Newsletter No. 36

MHYFVic Annual General Meeting

A very informative MHYFVic Annual General Meeting for 2012 was held on Saturday 10th November at the Cairnmillar Institute, Burke Road, Camberwell. After the business meeting there were presentations of three excellent papers that had been given by MHYFVic members at the recent IACAPAP Congress. This was the only opportunity that most of us had had to hear the papers, and it highlighted how valuable our contributions had been.
Our Committee wishes to remind all members that Membership subscriptions of $20 for 2012-13 are now due. This is our last Newsletter for the year and we take this opportunity to extend Seasons Greetings to all our members and friends.

PRESIDENT’S REPORT

Welcome everybody to the 2012 MHYF Vic AGM. I am pleased to report on another active year by the MHYF Vic Committee and the building of broader efforts to put our policies into actions and to achieve outcomes for children and families. As usual, we have not achieved as much as we would have liked to have done, because there is much to do. New attendees to our AGM might find areas of interest to which they might like to contribute. If you have interest, please speak with a Committee member and, of course, we invite new members to our Committee.
The major events of 2012 were squeezed into a particularly busy mid-year period and into the last few weeks as we prepared for this AGM. The third Winston Rickards’ Memorial Oration was delivered by former Family Court Chief Justice, Professor Alastair Nicholson in August to a large audience at the new Royal Children’s Hospital. This was very well received and thoughtfully responded to by our 2011 Orator, Dr Dorothy Scott. We are seeking a speaker with consumer background for 2013. The event symbolizes our admiration for Dr Rickards, but also our determination to make MHYF Vic a forum for all those interested in child and family mental health: we have had a child psychiatrist, a social worker, a Family Court justice, and next, perhaps, a consumer advocate. Dr Rickards was, above all, a collaborator.
Dr Rickards was also a long time advocate for IACAPAP: the International Association for Child Psychiatry and Allied Professions. Dr Rickards was instrumental in getting the Congress to Australia in 1978 and was involved, despite illness, in the 2006 Congress in Melbourne. The organizer of the Scientific program in 2006 was MHYF Vic’s Dr Suzanne Dean, who is now a Deputy President of IACAPAP and the only non-psychiatrist on the Executive. Dr Dean got a number of MHYF Vic members and national and international collaborators to participate in three Symposia at the 20th IACAPAP congress in Paris in July; as the Tour de France bikes were rolling down the Champs Elysee, the congress was in first session. A sample of papers from across these symposia will be presented today. We would hope to present other papers at other MHYF Vic forums in the New Year. This is the start of what we hope is a productive collaboration with Cairnmillar and a series of Saturday afternoon special events. Anybody interested in presenting or sponsoring or suggesting a theme should speak with a member of the Committee.
The Committee has been stable for a few years with the faces of Allan Mawdsley, Suzanne Dean, Jenny Luntz, and Ron Ingram turning up most months to do the work. I have been a member for five years and Lillian Tribe was a foundation member, who rejoined after a break. More recently, the voices of Sarina Smale and Miriam Tisher have added new perspectives. In recent years, we have seen the contributions of Rita Gordon, David Mushin, Suzanne Robson and Jacinta Bleeser ended as they moved to other challenges. We are hopeful that a past member who moved north may rejoin, today. We are always seeking extra people and extra energy. Of course, there have been other members who have served our Committee and moved on who cannot be listed, but we should not fail; to mention founding President, Winston Rickards.

Unfortunately, our Secretary became overloaded with family business and was not able to continue. We thank Prashnitha Prakash for her contributions over the past three years. The Secretary’s role has often gone to a young professional seeking to understand how their likely profession functions and I believe we have another such person keen to take on this role from now on. But we have another reason to thank Nitha and that is the ability to round up volunteers to take on small jobs at the Oration and to undertake small projects on our behalf. Any students who want to be involved like this should speak with Sarina Smale, or our Projects Officer, Dr Kylie Cassar.
Our capacity to move policy into implementation in 2012 was greatly facilitated by our newest Committee member Dr Cassar. Those who have seen our website will have noticed that we have a lot of projects that we are working on, but not much news ever gets reported. Well it is Kylie’s role to make the work appear. She will also have an important role, along with Sarina, with the new group of volunteers, to help them gain first hand experience of working with mental health researchers and policy drafters, while also doing background work on specific projects. We would hope that some of this project work could be done through university coursework; so we invite the attention of the gathered academics to consider how they might make a contribution to mental health policy and practice through student projects.

The big project that we have begun in 2012 is a Practice Atlas for child and adolescent mental health. We want to survey current practices across age groups, cultural groups, and special needs groups, across diagnoses and within diagnoses, to find out what is world’s best practice. This is something that may never be complete, but can be a fully working, work in progress, like the paint job on the Sydney Harbour bridge. We have made a start by developing a scaffold. Thanks for this go principally to Allan Mawdsley, but we need lots of volunteers to put in the struts and to tighten the bolts.

Another big project for 2012 has been the website. Ron Ingram has worked away on this for several years and the Committee still wants to improve it, but apart from Sarina, Nitha, Kylie, and Ron, we do not know how to improve it. Allan does solid liaison work around the improvements, but we need help to know that it is doing what it needs to do. Volunteers can make useful contributions in this area; anybody can provide us with feedback. Websites have become the backbone to the skeleton of organizations and we want to have a taut and trim physique! Ron’s work is deeply appreciated, but he, as artist and technician, is not responsible for incomplete or ineffective content.
The part we feel most flabby or ineffective about is actual inclusion of carers and consumers in our Committee work and general organizational processes. We invite consumers who are present to join us at all levels of our endeavours.
I would like to offer special thanks to Allan Mawdsley for his efforts this year. Last year he published two social histories: one on the St John’s Ambulance and another on the Creswick Foundation. This year he has published our Newsletter, which has been of a high standard, if a somewhat irregular appearance. Part of the problem was an effect of the loss of our Secretary and email lists; both of which were rescued by Allan in his usual detailed manner. Allan was also our correspondent with the new Children’s Mental Health Coalition.

Further special thanks are deserved by Suzie Dean. In a year of family illness, she has done an incredible amount on the world stage through IACAPAP. Her efforts will see a major Pacific Rim IACAPAP event in 2013, in conjunction with the RANZ College of Child and Adolescent Psychiatry. The Oration Committee is chaired by Suzie, as well.

Another who deserves special thanks is our erstwhile Treasurer, Lillian Tribe. She is also a carer advocate and continues to try to gain membership from the consumer sector.

The energy of the year award goes to Sarina. No correspondence needed!

We want more members across the board; we are wondering if the fee of $20 is exclusive of membership or so low as to not warrant the effort in collection. However, we do have real costs and welcome comments on how we might raise funds. Gold coin donation worked well at the Oration.

So, please consider the following questions for feedback now, or through email:

1. Project participation
2. Practice Atlas research and support
3. Website feedback
4. Membership fees
5. AGM structure
6. Saturday forums

We move into 2013 with a full agenda and we need hands on deck.
Thank you for your attention.

Jo Grimwade
President

SECRETARY’S REPORT

As Acting Secretary it is my privilege to deliver the Secretary’s report for the 2012 MHYFVic AGM.
Our previously elected Secretary, Prashnitha Prakash, sadly experienced some major family crises necessitating her precipitant return to India and subsequent withdrawal from MHYFVic activities. We thank her for her past contributions to MHYFvic and wish her well with resolving her life difficulties. The transfer of responsibilities unfortunately had some significant complications for MHYFVic during an exceptionally busy year, including the loss of our membership database which has had to be reconstructed from earlier listings. It may be that some paid up members have not been receiving material to which they were entitled, and some former members may be receiving material to which they are not strictly speaking entitled to receive but which we are still quite happy for them to receive. Please forgive us our sins and help us get back on a sound footing.
When I say that we have had an exceptionally busy year I should mention a variety of activities which fall into four main areas :

• the Winston Rickards Memorial Oration,
• the IACAPAP Congress presentations,
• liaison with other organizations, and
• MHYFVic organizational matters

The Winston Rickards Memorial Oration, this year delivered by The Honorable Alastair Nicholson on the topic of “Human Rights of Children and Youth in Australia : It’s time we got serious”, was a particularly memorable event. It was held in the Ella Latham Theatre at the new Royal Children’s Hospital, and the response was delivered by last year’s Orator, Emeritus Professor Dorothy Scott. The considerable organizational workload in preparing and running the event was shared by the Committee and a small band of voluntary helpers including a former MHYFVic Secretary, Jacinta Bleeser, and a number of students who volunteered as ushers. We also thank Psychological Press for printing our publicity posters. Several of the student volunteers have indicated an interest in further assistance of MHYFVic.

The IACAPAP Congress presentations in Paris, several of which you will hear today, also took a huge amount of preparation not only in their intellectual content but also in organizational tasks such as fundraising for consumer/carer representatives who might not otherwise have been able to go. Much of the impetus for this has come from Suzie Dean, one of our committee members who is a regional Vice-President of IACAPAP for the Oceania region.
Liaison with other organizations has been greater this year. Two, in particular, are worthy of special comment. The Children’s Mental Health Coalition includes a range of national organizations like the Australian Psychological Society, the RANZCP Faculty of Child & Adolescent Psychiatry, the Australian Medical Association and some smaller lobby groups like MHYFVic. Its main preoccupation has been to develop a mental health initiative for children and families that would parallel the very successful initiative of Headspace Centres for adolescents.

The liaison with Grandparents Victoria has been around the issue of kinship care. Child Protection services have been moving more and more towards kinship care rather than foster care of children who need out of home placement, and the majority of cases are with grandparents. Problems include a high prevalence of mental health issues that may not reach the threshold for intake into specialist services, insufficient support for carers who have generally not had any training for care of disturbed children, and often contentious relationships with the parents of the children in care (who are their own kin). One of our committee members, Miriam Tisher, has joined the kinship care group.
There is ongoing liaison with AICAFMHA (Australian Infant, Child, Adolescent and Family Mental Health Association), of which one of our Committee members, Mrs Jennifer Luntz, is the Victorian representative on their board of management, and we continue to have a strong interest in one of their projects, COPMI (Children of Parents with a Mental Illness).

We are undertaking collaborative discussions with the Faculty of Child & Adolescent Psychiatry regarding the holding of Consumer/Carer and Youth Forums at their 2013 Conference in Melbourne. We are also liaising with them in a leadership group for formation of a IACAPAP Oceania Study Group promoting development of Child &Adolescent psychiatry in south east Asia through such mechanisms as bringing mental health professionals to conferences and seminars in Australia.

MHYFVic organizational matters have taken up a great deal of time. Besides the reconstruction of our membership list that I previously mentioned, we have made considerable progress with reconstruction of our website through the splendid work of our webmaster, Ron Ingram, and input from Sarina Smale. Among a number of improvements has been the inclusion of a Linkages page giving links to the websites of organizations that share our objectives for improvements in a variety of aspects of mental health services.

Our Newsletters have also become somewhat more reliable since the reconstruction of our electronic mailing list although we would still like to be informed of any updated email addresses for future editions.
We would dearly like to hear from any young people, consumers and carers who would be prepared to express their views on mental health service delivery, good and bad, in the cause of our objective of improving services for the future. Just make yourselves known to any committee member at any time.

Several young people who assisted with the Winston Rickards Memorial Oration have offered to do additional work for MHYFvic. This may involve mental health advocacy projects or joining the committee or as associated helpers with tasks. We very much want to improve our communication using more modern methods such as Facebook and Twitter which do not come easily to elderly citizens, in order to engage young consumers. We also hope to become better at monitoring and reporting of related mental health websites.

We have clearly set out our aims and objectives, policies and principles, and we have a strategic plan to achieve those objectives. We have a number of projects that members are undertaking towards development of specific proposals that we wish to see implemented for improvement in mental health services. We are now also engaged in formulating a “Best Practice Atlas” which identifies effective programs in other places which might usefully be implemented here. We welcome any suggestions for additional improvements. Please let us have your opinions, and particularly any offers of contributing to our work.

Finally, a word about our meetings. Over the last several years our Annual General Meetings have been in the form of Wednesday evening meals with after-dinner presentations on topics of particular interest. Last year, for example, Laura Caire spoke on language impairments in Juvenile Justice clients, and the implications of this for management. This year the meeting is followed by papers on a Saturday afternoon. It is possible that there could be future seminars on Saturday afternoons through the year but we need to know what you think about this. Would you prefer our AGM to take place at one of those meetings during the year, or revert back to a Wednesday evening dinner next year? Please give your opinions on this, or any other topic of importance to you, to any of our committee at any time.

Dr Allan Mawdsley, MHYFVic Acting Secretary,

History Corner, 1812

With the IACAPAP Congress in Paris and the Napoleon Exhibition at the National Gallery of Victoria, it has been a very French year for MHYF Vic (incidentally, a visit to the Briars on the Mornington Peninsula can further fuel a Napoleonic interest!). But there is a link to the history of the practices of family mental health, as well.

The Napoleonic wars (1797-1815) saw a medical innovation: triage. Napoleon’s personal physician, Baron Dominique Jean Larrey, was also the Chief Military Surgeon. He was able to address the need for a ready supply of fit men for the front, by having the injured treated quickly and then returned to the battle.

The ambulance office, literally a person who got the injured soldier fit to walk, would go out onto the battlefield and make a rapid assessment of the state of the soldier. If able to walk, then the soldier would be ordered to make his own way back to his lines. If injured, the officer would assess the likelihood to be able to return to the front, if treated. If so, the soldier would be helped back to safety by assisted walking, trolley, or donkey. If not able to be treated, the wounded would be left to die..

These three categories of response have been assumed to relate to the “tri”, but, in fact, the French verb “trier” means to select or sort. The ambulance officer, or triage agent, is sorting into categories and then selecting an appropriate response from a limited number of options. In mental health, the no treat option does not exist as does not the option to leave to die,. But in emergency departments, triage, as first described by Napoleon’s doctor, still applies. Many believe that CAMHS intake is a form of triage, but there are several important distinctions:

1. Triage is done almost always in the direct sight of the patient, referral and intake usually occurs over the telephone,
2. Decision-making by the triage agent immediately, whereas the referral and intake work consults with team leader,
3. The referral contact is not a decision-making event; it is for information transfer,
4. The time frame for Triage has to be urgent. Referral for child and adolescent can take twenty to thirty minutes, but may involve much longer and deeper discussion and may involve various follow up enquiries to other agencies and other professionals,
5. Psychosocial factors affecting symptoms at presentation for triage are not given much importance relative to the medical needs of the patient and the availability of medical resources within the emergency department. Whereas for referral to child and adolescent mental health services, many psychosocial factors have to be considered and evaluated, as offering treatment is not rational if the child cannot be brought for treatment or treatment cannot be appropriately supported by parents and other social resources (welfare, schools, …), and
6. Referral for child and adolescent mental health service needs to be an interpersonal event of meaning, where naïve participants gain confidence in a process, whereas triage needs to minimize the interpersonal part of the transaction in favour of the mechanical task of rapid assessments and decision-making.

Nevertheless, 1812 provides an overture to current practices.

Au revoir, 2012.

AICAFMHA News

MHYFVic is a kinship organisation to AICAFMHA, which carries out an advocacy role at the national level similar to what MHYFVic is trying to do at the state level. The following items are reprinted from the AICAFMHA electronic newsletter.
Targeted family interventions for families where a parent has a mental illness: Early intervention benefits to children
The latest GEMS – “Targeted family interventions for families where a parent has a mental illness: Early intervention benefits to children” is now available on the COPMI website at
http://www.copmi.net.au/images/pdf/Research/gems-edition-13-sept-2012.pdf
This GEMS outlines evidence showing that family-focused, targeted prevention interventions are effective. The interventions highlighted here are different from those that focus on adult family members of adult consumers; instead this GEMS reviews programs for families where the adult consumers are parents, alongside their partners and their children. Two programs “Family Talk” and “Let’s Talk about Children,” that will soon be available to Australian families, are also reviewed.

Unaccompanied Humanitarian Minors in Australia: An overview of national support arrangements and key emerging issues
The Multicultural Youth Advocacy Network has recently developed a policy paper on Unaccompanied Humanitarian Minors (UHMs), providing a national overview of support arrangements and key emerging issues from the sector. UHMs are a particularly vulnerable group of young people, with diverse and complex needs. Given the absence of a nationally consistent approach to the care and support of this group of young people, and the increased numbers of UHMs arriving through Australia’s on-shore protection system, the paper is designed to address an identified gap in clear information about the type of care and support available to UHMs in each state and territory, and highlight gaps and challenges in the provision of adequate care and support. The paper was developed in collaboration with MYAN partners, as well as the Department of Immigration and Citizenship (DIAC). To download a copy of the paper, go to
http://www.myan.org.au/file/file/MYAN%20UHM%20Policy%20Paper%20Sept%202012.pdf

Cultural Diversity and Child Protection: A review of the Australian research on the needs of culturally and linguistically diverse (CALD) and refugee
The aim of this paper is to review the available Australian research on the interface between Child Protection System (CPS) and families from CALD and refugee backgrounds; to identify gaps within research knowledge and propose future research priorities; and to develop recommendations for ways in which practitioners and policymakers can begin to address the current gaps in service delivery, data collection, policy and practice guidelines. The Report includes research on cultural diversity in CALD and refugee communities; risk factors for child abuse and neglect in CALD and refugee families; communication and language considerations ; child protection assessment frameworks; key messages from the Australian research on CALD and refugee families in CPS; presentation of CALD and refugee communities in CPS and their experiences; and a scoping Study on CALD and refugee children and young people in OOHC ( Out of Home Care) in Victoria. To download the report, go to
http://www.jkdiversityconsultants.com.au/Cultural_Diversity_&_Child_Protection_Kaur2012_A4.pdf

Talking Anxiety App
SANE Australia, has now launched an app- available from the Apple App Store – to help people to manage their anxiety. The Talking Anxiety App helps people to learn how to manage anxiety from people who’ve “been there'” and discovered techniques that really work and complement medical therapy. The Talking Anxiety app for the iPad and iPhone brings you the video stories of eight people living with an anxiety disorder. Four modules, ‘Understanding Anxiety’, ‘What Helps’, ‘How to Help Yourself’ and ‘How Family and Friends Can Help’ help you understand anxiety and how it can be successfully managed. In addition to video of people explaining the tips that worked for them there are quizzes to test your own progress, and an optional Daily Tip sent to your iPad or iPhone. This app is intended to provide information and support to people affected by anxiety disorders and those who care for them. It does not provide specific advice, which should be sought from a doctor or other suitably-qualified professional. For more information, go to

http://www.sane.org/information/bookshop/details/93/34/apps/anxiety-app

2013 MHYF Vic Committee

* President, Jo Grimwade
* Vice-President, Jenny Luntz
* Past President: Allan Mawdsley
* Secretary, Zoe Vinen
* 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