A presentation given by Nick Kowalenko at The Journey, CHA Conference 2012, in the 'Innovations in Mental Health Care for Children and Young People' stream.

1. PREVENTING MENTAL HEALTH
PROBLEMS IN FAMILIES AFFECTED
BY PARENTAL DEPRESSION
Putting Prevention into Practice
Nick Kowalenko
Deputy Chair, AICAFMHA
Senior Lecturer University of Sydney
Chair, Faculty of Child & Adolescent Psychiatry, RANZCP

2. Depression and Families
1 million Australian children live with a
parent who has depression(estimate)
Mental illness:
2-4 times higher
40-70 %
Social, developmental, educational and
emotional difficulties
(Beardslee, Solantaus, Morgan, Gladstone & Kowalenko, 2012)
Paternal and Maternal Depression
(Fletcher et al 2011)

3. PPEI Concepts

4. Ottowa Charter
Developing personal often via family members & people who
skills and knowledge work with children, parents and families
Developing locally
supportive through key partnerships that can
environments influence local change
Supporting facilitating broad participation in the
community action planning, development, implementatio
n & evaluation of strategies
including development of accessible, high
Reorientation of
quality resources & guidance for
services
organisations
Influencing the especially as it relates to identification of
development of strengths, needs & support for families.
public policy

5. Developing personal skills
and knowledge

6. Developing locally
supportive environments

7. Supporting community action
Inclusion of
 People recovering from mental illness
and
 those that care for them (including
young people)
in the development of
guidelines, information, and workforce
development resources within the COPMI
national initiative

8. Reorientation of Services:
Sustainable systems change
Children of Parents with a Mental illness. Systems Change in Australia Report
Owen Educational Consultancy
http://www.copmi.net.au/images/pdf/Research/final-report.pdf

9. Developing Quality Resources

10. Family Focus: Prevention in Practice
COPMI national initiative
Funded by Department of Health and
Ageing in 2010-2012 to develop:
DVD – for families where a parent has
depression or anxiety
elearning resource – to train mental health
clinicians in a preventive family
intervention

11. Family Focus Origins
Studies on risk/resilience in COPMI
Beardslee ‘Family Talk’ intervention
Pilot version developed in USA
RCT: Lecture material Vs clinician
facilitated intervention (Beardslee, 2008)

12. Outcomes of Family Focus
Child/Parent Family/Professional
Child Family
 Diminished internalising  increased family
symptoms communication about parental
 Increased understanding of the mental illness
parent’s illness  increased positive family
 increased recognition and interactions
treatment of children with  improved family functioning
depression. 6 7  increased family problem-
Parent/s solving regarding experiences of
 increased understanding of parental depression. 6 9
mental illness Mental health professional
 improved understanding of their  increased satisfaction and job
children motivation at work
 felt assisted with child and illness  improved collaborative
related concerns relationships with local
 improved outlook for the family's organisations. 2
future. 4 6 8

13. Keeping families
and children in mind

14. Family Focus DVD
Children Observe
Build parent awareness that mental illness
is a family experience
Children make sense
Communicate with children about mental
illness to help them make sense of what it
happening
Children respond
Support parents to recognise that they
can influence this response (and future
outcomes)

15. Family Focus DVD
Parent only section
Lived experience interviews
Fictional storylines (promote key messages)

16. Family Focus DVD
Children’s section
Parents can show
children (8-12 year olds)
Starting point for
communication about
parent depression or
anxiety

17. Family Focus: e - learning
Six modules
1 Working with us
Working with families
Why focus on families?
Prevention
Determinants
Risks &protective factors
Your practice
Mental health promotion
...etc
2 Building understanding
3 Dialogue with the
child
4 Partnering with
parents
5 Resilient families
6 Enabling the future

18. Family Focus intervention

19. The future
Dissemination into routine practice
Skills training for primary, secondary &
tertiary workforce
Rights agenda & legal initiatives
Younger age groups
Coordinate and support evaluation &
research initiatives
Growing consumer leadership
Marketing strategies (especially to rural
areas)

20. The future (continued)
Key partnerships
AOD
Physical illness
Child protection
Incarceration
Collaborations
Professional
Academic
Non government & government
Care pathways
Consumers

21. New COPMI website

22. COPMI couldn’t
do what it does without input
from so many people ...

23. Thank you ...
Australian Government
Department of Health and
Ageing

24. Useful resources

25. Resources for dads

26. Challenges
 Impact is difficult to assess
 Evidence base limitations
 Preventive health is poorly funded
 Mental health is poorly funded
relative to physical health
 Child and adolescent mental health is
poorly funded relative to adult mental
health (WHO, 2003)

27. The future
Dissemination into routine practice
Skills training for primary, secondary &
tertiary workforce
Rights agenda & legal initiatives
Younger age groups
Coordinate and support evaluation &
research initiatives
Growing consumer leadership
Marketing strategies (especially to rural
areas)