Past President Jim Dwyer introduced guest speaker Caroline Byrne, Director of Mental Health Services Division at South West Healthcare. Caroline is a Registered Psychiatric Nurse, and also holds a Post Grad Diploma in Social Sciences (Drug Dependence), a Graduate Diploma in Business (Health Admin), and a Master of Applied Science (Innovation and Service Management). Caroline has led our psychiatric services since 2004 and is listed in the Who’s Who of Australian Women. She has dedicated herself to working in the field of mental health for over 30 years and addressed us on the provision of mental health services in South West Victoria.
The Division operates across the local government areas of Moyne, Glenelg, Southern Grampians, Corangamite and the City of Warrnambool. Regional offices are maintained in major towns across the catchment with the aim of supporting access to care close to home.
120 staff provide mental health services for a population of 110,000. We see 25 consumers per 1000 population, compared to the state average of 11 per 1000, and cover all ages – new born and infant care through to the elderly in hostels and nursing homes.
Caroline is proud of the fact that her service has some of the lowest seclusion rates in the state, focusing on voluntary admissions to acute care whenever possible.
As people with serious mental illness die 20 - 25 years earlier than the general population, building a strong more connected and equitable health care system can influence the long term outcomes for all people with severe mental illness. Our area is characterised by high rates of alcohol and family violence, and we have a concerning rate of suicide.
Mental illness still has to cope with the issue of social stigma, though less than in the past. Bill Clinton has said that mental illness is nothing to be ashamed of, but stigma and bias shame us all. Talking about mental illness as we do with any illness is important in reducing stigma and like physical illnesses, mental illness also has a physical component to it.
What causes mental illness? The stress-vulnerability model provides the most common and highly regarded explanation. ‘Vulnerability’ refers to our basic biological susceptibility to mental health problems, and it seems that some people are biologically more vulnerable than others.
‘Stress’ refers to the challenges faced in our lives, and our resilience in dealing with it. Stress in the environment can worsen biological vulnerability, worsen symptoms, and cause relapses.
While a stress response can be a positive thing, prompting us to remove ourself to a position of safety, exposure to constant stress or constant emotional pressure makes our body’s survival systems stay switched on (ready for fight or flight) and cause harm.
Mental health service provision has changed greatly, especially since the Kennett government resolved to close the traditional mental hospitals like Brierley and opt for a combined regular hospital and community based approach to care. The new Mental Health Act 2014 introduced new client safeguards and strengthened existing ones. There is a focus on recovery oriented practice, and constant service improvement.
A presumption of capacity- foundation of supported decision making values the client’s role in shaping their treatment and care. Second opinions to support self determination and must be considered, and client advocates must be made available to provide information, advice and support.
Major advances in treatment options have been evident in the last twenty five years, including in the 1990s, new antipsychotic medications called second generation, or "atypical" antipsychotics. One of these medications was clozapine. Depression is now commonly treated with antidepressant medications including selective serotonin reuptake inhibitors (SSRIs). Bipolar disorder, also called manic-depressive illness, is commonly treated with mood stabilizers.
The future for mental health services in the South West looks promising. In 2017 we will open a Prevention & Recovery Care Centre (PARC) on part of the old Brierley site. More than $4 million has been allocated for the facility, able to house up to eight people at a time.
This will help in filling a crucial gap in our service system, for those whose mental health needs have not been well met in the past – younger and older adolescents; mothers and babies, and our Aboriginal communities, and will offer patients a home-like setting that was different to the more formal atmosphere of a hospital wing. Four beds will be allocated for people aged between 16 and 64 and four beds set aside for patients aged 65 and over. It will cover early intervention for people who are becoming unwell as well as people in the early stages of recovering from illness. The centre would fulfil a need for patients who were not coping at home but did not require the high level of care provided at a hospital.
Warrnambool is a growing regional centre and in any regional city you need services like this in order to fill that need in the community.
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