Who we are and why are we here?

The Victorian Statewide Problem Gambling and Mental Health Partnership Program 2009-2011

Who are we?

Anthony KennedyProject Manager

Karen HarrisonProject Officer, Training and Education

Mick FieldSenior Clinician, Clinical Services

Evan SymondsConsultant Psychiatrist, Clinical Services

Stuart LeeEvaluation Officer

Partnerships

And why are we here?

A brief background of the pilot project and current research to support the need for services within the mental health and problem gambling communities

Problem Gambling & suicide

The Productivity Commission (1999) – 9% of problem gamblers thought about suicide because of their gambling; 60% of those were in counseling

Studies have reported levels ranging from 17%- 80% for suicidal ideation and 4%- 23% for suicide attempts

Problem Gambling & suicide

Penfield et al (2006) study of attempted suicide &/or self harm episodes screened for problem gambling in A&E Dept of Auckland Hospital reported 17.1% had gambling problem.

MAPrc-Alfred study (2006 & 2009), CATT presentations: 17.2% screened positive for problem gambling.

Problem Gambling and Suicide: MAPrc-Alfred Study 2009 50% of clients report being suicidal before

they had gambling problems

50% of clients reported being suicidal after they had gambling problems

Problem Gambling and Suicide: MAPrc-Alfred Study 2009

80% of participants had been gambling for more than 10 years.

55% of participants had spoken to their GP about problem gambling while100% had spoken to their GP about Suicide.

Co-morbidity and pathological gambling: Epidemiological data43,093 US adults participated in face to face

interviews in the 2001-2002 survey.

73.2% of pathological gamblers had an alcohol use disorder 38.1% had a drug use disorder 60.4% had nicotine dependence 49.6% had a mood disorder 41.3% had an anxiety disorder60.8% had a personality disorder

Petry et al (2005)

Co-morbid problem gambling and “serious mental illness”

• McIntyre et al (2007) Bipolar Affective Disorder (6.3% problem gambling)

• Desai & Potenza (2009) Psychotic disorders

(19% problem/pathological gambling;10% pathological gambling)

Pilot Project: Alfred Psychiatry & Gamblers Help Southern

Relationship building between Alfred Psychiatry and Gamblers Help Southern.

Establishment of screening and brief intervention to clients presenting to the Alfred with PG.

Education and training mental health clinicians on PG.

Protocols to support inter-agency liaison. Problem Gambling special interest group within

Alfred Psychiatry established.

Screening and brief intervention referrals within the community

CATT/ triage (42%) Acute inpatient units (20%) Gamblers Help Southern (10%) Community mental health/ community

health (28%)

Our Mission:

To increase knowledge and capacity within Victorian Area Mental Health services (VMHS) and Gamblers Help services (GHS) to provide optimal outcomes for clients who present with co-occurring Problem Gambling (PG) and mental illness (MI).

Main Aims:

1) Raise awareness…  

(2) Enhance accessibility… 

(3) Provide timely access…

 (4) Increase knowledge and skill capacity… 

How the program works:

This program will use a two tiered approach consisting of:

education and training clinical service support

Training Needs and Analysis

What do we want to know?

What do you want to know?

Education and Training

Development of tools to assess the capacities of the VMHS and GHS to effectively respond to co-morbid mental health and gambling problems: Mental health screening/assessment tools Managing suicidal clients Managing clients who self-harm

Education and Training

What do you know about…High prevalence disordersLow prevalence disordersSubstance abuse

AND Problem Gambling?

What is your experience?

Who are your clientele? What are their needs? How do you support them?

Too much or too little?

Psycho-education Pharmacology and mental illness Social strategies Psychological interventions

Are you comfortable with…

Monitoring your clients’ mental illness? Preparing a relapse prevention plan? Navigating the mental health service

structure?

What is your experience with…

Integrated treatment?

“No wrong door” philosophy

What works/what needs work?

Established partnerships/collaboration Established referral pathways Access to area mental health services

Tell us your stories…

Real struggles Real issues Real people

Clinical Service

Primary and secondary consultancy service

Specialist support and system development

Continued local partnership with Gamblers Help Southern

Primary and secondary consultancy Clinic staffed by a senior clinician,

consultant psychiatrist, other services on a needs basis.

Provide specialist psychiatric consultation to Gambler’s Help services in relation to clients with co-occurring mental health issues.

Primary and secondary consultancy

Support clinical pathways for clients with co-occurring mental health issues and problem gambling

Develop and conduct training and professional development activities for Gambler’s Help staff (MH portfolio positions) and MH clinicians.

Specialist support and system development

Strengthen and enhance workforce capability

Support the establishment of policy and procedures to enhance service collaboration.

Workforce and organisation engagement

Gambler’s Help managers and Mental Health portfolio workers

Senior psychiatric nurse network Area mental health manager network. Primary mental health team network

How to contact us…

For clinical services:

Mick FieldOffice: (03) 9076 4700

Mobile: 0400047169

For education and training:

Karen HarrisonOffice: (03) 9076 4700

Mobile: 0438371141

pgmi@alfred.org.au www.pgmi.org.au