Abstract
WS01 CLINICAL UPDATE ON GAY AFFIRMATIVE PSYCHIATRY
Gene Nakajima, Sami Kalife, Sean Chappin, Howard Rubin
WS02 WORKING TOGETHER FOR OPTIMAL RECOVERY FROM BIPOLAR DISORDER
Martha Sajatovic, Frederic Blow, Amy Kilbourne
WS03 INITIATIVES TO SUPPORT AND PROMOTE THE WELLBEING OF TRAINEE PSYCHIATRISTS
Fran Arcuri, Kym Jenkins, Sam Margis
To provide information about two models of support for psychiatry trainees:
mentoring program peer support program
And how they have been established in an inner metropolitan psychiatric service. To stimulate discussion amongst delegates about how these models, as well as other potential forms of support meet the needs of trainee psychiatrists.
Both models of support are beneficial and are complementary.
All processes of support need to be dynamic, flexible and anticipatory so that difficulties can be dealt with early.
Evidence is limited regarding the efficacy of such support programs, is largely qualitative in nature. Reports suggest that they have been well received and have good face validity.
Further research into this field is needed to enable support programs to be implemented more broadly. Greater resources and organizational support is essential for the continuation of these programs so that the important issue of trainees’ wellbeing continues to be addressed.
THE NEED FOR SUPPORT SYSTEMS FOR JUNIOR DOCTORS
Fran Arcuri
This paper presents a review of the literature pertaining to the health and need for support of doctors in training.
MENTORING PROGRAMS FOR PSYCHIATRIC TRAINEES
Kym Jenkins
The establishment of a mentoring program in the psychiatric department of a major teaching hospital is outlined. The progress and evaluation of the program over three years is described and critically evaluated. Suggestions are made regarding “optimal” mentoring programs.
PEER SUPPORT FOR PSYCHIATRIC TRAINEES
Sam Margis
The background to and the setting up of a peer support program for psychiatric trainees is described together with initial reports of its perceived success.
WS04 PROMOTING GREATER AWARENESS OF MENTAL HEALTH ISSUES THROUGH ART
Eugen Koh, Hans-Otto Thomashoff, Bradley Shrimpton, Rosalind Hurworth
The growing trend of caring for people with mental illness in the community has highlighted the impact of damaging stigma mental illness. This stigma increases the isolation of people with mental illness. Stigma also prevents people who experience mental illness from seeking early intervention and treatment. One of the main cause of stigma is a fear of mental illness that arises from ignorance as to what mental illness is. Another factor is the continual portrayal of negative images of mental illness in the media.
This symposium shall explore how art may be used to promote a greater understanding of mental illness and foster a more positive image of mental illness in the general community through the activities of the Cunningham Dax Collection.
The Cunningham Dax Collection is a body of more than 12,000 works by people who have experienced mental illness and/or trauma and has been assembled over the past 60 years. Its mission is to promote more widely a greater understanding of people who experience mental illness and/or trauma, and foster an appreciation of their creativity, through the ethical preservation and presentation of their original works.
ART AGAINST STIGMA: INTRODUCING THE CUNNINGHAM DAX COLLECTION
Eugen Koh
This paper begins with a brief historical overview of art in mental health and discusses the role Dr Eric Cunningham Dax had in the development of this field over the past 60 years. It then discusses the activities of the Cunningham Dax Collection. The usefulness of art in countering stigma and increase mental health literacy is considered through a presentation of some of the images of the artworks from the Collection.
PROMOTING AN UNDERSTANDING OF MENTAL ILLNESS THROUGH ART: INDEPENDENT EVALUATION OF THE CUNNINGHAM DAX COLLECTION
Bradley Shrimpton, Rosalind Hurworth
The Cunningham Dax Collection is one of the world's largest collections of art by people with mental illness, consisting of over 12,000 works. The aim of the Collection is to foster awareness and understanding of mental illness amongst the general community to counter the problem of stigma. One way this has been achieved is through school partnerships with the training of Victorian VCE Psychology teachers as well as education tours for school students and outreaching touring exhibitions in the community.
In 2007, the Centre for Program Evaluation was commissioned to undertake a review of the collection in relation to the impact of such partnerships and programs. The specific aims of the review have been to determine the relevance, effectiveness and impact of the Collection and whether it has been able to demystify mental illness. This paper aims to discuss the progress of the evaluation.
Methods used within the review have been participant observation, interviews, focus groups and survey's of program participants. Results determined to date will be presented and preliminary conclusions drawn.
USE OF ART FOR MENTAL HEALTH EDUCATION: ISSUES TO CONSIDER
Eugen Koh
For many, art is an object of beauty or expression. Few recognise art as having an educational function. The art of people with an experience of mental illness is an invaluable, but under utilised, educational tool. However, exhibitions of these type of art may run the risk of being seen as “freak shows” with the emphasis on oddity and strangeness. These exhibitions will lead to negative perceptions of mental illness and go against any effort to counter stigma.
WS05 POSTGRADUATE TRAINING IN PSYCHIATRY IN ASEAN: SIMILARITIES AND DIFFERENCES
Pichet Udomratn, Hussain Habil, Felicitas I. Artiaga-Soriano, Hong Choon Chua
The term ASEAN refers to the political, economic and social grouping of Association of South East Asia Nations. The ASEAN region is geographically situated at the heart of Southeast Asia and while it generally has a tropical climate it is extremely diverse in political, religious, linguistic, ethnic origins, and also perhaps training in psychiatry. In this symposium, residency training programmes will be presented from Malaysia, the Philippines, Singapore, and Thailand. Participants will learn the outline of the curriculum, teaching in psychotherapy, clinical supervision, the examination, and accreditation of training institutions. The differences and similarities of training programmes will be compared. If it is possible, then working together for the unification of psychiatry training in ASEAN is challenging.
WS06 SPECTRUM DISORDERS IN PSYCHIATRY
Debashis Ray, Pedro Ruiz, Asit Baran Ghosh, Dipesh Bhagabati, Asim Mallik, Gautam Saha
Like other disciplines of medicine psychiatry should also start a nosological shift from categorical to a more dimensional paradigm for greater accuracy of diagnosis and treatment.
The term “spectrum” was first used in psychiatry in 1968 for the schizophrenia spectrum which integrated schizoid personalities (Kety et al., 1968). The spectrum concept was arguably first used in psychiatry by Kretschmer in 1921 for schizophrenia (schizothymic > schizoid > schizophrenic) ¬and for affective disorder (cyclothymic temperament > cycloid ‘psychopathy’ > manic depressive disorder).
Various models have been postulated to explain the problems with the boundaries between the Axis I and the Axis II disorders. Common cause models, Spectrum models, Vulnerability models, Pathoplasty models and Complication models. Of these the Spectrum models have been the most reliable and unifying in empirical researches and family studies contributing to cognitive/perceptual aberrations, affective regulations, and impulse control and anxiety modulation. There are several spectrum disorders described in psychiatry today which are one of the major final common pathways in the making of ICD-11 and DSM-V.
SPECTRUM OF POST TRAUMATIC STRESS DISORDERS
Dipesh Bhagabati
Historically symptoms of post traumatic stress disorder (PTSD) have been described first by an Egyptian Physician in 1900BC. During the American Civil War Soldiers Heart was described. In 1871 De Costa's syndrome came to be known. Till DSM III, the features similar to current PTSD were described under various names.
However, various authors have opined that PTSD cannot be described as a single entity. Residual PTSD and Sub-Threshold PTSD are two entities of the spectrum. Partial PTSD has been described when people have the re-experiencing cluster and either hyper arousal or avoidance cluster.
Dimensional approach to stress related disorders spectrum can also be described under the following: Symptom severity, Nature of stressors and Response to trauma. It has also been observed that even if the person may show features of PTSD and experience stressful event, avoid reminders, have hyper arousal with significant impairment but may fail to qualify for PTSD if stress is not deemed traumatic. Pure PTSD is relatively rare and response to trauma is heterogeneous. Responses to trauma is varied as well as other disorders like Borderline Personality Disorder, Major Depressive Disorder, Anxiety Disorder, Alcoholism and Drug misuse can be co morbid conditions. Life events can also generate as many PTSD symptoms as traumatic events, raising the question – “Are traumatic events specific as a cause of PTSD?” Chronic and debilitating PTSD symptoms have been observed in middle aged or older widow and widowers after chronic terminal illness.
As such PTSD can be said to be a spectrum disorder and not a single entity.
SPECTRUM OF MOOD DISORDERS
Asim Kumar Mallik
Mood disorders represent a wide gamut of complex psychopathology. Here ‘unipolar’ depression cohabits atypical, ‘pseudounipolar’ and bipolar variants across confounding variables like medical and psychiatric comorbidities like anxiety disorders, substance abuse. In 1977 Akiskal proposed a cyclothymia-bipolar spectrum. In 1981 Klerman proposed a mania spectrum. The current status of the spectrum of mood disorders is both as a spectrum of severity along psychotic/ nonpsychotic dimensions and durational parameters and as a spectrum of proportionality of the two major components of mood viz., mania and depression. The need of the hour is a dimensional approach to the patient which may extend the mood spectrum even to schizophrenia and schizoaffective disorders if long-term follow-up studies over at least 10 years are available.
SCHIZOPHRENIA SPECTRUM DISORDERS
Debashis Ray
Schizophrenia spectrum disorders (SSD) are defined as disorders which do not fulfill the diagnostic criteria of schizophrenia, share signs and symptoms, causes and risk factors and must be etiologically related to schizophrenia especially to familial and genetic factors.
What Bleuler described as “latent schizophrenia” and what was later described as “pseudo neurotic schizophrenia” by Hoch & Polatin (1949) later became the nucleus of the spectrum concept of schizophrenia after Meehl introduced the construct of schizotaxia, a stable syndrome of neuropsychological deficits & negative symptoms in relatives representing special vulnerability to schizophrenia.
WS07 WORKING WITH VOICES, WORKING WITH DISTRESSING BELIEFS
Patte Randal, Debra Lampshire, Janette Symes
Learn the “re-covery” model with its understanding of how to turn vicious cycles into victorious ones as we decrease our vulnerabilities and increase our strengths and how this relates to normalisation and validation. Learn the 5-part model, chain analysis, and how these can be used effectively in group settings to aid with dealing with voices and distressing beliefs. Learn effective skills for building and enhancing strengths. Learn effective skills for enhancing coping skills, reducing vulnerability and developing distress tolerance, including mindfulness.
The models and skills will be demonstrated by didactic teaching, their use will be role-played, with opportunity for participants to work with their own experience of distressing thoughts, beliefs or voices.
WS08 HOW CAN WE IMPROVE CONSUMER AND CARER INVOLVEMENT IN PROFESSIONAL ORGANISATIONS?
Ingrid Ozols, Jim Crowe, Murray Cameron, Wayne Miles
Many years on and this is still far from reality.
This discussion will focus on what does consumer and carer participation mean? How do we move from reality to rhetoric, the tokenism that still exists today needs to be moved towards a genuine philosophy where it is natural, automatic to have the lived perspective interwined in everything.
From the consumers and carers at the Royal Australian and New Zealand College of Psychiatry's board of community and professional relations, we will commence to explore these questions and provide some insights towards finding answers to these questions. We will also be using real examples from Australia and New Zealand sharing models of what has worked, how and why.
To increase understanding about consumers and carers and how we can better work together. To share examples/models of what has worked. To demonstrate the role of consumers and carers to help build links stronger links with the mental health sector to enhance services and treatment and enrich recovery of those touched with a mental illness. To highlight challenges and barriers that consumer and carers face when endeavouring to participate in organizations.
WS09 INTERNATIONAL PARTICIPATION IN HEALTH AND DISABILITY POLICY AND GLOBAL LEADERSHIP
Harry McConnell, Ashley Pardy, Tenagne Haile-Mariam
To appreciate the role of civil society in international policy development and selection of policy leaders To look at the role of transparency in international health and disability policy and leadership choice To understand the role of communications technologies in facilitating debate in global health and disability To review the experiences relating to the World Bank, WHO, African Union and the Afro-Caribbean Pacific/European Union and other international bodies in participating in debates using interactive media.
International Health and Disability Policy should be a participatory process for all stakeholders. Telecommunications facilitates global debate and international participation by stakeholders in policy development and the choice of leadership.
INNOVATIVE APPROACHES FOR LEADERSHIP DEBATES
Harry McConnell
Professor McConnell will look at his experience of organizing and convening two debates for candidates for the position of Director General for the World Health Organization. He will review also related experiences relating to the World Bank, WHO, African Union and the Afro-Caribbean Pacific/European Union and other international bodies in participating in debates using interactive media.
USE OF TECHNOLOGIES FOR COLLABORATION FOR DEVELOPING NATIONAL HEALTH AND DISABILITY POLICY
Ashley Pardy
Ms Pardy will examine a current project aiming at establishing a national policy for mental health and disability in Ethiopia using innovative approaches for international collaboration. This is developing with key stakeholders throughout Ethiopia as well as internationally following on from the model of the Harvard-WHO Mental Health for nations programme and using real time and asynchronous methods of collaboration including Videoconferencing, Desktop conferencing, Wiki, document sharing, and online polling in addition to more traditional onsite methods.
eLEARNING, CAPACITY BUILDING AND LEADERSHIP IN DEVELOPMENT
Tenagne Haile-Mariam
This presentation will expand on the experience of the use of technology for establishing effective mental health and other health and disability policy through her personal experience in Ethiopia and her work in the WHO Director General Online Debates and African Union Summit. Dr Haile-Mariam has used innovative approaches to collaboration for capacity building including digital satellite radio, and low bandwidth solutions allowing participation in areas with little or no reliable electricity or telecommunications infrastructure.
WS10 INTERNATIONAL COLLABORATION IN TEACHING NEUROPSYCHIATRY
Harry McConnell, James Quattrochi, Wendy Ham, Prita Chathoth, S. Rangarajan
To understand the challenges and added value of case-based, real time and asynchronous learning across multidisciplinary networks. To identify the available networks for teaching and learning in industrialized and developing countries. To gain appreciation of tracking the learning path in real time case simulation of a problem solving, clinical event and the advent of new problem based learning environments using the ICON system not usually considered with traditional educational resources and tools. To identify the available mechanisms for reaching areas with no telecommunication infrastructure. To understand cross-cultural, global issues in teaching Neuropsychiatry in different regions.
Real time, problem based learning offers a unique opportunity to identify and measure decision making processes and outcomes in medical students and clinicians, affording a stimulating way for students to partner with clinician mentors in learning critical clinical concepts placing them in the position of decision making and team care of the patient. Many web-based platforms and networks are available to make international and cross regional collaboration easy and affordable. Clinical Neuropsychiatry can be taught with remarkable vertical range in a cross cultural, global partnership of practice across borders, advancing a new multidimensional assessment of learning behaviors and competencies. Digital satellite radio offers real time and asynchronous delivery to areas with no electricity or existing telecommunications infrastructure. Interactivity is key to success in any online pedagogy and is particularly important in establishing a new order of international collaboration.
WS11 BREAKING THE CYCLE: PEOPLE WITH A MENTAL DISORDER AND THE JUSTICE SYSTEM
Eva Perez, Ashley Dickinson
The justice system sees the effects of mental disorders on individuals and communities every day. We know that they can impact greatly on how safe, supported and included people feel. Accordingly, the justice agencies are focusing on building knowledge, partnerships and service options to better understand and meet the needs of people with a mental disorder.
In this workshop, representatives from police, court, corrections and mental health services will use several hypothetical case studies to discuss the issues and options they face and the strategies they use to intervene early, effectively and collaboratively.
The workshop will be relevant to practitioners in other jurisdictions as it will highlight specific programs, processes and tools that have been developed in Victoria to contribute to better mental health outcomes for individuals who come into contact with the justice system.
The panel looks forward to an interactive session with the audience and the potential to share and get feedback on their approach.
WS13 MENTAL HEALTH AND RECOVERY IN THE GULF COAST AFTER HURRICANES KATRINA AND RITA: LESSONS LEARNED
Richard Weisler, James G. Barbee IV, Mark H. Townsend
Hurricane Katrina was the most devastating natural disaster in US history. Large parts of New Orleans and nearby Louisiana parishes were destroyed. About 90 000 square miles of the Gulf Coast, an area roughly the size of Great Britain, was declared a federal disaster area. As recently as June 19, 2006, Federal Emergency Management Agency officials estimated that about 2.5 million Gulf Coast residents may have been displaced from their homes by Hurricanes Katrina and Rita, this number is based on FEMA applicants whose mailing addresses were outside of their home zip code and the assumption that each applicant represents an average of 2.5 people. Although more than 1.5 million residents fled the storm, hundreds of thousands remained behind, and many of those died or were injured either during or in the immediate aftermath of the storm. As of July, 2006 over 1,800 deaths were reported, including 1577 living in Louisiana, and 231 in Mississippi. The number of fatalities would undoubtedly have been higher without pre-storm evacuation and the efforts of many government and military personnel, first responders, area citizens, and volunteers.
With an estimated 500 000 people in the Gulf coast region potentially needing mental health assistance, more federal and state help is still required to help rebuild local mental health resources. Assistance and resources are also required for other communities that have accepted internally displaced residents from the storms. The impact of the two hurricanes on the rates of suicide, murder, PTSD, affective and anxiety disorders, and other psychiatric disorders will be discussed. Treatment delivery successes and problems in the impacted regions will be explored.
The Stafford Act's limiting individual states financial flexibility to use SAMHSA crisis counselling funds for continuing treatment of new individuals in need of mental health treatment as well as those individuals with past histories of mental disorders following disasters will be discussed.
WS14 BIOPSYCHOSOCIAL AND SPIRITUAL ASPECTS OF TREATING OUR PHYSICIAN COLLEAGUES
Syed Naqvi, Monisha Vasa, Emir Ettekal, Michael Myers, Alicia Ruelaz
Maslach eloquently described burnout as “erosion of the soul.” Burnout is a syndrome characterized by emotional exhaustion, decreased personal satisfaction, and a sense of depersonalization in physicians exposed to chronic stress. Personal consequences of burnout include marital difficulties, substance abuse, and the development of depression and anxiety. Physician burnout has also been associated with poor prescribing habits, and increased likelihood of physician error. Depression is just as prevalent in physicians as in the general population, however, physicians have an increased suicide rate compared to the general population, as well as compared to other professionals. As psychiatrists, we are poised in the unique position of understanding the biological, psychological, social, and spiritual factors that affect a physician throughout training and practice. We need to assume a leading role in decreasing stigma associated with mental health care in physicians, and encouraging physicians to receive treatment for burnout and its debilitating consequences. This workshop is intended for all mental health professionals who are involved in the care of physicians. Forty-five minutes will be lecture-based, the remaining forty-five minutes will be reserved for lively interaction with the audience. This section will include case discussions, audiovisual clips, and experiential exercises for the participants.
WS15 ausMHLP1: LEADERSHIP AND MENTAL HEALTH SYSTEM REFORM
Harry Minas, Adrian Keller, Renee Bauer, Campbell Thorpe
IT TAKES TWO: THE NEED FOR INCREASED PSYCHIATRIST LEADERSHIP IN AN ERA OF COMPLEX, EXPANDING MENTAL HEALTH SERVICE SYSTEMS
Adrian Keller
USING COMPLEXITY THEORY TO DEVELOP A SINGLE MODEL OF CARE
Renée Bauer, Tom Callaly
Care must be based on continuous healing relationships Care must be based on client needs and values Knowledge and information should be shared Care should be evidence based Needs should be anticipated Cooperation among clinicians.
These rules will form the foundation for future development. The rules have been circulated to all staff for comment and to encourage their engagement in this novel approach to service development.
ROLE OF CONSUMERS AND CARERS IN THE DEVELOPMENT OF MENTAL HEALTH SYSTEMS
Campbell Thorpe
LEADERSHIP FOR CHANGE: EVALUATION OF THE AUSTRALIAN MENTAL HEALTH LEADERSHIP PROGRAM
Harry Minas
a greater knowledge of the mental health system leading to: an appreciation of the ‘bigger picture’, an understanding of the process of change, and being able to participate in debates about mental health policy a greater understanding of leadership principles and style and a greater an increased confidence to take on leadership roles: and an increase in reflective practice.
WS16 INTEGRATED TREATMENT FOR DUAL DIAGNOSIS: THE COLLABORATIVE THERAPY MANAGING MENTAL HEALTH AND SUBSTANCE USE PROJECT
Brendan Pawsey, Catherine Bunton, Jamie Chamberlain, Katie Wyman
Over 4 years, and across four Victorian area mental health services, (both metropolitan and regional), the CTU researched the program. The research was implemented within existing service structures ensuring the program is readily adopted into current systems.
This workshop will present the research findings, detail the integrated system-level nature of research and implementation, and the integrated nature of the program itself, highlighting the contents. Furthermore we will introduce the reasons for use scale (RFU) that examines motivations for use in the context of comorbidity, and provide an adequate platform for all to better understand this treatment option for Dual Diagnosis.
WS17 DOPING IN ADOLESCENTS AND NON-ELITE ATHLETES: A PSYCHO EDUCATIONAL PERSPECTIVE
David Baron, Samir Abdul Magd, Thomas Wenzel, David Martin, Li-Jing Zhu, Said Abdel Azim
Present recent data on steroid-abuse in adolescents from a multinational perspective Discuss physical and psychiatric aspects of doping in adolescents Review one of the few successful school based doping education programs, ATLAS Encourage participants to take an active role in establishing culturally sensitive doping education programs
Doping by adolescents in a significant problem world-wide Primary prevention is the optimal intervention strategy Steroid abuse in adolescents can present as major psycho pathology and is often misdiagnosed
WS18 MULTIDISIPLINARY TREATMENT OF PAIN
Vladimir Bokarius, Steven Richeimer, Ali Nemat, Lisa Victor, Yogi Matharu, Mary Wolf
Chronic pain is estimated to affect about a third of the world's population. Pharmacological and interventional treatments help most people control their pain. However, currently available methods of pain treatment are either not effective or can cause serious side effects for many patients. Moreover, the course of treatment may be significantly complicated by comorbid mental disorders. We utilize the most advanced technology for patient's physical improvement, as well as treatment to strengthen the patients’ emotional ability to cope with debilitating effects of pain, and to promote the patients’ return to a fully productive life. Our team consists of anesthesiologists, physiatrists, psychiatrists, psychologists, and physical and occupational therapists. The goal of this presentation is to show the role of the combined effort of different healthcare professionals in the treatment of chronic pain.
WS19 FEASIBILITY OF HUMOR AS A TREATMENT MODALITY IN PATIENTS WITH DEPRESSION
Anna Bokarius, Vladimir Bokarius, Ed Dunkelblau
Humor has stimulated the curiosity of many researchers and has been proposed as a potential adjunct treatment for various medical issues. In the field of psychiatry it has been shown to help reduce stress and anxiety. However, the possibility of using humor to treat depression remains largely unconfirmed, and early publications involved little research data. More recent studies have shown modest results in humor alleviating depression, but were based on healthy volunteers, lacking evidence-based validity.
Given the limited amount of research on this topic, it is important to consider the feelings of patients themselves before testing the effects of humor in treating depression.
A study in the outpatient clinic of Thalians Mental Health Center assessed patients’ disposition toward humor and correlated it with their level of depression. Results showed no correlation between disposition toward humor and depression, indicating that depression does not seem to affect disposition toward humor. Consequently, regardless of their level of depression, patients generally appreciated humorous messages and situations, expressed humor themselves, and even welcomed humor as a possible adjunct to their treatment.
With this newly confirmed possibility of integrating humor as an adjunct treatment of patients with depression, we can investigate the means of implementing this new strategy. Some pioneering mental health professionals have already begun to apply humor in building rapport with their patients or even in treating depressive symptoms. This workshop sheds light on not only the possibility of using humor, but also the novel methods of the field's most forward-thinking and innovative specialists.
WS20 ARE WE THERE YET: MAGNET JOURNEY FOR HUTT VALLEY DISTRICT HEALTH BOARD MENTAL HEALTH AND ADDICTION SERVICES
Garth Healey, Julia Hennessy, Frances Hughes
Magnet hospitals have been recognised through a formal accreditation process in both the United States and Australia. They are hospitals that have adopted a set of key governance, management and leadership principles, attaining set standards that result in safe, quality focused healthcare, and attract, motivate and retain well qualified and committed nursing staff.
This model has been closely examined for its applicability to New Zealand culture. The Minister of Health, Chief Nurse and senior nursing leadership groups consider the Magnet Recognition Programme as having significant potential and merit to be introduced in New Zealand.
On December 5th, 2002, HVDHB approved a proposal to participate in the Magnet Recognition Programme with the aim of developing Hutt Hospital as:
An organisation that creates/develops an environment/culture emphasising quality, professional models of care, consultation, autonomy, professional development and nursing leadership, Having improved patient care and outcomes, and A centre of excellence.
The introduction of the principles (Forces) of Magnet, which is predominately nursing, focused into mental health services, which is predominately multidisciplinary, has provided a challenge for mental health services.
This workshop explores the challenges of aligning the Recovery competencies and the multi-disciplinary teams specific professionals standards with these Magnet principles. How these issues have been addressed in this setting, what are the spin offs, what are the downsides and how this journey will ultimately benefit not only the service users but all staff.
WS21 UNDERSTANDING INDIGENOUS MENTAL HEALTH FROM PROMOTION, PREVENTION AND EARLY INTERVENTION TO MODELS OF CARE
Mary Guthrie, Craig Allen, Thomas Brideson
PROMOTION, PREVENTION AND EARLY INTERVENTION IN INDIGENOUS MENTAL HEALTH
Mary Guthrie
KEEPING THE FOCUS ON INDIGENOUS YOUTH
Craig Allen
BUILDING ON SUCCESS IN INDIGENOUS MENTAL HEALTH
Thomas Brideson
WS22 USING INTERVENTIONIST MEDIA IN INNER-CITY HEALTH: A CASE STUDY
Ian Dawe, Katerina Cizek, Gerry Flahive, Joanne Walsh, Nancy Read, Heather Frise
Since the de-institutionalization of people with mental illnesses across North America, police have been increasingly called upon to respond to mental health crises. Unfortunately, in Canada alone police have killed 13 people with mental illnesses in recent years, and numerous coroner's inquests into these deaths have all pointed to the pressing need for innovative inter-disciplinary models to decriminalize mental health crises. Consequently, several models of Mobile Crisis Intervention Teams have been sporadically developed by hospitals and law enforcement agencies across the continent.
One such model has been developed at the Psychiatric Emergency Service of St. Michael's Hospital in a joint initiative with Toronto Police Services. The team is actively researching, advocating for and educating about the need for best practices and appropriate responses across the city, province and country.
Meanwhile, an experimental media project at the National Film Board of Canada has placed a Filmmaker-in-Residence at St Michael's Hospital, to create community-based interventionist media with health-care partners. The Filmmaker-in-Residence is exploring how to use media as a tool for social action, rather than simply as a tool to make conventional films.
In 2006, the MCIT team asked the Filmmaker-in-Residence to document their work cinematically, in their efforts to decriminalize mental health crises.
This presentation describes how the filming experience itself, the discussions and insights it generated and the resulting film changed and deepened the concept of interventionist research and advocacy regarding the decriminalization of mental health crises. Excerpts from the resulting film, THE INTERVENTIONISTS, will be screened.
WS23 WHEN THE MAD ARE BAD: MENTAL ILLNESS AND HOMICIDE
Renee Sorrentino, Susan Hatters-Friedman, Joy Stankowski, Gunter Lorberg
The psychiatric morbidity among homicide offenders will be discussed. The relationship between psychotic disorders, affective illnesses, paraphilias and personality disorders will be reviewed. In conclusion a method for assessing the risk of homicide in psychiatric populations will be presented.
WS24 BUILDING BRIDGES, THE WORKPLACE AND MENTAL HEALTH SECTOR
Ingrid Ozols, Lynn McAtamney, Bernard McNair
The Australian workforce is slowly starting to learn to recognise the signs and symptoms of mental health problems. However there are still concerns around this being the workplace's business? Would an educational program cause workers to perceive that boundaries were being overstepped and that their privacy was being invaded? If one is unqualified to help could this make matters worse? Stigma and secrecy have compounded issues keeping them well hidden in the corporate cupboard.
If one is unqualified to help could this make matters worse? Stigma and secrecy have compounded issues keeping them well hidden in the corporate cupboard.
Poor mental health is costing Australian business approximately $13 billion annually in lost productivity, increased absenteeism (lost workdays), presenteeism (reduced effective outputs whilst working), safety risks, accidents, psychological injuries, medical costs and workcover claims.
Yet the workplace provides an excellent setting for mental health and resilience promotion, and mental illness prevention and early intervention.
Today, some progressive workplaces are starting to include mental health and wellbeing on their agenda's. This discussion will demonstrate and describe some examples of workplace initiatives in this arena and the powerful impact of their building partnerships with the mental health community.
To increase collaboration between the mental health and corporate sectors. To share examples of mental health wellbeing and resilience promotion, prevention and early intervention workplace programs and how they have included the mental health sector to integrate with the business world. To demonstrate the role of consumers and carers to help build links between the workplace and mental health sector. To highlight challenges and barriers that businesses are facing when endeavouring to create supportive environments for people with mental health problems.
WS25 SLEEP PHYSIOLOGY, SLEEP DISORDERS AND MENTAL HEALTH
Antonio Fernando, Bruce Arroll, Guy Warman
Patients with mood disorders, psychotic disorders and anxiety disorders have disrupted sleeping pattern and circadian rhythms. Sleep disorders like obstructive sleep apnoea, circadian phase shift disorders and idiopathic hypersomniacs present with psychiatric complaints. They are often misdiagnosed as having depression and their main treatments are neglected.
This workshop will educate the participants on 1) basic sleep and circadian physiology 2) bedside diagnoses of various sleep disorders 3) diagnoses and management of various types of insomnia, with a special focus on the psychiatric population.
The first session will be focused on understanding the latest neuroscientific explanations on sleep mechanisms and circadian rhythms. This session will review the recent elucidation of the sleep and wake “switches”, the genetics and physiology of sleep and circadian rhythms.
The second session will review the different clinical presentation, assessment and management of common sleep disorders. This will cover the insomnias, parasomnias and excessive daytime sleepers. A newly developed primary care bedside screening tool will be presented.
The third session will discuss the diagnosis and management of the different types of insomnias. Our latest clinical trial results on the management of primary insomnia using a single-session behavioural intervention will be presented. Practical aspects of managing insomnia in the psychiatric population will be discussed. This includes the use of medications, behavioural interventions, light and melatonin.
At the end of the workshop, the attendee will have a better understanding of the biology of sleep, diagnosis and management of common sleep disorders and the management of various insomnias.
WS26 PRIMARY CARE PSYCHOLOGICAL TREATMENTS
Grant Blashki, Evelyn Van Weel, David Pierce
Describe current research projects examining psychological treatments provided in primary care settings by general practitioners Report evaluations of three studies exploring primary care psychological treatments provided in general practice Discuss the implications of these studies on training, policy and research in this field Suggest an agenda for future training, research and policy development
Following presentation of these studies Dr Grant Blashki will lead a discussion around the findings and delegates will be encouraged to consider how these findings could inform the development of models of delivery of psychological treatments in primary care.
PRIMARY CARE EVIDENCE BASED PSYCHOLOGICAL TREATMENTS – THE PEP STUDY
Grant Blashki, Leon Piterman, Graeme Meadows, David Clarke, Jane Gunn, Fiona Judd, Andre Tylee
An increased knowledge of CBT An increase in confidence in delivering CBT in general practice An improvement in the quality of CBT they deliver in simulated role plays Improved clinical outcomes for patients (recovery rate from depressive disorder) Improvements in Consumer satisfaction and experience of care
HOW IS TRAINING IN PROBLEM SOLVING TREATMENT RECEIVED BY GP-REGISTRARS?
Evelyn van Weel, Lieke Franke, Peter Lucassen, Mechtild M. Beek, Laurence Mynors-Wallis, Chris van Weel
DEVELOPING EXPERIENCED GENERAL PRACTITIONERS PROBLEM SOLVING THERAPY SKILLS
David Pierce, Jane Gunn
Change was assessed using pre and post measures, including an observer completed survey tool (Problem-solving Treatment Adherence and Competence Scale- PST-PAC), quantitative self-report surveys and qualitative semi-structured interviews.
WS27 REDUCING ADOLESCENT DEPRESSION – FROM THEORY TO PRACTICE
Sally Merry, Karolina Stasiak, Barbara Bulkeley, Sarah Hetrick
an updated analysis of depression prevention programmes with a sub-group analysis to determine whether there is a differential effect by individual programme the results from a pilot study of a computerized cognitive therapy designed for adolescents for use in primary care settings the findings from studies investigating the role of school guidance counsellors in the detection and management of adolescent depression a meta-analysis of remission rates for depressive disorder in adolescent on specific serotonin reuptake inhibitors and clinical implications of these findings (this contrasts with previous meta-analyses which have reported response rates rather than clinical remission)
Results from depression prevention programmes have been mixed. Some programmes with evidence of efficacy have not been effective when implemented in practice. Identifying the most effective programmes and developing these further to maximize the chance of effective implementation is the next logical step in depression prevention.
Most adolescents do not receive any intervention for depressive disorder. It is important to make interventions more accessible. School guidance counsellors, general practitioners and other primary health care workers are well placed to meet some of this need but many do not have the training to assess and manage adolescent depression. School guidance counsellors are well placed to assess and manage adolescent depression but over 90% reported that they need further training in this area.
Computer based interventions are potentially effective and acceptable though they need be developmentally appropriate.
While antidepressants may provide help for some young people, the limited remission rate is of concern and should be discussed, along with the risk of medication with young people and their families. Other types of interventions should be considered with further research required into the potential efficacy of SSRIs in more severely disordered young people.
DEPRESSION PREVENTION – THE WAY FORWARD?
Sally Merry, Sarah Hetrick, Heather McDowell, Juliet Bir
COMPUTERIZED CBT FOR ADOLESCENTS
Karolina Stasiak, Sally Merry, Simon Hatcher, Iain Doherty
To develop an adolescent-specific CCBT programme to treat mild-to-moderate depression in a school setting To pilot the programme via an RCT (focus of this presentation) To gain adolescents’ feedback on the intervention delivered by the computer
SCHOOL GUIDANCE COUNSELLORS AND ADOLESCENT DEPRESSION
Barbara Bulkeley, Simon Hatcher, Sally Merry
SPECIFIC SEROTONIN REUPTAKE INHIBITORS – CLINICAL IMPLICATIONS FROM A META-ANALYSIS
Sarah Hetrick, Sally Merry
WS28 STORM (SKILLS BASED TRAINING ON RISK MANAGEMENT)
Linda Gask
WS29 RECOVERY ABOVE AND BELOW THE NECK
Suzanne Vogel-Scibilia, Risdon Slate
WS30 MENTAL AND PHYSICAL HEALTH ASSOCIATIONS OF INTIMATE PARTNER ABUSE
Kelsey Hegarty, Stephanie Brown, Gail Gilchrist, Ellie McDonald, Deirdre Gartland, Jane Gunn
WS31 TRADITIONAL HEALING AND INDIGENOUS MENTAL HEALTH
Helen Milroy, Andy Tjilari, Rupert Peters
TRADITIONAL HEALING: ANANGU WAY
Andy Tjilari, Rupert Peters
WS32 ADVANCES IN GENETIC AND CLINICAL ASPECTS OF ETHNO-PSYCHOPHARMACOLOGY
Chee Ng, Keh-Ming Lin
Inter-individual and cross-ethnic variations in psychotropic response are influenced by genetic patterns. Genes controlling the expression of drug metabolizing enzymes and brain function are highly polymorphic. The effects on drug pharmacokinetics and pharmacodynamics due to differences in genotypes of CYP enzymes and serotonin transporters and other polymorphisms are recognized to be clinically significant. It is likely that data derived from pharmacogenetic tests would be useful to inform clinicians regarding the choice of medications, dosing strategies as well as potential risks for different side effects. In addition, gene expression is also influenced by environmental, dietary and sociocultural factors. Apart from biological influences, culturally determined beliefs and behavioral patterns also profoundly influence patients’ expectations of treatment response, adherence, as well as clinicians prescribing habits. This workshop aims to address some of these critical issues in the emerging field of ethnopsychopharmacology, which has led to the establishment of International Collaborative Ethnopsychopharmacology Research (ICER) in the Asia-Pacific. The researchers from the region will overview current advances in clinical practice and research perspectives as well as their implications concerning clinical practice. These include the genetic variability on response to psychotropics in the treatment of major psychiatric disorders, pharmacokinetic differences and variability in the psychotropic drugs prescribing patterns in Asia–Pacific.
WS33 BALINT GROUPS
William Betts, Donald Nease Jr, Albert Lichtenstein
A modern Balint group consists of a group of six to ten clinicians plus a trained leader (or leaders) who meet regularly to present and discuss cases using the Balint method.
In Germany, General Practitioners (GPs) and Psychiatrists who have completed thirty hours of Balint work receive increased remuneration.
Balint work has been shown to reduce burnout and increase job satisfaction in GPs.
This workshop will have an initial exposition on Balint work followed by an experiential demonstration of a Balint group. The final twenty minutes will include discussion and questions about the method. Those attending should be clinicians.
WS34 INTEGRATING A FOCUS ON UNHELPFUL SCHEMAS INTO CBT
Bob Montgomery, Laurel Morris
Refresh the evidence-based practice of CBT. Identify patients who would benefit from a schema-focussed approach. Help patients to identify their personally relevant unhelpful schemas. Help patients to recognise and challenge the intrusion of unhelpful schemas into present life. Help patients to deal with their unhelpful schemas, by questioning them, reinterpreting their origins, and confronting their sources.
WS35 A DEMONSTRATION OF THE USE OF VIDEOCONFERENCING TO FACILITATE PEER REVIEW OF THE PRACTICE OF ELECTROCONVULSIVE THERAPY
Patrick Clarke, David Barton, Ken Fielke, Brian McKenny, Daniel Mosler, Tom Patterson, Peter Tyllis
All members of the peer review group have found this process to be rewarding both in terms of improving their knowledge base and clinical acumen in electroconvulsive therapy. The videoconferencing technology has readily leant itself to this process with the experience of few technological difficulties.
WS36 CRISIS INTERVENTION: THE UNITED STATES MODEL
Suzanne Vogel-Scibilia, Risdon Slate
WS37 HELPING PEOPLE LIVE WITH CHRONIC MENTAL ILLNESS
Bob Montgomery, Laurel Morris
How to develop a working, collaborative relationship with patients. How to share effective goal-setting to facilitate a patient's adherence to a personal illness-management plan using positive motivation. How to help patients change their illness-related behaviour. How to help patients get and stay motivated. How to help patients to anticipate, prevent and manage relapses.
WS38 SELF-TRANSCENDENCE AND OTHER EXISTENTIAL THEMES IN ALCOHOL DEPENDENCE
Christopher Wurm, Mila Goldner Vukov, Mat Gelman
To balance the competing demands of developing rapport and collecting necessary clinical details. Several models, which have been proposed to help understand and manage problems related to dependence on alcohol and other drugs will be discussed.
WS39 EROTIC TRANSFERENCE/COUNTERTRANSFERENCE AND THE NARCISSISTIC THERAPIST
Carolyn Quadrio
WS41 HOLDING ANXIETY IN CLINICIANS AND TEAMS TREATING PATIENTS WITH BORDERLINE PERSONALITY DISORDER: WHY IT MATTERS AND HOW TO DO IT
Josephine Beatson
Finally, we will discuss what Spectrum does to hold anxieties when they spread to involve whole mental health systems.
Thirty minutes for questions, comments and further elaboration will be available after the formal presentations.
WS42 INTEGRATING MENTAL HEALTH SERVICES IN PRIMARY CARE: A CANADIAN EXPERIENCE
Nick Kates
WS43 APPLYING CHRONIC DISEASE MANAGEMENT MODELS AND PSYCHOSOCIAL INTERVENTIONS TO CHRONIC POST TRAUMATIC STRESS DISORDER
Antony Fernandez, Demetrios Julius, Victor Vieweg, Lynn Sattherwhite
Combat related PTSD is often a chronic illness, characterized by severe impairment in psychosocial functioning. We should apply a long-term multidisciplinary management plan involving a Chronic Disease Management Model since pharmacotherapy and routine medical management are commonly insufficient. The Chronic Disease Management Model was first proposed by Wagner, and identifies the essential elements of a health care delivery system for high quality management of patients.
Recognize the chronicity of combat related PTSD Apply evidence-based knowledge about treatment interventions for PTSD
We modified the Chronic Disease Management Model to create an integrated phased approach for veterans with combat related PTSD. After initial screening veterans are enrolled in the program where they receive psychoeducation and gradually phased into various components of the program with an eye towards maximizing participation. The team consists of a Physician, a Physician extender (Nurse Practitioner), Psychologists, Social workers, Occupational therapist and Recreation therapist. Pharmacotherapy is complemented with cognitive behavioral interventions and group therapies that are targeted based on the stage of illness and severity of symptoms. Organizational and financing issues, leadership, training and supervision, decision support systems and monitoring of data are essential components of a successful program. This presentation will summarize recent developments in psychoeducation, exposure, cognitive behavioral therapy and family therapy interventions and further identify provider-targeted measures to improve treatment.
Successful implementation requires involving all major participants (clients, family members, clinicians, program leaders and governmental agencies) in the process. Psychosocial treatments such as psychoeducation and cognitive behavioral therapy when used as adjuncts to pharmacotherapy improve outcomes in PTSD clients.
WS44 WHO ADOPTS WHOM? A CHALLENGING LIFE EVENT FOR BOTH ADOPTIVE PARENTS’ AND INFANT MENTAL HEALTH
Sam Tyano, Mireille Keren
Adoption was taboo in many societies, and adoptive parents would hide it from their environment, as well as from their child, as long as they could. This state of mind has changed in many countries, where adoption has become more acceptable, more common. Yet, it is a decision parents take after many years of unsuccessful trials to get pregnant. As we have found in our study, the experience of infertility is often perceived as traumatic, and impacts on the parents’ parenting behaviors towards the adopted infant. In parallel, the impact of deprivation on the adopted infant's brain development puts the infant at risk for maladaptive and abnormal behaviors during the first year post adoption, which in turn, often deceit the adoptive parents’ high expectation that love and commitment will be enough to overcome past deprivation and lack of basic trust. This mismatch puts the parent-child relationship at risk. Limited ability of the child to attach to his new family, or to let go his biological one, parents’ expectation of a less difficult child, unresolved fertility issues, gaps in information about child's history, and inadequate support for the adoptive parents, have been identified as factors linked to likelihood of adoption failure (Nalven, 2005). Adoption failure is a traumatic event for both parents and infant with long term negative impact, and therefore must be prevented. In this workshop, we propose to show our intervention study of an attachment-based home intervention for adoptive parents and infants, aimed at this preventive goal.
WS45 TRIPLE DIAGNOSIS: DUAL DIAGNOSIS AND HIV DISEASE
Antoine Douaihy
WS46 DECONSTRUCTING SECOND GENERATION ANTIPSYCHOTIC-INDUCED METABOLIC SYNDROME
James J. Kim
Furthermore, it will briefly describe hyperglycemia and hyperlipidemia. It will outline current guidelines for control of hyperlipidemia and hyperglycemia. Finally, it will offer practical strategies for the management of glucose, lipid and weight control. This presentation is ideal for front-line practitioners, nurses, pharmacists, psychologists, social workers, occupational therapists and activity workers.
Understand and recognize the significance and prevalence of metabolic syndrome. Review neurochemistry related to weight gain. Describe current monitoring recommendations. Familiarize with current strategies for the management of metabolic syndrome.
WS47 WORLD ASSOCIATION FOR YOUNG PSYCHIATRISTS AND TRAINEES
Radwa Abdelazim, Victor Buwalda, Winston De la Haye
World Association for Young psychiatrists and Trainees (WAYPT) was the fruit of gathered efforts of European, African, Middle Eastern, Asian, and American young psychiatrists and fellows, forming its first workshop in XII WCP in Yokohama, as a taskforce of WPA fellows and Young Psychiatrists asking for collaboration with WPA, and forming a distinct body, that of the World Association for Young Psychiatrists and Trainees.
The association primary goals are: to exchange ideas and discuss interests amongst young psychiatrists and trainees across the world, to exchange knowledge about training programs’ throughout the world, to collaborate and create links, to stimulate educational networks and to reduce isolation in countries with limited resources, to think and act within an international perspective, as the world becomes more connected and perceptibly “smaller” and richer, sharing cross cultural experience and learning from each other.
We are welcoming all young psychiatrists to share in our Workshop held in WPA regional Meeting in Melbourne, especially Australians, looking forward to enrich everyone experience after attending our workshop.
WS48 PARTNERSHIPS IN THE AMERICAS: UPDATE FROM THE WORLD PSYCHIATRIC ASSOCIATION
Michelle Riba, Lawrence Hartmann, Edgard Belfort, Enrique Camarena, Roger Montenegro, Rodolfo Fahrer, Julio Arboleda-Florez, Alfredo Ortiz Fragola
Within the World Psychiatric Association, there have been increased linkages between member countries in the Americas. This workshop will highlight topics in the Americas related to a number of clinically important topics such as: work force; primary care psychiatry; adolescent psychiatry; role of WPA member societies in the Americas; and diagnostic issues as they relate to culture and ethnicity. Panel members will each highlight an important clinical topic in their WPA zone. This presentation will allow for audience participation and discussion between WPA and APA members.
Review several of the clinical projects being undertaken by psychiatry colleagues in the Americas; Examine various cross-cultural clinical factors in caring for patients in the Americas; Determine some of the opportunities for psychiatric collaborations between the Americas, and with WPA-APA
KEY ROLE OF WPA MEMBER SOCIETIES IN THE AMERICAS
Roger Montenegro
The conditions are given for WPA Member Societies in the Americas to become a very important tool in the processes of psychiatric education, certification and re-certification. This is clearly shown by the increasing number of high quality scientific congresses there are in the region, which include CME courses about a wide variety of medical topics, developed according to the highest standards. Their capacity to network among themselves and with other NGOs and GOs also favours this position.
Member Societies also fulfil their educational goals through their publications and the use of other means of communication such as the Internet. For example, the WPA has a variety of Educational Programs which have been translated into Spanish and other languages, as well as other educational material, which have become an excellent source of information for professionals.
Moreover, there is a growing interest among societies and individuals for obtaining CME credits for congress attendance, as they consider the WPA an umbrella organization which can guarantee the quality of their continuing professional development.
PSYCHIATRIC TRAINING OF THE PRIMARY CARE PHYSICIAN
Rodolfo Farer
The Primary Care Physician has the first contact with the patient, the family and the community. The general practitioner, the family doctor, the paediatrician, are in a privileged position to adhere to the main principles of Primary Health Care: availability; accesibility; continuity. Therefore, the training of the General Health Physician in medical school, residency training, and post training, must be drastically updated for the comprehension and management in Primary, Secondary and Tertiary Prevention. Training opportunities vary, but specific psychiatric training essentially takes place in three main settings: during an attachment in psychiatry as part of a vocational training scheme; during trainee appointment, and over continued education. Training of the Primary Care Physician shuld include understanding and management of different disorders; fighting against stigma; integration of psychosocial and psychiatric elements in daily medical practice. The PCP should be acquainted with the main groups of antidepressant drugs, the leading psychological treatment techniques and the principles of social treatment and rehabilitation. Teaching and learning foster attitudes as well as the acquisition of knowledge and skills: self-directed learning, based on problem solution; locally developed teaching instruments; practice with a wide range of patients in different settings; integration of psychiatric teaching and learning process in the school of medicine curricula.
OUT OF THE SHADOWS AT LAST
Julio Arboleda-Florez
Through much concern among Canadians about the extent and impacts of mental conditions, the unequal distribution of these conditions among specific and defined demographic groups, the inequity of services provided and the lack of leadership for a national approach to these problems, the Federal Government of Canada created a National Task Force, lead by Senator Kirby, with a mandate to study the problems in depth, to produce a report and to recommend to Government possible solutions. In order to meet its mandate, the Task Force travelled across the country, set up working groups, organize special hearings in the House (Parliament) and interviewed thousands of Canadians for over five years in order to produce its Final Report, Out of the Shadows, at Last. This presentation will highlight findings of the Kirby Task Force and its Report and will comment on the reply of the Federal Government to its recommendations.
WPA ZONE 4 AND ZONE 3
Edgard Belfort, Enrique Camarena
Jointly the countries represented by zone 3 and 4 of the World Psychiatry Association, have evidenced some common needs and opportunities for the improvement of the zones just mentioned.
In the presentation, some common problems of the member nations of the region will be analyzed, such as the following:
The existing programs cannot be structured by different governmental and nongovernmental institutions, due to inadequate communication and a lack of coordination. There is a lack of training of the people involved in the coordination and implementation of the mental health programs. Important efforts to improve population mental health remain with improper evaluation due to the lack of indicators measuring their impact over the mental health. There is a lack of coordination among intersectional programs.
In this sense it will be presented valid information regarding possible needs ands solutions, evaluating this way related strategies for actions and its impact on the quality of life of their people, especially on those vulnerable population.