Mental Health Matters - Edition 2 (March 2023)

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MENTAL HEALTH MATTERS

A MAGAZINE FOR MENTAL HEALTH PROFESSIONALS

ISSUE 2 - MARCH 2023

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Contents

SECTOR SNAPSHOT

News from around the mental health sector in Australia & New Zealand

PAT DUDGEON

Pat Dudgeon, pictured on cover, leads the way in Indigenous mental health

FORTEM AUSTRALIA

Supporting the nation’s first responders and their famiies

CAMERON WATTS

Former policeman Cameron Watts lives with PTSD and now advocates for first responders

LIVINGWORKS

How LivingWorks helps keep young people safe from suicide

ABI COOPER

Abi Cooper brings her lived experience of mental health to her peer work

AND THEN WE GO TO WORK

Healing Works Australia CEO Dean Bayliss on the need for a collective Voice

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PSYCHEDELICS APPROVED

ANZMHA CONFERENCE ROUNDUP

Reports from ANZMHA’s three most recent conferences How youth workers play a vital role as part of the mental health workforce

YOUTH WORKERS

SELF CARE

Why all mental health professionals should create their own self care plan

Q&A

ANZMHA Ambassadors discuss the impact of the recent changes to Better Access

SUSAN DANG

TGA approves two psychedelics for medical purposes 24 27 30 33 34

ANZMHA Ambassador Susan Dang writes a letter to her younger self

BOOK REVIEW

Newly released memoir, Dear Psychosis, tells one family’s experience of psychosis

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Contents 38

THE MISSING THOUSANDS LIVING WITH HCV

IT’S TIME TO TALK TO YOUR AT-RISK PATIENTS ABOUT HEPATITIS C

An estimated 117,800 Australians live with chronic HCV1 – and ~1 in 5 of these are unaware of their infection.2

Over many years, chronic HCV can lead to cirrhosis, liver disease and liver cancer. 3 But Hepatitis C can also a ect a person beyond the physical, impacting their mental and emotional well-being. 3

Start a conversation with your patients who have risk factors for HCV today to help identify those a ected – and bring Australia closer to achieving HCV elimination by 2030.

References: 1. Australia’s progress towards hepatitis C elimination. Annual Report 2022. Burnet Institute and UNSW Kirby Institute. Available at: https://burnet.edu.au/system/asset/file/5604/Australia_s_progress_towards_hepatitis_C_elimination_annual_report_2022.pdf Accessed: November 2022. 2. Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM). National Hepatitis C Testing Policy v1.3 (2020). Available at: http://testingportal.ashm.org.au/national-hcv-testing-policy/. Accessed: November 2022. 3. World Health Organization: Hepatitis C Available at: https://www.who.int/en/news-room/fact-sheets/detail/hepatitis-c. Accessed November 2022.

2022 AbbVie Pty Ltd. ABN 48 156 384 262. 241 O’Riordan Street, Mascot NSW 2020. All rights reserved. AbbVie®. is a registered trademark of AbbVie Inc. AU-HCV-220006. November 2022. ABV0139.

Every person with HCV you identify brings Australia closer to achieving HCV elimination by 2030

Welcome

Welcome to our second edition of Mental Health Matters.

We had a fantastic response to our inaugural edition in September last year, which was launched as part of our flagship event, the International Mental Health Conference.

More than 13,000 readers, mostly across Australia and New Zealand, read the first issue either online or in printed form.

This success tells us there is a real audience for mental health stories, whether it is first-hand accounts of lived experience, profiles of best practice community programs or information on self-care for mental health professionals.

The stories in this edition reflect the themes of ANZMHA’s upcoming conferences which focus on the mental health of children and adoles-

cents, frontline workers and those living with addiction.

As always we applaud the individuals and organisations making a difference in these areas, especially those dealing with difficult environments or limited resources.

I would also like to thank all the advertisers who have supported us and we trust that the exposure through Mental Health Matters amplifies your work.

We would greatly value feedback on our magazine and welcome submissions for our next edition which will be published in September 2023. You can contact the editor Melissa Le Mesurier directly via editor@anzmh.asn.au

Mental Health Matters is published by the Australian & New Zealand Mental Health Association (ANZMHA), a non-for-profit association established in 1999 to unite mental health leaders.

The magazine is published twice per year in September and March. The deadline for the September 2023 edition is 22 July 2023 for both editorial submissions and advertising bookings.

Editorial submissions can be sent to editor@anzmh.asn.au. Advertising enquiries and bookings can be sent to partner@anzmh.asn.au

Disclaimer

The information published in Mental Health Matters is intended to provide readers with resources and information which they may find useful and of interest.  While we take all reasonable steps to keep the magazine content current and accurate, errors can occur.  The information is therefore provided as is with no guarantee of accuracy, completeness or timeliness. All thoughts, opinions or views expressed in the magazine belong to the authors.

The digital version of Mental Health Matters may include hyperlinks to third-party content, advertising or websites but ANZMHA does not endorse any advertising, products or resources from external sources.

All editorial material is protected by copyright and can only be reproduced with the express permission of ANZMHA.

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SECTOR SNAPSHOT

Two new MH consumer peak bodies created

The Australian Government will invest $8.5 million to support those with a lived experience of mental health to shape the policies and programs that affect them.

Funding of $7.5 million will establish and operate two independent national mental health lived experience peak bodies – one representing consumers and the other representing carers, families and kin. Lived Experience Australia will also receive $900,000 to continue its work to lead lived experience research and build the capacity of consumer and carers. Funding of $100,000 will establish a regular stakeholder forum to increase transparency, accountability and partnership with the sector.

These steps address recommendations made in recent inquiries including the Productivity Commission’s Inquiry into Mental Health and work undertaken by the National Mental Health Commission.

The announcement of the two peak bodies comes as the Minister for Health and Aged Care Mark Butler and Assistant Minister for Mental Health and Suicide Prevention Emma McBride hosted people with lived experience alongside experts, clinicians and service providers at the Mental Health Equity and Access Forum in Canberra on 30 January.

People with a lived experience of mental ill-health made up the largest cohort of the more than 80 attendees, sharing invaluable insights into a system in need of repair.

Discussions focussed on how to make services more affordable and accessible to those who need them most, as part of the broader system of care.

Webinar features six Indigenous global leaders

Six Indigenous global leaders in mental health and wellbeing from four different countries held a free

two-hour webinar as part of Black Dog Institute’s recent Summit on Self-Harm.

Each participant shared their experience of walking in two worlds and of navigating mental health systems to ensure the wellbeing, healing, and self-determination of Indigenous peoples.

Often people use the phrase “knowledge is power,” yet often knowledge is not shared with the masses and is protected by institutions and peoples in positions of privilege and power, Dr Clinton Schultz, Director of First Nations Partnerships said..

“As responsible corporate citizens, institutions and individuals within these, we hold a responsibility to ensure knowledge and learning opportunities are accessible to as many people as possible as a means of education and empowerment,” he said.

A recording of the webinar can be viewed at https://www.blackdoginstitute.org.au/news/decolonising-mental-health-systems

Added distress for siblings of those with mental ill-health

People who have a sibling with mental ill-health experience higher levels of psychological distress than those who don’t, a new Orygen study has found.

“Siblings are a very important part of the family unit, yet they’re often overlooked when it comes to families of people with mental ill-health,” Anuradhi Jayasinghe, lead author of the study, said.

“The evidence suggests that siblings who feel less in control of their life, or evaluate their sibling relationship more negatively, experience higher levels of distress.

“Individuals who felt their sibling’s mental ill-health had negatively impacted their own social relationships also tended to experience more distress,” Jayasinghe said.

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The findings highlight a need for family-focused interventions.

“The study highlights the need for clinicians to consider not only to the individual they are seeing, but also their families including siblings,” Jayasinghe said.

“Clinicians should be informing families that when one child is struggling with mental ill-health it’s very common for siblings to experience their own mental health challenges. To help siblings, clinicians can provide families with referrals to digital mental health services and local support groups.

For more infomation: https://www.orygen.org.au/ About/News-And-Events/2022/Siblings-of-people-with-mental-ill-health-experience

NZ passes law to phase out tobacco smoking

New Zealand passed into law on 14 December 2022 a unique plan to phase out tobacco smoking by imposing a lifetime ban on young people buying cigarettes.

The law states that tobacco can’t ever be sold to anybody born on or after January 1, 2009.

It means the minimum age for buying cigarettes will keep going up and up. In theory, somebody trying to buy a pack of cigarettes 50 years from now would need ID to show they were at least 63 years old.

However, health authorities hope smoking will fade away well before then. They have a stated goal of making New Zealand smoke-free by 2025.

The new law also reduces the number of retailers allowed to sell tobacco from about 6000 to 600 and decreases the amount of nicotine allowed in tobacco that is smoked.

“There is no good reason to allow a product to be sold that kills half the people that use it,” Associate Minister of Health Ayesha Verrall told MPs in Parliament.

For more information: https://www.science.org/ content/article/final-puff-can-new-zealand-quitsmoking-good

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• • •
Above images: ©Tourism Western Australia

Auckland teachers trained to identify mental health issues

A new NZ initiative will have mental health clinicians train teachers to identify and support rangatahi experiencing mental health issues.

Under the early intervention programme, mental health clinicians working in Te Whatu Ora’s Marinoto (Child and Adolescent Mental Health) team will implement an apprenticeship training model for teachers in some intermediate schools in North and West Auckland.

The project has an initial capacity of up to 18 schools annually, with those prioritised in the first stage of the programme selected based on their rate of referrals to secondary mental health services.

The initiative’s model will support teachers who are trained in the approach to deliver the programme independently in subsequent years, significantly increasing the number of students who can access support.

The launch of the Skills Training for Emotions Problem Solving for Adolescents (STEPS-A) programme follows a successful trial in West Auckland secondary schools.

DIARY DATES

Do you feel confused by the growing range of online mental health resources? Are you unsure where to start and which would be most helpful for your clients? We

The e-Mental Health in Practice (eMHPrac) project is funded by the Commonwealth Government and provides free training and support in the use of evidence-based digital mental health resources to primary care practitioners nationwide.

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13-19 March Neurodiversity Celebration Week 20-22 March Child & Adolescent Mental Health Conference 30 March World Bipolar Day 2 April World Autism Awareness Day 26-28 April Australia & New Zealand Addiction Conference 1-31 May IAIM One-In-Five Challenge 7-9 June International Mental Health Conference 27 June PTSD Awareness Day 1-31 August OCD and Anxiety Disorders Month Find us at site P105 or visit our website www.emhprac.org.au for more information
can help you navigate the world of digital mental health resources!

Don’t gamble with their mental health

Harmful gambling can signal mental health problems in young people

While it is illegal for those under 18 to do so, most young people gamble at some point.1

Whether a cause or an effect, harmful gambling often signals mental health issues in young people and is associated with depression, suicidal ideation and low self-esteem.2

How young people experience gambling harm

Young people can experience negative consequences as a result of their own or someone else’s gambling.

In addition to mental ill-health, gambling harm can affect a young person’s relationships and school performance, and may co-occur with other issues, like alcohol and other drug use or family violence.

Children of parents who experience harm from gambling may experience psychosocial issues, such as a perceived lack of love, hope or competent parenting. This can affect the young person’s ability to function as a healthy member of their family or community.3

It is important that parents, teachers and health professionals learn to recognise the signs of gambling harm in young people so they can offer appropriate support and guidance.

Getting help

To access free, confidential support, adults and young people can call or chat online to a counsellor 24/7.

Gambler’s Help Youthline – 1800 262 376

Gambling Help Online – gamblinghelponline.org.au

Or for more information, visit gamblershelp.com.au/youthline.

REFERENCES

1. Purdie, N, Matters, G, Hillman, K, Murphy, M, Ozolins, C & Millwood, P 2011, Gambling and young people in Australia, Gambling Research Australia, Melbourne. 2. Hardoon, KK & Derevensky, JL 2002, ‘Child and adolescent gambling behavior: current knowledge’, Clinical Child Psychology and Psychiatry, vol. 7, no. 2, pp. 263–81. 3. Suomi, A., Laucas, N., Dowling, N., Delfabbro, P., 2021, Gambling harm experienced by children of parents who gamble, Victorian Responsible Gambling Foundation, Melbourne.

PAT DUDGEON LEADS THE WAY IN INDIGENOUS MENTAL HEALTH

In 1985 Pat Dudgeon became the first Indigenous Australian to graduate with a psychology degree and she’s been leading the way in mental health ever since.

As a Professor at the University of Western Australia’s School of Indigenous Studies, she has literally written the (text) book on Indigenous psychology. To list her awards, research papers and contributions to various national committees would take pages.

And after 30+ years of fighting for social justice for First Nations people, she is sensing a turning in the tide not only in the psychology profession but also in public sentiment.

She believes the broader Australian community is recognising the colonial injustices of the past, with a greater social consciousness of the issues and trauma experienced by our Indigenous community.

The next litmus test of the public’s opinion will be the national referendum on the Voice later in the year.

She supports the Yes vote but is concerned the debate leading up to the referendum could be damaging to the mental health of many Indigenous people as racist views, often hidden, emerge.

“Racism has always been there, but the debate is likely to bring it to the surface, especially as some influential people who are against the Yes vote whip up hysteria and irrational opinions,” she said. “I’m concerned about the impact this will have especially on our youth.”

As the lead researcher of the Australian Indigenous Psychology Education Project

(AIPEP) at UWA, Pat is hoping all psychologists will provide a culturally safe environment for their Indigenous clients.

In particular, she wants their mental health viewed holistically through the lens of social and emotional wellbeing (SEWB) which considers not only mental and physical health but also one’s connections to family, community, Country, culture and spirituality.

“This approach was first promoted by the Australian Indigenous Psychologists Association (AIPA) in 2015 but it really has been reinvigorated since 2020 and is now in many schools of psychology – at least 80% are part of the project,” Pat said.

She is also heartened by the increase in the number of Indigenous psychologists.

“We currently have about 260 practising professionals but of course, we need about 1000 to reach population parity. AIPA and AIPEP are pushing for more places for Indigenous entrants into university psychology programs, be it through special entry, scholarships or mentoring.”

“As well as this, we need a psychological workforce that is culturally competent and inclusive. So, increasing Indigenous perspectives in psychology programs is essential,” she said.

There’s no doubt the need for mental health services is huge and growing.

Compared to other Australians, Aboriginal and Torres Strait Islander peoples are almost three times more likely to experience high psychological distress, twice as likely to die by suicide and twice as

likely to be hospitalised for a mental health condition.

Just like physical health, she says there is a long way to Close the Gap in mental health.

There is plenty of work still to be done by Pat and the Indigenous colleagues who have followed in her footsteps. It is a movement that has been gaining traction in recent years and this will not only benefit our Indigenous community but bring harmony to all Australians.

Resources for psychologists on providing culturally safe practice:

Working Together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice.

https://www.telethonkids.org.au/globalassets/ media/documents/aboriginal-health/working-together-second-edition/ working-together-aboriginal-and-wellbeing-2014.pdf

Australian Indigenous Psychology Education Project (AIPEP) https://indigenouspsyched. org.au

The Australian Indigenous Psychologists Association (AIPA) https://indigenouspsychology.com.au

Social and Emotional Wellbeing Fact Sheet

https://timhwb.org. au/wp-content/ uploads/2021/04/SEWBfact-sheet.pdf

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Fortem supporting first responders

First responders are always there for Australians in their time of need.

They turn up to unimaginable events to help and support someone who is likely to be experiencing the worst day of their life - but for the first responder, it is another day on the job.

While they put on a brave face to support those who needed them, this exposure to repeat trauma has a lasting effect.

We know that more than half of all first responders are deeply impacted by the traumas they face in the course of their duties:

• 1 in 3 first responders experience high psychological distress from trauma experienced on the job.

• The first responder community has higher rates of psychological distress, higher rates of diagnosis for mental health conditions, and higher rates of suicidal thinking and planning than the general adult population.

• First responders are more than twice as likely to have suicidal thoughts and to experience high psychological distress.

• Family members of first responders feel it too, through vicarious trauma.

Fortem Australia is a not-for-profit organisation that supports the mental fitness and wellbeing of first responders and their families.

Fortem provides free evidence-based mental fitness and wellbeing support to the first responder community.

Its services and programs operate outside the workers’ compensation system and offer a comprehensive approach to psychological wellbeing.

The word ‘fortem’ is Latin for ‘brave,’ meaning having the strength to face danger, fear, or difficulty.

At Fortem Australia, this means prioritising wellbeing, breaking stigma, starting conversations about mental fitness, preventing, and treating the deep impacts

of first responder work, making tough decisions (including the decision to leave first responder employment), and seeking or allowing support from loved ones and the community.

Prior to Fortem’s establishment, there were no specialised community-based services to support the health and wellbeing of first responder families.

While many first responder organisations have their own ‘in-house’ support available, Fortem Australia operates independently of the organisations providing a holistic approach to mental health and wellbeing.

Utilising an evidence-based framework, Fortem Australia provides in-person and virtual wellbeing and social connection activities to enhance resilience — not only in individual emergency service workers, but in family units.

From cooking lessons to yoga, or something as simple as a coffee catch-up, these free activities provide opportunities to build connections within and between

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families, teams, and different emergency service agencies. Our wellbeing activities build networks of safety and support — a key protective factor for suicide.

These activities pave the way for early detection and early intervention for mental ill-health. Fortem’s specialist psychologists provide care that is emergency service-culture informed, confidential, accessible, and inclusive of family.

Our clinical services consist of on-line, self-directed mental fitness tools, care coordination, and psychology services.

Seventeen per cent of Fortem’s clinical service participants accessed support after taking part in a Fortem wellbeing activity, with many reporting that they otherwise would not have sought help in as timely a fashion.

Fortem’s on-the-ground teams also work actively with local emergency service agencies to improve awareness and access to

available and appropriate mental health and wellbeing supports for their members.

It also offers support for those first responders that are considering alternative careers within and beyond first responder employment.

“What we do is take a deep dive into what motivated the first responder to be in the job in the first place, before working together to translate that to a future role,” Fortem’s MD John Bale said.

“We leverage their unique skills and experience to explore the roles they are interested in, and which give them motivation and purpose.”

Over the last three years, Fortem has received over 23,000 wellbeing activity registrations, provided more than 3,600 counselling sessions, and created a vast library of resource materials for first responders and their families which have been downloaded more than 4,000 times.

“We have achieved a lot since we were established in 2019; supporting the brave men and women that support communities across Australia during their time of need. But we know more can be done,” John said.

“As we continue to grow, we hope that more police across Australia will be aware that help is available for them when they need it, and engage in our services to build broader, stronger support networks that “get it.”

To find out more about Fortem Australia and the services we provide you can head to: fortemaustralia.org.au

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Cameron Watts

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Despite some of the traumatic things he witnessed during his policing career, Cameron Watts took them in his stride and was progressing steadily through the Australian Federal Police (AFP) in Canberra.

Until he wasn’t.

His frontline career, which included stints investigating bribery and corruption, as well as the sexual exploitation of children, began to unravel following the birth of his first child in 2014.

“It happened overnight,” Cameron said. “One minute I was doing okay and then the next day after my son was born, I became hypervigilant – watching his monitors, checking his breathing constantly during the night and rushing home from work during the day if my wife didn’t answer the phone straight away.

“I was always thinking the worst had happened and I became obsessive about checking on my family,” he said.

Despite the signs, it wasn’t until six months later that he realised his mental health was deteriorating.

“Our baby wasn’t sleeping well so we attended a sleep school and a nurse there asked me if I had Post Traumatic Stress Disorder (PTSD),” he said. “It was obvious to her that things weren’t going too well for me.”

Like many other frontline employees, Cameron said he was initially reluctant to share his mental health concerns with his supervisors or even access the AFP’s employee assistance program.

“At the end of the day, I didn’t feel comfortable sharing my difficulties with them as I thought it would be the end of my career if the chain of command were notified.

“The older generation of police certainly had the mentality that you had to keep your issues to yourself and just get on with the job.”

However, things got worse with the birth of Cameron’s second son in 2017 with symptoms of PTSD increasing over time before coming to a head in 2020.

“I called my boss and told him I wasn’t doing well and went off to see a doctor who said, ‘you’re not going back to work’.

“Even though this meant I didn’t have to face the daily traumas that police work involves, I felt a very keen sense of isolation away from the ‘big blue family’,” Cameron said.

Once away from the force, Cameron and his wife began to rebuild their lives. His recovery involved initially going on medication which he says gave him the breathing space to cope with life again. He also began seeing a psychologist, and eventually left the ACT for Queensland’s Sunshine Coast to start afresh.

He also established a company called Hemisphere East which focusses on geo strategic government relations and national security.

Cameron has also become a vocal advocate for the prevention and treatment of PTSD amongst first responders. An ambassador for frontline support charity Fortem (see previous story), he mentors current and former emergency personnel helping them to build a positive mindset and healthy lifestyle while they seek professional support.

Cameron’s mental health issues had also taken a huge toll on his wife Sharn and their marriage.

“It was a challenging time,” Sharn said. “Each day was different and even though I told everyone around me such as friends and family I was ok, I really wasn’t. On a daily basis Cam’s mood could change dependent on the triggers around him and this caused considerable stress and tension in our life.

“I felt alone without any support from his employer, and I had to seek my own help from a psychologist as Cameron’s hypervigilance led to me developing anxiety.

“I ended up throwing myself into my business, partly as a distraction but moreso as I felt I had to save my husband and I thought having the freedom for him to walk away from his job could achieve that.”

Cameron also advocates publicly for changes to the way first responders with mental health issues are treated, calling for:

o A new approach and attitude to employees’ mental health challenges from the leaders in frontline organisations

o Greater access to independent psychological professionals whilst serving

o Greater public awareness about PTSD amongst frontline personnel (just like that afforded to military veterans in recent years)

o Consistency across Australia in how and when frontline personnel are medically retired and compensated

o Transition and retraining services for those who want to leave their frontline roles.

Cameron, pictured left with his wife Sharn, will continue his advocacy and share his story as a guest speaker at ANZMHA’s Frontline Mental Health Conference at the Gold Coast from 6-7 March.

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“I felt like I was on an island – isolated and dislocated from everyone else.”

Record-breaking suicide prevention training investment for schools, wellbeing leaders & communities

Keeping our young people safe from suicide is undoubtedly one of the highest priorities across our communities.

This year, LivingWorks - the global leader in suicide intervention skills training - marks its 40-year anniversary milestone by scaling the largest project of its kind: offering training to every teacher, parent and community youth leader across New South Wales.

Sydney teacher and mother of four, Kirstyn (pictured), advocates strongly for the training and its benefits for both teachers and parents alike.

“We are the first point of contact with our vulnerable children. If we learn these skills as a collective, we are supporting a whole generation of children to manage these feelings and seek the necessary help that they and we deserve,” Kirstyn said.

Funded by NSW Government’s Mental Health Recovery Package, the free training is available for the next 18 months and delivered both online and face-to-face, including through the two-day LivingWorks ASIST workshop.

LivingWorks Australia CEO, Shayne Connell said,

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“Our target is to offer training to up to 275,000 people across NSW so that school wellbeing teams, teachers, parents, sports coaches and community leaders can have the world’s gold-standard skills ready to help a young person with thoughts of suicide”.

LivingWorks training is accredited by the Australian Psychological Society, the Australian Counselling Association, the NSW Education Standards Authority (NESA) and has codesigned versions for Aboriginal & Torres Strait Islander peoples and LGBTQIA+ communities.

According to LivingWorks, the strength in their training has always been the focus on evidence-based practice.

“LivingWorks has four decades of evidence behind our training programs and what we know from the many studies, including a recent Australian study* on our training in high schools, is that it increases the willingness and confidence in students to talk about suicide while having no ill effects on their mental health,” Mr Connell said.

“Research is a critical part of knowledge translation to ensure collectively we have the strongest impact in keeping young people safe from suicide; that’s why this NSW project has funded Australia’s centre for excellence in youth mental health, Orygen, for evaluation,” he said.

LivingWorks has already trained more than 1,000,000 people across Australia since the 1990s and is rapidly increasing this number through training in workplaces, health, Defence and schools. A recent investment from the Victorian government is funding free training in many LGAs across the state as well as to LGBTQIA+ communities.

For funded training in your state, or for any training enquiries, email info@livingworks.com.au or call 1300 738 382.

*Universal Suicide Prevention in Young People: An Evaluation of the safeTALK program in Alice Springs High Schools. Robinson J, Bailey E, Spittal M, Pirkis J, Gould M (2016)

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Leading suicide prevention training across health, Defence, workplaces, schools and the community. Celebrating 40 years of LivingWorks ASIST. Helping to keep Australians safe from suicide @LivingWorks Australia www.livingworks com.au 1300 738 382 Free training now available across NSW: www.livingworks.com.au/NSW

ABI COOPER

Abi Cooper (she/her) is a lived experience consultant and youth mental health advocate living and working in Meanjin, Brisbane. Abi uses her own story to guide her work, advising on projects spanning policy, research, stigma reduction and recruitment. She is currently working as the Lived Experience Coordinator and Speaker with batyr, a youth mental health organisation where she teaches young people how to share their own story in a safe, empowering and impactful way. At 22 years of age, Abi recently won the 2022 Jude Bugeja Peer Experience Award as a testament to her input and impact on youth mental health in Queensland.

Tell me about where you grew up I grew up in Central Queensland on Darumbal Country, in the small town of Yeppoon. Here I first experienced a failing mental health system. Rights and basic dignity ignored, voices quashed, burnt out care workers, stigma was rife and confidentiality hard to come by. Government, schools, clinicians, peers, and even those I thought as friends, seemed to turn from my family in our time of greatest need. Unfortunately, this is not a new or unique story.

Growing up in Yeppoon I was steeped in a sense of community and saw the best and the worst of it. At best, a web of interconnected support where individuality and diversity thrives. At worst, particularly when you’re on the outside, it can be all the more isolating, exclusionary, single-minded.

How does a person’s community impact their mental health?

Growing up on the coast shaped so much of who I am and the values I learnt there are something

I’ve come to hold close in a myriad of different settings, but particularly in my work. Holistic is such a buzzword in the mental health space but in my mind this all comes back to community. It’s about having a diversity of interconnected support and the options and choice to find where you can fit into that. Holistic is also about building a community where we lean on each other as mental health professionals and set aside ego in the pursuit of a greater goal.

What would you like MH professionals to consider when working with young people?

A lot of clinicians and mental health workers are doing their absolute best when working with young folk and supporting them through such an intense mental health crisis. It takes a lot of guts and courage to stay in this system and even more to keep your heart and compassion as well. But that’s not to undermine the harm that can and has been done by mental health professionals. Stay curious, ask questions, hold yourself accountable and stay true to yourself – young people have an uncanny ability to see through a false front.

What’s worked best for you?

The most beneficial thing I’ve done for my mental health is stay consistent with therapy for the past four years. Most of the failed attempts I’ve had at therapy have been where trust and connection was never established. In this way, I feel that clinicians have a lot to learn from the lived experience workforce – the masters of finding common connection. Sometimes hearing a small story or sharing a laugh can make all the difference when you’re trying to find trust with one another.

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AND THEN WE GO TO WORK...

We are still here. Aboriginal and Torres Strait Islander people are resilient - we do resilience every day and have done for millennia. Post colonisation we continue to endure challenges, pandemics, poor health, lower life expectancy, new conversations about our lives such as the Voice debate, and that old chestnut racism which continues to impact our mental health and wellbeing in a significant way.

Our ancestors expect us to get up every day, to hold our culture tight and to survive. Our children and grandchildren expect it from

us too. It is our role to look after our family, to look after Country and to preserve our Culture and our Law. They are demanding and often obligatory roles to undertake, without question - such is our Law - and then we go to work (on unceded land).

We are business owners and lawyers, we are barbers and surgeons. We do much more than sport and art though we punch far above our weight in those domains. Many of us are fortunate to be educated and to have employment. Many of us are not that fortunate. The ongoing traumas

of living under a western system have taken their toil on many. The need for our collective voice to be heard by policy makers, for treaties and truth-telling is blindingly obvious some 230 years post invasion.

In 2017 some of the most dedicated and brilliant Black brains came together at Uluru. They delivered the Uluru Statement from the Heart - a beautiful invitation directly from Indigenous people to their fellow Australians. It is above politics – or should be. It rises above the temporary political terms and divisive political point

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scoring. It is a modest, gracious invitation towards reconciliation, towards living together in a better country. The first of the Uluru Statements asks is “Voice” - a very modest ask. We are asking for Indigenous people to have a say over matters affecting their lives, importantly enshrined in the Constitution so it cannot be disbanded by governments as they come and go. It is above and beyond politicking.

Many signatories of the Uluru Statement have dedicated a lifetime to improving the lives of their kin. Some who attended that 2017 summit have passed away before seeing the realisation of voice, treaty or truth – the tenets of the statement. Indigenous people have continually dedicated ourselves and tirelessly careered in the policy and health sectors, no doubt inspired by the sufferings of our own peoples. What does the Voice debate bring to Indige-

nous community members including health care workers on the ground?

The upcoming referendum is just the latest issue to be painfully digested and discussed in our communities. We are dealing with plenty already. Supporters of the Voice rely on the non-Indigenous Australian public (the 97%) to vote yes. Of course not all Indigenous Australians will vote yes, many want more, such as a treaty first, many are not enrolled to vote or reject the Westminister-based Australian Constitution. There is hope that now at least these conversations are being held and will hopefully be held respectfully.

Indigenous professionals, healthcare workers including social and emotional wellbeing (SEWB) staff have challenging roles day-today. In Aboriginal health, healthcare and politics are intertwined. Lack of access to services, racism

within healthcare, remoteness, lack of cultural safety all impact on service delivery and lives are lost – unnecessarily. The lived experience of Indigenous health workers can take its toll also, dealing with distress at home and in the community often with extended family.

SEWB workers do incredible work supporting community members, preventing suicides, building capacity and improving wellbeing. They now have Voice discussions to deal with and of course some differing opinions but healthcare workers are acutely aware that the old ways of delivering policy on the ground have failed Indigenous people.

A stronger, sustained voice may bring change. A Yes vote in the referendum can bring the country closer together, aid reconciliation and may, like the apology in 2007, allow for healing and hope.

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TGA APPROVAL FOR PYSCHEDELICS

The Therapeutic Goods Administration (TGA) announced last month that the medical use of MDMA and Psilocybin will be rescheduled from Schedule 9 (Poisons Standard) to Schedule 8 (Controlled Substance) on a restricted basis.

This means that from 1 July specially authorised psychiatrists will be able to prescribe these substances as part of therapy for patients with treatment-resistant depression (psilocybin) and treatment-resistant post-traumatic stress disorder (MDMA).

Australia is the first nation in the world to reschedule these medicines for medical purposes and mental health professionals are likely to receive increased interest from patients about this decision.

MDMA (3,4-methylenedioxy-methamphetamine) is commonly known as ecstasy, while psilocybin is a psychedelic commonly found in so-called magic mushrooms.

Speaking to The Guardian, Dr David Caldicott, a clinical senior lecturer in emergency medicine at Australian National University, said the TGA’s decision was a “very welcome step away from what has been decades of demonisation”.

He said that a controlled supply of both MDMA and psilocybin could particularly benefit returned ser-

vice men and women from the Australian defence force.

The former chief of the Australian defence force, Chris Barrie, had previously campaigned to remove barriers stymying doctors from using MDMA to treat veterans suffering post-traumatic stress disorder and depression.

Since 2021 Mind Medicine Australia has trained 240 psychiatrists, psychologists, psychotherapists, GPs, physicians, addiction specialists, mental health nurses, social workers and occupational therapists through its Certificate in Psychedelic-Assisted Therapies (CPAT).

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CONFERENCE ROUNDUP

More than 1200 mental health leaders attended ANZMHA’s last three conferences of 2022. Here is a snapshot of each event.

STOP Domestic Violence Conference

The annual STOP Domestic Violence Conference was held on the Gold Coast from 30 November to 2 December. The conference saw 400+ practitioners, community leaders and mental health professionals gather to address key topics, challenges and opportunities facing the domestic and family violence sector.

The 2022 conference theme, ‘A Safer Future is Everybody’s Responsibility: How We’re Continuing Our Mission for Change’, reinforced the vision behind the conference; ‘to stop domestic violence in our communities’.

Conference Chair Hayley Foster, CEO of Full Stop Australia, said: “The calibre of presenters from across government, health, academia and the wider domestic and family violence sector, as well as the information shared with the group this year, was incredible. We were excited for our delegates to receive such valua-

ble and key information which will allow them to really create on-the-ground change in their communities.”

The national plan to end violence against women and children was a central topic of the conference. The dynamic program saw over 50 presentations running concurrently in three conference rooms across two days, with a third day dedicated to six solutions-based workshops.

ANZMHA applauds the sector’s support of the STOP Domestic Violence Conference and is proud to announce that the 2023 event will take place in Hobart from 27-29 November.

Rural & Remote Mental Health Symposium

Held in Adelaide from 9-11 November, the Rural & Remote Mental Health Symposium saw 300+ mental health professionals gather to focus on early intervention, prevention and improving service accessibility in rural and

remote communities.

The conference was carefully curated for professionals and industry workers to share best practice, encourage multi-sectoral collaboration, facilitate meaningful connections and provide solutions to advance mental health treatment in rural and remote areas.

Presenters discussed the myriad of issues currently facing these communities including the unprecedented demand for mental health services, with a particular focus on Resilient and Empowered Families, Embedding Lived Experience Expertise and Engagement, Service Excellence and First Nations Social & Emotional Wellbeing. The program was designed by the sector, for the sector, from academia through to lived experience, with unique insight into the challenges and opportunities faced across many sectors of service care, accessibility, treatment, and recovery.

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In 2023, the Rural & Remote Mental Health Symposium will be hosted in Albury Wodonga from 8-10 November – with a fresh face and new brand to watch out for! The application for speakers is now open.

Indigenous Wellbeing Conference

The second annual Indigenous Wellbeing Conference was held on Kaurna Country in Adelaide, South Australia, from 24-25 October. More than 500 community leaders and health professionals gathered to address challenges of social and emotional wellbeing facing first nation communities around the world.

The vision behind the conference is to provide a platform for First Nations Australian, Māori and Pasifika people to come together, collaborate, teach, learn, create, and lead programs and services for greater social and emotional wellbeing.

The dynamic program saw more

than 50 presentations from well-respected individuals, including elders, indigenous academics, psychologists, mental health professionals and those with lived experience within the Indigenous mental health field. All shared valuable programs, initiatives and insights with the group, with a solutions-focused lens to improve health outcomes for Indigenous peoples.

“To have a whole conference focused on Indigenous people, put together by indigenous people and presented by Indigenous people is something we are incredibly proud to be a part of,” ANZMHA CEO Sam Stewart said.

The 2023 Indigenous Wellbeing Conference will be held on Larrakia Country in the Northern Territory from 30-31 October.

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Youth Workers: A Vital Part of the Mental Health Workforce

Youth workers play a vital role in supporting young people at risk of, or experiencing, mental ill-health. And yet, they are seldom recognised and valued as a part of the mental health workforce.

My colleague Heather, a long-time youth worker in AOD, LGBTIQA+ and mental health spaces, compares youth workers with midwives.

“In reproductive health, no one questions the role of midwives which complements the expertise of GPs and obstetricians. Similarly, in mental health, youth workers play a critical role in

prevention and early intervention support, as well as providing psychosocial support to complement clinical care by psychologists and psychiatrists in more acute settings.”

“Young people often don’t feel comfortable speaking with family or friends, and I’m able to talk and meet with them on terms that suit them best and link them in with appropriate mental health services.” Kieran West, Banyule City Council Youth Services

Even when a young person requires prolonged treatment by a psychologist or psychiatrist, youth workers can provide important,

trusted support to access that treatment. They can also help that young person holistically with other aspects of their lives related to their mental ill-health.

“It’s that non-judgmental support, it’s [being] relatable. And it’s that support to get them into appropriate mental health services as well. We can meet the young person in the community, and that can really help them become comfortable with the idea of accessing mental health support.” Marita Hagel,

Many young people don’t see mental health services as being for them. Discussing mental

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health issues and seeking help may not be acceptable in their family or community, or they may not relate to the people providing the services. That’s where youth workers from First Nations, refugee or migrant backgrounds, or who identify as disabled or LGBTIQA+, can smooth access pathways and provide support based on their lived experience.

“I was able to meet her on her terms. She could tell the difference of my approach opposed to other services, and I was able to break it down in her language what support these other [mental health] services provided and why they were important to her.” Sione Toangutu, Youth Support and Advocacy Service (YSAS)

Mental health supports for rural and regional young people are particularly limited, due to sparse services, transport barriers, and issues of stigma and confidentiality in local communities. In

those areas, youth workers play a crucial role in supporting young people, including ‘holding’ them until they can access more critical care.

“A lot of young people don’t know how to have those conversations, or they are scared to have those conversations with either parents or doctors.” Maree May, Latrobe Youth Space

“If a youth worker is in a young person’s life, and is hearing what a young person needs, often it can lead to them reaching out to other supports, especially mental health support.” Yumna Ahmed, Latrobe Community Health Service

As well as the social outcomes, youth work more than pays for itself. A recent return on investment analysis by Deloitte Access Economics showed a return of at least $2.62 for every $1 invested in youth work programs.

The Victorian Government is currently applying enormous resources to reform the mental health system, including creating a dedicated sub-system for children and young people, putting mental health workers in schools, adding new youth mental health beds, and creating roles for lived experience workers. Youth workers have been included on the Schools Mental Health Menu.

While there is still a long way to go, with new endeavours such as the state’s first Mental Health and Wellbeing Promotion Strategy, we hope to see youth workers further recognised and funded as a vital part of the mental health workforce.

Katherine Ellis is CEO of Youth Affairs Council Victoria (YACVic), the peak body for young people and the youth sector in Victoria, and a board member of the Australian Youth Affairs Coalition (AYAC).

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CREATE YOUR OWN SELF CARE PLAN

Healthcare workers are used to looking out for the health and wellbeing of others. In the midst of caring for others, we often overlook our own needs. Sometimes the last person we care for is ourself.

Self-care is often the first thing that gets sacrificed when life is busy and stressful. You may think that taking time for yourself seems indulgent. But self-care is not just about soothing activities; it’s about creating a plan that will help you focus, make decisions and stay healthy.

A self-care plan will identify what nourishes and sustains you, to help you get through the challenges presented by the COVID-19 pandemic, and better care for others. Remember, if you don’t look after yourself first you won’t be able to help your patients or the other important people in your life.

What is self-care? Self-care refers to the activities that we deliberately choose to engage in on a

regular basis to maintain and enhance our health and wellbeing.

Self-care helps to prevent stress and anxiety. By incorporating self-care activities into your regular routine, like taking a walk or socialising with friends, you give your body and mind time to rest, reset and rejuvenate, so you can reduce or prevent the symptoms of stress and anxiety.

Self-care makes you more effective. When you take time for yourself and give your body the food, rest, and activity it needs, you will actually have more energy to meet the demands of daily life – however unusual they might be at present. Bringing more balance to your daily routine will help you to be more resilient and productive.

Source: Black Dog Institute Resources & Support for Health Professionals

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1 2 3 4

Evaluate your coping skills

STEP STEP STEP STEP

Examining your own habits is an important first step in developing a self-care plan. When faced with increased demands, we can use either positive or negative coping strategies. Which strategies do you use? It’s important to be honest when evaluating your behaviours. If you find yourself feeling overwhelmed or angry, snappy with others, or unable to switch off the worries, it may be time to re-evaluate your coping skills.

Identify your self-care needs

Take a moment to consider what you value and need in your everyday life. Then consider what you value and need during these difficult times. Remember that self-care extends beyond your basic physical needs. Consider also your emotional, spiritual, social, financial, and workplace wellbeing. You will find a template for ‘Identifying needs’ at https://www.blackdoginstitute.org.au (search ‘self care planning’)

Reflect. Examine. Replace.

Reflect on your existing coping strategies. What’s working? What isn’t working? Examine: Are there barriers to maintaining your selfcare? Are there any small steps you can take to address these? Do you need to ask others for assistance? Replace: Work towards reducing, and then eliminating, negative coping strategies. If you find yourself using negative strategies, then begin by choosing one action you feel is most harmful and identify a positive strategy to replace it.

Create your Self-care plan

Once you’ve determined your personal needs and strategies, write them down. Your self-care plan can be as simple or as detailed as you need it to be. Look at it regularly, keep going back to it and refining it.

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FOR REFERRALS FROM ANZMHA MEMBERS CALL (03) 9663 9877

FAMILY & RELATIONSHIP LAW

(03) 9663 9877

adminfamily@khq.com.au

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Across Australia, police are called to a family violence incident on average once every two minutes

At least one woman a week is killed by a partner or former partner

Every three hours a woman is admitted to hospital as a result of family violence.

Intimate partner violence is the leading contributor to preventable illness, disability and death for women aged 15-44; the leading driver of homelessness for women; and a common factor in child protection notifications

As family and relationship lawyers, we see first-hand the devastating impact of domestic violence on families and have considerable experience working with agencies and organisations operating in this space to provide support and guidance to those escaping family violence.

Our expertise includes separation and divorce, family violence and intervention orders, parenting matters, property settlements and Financial Agreements, child support matters, injunctions, restraining orders and child abduction

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If you have any concerns about someone you’re supporting or have queries in relation to family law matters generally, please contact us for a free 30 minute consultation.

We are proud sponsors of the STOP Domestic Violence Conference.

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Q&A with ANZMHA’S Ambassadors

Q: In which way(s) do you think the restriction of mental health sessions will help or hinder access to psychological support?

The introduction of Better Access was met with resounding cheers and celebration from Psychologists Australia wide. The increasing of access to invaluable mental health services with rebates under Medicare allowed me to provide more services and reduce much of the financial stress so many of my clients were experiencing.

Limiting mental health services doesn’t speak to a therapeutic approach or nuances of individual clients. Limiting what a person can receive with Medicare rebates forces people to choose between their mental health and other things, with mental health being too often deprioritised or seen as a luxury. Better Access allowed people to prioritise their mental health and get the support they need.

For me as a Psychologist, it gave me space to dive into the work with clients. Mental health is not linear, nor is working in the mental health space. Some people come to deal with a specific issue; navigating a divorce or stress. Others need support for chronic pain management, grief, eating disorders, depression, trauma or addiction. These concerns may need more than just 10 sessions per year. Particularly working in a trauma-informed space. Healing from trauma and breaking cycles

of behaviour can take years. Ten sessions per year feels like a ‘one size fits all’ approach when we know that is just not the case. Mental health IS health and it shouldn’t be considered a luxury, but a necessity.

Like most journeys, we encounter hurdles along the way. Regression is a part of the journey. When someone I’m working with sees progress on their mental health journey and experience a regression it can be disheartening, frustrating and demotivating. That is how I feel about the repealing of Better Access. It feels like a step backwards, a regression, in progressing of our mental health system.

“A longitudinal study by the Australian National University found a significant increase in psychological distress between February 2017 and April 2020, 8% to 11% of people reporting a serious mental illness. This percentage has only increased between 2020 and 2022, which is why it was surprising to see the Federal Government revoke its “Additional 10 Better Access Sessions” for psychological support services.

The original “10 Better Access to Mental Health Service” sessions are built upon a cognitive behaviour theory model, in which the presumption is that clients will be able to resolve their current issues within 10 set sessions. However, this is not always the case, oftentimes clients present

with a range of complex issues not just one problem. Sociocultural determinants of health such as culture, religious background, ethnicity, socioeconomic status and so on can contribute to the complexities of the presenting problem. It can often take more than six sessions to even unpack the issues, let alone work through them. Clients struggling financially will often stop going to therapy after 10 sessions as their mental health care plan has run out, even if they haven’t resolved their issues. This means they leave therapy half-way, often waiting 6 months to return to therapy the following year which can be detrimental to their overall treatment. Sometimes having to restart their journey from scratch. Furthermore, therapy is a very personal journey and finding the “right fit” can sometimes take one to two tries. With only 10 sessions, this would mean a client has essentially “wasted” two sessions trying to find the right therapist.

There is a flipside however, when it comes to better access to mental health support - subsidized mental health support is indeed helpful for those of a mid to high socioeconomic status. Individuals from low socioeconomic backgrounds often experience the highest levels of mental health issues, but also are less likely to access support as they cannot afford it despite there being a rebate. This sheds light on the financial barriers to seeking mental health support and poses the question: should the government be doing more to focus on affordability as well as accessibility of mental health services in Australia?

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A: Shanna White (Psychologist, Clinical Consultant, and Family Therapist) A: Anushka Phal (Founder & Principal Psychologist at Umeed Psychology, School Psychologist)

Letter to my younger self

Suzanne, you will put on a fake smile even though you will be hurting inside. You will tell people you are okay and strong even though you are not coping. You will put on a strong and resilient mask wherever you go. You will meet many men who would take advantage of you physically.

You will go through rape and trauma. You will cry a lot. You will want to end your life and do bad things to yourself. You will lose a sense of who you really are. You will lose hope and have no faith in humanity. You will be angry at God for giving you Bipolar. You won’t understand why God made you who you are. You won’t understand why God put you in such a difficult position. You won’t understand why you got excluded from Nursing. You will feel like

you’re the biggest failure in the world. To yourself, to your family, and friends. You will want to prove that you’re a somebody and you want to find meaning and purpose in life. You will seek validation in your social media platforms and feel that your worth is based on how many likes you have and how many followers you get. You will try many medications, and not all of them will work.

You will have medication withdrawals and give up the fight with the right combination of medications. Some days you are not OK, and feel depressed. You will have fall outs in friendships and believe that you’re a bad friend. You will blame yourself on the bad things happening around you. You will at times feel worthless and helpless.

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But you want someone who you can cry to and have a shoulder to lean. The rape and trauma will make you stronger as a human being. Every tear drop that falls down your face will shape you and make you more resilient. You will be close to ending your life but God will protect you. Being excluded from Nursing will help you grow as a person – and failing Nursing will just be a small speedbump and a test to see how strong you are.

You will be a mental health advocate through your Bipolar diagnosis. You will incorporate self love and self care in your life and know what will work or doesn’t work for you. You will be an inspiration for many. You will fight battles every day but they will help you become who you are in the future. You will help more people than you think. Some days you won’t be OK, and that’s OK.

Your recovery is not linear, it’s up and down. You will have people and friends who will understand and believe in you. You will not give up in making meaningful and genuine friendships. You will learn to

reach out for community support and be employed as a mental health peer support worker full time. You will help other people with mental illnesses with their recovery goals and you will be a valued team member who everyone adores. You will do many public speaking gigs, and sharing your story openly, honestly, confidently, and vulnerably. You will receive much positive feedback from the audience where you are speaking at. You will be an inspiration for younger girls – and be the voice for those who are weak and inspire young girls who wants to try out modelling too.

You will reach and smash goals in life. You will recover from Bipolar. You will overcome Bipolar. You will reach a point where you share that your mental illness is your super power. You will get comments that you look normal, but you acknowledge that you do have an invisible disability and need to take medications for life.

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Book Review: Dear Psychosis by Sarah Martin

Dear Psychosis, a new non-fiction book by Sydney author and mental health advocate Sarah Martin, has just been published and it uniquely captures the experience of psychosis from three angles.

Most of the book is written by mother-of-three Sarah, with chapters also written by her son Jesse, and daughter Alice who suffered her first episode while travelling alone overseas aged 21.

This is Sarah’s story:

In 2015 mental ill health opened our door, ran inside, uninvited and most definitely unwelcome.

Our daughter then 21 was traveling alone overseas, in Turkey,  Istanbul, to be specific.

Alice mumbled when she spoke.  She had voices in her head.  She was delusional.  She was not safe to be left alone.

My girl had a drug-induced psychosis caused by a quarter of a tablet of the newest party drug in town. One which doctors back in Australia had never heard of.

The Oxford dictionary states psychosis is a severe mental condition in which thought and emotions are so affected that contact is lost with external reality.

The book been endorsed by Prof Gordon Parker AO, Founder of the Black Dog Institute, who said:

In this hair-raising account of her daughter’s psychosis Sarah Martin moves the common ‘lived experience’ paradigm from the sufferer to the family and to her daughter’s ‘on the ground’ supporters. Family members evidence striking strategies for moving through the crisis. This is an uplifting account of the rare kindness of strangers, how strengths of family members were achieved and how resilience generally requires exposure to a flame.

So what would you do if you received a message from an unknown person… telling you that your daughter was having some sort mental breakdown.

Wait … WHAT did he just tell me?  Is he a scammer?  Is she safe? Is this true?  Mental illness had come knocking rudely at our door.

Twenty-four hours later my 24year old son and I were on a plane to Istanbul to find our Alice.

Some 72 hours and 28,000km later, we were all on a plane back to Australia.

This was our Alice. Lost. Confused - at least in our eyes, but not in hers.

Sarah’s book, available to purchase from sarahmartinauthor. com, details not only Alice’s dramatic rescue from Istanbul, but her treatment in both the private and public mental health systems in Sydney.

Ultimately, it is a story of hope and how with the love of family, and the expertise of mental health professionals, Alice has returned to good health, completed a university degree and began full-time work.

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