Newsletters

October 2014

Newsletter No. 45

Children of parents with mental illness Prevention of mental disorders The President’s Report History Corner 1877

CHILDREN OF PARENTS WITH MENTAL ILLNESS

Members who came to our recent Annual General Meeting were privileged to hear a very fine presentation by Vicki Cowling titled, “Developments in support services for children of parents with mental Illness and their families”.
Vicki spoke with considerable authority on the subject because she has worked for some years as leader of a specialist mental health program in NSW targeting this problem, prior to which she was a project officer with the Australian Infant, Child, Adolescent and Family Mental Health Association on the COPMI (Children of Parents with Mental Illness) Program.
Her presentation began with a couple of case vignettes highlighting the many problems which make this situation such a mental hazard for young people. She followed this with a summation of survey findings on the prevalence and the risk and protective factors
influencing the impact at different developmental stages.
This led to discussion of a wide range of interventions for young people and their families to reduce the distress, and perhaps more importantly, a range of program changes within clinical support services to ameliorate the toxic effects of the parental illness on the young people. Avoiding the unnecessary and avoidable stresses is an obvious preventive mental health measure for clinical services, which regrettably is rarely a systematic part of the plan. The core issue is elegantly summed up in the title of the Medical Journal of Australia publication “Parental Mental Illness is a Family Matter”. Too often the focus on the identified adult patient obscures the needs of other family members, especially the young people.
This was such an important presentation that MHYFvic will arrange for the information to be posted on our website in the near future. Thanks, Vicki, for such a stimulating talk.

PREVENTION OF MENTAL DISORDERS

In the last MHYFVic newsletter I wrote about our policy supporting the principle of public health programs aimed at preventing mental disturbances rather than just programs aimed at treating disturbances once they had become established. I mentioned the growing groundswell in favour of such interventions as highlighted in the article by 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 note also referred to the public health paradox that Universal interventions are notionally the most effective for the population but are the most costly and have the weakest evidence base. Selective interventions, such as those for children of parents with mental illness, 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 for the population as a whole because, by definition, they are focused on a small, 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. Over five
newsletters we intend to outline some of the material already gathered for each of the five task areas. In this newsletter I am referring to the first question and in the succeeding four newsletters will refer to the other four questions in turn.
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?
As one of the world’s more developed countries, Australia has relatively satisfactory universal services in these areas although we could do better. Our policing and criminal justice systems assure a fairly reasonable level of safety and personal security. Our public housing system struggles to meet the needs of our poorest citizens and needs considerable propping up by non-Government agencies. Our Health system is probably one of the world’s best, although in the area of mental disorder prevention is still in embryonic stages. Our education system assures reasonable levels of literacy and numeracy.
In recent years the Council of Australian Governments (COAG) has endorsed National Health and National Mental Health Plans, and has set up the government-sponsored but administratively independent organisation “The Australian Institute of Health and Welfare” to monitor the performance outcomes of various health initiatives. By agreeing on indicators, setting goals, measuring outcomes and reporting the results to inform further remediation, huge steps have been made in our general health status. The reports show, however, that there has not been a comparable focus on mental disorder prevention.
In the area of Welfare, this management by objectives has been very much more fragmented. There does not seem to have been a similar umbrella set of objectives but a patchwork of politicians’ doorstoppers. The main themes have been on Social Security payments and Child Protection services.
Interestingly, an internet search of welfare monitoring revealed a surveillance system for animals which, if analogously applied to humans would hugely improve our public welfare policy. The animal welfare measurement is based on the list of ‘five freedoms’.

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The RSPCA sets standards, undertakes assessments, offers expert consultancy on resolving non-compliance with standards, and publishes the outcome studies. Compliance is voluntary except where there has been law-breaking, but the spotlight of public scrutiny is generally enough to encourage compliance. We have seen some examples of the political effects this in the live animal exports trade.
If a similar process of ‘indicators, goals, and outcome reporting’ was adopted by COAG for welfare as it has done for health, monitored through the Australian Institute of Health and Welfare, there is every reason to believe that comparable gains in welfare could be achieved, and if this was done there is every reason to believe that there would be a significant improvement in generic mental health measures. The science is clear for general health. Why not take a similar scientific approach to mental health?
Project Coordinator : Dr Allan Mawdsley Members welcome
Contact Allan Mawdsley on 0419 77 00 66 or
mawdsley@melbpc.org.au

PRESIDENT’S REPORT 2014

Welcome everybody. I hope you all do take the opportunity to speak with us and to enjoy the presentation of Dr Vicky Cowling, who will describe developments that have occurred over the last two decades in support services for children whose parent has a mental illness.
MHYFVic is an organization committed to hearing the voices of consumers and of professionals. At each of forums, and in our newsletters we try to present the range of professions that contribute to the delivery of quality mental health services for children and families. Tonight we receive input from a Social Worker.
At last year’s Annual General Meeting a new Constitution was adopted. This was necessary because the Government has legislated for a new model Constitution covering all incorporated Associations. Our new Constitution complies with all the provisions of the model but incorporates all the provisions of our former Constitution. The only substantive change is provision for an additional category of “Associate Member”. We hope this new category of member is represented, here, tonight.
We hope all members follow our Newsletters and our Website. Our Website has been re- vamped several times over recent years, but finally, we think we have a site that is both attractive and informative. I thank Sarina Smale, Allan Mawdsley and Ron Ingram, our Webmaster, for this ongoing work-in-progress. Please get out your phones and take a look, tonight, and then add to the feedback. Of particular concern was that much of the background information had not been provided, so Allan filled in many of the gaps.
Allan Mawdsley is also our Newsletter editor and scanning the four editions since our last AGM provides an overview of our activities for the year. Along with the usual items on Committee membership, reports of conferences, reports of specific projects, news items (often drawn from AICAFMHA), and the History corner, we have reported on issues of significance to our field.
Edition 41 (November, 2013) reported on the RANZCP conference and IACAPAP’s Pacific forum for child mental health practitioners from Fiji, Papua New Guinea, Kiribati, New Zealand, and the Cook Islands. This was a very interesting exercise and MHYFVic supplied many inputs from housing to conference papers
Edition 42 (February, 2014) reported on developments in early childhood education. Edition 43 (May, 2014) reported the WRMO of Professor Newman and provided an update to the work of a past AGM presenter, Laura Caire, on language and youth detention.
Edition 44 (August, 2014) reported on Children of parents with Mental Illness in preparation for tonight’s AGM and on MHYFVic’s elaboration of its policies on mental health prevention and health promotion.
This year, we have continued to work to achieve more understanding of the needs for mental health services for children and families through a series of collaborations. Most of the activities have been reported in our newsletters, but we have been active within:
 IACAPAP
 RANZCP
 AICAFMHA
 Winston Rickards Memorial Oration
The involvement with IACAPAP has largely been through the efforts of Dr Suzanne Dean as one of the Vice-Presidents on the organization and with responsibilities associated with the Asia-Pacific region and with consumer advocacy. Dr Dean was unable to be present at the recent IACAPAP
conference in South Africa, but was active in the presentation of tow symposia to the conference.
I have already mentioned MHYFVic’s role in getting the forum for south Pacific practitioners established. The idea had come from IACAPAP President, Nigerian child psychiatrist, Dr Olayenka Omigbodun, and was largely orchestrated through Suzie Dean. The group continues to live through its email list and draws strength from each other, as it maintains links with Australia and New Zealand.
MHYFVic remains interested in supporting our National Lobby group: AICAFMHA. MHYF Vic is pleased to acknowledge the work of Ms Jenny Luntz as a Director of AICAFMHA, representing Victoria, for the past nine years. The Victorian Director role has been taken up by Dr Vicki Cowling.
The achievement of the year was the Winston Rickards Memorial Oration with a fifth Orator and now well-established in the calendar for those interested in our field. The committee of Dr Dean, our secretary, Ms Jacinta Bleeser, and our treasurer, Ms Lillian Tribe, once again did a splendid job. This was the most political of the WRMO series when Professor Louise Newman presented: “Cry Freedom! – Child asylum seekers in Australia: the intersection of mental health and human rights”. The house was packed and the presentation was powerful and well-founded in clinical data. Our immediate past Orator, Professor Allan Fels was unavailable to provide a response, but Professor Suresh Sundarum stepped in and did an admirable job of responding to the presentation from a consumer position as well as from the position of a psychiatrist involved in the assessment of children in detention. Questions were drawn from the floor and provided a very lively exchange. The speech is on our website.
A special feature of the WRMO for the last three years has been the presence of students as ushers and administrative support. Through this process initiated by previous Secretary, Ms Nitha Prakash, we were able to recruit our next secretary, Ms Vinen. We thank Ms Prakash for her support in this way and for help with printing. We look forward to welcoming some of these volunteers to special project work for the committee. Thanks are due to Dr Dean for hosting a thankyou afternoon for the volunteers.
Our grand project: the Best Practice Atlas has begun growing. This is the idea of Allan Mawdsley. Last year, we reported that we have a skeleton of what might constitute best practice in our field and we want sufficiently skilled and knowledgeable people to write summary statements about best practice on any topic within our field. Some parts of this large and complex matrix have been filled in. We hope others can contribute.
Administratively, several changes have occurred. Ms Zoe Vinen has begun post- graduate training and has had to stand down as Secretary. We give thanks, formally, to Zoe for her efforts on our behalf. Zoe attends Committee meetings when she can, so has not really left the Committee. The position of Secretary is still vacant; we thank Allan Mawdsley for his participation as acting Secretary. Similarly, Dr Miriam Tisher has continued to support us but has not been able to attend Committee meetings.
We bid farewell for the second time to one the Committee’s most valuable contributors, Ms Lillian Tribe. Lillian has always been a supported and, as a carer of a service consumer, has tirelessly pursued issues of consumer participation in our field. And, for the past four years, she has also been our Treasurer. Further, as membership list administrator, in conjunction with Allan Mawdsley, we have version of the membership list that is user friendly and has been trimmed to avoid sending information to addresses that are no longer active. We hope that she would feel able, in the future, to come back to us, once more. Thankyou for your contribution Lillian: we are truly grateful and much indebted.
Another Committee vacancy has been the departure for motherhood of Ms Sarina Smale. We don’t like losing members, as all provide special contributions. Sarina’s contribution was across all portfolios as she provided a voice for the young professional
and was especially useful in re-vamping our Website.
So we have, at least, two Committee vacancies: consumer advocate and Treasurer. The now small job of membership secretary could become the first job of someone wishing to join the Committee, but who wants to do something useful while a bigger role is considered. Members can join without portfolio, of course! So, sign up now and be nominated!
I need to thank the other members of the Committee, Ms Jenny Luntz, and Dr Kylie Cassar. Jenny is a continued source of wisdom and often, with Allan, the provider of the venue for our meetings. Kylie has done many small tasks in the Projects area and with the Website and was able to capture the WRMO speech and turn it into a paper that can be downloaded from the website (this was another task supported by Allan Mawdsley).
Finally, I wish to express my gratitude to the committee for the work of the year. Dr Dean and Dr Mawdsley are great contributors on all topics.
Thank you very much.
Once more I invite participation of all at whatever level you can. Please let us know of your interest.
Jo Grimwade

HISTORY CORNER 1877

The organization now known as Berry Street was where infant welfare began, institutionally, in Victoria, in 1877. Berry Street is no longer the address of the organization, but rather the name of the largest child and family welfare organization in Victoria. This year marks fifty years since the name was incorporated as Berry Street Babies’ Home and Hospital, at which time it took on a special role in the training of Mothercraft Nurses. Previously, it was the Foundling Hospital and Infants’ Home, a name given to replace the foundation name of the Victorian
Infant Asylum (1877 to 1902, then Victorian Infant Asylum and Foundling Hospital from 1902 to 1906). In 1975, it became Berry Street Child and Family Care.

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Infant Asylum
It is twenty years, since the merger of Sutherland Homes for Neglected Children with Berry Street. In 2012, Lisa Lodge in Ballarat merged with Berry Street. Berry Street continues to expand services across the state, having originally been more associated with the southern and eastern districts.
The Infant Asylum was the effect of the efforts of charitable women worried about the high rates of infant mortality and pregnant single mothers-to-be. The wife of the Governor of Victoria, Lady Bowen, was the organizing voice of fundraising directed at providing shelter for the infants and their mothers. Originally, the Infants’ Asylum was in Fitzroy. In 1881, the service moved to East Melbourne; the corner allotment of Berry and Vale Streets, near Yarra Park (and the MCG).
A New Zealand woman, Selina Sutherland, was Victoria’s first ‘child rescuer’ in 1888. In 1909
she established the Sutherland Homes for Neglected Children and, in 1910, Auguste Meglin donated 40 acres of Diamond Creek land for the establishment of residential services for the permanent care of children without homes. Sutherland Homes served much of northern Melbourne.
Young girls in Ballarat were the focus of the efforts of women Probation Officers in the Grampians region of Victoria. Housing was needed to keep these from coming before the courts or being sent away from Ballarat. They founded Lisa Lodge.
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Mothercraft Nurses – the first of the new profession to be employed in Victoria
Along the way, Berry Street took on projects and responsibilities that brought together a range of services for vulnerable children and adolescents and their families: adoption agency (this program finished in 1975); foster care; kinship care; residential services; and since 2003, a therapeutic service for Child Protection clients (often children at-risk of needing out-of-home care): Take Two. There are also other counselling services, including ones aimed at dealing with Domestic Violence. There are employment and training programs, including a secondary school at Northland in Preston. There is a service that tracks the personal history of former clients of the services. There are a range of other community programs and family support programs, including a service that provides supervised access for children whose parents are in dispute.
While policies and priorities have changed over time, there is a theme that runs throughout this formidable history of contribution to at-risk children and families: “never give up”. Generations of Victorian women initiated and maintained this enduring benefit to our community. MHYF Vic acknowledges the founders of the services and the current day service providers.
Jolyon Grimwade.

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

2014 MHYF Vic Committee

* President, Jo Grimwade
* Vice-President, Jenny Luntz
* Past President: Allan Mawdsley
* Secretary, Celia Godfrey
* Treasurer & Membership Secretary,
Vacant
* 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
Your 2014-2015 MHYFVic Membership is now due.
Please send your cheque for $20
to:
MHYFVic
PO Box 206, Parkville, Vic 3052
or make a Direct Debit to our Bank account BSB 033 090 A/C 31 5188 with your name in the Reference Box.

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