Workbook - COPMI · 2014-10-22 · Worker 1 – I’m not sure how he's handling the kids when...

Workbook 20 August 2013

This workshop is proudly presented by the COPMI national initiative* and was developed in partnership with Lived Experience Representatives: Kerry Hawkins, Louise Salmon, Jane Grace and John Clark. Family-centred practice visual representations designed by Genevieve Flynn. Contact: [email protected] *The Children of Parents with a Mental Illness (COPMI) national initiative is funded by the Australian Government.

mailto:[email protected]

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Sessions One and Two Introduction and workshop

Following the presentations please note the following:

Examples of service-centred approaches Examples of family-centred approaches

Key points to remember:

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What would you like to change in your situation/practice as a result?

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How can you make this happen (even if only ‘baby steps’)?

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Please use this space

for your own notes or drawings

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Session Three Interview with Rose Cuff

How did this session relate to:

Systems (policy, processes, funding, etc)?______________________________________________

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Workforce (skills, education, knowledge, etc)?__________________________________________

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Families (their roles and responsibilities)?______________________________________________

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Session Four Interview with Amanda Waegeli



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Session Five Interview with Cathie Knox



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Session Six Kerry Hawkins’ presentation



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Session Seven Enablers, barriers and opportunities

Area of change Barriers Enablers

Opportunities

Systems, workforce or

families?

What currently prevents

a family-centred

approach?

What currently supports

a family-centred

approach?

What can you do?

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Please use this space


13

Reading List Putting families and children at the centre of recovery

Trowse, L., Hawkins, K., Clark, J. COPMI GEMS: Putting Families at the Centre of Recovery.

Monash University; 2013. Retrieved 6 May 2013:

http://www.copmi.net.au/images/pdf/Research/gems-edition-14-march-2013.pdf

Norris, E., Ross, D. Negotiating the balance between recovery and parenting. Psychiatric Services.

2010; 61(10).

Australian Infant Child Adolescent and Family Mental Health Association. Principles and actions

for services working with children of parents with a mental illness. Stepney: Australian Infant

Child Adolescent and Family Mental Health Association; 2004. Retrieved 15 March 2013:

http://www.copmi.net.au/images/pdf/principles-and-actions.pdf

Maybery D, Reupert A. COPMI GEMS: The importance of being child and family focussed.

Monash University; 2008. Retrieved 15 March 2013:

http://www.copmi.net.au/images/pdf/Research/gems-edition-1-july-2008.pdf

Scott D. Think child, think family. Australian Institute of Family Studies. Family Matters; 2009;

81: 37-42.

Cowling V. Meeting the support needs of families with dependent children where the parent has a

mental illness. Family Matters 1996; 45: 22-25.

Arney F, Scott D. Working with vulnerable Families: A partnership approach. Cambridge

University Press; 2010.

Ning L. Building a ‘user-driven’ mental health system. Advances in Mental Health 2010; 9: 112-

115.

Allen RI, Petr CG. Rethinking family-centred practice. American Journal of Orthopsychiatry 1998;

68: 4–15.

World Health Organization. User empowerment in mental health – a statement by the WHO

Regional Office for Europe. Copenhagen: Denmark; 2010.

Centre of Excellence in Peer Support. The Charter of Peer Support. Melbourne: Victoria; 2011.

Australian Government Department of Health and Ageing, National Practice Standards for the

Mental Health Workforce, Standard 2: Consumer and Carer Participation. National Mental Health

Strategy; 2002

Nicholson J. Parenting and recovery for mothers with mental disorders. In Levin, B.L., Becker, M.

(Eds.) A public health perspective of women’s mental health. Springer. New York; 2010.

Solantaus T. Let's Talk About Children Module 1: When the parent has mental health problems.

Retrieved 15 March 2013: http://www.strong-

kids.eu/rpool/resources/restricted/KS_Module_1_Lets_Talk_about_Children_eng.pdf

http://www.copmi.net.au/images/pdf/Research/gems-edition-14-march-2013.pdf

http://www.strong-kids.eu/rpool/resources/restricted/KS_Module_1_Lets_Talk_about_Children_eng.pdf

http://www.strong-kids.eu/rpool/resources/restricted/KS_Module_1_Lets_Talk_about_Children_eng.pdf

14

Shepherd G, Boardman J, Slade M. Policy paper: Making recovery a reality. Sainsbury Centre for

Mental Health; UK; 2008.

McLean D, Hearle J, McGrath J. Are services for families with a mentally ill parent adequate? In

Gopfert, M., Webster, J., Seeman, M. Parental psychiatric disorder: Distressed parents and their

families. Cambridge University Press; 2004.

Deakin Human Services Australia. Education and training partnerships in mental health. National

Mental Health Strategy: Australia; 1999. Retrieved 15 March 2013:

http://www.health.gov.au/internet/main/publishing.nsf/Content/C88A8F732ED31670CA2571FF0

01FC989/$File/learn.pdf

Shahmoon-Shanok R. The supervisory relationship: Integrator, resource and guide. Zero to Three.

1991; 12(2): 16-19.

Bracken P, Thomas P. Postpsychiatry: A new direction for mental health. British Medical Journal

2001; 322, 724-727.

Trainor J, Pomeroy E, Pape B. A framework for support: 3rd Edition. Canadian Mental Health

Association. Totonta; 2004.

European Federation of Associations of Families of People with Mental Illness. Dublin

Declaration: EUFAMI’s vision for the future for families. Retrieved 4 June 2013:

http://europeanbraincouncil.org/pdfs/The%20Dublin%20Declaration%20-%20EUFAMI%20-

%2024%20May%202013.pdf

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Family-centred practice…

Contrasts with service-centred approaches which do not place people with mental illness and

their families at the core of their organisation

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Family-centred practice means…

People with mental illness and their families working

together in partnership with professionals.

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Systems based on a paradigm which puts the needs, participation and

leadership of families at the forefront of planning, communication,

values and practice.

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Research with and by people with mental illness and their families

to inform evidence-based practice and practice-based evidence.

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Services which are built from the ground up by people with mental illness and

their families, including children.

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Professionals who understand that people with mental illness are part of diverse

families, which may include children, and who use that understanding to guide

everything they do.

Feel free to reproduce these diagrams, but please acknowledge COPMI:

‘Children of Parents with a Mental Illness (COPMI) www.copmi.net.au ’

http://www.copmi.net.au/

21

Appendix Putting families and children at the centre of recovery

Role Plays used in Sessions 1 and 2

Not Family-centred

Baz – That Matt’s being a bit of a wuss

Gaz – Yeah hasn’t been out with the guys for a while – says his Mrs is crook – depression or

something.

Baz – Matt should tell her to pull herself together. Take a cup of cement and harden up.

Gaz – There was no depression in my Mum’s day – take a Bex and get on with it.

Family and User-centred

Worker 1 – Matt said he’s really struggling to know what to do to help his wife Trish. Her bipolar has

been really difficult to manage and he said she seems to push him away and he just feels powerless.

Worker 2 – Yes, he said he wants to be there and let her know that he’s there for her, but doesn’t

know how.

Worker 1 – I’m not sure how he's handling the kids when she's unwell. We need to think how we can

work with Matt and Trish to see what they need at the moment to get through.

Worker 2 – Yes, a session with them might unlock some things that can help them ride out this

tough time for them. Giving Matt some support and encouragement about how he’s going with

Trish and the kids could be helpful. Some sort of respite might be good for him too - and maybe

some resources for the kids. Let’s see what they think.

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Not Family-centred

Worker - Well I’m all out of ideas on how to deal with Linda!

Supervisor - She seems very up and down and her medication doesn’t seem to be working well. I

think she may need to go into hospital to get things worked out.

Worker - She freaked out when I told her I thought she would need a stay in hospital for a while.

She’s pretty irrational at the moment. Do you think I should speak to her psychiatrist about getting

an involuntary treatment order if she’s going to be so difficult?

Supervisor – Yes and she’s a single mother so you may need to need to call in Child Protection whilst

she is in hospital.

Family and User-centred

Worker – Linda says that she is really finding it hard to settle on her new medication. She really

wants to be there for her kids but is finding it a real struggle to get up in the morning and make sure

that her kids lunches are packed, uniforms clean and pressed and homework done. She feels pretty

stressed about getting the kids to school late because she is so drowsy from her meds.

Supervisor – What services or supports has she accessed previously when she was stressed about

getting everything done?

Worker – I’m not sure. She is pretty isolated I think. She was in foster care herself and really doesn’t

want that for her kids. She’s having a really hard time at the moment. I’m not sure what to do.

Supervisor – Have we asked her what specifically she would like from us? That way we can offer her

the support she really needs, that we might not have thought of.

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Putting families at the centre of recovery

User-driven services

Historically mental health treatment services

focussed on treating people’s illness and

symptoms, in isolation from their families and

communities.1 The capability of people with

mental illness to work, learn, form relationships,

raise children and live independently was

underestimated.2

Today, recovery and wellbeing principles

encourage people’s resourcefulness and self-

determination, and support individuals to build

their own support system around their personal

goals, needs and priorities.3 Recovery is not

necessarily getting back to life as it was, but is

instead, a discovery of a new life. The term

‘user-driven’ (sometimes called ‘consumer-led’)

in treatment and support services is central to

recovery and can mean a number of things:

People who use services having choice,

influence and control over their lives.4

Services that are driven by users’ needs,

priorities and expectations.3

Peer support services being accessible to all

who need them.5

People who use services and their families

being able to participate in policy

development, service planning and

development, evaluation and research.6

Family-centred practice

While a personal recovery approach is important,

the acknowledgement of families where a parent

has a mental illness emphasises the need for

family-centred practice, including extended

family members. Approaches to family-centred

practice include:

Services that work with the family to

strengthen their individual resources.

Services and policies that work with the

whole family as a unit.7

Core elements of family-centred

practice There are four core elements of family-centred

practice:

The centrality of the family as the unit of

attention.

An emphasis on maximising families’

options and choices.

A strengths, rather than a deficits,

perspective.

Cultural and spiritual sensitivity.8

Also important is the impact of the illness on the

individual as well as on the whole family, and

the need to support all. It is essential to

acknowledge that all family members are

potentially service users (for their own issues)

and service providers (by providing support to

the person with the mental illness).

Recovery, strengths and vulnerabilities

A recovery approach is a crucial element of

family-centred practice. Indeed, parental

functioning can be intimately related to the

recovery process. It has been found that children

can give parents the strength and will to ‘keep

going’ and provide parents with meaning and

purpose, both key elements to recovery.9

Parenting may also provide opportunities for

meaningful interactions and activities with others

in the community.9

Focusing on family strengths does not mean that

problems can be ignored. The vulnerabilities of

families need to be openly and sensitively

discussed in order to help families develop

strategies to enhance their strengths and

overcome the vulnerabilities they may

experience.10 At the same time, a focus on family

vulnerabilities and strengths also needs to

acknowledge the responsibility of services and

the community to provide appropriate resources

and support.

Being truly family-centred Sometimes what is described as family-centred

practice is really mother-centred practice

(ignoring fathers), it can be nuclear family-

centred (ignoring the role of extended family

members such as grandparents), it may be

parent-centred (rendering children invisible and

inaudible) or it may be child-centred (reinforcing

www.copmi.net.au | 77 King William Street, North Adelaide SA 5006 | 08 8367 0888

24

References 1. Bracken P, Thomas P. Postpsychiatry: A new direction for mental health. British Medical Journal 2001; 322, 724-727. 2. Trainor J, Pomeroy E, Pape B. A framework for support: 3rd Edition. Canadian Mental Health Association. Totonta; 2004. 3. Ning L. Building a ‘user-driven’ mental health system. Advances in Mental Health 2010; 9: 112-115. 4. World Health Organization. User empowerment in mental health – a statement by the WHO Regional Office for Europe. Copenhagen: Denmark; 2010. 5. Centre of Excellence in Peer Support. The Charter of Peer Support. Melbourne: Victoria; 2011. 6. Australian Government Department of Health and Ageing, National Practice Standards for the Mental Health Workforce, Standard 2: Consumer and Carer

Participation. National Mental Health Strategy; 2002 7. Arney F, Scott D. Working with vulnerable families: A partnership approach. Cambridge University Press; 2010. 8. Allen RI, Petr CG. Rethinking family-centred practice. American Journal of Orthopsychiatry 1998; 68: 4–15. 9. Nicholson J. Parenting and recovery for mothers with mental disorders. In Levin, B.L., Becker, M. (Eds.) A public health perspective of women’s mental health.

Springer. New York; 2010. 10. Solantaus T. Let’s Talk About Children Module 1: When the parent has mental health problems. Retrieved 15 March 2013: http://www.strong-kids.eu/rpool/

resources/restricted/KS_Module_1_Lets_Talk_about_Children_eng.pdf

11. Shepherd G, Boardman J, Slade M. Policy paper: Making recovery a reality. Sainsbury Centre for Mental Health; UK; 2008.

12. Maybery D, Reupert A. COPMI GEMS: The importance of being child and family focussed. Monash University; 2008. Retrieved 15 March 2013: http://www. copmi.net.au/images/pdf/Research/gems-edition-1-july-2008.pdf

13. Scott D. Think child, think family. Australian Institute of Family Studies. Family Matters; 2009; 81: 37-42.

14. Australian Infant Child Adolescent and Family Mental Health Association. Principles and actions for services working with children of parents with a mental illness. Stepney: Australian Infant Child Adolescent and Family Mental Health Association; 2004. Retrieved 15 March 2013: http://www.copmi.net.au/images/

pdf/principles-and-actions.pdf

15. Cowling V. Meeting the support needs of families with dependent children where the parent has a mental illness. Family Matters 1996; 45: 22-25.

16. McLean D, Hearle J, McGrath J. Are services for families with a mentally ill parent adequate? In Gopfert, M., Webster, J., Seeman, M. Parental psychiatric

disorder: Distressed parents and their families. Cambridge University Press; 2004.

17. Social Care Institute for Excellence. At a glance 18: Personalisation briefing: implications for community mental health services. London; 2009. Retrieved 15

March 2013: http://www.scie.org.uk/publications/ataglance/ataglance18.asp

18. Deakin Human Services Australia. Education and training partnerships in mental health. National Mental Health Strategy: Australia; 1999. Retrieved 15 March 2013: http://www.health.gov.au/internet/main/publishing.nsf/Content/C88A8F732ED31670CA2571FF001FC989/$File/learn.pdf

19. Shahmoon-Shanok R. The supervisory relationship: Integrator, resource and guide. Zero to Three. 1991; 12(2): 16-19.

Authors

Lydia Trowse

COPMI Lived Experience Coordinator

[email protected]

Kerry Hawkins

Lived Experience Representative

John Clark

Lived Experience Representative

Series editors

Darryl Maybery and Andrea Reupert

(Monash University)

on behalf of the Australian national

COPMI initiative.

Contact details

[email protected]

parental feelings of failure and shame).7

Services that are driven by the needs of the

families and children who use them, will better

facilitate recovery11 and help reduce mental

health problems developing in the children.12

Practice implications

Organisational history, professional boundaries,

workforce skill limitations, narrow performance

indicators (e.g. that focus on symptom

management) and funding models that focus

only on the person with the illness are among the

barriers that constrain the ability of services to

respond to the needs of parents and their

children.13 A common enabler across systems,

organisations and workers is to utilise the

‘Principles and Actions for Services and People

Working with Children of Parents with a Mental

Illness’14 as a guide to improve system responses

and practice.

Enablers for systems:

Review performance indicators and funding

models with a family-centred lens.13

Develop policies that acknowledge the

importance of families, and the role of workers

in supporting families.14

Enablers for organisations:

Commit to the training and resourcing of

professionals so that they feel confident in

working with parents with mental illness and

their families.15

Improve collaborative practice between

existing agencies which can ‘close the gaps’

and address the needs of parents with a mental

illness and their families.16

Consider the physical nature and emotional

climate of the service to ensure it is welcoming

to children and adults.7

Revise policies, job roles, team organisation

and the allocation of resources over time to

ensure that services can meet family needs.17

Involve people with lived experience of mental

illness and their families in the education,

training, development and evaluation of the

mental health workforce.18 This includes

employing people with lived experience.

Enablers for workers:

Reflect on values. Values based on

compassion, respect, integrity and self-

determination are the foundation of family-

centred practice, while personal qualities

include a high level of emotional intelligence,

interpersonal skills and self-awareness.7

Feel and display optimism as this will nurture

hope in families.7

Develop an equal and creative relationship

between people using services and their

families.17

Engage in reflective supervision in order to

consolidate worker strengths and partner with

supervisors to work on areas that need

development.19

The Children of Parents with a Mental Illness [COPMI] initiative is funded by the Australian Government.

Further resources and information about the initiative can be found at www.copmi.net.au | © AICAFMHA 2013

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Thank-you for your participation in the COPMI TheMHS workshop 2013.

For more information on the COPMI national initiative go to:

www.copmi.net.au [email protected]

Ph: 08 8367 0888 Fax: 08 8367 0999

77 King William Road, North Adelaide, SA 5006.

http://www.copmi.net.au/

mailto:[email protected]

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