Coroner slams mental health system

Harrowing outcome
http://www.abc.net.au/news/2014-03-12/mental-health-service-under-fire-in-coroners-findings-on-teenag/5315328
Someone has finally said something of the truth for once. Pretending that it is ok for children/ teenagers to not see a psychiatrist because somehow their mental illness is not as bad, or severe or real as an adult has lead to this disaster a well as many others no doubt. Of course children do not have a vote so lack the power to do anything here. Therefore they rely on adults to look after them and lobby on their behalf.
It concerns me that there is a code of silence around the poor mental health services because it is such a political hot potato.
I just hope that one coroner is enough to shake the system rather than someone makes another feel good statement, covers up the trail and its business as usual.
Please think about this and start lobbies for investigations of mental health resources and proper health care.

Mental Health Care

This report on the ABC News this morning  is important.
http://www.abc.net.au/news/2014-03-11/reachout-ceo-jonathan-nicholas-speaks-with-abc-news-breakfast/5311636
I would like to point out that although the best of intentions are being discussed her, that Jonathan Nicholas has a huge bias in his presentation. he is selling/ lobbying the government to spend not insignificant amounts of money on his early intervention program.
Where is the evidence that the things Reaachout offers has any validity in treating depression?
Is this just delaying people from seeking treatment when they detect problems early but are deflected by the concept that they can just pull up their socks and fix the problems themselves, not annoying specialist services like doctors, psychologists and psychiatrists, as he says? This means maybe another six months wait before again seeking help, by which stage the person is much more ill and suffering loss of friends, physical health, work, study and maybe becoming suicidal.
Where is the research that says that people are minimally ill by the time they seek first point of contact. What is the qualifications and abilities of Reachout staff? Is their agenda to stop people seeking medical care?
He specifically targeted intervention with children. he has specialist qualifications, as does his staff, for working with children? Is it possible that Reachout assumes that children are just small adults and the same things apply? What about notification of the parents of children and young people when they discuss their depression and suicidal thoughts? What are the confidentiality statements?
I have no doubt that Jonathan Nicholas and many other agencies and organisations that look on in horror at the lack of services for mental health, have the best intentions. I just ask that we stop accepting all the feel good stuff and look seriously at how we help, prevent, triage, resource the area and make responsible decisions that will not make things worse.
First- do no harm!

Depression and cancer

Most people do not link cancer with depression. despite many studies showing about 90% of cancer sufferers suffering depression.
I draw your attention to some extra reading on the matter
http://www.cancer.gov/cancertopics/pdq/supportivecare/depression/Patient/page2
http://www.cancer.org/treatment/treatmentsandsideeffects/emotionalsideeffects/anxietyfearanddepression/anxiety-fear-and-depression-toc
In fact it is more worrying when someone has no emotional response to a serious medical condition. Cancer however carries an emotional load in the very word. This i think is due to the fact that 50 years ago, cancer was a death sentence. Luckily today, cancer is mostly manageable and sometimes curable. Early intervention, prevention, community education have worked well and Australia has the best outcomes for management of cancer in the world.
Depression however can be caused by more subtle processes than our cognitive/emotional responses to threat to life and fear of medical treatments. There is a reciprocal problem that stress and depression can lower the immune system, causing cancer.
\http://www.cancer.gov/cancertopics/factsheet/Risk/stress
http://scienceblog.cancerresearchuk.org/2009/05/19/us-research-suggests-that-cancer-cells-trigger-depression/
There is also evidence that depression lowers survival rates in cancer.
So the link between cancer and depression is important. Prevention is the best approach. I suggest that information about the risk of depression in cancer be given to all patients with cancer and their families. I also suggest that screening for symptoms of depression and offering early treatment is important. Maybe there is room for cognitive retraining for cancer sufferers although there has been little research in the area. I know clinically that many people benefit from cancer support groups- self help groups where you do not feel alone and people can get on with life and living.
There is also little research into the effects of cancer on family members, especially children. It makes common sense to understand that this is a major problem because these people have little control or decision making. They can often feel guilty for being well and give up their lives to support their family member, worrying all the time over them and there is a breakdown of communication about how people really feel.
Unfortunately i suspect that this area is under-serviced and lacks research and resources because we continue to divide the mind from the body and fail to understand how united they really are.
If you see depression, there is help.  Call your doctor.

New rooms

Hi everyone
Thanks to the people reading my blog.
I have moved.
New Address is
6th Floor, Watkins Medical
225 Wickham Terrace
Spring Hill
Queensland 4000
phone is 07 38395626.
same email drjoycearnold6120a@gmail.com

We are Moving!!
New Address 
6th Floor Watkins Medical
225 Wickham Tce
Spring Hill
Qld 4000
ph 07 38395626.

The effects of parental mental illness on children

There is not enough research in this field but enough clinical evidence that parents who are unwell, effect their children. Common sense would also confirm the truth of this statement.
The effect varies with the type, length and severity of the illness.The effect varies with the child's age, developmental stage, intellectual capacity, resilience and other supports available.
The effects range from psychological, physical, developmental, social and educational impacts

Anxiety disorder is common, 30% of the general population and anxious parents usually have anxious children. The children do not feed or sleep well in early infancy, suffer reflux and separation anxiety later in childhood. The children suffer nightmares, anxieties of their own or shared with their parents. these children often are anxious about their parents as much as their parents are anxious about them. Adolescence can be difficult as separation anxiety, social anxiety, performance anxiety can affect the normal separation from parents and finding a sense of identity and place in society.
Depression is very distressing for infants who can only communicate by feeling the emotions of their parents and expressing their own emotions. Without external support and opportunity to have fun and play with other people or siblings, they often become depressed too. They often worry about their parents, and feel a sense of responsibility for the state of play or guilt that they may have caused the problem.
Substance abuse disorder has major problems for children as it is usually chronic, severe and affects all levels of family function from maintaining family denial, avoiding social groups, not able to take friends home, suffering neglect, lack of money, domestic fighting and violence, secondary effects of physical, mental complications in the parent and loss of employment and housing Frequent changes in accommodation and schools are common and this affects social, emotional and educational development. 50 % of children of alcoholics will abuse alcohol as well.
Psychotic disorders have been found to have a smaller effect on children so long as they are not neglected or abused.
Clearly the effects of prolonged illness, hospital admissions, side effects to medications and effects on capacity to work and provide family time have a greater impact on children than mild or short term illness. Suicide or attempts are particularly malignant for everyone in society but more so for children show have a sense of responsibility, guilt, abandonment and are more likely to copy a parent or try to be with them. Supporting a grieving parent can be very difficult for children. Some will try to take over the parent role and others will disengage.
Work in the field is mostly looking at how to build resilience and support systems for at risk children. 

Post traumatic stress

It seems like a long time since I penned a letter on my blog.
The current storm season, hail, winds, rain, electricity outages, damage to houses and cars as well as fires are hitting our news recently. It is that time of the year in Australia, a land of droughts and flooding rains.
My thoughts turn to those 20 % of people who when traumatic events happen will develop symptoms of acute stress reactions and post traumatic stress disorder. We used to think, hope, that this could be prevented with emergency therapy, critical stress debriefing, but research evidence seemed to prove otherwise. We certainly know that family and friend support, communities pulling together and sharing their grief and sorrows as well as their triumphs and joy is the best way to cope with the issues life throws at us. It is at these times that she discover our neighbours and community supports.
Early detection of stress disorder is now thought to be the best approach. If you have nightmares, can't sleep, have recurring memories of bad events, this can be the warning signs of post traumatic stress disorder.  Erratic moods with tears, sadness, irritability and frustration are also common signs of difficulty. Anxiety, agitation, worrying, are common. Withdrawing from people and activities you normally enjoy are also warning signs.
If these things happen, see your local doctor. Ask for referral to see a psychiatrist. Your doctor may also send you to a psychologist. There are also medications that can help. Getting sleep back in order is essential as lack of sleep can make the whole problem much worse.  Look after each other too. If a friend or family member is suffering suggest that help is available.
Knowledge of the problems is like a preparation plan for disasters. Not only do we need to have a fire, flood, evacuation plan with stores of batteries, a radio, food and fresh water available but a mental health plan as well.