View some local events:

Mental Health Month events – Sydney Metropolitan

Mental Health Month events – Regional NSW

We do wonder how the mental health commission will work with only approximately $2mil per year allocated for the next 4 years.  We want a great deal more independence for the Mental Health Commission.  We don’t want the Commission to be a select club chaired by the Minister for Mental Health that reports to the Prime Minister but with no real authority or funding to make a difference and to improve the lives of people with lived experience of mental health problems. 

We do want to be reassured that new and redesigned programs will work seamlessly together and that States and Territories will work co-operatively with the Commonwealth towards the best interests of the people that they set out to serve. 

More to come on the National Mental Health Reforms, but in the meantime, here is the mental health budget-at-a-glance.   

This Blueprint is very timely.  It aims to be transformative asking for real (though not enough) amounts of money for improving and enhancing Australia’s mental health services. The authors quite rightly state: “the Blueprint does not make specific recommendations regarding other key services which are currently within state/territory jurisdiction, such as community mental health services, judicial and police services etc” as these are do not come under the Commonwealth jurisdiction.  HOWEVER this perpetuates the existing, major, ongoing problems for mental health services in this country.  As John Mendoza has said, this is yet another band-aid solution to the problem of providing integrated, comprehensive, innovative and collaborative mental health services in Australia.  We must have a national approach that doesn’t set up a parallel system as happened under the Howard government.  States and Territories must work with the Commonwealth towards a national system which therefore will include community mental health services and inpatient services and all other state/territory funded mental health services.

To read the entire post and supporting documents go to the TAMHSS Blogpost

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Read the Judy Ryde seminar 4May11 Flyer which has all the details

Date:    4 May 2011

 Time:    4:00pm – 6.30pm

 Venue: Transcultural Mental Health Centre,

             Building 55

             Cumberland Hospital

             5 Fleet Street,

             North Parramatta

             NSW, 2150

Cost:    $35

Includes tea/coffee/nibbles

Application to: info@themhs.org

Strictly limited number of places available

Read the news article here regarding the report http://www.news.com.au/technology/doctors-issue-warning-on-facebook-use-which-they-say-can-lead-to-depression/story-e6frfro0-1226029570947#ixzz1HwRS0dIm

Read the APA release here http://www.aap.org/advocacy/releases/socialmedia2011.htm

Interestingly an article came out hot on the heels of their release entitled Pediatrics gets it wrong about Facebook depression.

The article goes on to say that there are issues because they can’t differentiate between correlation and causation. They go on further saying “Pediatrics and the American Academy of Pediatrics should be ashamed of this shoddy clinical report, and retract the entire section about “Facebook depression.”

Read the full article here http://psychcentral.com/blog/archives/2011/03/28/pediatrics-gets-it-wrong-about-facebook-depression/

What is your view? does this report have validity or not?

Tackling Aggression – understand, respond and prevent

Thursday 24 and Friday 25 February 2011

Please note the live blog posts are one person’s summary of the presentation and may not represent the full breadth and depth of the speaker’s session.

Trama, victimisation and PTSD in women – Kathleen Brady

Mental illness and violence what’s the evidence and how can we improve forensic outcomes for young people - Rosemary Purcell

Implications for workforce education - Kath Thorburn and Michelle Everett

The agitated patient in the emergency department - Ron Diamond

National Standards for mental health services Poster Video Competition

How seclusion and restraint is being addressed at St Vincents hospital - Douglas Holmes

Something to hold on t0 – restraint and seclusion reduction in Australia - John Allan

Borderline Personality Disorder – undestanding and responding to aggression -Ron Diamond

Ensuring the bricks and mortar support users quality of life and mental health - Penny Coombes and Gavin Adams

NICE Guidelines on Violence – UK - Kevin Gournay

Substance abuse and violence and aggression - Kathleen Brady

Understanding aggression and dealing with angry people - Ron Diamond

The Haven Project is a relatively new service operating in South-West Sydney, aiming to provide respite, support and activities for mental health carers. The service is auspiced by Anglicare and coordinates the efforts of a number of services in the region. The service employs indigenous and multilingual workers and hopes to expand outside its current geographical areas next year.

Learn more at www.havenproject.com.au

Kathleen makes the point that in domestic violence, safety should be the primary consideration, and treatment of the consequences of violence is impossible if they are still in an abusive situation.

PTSD is one of many psychiatric responses to trauma. Others include depression and anxiety disorders. Furthermore, most people who have faced trauma will meet criteria for other disorders. Kathleen argues that the comorbidity of PTSD with other diagnoses is an artefact of our diagnostic systems. Rather than trauma causing a number of different disorders, the symptoms experienced represent the complex somatic, cognitive, affective and behavioural effects of psychological trauma.

Post-traumatic sequelae are more likely in the context of a poor social support system, genetic and constitutional vulnerability, recent life stressors or changes, feeling loss of control, recent excessive alcohol or drug intake, and the subjective meaning of the stressor.

Are other factors involved in the gender differences seen in PTSD? Neurochemical responses are very different in men and women. For example, in PTSD, hypothalamic-pituitary-adrenal axis action is dysregulated and the cortisol feedback loop doesn’t function properly, so the flight or flight response continues without the normal level of negative feedback. In recent studies women have been shown to be more sensitive to HPA dysregulation caused by substances of abuse. Oxytocin also reduces the the fight or flight response and is associated with increases in caretaking and affiliative behaviour. Oxytocin is currently being studied as a potential therapeutic agent.

Pharmacotherapeutic treaments can reduce core symptoms, reducing associated symptoms, and facilitate the effectiveness of other therapies. Kathleen reported results of a number of studies which have shown that SSRIs can be effective for PTSD, however she emphasised that psychotherapy options are important, particularly those involving exposure therapy. Other techniques include stress innoculation training, eye movement desensitisation and reprocessing. She argued that there is no evidence for psychodynamic and other therapies in the context of PTSD. This provoked discussion in the questions and answer time around other therapies which are being used and about the importance of contextual factors in addition to therapeutic techniques.

We cannot offer recovery-oriented services without understanding the profound impacts of trauma. Trauma informed approaches are good for workers as well as consumers and carers (eg. addressing vicarious trauma). You can’t have one without the other, but you can change services by approaching through either “lens.”

What environments, practices and workplace cultures are needed?

• Vision
• Leadership
• Partnership (with consumers & stakeholders)

What do workers need to learn?

Threshold concepts – The critical issues that need to be taught. Things that lead us to think about things in new ways. High-value concepts. Can and should leave workers with more questions about the issues.

For recovery-oriented practice these are:

• Lived experience knowledge – legitimate
• It and me – impact of illness focused interactions & services on sense of self
• Us an them – power & healing
• Clinician’s illusion – “my knowledge is biased”
• Personal effort – “workers can’t do recovery”
• Recovery – process and outcome

For trauma-informed care:

• Trauma has profound psychological, biological and social impacts
• The past is in the present – “We carry our past in our bones” (Wells)
• The brain is altered by trauma – but brains (and people) can change

What has current research found?

• Recovery knowledge may increase without a corresponding change in recovery attitude
• Association between knowledge of recovery concepts & recovery-oriented practices
• Sharing of lived experience knowledge has a particular impact on attitude shifts
• Understanding impact of trauma increased worker empathy comfort in working with anger and/or aggression

There needs to be substantial groundwork on assessing and changing attitudes in service staff before charging into intensive workshops on recovery-oriented and trauma-informed practice.

Questions

Q1: Generational trauma is a major issue with the Aboriginal people of this country. How can this be managed?

It comes up & is discussed in the NSW IOP units.

Q2: Some people do not want to be identified by their trauma. Positive psychology emphasises this.

This is actually an element of trauma-informed care. Inadvertedly services can re-inforce this attitude but that’s not what trauma-informed care intends to do. Being informed does not mean we have to contually focus on it, but the knowledge helps (e.g. knowing an abused person’s triggers).

Q3: Are you finding workers struggling with the different concepts of recovery and recovery-oriented practice?

We’ve noticed a big shift towards recovery-oriented practice and services. This has also meant a shift in people’s knwoledge.

Q4: Other sectors dealing with people with mental illness do not have any of this kind of knowledge or training. How can this be made broader as a training tool?

We keep chipping away at the broader community. There are many conversations being had on a day-to-day level with people who talk to people who talk to people.