AICAFMHA:
promoting mental health for young Australians
Australian Infant, Child, Adolescent and Family Mental Health Association Ltd
ABN 87 093 479 022
The Experience of Developing a Consultation Process with
Parents in a Child and Youth Mental Health Service
Authors: Kerry Geraghty, Chair, Parent Advisory Group South Brisbane C.Y.M.H.S.
Tom O'Brien Consultant Psychotherapist C.Y.M.H.S.
Erica Lee Manager South brisbane C.Y.M.H.S.
Introduction
Background
Activity
Conclusion
INTRODUCTION
Good afternoon and welcome to the presentation "Getting to Know You", the
first in a number of consumer oriented contributions today. Before I begin to talk about
the process I have been involved with over the past 3-4 years, I would like to acknowledge
the numerous consumers who have passed through the system and in so many ways have made
their own contribution to improving the partnership between parents and the South Brisbane
C.Y.M.H.S. Some have had a vital input into the organization of this conference. Something
which may have been overlooked if not for their foresight and perseverance.
As I was preparing for this presentation I came across a rather pertinent quotation in a school newsletter. It was in the deep and meaningful paragraph- the one you miss as you turn to the sport’s draw or the tuckshop roster. But fortunately for me, that week it caught my eye.
"No one has all the wisdom. Everyone has a different piece-Everyone has some of the wisdom." [Mary Benet McKinney,educationalist]
I would like to propose that this is a statement that guides the relationship between parents and the South Brisbane C.Y.M.H.S.
My involvement with C.Y.M.H.S. began in September 1997 when my husband and I presented with our 11 year old daughter,desperately seeking help for her eating disorder. We had exhausted our reserves – we were totally at our wit’s end and prayed that the experts would be able to save our daughter and our family. I had no idea then that I would be standing here sharing our experience with you today. The reason I am, is that I realize how important it is for our health professionals to gain insight into how their services are perceived by parents and that is something only consumers can realistically describe.
Our association with C.Y.M.H.S. has been ongoing for 3 years. Our daughter was chronically ill and spent 7 months in hospital and so did we!! There were some very dark times for our family. Fortunately she has shown some steady progress in the last year and although we still visit the hospital every week for ongoing therapy we are almost allowing ourselves to think of recovery or at least transition. Throughout all of this life changing experience, I have become very aware of the quality of partnerships that exist between parents and treating teams of our young patients. I am also becoming increasingly aware that everyone has some wisdom to contribute to the whole puzzle. Negotiating the emotional minefield of caring for these young people is exhausting, confusing, confronting and yet it can also be enlightening and a growing time for us as parents. The most important things any treating team can offer parents are knowledge, support, and most importantly OPEN COMMUNICATION. From my personal observations over the last 3 years spent in a number of different institutions and from conversations with other parents, this communication is essential for a family to survive an ongoing mental illness. Parents need to be listened to seriously; they need to be consulted with, kept informed of treatment plans and at all times treated with respect. When parents are not included as part of the team, when they are expected to passively accept all decisions regardless of what their concerns may be, feelings of anger, resentment, frustration and antagonism may be aroused and these contribute negativity to the communication process and no doubt to recovery. Sometimes parents need to be forthright in their discussions. They need to gain understanding of why certain treatment plans are followed. Parents are the primary carers of these troubled young people. We love them, we know them intimately and we must be there for them. They need to see that we are all pulling together to assist their recovery.
During the course of treating a young person with a mental illness there will be difficult times, some very stressful situations will occur which will require the combined efforts of parents and health professionals to support the young person. It is so much easier to cope with these crisis times when trust, confidence and respect for each other’s skills have been developed through good communication and team collaboration.
BACKGROUND TO SOUTH BRIBANE C.Y.M.H.S.
Over the past five years the South Brisbane C.Y.M.H.S. has been exploring a collaborative
approach to providing a comprehensive mental health service to a population of 400,000
people. There had always been consumer satisfaction surveys in the service but the need
for more consultation has increased. Naturally in 5 years only some of the grand plans
first aspired to have been attained and in our discussion time we may further expand on
this history The one and a half plans operating are the Parent Advisory Group and the
series of focus groups on the needs of adolescents that have been run with youth
consumers.
As a member of the Parent Advisory Group I have been involved in a number of activities
which complement this collaborative approach. The group meets twice a term ie 8 times a
year. Each term it meets once as consumers only [including at the invitation of the Parent
Advisory Group; Erica Lee and Tom O’Brien, the staff who have worked with the
consumer program since its inception] and the second as consumers and team leaders from
the community clinics. Dr. Michael Beech, Director of the service comes to the meeting
once a year to hear directly the concerns of the Parent Advisory Group.
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ACTIVITY
Slowly we are planning and formulating our own agenda for our role to be more effective.
Since I have joined this group we have been involved in hosting a discussion evening
during mental health week which involved a parent speaker and a young person recovering
from a mental disorder as well as a psychiatrist and a social worker all of whom entered
into a discussion forum ;
Writing and encouraging other parents to write articles for the new newsletter Keeping Kid’s in Mind, an initiative of the Mater Management Unit to further develop the profile of the service. The feedback we have received has been very positive especially regarding the consumer page. Parents should never under estimate the knowledge they can impart to health professionals. Their perspective on what was helpful, what worked, what failed, can be of great benefit for future cases.
The opportunity to listen to developments around the clinics, personal contacts with staff and management provides a sense of unity of not being isolated in our journey. It is encouraging to see that worthile progress is occurring in the support area for young people and that some clinics are using creative ways to gather their young patients together in order to meet their needs. These meetings also allow staff to air opinions and ask for consumer input on specific issues eg new hospital/training programmes. Consumers have also been regularly invited to speak at a number of conferences [A.I.C.A.F.M.H.A. conferences, South Brisbane C.Y.M.H.S.,Q.C.A.G. ] and in so doing have raised the awareness of the realities of mental illness. Consumers have also been the instigators behind the formation of specific support groups and also in setting up local displays and information books at the community clinics..
Although there has been enormous progress in the input by consumers, sadly there is still a need to educate some health professionals in this area Taking the input of consumers seriously and acting on their suggestions is still a challenge for some organizations and for some individuals but I can only encourage both groups to try to see the benefits of collaboration Good team work results in better staff morale and therefore more successful outcomes for patients. -. There also needs to be an appreciation of just how exhausting and emotionally draining living with the young person is. I know there are times when staff reach the end of their tether but for the parent there is often no escape from the stress.
This probably brings me to the next problem encountered by consumer groups such as ours. Burn out of its members. For many of us extreme exhaustion is all too familiar and the prospect of attending yet another meeting is too daunting. What can be useful is a management approach that respects how much a person can contribute and does not over burden its members. Tapping into specific support groups can be a useful resource when certain information is required. Use of e-mail and fax allows people to contribute ideas without attending a meeting. There is room for all to make a contribution. Working in the confines of a large institution brings limitation to what can be realistically achieved. Budgets, priorities and policies all dictate the implementation of consumer’s ideas and this needs to be appreciated. In the future pressure may be applied to support consumer participation by financial reimbursement. .
CONCLUSION
In conclusion I would like to say that although there are problems to overcome, I have
strongly supported the consultation process between consumers and CYMHS,- both as a parent
of a young person struggling to win a battle over a deadly disease and as a member of a
wider team trying to promote better mental health service to our young people. Mental
health disorders affect all the family and the best way to handle the pressures and on
going stress is to work in collaboration with the team. There should not be a "winner
takes all" approach to negotiations which occur between consumers and the CYMHS. It
is time to work together, consulting, supporting, respecting each family and acknowledging
each other’s wisdom. I have been very privileged to work with very dedicated and
skilled health professionals. I have witnessed their efforts to include consumers, parents
and carers in their decision making and I am truly grateful that for our family we
benefited from that commitment.
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