Elizabeth Fudge and Andrea Reupert
COPMI national initiative, Australia
AICAFMHA
(Australian Infant Child Adolescent and Family Mental
Health Association)
Australian Government
Department of Hea...
Today
• Background to the Resource
– Why?
• Development
– How?
– Who was involved?
• Outcomes
– Who has used it and what d...
Background – Why COPMI?
• Approximately 23% of Australian children and
adolescents live in households where at least
one p...
COPMI national initiative
Established in 2002, after a review of
Australian services for children of parents with
a mental...
Aim: COPMI national initiative
To achieve better mental health outcomes for
children of parents with mental illness
Childr...
Children of Parents with a Mental Illness - COPMIChildren of Parents with a Mental Illness - COPMI
Consultation and Develo...
Children of Parents with a Mental Illness - COPMIChildren of Parents with a Mental Illness - COPMI
Booklets for families a...
Availability of information for workers and
families
Access to quality workforce development
resources
Access to evidence ...
Commitment to participation
• Dedicated staff member
• Budget for remuneration (e.g. time, child care
travel)
• Consultati...
Why Workforce Development?
Multi-component approach to prevention for
children of parents with a mental illness
Hosman & V...
Why Workforce Development?
In line with the
• National Practice Standards for the Mental
Health Workforce (2002)
Recognise...
‘ When a worker asks me about my kids, or
even just recognises that I'm a parent
first, rather than a consumer of mental
h...
Why an e-resource?
• Accessible (by individual learners and by
group facilitators) across vast distances
• Can tailor inpu...
Development - Planning
• Literature review
• Consultation with 25 Australian providers
• Consultation with key stakeholder...
Consultation via secure wikis
Multiple designated participants can edit a
simple webpage easily in their own time.
Enhance...
Consultation via wikis
Undertaking a Delphi study via a wiki to
decide on key content areas for the e-learning
resource (t...
‘ The unique thing about it was that even after
people started using their own names there
was no differentiation between ...
Development - Planning
• Findings
– Many would access it but ‘only if it matches face-
to-face opportunities’
– Some MH wo...
Development of the Resource
- matching a face-to-face experience
• Consultation group
• Lived experience group
• Working w...
Development of the Resource
- flexibility of use
• Content development in modular format
• Filming and audio taping – real...
Development of the Resource
- reduction of barriers to use
• Pilot testing in 2 states and in rural and urban
settings wit...
Endorsement
• Royal Australian New Zealand College of
Psychiatrists
• Australian College of Mental Health Nurses
• Austral...
‘Keeping Families and Children In
Mind’
• Available from www.copmi.net.au
• Free. Anyone can log in (families can also vie...
6 Modules (approx 1 hour)
• Mental health and families
• The parent
• The child
• The family
• Carers
• Putting it into pr...
Outcomes – Lived Experience
‘Throughout the whole process I have been
proud to be involved.... I am excited that the
whole...
Outcomes – Lived Experience
‘This resource is of an amazing standard. I feel
immediately ‘plugged in’..... The acting in t...
Who has accessed it to date?
What roles do they have?
Carer Consultant; 16
Clinician/Practitioner
; 195
Consumer
Consultant; 12
Manager; 13
Other; 78
R...
Where are they located?
10
1 2
46
21
18
12
1 2 3
67
11
21 22
3
1
22
1
9
1
8
55
18
1
13
0
10
20
30
40
50
60
70
80
Metropoli...
Initial Evaluation
Pilot evaluation conducted in 2009 at a rural
and urban site
– Focus group interview with participants
...
Pilot evaluation – focus groups
– Participants valued the interactivity of the resource
and life like depiction of familie...
Participant response:
‘ As a participant I was engaged throughout,
and really appreciate the extensive lists of
references...
Pilot evaluation – pre and post
questionnaire
27 participants (20F/7M) completed identical pre
and post training questionn...
Pilot evaluation – facilitator
journals
Facilitators report:
• Need to have reasonable proficiency in
technology (or acces...
Implementation Evaluation
2010-2011
• Design
– Pre, Post and 6 month follow up
• Family focused mental health practice que...
Range of Learner Interactions
Examples
• Blocks of 2 - 3 hours over 3 days
• Each of the six Modules seemed to take
approx...
Range of Learner Interactions
Examples continued
• I completed each module over many weeks/months
to allow time for reflec...
Access to Lived Experience
• Consumer and carer participants in the room
with you as you are learning is very powerful.
• ...
Lived Experience
Elizabeth Fudge
fudgee@aicafmha.net.au
Andrea Reupert
andrea.reupert@monash.edu
www.copmi.net.au
An e-learning resource for workers that incorporates experiences of families
An e-learning resource for workers that incorporates experiences of families
An e-learning resource for workers that incorporates experiences of families
An e-learning resource for workers that incorporates experiences of families
An e-learning resource for workers that incorporates experiences of families
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An e-learning resource for workers that incorporates experiences of families

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By Project Manager Elizabeth Fudge/
PhD Andrea Reupert.
The conference Developing Strength and Resilience in Children 1-2 Nov. 2010 in Oslo.

Published in: Health & Medicine
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An e-learning resource for workers that incorporates experiences of families

  1. 1. Elizabeth Fudge and Andrea Reupert COPMI national initiative, Australia
  2. 2. AICAFMHA (Australian Infant Child Adolescent and Family Mental Health Association) Australian Government Department of Health and Ageing Kylie Eddy, Chris Alliston, Darryl Maybery, COPMI Team and Consultation Groups Children of Parents with a Mental Illness - COPMI Acknowledgements
  3. 3. Today • Background to the Resource – Why? • Development – How? – Who was involved? • Outcomes – Who has used it and what do they think about it? – Other lessons learnt
  4. 4. Background – Why COPMI? • Approximately 23% of Australian children and adolescents live in households where at least one parent has a mental illness. Mayberry et al 2005
  5. 5. COPMI national initiative Established in 2002, after a review of Australian services for children of parents with a mental illness and their families.
  6. 6. Aim: COPMI national initiative To achieve better mental health outcomes for children of parents with mental illness Children of Parents with a Mental Illness - COPMI
  7. 7. Children of Parents with a Mental Illness - COPMIChildren of Parents with a Mental Illness - COPMI Consultation and Development of A ‘Principles and Actions’ Document
  8. 8. Children of Parents with a Mental Illness - COPMIChildren of Parents with a Mental Illness - COPMI Booklets for families and a website
  9. 9. Availability of information for workers and families Access to quality workforce development resources Access to evidence and evaluation resources Children of Parents with a Mental Illness - COPMI Goals Since 2008 (Early Intervention Services for Parents, Children and Young People)
  10. 10. Commitment to participation • Dedicated staff member • Budget for remuneration (e.g. time, child care travel) • Consultation procedures and policies – but multiple, flexible options for participation need to be in place
  11. 11. Why Workforce Development? Multi-component approach to prevention for children of parents with a mental illness Hosman & Van Doesum, Prevention Research Centre, Nijmegen University 2000
  12. 12. Why Workforce Development? In line with the • National Practice Standards for the Mental Health Workforce (2002) Recognised need to influence the attitude, knowledge base and skills of the Mental Health workforce
  13. 13. ‘ When a worker asks me about my kids, or even just recognises that I'm a parent first, rather than a consumer of mental health services, that's the thing I appreciate. My family is the most important thing to me in my life. I just want to be treated like everyone else and given recognition that even when I'm unwell, I'm thinking and I'm acting in the best interests of my family. ’ Keeping Families and Children In Mind Module 2
  14. 14. Why an e-resource? • Accessible (by individual learners and by group facilitators) across vast distances • Can tailor input to learner’s needs • Interactive • Consumer and carer informed • Free, easy to use • Funding
  15. 15. Development - Planning • Literature review • Consultation with 25 Australian providers • Consultation with key stakeholders about content (Delphi study)
  16. 16. Consultation via secure wikis Multiple designated participants can edit a simple webpage easily in their own time. Enhances coordination as everyone can see the latest draft of a document, everyone can change that draft (saving it as the latest draft) and everyone can see each others comments on the document. Can be used anonymously.
  17. 17. Consultation via wikis Undertaking a Delphi study via a wiki to decide on key content areas for the e-learning resource (three rounds of questions) enhanced participation through – Anonymity – Accessibility – Ease of rating Whitham et al, 2009
  18. 18. ‘ The unique thing about it was that even after people started using their own names there was no differentiation between a worker and a consumer/carer. This allowed everyone to feel safe with no pre-conceived ideas or discrimination regarding who they were.’ Participant quoted in Alliston, Kluge and Fudge, 2009
  19. 19. Development - Planning • Findings – Many would access it but ‘only if it matches face- to-face opportunities’ – Some MH workers prefer and/or have greater access to this medium than others – ‘a range of practical, bureacratic, managerial and technological factors intervene’ Herrington and Herrington (2006)
  20. 20. Development of the Resource - matching a face-to-face experience • Consultation group • Lived experience group • Working with producers
  21. 21. Development of the Resource - flexibility of use • Content development in modular format • Filming and audio taping – real life • Scripts for reflective individual and group activities • Engaging graphics
  22. 22. Development of the Resource - reduction of barriers to use • Pilot testing in 2 states and in rural and urban settings with a mix of end users • Working with those who may be able to influence uptake, e.g. – professional ‘champions’ – state and territory government mental health departments – workforce development facilitators
  23. 23. Endorsement • Royal Australian New Zealand College of Psychiatrists • Australian College of Mental Health Nurses • Australian Psychological Society • Australian Association of Social Workers • Australian Association of Occupational Therapists • Royal Australian College of General Practitioners
  24. 24. ‘Keeping Families and Children In Mind’ • Available from www.copmi.net.au • Free. Anyone can log in (families can also view the resource if they wish) • A five-minute promotional video about the resource can be viewed at the COPMI website
  25. 25. 6 Modules (approx 1 hour) • Mental health and families • The parent • The child • The family • Carers • Putting it into practice
  26. 26. Outcomes – Lived Experience ‘Throughout the whole process I have been proud to be involved.... I am excited that the whole process has included and valued my contribution. I want everyone to know that COPMI have not been tokenistic at any time; they have actually been bold and insightful by including not only professionals but consumers and carers.’ Consumer from the ‘Lived experience group’ quoted in Alliston, Kluge and Fudge 2009
  27. 27. Outcomes – Lived Experience ‘This resource is of an amazing standard. I feel immediately ‘plugged in’..... The acting in the fictitious case scenarios was just magnificent.’ Peer educator, 2009
  28. 28. Who has accessed it to date?
  29. 29. What roles do they have? Carer Consultant; 16 Clinician/Practitioner ; 195 Consumer Consultant; 12 Manager; 13 Other; 78 Researcher; 4 Workforce Educator; 51 Primary Professionals Completing 1-6 modules (total = 369)
  30. 30. Where are they located? 10 1 2 46 21 18 12 1 2 3 67 11 21 22 3 1 22 1 9 1 8 55 18 1 13 0 10 20 30 40 50 60 70 80 Metropolitan Other Regional Remote Rural Current Professionals Undertaking Modules 1 to 6 (Total = 369) General Medical Practitioner Mental Health Nurse Occupational Therapist Other Psychiatrist Psychologist Social worker
  31. 31. Initial Evaluation Pilot evaluation conducted in 2009 at a rural and urban site – Focus group interview with participants – Pre and post questionnaire responses – Facilitator journals (to gauge planning and implementation issues) Reupert et al, (in press). Child and Family Social Work
  32. 32. Pilot evaluation – focus groups – Participants valued the interactivity of the resource and life like depiction of families; ...it holds your attention much more than just reading...it brings it [the issues] to life – Described a heightened awareness of needs of family and collaboration; I think what’s come out of it was the importance of everyone who’s working with that family, working together... – Recognised a range of possibilities for implementation (e.g. staff induction, ) A/Professor Kim Foster analysed focus group data
  33. 33. Participant response: ‘ As a participant I was engaged throughout, and really appreciate the extensive lists of references and resources. The variety of modes of presentation – words, voice, video and assessment tasks worked well for me. The actors portraying the two families are very believable and the children, parents and families who directly describe their experiences offer so much.’ CAMHS worker
  34. 34. Pilot evaluation – pre and post questionnaire 27 participants (20F/7M) completed identical pre and post training questionnaires that assessed change in participant confidence, knowledge and skill when working with the parents, children and families (Maybery & Reupert, 2006) Post data show an improvement in participants’ knowledge, skill and confidence. Almost half of the 26 items showed a significant change, in the desired direction. A/Professor Maybery analysed the questionnaire data
  35. 35. Pilot evaluation – facilitator journals Facilitators report: • Need to have reasonable proficiency in technology (or access to others who do); • The family videos were a powerful and effective way to encourage participant discussion and reflection; • Need to have appropriate group processing skills.
  36. 36. Implementation Evaluation 2010-2011 • Design – Pre, Post and 6 month follow up • Family focused mental health practice questionnaire (33 item evaluation version Maybery, Reupert & Goodyear, 2010) – 8 Subscales eg Skill and knowledge, Confidence, Interprofessional collaboration – Also demographics – Post test – what, how did they use the resource • Online and hard copy • Data so far Pre – n=120, Post – n=21, Followup – n=3
  37. 37. Range of Learner Interactions Examples • Blocks of 2 - 3 hours over 3 days • Each of the six Modules seemed to take approximately four hours each as I worked diligently to follow links to References, Resources, listened to Audio, watched Video, filled in text for interactive boxes and did the Quiz at the conclusion of each section. • Worked through each module over consecutive weeks. 2.5 hrs each module
  38. 38. Range of Learner Interactions Examples continued • I completed each module over many weeks/months to allow time for reflection and integration into practice. • I completed the modules over two working days • I worked through each module individually . The first took an hour and a half and then 1 hour each after that. I mostly did it at home in the evenings • All in one day, took a break between modules
  39. 39. Access to Lived Experience • Consumer and carer participants in the room with you as you are learning is very powerful. • Where this can’t be achieved or would be potentially stressful for the consumer or carer, (especially children), video and audio clips can be very powerful. • Can also be more time effective.
  40. 40. Lived Experience
  41. 41. Elizabeth Fudge fudgee@aicafmha.net.au Andrea Reupert andrea.reupert@monash.edu www.copmi.net.au

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