Carers Corner: Stories From Mental Health Carers

The Mental Health Carers Voice team welcomes any input from mental health carers. Feel free to send us stories, poems, or relevant articles and information that mental health carers would be interested in.

Family Connections - Support for Loved Ones of those with Borderline Personality Disorder (BPD)

Two carers and four MH professionals attended Family Connections Leadership training in Sydney, led by Professor Alan Fruzzetti. Family Connections® is a free 12 week course that offers education, skills training, and support for people who are in a relationship with someone who has BPD. Family Connections provides: (i) current information and research on BPD and on family functioning (ii) individual coping skills based on Dialectical Behaviour Therapy (DBT) (iii) family skills and (iv) group support that builds an ongoing network for family members.
Family Connections programs start in Canberra in September. Register your interest now with BPD Australia www.bpdaustralia.com or email bpdfamilyconnections@gmail.com. Natalie Malcomson and Carolyn Minchin would like to thank both Carers ACT, ACT Heath and BPD Australia for their support for this program being delivered in the ACT

National Suicide Prevention Conference Report

Denis Strangman This event was held 25 - 27 July in Canberra. Denis was one of 440 delegates who attended the conference where a range of Australian and international presenters shared information about suicide. Read the full report here. Note: This paper opens with important stigma-reducing terminology to be used around the topic. 

Speaker Presentations from the National Suicide Prevention Conference  

Would you like to access the speaker's notes from the conference?  They can be downloaded on the Conference app, under the speaker profiles. If you do not have the app installed on your phone, you can click here to access the app. 

MyHome in Canberra

Our vision is to provide a safe, supportive and caring home for people with enduring mental illness who are homeless / at risk of homelessness, for those living in unsuitable accommodation or those who cannot live independently. We aim to provide safe, stable, secure, purpose-built and cost-effective long-term accommodation linked to community organisations and treatment services. Our first proposed site is Curtin but we need local support from mental health carers, Government, businesses, builders, philanthropists, colleges, schools and skilled volunteers to help us achieve our vision. If you can support MyHome in Canberra, email John Tucker on ejtucker42@outlook.com.   

Report from Carolyn Minchin, Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP) "Coming Together for a Greater Tomorrow" Alice Springs May 2016

ATSISPEP, the first national Indigenous-led suicide prevention conference took place in May - providing meaningful and encouraging opportunities to re-think our approaches to mental health, community risk-management, culture and wellbeing. Community courage and commitment to find solutions to the current crisis in suicide were evident, with some communities impacted by severe suicide blackspots, fund-raising to send young people to share stories and find practical, community-focused and culturally appropriate support. Some of the impressive speakers are presenting at the upcoming Suicide Prevention Australia conference 24 - 27 July. Related articles (1) and (2)

Paper on the Mental Health System - "From NEWTONIAN to QUANTUM INITIATIVE"

This report was prepared by carer Grace Chin in her personal capacity. The opinions expressed in this article are the author's own and do not necessarily reflect the view of Carers ACT. 

Carer Ms Grace Chin has submitted a paper she has written on the mental health system. She argues that the mental health system needs to move from treating physical and mental health separately as the two are interdependent on each other. Through her research into the literature and interviews conducted with various services the early 2000s, Grace explores the complex interaction of mental and physical illness and articulates the importance for services to have equally complex responses. It is interesting to examine these issues from how they have been understood and handled in the past, what has changed and what work still needs to be done. Click here to read the paper. To contact Grace in relation to her paper email mhcarers@carersact.org.au.

Report from Carolyn on Dialectical Behaviour Training (DBT)

             

We were fortunate to have two carers attending workshops on cognitive behaviour therapy DBT. One of these carers, Natalie Malcolmson will be provide an orientation to DBT during carer rep training 26 May. Founder Marsha Linehan emphasised DBT skills are useful, safe and effective tools to navigate through everyday life and when caring for people at risk of suicide/self harm. Marsha encourages the development of peer-lead skills training group using the worksheets in her very accessible second edition of the DBT Skills Training Manual (on public record). Anyone interested in furthering their DBT skills knowledge is welcome to contact Natalie and Carolyn via the Mental Health Carer's Voice, and we hope to make further opportunities for sharing and practising the skills available over the year, based directly on advice from Marsha Linehan's company Behavioral Tech.

SANE Forums: A Carer's Perpective

I came across the SANE Forums on one of those days when I felt hopeless and needed something to remind me that, whilst it is hard caring for a loved one with mental illness, I don't need to do it on my own and there is always support available to remind me there is HOPE and that I am just feeling overwhelmed in that moment.  
I have found the forums a great source of support, as so often our journey as MH Carers can seem lonely and isolating, well the best advantage is that you can access them 24/7. In that moment when you are overwhelmed and you need to vent they are there, and there are people who "get it", you don't need explain yourself, you will not be judged, they are a safe place.
It helps me to see what other people do in similar situations and it helps me to have my own feelings validated without judgement, and it's nice having a place where I can celebrate the successes we all have in our journey. Not everyone gets the absolute joy of celebrating a day/week/month of your loved one not self harming, but they do. In these groups others get your elation at such an achievement.
They also have set activities which are great, such as "Ask anything Mondays" and there are Discussions on set topics on Tuesday evenings. The topic is announced prior and you can join in the forum live with others to discuss the topic. So do yourself a favour and check the SANE forums out. As a MH Carer the MOST important gift to give yourself is the gift of SELF CARE.

- Natalie M

A Carer's Story

A carer has submitted this attached story of caring for her son. She examines the challenges of dealing with drugs and imprisonment and also how strong her son has remained throughout. 
"Ok, so you can’t wait for the day that your son is released. It is mixed with happiness and fear; there is no way to describe how you feel."

Click here to read her story. 

Labels, schizophrenia and stigma


During Schizophrenia Awareness Week (17-23 May 2015) Jack Heath, CEO SANE Australia, posed the question: should the term ‘schizophrenia’ be renamed?  Click here to read Mr Heath’s letter.

In response to this news item, a mental health carer has sent in this response to the MHCV team:
 
I strongly agree with some re-naming as stigma won’t budge. I have heard upbeat people using the term Schizy and I think this is very brave of them. It’s as an option for young people when they first learn about their illness, and could be introduced straight away. They could wear this name as a badge of honour without the stigma attached to schizophrenia.
 
I would prefer investigating the use of:

A carer

Ed. - The shortlisted article by Sandy Jeffs and Margaret Leggatt in the 2014 Gavin Mooney Memorial Essay Competition Award, considers this question in depth.  Click here to read ‘Schizophrenia: a dialogue on progress’.

 

Self-compassion and third wave psychology

We are in the midst of a gentle transformation taking place across the world in the way that psychology is taught and practiced. I was fortunate to be able to attend the World Conference of the Association for Contextual Behavioural Science in Sydney in 2013, where significant international research leaders in mindfulness-based behavioural science, such as Steven Hayes, Kelly Wilson, and Australia's Joseph Ciarrochi, Louise Hayes, and Russ Harris met with experts of compassion-focused therapy, including Dennis Tirch and Paul Gilbert. Developments in research since that time have confirmed and strengthened the case that we have a third wave in psychology, moving from early behavioural psychology to cognitive behavioural psychology, to third wave of mindfulness-based and compassion-focused therapies. We have new ways to measure programs based on their impact on our capacity to be self-compassionate, with the work of Kristen Neff.
 
We have the techniques in psychology and psychotherapy to access greatly improved treatment protocols in mental health. And the good news for carers is that many of these therapies - such as Acceptance and Commitment Therapy, Dialectical Behavioural Therapy, Mindfulness-Based Stress Reduction - are evidence-based, and based on skills training, so every member of the family can support the person who is experiencing mental illness, through learning and practicing the skills. Being skillful in self-compassion and mindfulness is crucial for family carers to overcome the impact of mental illness on the family system, and to adjust to the new reality that the experience of severe mental illness brings to a family.
 
Consumer/carer literacy in understanding the differences in therapies offered in the both the public system and private market is critical in achieving a good connection with a recovery team, and an understanding of what works, and how to move forward.  If treatment doesn't feel right, keep looking, there's hope, and family recovery is something that everyone in the family can work towards.
 
Carolyn Minchin

The risks of Seroquel

In December 2013, Mental Health Carers Voice published a link to a 7:30 report about Seroquel. The link can be found here.

Since then, Seroquel is back in the news, this time with a worrying trend of time-poor GPs prescribing the powerful anti-psychotic to address sleeping problems. Seroquel may have a range of side effects including weight gain, daytime sedation, fatigue, dizziness, dry mouth, raised lips and heart problems, as well as an increased susceptibility to chronic illnesses such as diabetes, or even result in cardiac arrest. More information on this can be found by clicking here.

- A Carer

Metaphor and Mindfulness skills in Acceptance and Commitment Therapy and Dialectical Behaviour Therapy


By Carolyn Minchin

Stephen Hayes and Marsha Linehan have both graced our shores recently, and the increased opportunities to train in both ACT and DBT have prompted me to reflect on the overlaps and differences between the two mindfulness-based cognitive behavioural approaches.

Both psychologists are striking in their honesty and openness in allowing the audience into their own human struggles and their personal reasons for developing their work. Both are generous and outstanding scholars, and the way their work is emerging in the literature on the third wave behavioural therapies gives their work a sense of collegiality and accessibility, making them both highly influential for practitioners from a range of professional backgrounds.

One key point in common is the way the programs focus on skills and assisting the client to develop internal locus of control. Kabat-Zinn’s work bringing mindfulness into medicine has laid a crucial groundwork for the acceptance of mindfulness and Mindfulness-based Stress Reduction (MBSR) is a valuable and well-structured introduction to mindfulness-skills in a medical context. The contribution that Hayes and Linehan make, as behavioural psychologists, is the focus on developing mindfulness skills within a personal context and bringing mindfulness to our choices and actions. Both make effective use of metaphor to communicate, and both grapple with dialectics, paradox and insistence on the clinician’s openness and application of the skills to themselves.

Hayes describes his work as a model, allowing clinicians great liberty in their development and application of that model. The Association of Contextual Behavioural Science (ACBS) provides support to enhance understanding of the Relational Frame Theory, the theoretical framework underpinning ACT. DBT is a more structured program, with insistence on accountability and adherence to the integrity of the program, including the structure of phone-coaching sessions, sharing of skills with friends and family, and structured skills progression.

Hearing Linehan speak movingly of how her work evolved, specifically targeting patients at the highest risk within the mental health system, makes it clear why this is the case. Her contribution is unique in terms of her capacity to bring hope and awareness into that dark room of suicidal ideation, and to engage in the struggle with the client to find a way out. Her suicide risk-management protocol is a valuable tool that combines validation of the client’s current state combined with effective and proactive action to protect life and generate hope.

Steven Hayes ‘driving the bus’ metaphor is about moving forward. Linehan’s firm and unequivocal message is that in a crisis, if you are making thing worse, sometimes you just have to stop. Taking sides as to whether ACT or DBT are better therapies makes about as much sense as arguing over whether teaching a child to ride a bike requires showing them where the brakes are or teaching them how to peddle.

ACT and DBT are effective and complimentary clinical tools, and although it is easy to fall into one camp or the other according to our personal preferences, it’s absolutely crucial as clinicians to be aware of the strengths and applications of both approaches. From a client perspective, it’s ok to be learning both sets of skills. The real clinical skills lies in keeping the client engaged and connected while they struggle through the difficult early stages of learning mindfulness skills and applying them to their own life journey.

Carolyn Minchin currently co-ordinates the ACT Interest group in Canberra and is a student in Social Work at CSU.

A copy of the report can be found here. Meta Analysis and Systematic Review Assessing the Efficacy of Dialectical Behavior Therapy (DBT) by Patrick T. Panos, John W. Jackson, Omar Hasan, and Angela Panos.

Online Mental Health Services

The ABC Radio National program recently covered the topic of e-mental health. Click here to read a transcript of the conversation. 

A carer has provided this contribution on the topic for Carers Corner:

From the info provided it seems that only mild anxiety and depression may be a good target for e-mental health at this stage.

I know the Federal government would like to find a cheap solution to big issues. 

For substantial mental health problems with possible psychosis such as paranoid schizophrenia and bipolar disorders, autism etc., it will be irresponsible and dangerous to use DVDs for self-diagnosis and cure. 

This is the problem of broadly addressing mental health in the News without knowing all the real implications. 

A carer

  

"Life is yesterday's memories, today's joys, tomorrow's dreams"

A mind held together

With gossamer threads

The world outside
Full of rushing strangers

Mind tangles with confusion
Rushes to escape

Injury caused this chaos
Took away reason

Love brought her back

Sometimes love is not enough
These thirty years of mixed blessings
Must count for something

Yet not all days are dim
Sometimes the sun shines
With such brilliance and hope

I worry for your wellbeing
What will happen when I'm gone?

When alone, with no protection
Where will you find a home?

A fragile mind
With gossamer threads
Caged by fate
Trying to escape

Yet I would not have missed this life with you
My fragile child

Jo Forestier

 

Living Well

The Mental Health Commission of NSW recently released a Report - Living well – Putting People at the Centre of Mental Health Reform in NSW. The report presents the case for reform, told from the perspectives of people living with mental illness, their families and carers, and the front-line workers who support them. Embedded in the report is a story by Alison Green, nurse unit manager, at Missenden Hospital. I found this story to be a very refreshing approach to recovery – it is a call for reform within the multidisciplinary treatment team. Carers in the ACT perhaps should expect no less from the treatment teams in our hospitals.
 
A Carer

 

Schizophrenia - my son suicided

A carer submitted an entry from her diary - a conversation with her son who took his life two years ago, aged 29. This article may be confronting for some people, so you may choose not to read it. Click here to read the diary entry.

If you wish to access supports for yourself or someone else, call Lifeline. Trained volunteer telephone crisis supporters staff Lineline 24-hours a day, seven days a week, accessible to anyone at any time. Lifeline is non-judgmental, informative and immediately accessible. It is also confidential. Call 13 11 14. Lifeline also delivers a range of mental health and suicide prevention training programs. To find out more, visit http://www.act.lifeline.org.au/Training/ or phone Erica on 6204 6402.