By Project Manager Elizabeth Fudge/ PhD Andrea Reupert. The conference Developing Strength and Resilience in Children 1-2 Nov. 2010 in Oslo.

1. Elizabeth Fudge and Andrea Reupert
COPMI national initiative, Australia

2. AICAFMHA
(Australian Infant Child Adolescent and Family Mental
Health Association)
Australian Government
Department of Health and Ageing
Kylie Eddy, Chris Alliston, Darryl Maybery, COPMI Team
and Consultation Groups
Children of Parents with a Mental Illness - COPMI
Acknowledgements

3. Today
• Background to the Resource
– Why?
• Development
– How?
– Who was involved?
• Outcomes
– Who has used it and what do they think
about it?
– Other lessons learnt

4. Background – Why COPMI?
• Approximately 23% of Australian children and
adolescents live in households where at least
one parent has a mental illness. Mayberry et al 2005

5. COPMI national initiative
Established in 2002, after a review of
Australian services for children of parents with
a mental illness and their families.

6. Aim: COPMI national initiative
To achieve better mental health outcomes for
children of parents with mental illness
Children of Parents with a Mental Illness - COPMI

7. Children of Parents with a Mental Illness - COPMIChildren of Parents with a Mental Illness - COPMI
Consultation and Development of
A ‘Principles and Actions’ Document

8. Children of Parents with a Mental Illness - COPMIChildren of Parents with a Mental Illness - COPMI
Booklets for families and a
website

9. Availability of information for workers and
families
Access to quality workforce development
resources
Access to evidence and evaluation resources
Children of Parents with a Mental Illness - COPMI
Goals Since 2008
(Early Intervention Services for Parents, Children and Young People)

10. Commitment to participation
• Dedicated staff member
• Budget for remuneration (e.g. time, child care
travel)
• Consultation procedures and policies –
but multiple, flexible options for participation
need to be in place

11. Why Workforce Development?
Multi-component approach to prevention for
children of parents with a mental illness
Hosman & Van Doesum, Prevention Research Centre, Nijmegen
University 2000

12. Why Workforce Development?
In line with the
• National Practice Standards for the Mental
Health Workforce (2002)
Recognised need to influence the attitude,
knowledge base and skills of the Mental
Health workforce

13. ‘ When a worker asks me about my kids, or
even just recognises that I'm a parent
first, rather than a consumer of mental
health services, that's the thing I
appreciate. My family is the most
important thing to me in my life. I just
want to be treated like everyone else
and given recognition that even when
I'm unwell, I'm thinking and I'm acting
in the best interests of my family. ’
Keeping Families and Children In Mind
Module 2

14. Why an e-resource?
• Accessible (by individual learners and by
group facilitators) across vast distances
• Can tailor input to learner’s needs
• Interactive
• Consumer and carer informed
• Free, easy to use
• Funding

15. Development - Planning
• Literature review
• Consultation with 25 Australian providers
• Consultation with key stakeholders about
content (Delphi study)

16. Consultation via secure wikis
Multiple designated participants can edit a
simple webpage easily in their own time.
Enhances coordination as everyone can see
the latest draft of a document, everyone can
change that draft (saving it as the latest draft)
and everyone can see each others comments
on the document.
Can be used anonymously.

17. Consultation via wikis
Undertaking a Delphi study via a wiki to
decide on key content areas for the e-learning
resource (three rounds of questions)
enhanced participation through
– Anonymity
– Accessibility
– Ease of rating
Whitham et al, 2009

18. ‘ The unique thing about it was that even after
people started using their own names there
was no differentiation between a worker and a
consumer/carer. This allowed everyone to feel
safe with no pre-conceived ideas or
discrimination regarding who they were.’
Participant quoted in Alliston, Kluge and Fudge, 2009

19. Development - Planning
• Findings
– Many would access it but ‘only if it matches face-
to-face opportunities’
– Some MH workers prefer and/or have greater
access to this medium than others
– ‘a range of practical, bureacratic, managerial and
technological factors intervene’
Herrington and Herrington (2006)

20. Development of the Resource
- matching a face-to-face experience
• Consultation group
• Lived experience group
• Working with producers

21. Development of the Resource
- flexibility of use
• Content development in modular format
• Filming and audio taping – real life
• Scripts for reflective individual and group
activities
• Engaging graphics

22. Development of the Resource
- reduction of barriers to use
• Pilot testing in 2 states and in rural and urban
settings with a mix of end users
• Working with those who may be able to
influence uptake, e.g.
– professional ‘champions’
– state and territory government mental health
departments
– workforce development facilitators

23. Endorsement
• Royal Australian New Zealand College of
Psychiatrists
• Australian College of Mental Health Nurses
• Australian Psychological Society
• Australian Association of Social Workers
• Australian Association of Occupational
Therapists
• Royal Australian College of General
Practitioners

24. ‘Keeping Families and Children In
Mind’
• Available from www.copmi.net.au
• Free. Anyone can log in (families can also view
the resource if they wish)
• A five-minute promotional video about the
resource can be viewed at the COPMI website

25. 6 Modules (approx 1 hour)
• Mental health and families
• The parent
• The child
• The family
• Carers
• Putting it into practice

30. Outcomes – Lived Experience
‘Throughout the whole process I have been
proud to be involved.... I am excited that the
whole process has included and valued my
contribution. I want everyone to know that
COPMI have not been tokenistic at any time;
they have actually been bold and insightful by
including not only professionals but consumers
and carers.’
Consumer from the ‘Lived experience group’
quoted in Alliston, Kluge and Fudge 2009

31. Outcomes – Lived Experience
‘This resource is of an amazing standard. I feel
immediately ‘plugged in’..... The acting in the
fictitious case scenarios was just magnificent.’
Peer educator, 2009

32. Who has accessed it to date?

33. What roles do they have?
Carer Consultant; 16
Clinician/Practitioner
; 195
Consumer
Consultant; 12
Manager; 13
Other; 78
Researcher; 4
Workforce Educator;
51
Primary Professionals Completing 1-6 modules
(total = 369)

34. Where are they located?
10
1 2
46
21
18
12
1 2 3
67
11
21 22
3
1
22
1
9
1
8
55
18
1
13
0
10
20
30
40
50
60
70
80
Metropolitan Other Regional Remote Rural
Current Professionals Undertaking Modules 1 to 6
(Total = 369)
General Medical Practitioner
Mental Health Nurse
Occupational Therapist
Other
Psychiatrist
Psychologist
Social worker

35. Initial Evaluation
Pilot evaluation conducted in 2009 at a rural
and urban site
– Focus group interview with participants
– Pre and post questionnaire responses
– Facilitator journals (to gauge planning and
implementation issues)
Reupert et al, (in press). Child and Family Social Work

36. Pilot evaluation – focus groups
– Participants valued the interactivity of the resource
and life like depiction of families;
...it holds your attention much more than just reading...it brings it
[the issues] to life
– Described a heightened awareness of needs of
family and collaboration;
I think what’s come out of it was the importance of everyone who’s
working with that family, working together...
– Recognised a range of possibilities for
implementation (e.g. staff induction, )
A/Professor Kim Foster analysed focus group data

37. Participant response:
‘ As a participant I was engaged throughout,
and really appreciate the extensive lists of
references and resources. The variety of
modes of presentation – words, voice, video
and assessment tasks worked well for me. The
actors portraying the two families are very
believable and the children, parents and
families who directly describe their
experiences offer so much.’
CAMHS worker

38. Pilot evaluation – pre and post
questionnaire
27 participants (20F/7M) completed identical pre
and post training questionnaires that assessed
change in participant confidence, knowledge and
skill when working with the parents, children and
families (Maybery & Reupert, 2006)
Post data show an improvement in participants’
knowledge, skill and confidence. Almost half of
the 26 items showed a significant change, in the
desired direction.
A/Professor Maybery analysed the questionnaire data

39. Pilot evaluation – facilitator
journals
Facilitators report:
• Need to have reasonable proficiency in
technology (or access to others who do);
• The family videos were a powerful and
effective way to encourage participant
discussion and reflection;
• Need to have appropriate group processing
skills.

40. Implementation Evaluation
2010-2011
• Design
– Pre, Post and 6 month follow up
• Family focused mental health practice questionnaire (33 item
evaluation version Maybery, Reupert & Goodyear, 2010)
– 8 Subscales eg Skill and knowledge, Confidence,
Interprofessional collaboration
– Also demographics
– Post test – what, how did they use the resource
• Online and hard copy
• Data so far Pre – n=120, Post – n=21, Followup – n=3

41. Range of Learner Interactions
Examples
• Blocks of 2 - 3 hours over 3 days
• Each of the six Modules seemed to take
approximately four hours each as I worked diligently
to follow links to References, Resources, listened to
Audio, watched Video, filled in text for interactive
boxes and did the Quiz at the conclusion of each
section.
• Worked through each module over consecutive
weeks. 2.5 hrs each module

42. Range of Learner Interactions
Examples continued
• I completed each module over many weeks/months
to allow time for reflection and integration into
practice.
• I completed the modules over two working days
• I worked through each module individually . The first
took an hour and a half and then 1 hour each after
that. I mostly did it at home in the evenings
• All in one day, took a break between modules

43. Access to Lived Experience
• Consumer and carer participants in the room
with you as you are learning is very powerful.
• Where this can’t be achieved or would be
potentially stressful for the consumer or carer,
(especially children), video and audio clips can
be very powerful.
• Can also be more time effective.

44. Lived Experience

46. Elizabeth Fudge
fudgee@aicafmha.net.au
Andrea Reupert
andrea.reupert@monash.edu
www.copmi.net.au