought on the mental health and wellbeing of rural communities. By early 2010 it was decided to broaden the scope of DMHAP and rename the program to better reflect the range of elements contributing to rural adversity.
The Rural Adversity Mental Health Program (RAMHP) has moved beyond considering drought alone as an environmental stressor, and the aim has broadened to reflect a more comprehensive approach to capacity building. The aim of RAMHP reflects current and emerging policy thinking across a number of commonwealth and state areas of responsibility. For example, the National Strategy for Disaster Resilience (NSDR) calls for the underlying principles of emergency management in Australia to be built on the concept of “prevention, preparedness, response and recovery”.
The NSDR also advocates for action-based resilience planning at local and statewide levels, to strengthen local capacity and capability. A focus on individual and community resilience to prevent and recover from mental illness is also a recurring theme in both state and national mental health policy, with an emphasis on building community capacity as an integral part of strategic health and mental health frameworks.
To assist in future planning, implementation and evaluation of RAMHP, a program logic representation was developed based on clearly articulated theoretical constructs and relevant frameworks for action. The theoretical framework allows RAMHP to contribute to the knowledge base of disaster resilience and community capacity building for better mental health, with reference to both state and national policy. Four broad goals of activity that emerge from the theoretical frame will form the “narrative” for the program as it establishes itself as a long-term contributor to community resilience in rural NSW. The relevance of the program goals in the context of state and national policy will be discussed.
Prof Prasuna Reddy, Centre for Rural and Remote Mental Health Co- Author: A/Prof Virginia Lewis, Australian Institute for Primary Care and Ageing
Prof Reddy will present at the:
The aims of the study are to: assess suicide predictors in rural and urban regions by comparing suicides to sudden-death controls; and, compare the differences between rural and urban suicides.
The Psychological Autopsy method was utilised to investigate suicides over the age of 35 in QLD by interviewing next-of-kin in 2006-2008. A case-control study design was applied using sudden-deaths as controls. The study involved 50 suicides and 26 sudden-death controls from rural and 150 suicides and 108 sudden-deaths from urban regions.
No significant differences were found between the urban and rural suicides and their controls by gender, age, ethnicity or language. In both areas, suicides were more frequently separated, living alone and unemployed, compared to the sudden-deaths.
There were no significant differences in marital status, living arrangements, education, and employment status between two suicide groups. Previous suicide attempt(s) and having any psychiatric disorder were significant suicide predictors in both urban and rural regions. Compared to the urban suicides, there was a significantly higher prevalence of psychiatric diagnoses in rural suicides.
Suicides had significantly higher neuroticism and lower agreeableness in both areas. Neuroticism was also higher in rural suicides compared to urban suicides. Aggression scores were significantly higher in suicides, compared to sudden-deaths; aggression score was significantly higher in rural than in urban suicides. No remarkable differences in physical health were found. While geographical location alone may not be a risk factor, life events and living conditions that are more likely to be found in rural environments may increase vulnerability to suicide.
In the present study, similarities in the predicting factors of suicide in rural and urban areas were found. However, some of the predictors were more prevalent in rural areas. For example, aggression, neuroticism and alcohol dependence were higher in rural suicides.
Dr Kairi Kolves, Australian Insitute for Suicide Research and Prevention, Griffith University
Co- Author: Prof Diego De Leo, Australian Insitute for Suicide Research and Prevention, Griffith University
Dr Kolves will present at the:
4th Australian Rural and Remote Mental Health Symposium to be held on the 19 - 21 November 2012, Adelaide, South Australia.
Web: http://anzmh.asn.au/rrmh | Email: ruralhealth@anzmh.asn.au
Adults are less likely to access health services for substance use disorders, than any other psychiatric disorder, despite high prevalence, morbidity and mortality. Comorbid substance use and psychiatric disorders cause moderate to severe illness and disability, yet only half of people diagnosed perceive the need for and then access health care. Of the people that do access treatment, many drop out or are dissatisfied with the service.
This study explored client experiences of help-seeking and accessing drug treatment services. To understand how people engage in health intervention for substance misuse and comorbid mental health and welfare issues.
A qualitative descriptive research design was utilised. Eight participants were recruited from drug treatment programs at one community health setting that serviced a larger regional area in Victoria, Australia. In-depth interviews focussed on experiences of substance use, health issues, help-seeking and service utilisation were used to collect the data. Each interview was digitally-recorded and transcribed verbatim by the researcher.
Interview transcripts and other descriptive data sources including field notes, were thematically coded using principles of phenomenology. From this, four descriptive themes emerged; polydrug use, comorbid health conditions, help-seeking experiences, and health behaviour change. Findings and discussion provide a valuable insight on the client experience of problematic drug use and the influence of illness, attitudes and structural barriers on treatment access.
Help-seeking was facilitated by social support networks and regional inter-agency partnerships and service models. Future research and changes to health policy are strongly recommended to consider issues of polydrug use and comorbidity, primarily mental illness, employment and homelessness.
Ms Nerida Hyett, La Trobe Rural Health School
Co- Authors: Dr Virginia Dickson-Swift, La Trobe Rural Health School
Dr Carol McKinstry, La Trobe Rural Health School
Nerida will present at the:
4th Australian Rural and Remote Mental Health Symposium to be held on the 19 - 21 November 2012, Adelaide, South Australia.
Young people have the highest need for mental health care across the lifespan, yet the lowest level of service use. Improving access to appropriate mental health care and increasing engagement with services is a priority for mental health reform in Australia. Providing services and interventions via online and mobile technologies is increasingly a focus for improving access and engagement for young people.
It is argued that because of the almost universal uptake and integration of online and mobile communication within young people’s lives, this is one of the best ways to reach this age group. eheadspace has been developed to augment the headspace youth mental health initiative to increase access to mental health care through a national online and telephone support service for young people.
eheadspace was rolled-out nationally in October 2011 and comprises a clinically supervised, youth-friendly, online mental health information and support service that offers an accessible ‘soft entry’ point to the mental health system.
This paper will describe the development and roll-out of eheadspace and present data on the characteristics of young people accessing the service. The limitations and challenges of such an online intervention approach will be described, with discussions about the role of such approaches in the mental health care system.
Ms Carmen Garrett, headspace will present at the 4th Australian Rural and Remote Mental Health Symposium to be held on the 19 - 21 November 2012, Adelaide, South Australia.
Rural Men and their families are often left to climb back through the gaps of systems and duly ignored and forgotten. I would ask at what expense and to whom!
Educational opportunities and resources for rural communities is an effective way in providing preventative measures for health and well-being particularly where suicide is prevalent. RAW continues supporting rural communities in Tasmania through years of drought, the collapse of the forestry industry, cuts to fisheries quota's, dairy, mining, and aquaculture Tasmanians continue to lose jobs, income, lifestyle and most importantly their health.
Rural Alive & Well with the support of our networking partners continue to play an intricate part in supporting rural men and their families through times where they are unable to cope independently. Many men have become fly-in fly-out workers to isolated areas in Queensland and Western Australia and places stress on their families. RAW's experience with client's who struggle with mental illness and who may be at risk of suicide is that they often are left undiagnosed, forgotten post treatment and not followed up with after care.
Clients invariably fail to attend appointments because of geographical, emotional and social isolate and visiting practitioners assume that their attending regularly isn't financially viable and stop visiting. RAW does not provide a diagnosis or clinical treatment following contact, rather, RAW provides intervention and emotional support with a our preference on referring to the most appropriate services and treatments available. An important element of RAW's work with clients is to ascertain any issues that may prevent individuals from turning up to planned appointments and then arrange safe avenues for clients in getting there. Rural Alive & Well is about helping people through the hard times, helping them build resilience while maintaining self-respect. RAW stands for supporting people rather than dwelling on the issues.
Garry Sharp, Manager of Outreach Team Rural Alive & Well Inc. will present at the:
4th Australian Rural and Remote Mental Health Symposium to be held on the 19 - 21 November 2012, Adelaide, South Australia.
The SANE Helpline is a national 1800 and online service providing information, advice, and referral to people concerned about mental illness.
Every year, the Helpline takes thousands of calls from people in rural and remote Australia who are worried about their own mental health, or that of a family member or friend.
The call might be about a daughter exhibiting signs of what might be a psychosis. It might be about a boyfriend who is depressed and suicidal. All calls are logged on our database, and while these records are anonymous, they include demographic data so that calls from rural and remote areas of the country can be aggregated and compared with national trends.
This data forms a rich resource of information about mental health needs in rural and remote Australia.
Are callers from country areas more or less likely than those in urban areas to express suicidal thoughts?
Are distance to services and transport issues which are raised?
Is stigma more of a problem or can smaller communities be more supportive?
Is ehealth a practical option to provide psychological support in areas where clinicians are thin on the ground, or is it seen as a second-best service? What support do rural carers most often request, and is this different to the needs of families in cities?
Analysis of the SANE Helpline database enables us to answer these questions and others, providing a finely-tuned, valuable image of mental health needs in rural and remote Australia based on the the actual experience of thousands of callers.
Dr Paul Morgan, Deputy CEO of SANE Australia will present at the: 4th Australian Rural and Remote Mental Health Symposium to be held on the 19 - 21 November 2012, Adelaide, South Australia.
Associate Professor Peter Harvey provides an overview of the phenomenological and methodological aspects of a treatment programme available for people who have serious gambling problems. A CBT based graded exposure therapy treatment programme is currently being provided for people with gambling problems through the Statewide Gambling Therapy Service (SGTS) in South Australia.
Approaches to treatment are being tailored to suit consumers from a range of communities including CALD, Aboriginal and Rural communities. Discussion focuses on current trends in identifying, assessing and treating people with gambling problems and highlights some of the difficulties experienced in providing gambling treatment programmes in rural communities.
Further, the proposition that a population health approach to remediating disordered gambling could address the emerging problems associated with the gaming industry is outlined, as the crucial question about who should fund help services and support programmes for people with gambling problems becomes increasingly topical in our communities today.
In conclusion, as problem gambling or disordered gambling is now seen as a form of mental illness, this classification raises the possibility of disordered gambling being treated and managed using self-management strategies similar to those used in the management of chronic and complex illness. Initial results of a pilot study into the application of peer led self-management education programmes are presented as an example of a relapse prevention strategy for clients following participation in the formal SGTS treatment programme.
Associate Professor Peter Harvey, Flinders Centre for Gambling Research & Manager of the Statewide Gambling Therapy Service, Flinders University will present at the:
4th Australian Rural and Remote Mental Health Symposium to be held on the 19 - 21 November 2012, Adelaide, South Australia.
The 2009 Victorian bushfires are arguably the greatest natural disaster Australia has faced. In early 2009, even while the emergency relief effort in response to the Victorian bushfires was in full-swing, the Foundation for Rural and Regional Renewal (FRRR) championed the creation of a collaborative grants program known as Repair-Restore-Renew. That program addressed many of the medium-term recovery needs however it also revealed that ongoing support is required to address volunteer fatigue. Three years on, the volunteers rebuilding bushfire affected communities are suffering a range of psychosocial and psychiatric issues due to the trauma they have experienced. Volunteers are over worked and performing tasks that do not match their skill base.
They are involved in the recovery mission due to necessity not through the normal motives that inspire individuals to volunteer in their community and the positive outcomes that volunteering usually instills in individuals are absent. All rural communities have a small pool of individuals from which to recruit volunteers. Without leadership and continuing support, the community’s experience of volunteering is likely to be disconcerting and unsustainable. Consequently, FRRR has developed the STEPS program - Skills, Training, Engagement and Practical Support.
FRRR’s CEO, Alexandra Gartmann, will share the lessons learnt from this recovery journey, which are incredibly relevant given the increasing prevalence of natural disasters across Australia. We will also share some of the findings and lessons from similar international events, as well as some other regional social research following 10 years of drought in rural Victoria. Finally, it will explore the critical role that the philanthropic sector can play in medium to long term natural disaster recovery.
Alexandra Gartmann, CEO of the Foundation for Rural and Regional Renewal will present at the:
4th Australian Rural and Remote Mental Health Symposium to be held on the 19 - 21 November 2012, Adelaide, South Australia.
The devaluing of rural Australia as an important contributor to Australia’s social and economic fabric, and the declining profitability of core industries in rural Australia, including an absence of understanding and support for these industries by metropolitan communities and governments, have been identified among the many complex factors attributed to the causation of the high rate of suicide in rural Australia. (SPA Position Statement - Responding to suicide in rural Australia 2008).
Farmers will tell you they want a dynamic, innovative, exciting, profitable and sustainable agrifood sector that attracts the best and brightest of the next generation, but farmers in Australia today are less than 1% of the population and the future of the farming sector in Australia is uncertain. Australia has developed sophisticated supply chains to supply our cities with fresh, affordable, ethically produced food and fibre but farmers have become victims of their own success - we have a food ‘value’ chain with farmers down one end and consumers at the other.
Farmers are feeling demoralised and physically pushed to the limit by the supermarket prices wars, animal welfare campaigns, a booming mining sector competing for land use, lack of a national food security plan and out-of-touch government policy. Our farmers are questioning why they bother to farm in this hostile environment.
Ms Fairleigh's workshop will explore current research on farmers, mental health and suicide; programs addressing the rural-urban divide; how improved understanding impacts positively on farmer mental health; and how to create a community which is informed about, and engaged with, agriculture and rural Australia.
Alison Fairleigh, Rural Development Officer, Mental Illness Fellowship of North Queensland will present a workshop at the:
4th Australian Rural and Remote Mental Health Symposium to be held on the 19 - 21 November 2012, Adelaide, South Australia.
Following the 2011 natural disasters in Queensland, the Queensland Government funded delivery of the SPR training and support program to hundreds of health, mental health and welfare providers across the state. This paper reports on the delivery and evaluation of this program.
For many, their difficulties will be limited to mild or sub-threshold mental health problems that may not require specialist interventions. The Skills for Psychological Recovery (SPR: Berkowitz et al, 2009) program was specifically developed to enable health practitioners and counsellors to teach coping skills to community members affected by such problems.
SPR focuses on evidence-based interventions including a brief needs assessment, problem-solving, promoting positive activities, helpful thinking, rebuilding social supports and managing distressing reactions. The Australian Centre for Posttraumatic Mental Health (ACPMH) has developed an SPR training and support program using a capacity-building dissemination model.
The aims of the program are to train and accredit competent trainers, improve the competence of practitioners to teach simple coping skills, and promote uptake of teaching these skills by practitioners. Key program activities include selection, training and accreditation of SPR trainers from both adult and child/adolescent services; quality assurance and support visits by ACPMH to practitioner workshops; teleconferences for trainers facilitated by APCMH; and completion of online modules by both trainers and practitioners.
Alexandra Howard, Clinical Specialist, Australian Centre for Posttraumatic Mental Health will speak at the 4th Australian Rural and Remote Mental Health Conference in Adelaide on November 19th to 21st, 2012.
The theme this year is PUTTING PEOPLE FIRST: MENTAL HEALTH NEEDS AND INITIATIVES IN AUSTRALIAN RURAL AND REMOTE COMMUNITIES.
Cognitive impairment (CI) includes acquired or traumatic brain injury, intellectual disability or Fetal Alcohol Spectrum Disorder (FASD). Cognitive impairment is a hidden disability which, for example, affects encounters with people in their surroundings, and can lead to difficulties in relations and contacts with society.
A high prevalence of substance use problems has been identified in cognitively impaired people and alcohol use is a frequent contributing factor to acquired brain injury. Some of the behaviours described as common features of CI such as poor self-monitoring and self-regulation and dependence/lack of initiative are seen to be causes and consequences of addiction thereby prescribing a moral rationale to behaviour that may have a physical cause.
To increase staff awareness of the prevalence of CI, screening of all consenting clients with the Addenbrooks Cognitive Examination – Revised (ACE-R) for a 3 month period was conducted. Analysis of the ACE-R total scores included qualitative variables (indigenous status and gender) and quantitative variables (age and effective years of education). Logistic regression was used to analyse the effect of all variables at once. The analysis of fifty completed ACE-R screens found that 40% of participants were likely to have a cognitive impairment (scored <88 88="88" age="age" and="and" below="below" br="br" clients="clients" effect="effect" gender="gender" had="had" indigenous="indigenous" likely="likely" more="more" no="no" on="on" p="0.0241)" results.="results." score="score" that="that" the="the" to="to" were="were"> These results have significant implications for the way drug and alcohol treatment interventions are provided, particularly in residential settings. The agency identified two strategies to improve accessibility for clients with cognitive impairment, a quality improvement plan with a training component and a resource review.
These strategies will be discussed by Dr Julaine Allan at the:
4th Australian Rural and Remote Mental Health Symposium to be held on the 19 - 21 November 2012, Adelaide, South Australia.
Youth suicide among Aboriginal communities is much higher than in the mainstream population. Both federal and state governments have highlighted the need to address this public health problem.
Njernda Aboriginal Corporation in Echuca is in the process of developing an early intervention response to suicide among Aboriginal youth.
As part of a larger youth suicide prevention program, this study explores help-seeking preferences of Aboriginal people in the event of a threat of or an attempted suicide in Echuca.
A cross-sectional pilot study wherein a survey of individual community members including Aboriginal youth, adults and Elders as well as service providers from both mainstream and the Aboriginal health service was conducted in Echuca using the Njernda CRUNCH questionnaire.
This is a pictorial questionnaire developed by Njernda to explore the current help seeking preferences of individuals in the event of a threat of or an attempted suicide. It asks participants to indicate how they would respond when confronted with an individual in seven different suicide related scenarios. Mr Stuart Hearn and Dr Anton Isaacs will describe help seeking preferences of people from Echuca when faced with a threat of or an attempted suicide and will provide crucial information in developing early intervention strategies for suicide prevention in rural Aboriginal communities.
Mr. Stuart Hearn, Community Support worker at the Mental Health Unit of Njernda Aboriginal Corporation and Dr. Anton Isaacs Lecturer, Monash University Department of Rural and Indigenous health at Gippsland in Victoria will present at the:
4th Australian Rural and Remote Mental Health Symposium to be held on the 19 - 21 November 2012, Adelaide, South Australia.
Helen Morton
Minister for Mental Health; Disability Services Sun 05 August, 2012 Portfolio: Mental Health
New cinema and radio ads designed for young Aboriginal people
Campaign focus on impact on the mind, body, law and support
New cinema and radio advertisements form part of an innovative campaign to prevent and reduce harm caused by alcohol and other drug (AOD) use among young Aboriginal people.
Mental Health Minister Helen Morton said the advertisements would feature as part of the ‘Strong Spirit Strong Mind’ Metro Project, which aimed to strengthen the range of AOD prevention and service responses for Aboriginal young people, their families and communities in the Perth metropolitan area.
“This campaign has been designed with help from Aboriginal young people keen to get the message out that alcohol and drugs can lead to doing things they may regret, and to encourage those who need help to seek support,” Mrs Morton said.
“The advertisements are the first of their kind for young Aboriginal people in Perth, and it’s great to see a focus on alcohol and cannabis, which are the primary drugs of concern.”
Consultation with Aboriginal youth groups and agencies identified that the campaign should focus on the effects of alcohol and other drugs on the mind and body, the law and where to get support.
The campaign is expected to run initially for four weeks, in metropolitan cinemas and radio.
Funding for the ‘Strong Spirit Strong Mind’ Metro Project was made available through the Council of Australian Governments Closing the Gap National Partnership Agreement, and includes culturally secure prevention and early intervention initiatives, along with the establishment of an outreach treatment team.
Fact File
In 2011, 77% of treatment episodes for Aboriginal young people indicated alcohol or cannabis as primary drug of concern
Surveys show Aboriginal people less likely to drink alcohol than non-Aboriginal people, but those who do, more likely to do so at harmful levels
Federal and state health ministers have finally succumbed to the demands of the sector and the needs of the thousands of Australians, having officially agreed to make dementia a National Health Priority Area (NHPA).
The nation's health ministers, who gathered for a meeting of the Australian Health Minister’s Advisory Committee in Sydney on Friday, have designated dementia as the ninth National Health Priority Area, along side eight other priority areas like asthma, mental health, cardiovascular health and obesity.
The motion was put forward by federal Minister for Health, Tanya Plibersek and Minister for Mental Health and Ageing, Mark Butler, who jointly argued the case to make dementia the ninth NHPA, saying the condition is predicted to become the leading cause of disability in less than four years.
“Today 280,000 Australians live with dementia and by 2050 that figure will have risen to more than one million,” said Mr Butler on Friday.
“This presents major challenges for health and aged care services.”
Mr Butler added that spending on dementia beyond 2060 is set to outstrip that of any health condition, with expenditure due to top $80 billion by 2062-63.
In Australia the recent development of draft guidelines for the treatment of Borderline Personality Disorder (BPD) will set a standard for the provision of services for people with this disorder.
It is therefore timely to review programs that are in place and consider how these programs fit with the proposed new national guidelines for the provision of comprehensive services informed by the recovery framework.
Dialectical Behaviour Therapy (DBT) is an evidence based treatment for BPD. Clients with this disorder have complex, multi-axial problems, are difficult to engage in treatment and intense transference and counter-transference issues can lead to clinician burnout.These problems are compounded when clinicians are working in isolated rural and remote areas.
Elizabeth Gifford will describe the challenges and opportunities encountered in providing DBT treatment as part of community mental health services in a rural area. The DBT program has evolved over the past ten years to provide treatment for adults diagnosed with BPD as well as a DBT informed program for youth aged 14-24 years with emerging disorders of the self.
Clinical outcome data from both the adult and youth cohorts from the past three years of the program will be presented which shows reductions in service utilisation and improvements in quality of life. These outcomes indicate that DBT is a promising treatment that can be offered utilising the resources of a rural community mental health service.
Elizabeth Gifford, Clinical Nurse Consultant in Community Mental Health, Co-ordinator Dialectical Behaviour Therapy Program in Western NSW LHD will be presenting at the:
4th Australian Rural and Remote Mental Health Symposium to be held on the 19 - 21 November 2012, Adelaide, South Australia.
By David Dunt, University of Melbourne
Physical injury and death in war is expected. But we also now know the stories of large numbers of veterans suffering major psychological trauma.
These involve Post Traumatic Stress Disorder (PTSD), anxiety, depression, alcohol and drug problems and sometimes suicide. Former soldiers, whether they fought in Vietnam or Iraq, are dealing with some common but distinct experiences.
All wars are horrible but each is different in its own way. Those who were in Vietnam, for example, often fought at close range with a resourceful enemy who could not be easily distinguished from civilians. Massacres occurred.
Those who fought in Iraq and Afghanistan were affected by the ever-present dangers of Improvised Explosive Devices (IEDs) and suicide bombers while on patrol during their period on deployment.
The failure to properly treat Vietnam veterans, should remind us of our obligation to help returning soldiers to get the support they need.
The war weary
The experience of soldiers in wars in Afghanistan and Iraq contrasts to those involved in the Vietnam War. First, deaths and physical injuries for our forces in Vietnam were much higher than in Iraq and Afghanistan. Second, levels of PTSD and other mental illnesses associated with the Vietnam War were also very high.
A full 29% of all veterans who ever served in Vietnam have had PTSD that is accepted for compensation by the Department of Veterans Affairs (DVA). Over 8% had alcohol dependence or abuse, 5.5% had anxiety and 3.6% had depression that was accepted for compensation. Some of the veterans, of course, had all four conditions. But surprisingly, levels of suicide for veterans, when compared to the rest of the population do not appear elevated or if so, only to a small extent.
These high levels of mental health issues immediately pose the question: what was it about the Vietnam War that was so disturbing.
Films like Apocalypse Now and The Deer Hunter vividly represent the profound personal crisis of many of the soldiers involved. The nature of the combat meant the soldiers were killing in close range.
But another key issue was that after Vietnam, we became much more aware of the psychological impact of war than previously. This awareness has led to changes in attitude and a greater understanding of veterans' mental health.
Post-traumatic stress
The PTSD syndrome was “discovered” in the aftermath of the Vietnam War. PTSD is characterised by re-experiencing the original traumas through flashbacks or nightmares, avoidance of stimuli associated with the trauma, and increased arousal – such as difficulty falling or staying asleep, anger, and hypervigilance.
To be accepted as a disability, symptoms must last more than one month and cause significant impairment in functioning. PTSD, of course, is not new – think of “shell shock” and “combat fatigue” as other words to describe the condition from earlier twentieth century wars.
In Vietnam, these high levels of mental disorders are linked with a massive absence of services. They were also substantially affected by the public response to their service involvement.
Vietnam veterans came home to no fanfare, to indifference and sometimes open hostility. It wasn’t until the Vietnam Veterans “Welcome Home” March of 1987 that public sentiment started to change but by then it was too late. A half generation of young men were psychologically scarred not only in the medical sense described above, but also through a loss of direction in life and embitterment.
Here to help
It is too early to know if Iraq and Afghanistan veterans will experience the same level of mental disorders. Early indications are that this is unlikely in Australia. Mental health services for both serving members of the Australia Defence Force (ADF) and retired veterans are much improved. Attitudes to veterans by the public are also more sympathetic.
Nevertheless, present problems are real and concerning enough, remembering that PTSD can present some decades after exposure to the wartime trauma.
More worryingly, there has been an increase in suicide rates in United States soldiers in Iraq or Afghanistan. This has not been observed to date in Australian soldiers but could still occur.
As noted, services are much improved. These include the post-deployment psychological screening programs and the All-hours Support Line for ADF members.
For veterans there is for example, the Veterans and Veterans Families Counselling Service (VVCS).
Room for improvement
However, treatment services can be further improved. In 2008, I conducted two ministerial reviews – Mental Health care in the Australian Defence Forces (ADF) and a study of suicide in veterans for the Department of Veterans' Affairs (DVA).
It was clear that the ADF mental health workforce needed to be considerably expanded and better trained. It was also clear that the model of a multidisciplinary care team of psychologists, psychiatrists, mental health nurses and social workers, that is commonplace in civilian practice, did not exist in the ADF.
Psychologists were engaged in a wide variety of roles, more in human resources and training and less in clinical psychology relevant to mental health problems and illnesses. For DVA services, recommendations were for a review of services for the treatment of PTSD.
A wide variety of mental health promotion programs also exist in the ADF and operate through DVA. For ADF personnel, there are for example, the Suicide Prevention Program and the Alcohol Tobacco and Other Drugs Program. For veterans, there are for example, the At Ease Mental Health and the Right Mix alcohol websites.
Best practice
Programs though need further development to achieve best practice including in suicide prevention. Both the ADF and DVA acted on the recommendations of the reviews and allocated $90 million to support their implementation. Upgrades and improvements to treatment services and mental health promotion programs are now in train but have not as yet been fully implemented.
Until they are fully implemented, members of the ADF and veterans will continue to face challenges to receive best services. Even when they are fully implemented, some problems are likely to continue.
For example, senior staff readily appreciate that military culture does not, by its nature deal well with mental health problems that can easily be stigmatised as weakness. New programs are likely to be only partially effective in changing these attitudes.
In defending and protecting Australian society, members of the ADF undertake activities that other Australians want but do not wish to do themselves. That these activities frequently have the consequences described above is a constant reminder that ADF members and veterans have every right to expect the best possible services and programs that can be provided. Last week marked the 50th anniversary of Australian forces arriving in Vietnam. The Conversation will be looking at the war’s legacy throughout a number of articles over the next week. Part 1: Forgetting the ‘American War’: Vietnam’s friendship with its former enemy David Dunt received funding from the Ministries of Defence and Veterans Affairs in 2009 in 2008-9 in completing two Ministerial reviews for the Australian Government - A review of mental health services in the Australian Defence Forces through transition to discharge and An independent study of suicide in the Ex-Service Community.
This article was originally published at The Conversation.
Read the original article.
Aims and Rationale The aim of this exploratory study was twofold. It sought to describe some of the challenges faced by people with dual diagnosis of ABI and MI; and secondly, from these findings make recommendations on service practices and policies that would be required for an effective post discharge rehabilitation and recovery pathway.
Methods This phenomenological study used in-depth interviews to obtain an insider perspective from eight individuals and/or their families, and case managers. Interviews were transcribed and the researchers used qualitative analysis to identify key themes that reflected the experiences of participants.
Findings Participants faced a lack of appropriate supports available which reflected a deficiency of expertise in understanding the complex intersection of disability and mental illness. This created confused pathways towards recovery and improved quality of life. Participants were either categorized as having ABI or MI leading to inappropriate accommodation, social isolation, and lack of engagement in meaningful activities such as leisure activities and employment. Commonly, participants with ABI/MI fell “between the cracks”. Implications for policy and practice The rehabilitation and recovery of people with ABI/MI requires services that have knowledge and expertise in each condition and the implications of dual diagnosis. Improved integration of disability and mental health services will be an important strategy to achieve this.
Mrs Annalise O'Callaghan, Lecturer, School of Occupational Therapy and Social Work, Centre for Research into Disability and Society, Curtin University will present at the:
13th International Mental Health Conference, "Positive Change -- Investing in Mental Health" 6th to the 8th of August 2012, on the Gold Coast.
Depression is by far the most common emotion associated with chronic back pain. The type of depression that often accompanies chronic pain is referred to as major depression or clinical depression. This type of depression goes beyond what would be considered normal sadness or feeling "down for a few days".
The symptoms of a major depression occur daily for at least two weeks and include at least 5 of the following (DSM-IV, 1994):
A predominant mood that is depressed, sad, blue, hopeless, low, or irritable, which may include periodic crying spells
Poor appetite or significant weight loss or increased appetite or weight gain
Sleep problem of either too much (hypersomnia) or too little (hyposomnia) sleep
Feeling agitated (restless) or sluggish (low energy or fatigue)
Published in the NursingReview Online 10 July 2012
Australian National University researchers say online interventions can have important flow on effects to a patient’s quality of life and physical health.
Online depression therapy programs can have a positive impact on more than just depressive symptoms, according to a new study.
Dr Lou Farrer, from the ANU Centre for Mental Health Research, trialled the effectiveness of online programs MoodGYM and BluePages with users of Lifeline’s telephone crisis line.
She found that the online programs had a positive influence across a range of problems, such as alcohol use.
“In addition to reducing depression symptoms, we found that the online programs were effective in reducing hazardous alcohol use in Lifeline callers. There was a significant drop in alcohol use among those who used MoodGYM and BluePages,” she said.
“The results also showed that people who used the online programs had a marked increase in their quality of life, as measured by a scale that assessed satisfaction with different areas of daily living.”
Thomas O'Byrne and Michelle Speirs The Guardian - Northern Victoria
SWAN
Hill Rural City Council and local health care workers have stepped up
their campaign to improve mental health outcomes for young people in the
municipality. With time of the essence, council is penning a letter to
Federal Minister for Mental Health Mark Butler seeking an urgent
meeting with him to argue the case as to why a Headspace facility should
be established in Swan Hill as a priority.
Headspace
centres are a Federal Government funded initiatve dedicated to
improving the mental health and well-being of Australia's youth.
Spearheading
the campaign is councillor Yvonne Jennings who said she raised the
issue during a recent trip to Canberra, where she spoke with Minister
for Early Childhood and Youth Peter Garrett.
While
talks of a Headspace facility were outside his portfolio, the minister
said he would personally convey council's concerns to Mr Butler provided
they were put forward in writing.
At last week's
council meeting, councillors voted to write to Mr Butler as a matter of
urgency with all councillors supporting the move.
"We've all seen the statistics and they are frightening," councillor Greg Cruickshank said.
"The community is largely ignorant as to what is happening out there."
Mental
health statistics put forward in Southern Mallee Primary Care
Partnership's 2009/12 strategic plan revealed that, in some cases, Swan
Hill had much higher figures than the rest of Victoria.
Depression and anxiety are found in every society in the world, debunking old theories that only Westerners get depressed.
These new findings come from the world's most comprehensive study of anxiety and depression research to date, published by researchers at The University of Queensland.
In two separate studies of anxiety disorders and major depressive disorder (that is, clinical depression) study authors found that surveys of clinical anxiety and depression have been conducted across 91 countries, involving more than 480,000 people.
They show that clinical anxiety and depression are serious health issues all around the world.
Anxiety disorders were more commonly reported in Western societies than in non-western societies, even those that are currently experiencing conflict.
Clinical anxiety affected around 10 per cent of people in North America, Western Europe and Australia/New Zealand compared to about 8 per cent in the Middle East and 6 per cent in Asia.
