What is infant and child mental health and why is it important for all practitioners to think about it?

Content type
Webinar
Event date

9 October 2018, 1:00 pm to 2:00 pm (AEDT)

Presenters

Brad Morgan, Helen Francis, Jaisen Mahne

Partners
Location

Online

 

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This webinar was held on Tuesday 9 October 2018.

This webinar was the first in an upcoming series of webinars being facilitated in partnership between Emerging Minds and CFCA, with a specific focus on the mental health of infants and children.

If the social and emotional wellbeing of children is to be everyone’s business, then consistent, cross-sector practices need to be employed in adult- and child-focused services. In this webinar, Brad Morgan, Emerging Minds’ Director, and Helen Francis, Emerging Minds’ National to Local Manager, described how Emerging Minds works across sectors to identify effective practice, and to support practice development that improves the early identification and prevention of child mental health issues. They explained the suite of resources that Emerging Minds produces, and how these can help practitioners and organisations to develop child-focused and parent-sensitive practice.  

Emerging Minds’ child and family partner discussed their experience of service delivery, examples where practitioners have provided child-focused service provision, and examples where opportunities were missed. 

Learning outcomes include understandings of:

  • why early identification and prevention of children’s mental health issues needs to be everyone’s business
  • managing the impact of adult issues on parenting as core business in adult health and social services
  • the work of Emerging Minds in partnership with practitioners and organisations to improve services for children and their parents
  • effective practice support for children’s social and emotional wellbeing, in the presence of family difficulties.

This webinar was the first in a series focusing on children's mental health. It has been co-produced by CFCA and Emerging Minds. They are working together as part of the National Workforce Centre for Child Mental Health, which is funded by the Australian Government Department of Health and Aged Care under the National Support for Child and Youth Mental Health Program.

Emerging Minds logo

Audio transcript (edited)

MR MOSS:

Good afternoon everybody and welcome to today's webinar, "What is infant and child mental health and why is it important for all practitioners to think about". So this is the first in a series of five webinars on children's mental health who will be facilitated in partnership between CFCA and Emerging Minds throughout 2018/19. We're really excited to be able to bring these webinars to you as part of a series. This webinar obviously involves Emerging Minds and Emerging Minds is the leading agency in the National Workforce Centre for Children's Mental Health, who partner with the Australian Institute of Family Studies, the Australian National University, the Parenting Research Centre and the Royal Australian College of General Practitioners. The National Workforce Centre is funded by the Australian Government Department of Health under the National Support for Child and Youth Mental Health Program.

So my name is Dan Moss and I'm the Workforce Development Manager at Emerging Minds and during this presentation I'm going to invite Brad and Helen to describe the history of Emerging Minds while discussing ways in which all practitioners and organisations can contribute to the early identification and prevention of child mental health issues through the provision of child-focus and parent-sensitive service delivery. They will describe the suite of products that Emerging Minds have produced and how they can help practitioners and organisations through child-focus and parent- sensitive practice. I would also like to welcome Jaisen our child and family partner. Jaisen will be interviewed a couple of times by Helen today regarding his experiences of service delivery and Jaisen is going to provide some examples for us where opportunities for child-focus practice were taken up as well as some times where opportunities may have been missed or service provision may have been enhanced.

Before I introduce our speakers I'd like to acknowledge the traditional custodians of the lands on which we are meeting today in Adelaide, the traditional custodians being the Kaurna people. I pay my respects to the Elders past and present and to the Elders from all communities from across Australia from where you're listening or participating today.  Firstly some housekeeping details.  One of the core functions of these webinars and the CFCA information exchange is to share knowledge.  So I'd like to invite everyone to submit questions via the chat box at any time during the webinar, there will be a time at the end of today's webinar for our panellists to answer your questions.  But please note any unanswered questions maybe published along with your first name on the CFCA website for a response from your presenters after the webinar.  Please let us know if you don't want your question or your first name to be published on our website. 

We'd also like to continue the conversation we begin today. To facilitate this we've set up a forum on the CFCA website where you can discuss the ideas and issues raised, submit additional questions for our presenters and access relevant resources.  We will send you a link to the forum at the end of today's presentation.  As you leave the webinar a short survey will be opened in your new window.  We would really appreciate your feedback and sense of how we can kind of keep building on and improving the webinars that we present.  Please also remember that this webinar is being recorded and that the audio transcript and slides will be made available on the CFCA website and the CFCA YouTube channel directly.  So without any further ado, I would now like to hand over to today's presenters, Mr Bradley Morgan, director of Emerging Minds, Helen Francis, the national to local manager at Emerging minds, and Jaisen Mahne who's our Emerging Minds child and family partner.  So please join me in welcoming our presenters, I'd now like to hand over to Helen and Jaisen who are going to discuss Jaisen's experiences.

MS FRANCIS:

Thank you Dan.  And welcome Jaisen.  I've got a series of questions that we'll go through, we'll start with some at the beginning of the presentation and then we'll have a couple to finish.  So Jaisen, can you tell us a little bit about your family please.

MR MAHNE:

Yeah sure.  I have four children and I'm married.  My eldest son is 26 and has social anxiety from years of bullying.  My 14 year old son has general anxiety and ADHD and I have soon to be 12 year old twins, both of who are on the autism spectrum.  While the twins are high functioning in some areas, my daughter suffers from high anxiety, depression, suicidal ideation and self-harm.  Her brother doesn't have the same anxieties that the other children have although he has his own way of seeing things.  So you may have heard the saying that "Meet one child with autism and you've met one child with autism". 

MS FRANCIS:

And what types of services have you accessed for support for you and your family?

MR MAHNE:

Yeah over the past ten years we've accessed several services both government and non-government organisations.  I've accessed mental health services for my own benefit which was our first port of call.  Secondly we accessed in-home care services to provide respite for ourselves and the children so that everyone felt comfortable and was given an opportunity to get the individualised assistance that we require.  We accessed early childhood intervention services to assist the twins after their autism was determined and we needed to find supports in the community around that.  So in that respect we also had the pilot autism specific early learning centre here in Burnie in Tasmania so that was a great help.  And the centre was staffed with people that were well versed in autism and had the knowledge required to manage the children which was a great benefit.  And we've also accessed mental health organisations to assist in the recovery management for myself and my 26 year old son.

MS FRANCIS:

So how do you think the services understood the stresses that you were experiencing as a parent?

MR MAHNE:

Well, for the most part, it was difficult because there was just so much going on.  In a household as large as ours there were complex issues and everyone was under a lot of pressure.  The services we accessed, some were okay but others were frankly appalling.  They didn't take into consideration the impact of changing carers would have on the children who were struggling to understand why so many different people were coming and going through the household.  One organisation that was providing respite for us were badly mismanaged and it led to a conflict and eventually we got tired of dealing with that and opted to forego the respite because it was doing more harm than good, particularly in relation to my mental health and causing anxiety in the children.  The mental health services I accessed for myself were a little preoccupied with trying to medicate me so that I was incapable of feeling anything.  They didn't take into consideration the fact that I was a father of four young children and that I needed to be present physically and mentally.  So that was a rough time for everyone until I found a doctor that was willing to listen to me and understand that I had responsibilities and that my wife could not run a household of six on her own.

MS FRANCIS:

So how visible were the mental health needs of your children when you were accessing services do you think?

MR MAHNE:

Well, it was evident in some cases but it wasn't until they were older that we realised the damage was done due to the instability of some of the services we were accessing during their developmental years, as well as the public school system.  Public school caused a great deal of angst because they failed to understand and refused to accept that the twins were autistic.  The twin's anxiety was through the roof and they were putting it down basically to bad behaviour.  My daughter was constantly dragged kicking and screaming into the office and my son was pinned to the ground by a teacher aid and the principal and this caused even more psychological damage to them and led us to having to home school and seek therapy for them through a local psychologist.  So we had to do all the groundwork ourselves and seek out services because the systems in place that should have been helping were actually hindering and creating situations which were making matters worse. 

MS FRANCIS:

So what do you think got in the way of your children's mental health needs being visible Jaisen?

MR MAHNE:

Well, I think if I'd been well enough I could've assisted more and the fact that I was so unwell at the time meant that a lot of the time was spent on my mental health issues and we weren't seeing the negative impact that some of the services we were accessing were causing.  Living in regional Tasmania doesn't help, there are a distinct lack of services available for young children, and the state mental health services are unable to take on children for therapy at the moment.  The NDIS is not helpful either, we have to get the twins reassessed before we can reapply for it.  And they're making it difficult for children on the spectrum to receive funding.  So while our children flounder we have to try and find resources that will assist us until such time as we can afford to get the reassessment done. 

MS FRANCIS:

So what do you think has helped?

MR MAHNE:

Well as I began to manage my recovery I was able to access more services and as I have an interest in mental health I started to find more organisations and resources that could assist.  The Children and Parents with a Mental Illness website COPMI, was brilliant because I could find ways there of talking to my children about how I was slowly getting better.  And I also think that after recognising the signs in the children of their growing mental health challenges that my wife and I realised that we had to be more proactive and choosy when it came to selecting services.  We've currently accessed the Secret Agents Society program for the twins and it's developed specifically for children on the autism spectrum. And while this is not a free program, we realised that if we waited for a funded organisation to run something like this we'd be waiting forever.

MS FRANCIS:

Thanks Jaisen, that gives us a really great lead into today's presentation and we'll talk at the end again.

MR MAHNE:

Thank you.

MR MOSS:

Thank you so much for that Helen and Jaisen, really appreciate your input there Jaisen.  I would now like to invite the Emerging Minds director, Mr Bradley Morgan to give us some information regarding the history of Emerging Minds.

MR MORGAN:

Hi everyone, I might just – I know we've had a few PowerPoint slide issues so I might just get the next slide to move forward.  Firstly I'd just like to thank Jaisen for sharing your family's experience.  I think for the many people and many families who we've been listening to I think your story resonates with many of them.  And it really does get to the heart of what many children and families experience, and it also helps us set a vision about what we would like to change and what we'll be using to sort of inform our discussion today.  So really today's presentation is to provide a snapshot of the information we've been gathering to assist us in the design, development and implementation of the newly formed Emerging Minds National Workforce Centre for Child Mental Health.  To start off I'll be really starting to unpack what do we mean by infant and child mental health, and I think recognising there are many explanations. 

But I think a useful way for us to think about it is to view infant and child mental health across a spectrum.  So looking at the points on the screen now.  At one end, or the top end there we've got mental health and social well-being, and things of what we're talking about is in infants and children is their developed incapacities to form relationships with their families, other adults and peers.  How they experience, express and manage a full range of emotions.  How they cope with the stresses of life.  And how they explore and participate in the world around them.  And if we move across this continuum, we do know that some infants and children experience short periods of difficulty where their emotions, their thoughts or behaviours cause disruptions to their relationships, to their development, learning and participation in their family and community. 

And then we also know there is a smaller number of infants and children who experience emotional behavioural difficulties of a severity or duration that meet a criteria for a diagnosis of a mental health condition by a mental health professional.  Due to the obvious challenges and limitations in adult diagnostic models there are different approaches and models to guide a diagnosis of a mental health condition in infants and children and many perspectives about the benefits and risks of this which we know was discussed in the previous webinar.  So in addition to thinking about infant and child mental health probably more from an individual lens, I think all definitions of infant and child mental health really need to be viewed in the context in which they are living.  As Jaisen discussed earlier in his family you could hear clearly that mental health does not exist in isolation, it is constantly shaped by the daily living experience of infants and children and their families and what's happening in their relationships but also in their communities.  And evidence to support this comes from a whole range of studies on adverse child experiences, trauma, longitudinal studies, and all of these studies demonstrate strong links between the community context that children live in and in their mental health.  In particular, we know that issues such as poverty, discrimination, exclusion and intergenerational trauma have flow on impacts to communities, they have flow-on impacts to families and to parents and then flow on impacts to children.  And we also know that whenever some children are living with high levels of adversity they are more likely to experience more mental health difficulties.

So there has been a lot of work happening in Australia exploring current service provision and a lot of that is still in progress including our work.  But if we're looking at prevalence of mental health difficulties in infants and younger children, we really do lack Australian studies to provide us with a national snapshot of how many infants and children are experiencing difficulties.  Internationally we have some estimates that indicate that around 16 to 18 per cent of infants and children will experience mental health difficulty [but we lack local data in this age group].  In children four and above we have the Australian Young Minds Matter national survey most recently done in 2015 and this provides us with information on specific mental health difficulties in children and adolescents aged 4 to 17.  This survey found that around 13.6 per cent or one in seven children aged 4 to 11 years experienced mental health difficulties of clinical significance in the previous 12 months.

If we move across the table the next column provides Australian data about sensitive children who are living in context.  That would indicate a likely need for specialist mental health support.  And then moving across to the final column we have a snapshot of levels of access to specialist mental health supports provided by Commonwealth and State funded mental health services.  As you can see looking across that data we do have a substantial gap between the need and what is currently provided.  So knowing that this is the current capacity of our specialist mental health system to respond to infant and child mental health it really highlights our need to increase the capacity of specialist mental health services to meet the needs of infants and children at this end of the continuum who are experiencing significant difficulties.  But alongside of this we also know that there are many opportunities outside of the mental health sector to respond, prevent and intervene early to support the mental health of infants and children. 

So when we've been thinking about how we support service systems to better identify, assess and respond to the mental health needs of infants and children, we were conscious that there are different lenses across workforce groups regarding how we should do this.  I use the analogy, we borrow this concept of doorways to support which describes the lens and the practice responses we promote as part of this lens.  A common lens that most of us have is the child protection lens which has been designed to assist us to observe and screen for risk factors with child wellbeing and safety.  And when a threshold is reached for a concern the normal action taken by a practitioner is to report or refer to child protection and honourable children's programs.  We see that screening is an important role but the consequence of this lens is it often creates a workforce culture that faces responsibility for nurturing and checking Australian children into one department or workforce group.  And other service systems miss opportunities to prevent the difficulties from emerging in the first place.

So if we move on to looking at a child mental health doorway or doorway support and we apply a similar approach that I mentioned before, what would be the consequences?  So we're looking at observing and screening promotional behavioural problems and thinking, yep, this is severe enough to reach a threshold and then we refer to specialist mental health support services.  Another challenge with this approach is then we'll be in – there are - we may miss the many opportunities but alongside is, we also need to recognise the important benefits of identification.

So is there an alternative doorway to looking at children's mental health?  So what we're looking at is an alternative doorway.  Which we're calling the doorway of child social-emotional wellbeing and resilience and the aim of this one is that it does need to integrate identification which incorporates the lenses that we were talking about before, but also it incorporates prevention and early intervention.  We're learning from international and local responses and refining this doorway and the aim is to shift the focus from common practices of halting, holding, weighting and referring to one that focuses on seeing the many opportunities for infant child mental health in everyday practice across a whole range of settings.

So how do we assist practitioners, organisations and systems to open this door?  Well there's some core knowledge and attitudinal changes we need to understand more of, and that is that children's daily lives and their mental health are impacted on by adult stresses, and these stresses can range from deep, brief changes in the family experienced because of something like the arrival of a new baby and subsequent issues associated with sleep deprivation and changes in the family to issues that can persist and impact on the family for a long time such as physical and mental health difficulties.  We also know there are issues that persisted for generations in many families such as trauma and disadvantage.

Understanding this we also then recognise that we have many more opportunities to respond and this does require an attitudinal shift in how services are delivered across both the adult and the child sectors. And this includes for both sectors to be able to seek proactive opportunities to support children's mental health when parents or children are presenting with difficulties, but alongside that to see that they're working in the context of being a child, a parent or family member and also the importance of understanding the prevalence of trauma and what being trauma informed looks like.

So, in addition to observing for risk factors, we're seeking opportunities across a range of sectors to strengthen practices that support infant and child mental health and enlisting on the practice chain, these are some of the areas that we 
really – really want to look at what practices can be integrated across a whole range of sectors so we're looking at opportunities to strengthen the parent-child relationship and reduce the impact of external issues on this relationship.  We want to look at opportunities to support emotional wellbeing ranging from supporting emotional literacy through to identifying and responding to psychological distress.  I'd like to highlight how important the daily rituals of life are for children's social and emotional wellbeing and finding ways to support and maintain these rituals and daily life rituals during times of disruption that families experience.  

We're also acknowledging the important role that adults play helping children to make meaning of their experiences.  So this can range from on a daily task of helping a young child understand and make sense of why they can't have a piece of chocolate through to how they make meaning of significant traumatic events or significant issues that are impacting on their family over a long period of time.  And the other element of what we're really looking at is how do we assist families to nurture the community relationships that wrap around the child?  And this can include their own support networks, but it can also, when required, activating different services and supports for the family that can address the issues impacting on children and mental health and family wellbeing.

So looking at how we're going to do this, we've been fortunate enough to be supported by the Australian Government Department of Health to implement a new national workforce program that aims to strengthen workforce responses to infant child mental health at risk of or experiencing mental health difficulties.  This also includes supporting those children and infants who are impacted on by trauma and adverse childhood experiences recognising both how important and fundamental supporting children in the context of the now is for their mental health but also the impact of these issues on their lifelong mental health as they grow into teenagers and adults.

So I've mentioned our focus is really on some opportunities across a whole range of services and sectors to respond to mental health needs of infants and children up to 12.  In parallel to our work which is really looking at health, social and community services there is also a new national education initiative which is led by Beyond Blue and delivered in partnership with Early Childhood Australia and Headspace and they're going to be focused on supporting education and care settings from birth to younger school and how they can strengthen support for infant, child and adolescent mental health. 

So how are we – that program being delivered.  We're really looking at three tiers of work we're undertaking including the continued development of a national website which provides access to education practice tools and resources for professionals and services.  We also have a national network of workforce consultants who will assist in engaging with and supporting organisations and developing practice champions to integrate workforce development strategies into their practice and into their organisations around how they construct general responses to infant child mental health and alongside of this we're also continually communicating and sharing evidence, resources and promising practices that we're learning about locally and internationally so that we can diffuse some of that evidence via different communication strategies so that we can stay up to date with what's happening.  So, I might hand over to Helen who's going to talk a little bit more about the focus of our work and how it's being delivered.

MS FRANCIS:

So in order to get started it's really important to note that we bring an evidence-informed approach to our work and really that brings three elements.  So we want to know and understand what the latest research and the current evidence base is.  What's happening in the world, what says – what do we know supports child mental health?  What do we know that gets in the way?  How do we bring that together with the wisdom of practitioners and the things that they understand about the people that access their services?  But also, importantly, much like we've heard from Jaisen at the start of this session, we also need to understand the lived experience of parents and families and especially children so that collectively we can make a difference by bringing these three elements together and this is what underpins the work that we're doing at the National Workforce Centre for Child Mental Health. 

The challenge also from this is to start seeing things differently.  In the Australian context we often have developed workers who look at an adult as an adult client.  We have others who will see the child and see the child client and some will be teaching parenting but what we often haven't been able to do is to actually see the adult client that comes into the service as a parent and whatever happens in that family is possibly causing some real parenting stress.  How that parenting stress then can impact on children, what is it that the child is seeing, hearing, feeling?  How are they making sense of what's happening in the family and how does that then impact on the child and their behaviour?  Whether that, as Brad said earlier, is externalising behaviour or whether it, in fact, is internalising. 

So the challenge, and what we're going to do is walk through some slides and ask you and your services to reflect and put the challenge out there, "Can we start seeing things differently to make a difference for children's mental health?"  Who are we hoping will come on this journey with us?  And it's really all of those services that currently focus on infants and children but all those services that also focus on parents and guardians.  So adult-focused services.  So together we are hoping that we can start conversations.  We can engage in the learning and resources that we're developing and really see how collectively we can look at these with a shared lens to make a difference for children and their families. 

I'm going to run through the next few slides and hopefully we can start that reflective thinking and maybe some of these slides you can take back into your organisation and start some of those conversations.  So in identification, what do we need to do to respond?  Are we responding early in the life of a child?  Are we responding early in the life of a problem?  Or also, can we respond early in the engagement with any service whether that's a parent entering a service or a child entering a service and how can we honour all of those early identification opportunities to be preventive and early interventionist? 

In our intake and assessment processes what lens do you have?  Do you have lens on the individual?  Whether that's the child or the adult.  Or do you take a family lens?  And how does your assessment process allow for a focus on both strengths and vulnerabilities?  How do we allow families to talk about the things that they are doing well but also to have those conversations about what they are worried about and what they are considering they could do differently or they need support to do differently so that they can strengthen what's happening within their families?  Can we take the opportunity to respond to both presenting issues and crisis while having a focus on prevention and early intervention?  Sometimes as service sectors we can get really bogged down in the crisis without being able to go, "Okay, what can we do for this family?  How can we support this parent?  And what difference would supporting the parent make for the child's social-emotional wellbeing," and stopping that feedback loop that we looked at earlier on the slide. 

How can we understand the stresses, the duration, the severity that the impact these stresses have on daily life both for the parent and for the child?  So, do we then add in a lens that has trauma and adversities?  Do we understand that there are both critical incidences, but there are also those drip feed of things that happen in families where stresses can be quite low level but they tend to come in patches or that they can cause huge amounts of stress, especially if families don't have the support mechanisms in place.  So how do you understand practice in a trauma-informed care?  Understanding what people bring into the room that we can't see or we don't hear about that really is their lived experience? 

How do we understand what families say about their experience when they're accessing our services?  How do we listen to those families and maybe make tweaks but also understand what it is that they're coming in for and how we keep that dialogue in a rich and nourishing way.   When we're supporting families, how do we integrate both child mental health responses into our roles?  How do we support the parenting role and really what do we do to connect and nurture that relationship between parents and their children?  How do we make sure that emotional well-being is considered, both for the parent and for the child?  And how do we support the family with those routines so that when there are stresses those daily things can still happen? 

Connecting them and making meaning because we know that children see, hear and feel things.  We also know that they can weave their own story together if nobody actually communicates what's happening in the family and those stresses of making their own story or interpreting things that are not quite how they really are can actually have a huge impact over a child's life, but also how do we connect children and families into the natural supports around our community and professional supports if they're needed, but really having that scan and lens about what's freely available for families to engage in?  What's out there to support children?  What parks, gardens and resources can we promote and help parents understand that there are things that they can do if they're feeling stressed that may be low cost or no cost?  How do we support us as practitioners to know what's out there in our communities so we can connect and offer that kind of support to the parents and the families we're working with?

So for me, they are some of the challenges.  It's not easy, but it's about how do we start these conversations in our organisations?  How do we consider the difference that we could make in the life of the family by supporting the parenting role and acknowledging the children and doing that in tandem as part of our work.  So I'll now hand back to Jaisen and hear from him, as he sums up some of his final thoughts.  So Jaisen, looking back, were there points where you consider opportunities to support your children's mental health might have been missed?

MR MAHNE:

Absolutely, my wife and I were trying to juggle a household of six.  With three children under five and a bullied teen.  So she was also caring for me at the same time.  If either of us had seen the damage that the earliest respite organisations had been doing we might have avoided the escalation of the anxieties.  I think had I been well enough back then I would have been able to see what was happening and make other choices.  Unfortunately one can't change the past but knowing what I know now makes it easier to ensure the future is brighter

MS FRANCIS:

And what could have been done differently to support the mental health of your children, do you think, over those years?

MR MAHNE:

Yeah, in relation to my eldest son I think that I should have got him in to see a psychologist sooner and maybe removed him from the school that he was attending.  The principal there didn't seem to be the least bit concerned about the bullying.  Tried all kinds of tactics to try and minimise their responsibility and their duty of care and it seemed to be a hot topic now with anti-bullying campaigns everywhere but the fact of the matter is that it's not being addressed by the schools and even some of the principals tend to be bullies themselves and no one wants to accept responsibility. 

So the bullies themselves are not being given any consequences and they do as they please and this often continues on as they get older.  And I think if there were more organisations or peer workers going into schools and presenting talks on mental health and the consequences of bullying it might take – make some of the kids as well as adults stop and think about the long-term effects their behaviour can have and the impact that it has on people's lives long after the last bell rings.

As for the twins, the appalling behaviour of the principal and the teachers, they could have been avoided if they'd been properly trained in university and at professional development meetings in how to approach children on the spectrum and indeed, neurotypical children with mental health issues, they should be some insight as to how to recognise anxiety and other emotions in children rather than just dropping them in the too hard basket and throwing the blame back at the parents and the children.

I believe that organisations need to work with parents and children to progress good mental health and well-being and there's a distinct lack of funding in many areas and this needs to be addressed.

MS FRANCIS:

Thanks Jaisen. 

MR MOSS:

Yeah and thank you, I'd just like to once again thank all of our panellists today for that, I'll think you'll agree they're all really excellent and thought provoking presentations.

WEBINAR CONCLUDED

IMPORTANT INFORMATION - PLEASE READ

The transcript is provided for information purposes only and is provided on the basis that all persons accessing the transcript undertake responsibility for assessing the relevance and accuracy of its content. Before using the material contained in the transcript, the permission of the relevant presenter should be obtained.

The Commonwealth of Australia, represented by the Australian Institute of Family Studies (AIFS), is not responsible for, and makes no representations in relation to, the accuracy of this transcript. AIFS does not accept any liability to any person for the content (or the use of such content) included in the transcript. The transcript may include or summarise views, standards or recommendations of third parties. The inclusion of such material is not an endorsement by AIFS of that material; nor does it indicate a commitment by AIFS to any particular course of action.

Slide outline

1. What is infant and child mental health and why is it important for all practitioners to think about it? 
Brad Morgan, Helen Francis and Jaisen Mahne 
CFCA Webinar 
9 October 2018

2. What is infant and child mental health?

Why is it important for all practitioners to consider?

3. Q & A: Jaisen

4. What is infant and child mental health?

  • Mental Health and Social and Emotional Wellbeing
  • Mental Health Problems
  • Mental Health Conditions

5. Infant and child mental health

Current service provision

Alt text: This table shows the discrepancy between those children who meet the criteria for a mental health diagnosis (16-18% 0-5 years and 13.6% 4-11 years) and the less than 1% of children 0-11 who receive specialist mental health services. The table also shows that as children grow older, they are at greater risk of more than one risk factor which would qualify them for specialist mental health support services (16.1% for 0-1 years compared to 32.8% 10-11 years from those children who meet the criteria for mental health diagnosis.

6. Why? Workforce responses: Doorways of support 
Child protection

  • Observing/screening for risk factors for child wellbeing and safety
  • Threshold reached
  • Reporting and/or referral to child protection/vulnerable children’s programs

7. Why? Workforce responses: Doorways of support 
Child Mental Health

  • Observing/screening for emotional and/or behavioural problems
  • Threshold reached
  • Referral to specialist MH Services

8. What are we trying to change? 
An alternative doorway

Children’s Social and Emotional Wellbeing and Resilience

Knowledge and attitudes 
Children’s daily lives and their mental health are:

  • Impacted on by adult’s stressors
  • Intergenerational issues

Responsibility of the adult and child sector:

  • Proactive and reactive
  • Child, parent and family focussed
  • Trauma-informed

Practice change 
Strengthening:

  • Parent-child relationships
  • Emotional wellbeing
  • Routines that support family functioning
  • Communication and meaning making
  • Support networks that wrap around the child and family

9. Emerging Minds: National Workforce Centre for Child Mental Health

  • New national program funded by the Australian Government: Department of Health
  • Infants and children at risk of, or experiencing, mental health difficulties
  • Trauma and Adverse Childhood Experiences
  • Strengthen health, social and community services responsiveness to the mental health needs of infants and children (birth to 12 years)
  • Parallel new National Education Initiative (BeyondBlue, Early Childhood Australia and headspace national)

10: How is it being delivered?

The National Workforce Centre incorporates three key components:

  • an online workforce gateway for members of diverse workforce groups to access resources such as practice guides, training, webinars, tools and apps
  • a national network of regionally-based Child Mental Health Workforce Consultants to assist organisations to implement workforce development strategies that strengthen support for infant and child mental health
  • a diffusion of evidence into practice via a strategic communications plan and knowledge translation strategy.

11. Getting evidence about ‘what works’ into practice 
Evidence-Informed Approach

Alt text: Emerging Minds external stakeholders comprise a diverse range of workforce groups, in both clinical and non-clinical, child- and adult-focused services. In addition to these high-focus workforce groups, stakeholders for the strategy also include researchers, organisational decision-makers and policy makers. Importantly, we value children and family partners with lived experience as equally important to any other kind of research. In this way the voices of children and parents contribute to the developing service landscape.

12. Seeing things differently

Alt text: This diagram shows the impact that parental adversity has on the children and children’s behaviour, and that a relational lens is critical in understanding the emotions and behaviours of all children.

13. Target workforce groups

  • Services focused on infants and children
  • Services focused on parents and guardians

14. Identification

When do you need to respond?

  • Early in life
  • Early in the life of the problem
  • Early in the engagement with services

15. Intake and Assessment 
What lens do you have?

  • Individual or family?
  • Do your assessment processes allow for a focus on Strengths and Vulnerabilities?
  • Take the opportunity to focus on:
    • Responding to the presenting issues/crisis and Prevention and early intervention
    • Distress in children – internalising and externalising
    • Concurrent stressors: duration, severity and impact on daily life

16. Intake and Assessment cont.. 
What lens do you have?

  • Trauma and adversities
    • Critical incidents and cumulative experiences
    • How do you understand and practice trauma informed care? What do your families say about their experiences of accessing your services?

17. Support

How do you integrate:

  • infant and child mental health responses into your role?
  • support for the parenting role?

What practices and interventions are you providing that nurture:

  • Parent-child relationships?
  • Emotional wellbeing?
  • Routines that support family functioning?
  • Communication and meaning making?
  • Support networks that wrap around the child and family
    • Natural supports?
    • Professional supports?

18. Final reflections: Jaisen

19. Learn more

Visit the Emerging Minds web hub to find out more, you can find us at: emergingminds.com.au 
20. Thank you

21. Continue the conversation

Do you have any further questions?

Please submit questions or comments on the online forum following today’s webinar.

Related resources

Related resources


Presenters

Brad is Director of the National Workforce Centre for Child Mental Health. He is responsible for bringing together the partner organisations for this exciting initiative, creating a knowledge bank and national commitment to supporting infant and child mental health. He is leading the establishment of the Centre and directing the development and delivery of the program.

Brad, while Director of Children of Parents with a Mental Illness (COPMI) national initiative, made a significant contribution both nationally and internationally to improving mental health outcomes for infants, children, adolescents and their families. His relationships contributed to the evidence flow between international and Australian research and practice. He brings his background in occupational therapy, rural health, early childhood development and mental health promotion, prevention and early intervention to the fore by leading systems change and workforce development strategies that build the knowledge, skills and capacity across systems and workforces. His contextual awareness and understanding of rural nuances drives his commitment to ensure learning and development is relevant and available to practitioners across Australia, especially in rural and remote Australia.

Helen is responsible for leading the National Workforce Centre for Child Mental Health's national to local strategy.

She has a vast knowledge of health/human/community services with a combination of over 30 years' management experience, identifying service gaps, and developing community partnerships advocating for ‘joined up solutions to local issues’.

She has extensive experience in child and family mental health, training and development, action research, community consultation, community development and capacity building initiatives, and ‘lived experience’ engagement in the process of co-design.

Jaisen is child and family partner with Emerging Minds. He has worked periodically in the mental health field since 2013 and holds a Certificate IV in Mental Health Peer Work. He has contributed to projects with organisations such as the Children of Parents with a Mental Illness national initiative (COPMI) and Emerging Minds, and is a trained facilitator and guest speaker, delivering short programs and speaking at mental health expos. He has sat in on interview panels and forums as a consumer representative, utilising his lived experience as both a consumer and carer to provide advice and feedback on issues surrounding the improvement of mental health services.

He currently works in a voluntary capacity for Flourish, Mental Health Action in Our Hands Inc., as both a consumer representative and as Coordinator for the North-West regional Flourish Action Group. He has also just undertaken a role on the board of Flourish. Passionate about the improvement of mental health services for people of all ages, he hopes his engagement with service providers and health services in his role as a consumer will lead to progress in service delivery. He lives in North-West Tasmania with his wife and four children.

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