Download The First International Youth Mental Health Conference, Melbourne

The First International Youth Mental Health Conference
29-30 July 2010
Melbourne, Australia
Conference reports added 1 September 2010
Jasmine Mordecai .............................................................................................................. 2
Liesl Butler .............................................................................................................. ............. 6
Reports submitted by RAMUS scholars and Alumni who attended this conference with support from
the RAMUS Conference Placement Program
1
The First International Youth Mental Health Conference
JASMINE MORDECAI
In July of this year I was fortunate enough to be sponsored to attend the first ever
International Youth Mental Health Conference in Melbourne, Victoria. I was particularly
keen to attend this conference for several reasons. First and foremost I have a personal
interest in psychiatry, in particular adolescent psychiatry and have considered this as a
future career path. Attending the conference presented an ideal opportunity to develop my
interest in the area through networking and education. I was also enthusiastic to attend this
conference as a personal advocate for a family member who has struggled with mental
health problems throughout adolescence and young adulthood. Having witnessed first hand
the unique challenges that young people face when they are burdened with mental health
problems, I hoped to be able to make a constructive contribution to conference debates. I
was also keen to attend this conference to increase my knowledge base of the available
resources for assisting young patients with mental health and addiction problems. I had
recently completed my rural GP placement and encountered many young patients with
mental health problems. I often found it challenging knowing where to refer such patients
and I hoped by attending this conference I would increase my knowledge of such resources.
Not only did the conference adequately address these aims, but it also proved to be an
extremely inspiring event – the details of which will be discussed below.
With recent evidence to suggest that up to one in four young Australians are suffering from
a mental health problem at any one time, the issue of youth mental health in Australia is
neither obscure nor foreign. Despite these staggering statistics there was to date, no
national conference addressing the issue. It was for this reason that Professor Patrick
McGorry, a well regarded child and adolescent psychiatrist set out to bring together key
players in the area of youth mental health from Australia and around the world for the 1st
International Youth Mental Health Conference. The aim of the conference was to explore
many of the issues specific to youth mental health; such as early intervention, resilience
building, service provision, education and vocation, substance abuse, youth suicide, e-health
and technology, forensic issues and Indigenous youth mental health. These topics were
delivered during keynote addresses and themed concurrent session streams. These formal
sessions were complemented by the individual stories of the brave individuals who were
courageous enough to stand up and tell their own personal struggles with mental health in
Reports submitted by RAMUS scholars and Alumni who attended this conference with support from
the RAMUS Conference Placement Program
2
their youth. For me, it was this element of youth participation that made the conference so
inspiring.
The conference opened with a vibrant performance from the Indigenous Hip Hop Projects
(IHHP) - a multicultural arts company who does amazing work with rural and remote young
Indigenous people around Australia. Their achievements were presented during one of the
concurrent session streams on day one of the conference which I was fortunate enough to
attend. After this colourful opening performance the conference underwent a change of
tone as we were addressed by the first keynote speaker – The Hon Nicola Roxon MP,
Minister for Health and Ageing. It was good to hear from the Minister at such a busy time in
the political calendar. This was perhaps a good indication that mental health reform was at
the forefront of the political health agenda. During her address The Minister made some
important commitments to the areas of suicide prevention, service provision and youth
vocational rehabilitation if her party was re-elected. The second keynote address for the
morning was from Professor Patrick McGorry himself. Through his address it soon became
very obvious that youth mental health provision - in particular early intervention and the
development of youth appropriate models of care was Professor McGorry’s passion. The
Professor highlighted many of the issues that arose from late intervention in the context of
youth mental health which were all too familiar to me from my own personal experience of
youth mental illness within my family. In order to prevent these complications Professor
McGorry advocated for a change in youth mental health service provision, building on
existing services such as Headspace to provide appropriate care for this unique population.
Having little knowledge of Headspace prior to attending the conference, I was pleased to
hear of the availability of such services. On reflection of this I found it unfortunate however
that those in remote and rural Australia are often isolated from such innovations – and
these are often the youths that need it most.
After the morning session we broke for morning tea held in the community market place
where I was able to collect information on available resources in the area of youth mental
health. This included contact numbers and information for young patients wanting to stop
cannabis - which was a common problem I encountered during my rural GP placement
earlier in the year. After morning tea it was time for the delegates to select the first of a
series of concurrent session streams running during the conference. Selecting a stream
proved a difficult choice as there were so many interesting talks on offer. With much
deliberation I selected the stream focused on vocational and education issues as I have a
strong belief in the role that vocational rehabilitation plays in the management of mental
health issues. Of all three speakers it was the first presentation by Associate Professor Eoin
Reports submitted by RAMUS scholars and Alumni who attended this conference with support from
the RAMUS Conference Placement Program
3
Killackey of the Orygen Youth Health Research Centre which really resonated with me.
Professor Killackey highlighted the importance of psychosocial recovery and the inability of
current services to address this need. The third talk by Dr Judith Slocombe from The
Alannah & Madeline Foundation was very educational. She discussed the issue of cyber
bullying and the impact that this has on youth mental health. On reflection of this
presentation I realised it was an issue that I will need to familiarise myself with if I am to
work in the field of child and adolescent psychiatry.
After a delicious lunch in the community market place I attended the concurrent session
stream for the afternoon. I selected to attend the stream which focused on Indigenous
youth mental health as this is an issue that particularly relevant to WA. The session proved
to be very educational and featured a presentation from a well known Indigenous child and
adolescent psychiatrist working in WA. Dr Milroy’s presentation highlighted the alarming
rates of mental health problems in Aboriginal youth when compared to non-Aboriginal
youth. She also went on to discuss some of the auditory and visual phenomena experienced
by some traditional Aboriginal people which are often mistaken for psychotic symptoms in
the western medical model. The next speaker, Michelle Noon from Beyondblue was as
equally educational. Michelle presented information about an amazing project sponsored by
Beyondblue known as IHHP. This project aims to engage young Indigenous Australians in
remote areas through dance and music in an effort to educate them about depression
mental health services. While this was an ideal medium for this target population I
suggested to Michelle that other notoriously difficult to engage populations – such as young
rural males - would benefit from a similar project with a different focus ie. group
automechanical projects.
Day two of the conference opened with an international theme with two international
keynote speakers. Professor Max Birchwood, Clinical Director of Youthspace in the UK and
Professor Jane Costello, an epidemiologist from the UK, both presented some interesting
reflections from their work overseas in the field of youth mental health. For the morning
concurrent session streams of day two I elected to attend a combination of presentations
from the ‘substance abuse’ steam and the ‘primary care’ stream as I considered both topics
too valuable to miss! In Professor Dan Laubman’s presentation on youth substance abuse I
learnt that 50 per cent of young people with alcohol and drug abuse problems have a comorbid mental health condition, and that this is unfortunately a poor prognostic indicator
for recovery if it is not addressed. Professor Laubman encouraged us to always be wary of
such co-morbid conditions in our young patients and this is something I am sure I will carry
through to my future practice. In the latter half of the session in the ‘primary care’ stream I
Reports submitted by RAMUS scholars and Alumni who attended this conference with support from
the RAMUS Conference Placement Program
4
was made aware of the new 2010 NHMRC Beyondblue Clinical Practice Guidelines for
Adolescent and Youth Depression which was followed by a healthy debate on the value of
evidence based medicine in actual clinical practice.
Feeling refreshed after lunch I ventured into the afternoon concurrent session stream on
the challenging topic of ‘youth suicide’. My heart goes out to the brave young girl who
opened this session with her own personal account of her struggle with depression and her
own suicide attempt. In the subsequent presentations saddening statistics were balanced
with some positive accounts of successful suicide prevention projects which have recently
been undertaken in the community. Continuing the international theme of day it was then
time for the final keynote speaker to address the delegates. This speaker was Dr Bob Illback
of Headstrong in Ireland. Headstrong is based on a similar model to the Headspace youth
centres in Australia. Dr Illback spoke of the challenges faced in setting up a youth health
service like Headstrong and in doing so provided some useful strategies for any delegates in
the audience planning to do such a protect in the future. Following this speech the
conference was brought to a close.
Overall, this was a inspirational conference – enlightening speakers, brave youth
representatives and startling statistics all combined to further develop my interest in the
field of child and adolescent psychiatry. Thank you RAMUS for the opportunity to attend this
event.
Reports submitted by RAMUS scholars and Alumni who attended this conference with support from
the RAMUS Conference Placement Program
5
The First International Youth Mental Health Conference
Liesl Butler
Held at the Melbourne Exhibition and Convention Centre on the 29 - 30 July 2010, the
International Youth Mental Health Conference was the first official congregation of those
with a passion for young people and their psychological well-being. Professor Patrick
McGorry, the current Australian of the Year, with the assistance of the National Youth
Mental Health Foundation, Headspace, was responsible for the development and
organisation of this unique event. The conference featured both international and local
speakers, sharing their expert knowledge and opinion in the hope of improving the state of
mental health in Australia.
Information was presented via two means: formal addresses from keynote speakers, and
smaller sessions run concurrently with a chair and panel of guests, facilitating group
discussion. During breaks, delegates congregated in the ‘Community Marketplace’, which
was home to the display posters (featuring research undertaken in the field) and various
exhibitors, from Beyond Blue to the Australian General Practice Network. There were
representatives present from all organisations to take queries; and multiple educational
resources were available for professionals, those affected by mental illness, and the general
public.
The conference was off to an energetic start, featuring two local entertainment acts, the
Indigenous Hip Hop Project, a multicultural arts company, and upcoming alternative music
group, Stonefield. Following a welcome from the traditional land owners and chair of the
Headspace board, Wendy McCarthy, was a special address by the Hon Nicola Roxon MP,
Minister for Health and Aging. She described how the current mental health system in
Australia was no longer sufficient and as a consequence was undergoing a major reform. Ms
Roxon was of the opinion that the system needed to be rebuilt from the foundations up;
services need to be integrated and to function in a coordinated fashion. Furthermore, the
system should be transparent, with those in positions of responsibility being accountable for
both its successes and shortcomings.
Professor Patrick McGorry, (Executive Director, Orygen Youth Health Research Centre;
Board Director, Headspace; Professor of Youth Mental Health, University of Melbourne)
launched the proceedings for Day One, with his talk, entitled, ‘Early Intervention and Youth
Mental Health Models of Care – 21st Century Paradigms for Australia’. He spoke of how
mental health is grossly under-resourced (at present only six per cent of the nation’s health
budget is assigned to this cause) and, despite the fact that the incidence of psychiatric
disturbance peaks during adolescence and the early twenties, young people have the worst
access to services. We were informed of the initial approach to this problem, the current
strategies in place and the direction he hoped such a reform would take. The difficulties
Reports submitted by RAMUS scholars and Alumni who attended this conference with support from
the RAMUS Conference Placement Program
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outlined by Professor McGorry were quite similar to those that rural health has encountered
in the past and continues to face.
‘The Importance of Youth Mental Health in the National Health Reform Process’ was
discussed by Dr Christine Bennett, Chief Medical Officer of Bupa Australia. As the former
chair of the National Health and Hospitals Reform Commission, she imparted that mental
health was a major priority in the reform process. The commission believed that an increase
in funding to the area was necessary; yet ‘the most important change needed is the
reorientation of mental health expenditure that focuses on prevention, early intervention
and delivery of coordinated care’.
A session I found particularly useful was that pertaining to ‘Clinical Complexity’. Dr Andrew
Chanen, a member of the Orygen team, highlighted the need for complex interventions in
youth psychiatry, since the risk factors for these illnesses tend to be complex social and
clinical problems themselves. I thought his point regarding the limitation of psychiatric
diagnosis in guiding management and predicting outcome was completely valid. The other
two panel members seemed to support Dr Chanen’s view that the inclusion of clinical
staging in diagnosis would be of great assistance.
The day concluded with the Delegate’s Reception, giving me the opportunity to meet others
with an interest in mental health and rural medicine.
Day Two of the conference proved to be a valuable learning experience, with the
presentation of revolutionary information and ideas. Professor Jane Costello from the Dukes
Institute for Brain Sciences gave some astonishing facts and figures in her lecture, ‘An
Uncomfortable Truth: the Onset and Development of Psychiatric Disorders’. Her research
demonstrated that mental illness is often present between the ages of two and five; the
prevalence of disorders being almost identical from nine to 25-year-olds. This has important
implications. It suggests that there is an interval period between the emergence of the first
symptom, recognition of the illness and its subsequent diagnosis; thus providing a generous
window for intervention.
The session on ‘Substance Abuse’ was of particular relevance to my objectives in attending
the conference, as in rural Australia and amongst marginalised groups such as the
Indigenous population, this poses a significant problem. It was suggested that health
professionals need to be on alert for drug and alcohol problems within their patients, as
they are not being detected readily enough and are often poorly managed. I thought a point
raised by one of the speakers was important to be aware of during my future practice. He
proposed that the terminology used to describe drug and alcohol problems be substituted
for more inclusive language; terms such as abuse can marginalise those trying to seek help.
Each member of the panel seemed to emphasise the need for cultural change (as an
Reports submitted by RAMUS scholars and Alumni who attended this conference with support from
the RAMUS Conference Placement Program
7
individualised approach is actually the least effective) and that this will only result from
alternations in social structure – not just marketing techniques!
Professor Ian Hickie of the Brain and Mind Institute, University of Sydney was the final
speaker for the day; he left us with several key messages. One such point was his dispelling
of the myth that young people do not seek help, rather, he said, they don’t seek help from
us. Thus, a collaborative approach to the care of youth is essential.
It was a privilege to attend the First International Youth Mental Health Conference; I found
it to be a wonderful learning opportunity and, overall, a thoroughly enjoyable experience.
Having undertaken two placements in psychiatry this year, I was able to consolidate and
build on the knowledge I had attained. What’s more, it crystallized my thoughts in relation
to pursuing this as a future career. The emphasis on rural mental health helped to broaden
my understanding of pertinent issues in the area; whilst it was inspiring to meet with
professionals who are working to improve the state of rural Australia’s mental health.
Reports submitted by RAMUS scholars and Alumni who attended this conference with support from
the RAMUS Conference Placement Program
8