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Putting Prevention into Practice
PREVENTING MENTAL HEALTH PROBLEMS IN FAMILIES AFFECTED BY PARENTAL DEPRESSION
Nick Kowalenko Deputy Chair, AICAFMHA Senior Lecturer University of Sydney Chair, Faculty of Child & Adolescent Psychiatry, RANZCP
Depression and Families
1 million Australian children live with a parent who has depression(estimate)
Mental illness: 2-4 times higher40-70 %
Social, developmental, educational and emotional difficulties (Beardslee, Solantaus, Morgan, Gladstone & Kowalenko, 2012)
Paternal and Maternal Depression (Fletcher et al 2011)
PPEI Concepts
Ottowa Charteroften via family members & people who work with children, parents and families
through key partnerships that can influence local change
facilitating broad participation in the planning, development, implementation & evaluation of strategies
including development of accessible, high quality resources & guidance for organisations
especially as it relates to identification of strengths, needs & support for families.
Developing personal skills and
knowledge
Developing locally supportive
environments
Supporting community action
Reorientation of services
Influencing the development of
public policy
Developing personal skills and knowledge
Developing locally supportive environments
Supporting community action
Inclusion of People recovering from mental illness
and those that care for them (including
young people) in the development of guidelines, information, and workforce development resources within the COPMI national initiative
Reorientation of Services: Sustainable systems change
Children of Parents with a Mental illness. Systems Change in Australia Report Owen Educational Consultancy http://www.copmi.net.au/images/pdf/Research/final-report.pdf
Developing Quality Resources
Family Focus: Prevention in Practice
COPMI national initiativeFunded by Department of Health and
Ageing in 2010-2012 to develop:DVD – for families where a parent has
depression or anxietyelearning resource – to train mental
health clinicians in a preventive family intervention
Family Focus Origins
Studies on risk/resilience in COPMIBeardslee ‘Family Talk’ interventionPilot version developed in USARCT: Lecture material Vs clinician
facilitated intervention (Beardslee, 2008)
Outcomes of Family Focus
Child Diminished internalising
symptoms Increased understanding of the
parent’s illness increased recognition and
treatment of children with depression. 6 7
Parent/s increased understanding of
mental illness improved understanding of their
children felt assisted with child and illness
related concerns improved outlook for the family's
future. 4 6 8
Family increased family
communication about parental mental illness
increased positive family interactions
improved family functioning increased family problem-
solving regarding experiences of parental depression. 6 9
Mental health professional increased satisfaction and job
motivation at work improved collaborative
relationships with local organisations. 2
Child/Parent Family/Professional
Keeping families and children in mind
Family Focus DVDChildren Observe
Build parent awareness that mental illness is a family experience
Children make senseCommunicate with children about
mental illness to help them make sense of what it happening
Children respondSupport parents to recognise that they
can influence this response (and future outcomes)
Family Focus DVD
Parent only sectionLived experience interviewsFictional storylines (promote key
messages)
Family Focus DVD
Children’s sectionParents can show
children (8-12 year olds)
Starting point for communication about parent depression or anxiety
Family Focus: e - learningSix modules1 Working with us
Working with familiesWhy focus on families?PreventionDeterminantsRisks &protective factorsYour practiceMental health promotion...etc
2 Building understanding
3 Dialogue with the child
4 Partnering with parents
5 Resilient families
6 Enabling the future
Family Focus intervention
The futureDissemination into routine practiceSkills training for primary, secondary &
tertiary workforceRights agenda & legal initiatives Younger age groupsCoordinate and support evaluation &
research initiativesGrowing consumer leadership Marketing strategies (especially to rural
areas)
The future (continued)Key partnerships
AOD Physical illnessChild protectionIncarceration
Collaborations Professional Academic Non government & governmentCare pathways Consumers
New COPMI website
do what it does without input
COPMI couldn’t
from so many people ...
Australian Government
Department of Health and
Ageing
Thank you ...
Useful resources
Resources for dads
Challenges Impact is difficult to assess Evidence base limitations Preventive health is poorly funded Mental health is poorly funded
relative to physical health Child and adolescent mental health is
poorly funded relative to adult mental health (WHO, 2003)
The futureDissemination into routine practiceSkills training for primary, secondary &
tertiary workforceRights agenda & legal initiatives Younger age groupsCoordinate and support evaluation &
research initiativesGrowing consumer leadership Marketing strategies (especially to rural
areas)