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PARTNERSHIPS IN HEALTH PROMOTION
Professor Graham D. Burrows, AO, KCSJ
BSc, MB, ChB, DPM, MD, FRANZCP, FRCPsych,
MRACMA, DipMHlthSc(Clinical Hypnosis), FAChAM
Department of Psychiatry, University of Melbourne
I speak to you today as President of the Mental Health Foundation of
Victoria. The Mental Health Foundation was formed in Victoria
in 1930, under the name of the Victorian Council for Mental Hygiene.
When I joined in 1970, we changed the name the next year to the Victorian
Council for Mental Health and then later to the Victorian Association
for Mental Health, and currently the Mental Health Foundation of Australia
(Victoria). It currently has a membership of 190 organisations,
representing approximately 15,000 people in other organisations, and
230-250 individuals around the state and interstate. The Mental
Health Foundation of Victoria is a member of the Mental Health Foundation
Over the years it has established a large number of support groups
for mental illnesses, including the Schizophrenia Fellowship in the
late 1930's, the Association for Relatives and Friends of the Emotionally
and Mentally Ill, the Anorexia and Bulimia Nervosa Foundation, the Obsessive
Compulsive Disorders Foundation Support Group, the Alzheimer's Association
of Victoria, the Mood Disorders Support Group, Carers Association Australia
through the Australian National Association for Mental Health (ANAMH),
the National Mental Health Week.
Current programmes include a major commitment to Mental Health Week,
which involves a launch, media committee, creative writing competition
to all schools, an art competition and a poster launch. The Mental
Foundation of Victoria also runs telephone information, referral, resource
and support services, the Mood Disorders Support Group, which has a
major commitment and attendance and conducts a series of lectures.
Current programmes include the Victoria links with National programmes,
such as the National Institute for Stress Evaluation and Management,
Stress, Anxiety and Depression Awareness Campaign, and has a major role
in Partnerships in Health Promotion. I Chaired the World
Federation for Mental Health Congress this year.
Priorities of the Foundation include the removal of stigma attached
to mental illness, promotion of mental health and prevention of mental
illnesses. One way of doing that is to produce a number of publications
for general practice and community education. These publications
include Understanding and Managing Stress, Understanding Depression,
Adolescent Health and Wellbeing, A Guide to Responsible Gambling, Post-partum
Psychological Disorders and is involved in a number of tapes and
videos, including Stress, Anxiety and Depression.
Major publications include the Depression Awareness Journal,
which is distributed to medical practitioners throughout Australia and
a journal called Mental Health Australia, however, brochures
play a major role also in education include Dealing with Negative
Emotions, The Anxiety Disorders: Causes and Treatment, and Depression
Causes and Treatment. I recall when I joined in 1970, I tried
to find publications on mental health or general education " I could
not find one. There was none in the Health Departments.
Today, there is a great amount of material produced, including information
on the Internet. Unfortunately, some of this is really quite incorrect,
if not, potentially damaging. We have an encryption system to
prevent inappropriate material being distributed. I show you a
copy of the Depression Awareness Journal, Mental Health Australia,
the brochures and many of the publications that we use, including Your
Guide to Understanding and Managing Stress and Adolescent Health
and Wellbeing: A Guide to Effective Coping.
Major projects included Towards a Gentler Society (TAGS), The Anti-Violent
Society (TAVS), The National Depression Awareness Campaign, Vision
Information Enhanced Wellbeing 21, Partnerships in Health Promotion,
and the National Institute of Stress Evaluation and Management.
Partnerships in Health Promotion
This was formed in November 2000, and its concept was to take consortium
national health and social impact of non-government organisations (NGOs)
(not for profit organisations) and to address issues of joint concern
to our individual constituencies. This is in recognition of the
governments and NGOs supporting partnerships in preference to replication
of services to overlapping constituencies. Foundation members
of Partnerships in Health Promotion (PIHP) included:
- Alzheimer's Association Australia;
- Australian Red Cross;
- Mental Health Foundation of Australia;
- National Stroke Foundation;
- Pharmaceutical Society of Australia;
- The Smith Family;
- St. Vincent De Paul Society Australia;
- Victims Referral and Assistance Service, and
- Victorian Relief Committee.
Other members include:
- Australian Cancer Society;
- Australian Council of Trades' Unions;
- International Diabetes Institute;
- The Royal Australian College of General Practitioners;
- The Royal Australian and New Zealand College of Psychiatrists (Victoria);
- The Asthma Foundation, and
- The Salvation Army.
The Young Australians' Mental Health and Wellbeing "Embrace the
Future", has developed out of the Partnerships Programme.
Future projects include: looking at stress in the workplace, racism
and bullying, children and parenting, self-esteem and self-images, early
childhood strategies for health awareness. "Embrace the Future"
the Young Australian Mental Health and Wellbeing project has been developed
because it has been recognised that young Australians do have problems.
Do children and Adolescents have a problem with mental illness?
The answer is, "Yes" " 14% have a mental illness at any one time.
This includes 1% of the population who experience schizophrenia, which
has its onset in adolescence; 1% of the population experience a bipolar
disorder, which has its onset in adolescence; 3-5% suffer from bulimia
nervosa, and 5% suffer from anorexia nervosa. Did you know that
anorexia is 10 times as common as diabetes in adolescence? Eight
percent suffer from anxiety disorder and 11% from depressive disorders.
Young Australians have a number of mental health risk factors.
- Family violence;
- Physical or sexual abuse;
- School failure;
- Parenting difficulties;
- Parental mental illness;
- Isolated, living in a rural or remote areas;
- Socially disadvantages;
- Early school leavers;
- Lack of control, and
- A sense of hopelessness about the future.
There are multiple changes and stresses for adolescents, including:
- Enormous physical and emotional changes;
- Completing higher education/leaving school;
- First serious romantic relationships;
- Employment / unemployment;
- Peer pressure " drugs, alcohol, fast cars;
- Loss of loved ones / parental separation loss and grief issues related
to divorce or family breakdown;
- Forced relocation;
- Loneliness and isolation;
- Parental expectation for performance, and
- Physical, emotional and sexual abuse.
In launching this programme, supported by Carole Crean, as Patron and
a launch attended by Cherie Blair, married to Tony Blair, Prime Minister
of the U.K., the following quote was given by me:
sporting, cultural, education and community leaders have an important
role to play in helping shape the dreams and aspirations of Australia's
youth. Their advocacy and involvement in this programme will be
vital for assisting young people along the pathways to fulfilling their
goals, with positive self-esteem as the first step".
The Young Australians' Mental Health and Wellbeing Programme
is part of the broader programme of the Partnerships in Health Promotion
Programme, setting young people on the road to positive mental health.
This will involve an education and training programme to develop strategies
- Protection of positive mental health,
- Prevention of illness,
- Early intervention in prospective illness, and
- The removal of stigma associated with mental illness.
The Partnerships in Health Promotion as you would appreciate
is a consortium with this network of independent health and social impact
non-government organisations, with a strategic vision to work
together for better health and wellbeing for Australians. This
collaborative network co-ordinates activities to address gaps in the
prevention of illness and promotion of health and wellbeing. Of
course, the Young Australians' Mental Health and Wellbeing project
will focus on the health and wellbeing of young Australians. The
aims of the youth programme are to strengthen individuals' and community
awareness of mental illness, which will involve experiential training
for young people, their leaders, teachers and mentors in mental health
and wellbeing strategies. The programme involves community education
to assist young people in achieving their goals, building confidence,
self-esteem and social skills, addressing depression, and stress and
anxiety in young people. The programme is a national programme
and will be promoted to remote and rural areas, the indigenous population
and to culturally diverse groups. Of course, the programme needs
to be accessible, affordable and will involve interactive multimedia
resource materials, and involves education and training programmes.
Young Australians' Mental Health and Wellbeing " Who are we?
We have a Board of Directors, we have multiple employed personnel, we
have a role to Governments and with Governments, there is a Charitable
Mental Health Trust Fund, we are involved with Mental Health Advocacy,
and the Education Programmes are all to do with Mental Health Promotion,
and prevention of mental illness and removal of stigma related to mental
illness " one of the biggest problems we have is stigma and myth.
To be successful, this must involve young Australians, must involve
partnerships and community linkages, it will be independently evaluated,
we have of course some funding and seeking more, set timelines and there
is a Reference Steering Group. School programme participants include
the students, parents, teachers, administrators, the community and Governments.
The Education and Training Programme will involve professionals with
extensive experience in working with young people and with appropriately
trained peer leaders and champions or mentors. The programme is
being developed in collaboration with young participants from the Partnerships
and Health Promotion members. The programme eventually will be
delivered and broadened to include school, cultural, sporting and community
youth groups and local councils. The programme involves effective
coping, particularly for the stresses of adolescence. This is
a most important dimension of effective coping for adolescents to feel
the support of family, friends, professionals and the community.
The Partnerships in Health Promotions Network involves local Mental
Health information databases, information resources, global Mental Health
experts on-line, local doctors, local pharmacists, community and home
health workers, workplace personnel, hopefully there will be multimedia
kiosks in shopping centres, which will eventually be linked to homes,
school and universities. One subset of this programme is called
the Depression, Stress and Anxiety (DSA). This involves four of
- Mental Health Foundation of Australia;
- National Stroke Foundation;
- The Smith Family, and
- Australian Red Cross
We have been fortunate to receive funding from beyondblue, the National
Depression Initiative, who are one of the partners.
We begin with what is the depression, stress, anxiety education and
training programme? One definition of stress is "a condition
in which there is a marked discrepancy between the demands made on a
person and his or her capacity to respond". Stress will lead
to anxiety - if it is long enough and severe enough. Anxiety disorders
may lead to depression " 80% of anxiety disorders may end up being depressed
eventually. We know that stressful events often occur in our lives,
but frequently we bounce back. Nevertheless, repeated stresses
can reduce our physical and psychological ability to cope. Our
programme involves a series of slides and material, which are going
to the four organisations. They are professionals, volunteers
and consumers. We will teach people how to relax, including:
- Proper diet and sleep;
- Avoidance of excessive alcohol and elicit drugs;
- Relaxation training;
- Yoga, and
- Proper use of leisure activities.
You may ask what is anxiety? Anxiety is a normal emotion experienced
by everyone. Anxiety, like stress can be useful and improve performance.
When anxiety is too severe, lasts too long, or connected to the wrong
thing, the anxiety can become an anxiety disorder. It has been
estimated that up to 10% of the population may experience an anxiety
disorder. These anxiety disorders include:
- Panic Disorder;
- Generalised Anxiety Disorder (GAD)
- Post-Traumatic Stress Disorder (PTSD)
- Obsessive-Compulsive Disorder (OCD), and
- Acute Stress Disorder.
We believe anxiety can be managed with psychological therapies of which
there are many types, Cognitive Behavioural Therapy (CBT), which is
based on learning. Medication may be necessary in some, particularly
if it is severe and a combination of medications and psychological therapy
is often the best approach. Of course, it depends on the nature
of the anxiety disorder to what type of therapy would be predominately
used. There are many famous people who have been depressed, including
Winston Churchill and his "black dog". We know that the course
of depression is variable. For some it will be an isolated event,
for others it may appear at particular times of their lives. It
is now recognised by many that stress contributes to depression.
It is obvious in the first episode, but subsequent episodes may not
involve stress. Depression leads to depression.
In Australia, depression is common " one in four women and one in six
men will have depression at some stage in their life. It often
begins in the mid 20s. Between 50-60% of people who become depressed
experience a relapse. Therefore, depression is a chronic condition.
It needs to be treated seriously and active treatment for the first
episode is important, if it is to reduce further episodes. In
Australia, over 800,000 people each year suffer from depression. The
cost to society is high. It is the fourth highest cause of death
and disability and it has been estimated that the cost to the community
is in the vicinity of $20 billion per year, as a result of the illness,
the impairment, loss, productivity, work loss and affect on the family.
Depression is now becoming the worlds leading cause of disability and
burden following cardiovascular illness.
Management of depression
Depression is treated with a number of talking therapies or psychotherapies,
particularly Cognitive Behaviour Therapy where there is an effort to
change the thoughts and beliefs. Activity is important, physical
activity leads to an increase of endorphins, encephalins, and natural
opiates within the brain, leading to an improvement in mood. People
need to develop better problem solving behaviour techniques, be involved
in anxiety and stress management and in the severe group, may require
electro-convulsive therapy. This is probably only 5% of the total
depressed people. In mild depression, talking therapies is the
approach best taken. In moderate depression, or clinical depression,
antidepressant medication and psychotherapy is important, while in the
very severe group suffering depression, antidepressant plus electro-convulsive
therapy is important.
The message the Mental Health Foundation is making, is to get across
to people that healthy lifestyle, stress management, looking after themselves
and prevention techniques is very important.
For further information contact:
Mental Health Foundation of Australia (Victoria)
270 Church Street, Richmond 3121
Tel: (03) 9427-0406
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