Newsletter No. 44

CHILDREN OF PARENTS WITH MENTAL ILLNESS

Child and Youth Mental Health Services have a mandate for working with children and adolescents who are currently struggling with mental health issues. They are less involved in working with those who are at risk of developing mental health problems in the future. A group at high risk of developing such difficulties are those children and adolescents who have one, or both, parents struggling with mental health issues themselves.
This group is certainly at risk environmentally, as a parent who is struggling with mental illness may be emotionally unavailable, or unpredictable. Low income, insecure housing and family violence may also impact on the family. Children of parents with mental illness also have a higher risk genetically of developing a mental illness than other children.
Our speaker at this year’s Annual General Meeting is Vicki Cowling. Vicki has been involved with this group for over 20 years, having contributed to the first research
project on the topic in Australia, and to mental health promotion, development of training materials, and publications including three edited books and journal articles on this topic.
Since 2002 Vicki has contributed to the development of the COPMI (children of parents with a mental illness) national initiative, based in Adelaide, through membership of the Reference Group, and various consultation groups.
Vicki has worked in public child and adolescent mental health services for 15 years in Victoria, including the CYMHS services at Maroondah and Monash, and also in New South Wales. She is a Board member of the Australian Infant, Child, Adolescent and Family Mental Health Association, the umbrella organisation that does nationally what MHYFVic does within Victoria. She is now an independent practitioner in child and family mental health in Melbourne and members who attend the AGM can be assured of a most interesting after-dinner presentation.

Annual General Meeting

The AGM will be held on Wednesday 27th August 2014 at Pacific Rim restaurant in Albert Park. Pacific Rim is a Thai restaurant in Bridport Street at the corner of Ferrars Street, Albert Park. It serves excellent food at very reasonable prices.
The meeting will begin with a short business component at 7.00pm, prior to which the dinner orders will be taken. Dinner will be served at about 7.45pm, after-which Vicki Cowling will describe developments that have occurred over the last two decades in support services for children whose parent has a mental illness.
Although the restaurant does not require pre-payment or pre-ordering of food, it does wish to know how many people will be attending. If you are intending to come, please let me know by an email to mawdsley@melbpc.org.au
Accompanying this Newsletter should be a Nomination Form for election to the Committee as President, Vice-President, Secretary, Treasurer/Memberships Officer, or member. Although Associate Members are most welcome at the AGM, only paid-up members are eligible to nominate or vote.

PREVENTION OF MENTAL DISORDERS

The MHYFVic “Principles and Policies” document strongly advocates the prevention of mental disorders as well as advocating better services for people who have developed a disorder. The World Health Organisation has published considerable literature on prevention and the Australian Government’s National Mental Health Plan expresses support for the concept, but in practice there has been minimal funding devoted to preventive programs notwithstanding authoritative support by the medical profession. (See Jorm, A.F. and Reavley, N.J. “Preventing mental disorders : the time is right” in ‘Perspectives’ Med J Aust 199 (8) 21 October 2013 p527).
The WHO Report “Prevention of Mental Disorders: Effective interventions and policy options” 2004, Geneva, gives the following ten point summation:
1. Prevention of mental disorders is a public health priority
2. Mental disorders have multiple determinants; prevention needs to be a multipronged effort
3. Effective prevention can reduce the risk of mental disorders
4. Implementation should be guided by available evidence
5. Successful programmes and policies should be made widely available
6. Knowledge on evidence for effectiveness needs further expansion
7. Prevention needs to be sensitive to culture and to resources available across countries
8. Population-based outcomes require human and financial investments
9. Effective prevention requires intersectoral linkages
10. Protecting human rights is a major strategy to prevent mental disorders
The implementation of these principles highlights the public health paradox. Universal interventions are notionally the most effective for the population but are the most costly and have the weakest evidence base. Selective interventions are moderately costly although the evidence shows them to be reasonably effective. Targeted interventions have the strongest evidence base and are the least costly because they are focused on the smallest group but have limited effectiveness because, by definition, they are focused on a significantly disadvantaged group.
MHYFVic advocates support for preventive mental health measures at all three levels but particularly at the universal level because of its potentially greater public health benefit.
For children and families this means programs that :
 Ensure adequate safety, housing, food and general health, welfare and educational services.
 Promote social stability, family functioning and adequate parenting skills.
 Enhance social cohesiveness and pro- social participation
 Encourage every child’s educational progress to reach his/her potential
 Provide processes to identify and deal with toxic events
MHYFVic is sponsoring a five-part Project to define the best practice approaches to prevention of mental disorders, and invites any interested members to join the project groups working on these tasks.
How do we ensure adequate safety, housing, food and general health, welfare and educational services? We have Government Departments and non-government agencies that deal with all of these issues, but are they enough? What are the appropriate benchmarks of adequacy? Proposing appropriate benchmarks will be Task One of this Project.
How do we promote social stability, family functioning and adequate parenting skills? Removing the destabilising influences mentioned in the previous paragraph is a necessary step but not sufficient; we also need processes to develop self-sufficiency in employment and recreation, social networks and skills. Proposing appropriate mechanisms will be Task Two of this Project.
How do we enhance social cohesiveness and pro-social participation? As an extension of the issues in the previous paragraph we need to encourage participation in community groups and volunteer activities. Proposing
appropriate mechanisms will be Task Three of this Project.
How do we encourage every child’s educational progress to reach his/her potential? Although this has traditionally been the responsibility of the family, research showing that the whole life trajectory is elevated by this achievement means that the human capital of the nation depends on this goal. Proposing appropriate mechanisms will be Task Four of this Project.
How do we provide processes to identify and deal with toxic events? Although Child Protection Services are mandated to respond to identified abuse and neglect, there are other unidentified barriers to overcome and proposing appropriate mechanisms will be Task Five of this Project.
Project Coordinator : Dr Allan Mawdsley Members welcome
Contact Allan Mawdsley on 0419 77 00 66 or mawdsley@melbpc.org.au

HISTORY CORNER 1904 Psychiatric diagnosis

With the production of DSM V in 2013, it is worth considering the one hundred years of development of the manual. Emil Kraepelin, in his sixth edition of his Textbook of psychiatry, formally drew the distinction between the two types of psychosis: manic- depressive illness and dementia praecox (to be renamed schizophrenia by Eugen Bleuler in 1911). In fact, he had made the distinction earlier than 1895, which was the year that Breuer and Freud published Studies in hysteria.
Kraepelin was against the unconscious ideas of Freud as they were, in his mind, anti-scientific, yet he, too, was very attracted to the study of dreams, especially his own. Kraepelin wanted to produce an organic psychiatry based on malfunctions of the brain and was convinced that dementia praecox was the endpoint of a total body ailment that was revealed catastrophically as psychosis. Kraepelin did not want to produce a diagnostic system based on symptoms, yet this is his legacy.
Another Freud collaborator, Pierre Janet, produced the first formal separation of the neuroses of hysteria from those of obsessive- compulsive disorder in 1892, although this would appear to have been a working distinction for more than two decades, and one that Freud, as neurologist and psychoanalyst, implicitly employed. But this was not fully formulated until 1919, when Freud and Janet had become distant.
Dementia praecox means a dementia that induced a child-like state. Bleuler corrected this idea, by rather describing the state as one of splitting of the mind (not split mind, but a dynamic disruption under certain conditions not easily observable externally). Bleuler collaborated with Freud, but like Jung and Adler, could not commit to the quasi-religious belief required by Freud of his followers.
DSM I was a psychodynamic diagnostic system first produced in 1952. DSM II (1968) was an elaboration of the former with greater emphasis on the subtypes of psychosis.
Somewhat ironically, the subsequent versions of the DSM (DSM III, DSM IIIR, DSM IV, DSM IV TR, and DSM V), focus on the distinctions of Kraepelin and of Janet and upon symptoms. Both had wanted to use symptom description as a means to describing underlying processes. The terms of manic-depression and hysteria have also disappeared. Further, from DSM III onwards, there has been an attempt to describe mental illness in the
context of other disorders and social challenges, although this emphasis, started by Michael Rutter in the 1970s, has now been reduced.
Further, with studies of genomes and pharmacology, the distinction between the two sorts of psychosis is now under question.
Diagnosis remains important as means of communication between professionals and to help with planning treatment, but as we are dealing with such complex behavioural, interpersonal, and social phenomena, our capacity to respond with clarity, precision, and compassion to those who consult us, has undergone many technical revisions, yet remains with a shape mapped out by Kraepelin, Bleuler, and Janet.
Jolyon Grimwade.

AICAFMHA News

The recent newsletter of the Australian Infant, Child, Adolescent and Family Mental Health Association had the following notes on important resources now available in the mental health field.
I’ve been there – Young people surviving pregnancy and parenting together Co-ordinated by the Mental Health Association NSW, “I’ve Been There” is a website for young parents to find out more about pregnancy and parenting, as well as some of the mental health problems that are common during this time. It includes information on pregnancy challenges, such as Don’t know what to expect and Problems with partner as well as parenting challenges and survival tips, such as Keeping up with old friends, Dealing with emotional changes during pregnancy, Getting to know your baby and Getting baby to sleep.
MHYF Vic: promote mental health, reduce stigma, advocate, resource, and collaborate 4
Eating Disorders in Schools: Prevention, Early Identification
Developed by the National Eating Disorders Collaboration, this resource is written for education professionals working in schools to assist them in understanding eating disorders, promoting health and wellbeing within their schools, recognising and responding to eating disorders, and supporting students who are undergoing treatment for an eating disorder. The resource encourages a whole- school approach to eating disorders.
Siblings: Brothers and sisters of children with disability(revised edition) tells what it is like to grow up with a sister or brother who has a disability or chronic illness. The siblings of children with special needs are often the overlooked ones in families struggling to cope. Besides giving siblings a voice , the author, Kate Strohm, also provides strategies that siblings themselves, parents and practitioners can use to support brothers and sisters of children with special needs. To order this book, click here.
WHO Report on Adolescent Health
“Health for the world’s adolescents” is a dynamic, multimedia, online report. It describes why adolescents need specific attention, distinct from children and adults. It presents a global overview of adolescents’ health and health-related behaviours, including the latest data and trends, and discusses the determinants that influence their health and behaviours. It also features adolescents’ own perspectives on their health needs.

OUR UPDATED WEBSITE

After much thought our website has been significantly revised to give casual visitors immediate information about what we do and what we stand for, whilst at the same time
allowing members to go straight to specific sections such as Projects or Newsletters or Events, without having to navigate past reams of information.
Now that the main revision has been implemented we are working on tasks of development of Projects to give us the evidence base for our advocacy. There are quite a few items under development at the present time which are not yet reflected in the website but over the next few months we expect to see a burgeoning of activity.
Visit us on mhyfvic.org

2013 MHYF Vic Committee

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

MHYF Vic
PO Box 206 Parkville Vic 3052
Phone: 0428 362 965 Email: admin@mhyfvic.org Website: www.mhyfvic.org

Notice of 2014 Annual General Meeting

Wednesday 27th August 2014 at 7.00 pm
If you wish to make a nomination for a position on the MHYF Vic Committee please return a completed nomination form at least 7 days prior to the AGM. Positions for election are President, Secretary, Treasurer and six Committee Members.
Members, Associates, partners and guests are all invited to attend the AGM but only full members may vote.
If you would like any special business addressed during the meeting contact the MHYF Vic Secretary at least 7 days prior to AGM.
The AGM will include a brief business meeting,
a pleasant, convivial meal, and
an after-dinner presentation by Vicki Cowling
“Children whose parents have a mental illness”
Please join us at
Pacific Rim Restaurant
68 Bridport Street, Albert Park (cnr Ferrars Street)
Ask for MHYF Vic
RSVP by Monday 25th August to Allan Mawdsley, Acting Secretary, mawdsley@melbpc.org.au
MHYF Vic
PO Box 206 Parkville Vic 3052
Phone: 0428 362 965 Email: info@mhyfvic.org Website: www.mhyfvic.org
Annual General Meeting Wednesday 27th August 2014 at 7:00 pm
Pacific Rim Restaurant, 68 Bridport Street, Albert Park
AGENDA Chair: Dr Jo Grimwade, President
7:00 Business meeting will consist of the following:
1. Review & confirm previous minutes – 24 July 2013
2. President’s Report – Jo Grimwade
3. Secretary’s Report – Allan Mawdsley
4. Treasurer’s Report – Lillian Tribe
5. Election of officer bearers & ordinary members
7:45 A-la-carte Thai dinner (order on arrival before the meeting) 8:30 After-dinner presentation by Vicki Cowling.
“Children whose parents have a mental illness”
introduced by Jennifer Luntz
MHYF Vic
PO Box 206 Parkville Vic 3052
Phone: 0428 362 965 Email: info@mhyfvic.org Website: www.mhyfvic.org
Nomination Form for election of Committee at AGM to be held on
Wednesday 27th August 2014 at 7:00 pm
I wish to nominate [name] __________________________________
for the position of ____________________________
Nomination and voting is only open to full members; Associates are not eligible.
Nominated by: ______________________ [name in block letters]
Signed: ______________________ Dated: ______________________
Seconded by: ______________________ [name in block letters]
Signed: Dated:
Acceptance of nominee:
Signed: Dated:
______________________
______________________
______________________ [name in block letters]
______________________
______________________
This form is to be returned to the MHYF Vic Secretary at least 7 days prior to the AGM
For further information contact Allan Mawdsley, Acting Secretary