One Door Mental Health Symposium 2019 on 18 May 2019, “Do it better or do it differently”

I attended the 2019 Mental Health Symposium organised by One Door Mental Health. It was also the opportunity to launch Schizophrenia Awareness Week by Tony Stevenson (image 2), CEO of MIFA (Mental Illness Fellowship Australia). MIFA is a peak body grouping of 7 mental health organisations, one from each state. 1 in 100 people in Australia suffer from schizophrenia, 230,000 people – less than 50% of them are receiving the help they need. Their life expectancy is 54 years due to various risk factors associated with their illness.

The day started with introductions by Professor Anthony Harris, Chair of One Door and Kathi Boorman, CEO of One Door. The keynote was delivered by Tim Heffernan, NSW MH Deputy Commissioner. Jason Threthowan, CEO of Headspace (image 3) spoke about the growth of Headspace across Australia with 70 organisations now running 110 Headspaces offices with PHN’s as the commissioner of services. He spoke about the lack of data being collected on unmet need for mental health services – there are no numbers on the people being turned away that then results in suicide. Since Headspace started 12 years ago as a service for 12-25 year olds with mild to moderate levels of distress, 500,000 people have been helped. Headspace is now collecting data and will produce a national youth mental health report card. A new Headspace PLUS model is being developed for the ‘missing middle’, people with moderate and complex illness. Australia is failing people of all ages with a patchy mental health system. Where do people go for longer term care?

Dr Justin Scanlan (image 4) from the University of Sydney spoke about his current research project, “Integrating Cognitive Adaptation Training (CAT)” into routine practice in Government and community managed mental health services. CAT is based on the idea of “the life that I want and the things I want to do” for people that suffer from severe mental illness. They are characterised by having had disrupted opportunities, lack of social connection, cognitive difficulties (planning and problem solving) – 30% of people have difficulty in daily function associated with their cognitive difficulties. There are two approaches to take: remediation (reduce, alter, fix) versus compensation (work around the deficits). The CAT approach takes a remediation approach by determining the ‘best fit” approach for adaptations (see image 5). CAT can be used in the home, with weekly visits by mental health workers following a structure; the CAT approach can be used to manage the symptoms of their illness. Justin wants to work with a CMO to partner a trial of the CAT approach. Contact him at Justin.scanlan@sydney.edu.au 93519022 if you are interested in participating.

Mitch Wallis, the founder of the Heart on my Sleeve Movement (reached 1 million people in its 1st week) was MC of the day and also spoke of his lived experience. Dr Annemaree Bickerton from the Family and Carer MH Program (FCMHP) of Illawarra and Shoalhaven LHD spoke about the “Staying Connected When Emotions Run High” workshops for carers and professionals supporting people with mental illness. 20 free workshops are being run across NSW. The 16th Annual Family Systems Conference being organised by the Family Systems Institute of Neutral Bay is coming up on June 19th in Sydney.

Dr Stephen King (image 6), Presiding Commissioner of the Productivity Commission on Mental Health spoke at the end of the day and was also part of the panel discussion “ Do It Better or Do It Differently?” with Lucy Brogden, Chair of the National Mental Health Commission, Carmel Tebbutt, CEO Mental Health Coordinating Council (MHCC) and Catherine Lourey, NSW Mental Health Commissioner (see image 7). The conclusion of the panel was to do it differently!

The date for submissions to the PC on Mental Health closed in April and the draft report is in progress. The final report will be given to Government on 23 May 2020. Dr King spoke about his first impressions from the submissions and comments that have been made. His biggest concern is the fragmentation in the system across many areas: there are fragmented services across Federal and State programs with little or no coordination, remote and rural Australia has less access to any services, there are gaps in the system “missing middle”, community supports are not where they are needed and there are not enough step down facilities. He said, “the key is not just how to fund mental health BUT how much and in what areas! . An investment mind set is needed and service navigation as offered in PIR and Phams programs needs to continue”. There are so many gateways into the system: GP, hospital, police, justice, Centrelink, public housing, schools, workplaces. NO WRONG DOOR needs to be the key. Data collection and evaluation of programs is needed in order to know what works best.

Panel discussion: Lucy Brogden, Chair of the National Mental Health Commission, Carmel Tebbutt, CEO Mental Health Coordinating Council (MHCC) and Catherine Lourey, NSW Mental Health Commissioner