A decade of Australian achievements for children of parents with mental illness and their families
Reprinted from "Parenting" issue of Visions Journal, 2004, 2 (2), p. 29
This article outlines the development of responses to the needs of children of parents with mental illness and their families in Australia, starting with the relevant recommendations of a National Enquiry into the Human Rights of People with Mental Illness, tabled over ten years ago, and leading to the creation of a national project currently in progress. The article also looks at some key developments that happened prior to the release of the Enquiry report, in particular, the Children’s Project in Melbourne, Victoria. Though there have been innovations in all Australian states and territories, the focus of the present article is on Victoria, given the author’s familiarity and involvement with developments in that state.
Key Developments Prior to the National Enquiry
Prior to the 1992 National Enquiry, recognition of the needs of parents with mental illness and their children was acknowledged in Victoria by concerned individuals through initiatives such as peer support programs for parents and professional education for mental health workers.
Just before the Human Rights Report was published, one of the first research projects to be conducted on this topic in Australia began at the Early Psychosis Research Centre in Melbourne, funded by the Victorian Health Promotion Foundation. It became known as the Children’s Project.
During the three-year course of the project, a one-day census of adult mental health services in Victoria was conducted, a survey of service providers completed, and focus groups and interviews with parents undertaken. Subsequent research in other states built upon aspects of this early work. As people learned about the research project, a substantial amount of time was soon given to speaking to many different groups in a variety of forums locally, and interstate. This process contributed to raising awareness and encouraging participants to think about changes they could make in their workplaces. It also led to the publication of the first Australian book on the topic, Children of Parents with Mental Illness.
The Release of the National Enquiry
In 1993, following three years of research, the report of the National Enquiry into the Human Rights of People with Mental Illness was tabled in Australian Parliament.
Chapter 16 of the report focused on children of parents with mental illness, and made several recommendations:
mental health workers should ask clients if they have children, ensure the children's needs are being met and make referrals if necessary
government departments such as health, education and family services should work together to plan and implement services which provide a range of family and child support services for the children and their families
agencies must be resourced to meet for varying needs of children: support when a parent is in hospital support after discharge from hospital, school-based support and community- based support
education authorities should provide school-based support for children.
government should allocate money to non-government services to enable them to provide services to families.
Following this report, the Commonwealth [Australian federal government] invited submissions for the development of new projects which would improve services for people with mental illness and their families. With this funding, two programs started in Sydney in 1994: a psychosocial intervention program for children which provided education and peer support, and a program to support parents with mental illness who had children up to five years in age.
1995 saw the convening of the first conference held in Australia about children of parents with mental illness. Around 100 people attended, with some travelling to Melbourne from other states. It was so successful that another conference was arranged in 1996.
Subsequently, the media became interested in the subject, leading to major newspaper stories, and to items on current affairs radio and television. In August 1995, an editorial was published in the Medical Journal of Australia, accompanied by an interview on the ABC Radio National program, the Health Report. This publicity also encouraged interest and enquiry.
The implementation of the Children’s Project led to the establishment, around the same time, of what is now well known as the Champs Project, for children of parents with mental illness. This project in of itself has had a number of very positive outcomes, as described below.
Peer support programs for children were started, such as school holiday programs, and weekend camps for children. Two videos were prepared to raise the awareness of workers in adult and child/ adolescent mental health services. One of the videos, Hard Words, can also be used by workers to help children talk about their own experiences and worries.
Early in 1997, the Victorian child protection service held a series of workshops to increase knowledge and understanding of the issues for children and parents among child protection workers. The workshops, groundbreaking in themselves, were enhanced by the participation of a parent, who described the experience of being a parent and having a mental illness. Since these first workshops, further training for child protection workers in Victoria has included parents as paid presenters.
Also in 1997, a new project began in the eastern part of Melbourne, known as Parents in Partnership, which over a period of twelve months, established two peer support groups for parents, and provided professional education sessions for workers in mental health and welfare agencies. The project continues and now provides regular weekend camps for children, as well as school holiday and afterschool programs. Feedback from the children attending the camps – as well as from their parents – was very positive, encouraging the Victorian government to provide funds so that camps could be run in several locations across the state over the following two years.
Around the same time, the Centre for Adolescent Health in Melbourne began providing peer support programs for young people between the ages 13 and 18, known as the Paying Attention to Self program. These groups have contributed to reducing feelings of isolation for these young people, reassuring them that others have similar family situations and also feel angry, alone and confused. The programs have also helped participants to find the confidence to become peer leaders who are responsible for helping run the groups. As one participant said: “Peer support means being there when things are good or bad, talking with other people your own age about the problems that happen at home. Learning from others and telling the truth when it is so easy to cover up what really is going on, by saying, ‘It’s OK.’”
In 2002, the Victorian government, Victorian Health Promotion Foundation and beyondblue, the National Depression Initiative, funded the development of more peer support groups for this age group in five different parts of the state. (See www.rch.org.au/ community).
In 2003, the same funding partners once again provided funds, this time to develop a model of best practice to promote the mental health and well-being of children aged 5 to 12 years who have a parent with a mental illness. Known as VicChamps, this project is a partnership between the Eastern Health Mental Health Program in outer eastern Melbourne, and Upper Murray Family Care in northeast Victoria.
The project has threeyears of funding to develop a best practices model suitable for both rural and metropolitan areas. Overall, the three aims of the VicChamps project are to increase the resilience and social connection of children who have a parent with mental illness; reduce stigma associated with mental illness; and enhance community capacity to assist these families through partnerships between sectors and services, peer support programs, workforce development services, and through educating the community as a whole. (For more information on VicChamps, and for general information on the topic of children of parents with mental illness, see champsworldwide.com).
The development of resources such as books and videos has also been a valuable part of the work taking place across all of Australia. Some examples are Jakes Dinosaurs and Robbie Rose and Monkey, developed in South Australia and written for younger children. The Association of Relatives and Friends of the Mentally Ill (ARAFMI) in Western Australia developed two books for children and young people: Handle with Care is for the younger age group, and A Book for Young People about Mental Illness is for youth aged 13 to 16 years old. SANE Australia has published Joe’s Diary for 10 to 14-year-olds, and You’re Not Alone, a cartoon-style book designed to build understanding about parental mental illness in young people aged 6–12 years. This book was initiated by Dan Halloran and his family, who were featured on the ABC TV program Australian Story in May 2003.
In Queensland, the Koping Video and Booklet were prepared to assist workers talking through issues with young people having a family member with mental illness. Children of Mentally Ill Consumers (COMIC) in South Australia has prepared a Supporting Our Family kit, which helps children and families plan for a parent’s hospitalization and ensure the child’s needs are met (see www.angelfire.com/ home/comic).
The resources described, and many others, are listed on the Children of Parents with Mental Illness (COPMI) website: www.aicafmha.net.au/copmi
The First National Conference
In April 2002, Australia’s first national conference on parental mental illness was held in Melbourne, where many of the initiatives developed over the previous few years were presented. The event was titled, “Holding it All Together: the First National Conference for all Involved in Meeting the Challenges for Children and Families where Parents have Mental Illness.” At this event, consumers, carers and young people were well represented among presenters, and Prof. Joanne Nicholson, University of Massachusetts, and Dr. Adrian Falkov, at the time in the UK, accepted the in vitation to make keynote addresses.
The COPMI Initative
Ten years after the Human Rights Report was published, we now have an Australia-wide project focusing on children of parents with mental illness and their families: the COPMI initiative.
In 1999, the Commonwealth Department of Health and Aging invited the Australian Infant, Child, Adolescent and Family Mental Health Association (AICAFMHA) to conduct a scoping study to gather information on key projects and services for children of parents with a mental illness, analyze and report on the findings of the study, and make recommendations for future action.
This report was presented in 2001 and, in response, funding was announced for a three-year national initiative known as the COPMI (Children and Parents with Mental Illness) project, which began in late 2001. Administered by AICAFMHA, the project aims to achieve better mental health outcomes for children of parents with mental illness. The draft of a key document arising from the project, Principles and Actions for Services and People Working with Children of Parents with Mental Illness, can also be found on the COPMI website (See www.aicafmha.net.au/copmi).
A glance back at the 1993 Human Rights Report recommendations shows that we have come a long way. And many opportunities lie ahead yet – for research and evaluation, the development of clinical services, and the further integration of services – so that the needs of children of parents with mental illness, and those of all family members concerned, may be asserted and met.
About the Author
Vicki is a social worker and psychologist who has contributed to research, innovative projects, publications and professional education in Australia and overseas concerning children of parents with mental illness. Her contributions include Children of Parents with Mental Illness (Ed.) (1999), and Children of Parents with Mental Illness 2: Personal and Clinical Perspective (Ed.) (2004), both published by www.acerpress.com.au. Vicki is the Mental Promotion Officer with a child and adolescent mental health service in Melbourne.
This article was adapted from a soon-to-be published piece that was prepared for The Clinician, John Hunter Hospital, Newcastle, New South Wales, Australia. It appears here with thanks to the author and to The Clincian, Adrian Falkow (Ed.). The original article is an edited version of a keynote presentation to a conference organized by the Scandinavian Network for Children of Parents with Mental Illness, "To visualize the invisible children: Preventive work with children of mentally ill parents, "given in Stockholm, 13-14 November, 2003
Human Rights and Equal Opportunity Commission. (1993). Human rights and mental illness. Report of the National Enquiry into the human rights of people with mental illness. Canberra, AGPS.