1. Paula Westhead drummond street services Mental Health and Illness Sailing the Seas to Success Prevention & Early Intervention

2. Why is mental health and illness an issue ? Who we are Why the interest – the issue How we might experience it What causes it What can helps

3. drummond street services 125 years old community not for profit Two core areas of work: 1. Provision of Services (responding to community need) 2. Contributing to the knowledge base (building evidence base)

4. What we do at drummond street Family Service Programs Family and Relationship Services Family Mental Health Support Service Specialist Trauma Services and Royal Commission Community Based Service Family Wellbeing Programs Community Awareness - Mental Health Literacy Parenting Seminars, Groups and Intensive Services Community Building Programs the drum Youth Service the drum - African Family Service queerspace Centre for Research and Evaluation (CFRE) Family Based Intervention Research Research, program development and evaluation Social Policy Research Dissemination and social commentary, advocacy

5. So what do we know about mental health and illness

6. A snapshot of mental health issues in Australia

7. Mental health refers to how people feel about themselves emotionally, socially and spiritually, and about their ability to cope with everyday life and the stressful events that may come up to reach the goals they have set out for themselves to go to work and work productively to be a part of the community they live in Mental health means much more than whether a person suffers from a mental illness. The World Health Organisation includes mental health in their general meaning of health, which is defined as a state of total physical, mental and social wellbeing.

8. What are our BIG three? Have a chat to the person next to you, which 3 mental illnesses are most common in our country?

9. In 2007, the Australian Bureau of Statistics (ABS) conducted the second National Survey of Mental Health and Well-being. The survey involved approximately 8,800 people aged over 16 years and living in private dwellings in all states and territories of Australia. That is the best and most recent data we have FIRSTLY – HOW MUCH DO WE KNOW?

10. But in the last 20 years We learnt about pathways to risk The complexities of mental health as a family and community issue Adolescence most common time for onset Transition to parenthood LSAC: 3 year olds showing mental distress

11. Almost one in five Australians surveyed had experienced symptoms of a mental disorder during the 12 month period before the survey. Anxiety disorders were most common – 14.4%, followed by affective disorders - 6.2% (of which depression is 4.1%), and substance use disorders – 5.1% (of which 4.3% is alcohol related). HOW COMMON IS MENTAL ILLNESS?

12. A handy way of seeing mental illness...

13. The percentage of people meeting the criteria for diagnosis of a mental illness was highest in younger people, with the prevalence decreasing with age. 26% of 18-24 year olds had experienced a mental disorder, while only 5.9% of people aged 65 years and over had experienced a mental disorder. WHO IS MOST WORRYING…

14. Total Persons aged 16- 85yrs (100%) Experienced any mental health disorder in lifetime (45%) Has experienced in past year or currently has a mental health disorder (20%) Had experienced mental health disorder at some point in life but not in past year (25%) Has not experienced any mental health disorder in lifetime (55%) The National Mental Health Survey 2007 ABS

15. DEPRESSION About 4% of people will experience a major depressive episode in a 12-month period, with 5% of women and 3% of men affected. Easier way of seeing it is (according to beyondblue) 1 in 5 women and 1 in 8 men in their lifetime (but it may be temporary)

16. Depression symptoms (beyondblue website) Behaviour not going out anymore not getting things done at work/school withdrawing from close family and friends relying on alcohol and sedatives not doing usual enjoyable activities unable to concentrate Feelings overwhelmed guilty irritable frustrated lacking in confidence unhappy indecisive disappointed miserable sad Thoughts 'I’m a failure.' 'It’s my fault.' 'Nothing good ever happens to me.' 'I’m worthless.' 'Life’s not worth living.' 'People would be better off without me.‘ Physical tired all the time sick and run down headaches and muscle pains churning gut sleep problems loss or change of appetite significant weight loss or gain

17. Anxiety disorder symptoms Generalised anxiety disorder For 6 months or more, on more days than not, have you: felt very worried found it hard to stop worrying found that your anxiety made it difficult for you to do everyday activities (e.g. work, study, seeing friends and family)? If you answered yes to all of these questions, have you also experienced 3 or more of the following..........felt restless or on edge felt easily tired had difficulty concentrating felt irritable had muscle pain (e.g. sore jaw or back) had trouble sleeping (e.g. difficulty falling or staying asleep or restless sleep)?

18. ANXIETY 14 % of Australians will be affected by an anxiety disorder in any 12-month period

19. About 5% of Australians will experience substance abuse disorders in any 12-month period, with men more than twice as likely as women to have substance abuse Often this is self medicating...a coping strategy gone to extremes ABUSING SUBSTANCES TO THE POINT WHERE IT’S DESTROYING MENTAL HEALTH

20. About 3% of Australians are affected by psychotic illness; such as schizophrenia, where there is a loss of contact with reality during episodes of illness. Approximately 2% of Australians will experience some type of eating disorder in their life, with women 9 times more likely than men. THANKFULLY LESS COMMON – low prevalence disorders

22. Negotiating Risk and Protective Factors Protective Factors Individual FactorsFamily FactorsSchool Context Life Events/Situations Community and Cultural Factors Risk factors Individual FactorsFamily FactorsSchool Context Life Events/Situations Community and Cultural Factors Refer to handout. Risk factors Protective Factors

23. looking at Mental Health and Wellbeing throughout the Family Life Course Develop view of the world. Begin School and learn to manage new social expectations and behavioral norms. Birth to 10yrs Transition to secondary school and beyond- face academic and social demands of new setting. Learning when to conform and when to assert while establishing yourself as an individual. ‘Finding Yourself’ Adolescence and early adulthood Social norm to form couples- balancing social expectations with the personal. Making commitment or not. Beginning to create own family unit Coming Together: Coupling

24. Decision to parent. Potential fertility difficulties. Parenthood brings big life change with changing demands along stage of child. Managing relationship with and behavior of child. Terrible Twos and Teens. For many coinciding with care of parents or other elderly relatives Parenthood Letting go of children. For some a stage of new beginnings in relationships too bringing stressful and upsetting change as part of the process. For others, if healthy, a time of contentment and potential for more involvement in leisure / community activities. Empty Nests and Child Free A time of change that can be positive or negative depending on attachment to or financial reliance on job. Potential involvement in parenting next generation of family as grandparent in varying capacities. Some find fulfilling social networks. Dealing with deteriorating health. Retirement and Old Age

25. Specific Populations Aboriginal families Refugee and Humanitarian Entrants – African Families Program GLBTI (Queer Community) Sole parents or parenting in isolation and young parents

26. Limited research suggests that Aboriginal and Torres Strait Islander people experience mental disorders more often as other Australians – and poverty and intergenerational trauma play a huge part – but family connections and spirituality are protective

27. CALD The settlement experience is the key Experience of racism and discrimination These families often deal with trauma for years with no support – inter generational Children and young people often live in two distinct worlds and must find a way to bridge them “school and family engagement can be harnesses” Isolation and financial difficulty can make getting ahead for these families more difficult

28. GLBTI Client Data Based on annual client snapshot at intake: Of total clients (1266 clinical clients year ) in one 17% lesbian, 10% gay, 3% bisexual GLBTI rate highest in our FMHSS program with 33% present with depression and anxiety 10% of GLBTI clients are SSAY many presenting with gender and sexuality identity issues

29. Those with a mental disorder averaged three days out of role (i.e. unable to undertake normal activity because of health problems) over a four week period. This compared with one day out of role for people with no physical or mental condition. HOW IT IMPACTS

30. Australian Human Rights Commission May 2010 MENTAL ILLNESS HAS HUGE IMPACT ON WORKPLACES Stress related workers compensation claims have doubled to over $10 billion dollars annually and Australian businesses are losing over $6.5 billion each year by failing to recognise symptoms and provide early intervention for employees with mental health conditions

31. We like to soldier on...we don’t get help when we should A national survey showed that only 35% of people with a mental disorder had used a health service and 29% consulted a GP within the 12 months before the survey.

32. 1.Ensuring we all have mental health literacy : Know the signs and symptoms (and behaviours Know that it is a illness and that there are effective treatments Know where to go for help 2.Reducing stigma through understanding the facts and having empathy 3.Knowing how to respond and offering containment We all have a role to play

33. Listen and acknowledge their feelings (everyone wants to be validated- then they relax) Ask simple questions and be encouraging when they answer If they are distressed ask if this sort of thing has happened before Suggest they think of things that have helped in the past Gently ask if they have seen a GP or similar Encourage them to return to a health professional they know- rather than suggesting a new one Try to help the make an action plan If you feel they are at risk try to speak to someone else they know If you are worried they may harm themselves confidentiality doesn]t apply- its good to give them a choice of who you can tell if possible TALKING TO PEOPLE WHO ARE UNWELL

34. Listen, listen and listen Acknowledge the humanity of it all, speak to the ideas, avoid, simply describing emotion Do not collude Offer assistance with emphasis to “Maslow’s Hierarchy ”- offer practicalities Reassure with authenticity Link them with supports Follow up DEALING WITH OTHER’S DISTRESS related to trauma

35. Safety is paramount – of client – of you and other staff – of the building/equipment

36. Spectrum of Interventions Model

37. For further information: Paula Westhead enquiries@ds.org.au www.ds.org.au