The session descriptions are ordered alphabetically under the Congress theme they relate to:
- General Child and Adolescent Mental Health
- Psychiatric Disorders And Co-Morbid Conditions
- Principles of Treatment And Care
General Child and Adolescent Mental Health
Keynote: Effecting System Change in Youth Mental Health
Speaker: J. Anthony Boeckh, Graham Boeckh Foundation, Canada
Tony Boeckh will describe the Graham Boeckh Foundation’s (GBF) focus on strategically leading and funding projects that will have a system-wide transformative impact to positively improve the access and delivery of mental health care services for young people (aged 12-25 years). He will talk about what GBF has been doing, what needs to be done and its progress to date. Tony will also touch on innovative approaches being developed to improve the access young people have to quality support and treatment in the community.
Tony’s personal story of his son’s horrible experience with the system epitomizes all that has been wrong with the system and why it must change. Graham Boeckh grew up as a friendly, passionate and sensitive boy with many friends; he was an accomplished athlete, outdoorsman, canoeist and student whose life began to unravel as the symptoms of schizophrenia began to take hold. He died at the age of 22 from Neuroleptic Malignant Syndrome (complications from medication).
The health system failed Graham, as it has countless others, and that is why GBF is determined to improve how patients and families are treated in Canada.
The basic message is one of optimism and why the dreadful track record of providing access and quality services to young people is in the process of changing.
- Recognize the importance of a comprehensive, sustainable, scalable and flexible model to address youth mental health
- Prepare to collaborate with policy makers, researchers, community care providers and youth and families
- Review the development of the evidence: the importance of robust research and evaluation
Keynote: Have we lost the subject? When time has come to reconsider the role of scientific positivism on clinical practice.
Speaker: Dr. Bruno Falissard, IACAPAP, France
Medicine has evolved over centuries from a theological stage (shamanism) to a metaphysical stage (Hippocrates’ theory of humors) and ultimately to a positive stage, emerging with Andreas Vesalius, which reached its apogee with Claude Bernard in the 19th century. The amazing impact of anatomy, physiology and statistics in the progression of therapeutics has subsequently shaped occidental medicine. Doctors are now trained in specializations according to organs (cardiology, urology, pneumology, etc.) and medical studies rely heavily on biology courses. As a consequence, we have lost a global medical approach that holistically incorporated, culture and mind, mind and body, body and organs. The impact of this loss has been particularly important in disciplines such as child and adolescent psychiatry, where culture and mind play an important role. It is time for clinicians to step back and to consider wisely all sources of knowledge necessary for their practice.
- Summarize the evolution of knowledge in child and adolescent psychiatry in the last two centuries.
- Demonstrate the impact of this evolution on our clinical practice.
- Discuss how to put the subject back in the center of our concern.
Keynote: Systems Collaboration
Speaker: Sheldon Kennedy, Sheldon Kennedy Child Advocacy Centre, Canada
Child abuse – including sexual abuse, physical abuse and severe neglect – is one of the most critical public health issues of our generation. Child abuse is a form of trauma. Prolonged trauma impacts the brain, leading to impairments in learning, behavior, and increasing the likelihood of physical and mental health problems over time. The Sheldon Kennedy Child Advocacy Centre addresses the direct impact of child abuse, with 40% of children assessed presenting with mental health issues, suicidal ideation, self-harm, sexualized behaviours and aggression. 63% of youth between the ages of 12 and 18 assessed struggle with one or more of these issues.
The impact of child abuse can last a lifetime. The good news is that we now know that hope and healing is possible. Innovative and integrated approaches based in the science of brain development and trauma are transforming how child abuse is addressed in Alberta and across the country. The Sheldon Kennedy Child Advocacy Centre brings together six government organizations including police, child protection, health, justice and education, to better serve children and families who are involved in the investigation, intervention and treatment of child abuse.
The Sheldon Kennedy Child Advocacy Centre pushes traditional boundaries to shape practice and policy around the needs of children and youth, offering streamlined and wrap-around interventions. Ground-breaking research and fearless innovation is providing direction in how to best intervene with children and families who have experienced child abuse, cultivating resilience that strengthens individuals and our communities.
- Describe why we are advancing the shift from: ‘what’s wrong with you?’ to ‘what happened to you?’.
- Make sense of how the dots connect between childhood trauma and life-altering impacts.
- Recognize that an effective and streamlined response to child abuse requires integrated practice and policy across sectors – increasing efficiency and effectiveness and positive outcomes for children and families.
Keynote: Out of the Shadows Forever
Speaker: Michael Kirby, Partners for Mental Health, Canada
Child and youth services are the most under- resourced, fragmented and discontinuous part of the mental health system. It is critical that these service problems be addressed if children and youth with a mental illness are to be able to live their life to the fullest extent possible.
To address these systemic problems will require a multi- year effort by children and youth, parents, service providers, and service funders from the public and private sectors.
This effort should be focused around the following five themes:
- Increasing mental health promotion and mental illness prevention initiatives. This requires a powerful anti-stigma program targeted at children and youth, and their parents and educating them about the signs of emerging mental illness.
- Focusing attention on early detection, diagnosis and treatment. Currently, detection occurs much later than it should and waiting times for treatment are totally unacceptable.
- Increasing the role of allied mental health professionals (eg. Child psychologists and other registered youth therapists). Let psychiatrists treat more complex cases which require their advanced training. (This requires changes to the Medicare funding rules in Canada.)
- Creating a seamless transition from the youth mental health system to the adult system. Currently a myriad of obstacles makes this virtually impossible.
- Eliminating the silos which exist between mental health services.
Canada’s first national mental health report was titled Out of the Shadows At Last. If significant progress is made on the above five themes, the child and youth mental health system will truly be Out of the Shadows Forever.
As a result of this keynote, participants will be able to:
- Describe their role in accelerating early detection, diagnosis and treatment.
- Demonstrate how the role of all mental health service providers needs to change.
- List the key factors that must be addressed to resolve the systemic problems in the current child and youth mental health system.
Keynote: Public Health Perspectives on determinants of suicide and population based strategies for children and adolescents in Canada.
Speaker: Dr. Alain Lesage, University of Montreal, Canada
From a public health perspective there are four great determinants of health states: i) Genetic/developmental (distal factors); ii) environmental factors (physical and societal); iii) health habits (can include substances abuse); iv) services. Taking as an example the remarkable decrease in the adolescent suicide rate in the province of Quebec, Canada; potentially effective population-based strategies with regards to services as determinants will be discussed. In addition, societal actions addressing distal factors, like universal child day care, that may also be playing a role will be considered. From a public health perspective, there seems to be enough evidence that population based strategies can help prevent suicide in children and adolescents. These population-based strategies include : i) promotion and prevention: universal awareness programs of idioms of psychological distress and the need to consult; ii), further training of primary care physicians; iii) better training of school and primary health and social workers; iv) targeting youth at risk like those presenting at the Emergency Room following suicide attempts,
- Recognize that multi-pronged population based strategies that address both distal and proximal determinants of suicide must exist for adolescent suicide prevention.
- Recognize that both universal school-based awareness programs for children and youth, mental health literacy programs, but also training of better detection in treatment of common mental disorders and substance abuse at the primary care level in collaboration with schools, are also important as well as coordination of specialist addiction, mental health services with the justice system.
- Explain that suicide in adolescents can be prevented with a combination of population based programs base and individually base effective interventions for common mental disorders being delivered, like medication, psychotherapy and case management.
Keynote: The Alberta Family Wellness Initiative: An innovation platform to improve health and well-being outcomes for all children and families through knowledge translation and application
Speaker: Nancy Mannix, Palix Foundation, Canada
The Alberta Family Wellness Initiative (AFWI) aims to mobilize and connect synthesized scientific research about early brain and biological development to better understand and address how intergenerational factors as well as experiences in children’s lives as they grow and develop impact on their health and well-being throughout life, in particular on mental health and addiction. Since its inception, AFWI has engaged with change agents and leaders in health, human services, justice, education, academia and community sectors to develop and support a multitude of activities in early childhood development, mental health and addiction meant to ultimately bring about positive, evidence-informed change in policy and practice for the benefit of children and families. This presentation will feature AFWI supported initiatives focused on applying the science through developing, testing and evaluating science-based policy and practice innovations. New Alberta based research projects will be highlighted along with examples of broad reaching, public health focused knowledge mobilization efforts. These efforts centre on building understanding about the importance of mitigating and buffering toxic stress in the lives of children and families as a way to build resilience and prevent poor outcomes throughout life.
- Describe early brain and biological development science (ie. the core story of brain development) and the influence that adverse childhood experiences (ACEs) can have on brain development and subsequent addiction and mental health outcomes.
- Review the novel AFWI approach to mobilizing and applying this science base to prevent addiction, and strengthen mental health beginning in early life.
- Recognize intervention research projects underway in Alberta that aim to apply the core story of brain development science and knowledge about the impact of ACEs on lifelong health in practice.
Keynote: Stigma and Its Consequences for Youth
Speaker: Prof. Heather Stuart, Queen’s University, Canada
The stigma associated with mental illnesses is often described as more debilitating and long lasting than the illness itself. This is particularly true for those who first experience symptoms during adolescence or young adulthood. This presentation will examine the nature and nurture of self-stigma, public stigma, and structural stigma and their implications for individuals, family members, and the larger mental health system. The importance of targeting anti-stigma interventions to youth, who are more likely to report being stigmatized, will be presented along with best practices in anti-stigma activities aimed at this group. In particular, the youth pilot projects undertaken by the Opening Minds Anti-stigma Initiative of the Mental Health Commission of Canada will be presented and the lessons learned will be reviewed.
At the close of this presentation, attendees will better be able to:
- Identify key components of the stigma process as it pertains to people with a mental illness;
- Recognize the implications of stigmatization for the self, family members, and mental health systems; and
- Describe the importance of targeting anti-stigma interventions to youth.
Keynote: Behavioral, Biological, and Epigenetic Consequences of Different Early Social Experiences in Primates
Speaker: Dr. Stephen Suomi, Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health (NIH), USA
Over the past decade a substantial body of research has demonstrated significant interactions between specific genetic polymorphisms and early social environmental factors that can influence behavioral, biological, and epigenetic development in nonhuman primates. Differences in early rearing social experiences (maternal vs. peer-only rearing during the first 6 months of postnatal life) have been associated with significant differences in behavioral development, in emotional regulation, in hypothalamic-pituitary-adrenal activity, in neurotransmitter metabolism, in both brain structure and function, and even in genome wide patterns of methylation and gene expression. Similar consequences for behavioral, biological, and epigenetic development can be demonstrated for infants whose mothers differ in social dominance status. Given the apparently “protective” power of secure early attachment relationships for young monkeys, recent research has been focused on characterizing specific aspects of social interplay between rhesus monkey infants and their mothers during the first month of life, particularly those involving face-to-face exchanges, that are associated with the development of secure attachment relationships. It now appears that these forms of social interaction are far more frequent, extensive, and intense than was previously reported. Moreover, such early social exchanges may provide the foundation for the acquisition of specific social skills and strategies associated with species-normative patterns of social behavior throughout development, and, additionally, may provide a means for minimizing at least some of the behavioral, biological, and epigenetic consequences of otherwise adverse early social experiences.
- Characterize behavioral, biological, and epigenetic consequences of early maternal vs. nursery rearing in rhesus monkeys.
- Characterize very early patterns of species-normative mother-infant interaction.
- Describe recent efforts to improve social responsiveness in infant monkeys who exhibit deficits in their neonatal social interactive capabilities.
Keynote: System Barriers to Children’s Mental Health Care
Speaker: Dr. David Swann, MLA, Alberta Liberal Party, Canada
Unacceptable wait times, inconsistent communications and care plans between professionals, lack of appropriate guidance through a maze of ‘silos’ adds to a starkly inadequate funding for children’s mental health.
Perhaps the greatest challenge in nearly all child mental health services is appropriate evaluation and a shift of resources to what really works!
Keynote: Unraveling the Developmental Origins of Disruptive Behavior Problems: From Social Learning to Epigenetics
Speaker: Dr. Richard Tremblay, University College Dublin, University of Montreal, Canada
This presentation will be based on a programme of large scale longitudinal and experimental studies from early childhood to adulthood.
- Recognize developmental trajectories of disruptive behaviors from early childhood to adulthood,
- Identify types of early interventions with disruptive children that can prevent school drop-out, substance abuse, delinquent behavior as well as criminal behavior,
- Describe epigenetic mechanisms that appear to lead to early disruptive behavior and that could be targeted in preventive interventions.
Keynote: Mental Health: A Social and Economic Imperative for Our Kids and Our Country
Speaker: Michael Wilson, Mental Health Commission of Canada, Canada
Session description coming soon.
Psychiatric Disorders and Co-Morbid Conditions
Keynote: A developmental approach to understanding the evolution of psychopathology: Improving early identification and novel treatment targets.
Speaker: Dr. Anne Duffy, University of Calgary, Canada
A developmental approach to studying the emergence of serious mental illness has yielded important information which should advance accurate earlier detection of evolving psychiatric diseases, separate these from transient distress or adjustment problems and identify novel opportunities for intervention. Approaches in mapping psychotic disorders have focused on symptomatic help-seeking youth, while more recent advances in recurrent mood disorders have focused on longitudinal follow-up of offspring of affected parents. The latter reflects the high heritability of recurrent mood disorders such as bipolar disorder. Despite independently replicated findings, our diagnostic approach has not as yet changed and routine clinical practice has not translated the evidence into improved individual treatment or care pathways. This presentation will illustrate these points using published data from studies of the offspring of bipolar parents. Implications and future directions will be discussed.
- Review published and replicated evidence of the natural history of the development of recurrent mood disorders in high-risk offspring.
- Highlight the implications for improving early detection, individual treatment, and developing evidence-based care pathways.
- Discuss barriers to advancements.
Gerald Caplan Lecture: Pediatric Psychosomatic Medicine in the 21st Century
Speaker: Dr. Gregory Fritz, American Academy of Child and Adolescent Psychiatry, USA
Pediatric psychosomatic medicine has evolved from a linear, psychoanalytic causal explanation of the etiology of seven specific illnesses to a comprehensive view of how the mind-body interacts in disease, with substantial interest in psycho-physiologic mechanisms. This presentation will use pediatric asthma to illustrate the characteristics and content of modern psychosomatic medicine.
- Apply a useful schema for biopsychosocial factors affecting disease at multiple points to pediatric asthma.
- Recognize the relationship between stress and immune factors in pediatric asthma
- Describe how ethnic and cultural factors are related to asthma prevalence and severity
- Explain the relationship between asthma symptom perception and morbidity
Keynote: Integrated Youth Mental Health: An African Odyssey
Speaker: Dr. Stanley Kutcher, IWK Health Centre, Canada
This address will inform the audience about an innovative integrated intervention designed and successfully applied to address the challenge of youth depression in Sub-Saharan Africa. This project, funded by Grand Challenges Canada has been, over the last three years, applied in areas of Malawi and Tanzania. The project consists of three integrated components: radio youth programming addressing youth mental health and depression; training of teachers in the guide mental health literacy resource and the development of “in-school” radio listening clubs supported by education and case identification of youth at risk; training of community health workers in the assessment, screening, diagnosis and treatment of youth depression. The project has brought together Canadian education and research expertise, Canadian and African educational radio expertise; African clinical, education and research expertise and Ministry of Health leadership in both countries. Research conducted in every component of this work has demonstrated significantly positive results. Currently the work is focusing on embedding these successes in the most relevant educational institutions and mental health policies of both countries. This demonstrates that an integrated, horizontal approach to youth mental health literacy and care needs can be successfully developed for the African context and suggests that scale up of this model may hold promise across the Sub-Saharan parts of the continent.
- Recognize how youth friendly media and schools can be used to effectively promote the development of youth mental health literacy
- Describe how an integrated horizontal pathway to care for youth depression can be built in the context of strengthening existing communication, education and health systems.
- Apply available and demonstrated effective educational, training, clinical and policy application strategies that could be applied in other low-income settings, in Africa and possibly beyond.
Keynote: Youth Mental Health: The New Frontier
Speaker: Dr. Ashok Malla, McGill University, Canada
The last few years have seen a burgeoning interest in youth mental health in several countries. In this plenary lecture I will trace the recent history of interest in and achievements of early intervention in psychotic disorders, arguably the most significant development in mental health services research and policy change in the last two decades, as one of the principal driving forces for the new interest in improving youth mental health services for all severities of mental disorders. I will touch upon other developments, largely outside the health sector, that have further advanced this ‘movement’. I will then briefly review the current state and models of transformation of youth mental health services across several countries (Australia, Ireland and the U.K.), including some efforts in low-middle income countries. Finally, I will provide a more detailed review of the Canadian approaches to transforming youth mental health services, with particular focus on the CIHR-GBF funded Pan-Canadian SPOR (Strategies for Patient Oriented Research) project, ACCESS Open Minds (ACCESS Esprit-ouvert). This project is designed to of evaluate a model for transformation of youth mental health services across six provinces and one territory with a view to scaling up in the future based on evidence produced from this project.
- Describe the rationale and origins of the recent interest in youth mental health;
- Recognize the current international efforts at transforming youth mental health services;
- Review the recent Canadian national CIHR-GBF funded research project on youth mental health service transformation and evaluation.
Keynote: Youth Mental Health: Strengthening Psychiatry and Society through Reform and Investment in the Mental Health, Well-being and Productivity of Young People
Speaker: Prof. Patrick McGorry, Orygen, National Centre of Excellence in Youth Mental Health, Australia
Mental and substance use disorders are among the leading health and social issues facing society, and now represent the greatest threat from non-communicable diseases (NCD) to prosperity, predicted by the World Economic Forum to reduce global GDP by over $16 trillion by 2030. This is not only due to their prevalence but critically to their timing in the life cycle. They are by far the key health issue for young people in the teenage years and early twenties, and if they persist, they constrain, distress and disable for decades. Epidemiological data indicate that 75% of people suffering from an adult-type psychiatric disorder have an age of onset by 24 years of age. Young people on the threshold of the peak productive years of life have the greatest capacity to benefit from stepwise evidence-based treatments and better health care delivery. Furthermore, the critical developmental needs of adolescents and emerging adults are poorly met by existing conceptual and service models.
The paediatric-adult structure of general health care, adopted with little reflection by psychiatry, turns out to be a poor fit for mental health care. Youth culture demands that young people are offered a different style and content of service provision in order to engage with and benefit from interventions. In Australia a new system of enhanced primary care, headspace, has been developed for 12 – 25 year olds. This is now operating in 100 communities in Australia. Access has been greatly improved especially for some traditionally hard to engage subgroups. Outcomes include reduced distress, better functional outcomes and reduced self harm. Similar programs are in place in Ireland, Israel, the UK and Denmark and are under development in Canada and the Netherlands. The need for international structural reform and an innovative research agenda represents one of our greatest opportunities and challenges in the field of psychiatry and a huge opportunity for child and adolescent psychiatry which may be able to “come out of its shell” and form the vanguard of mental health reform.
1. Gain an understanding of the pattern of burden of disease and its implications for mental health reform and modern society
2. Update knowledge on international progress of and opportunities for reform and investment in youth mental health
3. Understand the potential for child and adolescent psychiatry to expand as a discipline and assume a leadership role in mental health reform
Keynote: Introduction to the Neurosequential Model of Therapeutics: a developmentally-sensitive approach to clinical problem solving
Speaker: Dr. Bruce Perry, ChildTrauma Academy, USA
The development of a young child is profoundly influenced by experience. Experiences shape the organization of the brain which, in turn, influences the emotional, social, cognitive and physiological activities. Insights into this process come from understanding brain development. This session will provide an overview of key principles of neurodevelopment crucial for understanding the role of experience in defining functional and physical organization of the brain. Additionally, the session will provide an overview of the key functions of the brain, outline the hierarchy of brain development, and provide neurodevelopmental links to key functions of the brain and key times of development.
- Provide an overview of key principles of neurodevelopment crucial for understanding the role of experience in defining functional and physical organization of the brain
- Describe the emerging clinical and research findings in maltreated children that suggest the negative impact of abuse, neglect and trauma on brain development
- Outline the clinical implications of a neurodevelopmental approach to child maltreatment
- Discuss the role of public policy and preventative practices in context of the impact of maltreatment on children’s emotional, behavioral, cognitive, social and physical health
Keynote: Resiliency and Risk in Autism Spectrum Disorder
Speaker: Dr. Peter Szatmari, The Hospital for Sick Children in Toronto, Canada
The developmental health of individuals with autism spectrum disorder (ASD) is the result of the interaction between risk factors such as rare genetic variants and ‘resiliency’. Resiliency is the capacity to have a better than expected outcome given a background of risk but this topic is rarely discussed in the ASD literature. There are in fact many examples of resilient individuals with ASD as demonstrated in several recent familial and longitudinal studies of ASD. This presentation will review the concepts of risk and resiliency in the literature and highlight lessons learned that may be of use to all individuals with ASD.
- Describe the interaction of risk and resiliency in ASD
- Explain what resiliency means in the context of a diagnosis of ASD
- Discuss examples of resiliency from the recent literature on ASD
Keynote: Drugs, Neuro-Development, Cognitive Functioning and Mental Illness: Intersections on the Adolescent Highway
Speaker: Dr. Ken Winters, Winters Consulting Group, USA
Adolescence is a period of significant brain development. Research now suggests that the human brain is still maturing during the adolescent years with changes continuing into the early 20’s. The developing brain and early life experiences may give rise to adolescent risk behaviors and contribute to the negative effects of drugs and to the development of mental illness. This emerging science and implications for prevention and treatment efforts will be reviewed.
- Describe adolescent normal brain development.
- Explain how youth are particularly vulnerable to effects of alcohol and other drugs.
- Recognize the possible effects of early negative experiences on mental health.
- Discuss how to use this emerging science in drug prevention and treatment.
Keynote: Child Psychiatry Meets Cell and Molecular Biology
Speaker Dr. Charles Zeanah, Tulane University School of Medicine, USA
Current research in child development and psychopathology has begun to focus more intently on understanding the impact of early experiences, particularly exposure to stressful and traumatic experiences and subsequent responses to those events. Research is beginning to delineate the complex interactions among social contexts, psychological processes, and biological reactions that mediate the effect of experience on outcomes. There is increasing interest in cellular and molecular processes activated by exposure to adverse experiences, and how these processes may relate to pathological outcomes. This selective review considers the increasing attention to mechanisms mediating maladaptation, protection and recovery.
- Describe and illustrate diathesis stress versus differential susceptibility.
- State 3 examples of telomere length attrition in response to exposure to adverse experiences.
- Recognize how gene methylation relates to different caregiving experiences.
Principles of Treatment and Care
Keynote: Rising above the stigma, blame and the wait and see…a family and advocate’s journey
Speaker: Keli Anderson National Institute of Families for Child & Youth Mental Health, Canada
There were days when I wished I had never met my son – but that was before I knew him – he has given me a great gift – a dangerous gift – a gift of knowing.
This address will speak to the experience, and life, of a family, to illustrate the real test of resilience, not just individually, but as a family and as an advocate.
Maybe a “story” to others, but not to us – it has been our life, and it is not uncommon. But what we have done with our life is not common.
- Challenge what you may think is helpful to families in promoting positive mental health for their children and/or youth
- Understand the deep impact of blaming and how it stigmatizes families
- Be interested in thinking about how, or whether, your own practice makes a meaningful difference to the mental health of young people and families.
- Gain knowledge and tools to help enhance working with young people and families
Keynote: Building Resilience Through Community Partnerships: A Short Intro to the Neurorelational Framework (NRF)
Speaker: Dr. Connie Lillas, Interdisciplinary Training Institute, USA
It is not uncommon for infants, children, and families entering various service delivery systems to face fragmentation and isolated siloes of services. Creating transformative communities that coordinate service delivery across multiple sectors by sharing a common language and goals, addresses the fragmented care for our most vulnerable populations. The NRF’s assessment and intervention strategies address the public health challenge of infants, children, and families in toxic stress, by supporting relational resilience in the developing brain. Three core concepts of brain development are translated into three clinical steps for assessment and intervention that create a common language and a shared approach: 1) adaptive versus toxic stress, 2) age appropriate versus low levels of relational engagement, and 3) age appropriate developmental and functional brain capacities versus delays or disorders. Building resilience in communities can occur in different ways – coordinating care using the three clinical steps in private practice teams, agencies, and cross-sectored teams. These larger community teams intentionally organize and train practitioners from five service delivery sectors: medical, developmental disabilities, mental health, early care and education, and child welfare. As teams are trained simultaneously, they begin to shift practitioners from functioning in isolation to integrative collaborative care, and from multi-disciplinary to inter- and transdisciplinary work.
- Apply the knowledge of toxic stress to enhance assessment of observed behaviors
- Apply the NRF’s three clinical steps guides holistic assessment and intervention planning
- Discuss how NRF principles promote inter- and transdisciplinary practice across systems of care
Keynote: Couples Overcoming PTSD Everyday Program- A Family Journey
Speaker: Lt. Col Chris Linford, (Retired), Canada
Post-Traumatic Stress Disorder is not an individual‘s injury; it belongs to the family surrounding that individual. LCol (retired) Chris Linford served 33 years in the Canadian Armed Forces and deployed to the Gulf War, Rwanda and Afghanistan. Chris’ journey with PTSD stemmed from the deployment to Rwanda in 1994 but stigma surrounding this injury kept him from seeking help for ten years. During that time his family suffered daily with his mood swings, anxiety and intense anger. Finally asking for help in 2004, he started on a journey back to health attending therapy and got back to his military career and even deployed to Afghanistan.
During this deployment his PTSD returned with a vengeance forcing further therapy within the military but he needed something they could not offer; he needed to be around other similarly injured veterans. From this experience Chris learned of the importance of the family and that his PTSD had actually injured his spouse and children. He wrote the book “Warrior Rising- A Soldier’s Journey to PTSD and Back” and went on a cross country speaking tour partnered with his wife Kathryn to tell their story of the impact of PTSD in their home.
Through this learning they conceptualized and sought clinical input to create the COPE Program or “Couples Overcoming PTSD Everyday”. They are funded mainly through Wounded Warriors Canada and have this year nationalized COPE into several provinces. COPE is an innovative program that seeks to group couples to learn as a community about PTSD and how to better manage it in the home together. Through the power of the group, Chris learned PTSD can be owned by the family, vice it owning the family.
- Recognize that stigma continues to prevent those suffering with PTSD to come forward and ask for help;
- Explain how the COPE Program can be a solid choice to augment couples/family counselling; and
- Describe that PTSD impacts the entire family and thus the family needs to be treated as the client.
Keynote: Resilience, Resistance and Renewal for Indigenous Youth
Speaker: Dr. Rod McCormick, Thompson Rivers University, Canada
Given the Aboriginal holistic view of ‘community’ and in the philosophy of ‘all my relations’ it is not surprising that what promotes resilience in Aboriginal communities originates outside of the individual, that is, in the family, community, society, culture and in nature. Aboriginal resilience clearly has a collective aspect combining spirituality, family strength, elders, ceremony, oral traditions, identity and support. Using examples such as Attawapiskat and Idle no more this presentation will trace the healing path of Resilience, Resistance and Renewal for Indigenous Youth and the role that identity, belonging, balance, cleansing, empowerment, and responsibility play in this healing journey.
- Recognize the role that connection has in increasing resilience for Indigenous youth
- Discuss wholistic and interconnected nature of Indigenous healing and wellness
- Review examples of Indigenous Resilience, Resistance and Renewal
Keynote: Child and Adolescent Mental Health in Africa: Stigma Reduction through Training, Research and Service
Speaker: Dr Olayinka Olusola Omigbodun, University of Ibadan, Nigeria
At the close of the era of the MDGs on December 31st 2015, sub-Saharan Africa had the world’s highest child mortality rate, but also the largest absolute decline in child mortality. With this decline in child mortality, social and health interventions need to move towards creating a mental health-promoting environment for the youth who remain alive and form the future for this region. Even though estimates reveal that 1 in 5 children will have recognizable and treatable mental disorders, and that children constitute an age group, best targeted for effective mental health promotion, virtually all health interventions for children remain focused on causes of mortality. This trend is especially worrisome in a region with over 50% children and adolescents constituting the population and where children in ‘Exceptionally Difficult Circumstances’ known to have much higher rates of mental disorders abound. Needs Assessments reveal that children do not have access to mental health care due to poverty, stigma and a lack of services. The inability to access mental health care affects the stability of the child’s primary support group, the child’s social environment and access to education, while engendering economic difficulties.
This lecture reviews a three-pronged model approach to stigma reduction utilizing training, research and service instituted by the Centre for Child and Adolescent Mental Health (CCAMH). The efficacy and feasibility of training and the benefits of research leading to service development are highlighted. Enabling access to mental health care services and fostering healthy help seeking behaviours improves the overall quality of life not only in children and adolescents but also in their families and communities.
At the end of the lecture, participants will be able to:
- Describe the state of mental health of children and adolescents in sub-Saharan Africa
- Appraise key factors impinging on the mental health of children and adolescents in sub-Saharan Africa
- Explain approaches to stigma reduction in the context of child and adolescent mental health through training, research and service development
- Narrate the evidence of stigma reduction in CAMH through the various approaches
- Appraise the overall benefits of stigma reduction to mental health and quality of life
Keynote: Longitudinal Studies in Child and Adolescent Delinquency: Continuities, Discontinuities and Resiliency
Speaker: Prof. Helmut Remschmidt, Philipps-University Marburg, Germany
After a short description of the literature the lecture reports on two large longitudinal studies: (1) a study on a representative sample of 256 delinquent children with a follow up interval of 30 years and (2) a study on 114 juvenile murderers and violent delinquents including a follow up period of 13 years after the index offence.
Both studies allow to differentiate between several groups of offenders: desisters who finished their delinquent activity after the sentence, respective punishment, persisters, who continued to commit crimes after imprisonment and multiple chronic offenders (about 10% in both studies) who were responsible for the majority of delinquent acts in both studies and who revealed the highest rates of social adversities. Prediction of delinquent behaviour was possible to some extend by using individual, psychosocial and family variables and statistical procedures like Kaplan-Meier curves. Prevention measures and promising interventions will be discussed.
- Recognize methodological problems of longitudinal studies
- Describe antisocial behavior and delinquency during childhood and adolescence
- Explain how to differentiate delinquent behavior during the course of development
- Describe the background of deviant behavior at different ages and in different environments
- Review how to prevent antisocial and delinquent behavior in children and adolescents
- Discuss what makes children stronger and resistant
Keynote: Understanding the Heterogeneity in Mental Health Outcomes Among Bullied Youth: Genetic, Neurophysiological, and Neuroendocrine Considerations
Speaker: Dr. Tracy Vaillancourt, University of Ottawa, Canada
Bullying, defined as a systematic abuse of power, is pervasive with 30% of North American children and youth reporting being bullied occasionally and 10% reporting being bullied on a daily basis. Longitudinal studies point to a causal relation between being bullied and subsequent mental health problems. For example, there is strong evidence that bullying causes depression. Importantly however, not all children and youth become unwell as a consequence of poor peer treatment. In this presentation, the heterogeneity in mental health outcomes of bullied youth is discussed. Specifically, the roles of genetics, neurophysiology, and neuroendocrinology are considered.
- Examine the link between bullying and mental health.
- Identify the temporal sequence between bullying and mental health.
- Explain heterogeneity in mental health outcomes by considering genetic, neurophysiological, and neuroendocrine evidence.