Leading the Way

We had another important Infant, Children and Adolescents Mental Health and Alcohol and Other Drugs Services Sectors Leaders Day on 25 August, where we were honoured to welcome:

⦁    Anja Theron of Maternal, Infant, Children and Adolescents Mental Health Service Team (MICAMH), Bay of Plenty District Health Board (BOP DHB), who shared the unique and informative experiences of the MICAMH Team in the area and their past six year journey;

⦁    Colin Hamlin and Peter Kennerley from the Ministry of Health (MoH) provided an update on the new strategic MoH framework and the dual focus vision of services promoting well-being and while effectively identifying and responding to mental health needs;

⦁    Associate Professor Marc Wilson from Victoria University, gave a review of the suicidal and non-suicidal self-injury knowledge base, it’s gaps and the important work to fill them by the team at Victoria University and beyond;

⦁    Dr Arran Culver, 3DHB Programme, who reminded us that data does not equal story, and provided an in depth analysis on youth suicide risk and developmental determinants;

⦁    Vas Ajello of our sister organisation, The Werry Centre, gave a key overview of the updates to the Early Childhood (0-5yrs) Mental Health Post Graduate course, new course ‘Youth Addictions and Co-Existing Problems’ as well as a proposed Masters of Health Practice in Infant, Child & Adolescent Mental Health for 2019;

⦁    And Maria Baker of Te Rau Matatini who gave an engaging presentation on the aims and structure Waka Hourua-National Māori Suicide Prevention Programme;

 

We’d like to thank all of our wonderful speakers and to those of you who availed of the day. We’d also like to afford special thanks to Lee Chrisholm, Contact Centre Manager of NetSafe for the links provided on the need to respond to harmful digital communications. These links and all presentations are available by following the hyperlinks, and where you can also sign up to stay up to date with future Sector Leaders by registering with us online.

PAG Biennial Fono 2017

After our popular screenings of ‘Resilience: The Biology of Stress & The Science of Hope’ in Auckland and Wellington, we showed this documentary in Christchurch late October at the Mental Health Education & Resource Centre (MHERC).

The film delves into the science of Adverse Childhood Experiences (ACEs) which are now understood to be one of the leading causes of everything from heart disease and cancer to substance abuse and depression. Beginning with the results of The ACE Study of over 9,500 adults published in 1998, ‘Resilience’ reveals how extremely stressful experiences in childhood  are capable of altering brain development and have lifelong effects on health and behaviour.

Due to the sheer number of practitioners who were keen to come along, we added an additional screening.  Thank you to all who came to see this important film.  

 

 

 

 

 

 

The film was accompanied by an informative presentation from practitioner, Robbie Cave. As a learner of the new approach of Sensorimotor Psychotherapy, Robbie gave attendees in depth introduction to this new approach to treatment of those recovering from traumatic events. Showing our audience incredible footage of the practical implementation of this intervention provided by the Sensorimotor Psychotherapy Institute.

Showing how tracking the body can reveal so much of our past experiences, Robbie was able to demonstrate how an individual's body ‘remembers’ what verbal manifestations sometimes do not. Through a video demonstration, the audience was able to see the body being utilised as an entry point in traumatic therapy, and achieve healing through a blend of cognitive and emotional approaches to psychotherapy for the sensorimotor intervention.

We received wonderful comments and support from your evaluations and we look forward holding future events that will continue to interest, inform and support you thoughout your work.

Great conversations:
Third National Co-Existing Problems Telepaed, 2017

Since our last newsletter, we hosted the third national Co-Existing Problems (CEP) Telepaeds, where we welcomed 17 dedicated practitioners to discuss the latest issues in the sector. Our recent work with Matua Raki for resource ‘Bridging the Gap’ was a topic for discussion, as well as receiving valuable feedback and advice on our now released youth aimed info cards. These cards will be a helpful resource for practitioners and others to engage and inform youth in a non-judgemental and supportive way.

The CEP telepaed group have also been piloting and providing feedback this month on the new SACS ABC Brief Intervention which we hope will have helped support the vital work they do in the AOD sector. A refreshed intervention for primary services, the SACS ABC manual also received some excellent feedback and thoughts.

Funded by the Ministry of Health, this brief intervention is designed for young people aged 13 – 20 and is adapted specifically for GPs for brevity and to align with the well-known ABC approach for smoking cessation and alcohol. Many of our CEP network are still in the process of roll outs, but initial thoughts and feedback has been positive and we’re proud to continue providing assistance where needed.

 

New Alcohol and Other Drugs Youth InfoCards Released

This month we’re proud to release a series of new youth-friendly resources that are designed to give children and young people a quick reference point to know what they need to know about drugs, where to get help, and what to do for a friend in distress.

These non-judgmental and honest reference cards introduce teens to the real deal when it comes to effects of Meth, MDMA, Cannabis, Alcohol, Psychoactive drugs, LSD and partying in general. Colourful and easy to digest, our Youth Consumer Advisor has consulted with us to confirm that they’re both appealing and suitable for the youth audience. You can order these from the NZ Drug Foundation website by clicking here if you'd like us to post these resources to you for distribution at your workplace, or download them now by using the links below. 

• About Alcohol
• About Cannabis
• About MDMA
• Safer Partying
• About LSD
• About Methamphetamine
• Psychoactive Drugs

Practical Approaches to the Pōwhiri Poutama Framework

Hoani Watene and Brett Mataira of Hauora Tairāwhiti gave us an insight of how the Pōwhiri Poutama framework (1991) can operate in practice, through their work in the Tairāwhiti district health area for 14-19 year olds.

Many New Zealanders are aware of Pōwhiri, an important Māori ritual of greeting and understanding. Less well known is ‘Poutama’, which refers to a stairway design commonly seen in tukutuku (weaved lattice) panels on the walls and ceiling in decorated houses.

In Māori culture, many ICAMH/AOD clients can be considered as separated or detached, positioning them as tangata whaiora. Marae protocol positions tangata whaiora as tapu (his or her potentiality is restricted), an individual’s status before being called to pōwhiri. As such the Pōwhiri Poutama framework for counselling, is a meta-map for the task of scaffolding across a developmental phase or therapy (Drury, 2007).

Watene explained that through the seven stages of the framework (Karakia, Mihi, Whakapuaki, Whakatangi, Whakarata, Whakaora and Whakaoti), there can be effective communication with youth via a relationship on personal, social and spiritual levels. Watene suggests grounding oneself (Karakia) before a meeting and a simple mihi of ‘Kia Ora’ can be both practical and simple. Watene also opens with three Whakatauki (Proverbs) and a warm up or intro inviting the ancestors to take care of us.

“Let the philosophy drive the model” Watene recommends, noting that the original message of Marae ancestors is to share our experiences of one another. Reconnection within addiction work is paramount he adds, and embracing the cultural identities of our Māori youth can make all the difference.

For more, follow the below link to Drury’s research:
Drury, N. (2007). A Pōwhiri Poutama Approach to Therapy. New Zealand Journal Of Counselling, 27(1), 9-20.

New screening initiatives Rataora RapidReferral

George Morris in Northland gave us interesting new feedback on Rubicon's recent trial of supporting referrals through the Rataora RapidReferral screening app. Rubicon has been receiving referrals provided by the Emergency Department, wider Hospital, and the Police via their ipads, which are connected to RapidReferral through an app.

The app been has developed using the latest screening, brief interventions and Referral-to-Treatment research, and has previously been deployed in Wellington Hospital’s Emergency Department. Over 1200 patients there were identified as having Alcohol User Disorder by medical staff using the app, who then referred these patients to a connected network of services, including community based providers like Rubicon.

In Northland, the Rubicon team found no problem in using the new SACS ABC Brief Delivery approach to review incoming referrals, and hope to review its effectiveness later in treatment. The team also hope to develop networked services support for youth should the pilot lead to a roll out, especially for schools and communities such as Whangarei, Kaipara and far North.

One key finding however, has been in coming across referrals affected by complex trauma and the team now hope to investigate ways to respond. This also highlights the need for many of our services to be aware of trauma, and trauma informed care.

Where we've been: The Mental Health Service Learning Network in Sydney Australia

Late August our Senior Adviser Bronwyn Dunnachie and Business Analyst Leanne Eruera attended the Mental Health Services (The MHS conference) organised by the Mental Health Learning Network (MHSLN) in Australia. Run by a volunteer management committee, MHSLN promote positive attitudes to mental health while stimulating worthwhile debate that fosters idea exchange. This year’s conference welcomed a diverse mix of 800 delegates coming together to discuss “embracing change through innovation and lived experience”. This brought forward important discussions on making connections and recovery orientated practice, including the need to support personally defined success.

While the event had many talks and discussions that are more than worthy of report, we’d noted three of key interest to our New Zealand context.

‘Disruptive innovation’

Prof Mike Slade of MH Recovery and Social Inclusion from University of Nottingham discussed the intriguing concept of ‘disruptive innovation’. This argues the ‘disruptive transformations’ caused by our increased use of community-based service spaces has brought forward the need for ‘disruptive innovation’, to sustain and improve the effectiveness of their implementation.

One such suggested innovation which spoke to us was seeing lived experience as an asset to change, both in peer support worker and peer trained roles. This we know has supported much of what we’ve seen achieved by many of you.

‘Two Eyed Seeing’

Professor and Psychiatrist Lewis Mehl-Madrona from Vermont, spoke on building culturally appropriate mental health services, reflecting on his experience with Cherokee Indian communities in North America. Noting today’s dominant paradigm of epistemologically positivistic approaches to biomedical psychiatry, he discussed the model’s invariable dismissal of indigenous wisdom and potential short sightedness. As a rebuttal of overreliance on this epistemological basis, he provided an engaging presentation how indigenous approaches to psychology has something important to offer the modern world.

Two-eyed seeing is one such important offer. It is a new approach that can help practitioners embed an indigenous, humanistic understanding of ‘knowing’ that can help develop and share our understandings as individuals who are interdependent and interconnected within communities and wider world. This divergent epistemological approach to acknowledging truth by accepting a client’s version of reality, brings forward an enriched awareness of our interrelatedness via a collaborative interaction style of explanatory pluralism, supported by critical guiding principles covering all aspects of our lives.

Two eyed seeing is emerging as a way to integrate indigenous knowledge with other knowledge systems. More information can be found here: http://www.integrativescience.ca/Principles/

Trauma Intersecting with the law

Dr Cathy Kezelman, Director of the Blue Knot foundation, spoke on the importance of trauma-informed services, and highlighted the need to expand this to the justice system particularly. Attachment and neuroscience insights don’t inform law education she noted, and expressed the real need of legal practitioners to apply a trauma lens when reflecting on individuals.

Such individual,s Kezelman noted, ought to be worked with rather than acted upon. She highlighted the stressful challenges of the legal system for those experiencing trauma impacts, and how these can affect the person’s ability to provide a coherent narrative, necessitating the need for opportunities to provide their testimony in a supportive environment cognisant of their experience. As such, trauma informed lawyers might be able to work with these people to protect them from further negative impacts.

Trauma informed care needs to be a focus for the legal community and wider services as a whole, as the majority of New Zealand’s maltreated children will experience the impacts of trauma. So we encourage you to review and share our recently launched trauma informed care when working with infants, children and adolescents training which is suitable for all audiences including all those working in the legal system.

If you or some of the networks you work with can benefit from understanding more on Trauma Informed Care, see our FREE modules https://www.goodfellowunit.org/courses/childhood-trauma-impact-developme...

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