Infant, Child And Youth Mental Health And Wellbeing Services
Fact SheetInfant, child and youth mentalhealth and wellbeing servicesVictoria needs anewinfant, child and youthmental health andwellbeing systemto meet the needs of its futuregenerations, its childrenand young people.Data analysed by the Commissionindicates that there is a substantialgap between demand and actual hoursof community-based specialist mentalhealth services delivered. In 2019–20,there was need for anestimated 539,000 hoursof specialist mental healthservices for infants andchildren aged 0–11.Only 45,000 hours (lessthan 10 per cent of theestimated hours needed)was delivered by public mentalhealth services in 2019–20. For youngpeople aged 12–25, an estimatedneed for 1.148 million hoursof specialist mental health serviceswas met with only343,000hours (less than 30 percent of the estimatedhours needed) by public mentalhealth services in 2019–2020.1Recent data from headspace’s 2018National Youth Mental Health andWellbeing Survey examined the levels ofpsychological distress among more than4,000 young Australians aged 12–25years old. The survey indicated that:Nearly onein three32%(32 per cent) respondentsaged 12–25 yearsold reported highor very high levels of psychologicaldistress—more than three times therate reported in 2007 (9 per cent).Rates of psychologicaldistress were significantlyhigher amongyoung women38%(38 per cent compared with 26per cent of young men)18–21‑year‑olds reportedthe highest levels ofpsychological distress38%(38 per cent compared with20 per centof 12–14‑year‑olds)Victorian respondentshad the greatestpercentage35%of high or very high levelsof psychological distress35 per cent compared to33 per cent in Western Australia andSouth Australia, 31 per cent in New SouthWales and 29 per cent in Queensland.2
A mental health and wellbeingsystem for infants, children andyoung peopleThe right treatment, care and support that isdelivered as soon as mental health and wellbeingchallenges emerge can be life-changing, promotegood mental health and wellbeing for futuregenerations and reduce future demand for mentalhealth and wellbeing services.Victoria’s future system will include two servicestreams: an infant, child and family mental healthand wellbeing service stream for those aged 0–11years old and a youth mental health and wellbeingservice stream for those aged 12–25 years old. Strictage-based eligibility for services will be removedand developmentally appropriate transitionswill be applied between age-based systems andservice streams.The new mental health and wellbeing system willhave six levels, with most people accessing supportin the top three levels. The top three levels includeage-specific services as illustrated in the figurebelow, such as daycare, kindergarten and schools,as well as maternal and child health nurses andpaediatricians.To help schools to support the mental healthand wellbeing of children and young people,the Commission has recommended funding forevidence-informed initiatives in schools, includinganti-stigma and anti-bullying programs and thedevelopment of a digital platform that contains avalidated list of these initiatives.In 2020,COVID-19 pandemic restrictionswere associated with increasesin the number of young peopleaged 0–17 years seeking helpfrom emergency departments inconnection with intentional self-harmand suicidal thoughts, peaking in lateNovember 2020 at almost140 presentationsper week.3Primary and secondary care and related serviceshave a central role in the future service system andare where most infants, children and young peoplewill be seen and provided with treatment, care andsupport. To better support these services, Infant,Child and Youth Area Mental Health and WellbeingServices (described on the next page) will provideprimary consultation to infants, children andyoung people being seen in this level of the system,secondary consultation to primary and secondarycare and related services and comprehensiveshared care. This will include supporting Aboriginalcommunity-controlled health organisations.In 2019–20,less than half of consumers(47 per cent) who accessed a childand adolescent or child and youthmental health service experienceda positive change in their mentalhealth after receiving treatment (asmeasured by the Health of the NationOutcome Scale).4 This concerningoutcome suggests that currentservices are providing too little andsub-optimal types of treatment,care and support to children andyoung people.
Ms Nicole Juniper, a witnessbefore the Commission, said:Young people need to be atthe centre of their own careand treatment. They maynot always be the ones thathave to make a decision butthey should be involved. Idon’t fully understand thedecisions that were madearound my care growing up,either because I wasn’t told orI don’t remember. Being partof the decision‑making wouldhave helped me to understandmy own care so I could carefor myself.5The lower three levels of the system are local,area and statewide services, which provide morespecialised mental health and wellbeing servicesto a smaller number of people with higher intensitysupport needs.Local Infant, Child and Family Mental Health andWellbeing Services will consist of initially threeInfant, Child and Family Health and Wellbeing Hubs.Youth Local Mental Health and Wellbeing Serviceswill initially be provided by the 37 current andannounced headspaces.There will be 13 Infant, Child and Youth Area MentalHealth and Wellbeing Services. These will provide twoage-based service streams: Infant, Child and FamilyArea Mental Health and Wellbeing Services andYouth Area Mental Health and Wellbeing Services.The 13 Infant, Child and Youth Area Mental Healthand Wellbeing Services will be delivered throughpartnerships. These will be between public healthservices or public hospitals and non-governmentorganisations that provide wellbeing supports(currently known as ‘psychosocial’ supports).Newly established specialist trauma practitionerswill also support children and young people withtrauma histories by becoming, where required, partof their multidisciplinary care team.Infant, Child and Youth Area Mental Health andWellbeing Services will provide a broad range ofsupports. Extended days and times of operation willpromote family inclusion and support educationand daily routines. Telehealth will be extended,and targeted assertive outreach will be provided.Services will also work to be reflective of andresponsive to the diversity of younger Victorians.Infant, Child and Youth Area Mental Health andWellbeing Services will collaborate with Local MentalHealth and Wellbeing Services to support theestimated 58,000 infants, children and young people(2020-21) who need short‑term, ongoing and ongoingintensive treatment, care and support. This willensure these infants, children and young people arenot turned away and will also reduce wait times.At the most specialised level of support arestatewide services, providing support to thesmallest number of people with the most complexsupport needs.Ms Alison Smith, DivisionalManager for Child and YouthMental Health at AustinHealth emphasised theCommission’s opportunityfor change:If we invest early, we changepeople’s trajectories. We endup with a healthier systemand a healthier group offamilies down the track. Andthat investment is repaid overand over and over. So I’d bevery, very keen to be bravein Victoria and do somethingdifferent.6
Figure 1: An overview of the future mental health and wellbeing systemInfant, child and youth mental healthand wellbeing system (0–25)Levels of themental health andwellbeing systemFamilies, carers and supporters,informal supports, virtualcommunities, and communitiesof place, identity and interestBroad range of governmentand community servicesRegional Mental Health andWellbeing BoardsPrimary and secondarymental health andrelated servicesLocal Mental Healthand WellbeingServicesArea MentalHealth andWellbeingServicesInfant, child and familymental health and wellbeingservice stream (0–11)Youth mental healthand wellbeing servicestream (12–25)Self-care and support from others such as families, carers,supporters, neighbours and communitiesFor example: earlychildhood education(daycare and kindergarten),libraries, primary schools,child protection, disabilityservicesFor example: schools,universities, TAFEs and traininginstitutes, libraries, childprotection, disability services,housing servicesServices for all ages, for example: GPs, allied health (includingpsychologists), private psychiatrists, alcohol and drug supportprovidersFor example: earlychildhood education(daycare and kindergarten),libraries, primary schools,child protection, disabilityservicesFor example: schools,universities, TAFEs and traininginstitutes, libraries, childprotection, disability services,housing servicesInfant, Child and Family LocalHealth and Wellbeing Services(initially three new hubs)Youth Local Mental Healthand Wellbeing Services(e.g. headspaces, initially37 current and announced)Infant, Child and Youth Area Mental Healthand Wellbeing Services (13 areas)Infant, Child and Family AreaMental Health and WellbeingServices (service stream)Youth Area Mental Healthand Wellbeing Services(service stream)Area crisis services, primarily based in Adult and Older Adult AreaMental Health and Wellbeing ServicesStatewideservicesRange of statewide mental health and wellbeing servicesdelivered through area and local services,and a limited number of statewide bedsHelplines, emergency departments, emergency servicesNote: Developmentally appropriate transitions will be applied between age-based systems and service streams.
Mental health and wellbeingservice stream for infants,children and familiesThe future infant, child and family mental health andwellbeing service stream, for people aged 0–11 yearsold will offer a responsive and integrated system oftreatment, care and support that is compassionate,recovery-oriented, proportionate to need andtailored to the experiences of infants and children.To ensure treatment, care and support aredevelopmentally appropriate and there is adegree of specialisation, services will tailor theirmodels of care to the age cohorts of 0–4‑year‑olds(encompassing infants, toddlers and pre-schoolers)and 5–11‑year‑olds (encompassing the breadth ofthe primary school years).This service stream will be designed around thefollowing four concepts: a balanced approach to emotional wellbeing,behavioural and developmental challengesand mental health developmentally and relationally informedtreatment, care and support a focus on early intervention recognising the many systems that supportinfant and child mental health and wellbeing.The time around the birth of a child is one of life’smost important stages, but at the same time, is alsoa high‑risk period for mental health and wellbeingchallenges. Accordingly, community perinatalmental health teams will be based in all Adult andOlder Adult Area Mental Health and WellbeingServices. They will provide evidence‑basedtreatment, care and support to help prospectiveand new parents to stay at home and focus onbuilding strong relationships with their infant.There will be an increased focus on supportingparents, carers and families to build positiverelationships with their children, with the intensityof supports matched to need. This will includeestablishing two statewide subacute residentialfamily admission centres located in the community(one in metropolitan Melbourne, one in regionalVictoria). These centres will provide five‑dayadmissions in an intensive therapeutic environmentfor families with a child aged 0–11 years who isexperiencing major behavioural, emotional andProfessor Frank Oberklaid, OAM, apaediatrician at the Royal Children’s Hospitaland Co-Group Leader of Child Health Policy,Equity and Translation at the MurdochChildren’s Research Institute stated:A fundamental rethink of ourapproach to child mentalhealth is required as thereare macro, structural andsystemic issues which need tobe addressed for any reformof Victoria’s mental healthsystem to be successful.7relationship difficulties. In addition, an equivalentthird service is recommended exclusively forAboriginal families.Three new Infant, Child and Family Mental Healthand Wellbeing Hubs will be established to provideLocal Mental Health and Wellbeing Services.These will not require a referral or a diagnosisbefore access. They will take a ‘one-stop shop’ and‘whole‑of‑family’ approach to supporting infantsand children with emotional and mental health,developmental and physical health challenges.These hubs will provide assessments for a rangeof conditions, including autism, and will enablethose who need it to access publicly fundedpaediatricians, psychologists and psychiatrists.For infants and children who need higher intensitymultidisciplinary treatment, care and support,the expanded service stream of Infant, Child andFamily Area Mental Health and Wellbeing Serviceswill provide a developmentally appropriate model ofcare. These services will offer a more holistic rangeof evidence-based therapies, wellbeing supports,care planning and coordination and education,peer-support and self-help.Pathways to access Infant, Child and FamilyArea Mental Health and Wellbeing Services willbe established. Unless people are experiencing acrisis requiring an urgent response, they will needa referral from a medical practitioner (such as aGP, psychiatrist or paediatrician) or an Infant, Childand Family Mental Health and Wellbeing Hub.
Mental health and wellbeingservice stream for young peopleThe future youth mental health and wellbeingservice stream, for people aged 12–25 years oldwill offer a responsive and integrated system oftreatment, care and support underpinned by threefundamental features: developmentally appropriate transitions early intervention for young people involvement of families, carers and supporters.The system will be highly integrated and connected.This will begin with the development of formalpartnerships, step-up and step-down referralpathways, shared staff and infrastructure and colocation between headspace centres and Infant,Child and Youth Area Mental Health and WellbeingServices. In addition, Infant, Child and Youth AreaMental Health and Wellbeing Services should becomethe preferred providers of headspace centres wherethey exist or are established in Victoria.Within Infant, Child and Youth Area Mental Healthand Wellbeing Services will be a new servicestream—Youth Area Mental Health and WellbeingServices—for people aged 12–25 years old.The reformed and expanded service stream ofYouth Area Mental Health and Wellbeing Serviceswill provide developmentally appropriate,multidisciplinary models of care for young people.This includes working directly with young peopleto increase the accessibility of services andembedding a welcoming, youth‑friendly culture thatembraces diversity.Youth Area Mental Health and Wellbeing Serviceswill deliver the core functions of community mentalhealth and wellbeing services. These include: a range of treatments and therapies, suchas psychological and pharmacologicaltherapies, trauma-informed therapies,speech therapy, occupational therapy, artsand creative therapies. This will includeproviding integrated care for young peopleliving with mental illness and substance useor addiction. wellbeing supports (currently known as‘psychosocial’ supports), focused on study,employment, housing and life skills to fosterindependence. This will include expansionof the Individual Placement and Supportprogram if Commonwealth Governmentco‑funding can be secured. education, peer support and self-help,including the creation of a youth recoverycollege (or ‘youth discovery college’)in each Youth Area Mental Health andWellbeing Service. care planning and coordination.Natasha (Tash) Swingler, who is 21,told the Commission that:It’s disheartening when youare surrounded by adultswho are critically unwell–youquestion whether that’s whatyour future will hold. Will Ialways be so unwell? Will Iever amount to anything?8
Clear pathways into Youth Area Mental Healthand Wellbeing Services will be established. Unlessyoung people are experiencing a crisis requiringan urgent response, they will need a referral from amedical practitioner (such as a GP, psychiatrist orpaediatrician) or a Youth Local Mental Health andWellbeing Service (for example, headspace).For the small number of young people with the mostintensive support needs, reforms will strengthenbed-based services for young people through: ensuring every region has a Youth Preventionand Recovery Care Unit (Y-PARC). Y‑PARCsoffer voluntary, subacute, intervention andrecovery‑focused clinical and non‑clinicaltreatment services in residential settingsfor up to 28 days for young people aged16–25 years9 establishing a new youth acute inpatientstream, including Hospital in the Home asan alternative to inpatient admissions—thiswill ensure young people aged 18–25 yearsold are no longer admitted to adult acuteinpatient beds reviewing youth residential rehabilitationfacilities.In addition, young people will be supported by: a further 500 new medium-term (up to twoyears) supported housing places for youngpeople aged 18–25 years old who are livingwith mental illness or psychological distressand experiencing unstable housing orhomelessness four new safe space facilities, a mix of drop-inspaces and crisis respite services, for youngpeople across the state who are experiencingmental health crises or psychological distress a new statewide model for the delivery ofyouth forensic mental health treatment,care and support for young people who areengaged with, or at risk of engagement withthe youth justice system as recommended in the Commission’s interimreport, the creation, delivery and evaluationof the first phase of a new assertive outreachand follow-up care service for children andyoung people who have self-harmed or whoare at risk of suicide.Elvis Martin told the Commission that:What we have right nowis much better than anyother country, I would say.But [it’s] still not workingcompletely. So we still need toacknowledge that. Yes, we aredoing good but there is away to go.10
1A calculation by the Commission based on Department of Health (Commonwealth), National Mental Health Service PlanningFramework; Australian Bureau of Statistics, Australian Demographic Statistics, June 2020, cat. no. 3101.0, Canberra; Department ofHealth and Human Services, Client Management Interface/Operational Data Store 2010–11 to 2019–20. Note: Some of the gap maybe met through services delivered in the private mental health system. Consumer-related service hours are defined in the NationalMental Health Service Planning Framework as time spent working with or for a client. This includes direct activity, for example,assessment, monitoring and ongoing mangagement, care coordination and liaison, respite services, therapies, peer work, review,intervention, prescriptions, pharmacotherapy reviews, carer peer work and support services and community treatment teams. Itdoes not include administration, training, travel, clinical supervision and other activities that do not generate reportable activity on aconsumer’s record.2headspace, New Headspace Research Reveals Alarming Levels of Psychological Distress in Young Australians, ungaustralians/ , [accessed 21September 20203Department of Health and Human Services, Victorian Emergency Minimum Dataset 2016–17 to 2020–21.4Department of Health and Human Services, Client Management Interface/Operational Data Store 2010–11 to 2019–20.5Witness Statement of Nicole Juniper, 28 June 2019, para. 44.6RCVMHS, Infant and Child Mental Health Roundtable: Record of Proceedings.7Witness Statement of Professor Frank Oberklaid AM OAM, 9 June 2020, para. 78RCVMHS, Interview with Natasha Swingler, August 2020; Natasha Swingler, Correspondence to the RCVMHS, 2020; Personal Story ofNatasha Swingler, Collected by Victoria Legal Aid9Victorian Auditor-General’s Office, Child and Youth Mental Health, 2019, p. 35.10RCVMHS, Interview with Elvis Martin, November 2020To read the final report go to rcvmhs.vic.gov.au.
infant and child mental health and wellbeing. The time around the birth of a child is one of life's most important stages, but at the same time, is also a high-risk period for mental health and wellbeing challenges. Accordingly, community perinatal mental health teams will be based in all Adult and Older Adult Area Mental Health and Wellbeing
2.3 Feeding the infant/young child under "normal" circumstances 18 2.4 Feeding the Infant/Young Child of a working mother at work places 20 2.5 Feeding the Infant/ Young Child who is exposed to HIV 22 2.6 Feeding Infant and Young Child in Other Specific Situations 23 Chapter 3 : Implementation Strategy 3.1 Implementation framework 28
your Infant Car Seat, as described in the instruction manual provided by the Infant Car Seat manufacturer. † WHEN USING ONLY ONE INFANT CAR SEAT ADAPTER OR TWO FOR TWINS, THE FOLLOWING INFANT CAR SEATS CAN BE USED: † If your Infant Car Seat is not one of the models listed above, DO NOT use your infant car seat with this car seat adapter.
Infant mortality is the death of a child within the first year of life. Worldwide, infant mortality continues to decrease, and in the past 10 years, rates in the United States have fallen by 15% (CDC). The infant mortali-ty rate is the number of infant deaths for every 1,000 live births. In 2017, the total number of infant deaths
CHAPTER I Introduction At the birth of an infant, a mother as a dependent-care agent for her infant, begins a series of decisions about her infant's health care. Decisions must be made early in the life of the infant on feeding methods, a health care provider for the infant, and, if the infant is male, on circumcision.
Infant Feeding Counselling Cards This counselling card flip chart is based on the National Infant and Young Child Feeding Policy. These counselling cards have been created to help health workers trained in infant feeding counselling to support HIV-positive mothers. All HIV-positive mothers should receive counselling on how to feed their babies.
Care needed: (check all that apply) Child #1 Child #2 Child #3 Child #4 Child #5 Preferred Location (Zip Code other than home) Full day Part day Evenings Overnight Weekends Special Needs: Child #1 Child #2 Child #3 Child #4 Child #5 Limited English Child Protective Services Severely Handicapped
the protection, promotion, and support of optimal infant and young child feeding practices is a priority lifesaving intervention. Infant feeding practices in Lebanon fall short of recommendations. In Lebanon, there's a lack of national-level data on nutrition among the Lebanese population routine infant and young child feeding practices
The API Specification and the EEMUA Specification differ slightly in some respects. The main differences in the specifications are in the requirements for the rheological properties and filtrate loss of the slurry. The rheological properties of the slurry at different rates of shear are determined using a direct reading viscometer. Filtrate loss is determined using a filter press. Test methods .
