Youth Friendly Care: Recent Episodes
Bianca Forrester
In this series, the Department of General Practice Youth team share panel presentations from interactive webinars. Listen to experts in the fields of healthcare, social care and education speak about how primary care can support teens and young adults.
·Welcome to Project ECHO- university of Melbourne hub· Adolescent Mental Health Network-Series 3, session 4·and I’d like to acknowledge the support of the Victorian Government in the production of this series.· Tuesday 23rd of August 2022This session is titled- Sleep in teensOr just Have a good nights sleepThis term we are focusing on the foundations of good health.Our last session focused on disordered eating and in this session we’ll explore the common presentation of disordered sleep.It’s such a common presentation to primary care and perhaps even more common in teens presenting to the DiSS clinic post the pandemic lockdowns. Whether it is the presenting issue or something that we pick up on our comprehensive screen, I think many of us are quite familiar with working with this problem.But how do we quantify this issue?How much sleep is enough sleep and does quality matter?When can we simply blame poor habits and when do when do we need to pay special attention to red flags or warning signs?What are the principles of good management and when do we need to refer for investigation and or management?Our didactic will focus on many of these questions tonight and we’ll be putting some of the principles and skills learnt into practice through our case discussionRecorded on Tuesday 23rd August 2022University of Melbourne ECHO HubDepartment of General PracticeBianca Forrester (Facilitator)Ann-Maree Duncan (ECHO Co-ordinators)Bianca Forrester, audio production
· Welcome to DiSS Breakfast serial· a short order clinical training offering for the Doctors in Secondary schools clinical training program,· brought to you by the Department of General Practice in Collaboration with Sexual Health Victoria· and I’d like to acknowledge the support of the Victorian Government in the production of this series.· It’s Wednesday the 3rd of august 2002 and this morning we’ll be offering up a healthy serve of cereals, scientifically tested and proved to promote improved mental health and wellbeing. This morning we’ll be opening the cereal box of brief interventions for mental health.· In this mornings session our expert chefs from orygen will be lifting the lid on some evidence based tools for therapy and offering serving suggestions for their use in primary mental healthcare.
Good morning early birds and thank you for joining us.· I’m Bianca Forrester and I’m a GP- I’ll be your barrista this morning, so please send any special coffee orders to me in the chat· I’d like to introduce you to our subject matter expert and visiting chef, Desiree Smith from Orygen.· She'll be brining you years of clinical, educational and research expertise to share a breakfast spread of best practice approaches to supporting teens with mental health issues
Welcome back to ECHO.As we move into term 3 at the schools, we’ll focus on the fundamentals of health.Eating well and sleeping well- 2 of the basics needs that we as human animals must achieve if we are feel secure, safe and steady in our foundations before we build upon those lovely idelas of psychological growth, flourishing and self actualization.As clinicians working with young people, we see issues with eating and sleeping so commonly as to know in our gut how crucial it is to get these things right. In these sessions we’ll be focusing on how to recognise issues and intervene early and effectively.Tonights session will focus on eating disorders and move from the basics of screening and recognition into early intervention and multidisciplinary team based care. And we’ll be considering how we can work with schools to create those early access pathways into healthcare.
Recorded on Tuesday 26th July 2022University of Melbourne ECHO HubDepartment of General PracticeBianca Forrester (Facilitator)Ann-Maree Duncan (ECHO Co-ordinators)Bianca Forrester, audio production
Welcome back to series 3 of Project ECHO our adolescent mental health series.In this series we are going to focus on strengthening some of the foundations of good mental health. Safety, Sleep, eating and relationships. In our last session Sandra explored the theme of mental health recovery and resilience and we asked the question:Who is presenting?What are they presenting with?What have been their experiences through the pandemic crisis?How might this have impacted upon normal development and how might we consider a management plan that helps them access recovery?In this session we’ll focus a little deeper on some of the things they may have missed out on and how we can build some of those internal resilience skills, capacities and behaviours.Our case will focus on a young person who experienced many of the vulnerability and risk factors prior to the pandemic and is struggling to re-engage socially and academically and is even now in trouble with the law. We’ll be exploring how to build resilience in his life through appropriate support.Presenter: Professor Sandra Radovini, Mindful Centre for Training and Research in Developmental Health, Dept of Psychiatry, University of MelbourneRecorded on Tuesday 7th June 2022University of Melbourne ECHO HubDepartment of General PracticeBianca Forrester (Facilitator)Ann-Maree Duncan (ECHO Co-ordinators)Bianca Forrester, audio production
Mental health wellbeing and Recovery: what does it mean for teens?We kick off our 3rd series of the adolescent mental health ECHO network for clinicians working with school aged teens.Welcome back to those of you who have been with us for previous sessions and a special welcome to any newcomers.The COVID-19 pandemic crisis has created a context of stress, disruption, pressures, change and fear on a global level. During this time we have witnessed and no doubt experienced first hand an increased number of young people presenting with distress and mental health issues.This series will sit under an overarching theme of recovery and resilience, and we will aim to build practices that bear stress and pressures born out of the pandemic in mind when assessing young people attending the DiSs clinic and we will consider interventions relevant to our current context. We will also focus on some of the basics- food, shelter, sleep and safety and consider how some of these basic needs may be unsettled and undermine mental health in teens and we’ll talk about how we can play a useful role in recognising and helping teens with these issues.Presenter: Professor Sandra Radovini, Mindful Centre for Training and Research in Developmental Health, Dept of Psychiatry, University of MelbourneRecorded on Tuesday 1010th May 2022University of Melbourne ECHO HubDepartment of General PracticeBianca Forrester (Facilitator)Ann-Maree Duncan (ECHO Co-ordinators)Bianca Forrester, audio production
Draft pending approval for releaseRecovery and resilience in teens- how can the GP help?In this episode, GP Bianca Forrester speaks with Professor of Public health Professor Lisa Gibbs Melbourne School of Population and Global Health"The conversation needs to be around strengths and vulnerabilities and how do we provide opportunities for kids to demonstrate their competence and supports where it's needed and when it's needed." ShownotesProf Lisa Gibbs’ researchhttps://findanexpert.unimelb.edu.au/profile/187995-lisa-gibbsArticle referenced: Giving Students time for recovery and learninghttps://pursuit.unimelb.edu.au/articles/giving-students-time-for-recovery-and-learningRisk resilience framework included on page 57 of theAdolescent Health GP Resource kit2nd editionBy Peter Chown, Dr Melissa Kang, Dr Lena Sanci, Verity Newnham and Clin Prof David Bennett AOy Peter Chown, Dr Melissa Kang, Dr Lena Sanci, Verity Newnham and Clin Prof David Bennett AOA collaboration between NSW CAAH and NSW Transcultural Mental Health Centre.https://www.health.nsw.gov.au/kidsfamilies/youth/Pages/gp-resource-kit.aspxPage 57 in this section:https://www.health.nsw.gov.au/kidsfamilies/youth/Documents/gp-resources-kit/gp-resource-kit-sect2-chap5.pdfPsychological First Aid (PFA)Principles of PFA:· Sense of Safety· Calming· Self-Efficacy· Connectedness· Hopehttps://www.health.vic.gov.au/worker-health-wellbeing/psychological-first-aid-for-post-incident-supportMental Health recovery: CHIME Bianca mentions the CHIME conceptual framework. Here’s the systematic review:Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis.Leamy M, Bird V, Le Boutillier C, Williams J, Slade M.Br J Psychiatry. 2011https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/conceptual-framework-for-personal-recovery-in-mental-health-systematic-review-and-narrative-synthesis/9B3B8D6EF823A1064E9683C43D70F577Kate Brady’s researchhttps://findanexpert.unimelb.edu.au/profile/877124-kate-bradyStressors and Supports in Post disaster Recovery: Experiences After the Black Saturday Bushfireshttps://findanexpert.unimelb.edu.au/scholarlywork/1504718-stressors-and-supports-in-postdisaster-recovery--experiences-after-the-black-saturday-bushfiresThis Podcast was recorded over "zoom" in November and edited "at home" in December 2021Presented by: Bianca ForresterInterviewees: Prof Lisa Gibbs, Melbourne School of Population and Global Health and Tom Forrester, student, age 14 yrsProduced by: Bianca ForresterMusic: Space Cadet LullabiesGraphics: Gaal CreativeThe Maze Phase is a production of the University of Melbourne, Australia. The Maze Phase is licenced under Creative Commons, Copyright 2017, the University of Melbourne.
In our last session we discussed the context of families in the care and recovery of young people with mental health presentations.Sandra described the continuum of caregiving and interventions to support families through their own struggles and the impact of crisis on caregiving.In this session, we’ll be focusing on the group of young people living in out of home care.Guest speaker and expert in this field, Dr Susan Webster, will highlight the needs of this group of young people and in our case based discussion we’ll consider how we as GPs and nurses in school clinics can best work to support this group made vulnerable through their caregiving and living arrangements.
Presenter: Dr Susan Webster, Honorary Research Fellow, Department of General Practice, Melbourne Medical School
Recorded on Tuesday 19th October 2021University of Melbourne ECHO HubDepartment of General PracticeBianca Forrester (Facilitator)Ann-Maree Duncan (ECHO Co-ordinators)Bianca Forrester, audio production
Teens, families and RelationshipsThroughout the ECHO series we’ve maintained a focus on the young person’s presenting issues in the context of their families.In our case based discussions we’ve evaluated these important relationships both as predisposing, preciptating and perpetuating factors in mental health presentations and as protective factors for intervention and recovery.* In this session, we’ll take a deeper dive into the themes of caregiving and harm and consider some useful frameworks through which to better understand how to work with natural supports and where professional services may play a role.
Presenter: A/Prof Sandra Radovini, Child and Adolescent Psychiatrist, Director of Mindful, University of Melbourne
Recorded on Tuesday 5th October 2021University of Melbourne ECHO HubDepartment of General PracticeBianca Forrester (Facilitator)Ann-Maree Duncan (ECHO Co-ordinators)Bianca Forrester, audio production
In our previous sessions we’ve discussed the impact of environmental stressors on the developing teen and the predisposing, precipitating, perpetuating and protective factors on the mental health of young people.In this session we’ll take an occupation or perhaps functional approach to understanding teen presentations to the DiSS clinic and discuss the drivers and issues that lie behind a presentation of poor school attendance.
In this session, child and adolescent Psychiatrist, A/Prof Sandra Radovini describes the key presentations of poor school attendance, key areas of enquiry as part of a comprehensive assessment and provides some tips for team based management in the primary care and school setting.
Presenter: A/Prof Sandra Radovini, Child and Adolescent Psychiatrist, Director of Mindful, University of Melbourne
Recorded on Tuesday 7th September 2021University of Melbourne ECHO HubDepartment of General PracticeBianca Forrester (Facilitator)Ann-Maree Duncan (ECHO Co-ordinators)Bianca Forrester, audio production
In our last session we explored the common presentation of self harm and discussed some of the dilemmas that clinicians face when working with teens expressing maladaptive behaviours in response to distress.This perhaps foregrounds this next theme quite well as while for many this behaviour may be self limiting and easily treated, for others it may be the first presentations of a more complex suite of difficulties for a young person and we might find ourselves asking the question: Is this Borderline Personality Disorder?*
In this session, child and adolescent Psychiatrist, A/Prof Sandra Radovini describes why early recognition and assessment alongside the relevant criteria is important and how this can guide our interventions with these kids.
Presenter: A/Prof Sandra Radovini, Child and Adolescent Psychiatrist, Director of Mindful, University of Melbourne
Recorded on Tuesday 24th August 2021University of Melbourne ECHO HubDepartment of General PracticeBianca Forrester (Facilitator)Ann-Maree Duncan (ECHO Co-ordinators)Bianca Forrester, audio production
In this session we’ll focus on another common presentation of distress- Self harmWe’ll seek to understand the feelings behind the behaviours, the difficulties that these teens experience in processing and regulating emotions in more adaptive ways and we’ll discuss the principles of management.
Presenter: A/Prof Sandra Radovini, Child and Adolescent Psychiatrist, Director of Mindful, University of Melbourne
Recorded on Tuesday 10th August 2021University of Melbourne ECHO HubDepartment of General PracticeBianca Forrester (Facilitator)Ann-Maree Duncan (ECHO Co-ordinators)Bianca Forrester, audio production
In this session, we'll beexploring Anxiety through the lens of social determinants of health and considering the needs of young people who may be experiencing discrimination and or disadvantage due to their status as CALD, refugee, LGBTI, ATSI and or experiencing a disability.Presenter: A/Prof Sandra Radovini, Child and Adolescent Psychiatrist, Director of Mindful, University of Melbourne
Recorded on Tuesday 27th of July 2021University of Melbourne ECHO HubDepartment of General PracticeBianca Forrester (Facilitator)Ann-Maree Duncan (ECHO Co-ordinators)Bianca Forrester, audio production
This is the audio recording for the DiSS onboarding training session 3-Understanding Adolescents released for registrars in the program. This audio accompanies the slide deck to be sent out.
Draft pre-release pending formal approvals and release.
Interviews with Prof Susan Sawyer, Paediatrician and Director Centre adolescent Health at RCH and A/Prof Sandra Radovini, Director Mindful centre, Child and Adolescent Psychiatrist.
References and show notes to be developed.This Podcast was recorded "at home" across a few dates in November, 2020Presented by: Bianca ForresterInterviewees: Prof Susan Sawyer, Paediatrician and Director Centre adolescent Health at RCH and A/Prof Sandra Radovini, Director Mindful centre, Child and Adolescent Psychiatrist.Produced by: Bianca ForresterMusic: Space Cadet LullabiesGraphics: Gaal Creative
The Maze Phase is a production of the University of Melbourne, Australia. The Maze Phase is licenced under Creative Commons, Copyright 2017, the University of Melbourne.
Draft of a Podcast interview between GP Bianca Forrester and Prof Susan Sawyer (Paediatrican) and A/Prof Sandra Radovini (Child and Adolescent Psychiatrist) about medicolwegal and ethical considerations in working with young people in Primary care.
This is a draft post production copy of the upcoming Episode 8 of the Maze Phase. GP academic Bianca Forrester interviews Paediatrician Michele Yeo and GP expert in eating disorders, Dr Jenny Conway about best practice approaches to management.
Shownotes:
Support for familiesNEDC website- https://nedc.com.au/support-and-services-2/families-carers-lived-experience/Butterfly Foundation- https://butterfly.org.au/get-support/how-we-help/Inside out institute- https://insideoutinstitute.org.au
Resources for familiesFeed your instinct- https://feedyourinstinct.com.auAround the dinner table- feast- https://www.aroundthedinnertable.orgEating disorders families Australia- https://edfa.org.au
This is a draft post production copy of the upcoming Episode 7 of the Maze Phase. GP academic Bianca Forrester interviews Paediatrician Michele Yeo and GP expert in eating disorders, Dr Jenny Conway about early recognition, assessment and early intervention.Shownotes:1)Eating disorders Queensland resource “Understanding eating disorders”https://www.eatingdisordersqueensland.org.au/wfheict/uploads/2018/12/Understanding-Eating-Disorders-Booklet-EDA-2017.pdf2) NEDC websitehttps://nedc.com.au/professional-development/health-professionals/3) Jenny mentions Mental Health screening toolsK10- https://www.blackdoginstitute.org.au/wp-content/uploads/2020/04/k10.pdfDass 21, RCADS-headspace clinical toolkit https://headspace.org.au/clinical-toolkit/anxiety/SCOFF: http://www.cedd.org.au/hne/other/scoff_questionnaire.pdfESP- http://www.mendedwingcounseling.com/wp-content/uploads/2014/08/ESP.pdfFor for more information about identifying eating disorders in primary care:https://www1.racgp.org.au/newsgp/clinical/identifying-eating-disorders-in-general-practice4)Eating Disorders examination- QuestionnaireEDE-Q: Online version - https://insideoutinstitute.org.au/assessment?started=trueFor paper version: https://insideoutinstitute.org.au/assets/ede-q_6-scale-scoring-eating-disorder-screen.pdf5) Self-help guidesSelf help and family support: The Butterfly Foundation https://butterfly.org.auInside out institute: https://insideoutinstitute.org.au6) Maudesley model from the UKEvidence based treatment:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414759/7)Australian psychological society- therapist finderAPS website:https://www.psychology.org.au8) Australian Dieticians association websiteADA- https://dietitiansaustralia.org.au/find-an-apd/9) PHN Health Pathwayshttps://vtphna.org.au/our-work/best-practice-prevention-management-and-support/statewide-paediatric-healthpathways-project/10) RCH Guidelines for admissionhttps://www.rch.org.au/clinicalguide/guideline_index/Management_of_Eating_Disorders_in_the_Emergency_Department/11) Secondary consultation is available through-NEDC National eating disordershttps://nedc.com.au/eating-disorders/early-intervention/health-professionals/-CEED Centre of Excellence in Eating Disorders Victoria for secondary consultation support.https://ceed.org.au/health-professionals-services/clinical-consultation-services-summary/Support for familiesNEDC website- https://nedc.com.au/support-and-services-2/families-carers-lived-experience/Butterfly Foundation- https://butterfly.org.au/get-support/how-we-help/Inside out institute- https://insideoutinstitute.org.auResources for familiesFeed your instinct- https://feedyourinstinct.com.auAround the dinner table- feast- https://www.aroundthedinnertable.orgEating disorders families Australia- https://edfa.org.au
Through this series we’ve sought to lay the foundations of mental health assessment and basic management in adolescents. In this session, child and adolescent Psychiatrist A/Prof Sandra Radovini provides tips on asking young people about stressors, in both the past and present, that may be contributing to depressive symptoms. She continues to work through the "4Ps of formulation" in Psychiatry by describing common predisposing, precipitating, perpetuating and protective factors for teens experiencing depression and provides an overview of the first steps in medication management.
Presenter: A/Prof Sandra RaoviniFacilitator: Dr Bianca Forrester
In this session, child and adolescent Psychiatrist A/Prof Sandra Radovini discusses common stressors and triggers for the common presentation of Anxiety in teens. She takes us beyond the basics and describes the development of a formulation and how this contributes to the development of a tailored management plan.
Presenter: A/Prof Sandra RaoviniFacilitator: Dr Bianca ForresterResources Described•Orygen- https://oyh.org.au•Headspace- https://headspace.org.au•Beyond Blue- https://www.beyondblue.org.auCochrane Library- https://australia.cochrane.org/cochrane-library
In this panel presentation, child and adolescent psychiatrist A/Prof Sandra Radovini opens up the topic of exploring relevant co-morbidities that might occur when a teen presents with a mental health problem. She discusses the increasing recognition of these disorders, common presentations that might be suggestive and highlights the value of considering neurodevelopmental disorders early in the assessment phase. Common conditions are outlined and first steps in assessment in the school based health clinic settings are discussed.Resources described:Free ASD screens: https://www.autismresearchcentre.com/tests/See attached scoring guide for SNAP-IV 26-Item Teacher and Parent Rating Scale
In this panel presentation, child and adolescent psychiatrist A/Prof Sandra Radovini continues the conversation about adolescent development with a didactic presentation examining Adverse Childhood Experiences (ACEs) and trauma. She discussed the potential impact that ACEs have on early development and this might be key to understanding mental health and behavioural problem presentations in affected adolescents. We'' continue to explore the risk resilience framework, this time, by exploring the influence of risk factors upon adolescent development.
In this panel presentation, child and adolescent psychiatrist A/Prof Sandra Radovini opens up our five session cohort series by examining normal development and by reviewing the protective factors that can support teens to grow, develop and thrive in the second decade of life. She describes the first of a suite of 5 tips for assessment and management in the school setting.
Listen to the didactic component of the first in our reflective webinar series. A/Prof Sandra Radovini, Department of Psychiatry and Director of Mindful, presents the topic of Suicidal Risk Behaviours assessment and first steps in management.
Proud Gunditjmara and Wathaurong woman and Psychologist, Tania Dalton, presents an overview on the Aboriginal Social Emotional Wellbeing Framework in this session. GPs and nurses working with indigenous students in schools are aware of the impact of social isolation upon teens. This is particularly important for Indigenous Australians, for whom connection to family and community is crucial to mental health and wellbeing.
Somatic symptom and related disorders (SSRDs) are mental health conditions that are characterised by the presence of excessive feelings, thoughts and behaviours around physical symptoms that cannot be fully explained by a medical condition and that significantly effect daily functions. Are there any "flags" that can help GPs to "rule in" this issue? How can we explain this diagnosis to adolescents and their families? And what treatment supports functional recovery? Listen to Professor Susan Sawyer discuss this interesting presentation to both primary and tertiary services.
Professor Kelsey Hegarty speaks about supporting teens experiencing family violence in the context of the COVID 19 Pandemic. How can GPs and Nurses work with teens safely through the telehealth platform to support them at this time. Recorded May 19th, 2020