How Stigma Interferes With Mental Healthcare: An Expert Interview With Patrick W. Corrigan, PsyD

The stigmatization of people with mental illness is widespread in our society. What is stigma? How does it negatively affect patient outcomes and how can it be reduced? Randall F. White, MD, contributing writer at Medscape, interviewed Patrick W. Corrigan, PsyD, about these issues. Dr. Corrigan is a Professor of Psychiatry and Psychology at Northwestern University and Executive Director of the Center for Psychiatric Rehabilitation at Evanston Northwestern Healthcare, both in Evanston, Illinois. He and his collaborators work at the forefront of understanding the stigmatization of people with mental illness in our society.

Conference Report
Culture and Mental Health: Highlights of the 54th Annual Meeting of the Canadian Psychiatric Association
October 14-17, 2004, Montreal, Quebec, Canada

The Canadian Psychiatric Association held its 54th Annual Meeting from October 14 to 17, 2004 in Montreal, Quebec, Canada. The theme of the meeting was culture and mental health. Below are summaries of selected sessions on the mental health of immigrants and cultural considerations for treatment of mental health issues.

Joshua Fogel, PhD
Posted 11/30/2004

The National Report on Health Sector Performance Indicators 2003
Catalogue No. HWI-78, Available from CanPrint (ph: 1300 889 873)

"Australians' health getting better but there is room for improvement"

The National Report on Health Sector Performance Indicators 2003 is designed to help policy makers and others understand trends and patterns in health, and to identify areas for action. It examines 44 indicators of performance across the three tiers of the NHPC's National Health Performance Framework - health status and outcomes, determinants of health and health system performance.

In general, Australians are living healthier as well as living longer, with significantly lower rates of heart disease, stroke and injury compared with a decade ago. However, diabetes, mental illness and psychological distress are all more common.

There are also still substantial health inequalities in Australia. People living in the most disadvantaged areas have avoidable mortality rates 54% higher than those living in the least disadvantaged areas. But the starkest health inequalities are between Aboriginal and Torres Strait Islander peoples and other Australians. Infant mortality for indigenous Australians is twice as high and, for older people, their chances of dying from circulatory disease, diabetes and injuries due to accidents, suicide and assault are much higher than for other Australians.

The report looks at determinants of health - those which have protective benefits, such as fruit and vegetable intake and physical activity, and those that are hazardous to health, such as overweight and obesity and tobacco use. For example, in 2001, 46% of Australians were sufficiently active to achieve a health benefit and 16% of adult Australians were obese.

Health system performance information in the report includes indicators of effectiveness (such as childhood immunisation rates), responsiveness (such as waiting times in emergency departments) and safety (such as adverse events in hospitals.)

Canberra, 9 December 2004

Depression affects elderly people's lives more than physical illnesses
BMJ 2004;329:1307 (4 December)
Janice Hopkins Tanne

Severe depression impairs elderly patients' lives more than serious medical illnesses, and treatment of depression "has the potential to improve patients' lives in spite of other medical comorbidities," says a multicentre randomised controlled US study published in the Annals of Family Medicine ( 2004;2: 555-562).

Australian Health Promotion Association Conference
Canberra March 13th - 16th 2005

The 'theme 20/20 Vision' focusses on progress to date and a look at the future for health promotion. Plenary speakers will talk on the five action areas of the Ottawa Charter, including Dr. Debra Rickwood, national consultant/writer on mental health policy, on "Reorienting Health Services".

Other specific mental health content is around mental health and schools, stress and health, preventing depression, and resilience. There are workshops on the Mindmatters program and InterCAMHS. A networking session for workers in mental health promotion will discuss the idea of a national association focus/representation either within AHPA or elsewhere, and other current issues for workers in this area.

Important dates
17 DECEMBER 2004 Early bird registration deadline and cut-off date for presenters to register
11 FEBRUARY 2005 Standard registration deadline

For further information
Conference Co-ordinatorsAHPA National Conference Secretariat, PO Box 139 Calwell, ACT 2905 Phone: (02) 6292 9000 Email: ahpa@confco.com.au
Or visit the ACT Health Promotion website: http://www.healthpromotion.act.gov.au

Events
Annual candlelight service
The Compassionate Friends provide support and understanding to bereaved parents and invite you to bring a plate of food and a framed photo of your loved one to place of their table.
WHEN: Sunday December 12, 6.30pm
WHERE: St Georges Cathedral, St Georges Terrace and Cathedral Avenue Perth.
COST: Free, but donations are valued and welcome
CONTACT: 9486 8711

Crisis, Vol. 25, No. 1, 2004

Peer Suicide Prevention in a Prison
Summary: Suicide rates among inmate populations in prisons are considerably higher than in the general population. Suicide prevention is a common need among penal Institutions around the world. Traditional approaches involving only correctional staff in suicide prevention efforts have proven to have their limitations. The involvement of inmates in peer prevention efforts seems to be a reasonable alternative approach. This study examines such a program, called SAMS in the Pen, operated jointly between the prison and the Samaritans of Southern Alberta. This service, the first of its kind in Canada, involved inmate volunteers, known as SAMS, who were trained in listening skills, suicide prevention, and risk assessment. Data was collected for the research from volunteers, correctional staff, general inmate population, and professional staff. However, given the low absolute number in the one institution where the study was carried out, statistical analyses were not practical. As with any new service, the SAMS in the Pen experienced some developmental problems but was perceived to be a worthwhile service to both inmates and staff of the prison.
Keywords: Suicide prevention, prisons, Samaritans, peers

Hall, B & Gabor, P. Peer Suicide Prevention in a Prison (2004). Crisis. Vol. 25, No. 1, 19-26


Complicated Grief in Survivors of Suicide
Summary: Complicated grief is a newly defined and distinctive psychiatric disorder that occurs in response to a significant loss through death. New findings suggest that survivors who were close to the deceased are at heightened risk for complicated grief. Little is known about whether close kinship (spouses, parents, children, siblings, vs. in-laws, aunts/uncles, nieces/nephews, friends, or coworkers) to a suicide victim also represents a heightened risk for complicated grief. Assessing for complicated grief is important, especially with survivors of suicide, because of the potential for associated health risks. This report contains preliminary data from an exploratory, descriptive pilot study examining complicated grief in adult survivors of suicide. Sixty bereaved subjects, within one month after the suicide of a family member or significant other, were assessed for complicated grief symptoms. Statistically significant differences, as measured with the Inventory of Complicated Grief, were noted between closely related and distantly related survivors of the suicide victim. These preliminary results indicate that health care professional's assessments and interventions for complicated grief should take into consideration the bereaved's familial and/or social relationship to the deceased. The closely related survivors of suicide had higher levels of complicated grief and could be at risk of developing physical and/or mental health problems, including suicidal ideation, in the future.
Keywords: Bereavement, complicated grief, grief, suicide, survivors of suicide

Mitchell, A.M., Kim, Y., Prigerson, H.G. & Mortimer-Stephens, K. Complicated Grief in Survivors of Suicide. 2004. Crisis. Vol. 25, No. 1, 12-18

Kids Help Line Newsletter.
November Edition

Over the past decade there has been an increasing level of concern about the welfare of boys and young men in Australia. Higher rates of completed suicide, homelessness, incarceration, and poorer educational and health outcomes for young males compared with females is disturbingly juxtaposed to lower rates of help seeking by males. In an attempt to discover why males are more reluctant to seek help and what may prevent them from expressing their needs readily, Kids Help Line surveyed 422 young males. A key aspect of the survey focused on how ofen boys talk about their feelings and concerns.

Australian e-Journal for the Advancement of Mental Health (AeJAMH)

Volume 3, Issue 2, August 2004
Contents
Download all the editorials/abstracts for this issue (~80kb), or the full issue (~309Kb).

Editorial - On accountability
Professor Graham Martin

Guest Editorial - Suicide prevention: part of the way there?
Robert Kosky, Consulting Editor

Guest Editorial - Growing up with a parent with a mental illness - a personal perspective
Paola Mason

Consulting with young people about service guidelines relating to parental mental illness
Elizabeth Fudge and Paola Mason

When is it serious enough? The protection of children of parents with a mental health problem, tough decisions and avoiding a 'martyred' child
Carolyn Cousins

Kick'n'On: Helping young males kick back into life
Chris Lloyd, Phillip Lee Williams and Dan Sullivan

Factors predicting program fidelity and delivery of an early intervention program for first episode psychosis in rural Australia
Richard O'Kearney, Graham Garland, Mark Welch, Len Kanowski and Sylvia Fitzgerald

Key National Indicators of Children's Health, Development and Wellbeing
AIHW Bulletin No. 20.

Monitoring the progress of Australia's children is central to the National Agenda for Early Childhood (Department of Family and Community Services, 2004). The AIHW has been monitoring the health, development and wellbeing of Australia's children since 1996 with funding from the Department of Health and Ageing. To date the Institute has produced four comprehensive national reports in this area-Australia's Children (published in 1998 and 2002) and Australia's Young People (published in 1999 and 2003). In keeping in line with a new emphasis on a whole of government cross-sectoral approach to childhood policy, the AIHW has broadened its reporting framework in this area to encompass a wider set on influences on childhood development. This work has been guided by an Advisory Committee comprising key experts and jurisdictional representatives, the Australian Government Taskforce on Child Development, and the Australian Council for Children and Parenting. This bulletin provides an overview of the key indicators to be published in A Picture of Australia's Children 2005, as
part of a national program of indicator development, data collection and regular reporting.

Public Health Association of New Zealand Conference 2005
Making the Links for Public Health

Invitation to submit an abstract to Public Health Association of New Zealand
Conference.

Close date for abstracts January 28th 2005. Details for submitting abstract
online are on http://www.pha.org.nz/ or contact pha@actrix.co.nz or telephone (04)
472-3060

The theme, Making the Links for Public Health, will flow through the five
streams of the Conference:
1. Reducing inequalities in health
2. Sustainable development
3. Public health law and public policy
4. Place-based public health initiatives
5. Research and evaluation methods

Mental Health Workshop

The Office of Mental Health and Statewide Public Mental Health Services are seeking the views of mental health consumers and carers on a structure for participation in mental health services. A consumer and carer workshop has been organised for Friday 12th November, 10am-12.30pm, at the City West Function Centre

This workshop will provide a chance to express your views on how consumer and carer participation in mental health services should be supported. It is hoped that the workshop will cover a wide range of issues, including:
- What should formal consumer/carer participation services look like?
- What do you want out of a participation service?
- Should consumer and carer participation services be run by the same organisation?
- Who should oversee this organisation/s?
- How will we know when we've got it right?
- What are the range of consumer/carer participation roles and activities?

Following this workshop a participation reference group will be established with a work plan and objectives. The Office of Mental Health will seek consumer and carer representation on this reference group.
Light refreshments will be served during the workshop. A light lunch will also be provided after the workshop.
RSVP: Please contact Kylie at the Office of Mental Health on 08 9222 4405 to confirm your attendance.
The Office of Mental Health has a small budget for rural and remote travel expenses; please contact Kylie for further information.

Information extracted from Carers WA newslink 2004

COMING UP ON INSIGHT...TEENAGE DEPRESSION
TUESDAY 9 NOVEMBER,7.30pm.
Last year over 250,000 antidepressant prescriptions were issued to teenagers, and children as young as five. Yet no antidepressant has ever been approved by Australia’s drug regulatory body for use with adolescents. INSIGHT examines the growth in what is termed teenage depression and its treatment. Are all anti depressant drugs safe for adolescents ? INSIGHT has an exclusive interview with Susan Crane whose daughter Vivian committed suicide after being prescribed the antidepressant Zoloft. Neither mother or daughter were warned of the dangers associated with the use of the antidepressants. Susan Crane feels that the tragedy may not have happened if they had been made aware of the risks. Why do GPs continue to prescribe antidepressants to adolescents when there are well known risks? Some doctors argue that they have little choice as there are insufficient mental health resources to service the needs of young people. And is it possible that we are too quick to diagnose the ‘normal anxiety and drama’ of adolescence as clinical depression?

A panel including British child psychiatrist David Healey, Dr Jon Juriedini, Dr Choon Yiew Soong, and Professor Ian Hickie and many adolescents who’ve been diagnosed as ‘depressive’ will discuss this issue next
Tuesday on Insight.

* PLEASE NOTE, INSIGHT IS REPEATED ON FRIDAYS AT 1PM

Selling smaller packs of painkillers slashes suicide risk
UK legislation on analgesic packs: before and after study of long term effect on poisonings

Selling paracetamol and other painkillers in smaller pack sizes has slashed rates of suicide and damage to the liver from paracetamol poisoning, concludes a study on bmj.com this week. Suicides from overdoses of paracetamol or aspirin dropped nearly a quarter in the three years following new legislation in 1998, which cut pack sizes and limited how many tablets a retailer was allowed to sell. The researchers also found that numbers of tablets taken in non-fatal overdoses of aspirin and paracetamol fell significantly after the legislation. As a result admissions to liver units for paracetamol poisoning, and numbers of related liver transplants also dropped heavily - down by nearly a third (30%) in the four years after the laws came into force. Researchers analysed rates of suicides and non-fatal overdoses from paracetamol, salicylates (aspirin) and ibuprofen across the UK between 1993and 2003. While overdosing from paracetamol and salicylates - both covered by the new laws - decreased, patterns of overdosing from ibuprofen, which was not targeted in the legislation, remained roughly the same. Although smaller pack sizes do not prevent someone from buying multiple packs from various retailers, many of those who overdose do so impulsively - using tablets to hand in the home, say the authors. Smaller pack sizes will prevent deaths, say the authors. Their research provides a persuasive argument to reduce pack sizes still further, they conclude.

For further information contact Sue Simkin, senior researcher, Centre for Suicide Research, University of Oxford Department of Psychiatry,Warneford Hospital, Oxford, UK Email: sue.simkin@psych.ox.ac.uk

MindMatters National Conference
“Going Well ”
Novotel, Brighton Beach, Sydney
18–19 March 2005
Pre-conference workshops 17 March 2005

Our theme explores our resources and experiences in ‘going well’ as individuals, schools and community.
The main conference workshops and features are:
• The Media and Health & Wellbeing
• Internet and intranet resources
• Staff Matters — our new resource
• The launch of the new MindMatters video
• Aboriginal and Torres Strait Islander perspectives
• Families Matter
• MindMatters Plus — schools talk about supporting students with high needs
• Leadership and Health & Wellbeing
• Evaluating Health & Wellbeing
• Primary schools and Health & Wellbeing

The Pre-conference workshops include:
• Australian Divisions of General Practice and schools
• MindMatters Plus schools
• Health & Wellbeing for Principals
• Families Matter training for parents, families and schools
• ResponseAbility — the tertiary perspective
• Student Leadership

Help-seeking behaviours of suicidal men aged 17-35 years: A consumer consultation and participation pilot project.

To respond to the increasing rate of suicide among men aged 17-35 years in Western Australia, the Commonwealth Department of Health and Ageing funded the Ministerial Council for Suicide Prevention to conduct research and consultation on a range of issues related to men and suicidal behaviour, including help-seeking, service provision and access to services.

The project was conducted between December 2002 to July 2004, with data collected between September 2003 and May 2004.

The central task of the project was to gain information from men themselves regarding their attitudes to, and knowledge of, suicide, their behaviours in dealing with their own suicidal ideation or knowledge of how other people deal with their suicidal ideation, and their experiences when seeking help either from professionals or from family, friends and informal networks. The project also consulted carers, community members and service providers to explore their experiences of supporting suicidal men thereby obtaining more holistic view of the issues. Consultations targeted individuals and services in Perth metropolitan and outer-metropolitan areas.

Positions Available
Department of Justice
Manager Suicide Prevention
003180
Level 7: $73,030 - $78,274 pa (PSGA)

WORK TYPE: Permanent - Full Time
LOCATION: Offender Services
JOB DESCRIPTION: The Manager Suicide Prevention oversees and continuously refines the policy and practice of a comprehensive suicide prevention strategy for the Prisons Division.The position provides support for operational prison based teams, ongoing monitoring of suicide prevention standards and implementation of relevant strategies and identifies and coordinates suicide prevention training. The Manager is also responsible for fostering and maintaining relevant partnerships and networks to ensure a comprehensive suicide prevention strategy.
JOB APPLICATION PACKAGE: jobs.wa.gov.au or 08 9476 0011

Diagnostic Complexities and Treatment Issues in Childhood Bipolar Disorder

Bipolar disorder in children was previously thought to be an uncommon occurrence. It is becoming increasingly recognized that bipolar disorder commonly presents in childhood and early adolescence. However, the diagnostic process is complex in youth. The developmentally specific and variable presentation that characterizes pediatric bipolar disorder leads to diagnostic confusion, yet the impact of bipolar disorder on the psychosocial and psychological development of children and adolescents is significant. Early diagnosis and treatment of bipolar disorder may decrease the symptoms and possibly alter the course of illness. Treatment options for bipolar disorder are expanding rapidly, and the clinician is now better able to treat the disorder while minimizing side effects.

DelBello, M.P (2004) Diagnostic Complexities and Treatment Issues in Childhood Bipolar Disorder. Medscape Psychiatry & Mental Health 9 (2)

Carers Week 17-23 October 2004
Carers Week is a national awareness week held during October each year in Australia. The event was established to promote and raise awareness of the valuable role that carers play in our community and to generate discussion about carer issues. Carers Week also provides an opportunity for carers to come together, support one another and share ideas and information.

The theme for Carers Week 2004 is - 'Health and Wellbeing' and the focus will be to:
- Raise awareness of the extra role that carers take on, and the health issues they may face
- Support carers to take action which positively enhances their own health and wellbeing

For more information go to on carers week events and the Carers Week calendar visit: www.carersaustralia.com.au

The Australian Psychological Society Ltd
INTEREST GROUP ON CHILD, ADOLESCENT AND FAMILY PSYCHOLOGY (W A)
Professional Development Programme 2004

"Working together: Interagency collaboration on children who have a parent with Mental Illness"
presented by Anna Clippingdale, Senior Program Officer, Office of Mental Health and Professor David Hay, School of Psychology Curtin University

Date: Monday, October 25th, 2004
Venue: Ruah Centre NORTHBRIDGE 33 Shenton Street (cnr John St.) Opposite Russell Square.
Time: 6:30 pm, Light Supper 7:00 pm
Seminar Cost: $5 CAFPIG members & students. $10 non-members
Please RSVP to Carole Gamsby on 6304 5626 Fax: 6304 5834 or e-mail c.gamsby@ecu.edu.au

In late 2002 the report "Pathways to Resilience" was launched, identifying for WA the needs of children with a parent who has mental illness (COPMI). Since then, a Statewide Strategic Committee has worked on how best to implement services for these children. Anna will outline the initiatives to help agencies collaborate on the support of COPMI and David will discuss the issues in prioritising workforce development - who needs additional skilling and awareness of how other agencies see the same family. Both Anna and David will discuss the difficult issue of why agencies feel they need to intervene with these children and how their intervention could be evaluated.

ABC Radio National
IN CONVERSATION: Devils, Drugs and Doctors
Thursday 21 October, 2.15pm

Dr Tony Kidman has written a short history of depression - an ailment suffered by the young people he treats. What is the choice of therapies? What horrors did folk of old have to endure? And what are the prospects forthe remarkably large percentage of Australians who are
depressed?

Medical Journal of Australia - year 2004 - volume 181 - issue 7 - part SUPPL
Depression: Reducing the Burden
4 October 2004

Table of contents
---------------------------------------------------------------
Reducing the burden of depression: Are we making progress in Australia?
Hickie, I.B
---------------------------------------------------------------
"How much more can we lose?": Carer and family perspectives on living with a person with depression
Highet, N.J., McNair, B.G., Davenport, T.A & Hickie, I.B
---------------------------------------------------------------
Suicide and mental health in rural, remote and metropolitan areas in Australia
Caldwell, T.M., Jorm, A.F. & Dear, K.B.G
---------------------------------------------------------------
General practitioners' response to depression and anxiety in the Australian community: A preliminary analysis
Hickie, I.B., Pirkis, J.E., Blashki, G.A., Groom, G.L. & Davenport, T.A
---------------------------------------------------------------
Making new choices about antidepressants in Australia: The long view 1975-2002
Mant, A., Rendle, V.A., Hall, W.D., Mitchell, P.B., Montgomery, W.S., McManus, P.R. & Hickie, I.B
---------------------------------------------------------------
Overdose in young people using heroin: Associations with mental health, prescription drug use and personal circumstances
Burns, J.M., Martyres, R.F., Clode, D. & Boldero, J.M
---------------------------------------------------------------
Effectiveness of complementary and self-help treatments for anxiety disorders
Jorm, A.F., Christensen, H., Griffiths, K..M., Parslow, R.A. Rodgers, B.B & Kelly, A.
---------------------------------------------------------------
Experience with treatment services for people with bipolar disorder
Highet, N.J., McNair, B.G., Thompson, M., Davenport, T.A - Hickie, I.B
---------------------------------------------------------------
A National Depression Index for Australia
Mackinnon, A., Jorm, A.F. & Hickie, I.B

Adolescent depression and suicide risk: Association with sex and drug behavior

Depression is common among adolescents, and suicide is the third leading cause of death among 15- to 19-year-olds. Although both health problems have been associated with drug use and early sexual intercourse, the relationship has not been systematically studied in a nationally representative sample.

The study found that teens engaging in risk behaviors are at increased odds for depression, suicidal ideation, and suicide attempts. Although causal direction has not been established, involvement in any sex or drug use is cause for concern, and should be a clinical indication for mental health screening for girls; both boys and girls should be screened if engaging in any marijuana or illegal drug use.

The full citation of the article is:
Hallfors, D.D., Waller, M.W., Ford, C.A., Halpern, C.T., Brodish, P.H and Iritani, B. Adolescent depression and suicide risk: Association with sex and drug behavior. 2004. American Journal of Preventive Medicine 27 (3) : 224-231

Focus on Carers Symposium 2004
"We must be the change we want to see "

21 October 2004
Opens 7.45am to 5.30pm
Buswood Convention Centre, Perth

The symposium examines the four key components that are vital in meeting the needs of people with a caring role.
Program Topics
1. Recognition: Carer friendly community
How do we create a caring culture which values and respects carers? Learn of models that recognise, involve and consider the caring role.
2. Methods: Carer friendly practices
How are services developing and responding to carer needs?
3. Relationships: Caring together
How do we nurture relationships built on listening to, understanding and supporting each other?
4. Health & well-being: Caring for myself
What we need to do to look after ourselves, taking steps to feel good inside and out.

All enquiries prior to the symposium can be directed to the appointed Symposium Manager:
EventEdge International, on (08) 9387 1488 or at info@eventedge.com.au.

Positions available

Manager, Bentley Community HealthSouth Metropolitan Area Health ServicePosition no: 003356
Level 9, $75,521-$78,118
Responsible to manage and lead the Community Health program in the Bentley region and for the ongoing management of community health services in the Bentley area. Working as part of the Population Health management team, developing and implementing the business and strategic plans for the service. The Manager will develop and maintain relationships with community stakeholders across the region with the aim of optimising service delivery by building effective partnerships.Further job related information contact Mandy Seel 9431 0200.
For job application package visit jobs.wa.gov.au or phone 9431 2474
Closing date: 4pm Friday 29 October

Community Safety Month
For the first time in Western Australia, the State Government will host community Safety Month in October, 2004. The month aims to raise awareness of safety and injury prevention through the showcasing of government and non-government community safety progress, events and activities - and the role they play in building safer communities.
Community Safety Month will focus on the following themes:

• Injury Prevention
• Crime Prevention
• Road Safety
• Fire and Emergency Services
• Women's Safety

Details of community safety activities and injury prevention events during Community Safety month can be found by visiting the website: www.communitysafetymonth.wa.gov.au (Extracted from, Injury Control Council of WA, October 2004 newsletter).

ABC THE HEALTH REPORT
The end of stress as we know it

Monday 4 October, 8.30am, Radio National
Stress is a term that is often over-used and misunderstood. Professor Bruce McEwen of Rockefeller University in New York City has written a book titled 'The End of Stress as we know it'. He claims that once people have read this book they will not think of stress in the same way as before. The book, whose co-author is science writer Elizabeth Norton Lasley, deals with the biology and psychology of stress. In this week's Health Report, Professor McEwen talks about his work and ideas on stress.

Positions available

Youth and Family Service Manager (Youth Focus)
We seek a highly experienced full-time professional with appropriate qualifications to co-ordinate and ensure best practice in the delivery and development of services provided by Youth Focus to young people 12-18 yrs and their families, showing early signs associated with suicide and deliberate self-harm.

The successful applicant will have a minimum of 10 years experience in, and commitment to, the youth field, including a background in development, implementation and evaluation of therapeutic support programmes. The applicant will have qualifications in management and substantial experience as a programme manager. The applicant will have knowledge of industry issues, a thorough understanding of engaging young people with complex/multiple issues and an ability to secure funding.

The Youth & Family Services Manager will hold a senior position reporting to the CEO with an involvement in strategic direction and service development. An attractive salary package of $65,000 - $75,000 is offered. Previous applicants need not apply. Applicants must include a curriculum vitae and selection criteria response. For an application package, please telephone 9362 4222 or email youthfocus@yct.asn.au. Applications should be addressed to CEO, Youth Focus, 54 Goodwood Parade, Burswood, 6100 or emailed to jenny@yct.ash.au by 8th October 2004

Services Manager (Youth Focus)
Fulltime with some evening and weekend work required
(Salary Package - $65,000 - $74,000)

POSITION OBJECTIVE
To coordinate and ensure best practice in the delivery and development of services provided by Youth Focus to young people (12-18 years) and their families showing early signs associated with suicide and deliberate self-harm.

PRINCIPAL DUTIES AND RESP0NSIBILITIES
- To maintain overall management and clinical standards of Youth Focus' Youth and Family Services.
- To ensure the ongoing promotion and development of Youth Focus programs and services as a 'centre of excellence'.
- To adopt a lead role in the promotion and ongoing development and implementation of agency policy and procedures.
- To work in partnership with the CEO to review and develop strategic direction and appropriate service response/s.
- To be responsible for the administration of the Services budget.
- To compile and present annual Business Plan, agency statistics, and written reports to meet funding body and organisational requirements.
- To promote and represent Youth Focus on local, state and national committees and working parties as required and to undertake regular formal and informal networking.
- To work alone and in partnership with Youth Focus personnel as well as external organisations in order to source and secure ongoing and future funding.
- To ensure ongoing and effective evaluation of Youth Focus’ services.
- To ensure that all targets and funding conditions of funding agreements are met to a level of excellence.
- To liaise daily with the CEO to ensure effective management of the agency.
- To provide professional supervision and clinical direction for Youth and Families Service senior staff.
- To ensure that Youth and Family Services works in partnership with other areas and aspects of the organisation, in order to deliver a efficient and effective service to clients, sponsors and partners.
- Participation in appropriate training and professional development.
- As part of the team, work to ensure the values, purpose and vision of Youth Focus is upheld.Other duties within the scope of the position.


For an application package, please telephone 9362 4222 or email youthfocus@yct.asn.au. Applications should be addressed to CEO, Youth Focus, 54 Goodwood Parade, Burswood, 6100 or emailed to jenny@yct.ash.au by 8th October 2004.

Fetal Growth Restriction, Adverse Maternal Conditions Affect Offspring's Suicidal Risk

"Adverse pregnancy and maternal-related conditions are associated with an increased risk of suicide in adolescent offspring, prospective study results from Sweden suggest. Dr. Danuta Wasserman and colleagues at Karolinska Institute in Stockholm performed their cohort study by data linkage of six Swedish registers: the medical birth register, the 1990 population and housing census, the multi-generation register, the cause of death register, the inpatient care register and the register of the total population. "

"As they report in the September 25th issue of The Lancet, their analysis included approximately 700,000 individuals born between 1973 and 1980. They specifically looked at factors affecting attempted or completed suicide between the ages of 10 and 26 years. " Medscape

Fetal Growth Restriction, Adverse Maternal Conditions Affect Offspring's Suicidal Risk. 2004. Lancet (364), p 1102-1103, 1135-1140.

"Being in a Funk": Teens’ Efforts to Understand Their Depressive Experiences
Jennifer P. Wisdom and Carla A. Green

"Although there is literature about adults’ experiences of depression, little research has focused on teenagers’ experiences. In this article, the authors describe how a sample of adolescents makes sense of depression and responds to a depression diagnosis. Twenty-two adolescents participated in in-depth individual or focus group interviews. Teens discussed their experiences with depression and getting health care for depression, and described a trajectory similar to that found among adults: a slow growth of distress, a time of being in a funk, and a time of consideration of whether they are depressed. Teens who received a diagnosis from a medical provider then sought to make sense of their depression. Teens understood a depression diagnosis as a helpful label, a chronic medical problem, or a significant part of their identity. Understanding the subjective experience of adolescents who are depressed might increase health care providers’empathy and improve their communication with teens. "

Wisdom, J.P and Green, C.A (2004) Being in a funk: Teens' efforts to understand their depressive experiences. Qualitative Health Research (14) 1227-1238

Methodology of the Youth Risk Behavior Surveillance System
September 24, 2004

"CDC developed the Youth Risk Behavior Surveillance System (YRBSS) to monitor six categories of priority health-risk behaviors among youth behaviors that contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases, including human immunodeficiency virus (HIV) infection; unhealthy dietary behaviors; and physical inactivity plus overweight. These risk behaviors contribute markedly to the leading causes of death, disability, and social problems among youth and adults in the United States."

ABC radio
Self harm 16 August 2004
Deliberate self harm is not uncommon in Australian youth, especially among girls. A Queensland study has looked at self harm among high school students on the Gold Coast with worrying results.

Bipolar Disorder 9 August 2004
ABC sports broadcaster Craig Hamilton talks about his own personal experiences with bipolar disorder. And Australian researchers recently published the results of a study looking at the prevalence and disability of bipolar disorder in Australia. Professor Philip Mitchell from the School of Psychiatry at the University of New South Wales talks about the findings of this investigation.

Study identifies adolescents' attitudes about coping and help-seeking strategies in response to suicidal thoughts and behaviours

"Suicide prevention and health promotion programs aimed at encouraging adolescents to seek appropriate help from professionals need to not only enhance [adaptive] coping strategies, but also explicitly address adolescents' maladaptive coping strategies," note the authors of an article published in the September 2004 issue of the Journal of the American Academy of Child & Adolescent Psychiatry. Suicide is the third leading cause of death among adolescents, yet little is known about the factors associated with adolescents' attitudes about coping with suicidal thoughts in their peers or themselves. The article presents findings from a study to identify adolescents' attitudes about coping and help-seeking strategies for suicidal ideation/behavior and to examine the demographic and clinical correlates of these attitudes.

The full citation of the article is:
Gould MS, Velting D, Kleinman M, et al. 2004. Teenagers' attitudes about coping strategies and help-seeking behavior for suicidality. Journal of the American Academy of Child & Adolescent Psychiatry 43(9):1124-1133.

Combination Treatment Most Effective in Adolescents with Depression

A clinical trial of 439 adolescents with major depression has found a combination of medication and psychotherapy to be the most effective treatment. Funded by the NIH's National Institute of Mental Health (NIMH), the study compared cognitive-behavioral therapy (CBT) with fluoxetine, currently the only antidepressant approved by the Food and Drug Administration for use in children and adolescents. John March, M.D., Duke University, and colleagues, report on findings of the multi-site trial in the August 18, 2004, Journal of the American Medical Association (JAMA).

ABC Radio does it again...

ABC radio had run several programs about mental health issues recently.

Worried Children - how anxious should we be?
This program was aired on "All in the Mind" on ABC Radio National on 14 August 2004.

When should you be anxious about an anxious child? Child anxiety can mean not wanting to leave mum or dad's side, complaints of tummy aches, and fears about trying new challenges, going to school, and meeting other kids. The link between child anxiety and depression later in life is becoming much clearer. This week, All in the Mind looks at innovative efforts to target parents with anxious children in regional New South Wales, who are starved for support services. The idea is to get in early, before anxiety becomes a disabling life pattern into adulthood.

Bipolar Disorder
The Health Report aired this story on 9 August 2004.

ABC sports broadcaster Craig Hamilton talks about his own personal experiences with bipolar disorder. And Australian researchers recently published the results of a study looking at the prevalence and disability of bipolar disorder in Australia. Professor Philip Mitchell from the School of Psychiatry at the University of New South Wales talks about the findings of this investigation.

In additon, All in the Mind is airing a story on bipolar disorder on 21 August. The transcript of this story will be added once it is available (approximately 26 August)

International Conference on Mental Health Promotion and Prevention

15 - 17 September 2004, Auckland
From Research to Effective Practice
The Third World Conference on The Promotion of Mental Health and Prevention of Mental and Behavioural Disorders
For further information phone: 09 300 7010 
or Email: conference@mentalhealth.org.nz

Antidepressants and the Risk of Suicidal Behaviors

This new article from The Journal of the American Medical Association looks at the link between selective seratonin inhibitors and suicide ideation. The article concludes:

"The risk of suicidal behavior after starting antidepressant treatment is similar among users of amitriptyline, fluoxetine, and paroxetine compared with the risk among users of dothiepin. The risk of suicidal behavior is increased in the first month after starting antidepressants, especially during the first 1 to 9 days. A possible small increase in risk (bordering statistical significance) among those starting the newest antidepressant, paroxetine, is of a magnitude that could readily be due to uncontrolled confounding by severity of depression. Based on limited information, we also conclude that there is no substantial difference in effect of the 4 drugs on people aged 10 to 19 years."

This article is not available online without a subscription to the journal, so contact your library to for assistance in accessing it. The ABC Science website has a good summary of the findings along with links to the Australian Theraputic Good Administration website, reviewing the safety of antidepressants for adolescents.

The full citation for the JAMA article is:
Jick H, Kaye JA, Jick SS. Antidepressants and the Risk of Suicidal Behaviors. Journal of the American Medical Association 2004; 292 (3): 338-343

Therapists as Survivors of Suicide
During their career, therapists may face the death of a client by suicide - a potentially traumatic experience. This site, from the Clinician Survivor Task Force of the American Association of Suicidology provides a variety of resources including an extensive bibliography and personal accounts from clinicians.

Paracetomal and suicide
An interview by ABC's Stateline program in Queensland about the incidence of paracetamol overdoses, and possible action that may reduce it. It includes an interview with Diego De Leo, and a discussion of the effects of the Heron paracetamol recall in 2000.

beyondblue: the national depression initiative - Australia's media joins the fight against stigma and ignorance
Beyone Blue launched a national intitative to raise awareness about depression, and reduce the stigma associated with it. The site quotes:

Less than 5% of respondents identified depression as a major health problem (despite the fact depression is the leading cause of disability in Australia), citing cancer (47%) and heart disease (40%) as bigger health problems.

Morbidity and Mortality Weekly Report

The latest issue of this report from the US Centers for Disease Control and Prevention has a number of articles about suicide, including reports on suicide in China, and US school associated suicides.

Resilience in Mental Illness
All in the Mind - ABC Radio National 15 May

Margaret Cook and Pauline Miles are well known figures in West Australia’s mental health advocacy community. Born as identical twins in Wales, they grew up in the UK with a mother with major mental illness and a shared history of abuse. Now themselves parents of adult children, they join Natasha Mitchell this week to reflect on their own experiences of hospitalization in psychiatric wards, the search for identity in suffering, and inspiration in healing, activism and awareness.

A systematic review of the incidence of schizophrenia: the distribution of rates
and the influence of sex, urbanicity, migrant status and methodology.
This new paper from a team at the University of Queensland looks at variations in the distribution of schizophrenia.

Help-seeking behaviour and the Internet: An investigation among Australian
adolescents
From the Australian e-Journal for the Advancement of Mental Health (AeJAMH), Vol. 3, Issue 1, 2004:

The purpose of this study was to evaluate the effect of a brief school-based intervention on help-seeking behaviour among Australian adolescents. The aim of the intervention was to encourage adolescents to seek help, focusing on the use of the Reach Out! website (www.reachout.com.au) as a help-seeking source. Male and female adolescents were compared.

Antidepressant Medications for Children: Information for Parents and Caregivers
This is the latest information about antidepressant medications for children from the US National Institute of Mental Health.

Mental Health Services in Australia 2001-02
The Australian Institute of Health and Welfare has released a new report looking at mental health services in Australia.

"Mental Health Services in Australia 2001-02 describes the characteristics and activity of Australia's mental health services including ambulatory and residential mental health-related care provided by hospitals, community-based services, general practitioners, private psychiatrists and some disability support services. Information on the broad trends in mental health care is presented in an easy-to-use summary. Detailed statistics show the hospital care of patients admitted with a mental health-related diagnosis, the services, beds, staffing and expenditure in psychiatric hospitals and community-based services, and mental health-related medications prescribed by general practitioners and private psychiatrists. A special theme chapter has been included for the first time, presenting an overview of the available data on the mental health care of people with depression. "

Selective serotonin reuptake inhibitors in childhood depression: systematic review of published versus unpublished data
This article was published in the latest edition of The Lancet. Free registration is required to access the abstract and subscription is required to access the full text. Contact your library for assistance in accessing the full text.

"Published data suggest a favourable risk-benefit profile for some SSRIs; however, addition of unpublished data indicates that risks could outweigh benefits of these drugs (except fluoxetine) to treat depression in children and young people. Clinical guideline development and clinical decisions about treatment are largely dependent on an evidence base published in peer-reviewed journals. Non-publication of trials, for whatever reason, or the omission of important data from published trials, can lead to erroneous recommendations for treatment. Greater openness and transparency with respect to all intervention studies is needed."

Full citation: Craig J Whittington, Tim Kendall, Peter Fonagy, David Cottrell, Andrew Cotgrove, Boddington E. Selective serotonin reuptake inhibitors in childhood depression: systematic review of published versus unpublished data. The Lancet 2004;363(9418):1341-1345.

Tracking Tragedy: A systemic look at suicides and homicides amongst mental health inpatients.
This report was released by the NSW government in December 2003. From the report:

"There is a common perception that any suicide death or homicide by a person in contact with public mental health services represents a failure on the part of mental health services. This is not always so, as will be discussed later in the report. Mental health services in general do a very effective job of managing people with severe mental illness, as detailed below, and in all likelihood prevent many incidents of minor and major self-harm, and violence towards others. Indicative data from NSW Health shows that of 22,061 admitted patients’ episodes of care in public psychiatric hospitals and mental health units of general public hospitals in 2002-3, there were 8 possible suicide deaths of patients who were in care as inpatients at the time of their death. In the 3-year period from 2000-1 to 2002-3, there were almost 62,000 admitted patient episodes of care. During this time there were 8 homicides perpetrated by patients in contact with mental health services. While the incidence of death might be extremely low, it is not, as would be preferred, zero."

Using the Internet for Suicide Prevention: A Guide

The Ministerial Council for Suicide Prevention is pleased to announce the release of its latest research publication Using the Internet for Suicide Prevention: A Guide.

From the introduction:

"The rapid development and use of the Internet in delivering information and fostering interactions has created new forms of communication. This guide has been developed to assist consumers and professionals in accessing suicide prevention information, counselling and chat rooms on the Internet.

It provides practical, easy steps that will assist users to assess and select the most appropriate, sound website that best meets their needs. It also provides a useful resource for organisations developing a suicide prevention website. Although other organisations have developed guidelines for information sites and ethical standards for Internet counselling, this resource incorporates the specific issues for users in the context of suicide prevention."

The publication is available in pdf format from the Ministerial Council's website or print copies can be ordered. Order forms are available on the website.

Anti Depressants - Possible Side Effects
Dr Norman Swan on ABC's Health Report interviews Ian Hickie about possible side effects of anti-depressants in the light of the recent release by the US Food and Drug Administration.

FDA Public Health Advisory - Antidepressants

The United States Food and Drug Administration has issued a further warning about certain antidepressants:

"Today the Food and Drug Administration (FDA) asked manufacturers of the following antidepressant drugs to include in their labeling a Warning statement that recommends close observation of adult and pediatric patients treated with these agents for worsening depression or the emergence of suicidality. The drugs that are the focus of this new Warning are: Prozac (fluoxetine); Zoloft (sertraline); Paxil (paroxetine); Luvox (fluvoxamine); Celexa (citalopram); Lexapro (escitalopram); Wellbutrin (bupropion); Effexor (venlafaxine); Serzone (nefazodone); and Remeron mirtazapine)."

Further information including the full text of the public health advisory is available here.

The latest information from the Australian Therapeutic Goods Administration is available here, released 11 March 2004.

World Health Organization: Mental Health
This site has been featured previously, but there are a number of new publications that may be of interest:

Investing in Mental Health

"Mental health has been hidden behind a curtain of stigma and discrimination for too long. It is time to bring it out into the open. The magnitude, suffering and burden in terms of disability and costs for individuals, families and societies are staggering. In the last few years, the world has become more aware of this enormous burden and the potential for mental health gains. We can make a difference using existing knowledge ready to be applied. We need to enhance our investment in mental health substantially and we need to do it now."

The Mental Health Context : Mental Health Policy and Service Guidance Package.
This is part of a series of modules on developing mental health policies. The rest of the series is available here.

Caring for Children and Adolescents with Mental Health Disorders : Setting WHO Directions

"The lack of attention to the mental health of children and adolescents may lead to mental disorders with lifelong consequences, undermines compliance with health regimens, and reduces the capacity of societies to be safe and productive. Contemporary recognition of child and adolescent mental disorders and advances in the care of children and adolescents with mental disorders provide an incentive to synthesize current knowledge, identify issues for future exploration, and consider appropriate policies."

Worried, Tired and Alone... A Report of Mental Health Carers' Issues in WA.

"This research into the issues affecting carers of people with mental illness in Western Australia was commissioned by Carers WA in July 2003 as part of their ongoing commitment to identify carer needs and to advocate on their behalf. The research was undertaken in partnership with the Mental Health Carers Issues Network which works collaboratively to identify, promote and address mental health carers’ issues in WA.
The aim of this research was to identify the current needs of carers and the issues impacting on their lives. The research also aimed to establish if there were any new issues emerging that have not previously been identified."

Delivering interventions for depression by using the internet: randomised controlled trial

This article looks at the effectiveness of delivering cognitive behaviour therapy and psycho-education interventions via the internet. Helen Christensen was interviewed on the ABC Radio Health Report recently about this project.

The programs Helen speaks about are Moodgym and Bluepages.

The 3rd World Conference: The Promotion of Mental Health and Prevention of Mental and Behavioural Disorders From Research to Effective Practice

The main theme of the Conference is how to develop effective practice that is based on sound research and as such will continue the work begun at the first two world conferences in Atlanta in 2000 and London in 2002.
The New Zealand Conference will once again be an international working meeting designed to move forward the prevention and promotion field, by organising and mobilising influential individuals and organisations. Collaborative relationships will be the vehicle of the movement and the Conference is designed to strengthen these relationships during and through its proceedings.
The 2004 Conference will thus build upon the organisation and aims developed in the previous world conferences. It will evaluate the progress made since London, develop new and/or updated strategies and action plans and seek to broaden the support for prevention and promotion in mental health across countries, regions, cultures, social class, disciplines and amongst the different stakeholders.

The Science of Public Messages for Suicide Prevention [Powerpoint presentation]

NIMH, the Center for Disease Control and Prevention (CDC), and the Center for Mental Health Services (CMHS), part of the Substance Abuse and Mental Health Services Administration (SAMHSA), convened a workshop on “The Science of Public Messages for Suicide Prevention,” in October 2003. Suicide prevention advocates in the field, evaluation specialists, and experts in suicide contagion, public health message development, mental health literacy, stigma, and marketing were brought together to discuss research on public messaging campaigns, and address specific issues in suicide prevention. The purpose of the workshop was to consider safe and effective ways of raising public awareness that suicide is a preventable public health problem. In breakout sessions, participants were asked to discuss three examples of current public awareness campaigns from state and regional efforts, and to consider ways of testing assumed “active ingredients,” market penetration, and proposed outcomes.

Also of interest may be other papers from the same conference. These papers are on the US Suicide Prevention Resource Center site, which has a wealth of material including a library catalogue, providing access to online information.

Resilience - by Anne Deveson

How is it that some people can be resilient in adversity while others become overwhelmed?

Anne Deveson’s long and distinguished career with the media and social justice organisations have granted her rare insight into people who have faced suffering – ordeals of family breakdown, mental illness, human rights abuse, disaster or war. What is it, she wonders, that enables individuals or communities to arise from despair?

Her exploration of the nature of resilience weaves together research, reflection and memoir in an intellectual and personal story, made all the more vivid by the fact that, as she embarked upon it, she became an intimate witness to the struggle for resilience of someone she loved.

In this series of programs from ABC Radio National she reads from her book Resilience.
NOTE: Transcripts of this program are not available, but it is possible to listen to the audio files.

Leaving You: A Cultural History of Suicide
From ABC Radio National's All in the Mind program:

In 1938 historian Lisa Lieberman's grandfather, the son of an Austrian Rabbi, killed himself. It's a mystery that's long haunted her and one which sent her rummaging into the historical archives of self destruction. From Socrates to Sylvia Plath, post-revolutionary France to Auschwitz - suicide has been seen as both a personal and a political act. But Lieberman provocatively argues that modern medicine has stripped it bare of meaning and reason, and diminished individual responsibility for the decision to die. She joins Natasha Mitchell to share her unease...and historical insights.

Bipolar Disorder – Treating the Rollercoaster
This recent story from All in the Mind on ABC radio looks at treatment for bipolar disorder.

Manic depression or bipolar disorder is most famous for its extreme highs. In the throws of mania many people don’t sleep, spend huge sums, and live life larger and faster than ever. The condition has traditionally been thought to be unresponsive to psychotherapy and Lithium, discovered by an Australian and toxic in overdose, has long been the mainstay of treatment. But the picture is changing - and psychotherapy is making a revival. Neil Cole, ex Victorian MP joins Natasha Mitchell along with leading researchers at the recent International Bipolar conference.

The upcoming edition of All in the Mind on Saturday 21 February loks at the cultural history of suicide. It can be heard at 1.30pm on Radio National. The transcript will be available by the following Thursday when it will be added to the Blog.

Link between Depression and Heart Disease in Post-menopausal Women.
This article discusses a new study published in the latest edition of Archives of Internal Medicine. The study involved over 90 000 women in the United States, over a 4 year period. The abstract can be accessed via the link above. MCSP staff will be able to access the fulltext, but other readers should contact their library for access.

A media statement from the authors can be accessed here.

Full citation:
Wassertheil-Smoller S, Shumaker S, Ockene J, Talavera GA, Greenland P, Cochrane B, Robbins J, Aragaki A, Dunbar-Jacob J.
Depression and cardiovascular sequelae in postmenopausal women: The Women's Health Initiative (WHI). Archives of Internal Medicine. 2004 Feb 9;164(3):289-98

If suicide is a public health problem, what are we doing to prevent it?
This article appears in the January 2004 edition of the American Journal of Public Health. The link gives access to the abstract. MCSP staff can contact Tracy to access the fulltext. Other readers should contact their local library.

Full citation:
Knox, KL, Conwell, Y & Caine, ED 2004, 'If Suicide Is a Public Health Problem, What Are We Doing to Prevent It?' American Journal of Public Health, vol. 94, no. 1, pp. 37-45.

Suicide warning on child drugs
The West Australian has this as the front page story. Back in November 2003 the blog provided links to the US FDA Public Health Advisory about this issue. Click here to go to the entry.

Youth Unemployment in Australia: a contextual, governmental and organisational perspective.

"Young jobless males were nearly nine times more likely to take their own lives than their peers who were working or studying.

And the Smith Family study into youth unemployment calculates the cost of lost earnings and social security benefits for young people who did not complete Year 12 at $2.6 billion a year. "(From The Australian 28 January 2004)

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More Smith Family publications available here.

Tracking Tragedy : NSW Mental Health Sentinel Events Review Committee, First Report December 2003

The [NSW Sentinel Events Review] committee was established in May 2002 by the NSW Government to independently review and report on morbidity and mortality issues associated with the care of people with mental illness.

"The Committee looked at a sample of 35 inpatient suicides occurring over the past five years and eight homicides perpetrated by patients of mental health services between 1999 and 2002, in order to analyse systemic factors that may have contributed to these events.

"It found that mental health services in general do a very effective job at managing people with severe mental illness and that suicides and homicides were relatively rare events when compared to the numbers receiving care from mental health services.

Directory of Western Australian Community Alcohol and Other Drug Agencies
This directory has just been released by The Western Australian Network of Alcohol and other Drug Agencies (WANADA). Copies are available from WANADA. Click here for contact details.

Education Queensland's Suicide Prevention Website
This site from Education Queensland provides resources for teachers suitable both for use in the classroom and for professional development. It also has resources suitable for parents.

"The website has been established to assist Education Queensland personnel to access appropriate information concerning suicide, suicidal ideation and self harm with intent to suicide of young people.

Sections of the site are specifically designed for use by mental health personnel working with young people in schools (eg. Guidance Officers).

The site includes information on professional development, strategies to support young people at risk, schools role in prevention, postvention, critical incidents and a range of other information.

This site is an initiative of Education Queensland under Reducing Suicide: The Queensland Government Suicide Prevention Strategy 2003 – 2008."

(Thanks Bron)

Firearm related deaths in Australia 1991-2001
A new publication from the Australian Institute of Criminilogy:

An examination of firearm related deaths in Australia between 1991 and 2001 found a 47 per cent decrease in numbers, with a fall in the number of suicides accounting for the largest part of that decrease. Nine out of 10 firearm related deaths involved males. Compared to firearm related suicides and accidents where less than 10 per cent involved the death of a female, a higher proportion of homicides involved a female victim (33%). Persons under the age of 15 years were least likely to die as a result of a firearm related injury. Males and females who suffered a fatal firearms injury tended to follow a similar age distribution, with persons aged between 24 and 34 years accounting for the largest number of firearm related deaths. There appears to be a shift in age related risk between 1991 and 2001. In 1991, males aged between 15 and 24 years had the highest risk of firearm related fatal injury (rate of 9.5%), whereas in 2001 males aged 65 years and older had the highest risk (rate of 4.9%). The majority of firearm related deaths were committed with a hunting rifle, although there has been an increase in the use of handguns

SIEC Alert - Suicide among gay, lesbian bisexual or transgender youth
The lastest SIEC alert from the Centre for Suicide Prevention in Canada.

WAAMH Advocacy Training Workshop
Expressions of interest are being sought for the Advocacy Training Workshop to be held on Friday 6 February 2004, for 18-20 mental health consumers and carers. Limited assistance towards travel costs for attendees will be available as follows:

• $10 for metro-based participants


• Up to $50 for country participants.

Refreshments and lunch will be provided on the day. If you would like an opportunity to register your attendance at this workshop, please complete the application form and send it back to WAAMH by 20 January 2004.

Welcome to 2004

WA Psychiatric Rehabilitation Symposium 19-20 February 2004

The WA Psychiatric Rehabilitation Symposium - Recovery: A New Way of Being, will be held at the Department of Health, 189 Royal Street, East Perth on the 19th and 20th of February 2004. Videoconferencing is available for rural and remote sites.
The symposium is free, but places are limited and registrations must be received by Wednesday 4 February 2004.

Registration forms available on the website.

Reveiw of mental Health Services in Australia for 2003-2008

In April 2003, the Mental Health Council of Australia launched its national review of mental health services in Australia: “Out of Hospital, Out of Mind!”. The report highlighted the obvious deficiencies in care but also presented community priorities for further action. A key proposal was increased accountability. To date, we have insufficient data from government agencies about what really happens in mental health at local, regional and state/ territory levels. Consequently, the Mental Health Council of Australia, with academic support from the Brain & Mind Research Institute, is undertaking a state-by-state review of services in 2003. Our goal is to produce a report in each state/ territory to underpin urgent reform in your local area.

The study is being conducted by Professor Ian Hickie, Professor of Psychiatry and Executive Director, Brain & Mind Research Institute, The University of Sydney; and, Dr Grace Groom, Chief Executive Officer, Mental Health Council of Australia.

If you wish to participate in the survey, it can be accessed at http://www.mhca.com.au/survey/.

Childhood and Adolescent Predictors of Major Depression in the Transition to Adulthood
In this new research the authors conclude that "our findings suggest clear markers [for major depression during the transition to adulthood] apparent in childhood and adolescence, presenting opportunity to those working with and treating this population."

The full abstract is available via the link above, and you may have access. If not, contact your organisation's library or your local public library. MCSP members can contact Tracy to access the fulltext.

Journal of Suicide and Life Threatening Behaviour
Link to the table of contents of Volume 33 No 4

Issue 4 has arrived and MCSP staff can contact Tracy to access it. Other readers should contact their local library.