Newsletter No. 34

MHYFVic Annual General Meeting
The MHYFVic Annual General Meeting for 2012 will be held on Saturday 10th November at the Cairnmillar Institute, 993 Burke Road, Camberwell at 1.45pm for a 2.00pm start. After a short business session there will be a selection of papers from presentations made at the recent IACAPAP Congress in Paris.
Accompanying this Newsletter is an official notice of the meeting and a Nomination Form for election to the Committee. Please have your nominations in to the Secretary at least a week before the AGM.

Winston Rickards Memorial Oration for 2012
The Oration took place on August 8th at the Royal Children’s Hospital, when The Hon. Alastair Nicholson AO RFD QC, former Chief Justice of the Family Court of Australia, reflected upon his unique experience of urgent problems and issues currently facing families in Australia. The full text of the Oration can be found on the MHYFVic website.

VISITING THE CITY OF LIGHTS!!
MHYF Vic takes Advocacy Issues to the World Congress!!
A number of MHYFVic members, including Committee members Dr Suzie Dean, Sarina Smale and Dr Jo Grimwade, have attended the 20th World Congress of the International Association of Child and Adolescent Psychiatry and Allied Professions (IACAPAP) in Paris from July 21st to-25th. Suzie has written the following first hand account of the highlights for our newsletter.

“Three Symposia, twelve separate presentations, and a total of ten individual speakers were organised by MHYF Vic to take cutting edge ideas about advocacy to the 20th World Congress of the International Association of Child Psychiatry and Allied Professions (IACAPAP), held in Paris in July this year. IACAPAP is the peak world organization concerned with the mental health of children, young people and their families.

From the same advocacy perspective, the Austin Child and Adolescent Mental Health Service in Melbourne presented a Symposium “Terrorists or missionaries? Breaking myths of collaborative partnerships with consumers/carers”. It featured papers by Lynne Ruggiero, Maired Cardamone, Christine Denton and Neil Coventry (Director). Further, a Workshop was given by Victorian government Family Consultants in child and adolescent mental health – Lynne Ruggiero, Anne Casey and Rosemary Lawton. It was titled “Integrating family perspectives into clinical practice”.
This was the fourth time that MHYF Vic and the Austin service have organised significant presentations on professional-consumer/carer advocacy at the IACAPAP World Congress. Those previously were in Melbourne (2006), Istanbul (2008) and Beijing (2010). The contributions in Melbourne were ground- breaking, orchestrated by MHYF Vic, AICAFMHA and other groups, including the Austin and The Mater Hospital (Brisbane). As a result, the Executive Committee of IACAPAP asked me, Suzie Dean, as a Vice-President of IACAPAP, to investigate finding a regular place for consumer/carer issues and involvement in the Congress. A place was certainly achieved at the Paris Congress!

Reporting Pioneering and Reflective Work
France and the United States joined in the MHYF Vic Symposia, but the initiative to present, explore and promote advocacy in this international setting came from Victoria, and Australians came to the party with enthusiasm. Excellence was the keynote. All of the presentations focused upon pioneering work in enhancing working relationships between professionals and service users, took a reflective and critical stance, and stimulated spirited discussion.
A thread running through the MHYF Vic Symposia was awareness of the tremendous challenges facing advocacy for the mental health for the young, even in the relatively wealthy countries of the world. Challenges spring not only from increasing economic constraints being suffered everywhere, but also from forces within each of us – forces that can blind people to the psychological needs of children, and to the child which each
of us carries within. Unlocking responsiveness to our own needs and to those of others was a theme throughout, emerging with our first Symposium, in the heartland of mental health work – psychotherapy.

Psychotherapy Frees Understanding and Expression
Psychotherapy as an experience wherein parents, children and young people can find their own voice to express their own needs – where advocacy begins – was the subject of the first Symposium. It was titled “Meetings of minds: The centrality and power of the clinician-client relationship in psychotherapy from infancy to young adulthood”. This Symposium was led off by Campbell Paul, of the Royal Children’s Hospital in Melbourne, and a world leader in Infant Psychiatry. Campbell spoke with great sensitivity about how psychotherapy can help a troubled parent of a troubled infant find her own infantile feelings, then observe more clearly her own real baby expressing needs, so she comes to identify with her infant, thus becoming more attuned to the baby’s needs for understanding.
Our President, Jo Grimwade, Clinical Psychologist, followed this, with a paper reporting his research about parents undergoing the fraught processes of referral and intake to child and adolescent mental health services. He explored the hidden impact of this experience on subsequent psychotherapy and other treatments. Jo’s research has been influential in advocacy about improving access to services in Australia. Ros Webb, Child and Adolescent Psychotherapist, was the next presenter, speaking in a very moving way about an adolescent in psychotherapy. The young person was able to use psychotherapy to confront intangible and crippling inner fears, and thus find the inner self that was longing to emerge from “nothingness”, to claim personhood and a personal voice.
Finally, I, Suzie Dean, presented theoretical advances in understanding attachment in the psychotherapeutic relationship, advances that highlight what is valuable about psychotherapy in helping us to find freedom of thought and feeling. Child psychotherapy opens up freedom for the child to find within the means to express his or her deeper needs, and thus discover the essence of advocacy.

Consumers and Carers Collaborate with Professionals
The second Symposium, entitled “Professionals, consumers and carers share visions and responsibility to strengthen child, adolescent and family mental health services”, showcased consumer/carer involvement in the detail of advocacy work, across various settings. Social Worker Sarina Smale began, with a paper about how Australian early childhood professionals (aka Kindergarten Teachers) work within the UN Convention on the Rights of the Child to develop holistic approaches to advocacy. Sarina’s research has shown how meaningful advocacy at the preventive level can be carried out by individual workers, passionately committed to including families and small children, as well as other professions, in their advocacy activities.

Next, Erica Lee, Executive Manager of The Mater Hospital Child and Youth Mental Health Service in Brisbane, then presented the story of the outstanding, comprehensive collaborative work between child and adolescent mental health professionals and consumers, carers and families in advocating for improved services. This work provides a model to the international community of how collaboration at the grass roots, staying in tune with families over a sustained time, can
be really effective in generating higher order change.

I, Suzie Dean, spoke next, reviewing how collaborations between professionals and consumers and carers has been building advocacy at a national level in Australia, teasing out factors that either hinder or enhance the work of advocacy coalitions today. The French perspective in this important area was then introduced by Jean- Paul Agard, President of Federation Francaise Sesame Autisme, the French national organization of parents of autistic children. Jean-Paul, from his position as a father, described how Sesame Autisme was formed by families, how it evolved, and how it functions and meets the challenges of advocacy in current times. His presentation highlighted for all of us how similar the issues are for families in different cultural contexts.

Advocacy Both Needs and Promotes Thoughtful Policy
In our third Symposium, we moved to the level of policy about collaborative advocacy. This session was scheduled in “prime” Congress time, and in an auditorium that allowed for simultaneous translation into French!
Titled “Advocacy for children, adolescents and families: To strengthen public policy and resources enhancing development in mental health in communities”, this Symposium brought together Australian, American and international thinking. Lynne Ruggiero, Family Consultant at the Austin Hospital Child and Adolescent Mental Health Service in Melbourne, began this session with an exciting report of her role. Lynne advocates to inform both practice and policy in the Austin service itself, but also at the higher level of the Statewide services in Victoria.

Next, Gordon Harper, Professor in Psychiatry from Harvard Medical School in Boston, gave a fascinating review of multi-layered advocacy for child and adolescent mental health, and inputs to that advocacy, over the years in the United States. Gordon included some extremely useful conceptual maps of how policy can be influenced.

I, Suzie Dean, then delivered a paper primarily authored by Chris Smale, Melbourne Barrister and ex-Ministerial Advisor, which considered how lobbyists can best steer advocacy towards government. Presenting a strategic proposal, Chris indicated the value of gaining the support of diverse expert disciplines, such as paediatrics and general medical practice. Our thinking was then taken to the international arena by Myron Belfer, Honorary President of IACAPAP and Advisor to WHO on children’s issues. Myron has unique experience in IACAPAP’s own efforts in advocacy for the young, especially in developing countries, in Africa in particular. Myron portrayed the advocacy policies of IACAPAP, pointed out difficulties encountered, and outlined the broad range of advocacy and educational activities recently initiated by IACAPAP. The wealth of ideas emerging from this Symposium are worthy of serious further study, integration and debate.

Conclusions? Where to from here??
These three MHYF Vic Symposia embraced very many diverse experiences and innovative ideas. Are there conclusions that can be drawn? For me, five stand out.
First, advocacy for child and adolescent mental health certainly is alive and well, actively pursued by professionals, young people and families – every hour of every day. The importance for the future of this unstoppable movement cannot be overlooked.
Second, nevertheless, there is much to be improved by advocacy for the young, and we need to begin drawing together the experiences of active groups, to integrate policies and share the tools found useful in this challenging work around the world.
Third, the critical value of mutual support and joint action in advocacy was evident at every turn. The job of advocacy can be really tough. The relationships formed in collaborative advocacy are powerful and must be celebrated and treasured.
Fourth, advocacy for child and adolescent mental health has no beginning and no end. It will remain a concern of human beings forever, as there will always be new issues developing. Just look at the internet!! We must remember that advocacy for the wellbeing of the young is an ongoing activity, with very subtle achievements, and only rare high-profile gains. Thus, the signing by a country of the UN Convention on the Rights of the Child is a significant, news-worthy event, but its actual implementation on the ground occurs in very small, possibly invisible changes in society’s attitudes and in commitment to services. We are in this for the long haul!
Finally, it is clear that, at present, Australia is eally needed to bring advocacy issues, together with the role of professional- consumer/carer collaboration, to the international stage of the child and adolescent mental health community.
MHYF Vic is dedicated to taking inspiration from experiences such as these three Symposia in Paris, and to continue with advocacy initiatives. “
Suzanne Dean, Member of the MHYF Vic Committee
Clinical Psychologist and Psychotherapist

History Corner, 1937
MHYF Vic members recently presented three symposia in Paris at the Twentieth Congress of the International Association of Child and Adolescent Psychiatry and Allied Professionals (IACAPAP). One feature of the celebrations was recognition of the 75th anniversary of IACAPAP.

In fact, the foundational Congress was not until 1948 in London, but a meeting was held of interested Child Psychiatrists in Paris in 1937. The field of Child Psychiatry was in its infancy at that stage with the first of the child guidance clinics having opened in 1917. The term became secure when Kanner produced the first text book, Child Psychiatry, in 1935. Given the turbulence of the times and the Second World War, it is not surprising that the emerging international organization was not able to meet until 1948.

The organization has been headed be a series of prominent, important Child Psychiatry professionals including Albert J Solnit, John Bowlby, Serge Lebovici, James Anthony, Donald Cohen, Helmut Remschmidt, Lionel Hersov, Colette Chiland, etc.

A sign of the internationalization of the association has been the election of Nigerian, Dr Olayinka Omigbodun as president of IACAPAP. This is all the more significant as the Dr had been sponsored to study in the United Kingdom under a IAQCAPAP development fund scholarship.

At the twentieth congress, Dr Kari Schleimer
75 Years with IACAPAP, The History of IACAPAP launched the book that documented IACAPAP’s history with a selection of summaries of major papers from each of the congresses. Interested readers are encouraged to access the book through:
kari.schleimer@comhem.es

The congress was held in Paris for the first time since 1986. Interestingly, the only other city that has been a host more than once has been Melbourne in 1978 and 2006; both because of the energetic role played within
IACAPAP by Dr Winston Rickards, although sadly, he was too ill to really enjoy the latter congress.

Australia has often played a significant role within IACAPAP. Currently, the only Allied Professional on the IACAPAP Executive, is MYHF Vic’s Suzanne Dean.
The next congress is to be held in 2014.

Assoc Prof Jo Grimwade

AICAFMHA News
The following three items are reprinted from the AICAFMHA electronic newsletter.
‘Children of Parents with Mental Illness’ (COPMI) is set to roll out its new Family Focus intervention course, which is an evidence- based program designed for mental health professionals treating parents with depression and/or anxiety to foster resilience in their children and the family unit. Training in the Family Focus approach is available to GPs, psychologists, psychiatrists, social workers, occupational therapists and mental health nurses. For more information and to access the course, go to

http://www.copmi.net.au/professionals/professional-tools/family-focus.html.

SANE Australia’s recent research on Parenting and mental illness in the School Years was conducted in partnership with COPMI. The survey found that many parents with a mental illness raising children lack support from health professionals and school staff, and they feel ashamed to ask for help. SANE Australia’s study found that only around a third (31%) of survey respondents have told their child’s school they have a mental illness and half of these found the disclosure unhelpful, leading to stigmatising by other parents and, in some cases, bullying of their child. To view go to http://www.sane.org/images/stories/informat ion/research/1208_info_rb16.pdf.
At the TheMHS conference, “Recovering Citizenship” held in early August, COPMI won a Gold Special Achievement Award for their work promoting better mental health outcomes for children of parents with a mental illness. Congratulations to all winners.
As many of you are already aware, Elizabeth Fudge will soon be retiring from the position of COPMI Director. Phil Robinson, Chair of the Board of Directors of AICAFMHA, is leading the recruitment process for the Director position and has asked that I draw your attention to the SEEK advertisement which can be found using the following link
http://bit.ly/U5AuDJ
Please bring the upcoming vacancy to the attention of anyone who may be interested in applying.

Social and emotional outcomes of young Australian children from Indigenous and CALD backgrounds
Evidence from developed countries suggests that young children from Indigenous and cultural and linguistic diversity (CALD) backgrounds experience poorer health and wellbeing outcomes compared to their peers. However, it is difficult to know what explains these different outcomes, as apparent effects of ethnicity, culture and immigrant status may also reflect different family or neighbourhood circumstances. A recent study of the social and emotional outcomes of Australian children from Indigenous or CALD backgrounds aimed to provide some insights on these issues. The study was based on analyses of Wave 1 of the Longitudinal Study of Australian Children, including children aged 4-5 years. The social emotional outcomes of children were compared according to their mothers’ country of birth, Indigenous status and language spoken at home. Overall, these findings highlight that children from Indigenous and CALD backgrounds are more likely than other children to be exposed to risk factors for poor child mental health outcomes within their family and neighbourhood environments.

Depression in rural adolescents: relationships with gender and availability of mental health services
This study examines the relationship between depression and possible determinants of mental health among rural adolescents. The determinants identified were degree of remoteness, gender, socioeconomic status and the perception of rural community characteristics and the rural community characteristics examined were long waiting lists and lack of mental health professionals. Respondents were South Australian adolescents aged 13 to 18 years, living outside the Adelaide metropolitan area. The results suggested that depression was related to gender, with more females (23%) screening positive for depression than males (11.8%), whilst prevalence of depression was unrelated to degree of remoteness or the socioeconomic status of the participants. The authors concluded that efforts to enhance the mental health of rural Australian adolescents should focus on improving the availability of mental health services, improving mental health literacy and promoting help-seeking behaviour for mental health difficulties.

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