April 2011

Newsletter No. 29

Annual General Meeting Winston Rickards Memorial Oration Children’s Mental Health Coalition HISTORY CORNER: 1870 and 1932 Membership Subscriptions MHYF Vic Committee

The MHYFVic Annual General Meeting will again be held at the Hot Honey Cafe in Middle Park, in conjunction with a dinner and a stimulating after-dinner presentation on a topic in keeping with the objectives of MHYFVic. Last year, as you will recall, the speaker was the Health Department’s Chief Child Psychiatrist, Dr Sandra Radovini. The previous year it was the Director of the ‘Take Two’ Program, Ric Pawsey. The relevance and importance of these presentations will be followed up this year by another challenging topic.
The date will be Wednesday 24th August 2011 at 7 for 7.30pm Please put it in your diary. The speaker and topic will be described in our next Newsletter.

The second Winston Rickards Memorial Oration was held in the Ella Latham Theatre at the Royal Children’s Hospital on Wednesday 30 March 2011.
The speaker was Emeritus Professor Dorothy Scott OAM. Professor Scott held the Foundation Chair of Child Protection at the Australian Centre for Child Protection at the University of South Australia.
The title of the oration, “Children as Clients, Consumers or Contributors: How these Roles may Shape Child Wellbeing” foreshadowed a thoughtful exploration of the interaction between children and society exemplified by assignment of these roles.
This delightfully engaging presentation was a long way removed from the usual trite justification of discarding ‘patient’ in favour of ‘consumer’ to redress a status imbalance or ‘client’ to redress a power imbalance. It looked at the meaning of each of the roles as a two-way interaction with costs and benefits. Most importantly, it introduced the role of ‘contributor’ as an active counterbalance to the passivity of roles usually assigned to children in the mental health system.
Professor Scott’s starting point was the WHO definition of mental health is “a state of wellbeing in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”.
She noted that there is little in the literature about how children and their families can contribute to their own progress, notwithstanding the routine offering of ‘parenting’ programs in mental health services.
She described a profoundly important example in an aboriginal community of a program engaging young mothers of babies who were failing to thrive. Using the positive reinforcement of a welcoming relationship with the leader and other participants in the group, the pleasant food and social experience, and encouragement with improving child care skills, the group gained additional strength from a secondary role of caring for old people in their community. The young mothers gained skills in caregiving, empathy for others and immensely improved self- esteem at the same time.
Professor Scott alluded to the change in recent generations towards reducing work responsibilities for children and greater passivity in a consumer society. She noted that the three roles of client, consumer and contributor, are not mutually exclusive. Children and young people, like adults, can occupy all three to varying degrees, and each role carries its own potential costs and benefits for the individual child, the family and the community.
The possible costs and benefits of the client and consumer roles were briefly explored. As clients the early diagnosis and intervention for children with developmental disorders brings immense direct benefits in maximizing their potential. Moreover, by defining, for example, a child’s behaviour in terms of a disorder, there may be an indirect benefit – the child may be less likely to be rejected and punished in the family and in other settings such as the classroom, as occurred in an earlier era. The costs of clienthood include having to obtain a diagnosis in order to secure the additional assistance required, and adolescents, like adults, can be stigmatized within the family and within other social settings by a diagnostic label and even acquire a client identity.
In looking at the costs and benefits of the contributor role, Professor Scott drew upon two additional sources of comment. One was an address by Professor Michael Rutter, who said, ‘.. it does seem desirable that we foster personality development in such a way that our children are cooperative and pro-social in their interaction with others, not because they feel they have to be so, but rather because they get pleasure from being so’. The other was the recent book by Phillips and Taylor, “On Kindness”, which said, ‘… the child needs the adult – and his wider society – to help him keep faith with his kindness, that is, to help him discover and enjoy the pleasures of caring for others. The child who is failed in this regard is robbed of one of the greatest sources of human happiness’.
The unifying theme in this analysis was that mental health and pro-social behaviour is fundamentally derived from secure attachments and the encouragement of empathy. Helping other people is crucial for mental health.
The annual Oration is given in honour of the wide-ranging and innovative contribution of Dr Winston Rickards AM (1920-2007) to infant, child, adolescent and family mental health in Australia and internationally. The full text of Professor Scott’s address will be posted on the MHYFVic website.

The historic first meeting of the Children’s Mental Health Coalition was held at the Royal Australian and New Zealand College of Psychiatrists’ Head Office in Melbourne at an all-day workshop on Friday 25th March.
Professor Louise Newman, one of the prime movers in convening the meeting and developing the discussion papers for its agenda, was unable to attend because of urgent University business but in her absence the meeting was chaired by Dr Phil Brock, Chair of the Faculty of Child and Adolescent Psychiatry of the College.
The Welcoming Address was delivered by Dr Maria Tomasic, President of the College, who pledged the support and active involvement of the College in advocacy for better mental health services for young people and their families. The initial session then looked at key priorities and some initiatives being proposed to address these.
The King’s College Survey of issues of political importance to people in various countries revealed that in Australia the three issues of greatest concern were the economy, climate change, and mental health. For this reason it was regarded as timely for the coalition to be developing its advocacy role.
Needs in the youth area have been receiving some attention but there are important unmet needs at all stages from infancy onwards. Australia-wide change is only achievable if it is encompassed through a National Mental Health Plan arising through the Council of Australian Governments. Thus, the mission of the coalition should be to drive development of a ten year roadmap of reform in mental health service delivery that gives adequate weight to the needs of young people and their families. A number of issues were flagged for further discussion, but the next presentation was by the Hon. Mark Butler, Minister for Mental Health.
As the first Minister ever appointed within the Australian parliament with the portfolio of mental health, Mr Butler has demonstrated considerable enthusiasm for consulting with stakeholders and for achieving an impressive understanding of the complexities of the field. There was no doubt whatever about his passion for making improvements in the system, and participants in the workshop were encouraged by his receptiveness and apparent willingness to continue dialogue with the coalition.
Subsequent discussion sessions identified several issues that would require considerable effort and skill to meld into an integrated approach. On the one hand it was desirable for pathways to help being through non-stigmatising universal service providers, but on the other hand most specialist assessment and therapeutic programs are funded through Departmental silos that do not readily incorporate crucial associated supports such as housing, employment and child care services. This highlighted that a ‘whole of Government’ approach will be required.
The urgency of an integrating approach was also made evident by individual contributions to the discussion from various delegates to the coalition emphasising the key concerns of their own organisations. These covered a diverse range from Children of Parents with a Mental Illness, the Australian Childhood Foundation, Childrens Hospitals Australia, National Investment for the Early Years, the Australian Psychological Association, Headspace, the Royal Australian College of General Practitioners, MHYFVic, and various university and hospital agencies.
Some comments pointed to policies currently under construction where urgent input would be desirable, such as the ‘Medicare Locals’ policy for General Practice. It could be argued that one third of the program should be oriented towards children, whereas at present there is no imperative for any of the program to assist children.
Similar sentiments were expressed about the need for a mandated share of mental health resourcing to be directed towards children and their families.
Other issues that were thought important included increased accountability for ensuring better mental health outcomes, and specific support for mental health workforce development.
No consensus was reached on the question of the future structure of the coalition. It remains a loose partnership of individual organisations but there will be further discussion of whether some form of corporate identity is necessary. In the meantime, some further work will be undertaken by volunteer participants. It was agreed, for example, that a letter would be forwarded to the Minister expressing our wish to continue the dialogue. It is to be drafted and developed collaboratively by Lyn Littlefield of the Australian Psychological Association and signed by all the participants.
The main message is very clear. We need a National Child Mental Health Plan.
Watch this space for further developments.

HISTORY CORNER 1870 and 1932
CAMHS owes a huge debt to the profession of Social Work for, arguably, the forerunners of this profession led to the establishment of contemporary CAMHS.
After the mayhem of the American Civil War, many children were fatherless and many of African origin were free but unemployed. European migration to the reconstituted United States was rising. The new social sciences were expanding.
The Conference of Charities was founded in 1870, as an offshoot of the American Social Science Association. In 1879, the link with the ASSA was broken as the participants became more interested in practical action, rather than social research. In 1884, the organization was reformed as the National Conference of Charities and Corrections. In the 1890s the Settlement House movement joined, and in 1898 the first Social Work courses began.
In 1917, the NCCC changed its name to the National Conference of Social Workers. This was the year of the launch of the first university course in Psychiatric Social Work at Smith College, and the year of the first Child Guidance clinics, where the professions were medicine, psychology, and social work.
In 1932, John Williams, who had commenced Australia’s first hospital child guidance clinic in 1925, described the occupational structure of the clinic as involving the medical doctor assessing and treating emotional problems, the psychologist providing intellectual and personality assessment, with the Social Worker designated to “look after home and school”. This was also the year of the appointment of the Royal Children’s Hospital first full time professional Almoner, Miss Agnes McIntyre.
CAMHS has been through name changes since then, but the need for the work remains the same.

Membership renewal
Subscriptions run for the financial year and should be paid before our Annual General meeting early in the new ‘year’. The fee remains at $20 and applies to organizations as well as individuals.

MHYF Vic Committee
* President, Jo Grimwade
* Vice-President, Jenny Luntz
* Past President: Allan Mawdsley
* Secretary, Nitha Prakash
* Treasurer & Membership Secretary, Lillian Tribe
* Projects Coordinator, Suzie Dean
* WebMaster, Ron Ingram
* Newsletter Editor, Allan Mawdsley
* Youth Consumer Representative, vacant
* Members without portfolio: Miriam Tisher, Sarina Smale


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