North West Conference Reviews 2011
North West Autumn Conference Review
9 November 2011 Manchester: A Lifetime of Caring
Dr Afshan Khawaja, Consultant Psychiatrist, Academic Secretary for
North West Division
The Autumn Conference held on 9 November 2011 in Manchester was
carried out in collaboration with the Women’s Special Interest
Group. The theme “A Lifetime of Caring” focussed on the
interaction between mental illness and parenting and caring
responsibilities. This was the first time a Division had
collaborated with another College Group and the Conference was well
attended and very well received.
The day was split into a
series of lectures and workshops covering specific areas throughout
the lifespan.
Dr Angelika
Wieck, Consultant Psychiatrist lead for North West
Perinatal Mental Health Services, started the day with a lecture
about prenatal assessments of parenting in women with severe mental
illness. We were provided with a systematic run through of
the major mental illnesses (schizophrenia and mood disorders) and
the impact on infants in utero, at birth and during childhood.
The facts that stuck in
my mind were; the lower birth rates in women with SMI; depression
and the proven adverse affects intrauterine in the first year and
long term: schizophrenia and the proven adverse affects on infants
and long term. Other important factors included the severity
of illness, chronicity and socio-economic status.
Dr Wieck reported on the
Mother and Baby unit survey with 80% of mothers with affective
disorders leaving the unit with baby but only 50% of women with
schizophrenia left with their baby.
Mother and baby units are
receiving increasing requests for parenting assessments of mothers
who are not unwell.
Delegates were then
offered a choice of three workshops:
Louise
Wardale, Family Co-Ordinator, Barnardos, made a particular
impact on delegates by bringing along two young adult carers who
were the sole carers for their parents who both suffered from
schizophrenia. Barnardos play a key role in promoting the
importance of partnership working and demonstrated during the
workshop how this is a critical ingredient in achieving better
outcomes for children and families affected by parental ill
health.
Dr Art
O’Malley, Consultant Child and Adolescent Psychiatrists,
provided delegates with an interesting briefing on research into
the neurobiological impact of parental ill health on infants.
Dr Louise
Theodosiou, Consultant Psychiatrist and Jane
Davies, Nurse Practitioner, attended from the Emerge Team
which provides services for 16-17 year olds. They used
case studies to discuss the complexity of adolescents with mental
health problems and their families.
Dr Kathryn
Abel, Director, Centre for Women’s Mental Health,
University of Manchester, closed the morning session with a lecture
which focussed specifically on schizophrenia and mothers. She
predicted an increase in the number of pregnancies in women with
schizophrenia, although women with affective disorders are more
likely to kill their children than women with schizophrenia.
Dr Abel described how we
can optimise maternal response and create resilience by improving
attachment. She described research from fMRI scans showing a
decreased response to own infant vs. other infant compared to
healthy mothers.
Research also shows that
managing mental illness better alone is not enough. Studies are
planned to test the plasticity in the maternal brain by combining
the use of hormonal intervention (giving oxytocin) plus parenting
intervention.
Dr Irene
Cormac, Honorary Consultant Psychiatrist, provided the
first lecture of the afternoon, which focussed on women as carers
and her involvement in National Carers Strategy.
There are 5.8 million
carers in UK (mostly older women). Carers can undergo a
prolonged grief and an adjustment after taking on the role – stress
and support needs can sometimes lead to maladaptive behaviours such
as rough handling. The burden of care can be reduced by
affection, finding the role satisfying, fulfilling social/religious
obligations, problem solving and family supports etc
Carers generally have
high levels of stress, poor physical health e.g. more hypertension
and CHD, and depression.
There is a duty to offer
assessment of carers needs under the Carers Equal Opportunity
act.
There was then a choice
of three further workshops:
Dr Sheena
Pollet, Consultant Psychiatrist, Described a novel
clinical approach of a joint clinic with psychotherapist Dr Pollet
seeing patients with a CAMHS consultant and a health visitor, which
offered multiple therapy options to parents, children and
families. Delegates were informed about how important it was
to listen, to allow things to’ tumble out’ and to look for
patterns. Similar to a market trader – look somewhere else
i.e. don’t look where all the noise is the real problem is
elsewhere.
She described the ‘threat
face’ that parents may be showing their children – making them
appear frightened/frightening and described different adult
attachment styles.
She spoke of how to
develop a parental reflective function e.g. through the CBT
child-parent game.
Dr Olivia Guly
and Dr Victoria Norrington Moore, Provided delegates with
a Forensic Psychiatrists view of assessing potential risks to
children, including those which may be associated with the
patient’s offending behaviour, their illness and/or abuse within
the family. They provided risk management strategies which
may be helpful.
Hannah Roscoe, Research Analyst from SCIE, using
the Social Care Institute for Excellence (2009) Guide “Think Child,
Think Parent, Think Family: A Guide to Parental Mental Health and
Child Welfare” delegates were presented with the experiences and
findings from the implementation sites in England and Northern
Ireland, lessons about good inter-agency working as well as
providing the opportunity to discuss and debate some issues that
remain challenging.
For the final lecture of
the day - Dr Daniel Anderson, Old Age Consultant
Psychiatrists, talked about the impact of a dementia diagnosis and
then discussed the film Iris (about a writer diagnosed with
dementia) from a psychotherapeutic perspective. He described
the diagnosis as similar to telling someone of a terminal illness,
which required palliative style care. We should expect anticipatory
grief and mourning. Over time a carer can come to act as an
auxiliary memory, and see a change of role to mothering or a
parent-child interaction.
For more information about the speakers and
workshop facilitators please click
this link
For a delegate evaluation of the conference
please click this
link
For copies of presentations please click the
links below. Please note that not all presenters have given
permission to access their presentations. If there is a
particular presentation not available here you may wish to contact
the presenter personally.
Contact details for Carer Related
Organisations:
Emerge: 16-17 CMHT, 140 Raby
Street, Moss Side, Manchester, 0161 226 7457
Rethink :
Mental Health Charity, setup by carers and
provides following services:
- Website: www.rethink.org
- Support services: Accessing Carer Assessments
with local authorities, acting as advocates, advising on
appointeeship
- Caring and Coping: a course from Rethink
Mental Illness. An expert
carers' course designed for those caring
for people with a severe mental illness.
- Advice, information and online support:
provide
expert advice and information on the
often confusing world of mental health, as well as practical
support with casework.
- Helplines: provide specialist helplines
covering particular areas or for particular groups of carers or
users of our services.
The Princess Royal Trust for
Carers - carers charity: Website allows to
search for a local group or centre, join in a chat group and
provides advice www.carers.org
Making Space –
charity: Provides residential accommodation and
support to carers. www.makingspace.co.uk
Mental Health Care: Information resources set
up by the Institute of Psychiatry and SLAM aimed specifically at
families of people with psychosis. www.mentalhealthcare.org.uk
North West Spring Conference
Review
11 May 2011
Manchester:
Trauma and War -
consequences for mental health - military and
civilian
Dr Afshan Khawaja, Academic
Secretary, North West Division
Military veterans have been an increasing focus of political
interest over the last few years. Mental health services,
prisons, addiction services and local authorities have struggled to
provide care to ex-military personnel. Trauma has an obvious
adverse affect on mental health whether this is the trauma of war,
or abuse that is suffered by the civilian survivors of life that we
treat every day.
Members of the College, other mental health
professionals, trainee psychiatrists, medical students, local
charities and service users and carers gathered in Manchester on 11
May 2011 for a series of lectures and workshops on how best
to help and manage veterans and civilians exposed to
trauma.
The speakers ranged from those who had
experienced trauma themselves, to those who were responsible for
developing treatments to deal with those who had suffered different
types of trauma. The workshops provided delegates with the
opportunity to hear from those delivering professional help and
care as well as service users and carers who had suffered
trauma.
Simon Weston OBE, a veteran of the Faulklands
War in 1981, opened the Conference by providing delegates with a
vivid and often moving account of what actually happened when
his ship, laden with ammunition, received a
direct hit from a missile. His description of the trauma of
the event and the aftermath took away all the perceived glamour of
the military life. The event robbed him of his military
career and livelihood. He gave a flavour of the flashbacks
that proved harder to cope with than his physical disabilities and
he pinpointed the importance of finding a role/identity that has
specific importance to a veteran who has suffered trauma.
This Key-Note presentation set the scene for
the day and other speakers followed with their experiences and the
lessons learnt from caring for those who have suffered trauma.
Our final speaker of the day, Dr Alistair Hull,
gave an interesting presentation about “Disaster Myths” which
illustrated how traumatic events are not predictable and they do
not affect all people in the same way.
Workshops during the day covered the following
subjects:
- Personal accounts from individuals recovering from traumatic
life events
- Trauma between parent and child
- Mental Health Care for refugee survivors of torture
- Working with traumatised adolescents and high risk
behaviour
For more information about the speakers and
workshop facilitators please click this
link
For a delegate evaluation of the conference
please click this link
For copies of presentations please click the
links below. Please note that not all presenters have given
permission to access their presentations. If there is a
particular presentation not available here you may wish to contact
the presenter personally.
Organisations
providing support to veterans:
Combat stress
- Provide assessment and
treatment to veterans with mental health problems, (they cannot
take over all aspects of care):
- Specialist Treatment Centres
– short stay residential centres – Ayrshire, Shropshire and
Surrey
- Developing Outreach Services
– Regional Welfare Officers, Mental Health Practitioners and
Community Psychiatric Nurses
- 24 hour helpline (delivered by
Rethink and funded by DOH) – provides signposting and help with
making referrals – 0800 138 1619
Contact:
The Chief Executive
Combat Stress
Tyrwhitt House
Oaklawn Road
Leatherhead
Surrey
KT22 0BX
01372 587000
British Legion
- Help making a claim for War
Disablement Pension (and War Widower Pension)
- Help if there is a service
inquest
- Free handyperson
- Benefits and Money
Advice
- Break centers
- Crisis funds
- Care Homes if need short
term or long term care
- Mentoring, guidance,
training and funding to help start a business
- Local and County Branches
Contact:
British Legion
199 Borough High Street
London
SE1 1AA
020 3207 2100
VIPA Veterans
in Prison Association
- Set up by prison officers on
the Isle of Wight
- Provide rehabilitation for
veterans in prison
The Medical Assessment Programme
The Medical Assessment Programme (MAP) provides mental health
examinations for all veterans with operational service since 1982
(including veterans of the Falklands Conflict).
The MAP is located at St Thomas' Hospital,
London. The facility is headed by a Consultant Psychiatrist with
access to a wide range of military experience and knowledge of
military health matters within the Ministry of Defence. Veterans
with operational service since 1982 who feel they would benefit
from seeing the MAP Consultant should seek a referral via their
General Practitioner.
Military Healthcare
NHS Information on healthcare for military personnel and
veterans, including getting treatment and contacts.
Information from DOH:
New Patients discharged from military
service
When members of the armed forces are
discharged, they are given a summary of their medical records to
give to a GP when they register; along with contact details to
enable the GP to obtain more detailed records if necessary.
The contact details to obtain summary or full
records are as follows:
Royal Navy
MDG(N) Medical Records Section
Institute of Naval Medicine
Alverstoke
Gosport
Hampshire
PO12 2DL
British Army
Secretariat Disclosure 3
(Medical)
Mail Point 525
Army Personnel Centre
Kentigern House
65 Brown Street
Glasgow
G2 9EX
Royal Air Force
ACOS Manning
Medical Casework
Room 1, Building 22
RAF High Wycombe
Buckinghamshire
HP14 4UE