Assumptions, Bias, Labels … why the search for justice is elusive

A BLOG POST

I have written previously on this site to try and give context to findings that were less than satisfactory to people who have just wanted understanding and fairness. I had hoped I wouldn’t have to write again.

The Coroner’s Court of Queensland is undoubtedly populated by experienced and deeply knowledgeable individuals – that is not disputed. Neither can it be denied that Talieha Nebauer, Will Fowell and Caitlin Wilkinson Whiticker were each precious, courageous, developing individuals.

And it is INDIVIDUALITY that is at the very heart of the matter that must be illuminated by what has transpired over the 6½ years since the inevitable closure of the Barrett Adolescent Centre was first revealed to be underway.

Each human being is unique. Even identical twins are not actually identical. Each of us has a physical make-up that is not organically replicated exactly in any other person. We are a one-of-a-kind collection of thought patterns and hopes and likes and backstories and quirks and motivations and needs and lifespans. But the world often seeks to put us into categories. To label or pigeonhole. To impose. And sometimes, to assume to know based on superficial information.

The need to classify is often understandable. It’s too hard to start with a totally blank page when dealing with thousands or even millions of people. So we are grouped and assigned and we have to compromise on the parts of ourselves that fall outside the parameters we are supposed to fit within.
And sometimes those compromises aren’t a big deal.
But sometimes they are.

As individuals, none of us has the capacity to be truly objective. Despite it being vital at times in professions and key life moments, our humanity can never totally be shut down. So we bring our histories and agendas and ambitions and perspectives of the world to all that we do.
And sometimes that isn’t a big deal.
But sometimes it is.

 

 

So when an individual provides their input on an issue or event,
what is FACT and what is INTERPRETATION?
And when several different individuals have their say on a particular situation,
who is providing what could be seen as the closest to OBJECTIVE information?

In the case of the Barrett Inquiry and the Coronial Inquest, for example,
whose evidence has been determined to be the EXPERT information on which findings will be based and whose evidence is viewed as FLAWED so has been broadly disregarded?

That has been for the Commissioner and the Coroner to decide. Based on years of legal knowledge, experience and precedents; standard practice; even societal conventions. There are high expectations of everyone involved. Protocols and time limitations to adhere to. It is no easy task and one where compromises must regularly come into play.

Not unlike those compromises we all have to make when we don’t fall into the stereotypes that can be assigned to us.
Like the mothers who have tolerated snap judgements about their relationships with children whose lives are in turmoil. (Because those mothers burst into tears when they finally admit out loud that they’re terrified their child could be dead every time they’re out of sight for more than a minute). But they continue because no other treatment has been effective.
Like the carers who have long given up on hoping vicariously for a life of professional achievement, fulfilling relationships and creative satisfaction for the suffering young person that they love. (They just want them to have a life. And then one that isn’t a never-ending nightmare.) But they continue because they are realistic and determined that the young person’s life will be better in some small way.
Like the parents who have sacrificed a stimulating and useful professional career and their own stable, healthy existence because the young person with such complex needs means more to them than anything else. (24 hr diligence and stress will always take a toll. And a life wholly focussed on another – a loved one who moves from torment to hopeless – drains like nothing else can.) But they continue because know their priorities and their responsibilities. Their child comes before anything for themselves. Anything.

So this blog post is just to note that:
Individuals make compromises based on their priorities.
Individuals categorise based on their particular agenda.
So all we can hope for is that, in every situation possible, everyone will do their best to take in everything each person says and does. As much as possible. Factoring in the context of the information being provided – the role of the individual, their incentive, their bias.
Each individual’s input should be seen as valuable. There should never be judgements based on stereotypes or assumptions.
This approach is something we all hope for many times through our lives. Over trivial incidents. And life changing events. Because it’s the only way to get closer to understanding. And fairness.
And those two things are vitally important. Especially in circumstances where individuals have suffered.
And are suffering.
And could suffer so much that the worst can happen.
If it hasn’t already.

 


The media have reported that the inquest found that “there are no strong links between the suicide of three Queensland teenagers and the controversial closure of a youth mental health facility,  … other factors played a more significant role in the suicides”. To try to consider the situation within the context provided by the people that experienced the closure process and aftermath … click on the button below.

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NEWS: Model of Service for new Centre; Carers Forum

MODEL OF SERVICE (MOS) FOR NEW ADOLESCENT EXTENDED TREATMENT CENTRE (AETC)

Independent Review of MOS

With Dr Paul Robertson engaged as an external consultant in March to provide independent clinical and expert advice on putting the theoretical Model of Service into operation terms, Queensland Health have now made Dr Robertson’s report available online:
– in summary (click linked text to access) and
– in full (click linked text to access) 
Other info and links can be found under the NEWS section of the YOUTH MENTAL HEALTH PAGES of the Queensland Health website.

VISUAL MOS

The visual Model of Service can also be viewed via the same page of the QH site or you can go directly to the 2 page document by clicking on the image below:


CARERS FORUM (October)

ARAFMI – originally started as an association for carers of those with mental health issues whose aim is now to “enhance the wellbeing of people with mental illness, their families, carers and volunteers” – is holding their Becoming Visible Carers Forum 2019 on 15th October (during National Carers Week) at the Brisbane Convention and Exhibition Centre.

As an opportunity for carers of someone with a mental illness to connect with others, hear from industry guest speakers and obtain the latest information about the person they care for this could be an invaluable day for many.

The forum is FREE to attend but spaces are limited so to find out more and/or REGISTER, click on the ARAFMI logo below.


 

 

*KEY ROLES FOR CONSUMERS AND CARERS in Selection of New Centre’s Staff

People with lived experience of severe and complex youth mental health issues have shaped the design of the new inpatient extended treatment centre at Chermside. They have had input into the model of care. AND NOW …

THEY HAVE THE OPPORTUNITY TO SIT ON THE SELECTION PANEL FOR THOSE THAT WILL STAFF THE CENTRE.

Children’s Health Queensland (CHQ) –the Hospital and Health Service under which the new AETC will operate – is committed to having consumers and carers as equal and valued members of the selection panel that will determine the appointments of professionals in the clinical roles at the Chermside Centre.

 

So Expressions of Interest are being invited now
with applications closing on 19 July
for Consumers and Carers to submit their completed forms.*

Consumer and Carers involved will, as has been the case throughout the development of the AETC, be comprehensively supported by Health Consumers Queensland (HCQ) and there will be

  • A 90 minute training session for every consumer/carer who becomes involved in the recruitment process as well as opportunities for pre-brief and post-interview debriefing
  • Reimbursement for travel and parking expenses and
  • Remuneration for time spent training, pre-reading, shortlisting, and interviewing at $40 per hour

We all know that it’s the PEOPLE that make a facility into a HEALING ENVIRONMENT.
And now, it’s those with the personal experience of the types of individuals who can do that whose contributions can lead to the selection of the team who will change lives.

YOU KNOW WHO’S NEEDED.

SO PUT IN AN EXPRESSION OF INTEREST TO BE AT THE TABLE OF THOSE APPOINTING THE STAFF WHO WILL COLLABORATE, RESPECT AND UNDERSTAND.

 

For more information, you can download the following documents:

CHQ on Consumer and Carer Involvement in Staff Recruitment

HCQ’s Recruitment Training

and to put in an Expression of Interest, just click on the link here to download the form.

OR

you can go to the dedicated page on the HCQ website for all you need.

*Note that if you can’t get your form in by 19 July and you still want to apply, you can contact Leonie Sanderson of HCQ on 0437 637 033.

And PLEASE, share this post as widely as possible to give all consumers and carers who might be interested the opportunity to be involved. 

IMPORTANT DECISIONS REQUIRE IMPORTANT PEOPLE 
and the most important people in this process are the Queenslanders who REALLY KNOW about severe and complex youth mental health issues.

NEW EXTENDED TREATMENT CENTRE NEEDS: Therapists, Nurses, Social Workers, Psychologists, …

The team that will provide the holistic treatment and support at the new Adolescent Extended Treatment Centre to open at Chermside in early 2020 will be truly multidisciplinary.

So Expressions of Interest are now being called for:

  • Art Therapists
  • Carer Consultants
  • Dieticians
  • Exercise Physiologists
  • Health Workers
  • Medical
  • Music Therapists
  • Nurses
  • Occupational Therapists
  • Peer Workers
  • Psychologists
  • Social Workers
  • Speech Therapists

This is a unique opportunity to work in a truly collaborative team based in a new purpose built centre focussed on changing the lives of young people and their families. To be able to provide hope, facilitate recovery and witness the development of young Queenslanders with the potential to live productively in the community and finally acknowledge their own value will be a professional experience that is genuinely enriching.

For more information, click here to go the relevant page of the Children’s Health Queensland HHS website  or, to be kept informed of recruitment activity as it unfolds, email a copy of your CV to AETService-Recruit@health.qld.gov.au.

It’s worth noting that CHQ HHS page linked above also has a digital ‘flyover’ video of what the exterior of the new Centre will look like (and from which the images used here were selected). So anyone with any interest at all in the Centre should find viewing this particularly interesting.

*****

“A New Era Dawns for Adolescent Mental Health in Queensland”

A ceremony today has marked the commencement of construction of the new Adolescent Extended Treatment facility within the grounds of Prince Charles Hospital at Chermside scheduled to open in 2020. The Queensland Premier – who attended along with the Health Minister Steven Miles – took the opportunity to release a Media Statement noting the significance of this next stage in the development of the vital health service that has been lacking since the closure of the Barrett Centre.

“My government is committed to making sure Queensland’s most vulnerable young people have access to highly specialised healthcare services to help them recover and return to their family, friends and communities. … I want to thank the patients of the former Barrett Adolescent Centre and their families, and other young people with a lived experience of mental health services for their invaluable input which will ensure that this facility and its services will be safe and effective.”

Melissa Fox, CEO of Health Consumers Queensland, the organisation facilitating and supporting the engagement of consumers and carers in the government response to the recommendations from the Barrett Centre Commission of Inquiry (work which includes the co-design of the new facility) also highlighted the important role of those affected by severe and complex adolescent mental health issues in the development of future services.

“… the design of this facility has been informed by meaningful engagement with young people and their families, and recognises their experiences in using mental health services … The input of young people in the development and design of services for young people is critical to providing better mental health services in Queensland.”

Consumers and carers, including former patients from the Barrett Adolescent Centre, who have been involved in the implementation of the recommendations, also spoke today at the ceremony, underlining the commitment of those at Queensland Health responsible for adolescent mental services to the ongoing involvement of the lived experience community in the evolution of a comprehensive and effective suite of services to support those affected.


 

Medical Director, Statewide Extended Treatment campus advertised

It’s likely to be of particular interest to many for whom child and youth mental health issues are important that Children’s Health Queensland (CHQ) is now advertising a position of some significance.

CHQ is the state government Hospital and Health Service under which the facility to be constructed at Chermside following the recommendations of the Barrett Adolescent Centre Commission of Inquiry will operate as one of the many vital options that young Queenslanders can access through the  Child and Youth Mental Health Service (CYMHS).

The position of a Medical Director of a campus focussing on Statewide Extended Treatment is clearly a key role in shaping how the clinical elements of the Model of Service and Model of Care will be delivered and the right kind of leadership and approach will be influential in achieving the best outcomes for the patients and families who access the services offered at that campus. So there are many people hoping for interest from a substantial selection of high calibre candidates with an appropriate management style and collaboration skills as well as excellent clinical qualifications and experience.

With that in mind, this post is to encourage the widespread proliferation of the existence of this vacancy. Because the more people that are aware of this opportunity, the better the chance there is of the appointment of the best Medical Director possible.

The person who fills this position will be pivotal in establishing an environment and tone across a service where those elements can have far-reaching effects – not only on those for whom the right support for severe mental health issues can change the direction of their lives but for the team of professionals who will work collaboratively under the leadership of the Medical Director. And although the title accurately indicates the clinical emphasis of the Director, the campus team for such a service would include staff in important non-medical positions (e.g Education, Administration etc.) whose  input and mutual engagement with those with clinical expertise must be as valued and intrinsically linked to the goals and values of the facility as any other professional contributor. The right Medical Director will be able to unite all those who stay, work at or visit the campus  to create the kind of healing community that provides the outcomes deserved by those affected by the mental health issues the campus aims to address. And his/her leadership and management style will engender a workplace where  dedicated professionals with a range of skills and experience will seek to be able to make a contribution when they know that will be valued, stimulating and productive.

So there can be no doubt that this is a role of significant opportunity and influence in an area where professional and interpersonal attributes beyond those solely medical will be fundamental.

The link to the advertisement for this role is:

https://www.seek.com.au/job/37690108?type=standard

or you can click on the image below to take you there directly.

Please share this post and/or the link above as widely as you can.

Thank you.

Inquest into deaths of Barrett Centre young people begins

Today was the first day of the inquest into the tragic deaths of Talieha Nebauer, Will Fowell and Caitlin Wilkinson Whiticker.

Being overseen by Deputy State Coroner John Lock, the entire process is scheduled to run across a number of weeks, with a number of the parties (i.e. individuals, groups, government bodies etc.) directly involved in the Barrett Adolescent Centre Commission of Inquiry (BACCOI) also represented at these proceedings (in some cases by the same legal counsel). Each young person’s situation will be scrutinised over several days before a final procedure where the collective issues will be examined so as to address the need to consider “opportunities to improve management of the risk of suicide“, as noted in the prioritised issues listed on the Inquest Schedule.

It has been a long and difficult wait for the families who lost young people more than four years ago. Many of the others involved – politicians, those involved in professional roles etc. – have been able to go on with their lives since the days in 2014 when those close to Talieha, Will and Caitlin were forced to face an existence without those they loved. And then again then since the procedure and conclusion of the BACCOI. But since the COI took a clear position to not encroach on any areas that could relate to an inquest – those being in the Coroner’s jurisdiction – Justice Margaret Wilson was not in a position to provide families with the answers they have needed. In fact, due to the time constraints of the COI, it was deemed necessary to ‘draw a line in the sand’ as regards a timeframe for consideration of consequences of the closure:

“This temporal limitation meant that the Commission’s factual inquiry started at the beginning of the transition and ended around one month after the transition client’s discharge from the BAC. The Commission’s terms of reference, and its factual inquiry, do not extend to a consideration of the following matters:

  • the immediate cause or root causes of the deaths of the three young people who died in 2014 who had formerly been patients of the BAC
  • whether those deaths were caused by or contributed to or affected by the closure of the BAC in early 2014
  • whether those deaths were caused by or contributed to or affected by the transition arrangements or the adequacy of care provided by the various receiving services.

Those are matters for the Coroner.”

Barrett Adolescent Centre Commission of Inquiry Report
p 385 of printed document, p 398 of pdf (
Click here to access)

This earlier post may provide more clarity on the relation of the findings of the COI to the coronial inquest. But it is clear that the Coroner’s office, in holding a combined inquest procedure for the three young people, has determined that the closure of the Barrett Centre must be examined as a factor in the deaths as, tragically, that is the key event that links all three.

This will be an extremely challenging process for those who have been emotionally affected by the losses of Talieha, Will and Caitlin and by the closure of the Barrett Centre. To relive trauma numerous times is a debilitating experience and to have to do so in a formal legal arena where events, accounts and perspectives will be questioned by those defending the positions of other individuals and groups will be gruelling.

It is rare to find anyone in our communities these days who has not been impacted by mental health issues in some way so we know that many people will be feeling for those whose lives have been changed dramatically because of severe and complex mental health issues in adolesence. And particularly now for those who lost three treasured young people. So perhaps, as the news reports are filed and the lawyers quoted, we should all keep in mind that this inquest is about 

TALIEHA

WILL

and 

CAITLIN

There are many people who have never, and will never, forget them.

So may this process provide the answers that these three deserve.


Note: Coverage by the ABC Radio’s ‘The World Today’ program can be listened to by clicking here.

All reporting on this and on other issues related to severe and complex mental youth health can be found on our In the Media‘ page.

Consumers and Carers NEEDED on Steering Committee for New Adolescent Treatment Facility

KEY ROLES on this VITAL STEERING COMMITTEE are available for YOUNG PEOPLE, FORMER YOUNG PEOPLE AND CARERS WITH EXPERIENCE IN SEVERE  & COMPLEX ADOLESCENT MENTAL HEALTH ISSUES …

This is a unique opportunity to help shape how the new Adolescent Extended Treatment Facility at Chermside will operate along with all the key issues that will ensure it genuinely meets the needs of the young people of Queensland who were failed by the closure of the Barrett Centre.

This community has gone from being ignored to being included at ‘the top table’. This Steering Committee makes the decisions on the design and layout of the centre, its model of care, staffing, education component … all the aspects that, if done correctly, will take young people from lives of isolation and continual distress to a place of hope, ongoing support along with independent abilities and skills and having the best chance at a productive adult life with personal satisfaction and achievement.

BUT WITHOUT THOSE WHO KNOW WHAT IS REALLY NEEDED, THIS WON’T HAPPEN!

As previous consumer and carer reps can attest, you will be thoroughly and understandingly supported throughout your involvement by Health Consumers Queensland (HCQ) and specialists in mental health. This is not a token gesture, you will be respected and have opportunities to say what’s needed within an environment that acknowledges your personal expertise. You can influence how the centre works and so ensure that young people in need become young people with promising futures. AND, you will receive remuneration for your time and reimbursement of expenses – info here.

For more information, you can go to this HCQ web page (i.e. at http://www.hcq.org.au/aetf-steering-committee-consumers-and-carers/ ) and, although Expressions of Interest (EOI) close on Friday 10th of August, if you think you might to apply but you’re unable to do so by this date, you can contact Leonie Sanderson, HCQ’s specialist Engagement Advisor on this issue, (on 0437 637 033 or via email at Leonie.Sanderson@hcq.org.au) to indicate your interest and for assistance in lodging your EOI. So if it’s after the 10th of August when you’re reading this, it may still not be too late.

This is a great opportunity to shape the future of adolescent mental health services for those impacted severely. Without those who’ve seen what’s lacking and what happens when that’s the case, the potential to create the most effective new treatment centre may never be reached.

YOU KNOW WHAT’S BEEN MISSING, YOU KNOW WHAT’S BEEN WRONG, YOU KNOW HOW THE SYSTEM HAS FAILED YOU … NOW YOU CAN MAKE IT RIGHT!

Please consider putting in an Expression of Interest today!

Stage II of development of improved services begins

With the first stage of the implementation of the Barrett Inquiry recommendations predominantly completed (as Rec #1 requires a review across Queensland Health and not just in relation to youth mental health, the acceptance of the related report is still pending) it’s worth looking back on how things progressed in relation to consumer/carer involvement, thanks to the Health Consumers Queensland video put together by Leonie Sanderson. Another very interesting video on how things have progressed is that of the first Plenary Session at HCQ’s Annual Forum where the initial stage of the co-design process for youth mental health services is the focus.

There seems to be unanimous agreement on the success so far of the involvement of those with lived experience – particularly in relation to the value placed on and respect given to consumer/carer participants. So the natural progression has been that the new committees and working groups currently being put together to work on the next stage of service development will again include a number of consumer and carer representatives.  Following the call for Expressions of Interest from people interested in taking on roles in the upcoming process, the resulting group of individuals selected has created a useful mix of those who were involved with the initial stage and new contributors. This bodes well for input that will represent a range of perspectives as well as the positive outcomes that can come from the productive combination of fresh ideas and experience.

Orientation Meeting

In order to acquaint all the successful consumer/carer reps for the next stage with
(a) the upcoming process
(b) each other and
(c) the relevant government staff members (from the Education Department and Capital Works as well as, of course, from Queensland Health)
an Orientation Meeting was held on the 6th of October.

As well as covering the necessary administrative issues, participants were able to connect with each other and with Leonie Sanderson and Melissa Fox of Health Consumers Queensland (HCQ) – who will again be facilitating the consumer/carer engagement. There was also a preliminary presentation on the overview of the program of work to be undertaken and the consumer/carer roles within that.

It’s hoped that there will be opportunities for others to participate in various ways as things progress so, if you’re interested, you can check in regularly at the dedicated HCQ page OR head there now and sign up to receive email updates on developments. Note: You can sign up for updates purely related to the post-Barrett Inquiry action AND/OR for any other consumers/carer opportunities to engage in other kinds of service planning and support across the Health sector. If you do the latter, you hear about opportunities like the following:

1.) Consumer/Carer Registrations for 1st Asia Pacific Conference on Integrated Care

HCQ has been given a number of registrations for consumers/carers to attend the three day conference at the Brisbane Convention Centre from 8 – 10 November. (Please note that these registrations cover only the cost of attendance and nothing additional in relation to travel, accommodation etc.)

The Congress is a partnership between The International Foundation of Integrated Care (IFIC), The Children’s Health Queensland Hospital and Health Service, Queensland Health Clinical Excellence Division, the University of Queensland and the Centre for Remote and Rural Mental Health. You can view the draft program here or click on the link here or in the title above to find out more about applying for the HCQ registrations.

2.) 5th Annual North Brisbane Partners in Recovery Forum

Registrations are still available to attend this forum which will be held on Thursday 2 November 2017 at Victoria Park, Herston. Because it includes keynote speakers with a focus on connecting mental and physical health and wellbeing , it seems appropriate to include it in this update.

North Brisbane Partners in Recovery‘ suggests that the following people attend:

  • frontline mental health workers and other community workers with an interest in mental health
  • health and community service managers, researchers and policy makers
  • consumer and carer representatives, volunteers, peer workers and management committee members.

To book, you can head to this event booking page or to find out more, contact danielle.francisco@brisbanenorthphn.org.au or 07 3630 7344.

And, as always, severeyouthmentalhealth.org will endeavour to keep site visitors and followers updated on any developments and issues relating mental health services for young people with severe and complex issues, particularly in Queensland.

Thanks to all our regular and new supporters. The more that people with compassion and personal understanding can engage in the development of services, the better the future will be for the young people and their families who need and deserve the best possible support.

$70 million in Queensland budget for Adolescent Mental Health

NEWS

The opening story on the 12 June bulletin on Queensland’s ABC television News was that the Palaszcsuk’s 13 June 2017 state budget – released this week – includes just under $70 million dollars to not only proceed with the establishment of the new extended treatment and rehabilitation facility at Chermside but to create four other complementary services aiming to support young people with mental illness in the community. (Online summary of ABC report here.)

Future plans include two new Step up Step Down facilities in south-east Queensland and two day programs to be based at Logan and the Gold Coast.

Justine Wilkinson, who lost her daughter Caitlin following the closure of the Barrett Adolescent Centre, has welcomed the allocation of funding but acknowledges that there is still much to be done to provide young people and their families with the full range of support that will make a significant difference to lives that can be indescribably turbulent and challenging. Ms Wilkinson’s ongoing advocacy has meant that she – along with other consumers and carers with lived experience in this area – has played a significant role in the ongoing co-design of new services following the government’s commitment to act on all the recommendations from the BAC Commission of Inquiry.

The engagement of Health Consumers Queensland has ensured that consumer and carer representatives sit on all committees and working groups undertaking planning to fulfil the recommendations and that people throughout Queensland have had opportunities to provide meaningful input into future service provision. This commitment to co-design ensures that those with lived experience not only are heard but heeded and can actively help to shape future services – a collaboration that should lead to programs and support that genuinely meet the needs of those in the community that require them.

Health Minister Cameron Dick believes the funding package to be a landmark step for young people so the community affected by youth mental health issues can only hope that innovative approaches to planning and needed funding continue to be at the forefront of the minds of all those responsible for providing vital services at all levels and in all sectors.

(More comment on this announcement can be found at the Blog post: ‘A Budget Boost –its implications for the Future and the Past.)