INSIDEFEATURES

Why learning works 6 Mental Health Review Board 7 Coronial submisson 8 & 9 Making a connection 10

NEWS Letters to Editor 2 Responding to Tsunami 4 Double Trouble DVD funded 5 Thinking aloud 11

MIVoice

for people with a mental illness, their families and friends

Autumn 2005 No. 97Registered with the Department of Human Services

Print Post Approved 350190/00023 ISSN 0816 7877

Making a connection

From the PresidentNow is the time for renewing your Membership to maintain your commitment to Mental Illness Fellowship Victoria. Please encourage others amongst your family and friends to join – we have various rates and have deliberately kept the cost low to make it accessible to as many as possible. Your membership is critical to enable us to advocate for the rights of people with a mental illness and their carers. Please renew today and save us money.

Each year, MI Fellowship recognises the outstanding contributions made within our organisation, in other mental health organisations or in the general community through the Mental Illness Fellowship Victoria Awards.

Our Awards provide an opportunity for you to nominate people who make a difference to the lives of people affected by mental illness. It is a way of thanking and publicly acknowledging the tremendous efforts of hard working and dedicated individuals. Please consider nominating someone you know who brings about positive change for people affected by mental illness, their family and friends.

Nomination forms are available from our website at www.mifellowship.org/newsevents.asp or by calling MI Fellowship on 03 8486 4257.

For the third year running Eli Lilly are generously funding a visit to Australia by an overseas expert to promote Schizophrenia Awareness Week. Professor Gary Bond will be presenting ‘Work Matters’ as our 7th Bruce Woodcock Memorial Lecture. Gary is a leading US research psychologist who advocates for individualised approaches to assisting people with a mental illness gain competitive employment. His 150 publications and presentations from Hong Kong to Helsinki have been awarded by organisations as prestigious as the National Institute of Mental Health (USA). Here he will outline realistic strategies to reduce the unemployment rate of Australians with a psychiatric disability, which is currently at 76%.

Professor Bond will be introduced by Neil Mitchell. Neil is 3AW’s assertive and entertaining morning presenter and has dominated Melbourne talk radio for over a decade.

I encourage you to join me to listen to Gary Bond and Neil Mitchell at the BMW Edge, Federation Square on Tuesday 17 May from 5.45pm. Reserve your place today by calling 03 8486 4200 or e-mail membership@mifellowship.org. Remember that members get free entry with others making a gold coin donation. A big thank you to Eli Lilly, 3AW radio and Federation Square for their generous support.

Living in Australia, it is important to convey our message at both state and territory level, and at the federal level. Mental Illness Fellowship of Australia (MIFA) is the means of conveying our message at federal level. As President of MIFA I represent that body on the Mental Health Council of Australia which has endorsed me as a member of their Executive and also Chair of their Policy and Sub Committee. I will from time to time let you all know about some of the initiatives taken at federal level. In the meantime I trust you will enjoy receiving the new MIFA publication, Engage, which is mailed with this edition of MI Voice.

Rob Knowles P A G E 2

Letters to the EditorI am concerned after just witnessing an advertisement of yours on ABC TV where the announcer quite confidently states that mental illness involves a chemical imbalance in the brain. To my knowledge chemical imbalance theories for mental illness remain scientifically unproven.

I feel that the message in your ad is misleading and irresponsible and therefore should be altered or removed. Name and address supplied

Ed. Thank you for your message regarding our ‘five in five’ Community Service Announcement (CSA).

Mental Illness Fellowship Victoria believes that causes of and treatments for mental illness are complex. We believe that mental illness is caused by a combination of biological, psychological and social factors and we believe that recovery involves addressing each of these factors.

Our CSA does say with confidence that mental illness involves a chemical imbalance in the brain. The body of scientific evidence supporting the involvement particularly of dopamine and serotonin in mental illnesses has increased dramatically over the last ten years. There

is almost universal acceptance within psychiatry and in the medical profession of the chemical imbalance hypotheses. There is no research to our knowledge that disproves the chemical imbalance theories and much research that strengthens the hypotheses.

It is a major debate within science itself of course about what constitutes a scientific ‘proof’. Most scientific theories begin as hypotheses, are strengthened by further research and grow in status until such time as they are disproved. At the moment the chemical imbalance hypotheses and the medications that have been developed as a result are yielding very good outcomes for people who experience mental illness.

Unfortunately in the current system in Australia, psychological and social aspects of recovery are very difficult to access. MI Fellowship continues to lobby governments to properly resource complementary treatments for mental illnesses, including addressing the need for employment opportunities, reskilling and appropriate and affordable housing options.

We stand by the statement in our CSA, but we also recognise the complexity of mental illness, both its causes and ways towards recovery. We take a biopsychosocial approach which we believe is holistic and treats people as people and not as patients.

I commend to you the research site of the National Institute of Mental Health at www.mental-health-matters.com for the most recent developments in research regarding mental illness and chemical imbalances. Thank you again for your comments.

I’ve been a volunteer with the Fellowship for twelve years, because my son suffered from schizophrenia. When the diagnosis comes, the family feels so isolated because of the stigma. Thank you for

From the Chief ExecutiveHuge media coverage has surrounded Cornelia Rau’s case, as a mentally ill Australian resident who mistakenly ended up in South Australia’s Baxter detention centre for ten months after leaving a psychiatric unit in Sydney. Like nothing else, the case of Ms Rau has compelled Australians to look again at how people with a mental illness are treated. That the 39-year-old former flight attendant who experiences schizophrenia was not given psychiatric care at Baxter is a dramatic and tragic illustration of the wider problem within the Australian mental health service and the community at large. How poignant was the report last week, where her family said that Ms. Rau’s mental health was beginning to improve after only a couple of weeks?

Although the Inquiry into the Cornelia Rau Matter conducted by Mr Mick Palmer AO had a very short time frame; we asked our members and supporters to respond. I am pleased to say that many of you did by putting forward your own real life experiences and opinions and advocating for a public inquiry to seek improvement to the mental health system in Australia. Thank you.

The Hon. Christopher Pyne MP, Parliamentary Secretary to the Minister for Health and Ageing said on 24 February that “Australia’s states and territories stand condemned for their failure to deliver adequate mental health services”. He is in the final stages of creating a Senate inquiry into mental health service provision in Australia with the terms of reference available at www.mifellowship.org/advocacy.htm The lack of services people with mental illnesses experience are across housing, employment, health and welfare areas. We will keep a watching brief on this inquiry and suggest that the work you have done for your Cornelia Rau submissions be fed into this investigation. Yes, there are major State issues, but there are also Federal issues, and it may be an opportunity for the Commonwealth to further review its commitment and leadership role through the Mental Health Plan 2003-2008.

Now onto state issues. Mark Kaufman was a 24-year-old diagnosed with mental illness, when he died as a consequence of a police shooting in January 2001. The Coroner has just concluded the hearing into his tragic death. We made a submission to the Coroner, covering major themes raised with us by people with mental illnesses, their families, police and clinicians over the last five years through Helpline, counselling and training activities. Please see our edited synopsis of the submission on page eight.

The issues that have been troubling us for so many years are currently being put on the public agenda. Change is not here yet, however there are positive signs. We applaud The Sunday Age and Peter Ellingsen in particular, for running a strong campaign called ‘the forgotten people’. On 6 March this year, they reported on the front page a ‘Big revamp for mental heath care: Mental health care in Victoria is set for its most dramatic overhaul in a decade’ with a blue print plan for an extra $600 million being put forward to cabinet for backing. Last week as part of a Vicserv delegation we met with the Parliamentary Country Caucus, which was part of an overall advocacy strategy to gain this extra funding and support. We are looking forward to positive outcomes and remain committed to continue improvement of the mental health sector.

Elizabeth Crowther

the advert that gives the community a completely different image of these lovely people. This will definitely do a lot to reduce the stigma, which will make all our lives easier. There’s never been such a delightful image of our whole situation given to the community. Everyone in my “Sticky Bun” suicide support group will be as impressed with it as I am, and as grateful. Thank you. Joan Cusworth

Your 5 in 5 campaign television advertisements really captured my attention!

They are very good - colourful and bright when dealing with a complex topic. It pinpointed the relevance of mental illness to every person’s life - making clear that people can help. It also contained a sensible degree of acceptance towards mental illness, which probably provides an opening where some people would never have thought about it before. The educational experience within the ad was very positive. Metaphorically it was like a door opening. It reminds everyone of the positive work that can be done.

It stood out to me because of the positive nature and tone of the ad. My experience with this type of thing in the past was so low-vibe it was depressing, with warnings and dire consequences if we don’t take action. Yours was more: “These are the facts but rather than dwell on problems lets do something!” Very uplifting!Narelle Keenan

Ed. Our ‘five in five campaign’ has continued to grow with an increasing number of people contacting us in response to our CSAs. Special thanks to The Age who have recently been giving us regular free advertisements – seven times in the Saturday 13th February edition alone and to Channel Nine for their continued terrific support.

My 65 year old husband Peter completed the Asics Melbourne Marathon recently, whilst our daughter was in Frankston Hospital unwell with a psychotic episode. After the marathon we drove back to the hospital to present her with the medal “as he did it for her”. I apologise for sending donations late but we know it will be put to a very good cause.June De-Jonge

I read with interest the Summer 2004/5 edition of MI Voice and your excellent 2004 annual report. I was delighted to read one of your ‘Letters to the Editor’ on page 2 about an experience of a Mental Health Review Board (the Board) hearing. Although the correspondent (to whom I personally responded at that time) sought to provide a somewhat negative spin on the Board and its processes, it provides me a perfect example to use to reinforce the benefits of the review and appeal process that the Board is required to provide under the Mental Health Act 1986 (the Act).

Briefly, the Board is a statutory tribunal established in 1987 to hear appeals lodged by, and conduct reviews of, psychiatric patients treated involuntarily (that is, against their will) within eight weeks of commencing treatment and then at least annually. Its role is to decide whether, on the day of the hearing, a particular involuntary patient meets the statutory criteria to continue to have treatment against their will. In the correspondent’s case, the Board heard an appeal lodged by the son, then an involuntary patient being treated in the community on a community treatment order.John Lesser – President Mental Health Review Board of Victoria

Ed. This letter is an excerpt from a detailed response. Please see page seven where we have made a feature of the Board’s response. Special thanks to Mr Lesser for making this possible.

FRONT COVER – Dr Daniel Hughes with Erica Menheere Thompson presenting one of many workshops on attachment issues for children. See page ten for full story.

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MI Voice : Autumn 2005

More than just a name changeOur Next Step Day Program in Shepparton has changed name… and direction.

MI Centre (pronounced ‘my’ centre), which has served local people with mental illnesses such as schizophrenia, depression, anxiety and bi-polar disorder since 1997, marked the new beginning on Thursday 17 February.

“We want to do more than just be a place for people with a mental illness to spend time,” says Lisa Pearson, Deputy Regional Manager-Hume Region. “We want to be an innovative centre where people with a mental illness, their families and friends get real value from their time learning skills in cooking, computing, gardening as well as exercise, information and friendship.”

With one in five people affected by mental illness during their lives MI Centre wants the entire community – those with and without mental illness – to feel that it is their centre too.

Mayor of City of Greater Shepparton Cr. Anne McCamish conducted the official opening and attendees enjoyed a delicious spit roast lunch. At the opening an activity booklet was launched describing programs available, which include: walking, journalling, discussion groups, gardening, cooking, computing, craft and music.

Open Door Day with Deborah Conway MI Fellowship’s Barwon region celebrated the official opening of its Fyans Street premises on Saturday 12 February. Acclaimed Australian musician Deborah Conway and Fyans Street band The Cartridge Family performed to the enthusiastic crowd gathered at the Family Education and Support Groups service opening. The merry band of volunteers cooked over 200 sausages, 50 chops and enough chickens to fill a large coop for the visitors gathered, who certainly went away satisfied.

Perspective on Japan Phil Watson is a member of the Home Based Outreach Support team in the Eastern Metropolitan Region. He recently travelled to Japan after being selected for the 3rd ‘Young Core Leaders of Civil Society Groups Development Program’, organised by the ‘International Youth Exchange Unit’ Cabinet Office of Japan.

“The Local Program for my stream was in Wakayama prefecture where we visited several services for people with disabilities. One of the services was ‘Mugi-no Sato’ (Social Welfare Corporation). This is a home and place of employment for people with disabilities, including physical, intellectual and mental disabilities. This service operates closely with the local community and is funded solely by donations”, Phil reports.

Phil also indicated that the Japanese government is shifting towards the policy of ‘de-institutionalisation’. There are about 345,000 people with mental disabilities who are currently admitted to institutions in Japan which is about 0.2% of the population. Japan has a 10-year plan to develop the Health, Medical, Social, and Institutional Services for people with mental disabilities. (Source: Annual Report on Government Measures for Persons with Disabilities, Japan 2004; Promoting Measures for Persons with Disabilities, Cabinet Office of Japan, 2002)

‘One thing that seemed to be a common theme was the desire for all people to attain and maintain their independence within their supportive community’ concluded Phil.

Round UpO’Meara House’s 1Oth Birthday partyOur O’Meara House service in East Ringwood celebrated 10 years of giving people with a mental illness and their carers a break. ‘Party time as respite house celebrates’ was how the Maroondah Journal featured it with a picture on 1 March 2005.

Over 2,500 families from suburbs including East Ringwood, Croydon, Kilsyth and Mitcham have benefited from O’Meara House on Railway Avenue, which offers five-day holidays for people with mental illnesses. O’Meara House accommodates eight guests at one time and has 24hr live-in staff. The focus is on relaxation with guests encouraged to plan their outings including horse riding, Devonshire teas in the Dandenongs and

art. There are also special weeks for young people and women.

With 40 per cent of adults with a mental illness living with their family, the five days is also a valuable respite for carers. The Open Day saw former guests, staff and friends gather for a sausage sizzle, tours of the building, a chance to meet and a cake cutting.

A guests perspective

When I was diagnosed with paranoid schizophrenia in 1966, places like O’Meara House didn’t exist. Treatment for mental illness was draconian and when I was first admitted to Larundal, you had no right to speak. I have seen a lot of changes in 39 years, mostly for the good. O’Meara House means to me a place you can catch up with friends and chill out but mostly, it’s a place where my carer can get a break. The whole point of respite is so your carer can get a break. One of the greatest hurdles to overcome involving mental illness is social stigma. O’Meara House also means to me that the stigma surrounding mental illness can begin to change for the better. I have attended O’Meara House nine times in 10 years and I look forward to another 10 prosperous years to come. I would like to personally thank Mental Illness Fellowship and the caring staff at O’Meara House for 10 wonderful years. Peter Pickett

Tsunami response

‘Friends of the Mental Illness Fellowship (program in Seymour) ran a Tsunami appeal sausage sizzle last Thursday and raised $375 for Oxfam Community Aid Abroad’s work with people affected by the natural disaster’

Seymour Telegraph, Front page – January 19 2005.

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Cutting the cake

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MI Voice : Autumn 2005

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Mental Illness Education Schedule April – July 2005:

Well Ways: A traveller’s guide to well being for families and friends of people with mental illness

Where: Waiora Community Mental Health Service, 600 Orrong Road, Armadale

Duration: Wednesday mornings for eight weeks

When: 10am to 1pm, April 6, 13, 20, 27 and May 4, 11, 18, 25

Double Trouble: A support and information program for families and friends of people with dual diagnosis (mental illness and substance use)

Where: MI Fellowship, Fairfield Place 276 Heidelberg Road, Fairfield

Duration: Thursday mornings for six weeks

When: 10am to 1pm, June 2, 9, 16, 23, 30 and July 7

Understanding Mental Illness Workshop: An overview of what mental illness is, symptoms, behaviours and helpful interventions for the general public

Where: MI Fellowship, Fairfield Place 276 Heidelberg Road, Fairfield

Duration: Thursday night – three hour session

When: April 22 (9.30am to 12.30pm)

For further information and booking forms please call 03 8486 4200 or www.mifellowship.org or email: enquiries@mifellowship.org.

Double Trouble DVD developed

Mental Illness Fellowship was successful in seeking funds from the Australian law firm Allens Arthur Robinson. Their Charity Committee provided $14,750 to develop a DVD training aid for the ‘Double Trouble’ course run by MI Fellowship. Double Trouble is designed to support those with ‘dual diagnosis’ (where there is a co-existing mental illness and substance dependence or abuse) by giving their family and friends the tools to care for them. As part of the Double Trouble course, representatives from the police force, CAT Teams and a psychiatrist are invited to speak. However often this is not possible and so the valuable input from these professionals does not happen. The DVD includes interviews with top professionals in these areas to overcome this problem. A draft of the DVD was presented to staff of Allens Arthur Robinson in February.

Mental Illness Fellowship has many projects that need funding, big and small. If you want to find out more, please contact James on 03 8486 4200 or jsaunders@mifellowship.org

Inspiration and action Advocacy – Our members making a difference

Our members and supporters are making a difference with many of you recently taking up the ten day window of opportunity to advocate through the Cornelia Rau Inquiry by Mr Mick Palmer AO (see the Chief Executive’s column on page three).

Typical of this new heightened level of engagement is Nicci Wall – an inspiringly active member of MI Fellowship. She recently co-ordinated a petition for increased mental health services funding, which included over 1,100 signatures and was sent to relevant politicians. Nicci is particularly passionate about service provision in her local area, the Melton Shire in Melbourne’s north. Despite a population of over 70,000 people, the Shire does not have a fulltime psychiatrist. Nicci’s advocacy work is, among other things, dedicated to finding a solution to this problem. She started the Melton Depression and Bipolar Support Group in mid 2004. In addition to the lobbying they do, the group is increasing awareness of mental illness through community displays, producing a T-shirt that says, “Mental Illness doesn’t discriminate. Do you?” and making presentations for local groups and events to dispel myths, initiate discussion and encourage empathy. Nicci features in our ’10 Minutes with... ’ on page 11.

For further information or enquiries about Nicci’s “Guide to setting up a support group”, contact her on 03 9747 3488 or forwalls@netcruiser.com.au

MI Raffles – Winners all round

Mental Illness Fellowship’s latest Autumn Raffle was drawn just before Christmas, providing our anonymous winner with a present to remember. The sporty VW Polo Elite was just right for the last minute Christmas sprint around town!

Our Raffle supporters have made a net profit to MI Fellowship of $400,000 since its inception in 1999. This continues to grow with an estimated 2004/5 financial year contribution of $140,000. 4,000 raffle supporters have gone one step further and chosen to donate directly to us, which has contributed a further $95,000. Thanks again to all our very special raffle supporters who have allowed us to develop innovative and effective programs for people with a mental illness, their family and friends.

If you would like to support us (our Spring Raffle has just begun), please contact Joanne Luciani on 03 8486 4250.

MI Helpline

Are you a person with a mental illness or a carer/family member of a person with a mental illness? Would you like to give something back to support other people with a mental illness and their families? Do you feel that you can offer four hours per week volunteering as a member of our MI Helpline Team that provides a telephone information and referral service?

To find out more please contact Bernadette on 03 8486 4254 or email bdoyle@mifellowship.org

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Why learning works!In the last 18 months, MI Fellowship has successfully delivered two adult learning courses to adults with a mental illness. Students graduated at the end of 2004 with Certificates in General Education Levels Two and Three, and an Introduction to Community Event Volunteering. At the conclusion of both courses it was deemed necessary to evaluate what strategies would support graduate students to participate in further study and/or volunteer for the Commonwealth Games in Melbourne 2006.

“This course is the best thing I have ever done”

The evaluation project in which past students were invited to participate has given us insight into how we can continue to create pathways for adults to overcome problems with concentration, confidence, motivation and memory. These problems were identified in an Australian study (McLean and Andrews 1999) into the learning support needs of students with psychiatric disabilities.

“For the first time in my life I have finished something I have begun”

The results have indicated that 50 per cent of the students who graduated from the CGEA course had enrolled into further studies. Three have entered mainstream TAFE Colleges to undertake Certificates 1 and 11 in Kitchen Operations and Animal Care. A number of students have continued in their roles as volunteers at MI Fellowship and Neami. Two have gained employment with other PDRS providers and one has joined a Fitness Recreational Club to lose weight and gain a higher level of fitness. All students who completed the Introduction to Community Event Volunteering have enrolled as volunteers for the Commonwealth Games.

“Knowing I have ongoing support gives me confidence”

The barriers or problems for most people (12 of those interviewed) involved public transport, motivation, fears, anxieties and not being supported beyond MI Fellowship.

A number of people mentioned that the friendly, accepting atmosphere of the classes and the supportive delivery of the curriculum along with a later starting time was significant in helping them stay and complete the courses. Other factors that helped were tutors, social support and the ongoing role of support workers.

“I cannot believe that I have successfully completed the CGEA and Community Event Volunteering Certificates”

The group was asked to imagine what would be a perfect day at a Registered Training Organisation. They came up with the following:

A perfect day is

In 2005 we have nineteen students who have commenced a Certificate of General Education for Adults. We thank Jay Myers for her management of the course and Debbie Speriandio for her delivery of the CGEA.

If you believe you can help in a tutoring role to our students please contact Bernadette at MI Fellowship on 03 8486 4254 or bdoyle@mifellowship.org

THE TANER TRIP

I was born in London ’68 when the gypsies were free and the music was gas,

Then my folks decided to set sail and haul away to Australia the land of luck and mass.

The first thing I remember was our first house in an old suburb called Altona,

My sisters played Cat Stevens and Beatles as they looked after me, the cutest baby toddler.

Quite soon after we moved house once again to Blackburn where I was to grow into a quiet young boy,

The seventies were my primary years filled with love and tears and happy joy.

I remained the quiet one who never fitted in anywhere,

But still managed to find some joy through new toys, super heroes and Humphrey B Bear.

The eighties came like a hurricane as my mother became sick and passed away,

Both my sisters were married and found their fate and way.

I found some solace in music and learnt to play the guitar,

I hoped my special talent would seal my fate and bring me far.

But life became a struggle and I became lost in the nineties,

My father and my worlds began to clash as I was nearing my thirties.

My father sold the house in Blackburn and we went our separate ways,

I was single and lonely and wandering in a confused adult maze.

After living in dodgy places hope and my music helped me through,

Started with Split Enz and Icehouse, and then found The Who.

Now I live in Ivanhoe and get along better with my father, we both have things in common as we struggle to get further.

Well now I’ve found a band that gives me hope to share my talents,

I only wish a girl would come and appreciate my presence.

The only thing remaining is a glimmer for the future, a steady job and woman to love to fill this picture.

By Taner Remzi, a CGEA graduateP A G E 6

• getting there on time• positive atmosphere• walking out feeling good

about myself• a sense of being a member of

the mainstream community

• being productive• co-operative classroom• humorous teacher• feeling relaxed and at ease• making allowances for

people’s differences.

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P A G E 7MI Voice : Autumn 2005

By John LesserMI Voice welcomes feedback from all readers. The following summary has been developed following a ‘Letter to the editor’ from John Lesser, President of the Mental Health Review Board of Victoria (see page three) in response to a letter from another reader in the Summer 2004/5 MI Voice. This article aims to inform our readers of the benefits of the review and appeal process that the Board is required to provide under the Mental Health Act 1986 (the Act).

About the Board

The Mental Health Review Board of Victoria (the Board) is a statutory tribunal established in 1987 to hear appeals lodged by, and conduct reviews of, psychiatric patients treated involuntarily (that is, against their will) within eight weeks of commencing treatment and then at least annually.

The Act is an attempt to balance often competing rights:• patients’ rights, wherever possible, to make their own health

care decisions and to be treated in the least restrictive manner• patients’ rights to adequate and appropriate treatment for their

mental illness, and• the community’s right to protection and safety.

There is a percentage among the carer population who would argue that the Act poorly protects the rights of family members and carers of those suffering a serious mental illness. However, the Board was established, among other things, to protect the rights established in the Act, but its jurisdiction is limited by the Act. Its role is to decide whether, on the day of the hearing, a particular involuntary patient meets the statutory criteria to continue to have treatment against their will.

External review process

As MI Fellowship regularly reminds us, mental illness affects many people in the Victorian community, most of whom fortunately receive treatment on a voluntary basis and with good family and community supports. It is entirely appropriate that, in the case of the relatively small number who require involuntary treatment because of the seriousness of their mental illness, there is a robust external review process to ensure that this is necessary in each case. Each division of the Board comprises three independent statutory appointees, a lawyer, a psychiatrist, and a community member, each of who has an equal vote and makes their decisions on a majority basis. Each has considerable experience of the issues under consideration and the jurisdiction. The President has no power to influence individual decisions.

Majority decisions are relatively rare reinforcing the value of a multi-disciplinary review panel with knowledgeable and open-minded members who independently weigh up the information provided by the patient, members of the treating team from the mental health service, a legal representative acting on behalf of a patient, if there is one, and others, including family members and carers. The Board encourages patients, as well as those in support roles, to attend and participate in the review process, generally in accordance with the patient’s wishes.

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It is not uncommon in the Board’s experience for there to be differences of opinion between patients, members of the treating team, and support persons about a range of issues, including medication, compliance with treatment, and lifestyle issues. The important thing is that the review process allows those differences to be expressed in a relatively informal and supportive environment, with the final decision being made by the independent umpire. That one of those views will be preferred at the end of the hearing is an inevitable consequence of a tribunal process, but one that fosters the sharing of views amongst stakeholders present.

Patient’s rights

The patient is equally entitled to express their views about the need for continued involuntary treatment as their parent, even if their views differ. Likewise, a patient is entitled to ask for a review by appealing at any time, and to seek legal advice and, if available, legal representation. It is important to understand that a decision of the Board does not affect the continuing treatment of a person as a patient of a mental health service, whether in a hospital or a community clinic. Over the course of the treatment of a serious mental illness like schizophrenia, it is not uncommon for some patients to require periods of involuntary treatment, often short-term and crisis-driven, mixed with hopefully longer periods of consensual voluntary treatment. The only decisions the Board has power to make are, firstly, whether the statutory criteria set out in the Act for continued treatment as an involuntary patient are met on the day of the hearing and, from 6 December 2004, to satisfy itself that the patient has a viable treatment plan that has been prepared in accordance with the Act’s requirements.

Discharging patients

In the 2003/04 financial year, the Board conducted over 5000 hearings, which resulted in decisions to discharge patients from their involuntary status in 4.4% of hearings. What is often not well understood is that the majority of decisions to discharge patients from their involuntary status are made, quite appropriately, by the consultant psychiatrist in charge of the patient’s treating team. This happened in over 25% of cases between the Board listing the review hearing and the date the hearing was to be conducted. This supports the view that the Board provides an appropriate trigger for a timely clinical review of patients’ mental illness, and treatment needs, setting (inpatient or community) and status (capacity to make their own treatment decisions).

Read more about the Board’s work at www.mhrb.vic.gov.au

“Stop Press” – Recent important legislative amendments that affect the practice of the Mental Health Review Board

The Mental Health (Amendment) Act 2003 was passed in October 2003. The amendments relating to involuntary patients commenced on 6 December 2004. The most important are:

• specifies one set of criteria for involuntary treatment (s8(1)).

• introduces involuntary treatment orders (“ITOs”) (ss12 and 12AA).

• simplifies the CTO provisions (s14).

• introduces compulsory treatment plans (s19A) and requires the Board to review them to determine whether the:

(i) authorised psychiatrist has complied with s19A; and

(ii) plan is capable of being implemented (s35A)

• provides a new power to order the service to make a CTO within a reasonable period of time (s36(4)).

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Advocacy – Coronial Submission about the death of Mark KaufmannAs part of MI Fellowship’s ongoing mission to advocate for people affected by mental illness, Elizabeth Crowther made a submission to the Coronial Inquiry into the death of Mark Kaufmann. The following is an edited version of that submission.

This submission is made as part of Mental Illness Fellowship’s role as an advocate for a better mental health system. MI Fellowship has contact with over 1,100 people with a mental illness annually through program delivery, and tens of thousands of families and community members. We also have contact with police through education and training activities.

As Chief Executive of MI Fellowship I have been involved with the Kaufmann family for nearly three years following Mark’s death. MI Fellowship has been involved with families and people with mental illnesses who have died as a consequence of their illness previously and can state that there are a number of common themes, some of which are addressed here.

1. Crisis Assessment and Treatment Teams (CATT) General Observations

We offer the following observations based on our experiences:

• There is a mix of satisfaction and great dissatisfaction with CATT interventions;

• CATT responses are inconsistent. The service that people with a mental illness receive depends on the interpretation of individual practitioners;

• Multiple stories of dissatisfaction highlights the development of a culture within CATT that focuses on the needs of the teams themselves and their perceived safety rather than the needs of people with a mental illness and their families;

• This culture appears to influence the teams to “gate keep” people out of service rather than asking probing questions that would ascertain the nature of the event. CATT triage processes put the onus back on families that do not have the training and experience required;

• We have spoken to a number of CATT clinicians that have told us off-the-record that they do not see their role as attending with police and will not attend where there is drug use or violence. There is a clear desire with CATT clinicians that the person with a mental illness be brought to a place where CATT can ‘safely assess’;

• CATT in some areas have advised carers, consumers and Mental Illness Fellowship staff that they will not attend anywhere except a police cell or a hospital setting after 11pm. It is unknown whether this is government policy;

• While all this is true in too many situations we wish to stress that there is no consistency of response, as clinicians in the same area interpret matters differently.

2. Specific Observations Relating to CATT and the Kaufmann Case

• In evidence, the CATT clinician stated that CATT was asked about availability rather than a specific request to attend. This evidence was subsequently changed when she was able to review the transcribed Intergraph conversation between that organisation and herself. Her explanation was that she did not “hear” the request and nor did she respond as if she heard the request. We believe that this is a reflection of CATT culture. Had the CATT clinician a different set of expectations we believe that it would change her behaviour.

• Mental health services are required to complete a discharge summary for all people treated within the public system. The CATT clinician should have used her access to Mr Kaufmann’s discharge summary to inform police of his past suicidal ideation. This would have been highly valuable information.

• Her questioning should have been more thorough and her considerable skills used to identify the nature of the crisis. The information she provided and the language used should have been tailored for a non-specialist audience.

• The inward-looking culture resulted in the CATT clinician failing to seek advice from her manager or re-considering allocating personnel within CATT to police at the site of the crisis.

• The suggestion that an individual CATT member cannot attend a crisis scene in the company of police by themselves shows that staff comfort is a higher priority than the job at hand. If CATT cannot provide expert knowledge and advice in such a situation the role of CATT needs to be questioned.

• The community expects that CATT will see a person with mental illness when in crisis. We submit that this expectation is not currently met. The policy and practice of CATT teams in attending people with a mental illness in times of crisis should be reviewed and new policy published to outline the expected scope and function of these teams.

• There is a belief about CATT responses among other services such as police and ambulance. When CATT doesn’t deliver the anticipated response police find themselves unable to effectively manage the situation.

P A G E 9

3. Specific Observations Relating to Police and the Kaufmann Case

• Mental Illness Fellowship Victoria consistently receives feedback that families are very reluctant to have police involved in crises based on a number of concerns including:

• public knowledge of police shootings;

• the belief that a person with a mental illness should be treated by mental health professionals rather than police, and;

• further stigmatisation of the family and the person when police are called in the neighbourhood.

It should be noted that people with a mental illness and their families regularly express their satisfaction with police. However, grave concerns remain about the response of their mentally ill relative and their reaction to the police in volatile situations.

In our work with police they express concern over a lack of training and support to deal with people with a mental illness who are in crisis. Our feedback is that past police education has been focused on controlling situations. Not understanding what is happening discomforts police and undermines their strategies. This is despite police advising us that as much as 30% of their work involves people with a mental illness.

Where we have been able to provide learning opportunities for police about what mental illnesses are and are not, predictable responses and what is happening to a person’s thinking, the unanimous feedback has been that practical education should become routine.

Better preparation of police is vital to more effectively manage events such as those that lead to Mr Kaufmann’s death. However police must not replace clinical interventions.

Recommendations for considerations

When a police unit calls for CATT assistance a protocol needs to be established which requires both parties to clarify the request and the responses.

Where a request is made of CATT and a denial of service results, a report by both parties should be required. This report should be reviewed within both services and forwarded to an independent third party, such as the Public Advocate, which reports to parliament on an annual basis.

Joint training for both police and CATT staff is essential to gain a better understanding of both scope and skills of each group and a greater capacity to work together. This training also needs to concentrate on the meanings of requests and provide an opportunity to give positive feedback to each party on the valuable skills each bring to a crisis situation. It should also include a community, consumer and carer perspective to assist each service member get behind the situation, providing potentially wider options.

MI Voice : Autumn 2005

The positive contributions that families can make in these situations needs to be examined by both parties, included in-training programs, and policy and protocol formulations.

Consideration of the Memphis Police Crisis Intervention Model from the USA. This has resulted in: fewer injuries and deaths (rates of injury to individuals with mental illnesses caused by police fell by almost 40%); reduced rates of arrest, incarceration and involuntary commitment; increased Police officer morale; and increased public confidence.

Elizabeth CrowtherChief ExecutiveMental Illness Fellowship Victoria

About Mark Kaufmann

Mark was born and raised in Melbourne, living with his parents and younger sister in the outer eastern suburbs. He was educated at Wesley College and later attended university for two years before succumbing to schizophrenia in 1998.

Mark had a happy, normal childhood and loved the outdoors with special interests in hiking, camping and soccer, eventually making it to captain of the school soccer team. Mark’s happy nature and concern for people, his humour and sense of fairness ensured that he had lots of friends and people who admired him.

After becoming ill with schizophrenia, Mark retreated from the world and struggled with the fact that schizophrenia damaged the thing he prized most dearly – his mind. Mark was on medication for two years and then decided to stop. Within a few months the symptoms of schizophrenia returned.

It is this illness that led to Mark’s desperate behaviour on the 19 January 2002. Mark’s real self was a peaceful loving, helpful young man. He had a tortured mind and he cried out for help.

At his funeral, attended by about 200 people, his best friend summed him up: “If we judge people by their actions, then there was no finer character than Mark Kaufmann.”

“There has to be a change to the mental health system and a change to police culture. People with a mental illness are not criminals. Our son was let down by the existing systems and we look forward to those who are capable of exerting change for the better to do so without further delay” said David Kaufmann, Mark’s father.

The Australian, 24-26 December 2004.

P A G E 10

Making a connection and helping childrenVisiting overseas expert, Dr Daniel Hughes, outlined his unique approach to the formation of early relationships and unlocking the issues that stop many children from making a normal connection with their parents or guardians.

Children with serious psychological problems from abuse, neglect and/or multiple placements or early life traumas and separations provide serious challenges to parents and therapists. For the past 15 years Dr. Hughes has specialised in the treatment of children who show serious deficits in their emotional, cognitive, and behavioural development, and at the same time demonstrate considerable difficulty establishing and maintaining relationships.

In Australia, as in many other countries, attachment disorder and its consequences for children, their parents, foster carers, direct care providers, adoptive parents, and society has only recently been recognised. Access to parents/professionals and teachers for training in dealing with children who suffer from attachment orders is almost non-existent.

“I know first hand what parenting a child who has attachment disorder is like. I also know that for someone in my position, Daniel’s approach and information is vital. He brought with him knowledge that is not readily available in Australia, and his visit made a big difference to many families”, said Erica Menheere Thompson, parent and MI Fellowship, Family Education and Support Groups Coordinator, Barwon.

Attachment disorder symptoms in young children include: superficially engaging and charming, indiscriminately affectionate with strangers, intensive needs to control, frequent lying, and reluctance to trust adults, especially their parents.

The objective of his work in Australia is to provide a vulnerable and misunderstood population of children the best possible chance of having a ‘normal’ adult life.

“I put a lot of value and importance in the parent-child relationship in my work around attachment disorder. I strongly

believe that, working with both parents and children using my PLACE approach - Playfulness, Love, Acceptance, Curiosity, Empathy, we can make a difference in children’s lives”, said Dr Hughes.

Dr Hughes visited Australia for the month of March as a guest of Mental Illness Fellowship Victoria speaking to teachers, mental health professionals and parents, in locations including Melbourne, Geelong, Warnambool and Sydney.

During his visit Daniel got extensive media coverage including on ABC TV’s ‘Stateline’ and on Radio National’s ‘Life matters’ twice – the second time by public demand.

About Dr Daniel Hughes

Dr Hughes’ treatment is family based, focusing on facilitating the child’s ability to establish a secure attachment with his/her caregivers. Developmental attachment theory and research is the primary model for relationship development and trauma resolution.

Dr Hughes received his PhD in clinical psychology from Ohio University, with a clinical internship at the University of Rochester Medical School. He consults with various mental health, social service, and residential treatment agencies in Maine (USA) and in other states and countries. Dr Hughes presents workshops and trains therapists while maintaining a small direct service practice in Maine.

Dr Hughes is the author of Facilitating Developmental Attachment (1997) and Building the Bonds of Attachment (1998) and a wide number of articles.

To find out more about Daniel and his visit or or to purchase his books and videos please contact Erica Menheere Thompson on 03 5229 8827

What makes us healthy?

The Australian Health Promotion Association has recently said that people are inundated with ‘lifestyle messages’ that, if they exercise, eat fruits and vegetables and stop smoking, all their health problems will disappear. But they believe that these messages are only part of the ‘bigger health picture’.

Dr Garth Alperstein, President of NSW Branch said, “Factors like income, education, employment, housing, the environment, society attitudes and the gap between the wealthy and the poor influence your health much more than medical treatments for sickness or disease”.

It was reported that there is a growing body of research showing that social determinants, the ‘bigger health picture’ factors, account for around 70 per cent of the overall health of communities and countries, while lifestyle issues and medical treatment only account for about 30 per cent of the overall health and well being of people.

“The health of children, for example, is more dependent on things like the income of the their parents, their mother’s education, parental support during pregnancy and the early childhood years, paid parental leave, universally accessible and affordable high quality child care and preschool education, than on respirators and antibiotics,” Dr Alperstein said.

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P A G E 11

Dates for your diary – 2005Professor Gary Bond and Neil Mitchell7th Woodcock Memorial Lecture, BMW Edge, Fed Sq 5.45 for 6pm start, Tuesday 17 May

Schizophrenia Awareness Week – 15-22 May

The 12th MI Fellowship Car Raffle Final Draw (Autumn) – 4pm, 16 June

Nominations for Awards – 5 pm, Friday 8 July

Nominations for Board of Directors – 5pm, Friday 2 September

2005 Mental Health Week – 9-16 October

Asics Melbourne Marathon, finishing at Albert Park – 8am-12pm Sunday 9 October

Open Mind Day Fiesta – 10-5 pm, Sunday 16 October

2005 AGM, Awards and Annual Lecture – 5.30 pm, Friday 21 October

Christmas Grief and Loss Memorial Service, St Johns Southgate – 11am, Saturday 10 December

Volunteer Thank You Party – 4 pm Thursday1 December

Please find out more about all activities by calling 03 8486 4200 or visit www.mifellowship.org/newsevents.asp

Park Bench, Observations of Daily lifeCreated by Peter Barker

‘Park Bench’ is a cartoon series, looking at life and social issues, provided by Peter Barker, who has lived with schizophrenia for twenty years.

MI Voice : Autumn 2005

Thinking aloudTen minutes with…Nicci Wall How are you involved with MI Fellowship? My family and I became members shortly after my diagnosis of bi-polar in November 2001.

I have become involved in promoting MI Fellowship to others seeking support and information on various mental illnesses, as well as linking into MI Fellowship’s advocacy campaigns to bring about change.

What makes you happy? At the moment it is striving for change by being the voice to increase awareness and reduce stigma, on behalf of those not confident enough to go public about their illness.

What makes you angry? The thing that angers me the most is people who believe having a mental illness is something to be ashamed of.

What are you reading? Dr Phil McGraw’s “Self Matters” - I am forever challenging myself to gain a better understanding of others and myself.

In one word, describe the essence of the Mental Illness Fellowship for you Liberator.

What is your most treasured possession? My computer, because it has enabled me to link myself with so many like minded, passionate and driven people.

To read more about Nicci’s work, check out our advocacy update on page five.

A STAND

She knows she must make a decision

Make a stand

Stop the violence

Stop the abuse

Believe in herself

Stand up for herself

No longer tolerate what is becoming a daily habit

Broken emotionally, physically and mentally

It’s all too much for her

She can’t take it anymore

Won’t take it anymore.

Isabella Fels

8&

MI Voice - Summer 2002/3

From the Editor…We hope that you enjoy your Autumn edition of MI Voice quarterly publication. To help us get it right, we welcome contributions from you for MI Voice. You can download current and past issues at www.mifellowship.org/mivoice.htm If you would prefer to receive communications from us electrically via e-mail please let us know.

To contact us please write to:The Editor – MI VoiceMental Illness Fellowship Victoria PO Box 359 Clifton Hill Vic 3068Telephone 03 8486 4200 Fax 03 8486 4265

Or email membership@mifellowship.org

Deadline for Winter issue of MI Voice and MI Support is Monday 25 April 2005.

Editor James Beckford SaundersAssistant Editor Stephanie Puls Design Artwords Printing Print Impressions

MI Voice is for Members and aims to keep them informed of the latest information on mental illness and our advocacy work. It is also our opportunity to keep potential and existing supporters who donate informed of the Mental Illness Fellowship’s activities and the difference their contribution makes. MI Voice is the quarterly publication of Mental Illness Fellowship Victoria, Fairfield Place 276 Heidelberg Road, Fairfield, Victoria 3078, Australia.

Telephone 03 8486 4200 Email enquiries@mifellowship.orgWebsite www.mifellowship.org

Mental Illness Fellowship retains the right to edit articles. Please note that the opinions expressed in this publication are not necessarily those of the Editor or of the Mental Illness Fellowship.

© Mental Illness Fellowship Victoria. All rights reserved.

ACN 093 357 165 ABN 93 093 357 165 ISSN 0816 7877

Who are we?Mental Illness Fellowship is Victoria’s leading membership-based not-for-profit organisation working with people with a mental illness, their family and friends to improve their wellbeing.

Our VisionOur vision is of a society in which mental illness will be understood and accepted. People with mental illness will be afforded the same regard as those with physical illnesses and resources will be available to offer early interventions and state of the art treatment and support. These interventions will be so effective that long-term negative consequences of mental illness will have disappeared for the person and their family. People will no longer experience stigma and that society will treat them with the same respect and dignity as any other person, and welcome and fully include them as community members.

Our ValuesHonesty Acceptance Equity Flexibility Commitment Participation

Our MissionMental Illness Fellowship Victoria works with people with mental illness, their families and friends to improve their well being. More specifically we work to achieve mental health reform through education, support and advocacy, and we provide a range of innovative programs in both membership and services. We also provide mutual support and self help, day programs, home based outreach and accommodation services, respite and residential rehabilitation services.

2004/5 Board of Directors

President – Robert Knowles Vice President – Doris Wisniewski Treasurer – Ian Priestley Secretary – Diane Brown Elaine Price, John McGrath, Louise Milne-Roch, Professor Christos Pantelis, Graeme Pocknee, Ian Priestley, Peter Robertson, Nathan Shafir, Alex Wood

Chief Executive

Elizabeth Crowther

Ways to support and keep us informedPlease use this form to change your address details, become a Member of the Mental Illness Fellowship or to show your support for our work.

• For credit card donations call 03 8486 4200 and quote MIV05, or complete this form and either post or fax your credit card details

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