Newsletter No. 58

THE EIGHTH W. S. RICKARDS MEMORIAL ORATION
“ADVOCATING ON THE EDGE IN PUBLIC SERVICE: THREE QUARTERS OF A CENTURY OF THE CHILDREN’S COURT CLINIC OF VICTORIA”

The Oration by Patricia Brown PhD FAPS, Clinical Psychologist, Director of the Children’s Court Clinic, Department of Justice, was given on 20th March 2017 in the Ella Latham Theatre at Royal Children’s Hospital.

The Children’s Court Clinic of Victoria is an icon in the child and adolescent clinical forensic field in Australia. Indeed, during its 73 years, it has earned an international reputation. As Director, Dr Brown has pioneered the modern era of the Clinic, and Child Clinical Forensic Psychology in Australia, especially in the universities, where she has been an esteemed post graduate educator. ln her address, Dr Brown considered the Clinic’s successive models of service and pathways to change over time, and its interface with the Children’s Court.
The full text of the Oration is published on the MHYFVic website.

Royal Australian and New Zealand College of Psychiatrists submission to the Victorian Government on the Youth Justice system
by Allan Mawdsley

In our October newsletter, last year, I paraphrased an article on the criminal justice system by John Silvester in ‘The Age’ newspaper, in which he pointed out that there were different kinds of prisoners who needed to be handled differently to achieve best outcomes. He described an innovative approach introduced in Texas for this problem. They saw prisoners in three categories. “There are some who will always come back [reoffenders], some who will never come back [single offenders], and some who are swingers who could go either way”.
“We decided not to waste money on those who are going to come back, spend a little money on education for those who will never come back, but invest in the swingers. We worked with them because you want them to be better when they walk out than when they walked in”.
The problem of differentiating those likely to respond well is much greater in immature youth, and the consequences of wrong decisions are much greater. It is therefore much more important to have the means of restoring positive developmental progress. For this reason, it is heartening to read the submission by the Victorian Branch of the Royal Australian & New Zealand College of Psychiatrists to the Victorian Government enquiry into the Youth Justice system. Here is the Executive summary of the document, which can be read in full on the College website https://www.ranzcp.org.au/files/about_us/0633o-president-and-vic-branch-chair-re-vic-youth.aspx
There is a significant body of evidence documenting the links between mental health issues and incarceration, as well as between childhood trauma and future psychosocial problems. Children and young people in detention exhibit higher rates of mental health issues than the general population and studies have shown that treatment for mental health issues is an effective way to decrease recidivism in mentally ill offenders. Mental health care can also help to alleviate the impact of the psychological stresses of the detention setting for children and young people at risk of developing mental disorder. In recent years, the youth justice system has been moving away from a supportive and rehabilitative model to one more punitive/restrictive. This can be seen in shifts in the staff culture as well as the government’s responses to recent events, including the housing of young offenders in high-security prisons, the increased arming of guards and the transfer of responsibility for youth justice centres to Corrections Victoria. Punitive approaches to the management of youth justice services, however, are unlikely to resolve the behavioural issues of detainees; instead, they serve to reinforce the sense of mistrust experienced by many children and young people in custody. Without a trauma-informed approach to the management of youth justice centres, at-risk children and young people will continue to face significant obstacles in their paths to recovery and rehabilitation, and staff in youth detention centres will continue to face significant difficulties in managing children and young people in their care. The RANZCP therefore advocates for a youth justice system separate from the adult justice system, characterised by the adequate provision of mental health and rehabilitation services and founded on attitudes and practices that are guided by compassion and a commitment to ensure that supportive, caring, and non-traumatising early experiences are provided for all children and young people in our care. While the RANZCP accepts that increased security measures may be necessary for a small number of seriously violent or recidivist offenders, a major move away from a rehabilitation focus for the majority of detainees would be a tragic outcome of recent events, likely to leave detainees more traumatised, demoralised and tarnished by their exposure to such a setting. The RANZCP also affirms the significant benefits of a justice reinvestment approach to criminal justice involving measures to decrease rates of incarceration and recidivism by investing in services in the community. Intervention strategies targeting the mental health of children and young people, particularly those who have experienced significant trauma and adversity, reduce the likelihood of adverse outcomes in relation to criminal offending. Thus, the development and implementation of strategies for the prevention and treatment of psychiatric disorders associated with increased incarceration rates is critical in efforts to reduce offending and guide young offenders towards recovery and rehabilitation.

HISTORY CORNER, 2016

Sometimes history is made on a day and is already important within a short period of time. Last year, on 3 May, 2016, World Maternal Mental Health Day was launched from the United Kingdom by the Maternal Mental Health Alliance (MMHA) under the leadership of psychiatrist Dr Alaine Gregoire.

In 2017, World Maternal Mental Health day will be embedded in the UK Maternal Mental Health Matters Awareness Week 1-7 May. Of course, this is history already as by the time the newsletter appears it will have passed.
The MMHA is a coalition of national professional and patient organizations committed to improving the mental health and wellbeing of women and their children in pregnancy and the first postnatal year.
As stated on the website: “there is extensive evidence that investing in maternal mental illness at this early stage can have a dramatic impact on long-term outcomes for mothers, fathers, children, families and society. Our vision is ‘to improve the lives of mothers and their infants’. We are motivated by the current shortfall in the quality, availability and accessibility of antenatal and postnatal mental health care and the lack of knowledge about this issue amongst health and social work professionals and the wider public”. Check it out at:
http://maternalmentalhealthalliance.org/

Dr Alain Gregoire, Chair, MMHA

Dr Gregoire is founder and Chair of the Maternal Mental Health Alliance. He is a member of the NICE Guideline Development Group for Antenatal and Postnatal Mental Health, and has contributed to the development of policy, guidance and clinical services in the UK and abroad. He is determined to ensure that all women have access to care for their mental health which is at least as good as the care available for their physical health in pregnancy and postnatally.
There is a You Tube interview of Alaine Gregoire (in English) available with Turkish Psychiatrist, located in La Teppe, France, Oguz Omay, made as a lead up to the Interpersonal Psychotherapy week in France organized with seminars in La Teppe (30 September to 6 October, 2017).
http://www.teppe.org/Actualites/1-la_sante_mentale_des_femmes_une_priorite
We could do well to start such an organization in Australia, especially as we will soon celebrate 100 years of Maternal and Child Health services in Victoria.
Jo Grimwade

Newsletter Items
Nine items from “Emerging Minds:
Six items from March e-News and three from the April edition.
Associations between parental bonding, parenting stress, and executive functioning in toddlerhood

This study examines the associations between parental bonding, parenting stress, and child executive functioning. Early social relationships and caregiving behaviour are important for children’s development of executive functioning skills, which relates to the cognitive processes that organise and direct thinking, emotion, and behaviour. Poorer parental bonding is associated with higher levels of parenting stress, which in turn is associated with more child executive functioning problems.

One third of young people in detention has alcohol related brain damage

Preliminary data from the Telethon Kids Institute has shown that about one third of young people in youth detention in Western Australia has Fetal Alcohol Spectrum Disorder (FASD). FASD is caused due to fetal alcohol exposure during pregnancy. Problems include brain damage leading to delayed development, social, behavioural and learning problems. Secondary outcomes can include poor school performance, unemployment, substance abuse, mental health problems and early engagement with the justice system. The findings may assist in developing effective strategies to support young people whilst they are in detention and upon their release.

The role of mindfulness in reducing the negative effects of childhood stress and trauma

Adverse childhood experiences such as: neglect, physical, sexual or emotional abuse; exposure to violence, substance abuse in the family, and low socioeconomic status may result in stress and trauma. A recent study by American researchers suggests that high-quality, structured mindfulness activities for youth populations may reduce the negative effects of stress and trauma related to adverse childhood exposures, assisting to improve mental health, behavioural, and physical outcomes.

Early signs of anxiety, depression may be evident in newborns

A study published in the Journal of the American Academy of Child & Adolescent Psychiatry found that the strength of newborn brain connections predicted the likelihood of the babies developing excessive sadness, shyness, nervousness or separation anxiety by age two years. These symptoms have been linked to depression and anxiety in older children and adults.

Resources to assist schools to recognise and respond to young people with complex mental health problems

The Project Air Strategy for Schools provides a detailed set of resources which have been developed to assist school counsellors, psychologists, health workers and teachers to recognise and respond to young people with complex mental health problems, including self-harm, suicide, trauma and emerging borderline personality disorder. The resources include guidelines, fact sheets, train the trainer resources and a short film.

No child should grow up like this: Identifying long term outcomes of forgotten Australians, child migrants and the Stolen Generations

This summary report outlines the life experiences of ‘care’ leavers who lived in institutions or other forms of out-of-home care as children during the period between 1930 and 1989. The research found that for many participants the loss of family was a major trauma that brought lifelong grief and loss.  Most participants in the study experienced abuse and maltreatment in care, including emotional, physical or sexual abuse with long term mental health impacts including anxiety, depression, self-harm, dissociation and suicidality. The full 277 page report can be accessed here.

Youth mental health report

A report by Mission Australia and the Black Dog Institute presents the findings from the Youth Survey which constitutes five years of mental health data collected from young people across Australia with key insights into the rates of psychological distress, their concerns, and the people and places they go to for help. The report found that one in four young people are at risk of serious mental illness; the risk of mental illness increases as adolescents age, becoming most prevalent in the older teen years; and the risk is greater in Indigenous groups and young women. These findings highlight a need to ensure that young people have appropriate and timely access to mental health education, evidence based services and interventions.

The impact of childhood abuse: what can we learn from neuroscience

This article from the National Society for the Prevention of Cruelty to Children (UK) discusses the theory of ‘latent vulnerability’ based on research focused on how experiences of abuse and neglect affect brain function. It discusses the case for a preventative clinical approach to identify those children who are most at risk of future mental health problems and outlines how a new clinical tool could help children’s mental health.

Strengthening prevention and early intervention services for families into the future

This report outlines how a coordinated strategy to increase family-based prevention and early intervention services could be utilised in Australia to prevent eight priority health and social problems including mental illness, developmental injury (i.e. child neglect) and school failure. The report recommends a more holistic and coordinated public health approach, offering both universal and targeted programmes and services.

Housing, Homelessness and Mental Health

During March and April this year, the National Mental Health Commission conducted workshops in eight jurisdictions in all states and territories to discuss and get input regarding housing and homelessness issues for those that experience mental illness.
Housing and homelesness is a priority for the Commission because for people who are living with a mental health difficulty, getting and keeping their own home is hard to achieve compared to the general community. For the most vulnerable and unwell, cycles of homelessness, unstable housing and poor mental health can become their total life experience.
In the workshops, the Commission discussed a range of topics including how the structure and dynamics of Australia’s housing system affect housing and health outcomes for people living with mental illness, what we know about housing experiences of people living with mental illness and how can service systems improve the housing experiences of people living with mental illness. Finally, we discussed how this issue can be moved forward on a local and national level, and how the Commission could support this.
The full report is published on their website, hopefully accessible through the above link.

Calling all Bostonians (and their colleagues)!

MHYF Vic wants to celebrate the centenary of the Judge Baker clinic in Boston (now part of Harvard) but has not been able to contact the leadership of the centre to arrange a celebration.
The Children’s Court clinic would co-sponsor the event.  We have in mind a video teleconference, whereby each of the CCC and the JBC introduce their work and answer three questions:
How did you start?
What have you achieved?
What is your future?
The aim of the session is to honour the instigating role of the JBC of a profession that is now worldwide. But, despite letters and emails, we have not had a response.
So, we ask our membership and friends: can you help us get this started? Please contact any of the committee or myself by return email or 0499 013 690.
Thank you.
Jo Grimwade
President, MHYF Vic

2017 MHYF Vic Committee
* President : Jo Grimwade
* Vice-President : Jenny Luntz
* Past President: Allan Mawdsley
* Secretary : Celia Godfrey
* Treasurer : Anne Booth
* Membership Secretary:Kaye Geoghegan
* Projects Coordinator, Kylie Cassar
* WebMaster, Ron Ingram
* Newsletter Editor, Allan Mawdsley
* Youth Consumer Representative, vacant
* Members without portfolio:

Suzie Dean, Miriam Tisher.

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