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.

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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.

Needed: Lived Experience reps to guide youth mental health services going forward

PLEASE SHARE THIS AS WIDELY AS YOU CAN …

N.B. Closing Date for Submissions is Thursday, 7 September

ADOLESCENT EXTENDED TREATMENT FACILITY AND EXPANDED YOUTH MENTAL HEALTH PROGRAM

YOU can have direct input into the development of the new facility AND the other vital new services for young people with severe and complex mental health issues in Queensland. 

Health Consumers Queensland are seeking Expressions of Interest for consumer and carer representatives for the following:

Overarching Committee chaired by the Deputy-Director General, Clinical Excellence Division, Department of Health to ensure processes are monitored and advice/direction is provided to support timely and successful delivery of the AETF, StepUp/StepDown Units and new adolescent Day Programs.
Project Oversight Group to oversee delivery of the program of capital works i.e. resolving design and coordination issues and providing advice to the Committee on risks and actions for resolution. (Meetings held monthly.)
Co-design consultation: A range of workshops seeking health consumer input/expertise for detailed design, model of service and integrated educational/vocational services.

Go to this page of the HCQ website for more info and to download the Expression of Interest form to be emailed to Leonie Sanderson by midday Thursday 7 September 2017.

Please phone Leonie on 0437 637 033 if you are interested in applying but are unable to submit by this date.

*

Just the beginning …

The response to the Barrett Commission of Inquiry has reached an important stage. The MHAOD (Mental Health, Alcohol and Other Drugs) Branch of Queensland Health is finalising the work required of it in relation to the recommendations that came from Justice Wilson’s report. The majority of the actions committed to by the current government in its Inquiry response involved analysis or exploratory activities that would lay the foundation for the development of practical changes in approach to future service provision i.e. in order to “improve service agreements …; evaluations…; transitions…; and coordination between services”, the current status of all of these things must be assessed/mapped. And, as a result of the research, appraisal and consultation, recommendations for future actions have now been put to the government for their decisions on whether/how things might progress. A summary of – and links to – the reports can be found on the August update on the Developments page of this site.

Of course it’s hoped by all those who have put so much time and effort into achieving what has been accomplished over the past year that this – or any future government – will continue what has been a productive beginning. Particularly because all contributors know that Queensland’s young people with severe and complex mental health issues and their families – and those who will exist in the future – have the most at stake.

It’s important to bear in mind that most bureaucratic processes can take extended periods of time and that what has been achieved so far has been done within a timeframe that would overpower many teams of public servants. But those involved have been able to accomplish a considerable amount. And, as a result of this process,  a dedicated Child and Youth Mental Health Team has been established within the MHAODB of Queensland Health, ensuring system leadership for child and youth mental health policy and planning. This can only lead to positive developments for children and young people and their families whose unique needs deserve specific representation at this level so it’s a very valuable step.

As well as acknowledging the focussed staff within Queensland Health, deep appreciation must be expressed to the amazingly passionate consumer and carer representatives whose contributions have significantly shaped the outcomes to date. Those in the position to provide invaluable perspectives are often also those for whom making the time and energy for meetings, forums etc. can be a considerable challenge. So anyone facing personal hurdles who overcame those to contribute in any way deserves our sincere gratitude and admiration. Thanks to the seamless and enthusiastic facilitation of Health Consumers Queensland, we know that the recommendations that are being put to government have been genuinely and appropriately influenced by those with lived experience. Both Qld Health Deputy Director General Dr John Wakefield and the Managing Director of the consulting firm undertaking the design of the new extended treatment facility have clearly stated that, without the input of those who have lived with the reality of severe and complex adolescent mental health issues, what is being presented to the government would have been quite different.

We now await the policy decisions of this or the next government (depending on when the next state election takes place) to find out if/how this strong foundation might grow into life changing approaches to mental healthcare.

Because, with generations of young Queenslanders still at risk, this is clearly only the beginning. And continued commitment to improving the services for some of the most vulnerable across our communities is not only logical and financially sound … it is the obligation of those with the ultimate authority to provide an adequate system of resources for the people of the state.

As we note this promising start , however, we can never allow ourselves to forget those who have been lost and those who have experienced such loss and irreparable damage.
They are always in our thoughts.
They drive us to do better.
And, for them, we will always do what we can to create a more understanding and healing world for those that are to come.

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A reminder of INADEQUATE TRANSITIONS

A BLOG POST

10 months ago, I posted on the BLOG page of severeyouthmentalhealth.org – where pieces that have personal perspective, analysis or opinions appear (other posts are News and aim to focus on facts and information about developments etc.). I had been compelled to write about the findings of the Barrett Commission of Inquiry in relation to the transitions of patients.

As independent reviewers undertake a look at the transitions from adolescent to adult mental health services, particularly in relation to those suffering severe and complex mental health issues, I would urge anyone who is unsure of what they can contribute to read that July 2016 post which reflects on how the Barrett families felt in relation to the findings of the BACCOI on transitions.

These families know what needed to be done and what was overlooked and I am confident that they are not the only Queenslanders with this kind of insight.

So now is the time to do whatever you can to share your knowledge and experiences – or encourage others to do so – so that the young people who need the best support, the most carefully planned and gradual transitions and our best efforts in all the services they require in order to finally see a light at the end of the tunnel have access to what will not just improve their lives but, in some cases, save them. NOW IS THE TIME TO SAY WHAT NEEDS TO BE SAID. Through processes that ensure confidentiality but that also will mean that the input given IS ON RECORD and MUST BE TAKEN INTO CONSIDERATION.

If you have an opinion following experience in this area or know someone who has, since the HOI reviewers’ survey is no longer accepting entries, please do the following yourself or encourage those who have important insights to:

The next few weeks provide key opportunities for those who understand what’s needed to contribute to providing those very things.

On behalf of all Queenslanders who are affected by severe and complex youth mental health issues – now and in the generations to come – I implore you all to give your expert input. From those who have seen the reality to those who can shape the future – the vital passage of ideas is the only way we can get closer to the right support for those who need it the most.

*

Have your say ~ Transitions between Adolescent and Adult Mental Health Services

NEWS

The Inquiry into the closure of the Barrett Adolescent Centre brought many issues to light in relation to mental health services for young people that need to be addressed.

In chronological and legal terms, an adolescent becomes an adult at 18 years old. But when that adolescent has been enduring severe and complex mental health issues for years, adult services are too often totally inappropriate for his/her needs and transition to those purely because they’ve passed their 18th birthday can frequently be more harmful than helpful. The process of transition (when a young adult does actually reach a stage where they have the reasoning capacities, lifeskills and emotional/social development of an adult – ensuring access to adult services will facilitate ongoing progress) is also obviously vital. Trauma is likely to have already been a significant experience in the lives of these young people and all efforts to support them must ensure that no therapeutic process or mechanism between processes contributes to that in any way. Individual readiness and gradual and appropriate transitions must not be an aspiration but a BASIC REQUIREMENT of their mental healthcare.

Justice Wilson’s Recommendations from the BACCOI included:
REC 5: Improve transitions for adolescents moving into adult mental health services
and the government’s action on this has been to assemble a working group to outline the terms of reference for the engagement of an organisation to undertake an independent review of the current situation as regards the alignment and transition arrangements between Queensland’s adolescent and adult services.

Health Outcomes International (HOI) and Synergy Nursing and Midwifery Research Institute are, as a result of their appointment, undertaking a range of consultations – from focus groups, discussions with key stakeholders and an online survey to gather information on issues including the following:

  • Mental Health Program/Services that currently exist throughout Queensland
  • Capacity/ resourcing issues
  • Processes for the transition of adolescents and young people to the adult mental health system
  • Collaborative working arrangements and communication between services
  • Service Innovations
Many young Queenslanders and their families will have valuable information based on their own experiences and it is only through sharing those experiences that access to the appropriate services and transition methods can be developed. The problems Queenslanders have personally experienced or witnessed cannot continue but any shortcomings or mismanagement can’t be addressed if they are not communicated to the independent reviewers. Please be assured that any contributor’s personal identity WILL BE PROTECTED.

CONFIDENTIALITY
HOI states clearly that the information collected by the survey is for statistical purposes only and won’t be used to identify survey respondents, mental health service users or their families/carers. If you have any questions or concerns, you can contact Andrew McAlindon, Senior Manager at HOI (AndrewM@hoi.com.au)
and/orLeonie Sanderson
please note that Leonie Sanderson at Health Consumers
Queensland is an ADVOCATE and ADVISOR for the needs of CONSUMERS and CARERS, specifically in relation to the government response to the Inquiry’s recommendations.

As the HCQ website states:

Health Consumers Queensland is a not-for-profit organisation and a registered health promotion charity and we believe in improving health outcomes for people in Queensland. One way we do this is through enabling consumers to be an effective voice in how health services are designed and delivered.

So you can contact Leonie at leonie.sanderson@hcq.org.au to clarify anything or provide anonymous information should you have any concerns about sharing information related to your mental health service experiences in a more public forum.

Those who were/are unable to attend the ongoing regional forums* should be encouraged to contact Leonie with their insights at the above email address or by phoning HCQ on 07 3012 9090 to arrange the best method and time of sharing your insights to suit your needs and availablity.

So please, urge those you know who have experience in the transition of a young person/s from adolescent to adult mental health services to undertake the survey (at http://www.surveygizmo.com/s3/3542411/Queensland-Health-Public-Mental-Health-Services-Mapping) and/or contact Health Consumers Queensland directly if you have additional insights to share regarding the services needed to address the needs of young people with severe and complex mental health issues. Contributions from those with experience are essential in ensuring that the right approaches, programs and attitudes to mental healthcare for our most vulnerable young people become standard practice as soon as possible.
* There are still places available for the following Youth Mental Health forums:
Townsville: 9.30am - 12.30pm, 19 May - Riverway Function Space, Tony Ireland Stadium.
Mt Isa: 12.30 - 3.30pm, 23 May - MICRRH, James Cook University Mount Isa Centre for Rural and Remote Health, Mount Isa Hospital, Joan St, Mount Isa City.
Logan: 9.30am - 12.30pm, 29 May - Logan Central, 51 Wembley Rd, Ground floor conference room Addiction, Mental Health Services.
Mackay: 10.30am - 1.30pm, 30 May - Ocean International Resort, 1 Bridge Rd, South Mackay.
Bundaberg: 10.30am - 1.30pm, 31 May - Burnett Riverside Motel, 7 Quay Street, Bundaberg.

Youth Mental Health Survey 2012 – 2016 Report

NEWS

Mission Australia, in collaboration with the Black Dog Institute, has undertaken a nationwide study into youth mental health and as reported in the Brisbane Times, it backs up what those affected by youth mental health issues have been saying for some time. The numbers of young people with serious mental health issues continues to increase. And, especially troubling, so does their reluctance to seek help.

The report focuses on the period between 2012 (when the cut-backs by the previous Queensland government began that included the closure of the only long-term inpatient facility) and 2017, so that now 21.9 per cent of young Queenslanders meet the criteria for having a probable serious mental illness – “up from 18.6 per cent in 2012”.

On the release of the report, Mission Australia’s Queensland state director Darren Young said the number of young Queenslanders facing serious mental illness was “alarming“.

“The effects of mental illness at such a young age can be debilitating and incredibly harmful to an individual’s quality of life, academic achievement, and social participation both in the short term and long term,” he said.
                                                                  Brisbane Times, 19 April 2017

The nationwide study also clearly states that:

“ …young people with a probable serious mental illness report higher levels of personal concern across a wide range of issues, meaning that services and supports need to be cognisant of the complexity of worries and concerns young people are experiencing. Services need to be able to support and skill young people to deal with these issues or to provide referrals when needed (as it may be beyond the scope of any one particular service to support young people with the diverse range of concerns noted) and help them navigate an often complex service system.

This emphasises the values in the current Queensland government response to the recommendations from the Barrett Adolescent Centre Commission of Inquiry. Young people and carers with lived experience MUST be part of a co-design team to create that full range of services needed to meet the needs of severe and complex youth mental health issues and a depth of understanding of these issues must be developed across the community – particularly in areas where young might seek help.

The Mission Australia study reports that:

“Young people with a probable serious mental illness have consistently reported that the top three sources they would go to for help with important issues in their lives are friends, parents and the internet.”

But even the statistics indicate that there are declines in seeking help from these preferred sources.

The would tend to indicate that any public rhetoric about the reduction in stigma is purely that – rhetoric – and, although positive publicity campaigns are a good starting point, more actions must be taken and/or attitudes changed at all levels for young people to have confidence in and/or knowledge of available support/services, particularly as the range of these expands to meet all needs.

The full report can be accessed here. We should all view it as a reinforcement of a call to action to do whatever we are able to make sure that future studies tell a very different story.

Be Part of the Conversation on Youth Mental Health Services

NEWS

As part of the Qld Government’s response to the Barrett Adolescent Centre Commission of Inquiry (BACCOI) Report, Health Consumers Queensland‘s collaboration with Queensland Health and Education Queensland continues to create vital opportunities for public input.

The next phase means thatcoming soon to a town near you will be a public forum where anyone with ideas, experience and information related to adolescent mental health issues are invited to talk directly to those responsible for the provision of health and education services throughout Queensland for young people and their families dealing with such challenges.  Consumer and carer representatives who have been actively involved so far will be present as will the Health Consumers Queensland staff who continue to advocate for co-design as the only means by which the best services can become available.  These forums are an opportunity to:

To register your attendance go to
www.health.qld.gov.au/improvement/youthmentalhealth or

contact EDyouthmentalhealth@health.qld.gov.au or
click on the thumbnail below right to open the info sheet
with location and registration information

Progress in Youth Mental Health Planning

NEWS

Queensland Health now have a website that deals specifically with their actions in relation to the Barrett Adolescent Centre Closure Commission of Inquiry. This will provide information on plans for the new extended treatment and education facility as well as other related developments and, along with this site and the dedicated page at Health Consumers Queensland, it’ll inform people of ways they can become involved in plans for future services and policies. Regular Communiqués will be posted on this page along with any other news and relevant information. Continue reading

New centre to be built at Prince Charles Hospital + SURVEY announced

NEWS

The Queensland Premier announced today that a new facility for young people with severe and complex mental health issues would be built in the grounds of Prince Charles Hospital at Chermside in Brisbane’s northern suburbs. A site visit was then made where Premier Palaszczuk and Health Minister Cameron Dick were joined by community members directly affected by the closure of the Barrett Adolescent Centre in January 2014. The Minister had met with families linked to the Barrett Centre yesterday to update them on the progress of the government’s response to the recommendations from the Commission of Inquiry (COI) into the closure and reassure them that health service consumers and carers would continue to play a significant role in planning and developments. Continue reading