Original Content at
March 4, 2012
Day 13 of the Australian Journey 2012
By Lewis Mehl-Madrona
Today is Day 13 of the Australian Cultural Exchange Journey for 2012. After a quick morning run, we went to Mission Australia's Youth Forum 2012. We met Nancy Ingram, an elder from the area who attended Harvard University and knew about Vermont. I have a talk about the importance of heroism for adolescents and finding ways for them to be heroic or to save face when they feel they have not been heroic.
::::::::Today, I had to arise at 5 am in order to run and be on time to Mission Australia's Youth Forum 2012 forum. We had a long taxi ride across Sydney to a beautiful, green-grassed, lake present, conference center, with crazy birds with long thin beaks, who made shrieks from time to time. The atmosphere was absolutely bucolic and the conference center modern and lovely.
After lunch, we heard Leonie Green, the Director of New South Wales Community Services talk about the recently launched Mental Health Strategies for Mission Australia. She said that their previous strategy did not fully identify the need they had. She talked about their biggest barrier being how to refer clients into clinical mental health services. When people rang the mental health outreach services, they didn't get responses because they didn't have the language down that mental health used. They don't actually see themselves as a provider of mental health support services in the broadest sense, though the majority of their clients presented with mental health issues. She said, if you look at the social determinants of mental health, they are homelessness, poverty, unemployment, family breakdown, and the like, so it should be quite natural that their clients should present with mental distress. She said that mental health should be everyone's business. When people stop being homeless, poor, and unemployed, often their mental health improves.
Six months ago, they started drug and alcohol services which have been rapidly expanding. They call this a community of practice for youth services. Everyone involved with youth in that area comes to the table to interact around managing these youth with drug and alcohol problems.
Here are some of the highlights of their 2012 strategy:
1) Replace the term mental illness with the terms "mental distress" and/or "loss of mental wellbeing", as these terms were less stigmatizing and recognize the diversity of experience that bring people into contact with mental health services.
2) Services should transition from inpatient hospital to integrated community services.
3) Social determinants of mental health need to be more widely recognized and addressed.
4) Adopt a Recovery Approach to underpin service delivery.
5) Establish a Consumer and Carer Reference Group to include the voices of people of lived experience of mental distress and loss of wellbeing and their carers in the planning, design, delivery, and evaluation of services.
We learned that aboriginal people have high rates of mental illness and loss of mental wellbeing in their communities. Rates of suicide and self-harm are 2 to 5 times higher for aboriginal people than other Australians (http://www.aihw.gov.au/indigenous-Australians). The New South Wales Social and Emotional Wellbeing Policy (2006-2010) states that the tragic state of Aboriginal mental health is due to a "" complex inter-relationship of individual, historical, social, cultural, economic, and environmental factors (and that) collective distress and trauma exist as underlying stressors to aboriginal life." (New South Wales Department of Health, 2007.
We learned that Mission Australia is at the forefront of responding to the social and emotional wellbeing needs of aboriginal people, especially in rural and remote portions of NSW. At their Mac River Youth Drug and Alcohol Rehabilitation Service in Dubbo (where Sally made her documentary on elders sharing stories with youth) every referral except one had been an aboriginal youth. They anticipate providing increasing services to aboriginal persons released from prisons due to their high level s of mental distress.
Next we heard about the Recovery Model, which was also prominent at the Hearing Voices conference from Day 3 and Day 4 of this journey. It emerged from the consumer/survivor movement following the de-institutionalization era of the 1970's and 1980's. They define recovery "as a deeply personal, unique process of changing one's attitudes, values, feelings, goals, skills, and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by illness. Recovery involves the development of new meaning and purpose in one's life as one grows beyond the catastrophic effects of mental illness." (Anthony, W.A. (1993). Recovering from mental illness: The guiding vision of the mental health service system in the 1990's. Psychosocial Rehabilitation Journal, 24(2), 159-168.). The U.S. does not subscribe to the Recovery Model so much but is steeped in the biomedical model. My sense of Australia is that its physicians are also steeped in the biomedical model with a large disconnect between psychiatrists and other mental health professionals.
Mission Australia (NSW Mental Health Strategy 2012) wrote that "Recovery is not dependent on professional intervention and can and does occur without it. Recovery does not mean an absence of symptoms. Rather when achieved, it allows people to live meaningful lives regardless of any unremitting symptoms and periods of relapses". [R]ecovery is not a linear process"."
Next Dr. Ramesh Manocha, Senior Lecturer at the Sydney University Psychiatry Department and Founder of Generation Next (you can google him) spoke about meditation -- what it is and what it's not. He's planning a study with Mission Australia to teach kids at risk how to meditate. He presented a study of 40 minutes of meditation instruction twice weekly for one term who experienced improved benefits in grades and study habits. He found that the people who were experiencing mental silence several times per day or more had the highest mental health scores. People who experience mental stillness less than once per month had the lowest mental health scores. He reported taking 14 women with hot flashes who were perimenopausal for 8 weeks twice weekly meditation instruction. They were to meditate twice per day. They found a 70 to 80% improvement in symptoms using meditation at the end of 8 weeks. The majority of women maintained a benefit at 16 weeks except for one woman who stopped meditating.
At this point we had to leave the conference for our trip back to Melbourne and the final day of the Australian Cultural Exchange Adventure 2012.