BUDDYS NEWS - yodaa.org.au News... · Page 3 Monash Health Dual Diagnosis Service For Your Diaries...
Transcript of BUDDYS NEWS - yodaa.org.au News... · Page 3 Monash Health Dual Diagnosis Service For Your Diaries...
YoDAA provides young peo-
ple and youth workers sup-
porting young people with
substance use related prob-
lems and dependence, with an
easily accessable advice, infor-
mation, referral and network-
ing service for youth specific
alcohol and other drug (AOD)
related needs. As a collabora-
tion of many agencies. YoDAA
provides a one-stop, multi-
channel service with website,
one telephone and email ad-
dress, as well as web chat.
Youth workers can access
online practice tools, research
information, a service finder
and secondary consultation,
and also share their events,
news, experience, questions
and ideas with colleagues from
across the State .
Through some channels, young
people themselves can access
advice and information, rele-
vant web-based content so
that the next step for them in
seeking help or information is
clear. YoDAA Manager Dom
Ennis says that “YoDAA will
enable a more accessable, co-
ordinated and navigable youth
AOD service system in Victo-
ria which will lead to better
outcomes for young people
and encourage consistent, evi-
dence based-based practice
across the sector.”
Youth workers can now ac-
cess the YoDAA website -
yodaa.org.au, the advice–line
te lephone number -1800
458685, contribute to the
online forum and also register
to be updated on training
opportunities.
The service will also extend to
families and schools later in
2014. Mr Ennis said YoDAA is
the first service to provide
YoDAA - Youth Drugs & Alcohol Advice A collaborative state-wide approach to youth drug and alcohol related problems
With permission from Leunig
June 2014 Issue 3
BUDDYS NEWS Building Up Dual Diagnosis in Youth Services with our partners
HYDDI - the Homeless Youth Dual Diagnosis Initiative
BUDDYS
BUDDYS is a Statewide
group of Victorian Dual Diag-
nosis Initiative (VDDI) youth
senior clinicians.
BUDDYS is committed to the
best possible outcomes for
young people through evi-
dence based best practice.
BUDDYS clinicians can sup-
port your agency in building
Dual Diagnosis capacity.
Page 2
headspace Warnambool
YSAS Dandenong - Bree Tapper
NEXUS DD Practice Initiative
Page 3
Monash Health Dual Diagnosis
Service
For Your Diaries
Book Review - Chris Rampling
Page 4
HYDDI -The Road Home- Roadwork in
Progress by Andrew Innes
Page 5
The Road Home cont.
Page 6
Editorial Team contact details
Inside this Issue
such an integrated and co-
ordinated response and will
be the platform for an ongoing
and informed conversation
about youth AOD needs.
“Through YoDAA, workers,
families. young people and
schools can access the most
up to-date AOD information
and quickly connect with the
service best matched to meet
their needs”.
The State`s largest AOD ser-
vice, YSAS - the Youth Sup-
port and Advocacy Service
will run YoDAA on behalf of
partner organisations. Mr En-
nis says: “As a workforce, we
can shape innovative new
practice and also potentially
reach many more young peo-
ple”.
The YoDAA website also pro-
vides access to a Youth
AOD Toolbox with a vast
range of evidence and litera-
ture.
“The power of YoDAA lies in
the collaboration of services”
Dominic Ennis YoDAA Manager
The Editorial team seeks contributions by youth service providers on team innovations and current projects which can inform our readers about your work in managing young people with complex needs. See back page for contact details.
Mark is a hospital trained
psychiatric nurse who has
been involved in dual diag-
nosis work since 1995. “I was hospital trained and
it was in that setting where
I observed many unhelpful
attitudes to substance use
in people with mental ill-
ness. It was easy to tell
people not to use; and of-
ten counterproductive. It
wasn`t until I began work-
ing in community settings
that I found a better way to
understand that substance
use is multi-faceted and
serves various purposes in
my clients` lives. This led
me to realise there was a
need for a more informed
approach to dual diagnosis
treatment. With this
knowledge, I later started
work in the AOD field. I
believe that Motivational
Interviewing and a harm
reduction approach is help-
ful to start engagement
with dual diagnosis clients. I
am now working for head-
space in Warnambool
where bringing the skills I
learned in adult services to
the youth sector is both
rewarding and stimulating. I
was part of the early for-
mation of the VDDI Rural
Forum and have been in-
volved in systems change at
both the state and local
levels. I am keen to see
further service delivery
improvements for clients
presenting with complex
needs; and for the artificial
barriers of the service sys-
tem to be dissolved”
work is assisting staff to
work with clients around
the interaction between
their mental health and
alcohol or other drug use.
A foundation question is
‘what is the person’s rea-
sons for using their drug(s)
of choice and how might
this impact on their mental
health?’ To try and answer
this question we have de-
veloped the Reasons for
Use Package in a Interac-
tive PowerPoint format. It
involves administering the
“Nexus has been commit-
ted to assisting agencies
with implementing dual
diagnosis based interven-
tions for some years now.
We are particularly inter-
ested in user friendly inter-
ventions that assist in
opening up dual diagnosis
conversations with clients
and then providing a guide
as the next step in treat-
ment. Using screens or
other tools can be useful in
this process. We believe a
key area of dual diagnosis
Reasons for Substance Use
Scale and then a series of
interventions that flow
from the client’s responses
to the scale. The RFU
Package is intended as a
user friendly, next-step in
working with clients. We
have been testing the pack-
age with various agencies
and the initial results are
positive.”
Headspace South West Victoria Mark Powell spoke to BUDDYS News about his role at headspace in Warnambool, including providing a thought
provoking quote from philosopher, H.D. Thoreau.
Practice Initiative - NEXUS Dual Diagnosis
New BUDDYS member YSAS Dandenong
team at YSAS around co-
occurring mental health
concerns and substance
use. Bree has been working
in the youth sector since
2011 and is currently com-
pleting Postgraduate Psy-
chology studies. Bree
joined BUDDYS because of
her passion for working
with young people with a
dual diagnosis; and her
desire to support services
to embrace co-occurring
mental health and sub-
stance use concerns, and
to address them as a single
presentation – rather than
two separate issues.
Bree Tapper is a new
member to BUDDYS, join-
ing the team from the be-
ginning of 2014. Bree is
currently working at YSAS
in Dandenong, where she
provides primary assess-
ment and counselling to
young people presenting
with dual diagnosis issues
and also secondary consul-
tation and training to the
Mark Powell
“The question is not what you
look at but what you see”
H.D Thoreau
writer and philosopher
Bree Tapper
Kevan Myers
Simon Kroes
Page 2
Wayne Wright was recent-
ly appointed to the Monash
Health Dual Diagnosis Ser-
vice. BUDDYS News spoke
to Wayne about his role. “I am a social worker who
has worked across the
mental health and alcohol
and other drug sector for
many years. I am a Senior
Youth Dual Diagnosis Cli-
nician with the Southern
Dual Diagnosis Service and
look forward to contrib-
uting to the field. During
my time within the field I
have also seen a shift to-
wards greater integration
of services. I have also par-
ticipated in the trend that
has seen the development
of improved screening,
assessment and treatment
options as the evidence
base has increased to sup-
port a more fully integrated
treatment approach. I understand that we still
have work to perform in
certain areas and look for-
ward to working with our
partners in the region to
meet these challenges. The
recent changes to the wid-
er service system and
changes within the youth
culture require us to be
working in a manner that is
flexible and responsive to
the needs of our communi-
ties. I look forward to
meeting many of you dur-
ing my work and am also
look forward to participat-
ing in the future develop-
ments and activities of the
wider dual diagnosis net-
works; to further enhance
our treatment options and
responses.”
Dual Diagnosis Service Monash Health
Book Review
petrol, through connecting with tribal elders, local community councils and state and federal agencies. The author is a white Aus-tralian with a background in Anthropology who wrote this book “to fulfil an adopted cultural re-sponsibility” of passing on his knowledge . He ap-proaches his task with something of a missionary zeal, including living apart from his wife and children for long periods of time to ensure the continued suc-cess of his cause. Stojanovski delves into many current day issues from an historical view-point which contributes to non-Aboriginal under-standing of Aboriginal cul-ture. The author details the components that have ena-bled the Mt Theo pro-gramme to succeed, in-cluding strategies to en-gage young people, using the “tyranny of distance” to promote engagement, the value of persistence and ‘getting it right’ with
the wider the Aboriginal community. He describes the real life tragedies asso-ciated with petrol sniffing, particularly the impact on the health of petrol sniff-ers. Stojanovski adores desert dwelling and describes his struggles with the materi-alism of non-Aboriginal cultures. Stojanovsky`s central argument is that commitment, building close relationships and supporting the Yuendumu people to take ownership of the programme - that will allow it to become sustainable, in spite of the many barriers he describes in maintaining govern-ment funding and the masses of red-tape in-
volved.
Reviewer Christine Rampling
NEXUS Dual Diagnosis St Vincent`s Hospital
Dog Ear Café How the Mt Theo
Programme beat the
curse of petrol sniffing
Author Andrew Stojanovski 2010.
Hybrid Publishers Melbourne.
The goal of this book is to inform about the preva-lence of petrol sniffing in the remote Aboriginal Yuendumu community, located 300 kilometres west of Alice Springs. It includes insights about successfully working with young people who sniff
Page 3 BUDDYS NEWS
For Your Diaries
BUDDYS will hold
our 3rd Youth Dual
Diagnosis Service
Providers Forum on
October 9th 2014 at
the Department of
Health building
Lonsdale Street.
Planning is under-
way for another
stimulating pro-
gramme.
Our theme this year
is: Youth Dual Diag-
nos is -Complexity
and Diversity. Look
for more details in
the next BUDDYS
News and an an-
nouncement closer to
the Forum about reg-
istration and Pro-
gramme details
through VAADA
news
Wayne Wright Acting Manager Monash
Health Dual Diagnosis
Service
“The Homeless Youth Dual Diagnosis Initiative was established in 2009 in an effort to address the mental health and substance use factors associated with homelessness.”
Since the eponymous gov-ernment white papers were introduced in 2008 as the key strategic plat-forms to halve homeless-ness across Australia by 2020, the phrases “The Road To Homelessness” and “The Road Home” have summoned images of the types of hardships young people who are homeless, experience. The Road Home, to use a meta-phor of traffic control strategies, aims to reduce the flow of traffic to home-lessness, and increase the amount of arrivals home. Project i, the seminal 2003 paper chronicling research into homelessness in Mel-bourne, highlighted youth homelessness on the politi-cal agenda as a burgeoning social issue and a priority to be addressed. In addition to reinforcing prior work conducted by other re-searchers, it laid the groundwork for the devel-opment of the Victorian Homelessness Action Plan. This plan identifies the groups likely to be at high risk of entering homeless-ness, and focuses on early intervention and preven-tion in an effort to divert those from graduating into
chronic homelessness with all its possible sequelae. In 2011, it was estimated that over 6000 young Victori-ans aged 12-24 were homeless on any given night; that is, over 40% of people experiencing home-lessness on any given night in this state. A further al-most 8000 young people were living in caravan parks and overcrowded or improvised dwellings. Many young people who are homeless experience poor mental health, pov-erty, substance use, famili-al and social isolation, and are often victims of vio-lence, disengaged from school, and unemployed. These risk factors can be a precursor to homelessness or the result of episodes of homelessness. Investigating the temporal link between mental health and home-lessness, Johnson & Cham-berlain identified that 40% (227 people) of the sample that experienced mental health issues beforehand were aged 12-24 years when they first became homeless; and, in the sam-ple of those experiencing mental health issues after-wards, 78% (530 people) were aged 12-24 years old when they first became homeless, 2/3 of whom also had substance abuse issues. Hope Street Youth and Family Services have partnered with North West Mental Health (a division of Melbourne Health) as lead agencies to work with homeless youth in the Northern Metro region of the DHS. Funding for this project was provided un-der the National Partner-ship Agreement on Home-lessness through the De-partment of Human Ser-
vices (Housing and Com-munity Building Division); and the Department of Health (Mental Health Drugs and Regions Divi-sion). Hope Street is a spe-cialist youth agency utilis-ing innovative evidence-based and practice-based expertise to respond to youth homelessness. It is Hope Street`s proficiency and range of programmes that resulted in the invita-tion from the departments to be the lead homelessness agency for HYDDI in the Northern Division of Mel-bourne. Hope Street attains better outcomes for home-less young people by providing crisis accommo-dation, intensive case man-agement, specialist coun-selling and advocacy to support young people with their immediate situation and in transition toward self-sufficiency and inde-pendent living within their communities. Hope Street and HYDDI have proven to be a complimentary fit enhancing the existing Hope Street services that assist young people to move out of homelessness and into meaningful and fulfilling independent life-styles. A HYDDI clinician has been embedded within Hope Street since 2012, and therefore well-placed to service Specialist Home-lessness Services, funded youth homelessness agen-cies and programmes within the Department of Human Services Northern division. Referrals are re-ceived by telephone or email from case managers that have concerns about the impact that mental health or substance use issues may have on a young person`s ability to
HYDDI and The Road Home – Roadwork in Progress By Andrew Innes HYDDI Senior Clinician – Northern Region SUMMITT Dual Diagnosis Service.
engage with services and address life issues and cir-cumstances, that are the causes of homelessness. After the initial assessment by the youth homelessness case manager, a collabora-tive approach is utilized to decide the best method to respond to the young per-son`s needs, as well as to enhance the capacity of the case manager. The Key aims of the initia-tive are: -Improved responses to episodes of mental health and/or substance related crises. Primary and Secondary consultations in order to assess mental health and substance use - Advice on strategies of engagement and treatment - Referral for specialist treatment - Co-ordination of services and clinical problem solv-ing - Co-case management - Training & Education - Service development Developing a program such as HYDDI has not been without its challeng-es. Interestingly, these challenges mirror those experienced by dual diag-nosis clinicians working in Mental Health and Alcohol & Other Drug services, in that the specialist services operated without much understanding of the other, although their client group experienced similar diffi-culties. The situation, like that one, continues to be a work in progress. Youth homelessness is as much an area of expertise as dual diagnosis and presents the HYDDI clinician with an opportunity for reciprocal learning and capacity building. Expanding on
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the point above, whilst many in the youth home-lessness sector have ter-tiary qualifications in that or a related field, mental health and substance use continues to be a perplex-ing issue that adds another layer of complexity when dealing with this vulnera-ble client group. That is not to say that staff are not unwilling or unable to attend to the needs of this group, but negotiating of the mental health and/or AOD service system can be difficult and discouraging. Having the ability to access such specialized input means outcomes for young people will be optimized, and the impact of mental health and substance use on homelessness reduced. For homeless young people accessing services for assis-tance, the stigma associat-ed with mental health and substance use often sees the young person denying any issues, despite their presence. The reasons for this are many; ranging from that perception that they will be denied service, to the other extreme where they think service will want to “cure” them. It is imperative youth home-lessness staff to be alert for mental health and sub-stance use issues, looking out and listening for any indication that the young person they are working with may be experiencing problems associated with them. Actively screening at intake, or as near to first encounter as possible, workers refer people with mental health AND/OR substance use issues for assessment. Such is the extent of co-existence of the two, there is a high
likelihood of uncovering one, whilst assessing for the other. Providing an integrated treatment op-tion is always preferred to working with one problem at a time; as the issues that is not attended to will more often than not derail the work that had been done on the others, bearing in mind that homelessness is also a co-morbidity. The HYDDI initiative was funded for 4 years, with a further year granted for 2013-14. The notion that homelessness, mental; health and substance use are enmeshed as co-morbidities has been wide-ly accepted by researchers, policy makers and work-ers in those fields, and is a scenario played out every-day by young people. The evidence-based best prac-tice for working with the dual diagnoses of poor mental health, and sub-stance use is that of inte-grated treatment. Similarly, the systems approach to remain responsive to homeless youth with com-plex needs should be one of integration of services to address the issues concur-rently. Embedding HYDDI within Hope Street builds upon current expertise of both service systems, and provides reciprocal capaci-ty building opportunities. The Victoria Dual Diagno-sis Initiative provides a framework for initiatives to address youth homeless-ness, with the goals of ear-ly intervention and pre-vention. The Homeless Youth Dual Diagnosis Ini-tiative has demonstrated that is does achieve better outcomes and need to con-tinue to help reduce the number of homeless youth
progressing into chronic homelessness. Case Study - Mike`s Story Mike was admitted to hos-pital after an attempt at suicide. He stayed there for three days, detained under the Mental Health (1986) as there were concerns for his mental health and safe-ty due to the context of a situational crisis and ex-treme alcohol consump-tion. During his stay, Mike was provided with ongoing support from both his Hope Street case manager and the HYDDI clinician. This was an opportunity to integrate clinical expertise and skills to service deliv-ery outside Hope Street, providing a more flexible and improved service re-sponse. Test results, and treatment plans were dis-cussed with the ward Reg-istrar, and discharge plans for Mike could be made with the Allied Health team. After Mike was dis-charged, the HYDDI clini-cian supported Mike`s Hope Street case manager to take an active role in regular assessment of his risk of self harm. Mike declined to take part in an assessment of his alcohol, but staff remained flexible in working around this by continuing to try and build rapport with him. Mike finally agreed to discuss his substance use, and strate-gies could then be em-ployed to give Mike the necessary information to combat his battle with al-cohol. Mike learned about the links between his self-destructive behaviour and the effects of alcohol con-sumption; and a safety plan was developed with him for the future. Hope Street reported back that
HYDDI and The Road Home – Roadwork in Progress By Andrew Innes HYDDI Senior Clinician – Northern Region SUMMITT Dual Diagnosis Service.
the experience has resulted in the team`s increased awareness of mental health issues and confidence in working with young peo-ple with dual diagnosis; and an improved ability to identify early warning signs and triggers of young people with Dual Diagno-sis. References -The Road Home: A National Approach to Reducing Homeless-ness. Commonwealth of Australia 2008. Rossiter, B., Malett, S., Myers, P, and Rosenthal, D. (2003) Living Well? Homeless young people in Melbourne. The Australia Re-search Centre in Sex, Health and Society. La Trobe University Mel-bourne - CHP fact sheet: Youth Homeless-ness in Victoria– Key statistics - Are the homeless mentally ill? Johnson, G., & Chamberlain, C,. 2008. (A paper presented at the Australian Policy Conference, University of NSW, 8-10 July, 2009) - Homeless SAAP clients with mental health and substance use problems. 2004-05. A Report from the SAAP National Data Collection. AIHW Bulletin 51, 2007 - Victorian Homelessness Action Plan 2011-2015. Victorian State Government This article first was first published in in the January 2014 edition of ‘Parity’ the e-newsletter of the Council To Homeless Persons; and reprinted with kind permission.
Page 5 Issue 3
Editorial Team Page 6
BUDDYS seeks contributions to this news letter
We would like to include submissions from anyone with an interest in Youth Dual Diagnosis. We are looking for [but not limited to]:
Developments in your service or team
New research and articles of interest about dual diagnosis with a focus on youth
Highlights and experiences from different programs around Victoria
Innovative ideas in your youth service sector
Examples of practice / intervention tools
Consumer and carer experience and ideas
National or international initiatives of interest
Notice of conferences or workshops
Photos and images
Submissions start at 125 words and written for a target audience from a varied background. Please in-clude links to articles and websites where applicable
Please forward items, suggestions, feedback or queries to the editorial team.
Steve West. Eastern Dual Diagnosis Service -Youth Hub, 43 Carrington Rd Box Hill.
Mobile 0457 544 103. email: [email protected]
Christine Rampling. NEXUS Dual Diagnosis Service Second Floor, Bolte Wing St
Vincent`s Hospital. Mobile 0417051405. email: [email protected]
Andrew Innes. HYDDI – Northern Region SUMMITT DD Service North Western
Mental Health -The Royal Melbourne Hospital. Mobile: 0409 029 102
email: [email protected]
“Dual Diagnosis is an expectation
not an exception”
Dr Kenneth Minkoff