Dear  

The Section of Youth Mental Health Psychiatry is pleased to present its latest newsletter.

Notes from the Chair

A long newsletter and so a very short note from me. My apologies for the late arrival since our last newsletter in September 2022. There has been a lot happening, so I’ll leave you in peace to read!

Certificate of Advanced Training

We received notification from the Education committee on April 11 that they will “be in touch shortly” to arrange a meeting to discuss our submission. This is in response to our request, following the lengthy process of Q&A via correspondence that took place between May and October last year. I have been reassured by the Chair, Nick O’Connor, that we can still achieve a start date for Youth Psychiatry Advanced training from February 2024. Keep watching this space!

Youth Psychiatry at Congress 2023 in Perth

I hope to see many of you at Congress in May. SYMH will again have a Symposium: “Diverse Issues in Youth Mental Health” Concurrent Session 7D, 11:00am-12:30pm Wednesday May 31. We will have the Section Members’ Forum during the lunch break following. There is also another series of Youth talks after lunch (different room): Concurrent Session 8F.

SYMH Conference 2023

Unfortunately, at the time of writing there are not yet details for this year’s Conference. Through no fault of our own, it has not been possible to schedule a Section conference in 2023 as the College plays catch up with putting on events that were impacted or postponed in 2021 and 2022. We were fortunate to be the only Faculty or Section able to run a conference in person in 2020, and we held a successful event in Alice Springs in July last year.

There have been resourcing limitations within the College with respect to managing events, and other conferences which did not run in 2022 have been prioritised. One option presented to us for this year was to work with an external conference organising company which is much more expensive.

We will let you know as soon as we have a confirmed date and location for our next Section conference.

SYMH Webinars 

Iain McMillan continues to co-ordinate our webinars. Due to a need for the College to try and balance topics covered in its webinar schedule, we have only been able to plan to put on two this year so far.  Last week on the 26^th of April, Committee member Donovan Moncur hosted Prof. Andrew Chanen and Dr Lukas Cheney presenting “The Complexities of Managing Borderline Personality Disorder in Youth”, including discussion and research findings related to clinical practice.

The Webinar was a great success, attended by 436 people and a recording will shortly be available to view via LearnIt.

We hope to continue the series later in the year with Committee member and former Chair, Prof James Scott presenting on the topic of management of psychotic symptoms in young people.

SYMH Committee Planning Day

The Section of Youth Mental Health Committee held an in-person meeting in Brisbane on Saturday 25 February. This was the first time since 2019, and the meeting served to help us consolidate the aims, objectives, and aspirations of the section. See below a summary of the outcomes and actions.

1. Seek ways to better engage with members of the section. Actively seek input from the membership through a variety of means, including survey of membership to determine what membership would like to see, and how we might best serve the interests of the SYMH membership.

2. Policy and Position Statements.

• Complete a review of college position statements and policies relevant to Youth Psychiatry to determine which are relevant to the practice of youth psychiatry, which might require elaboration or revision, and proactively seek to contribute to improving these position statements.

3. Strategic Partnerships

• Generate a list of partners and collaborators in the practice and delivery of youth mental health.
• Seek to engage with partners.

4. Training and Education

• Continue to focus on delivering accessible training relevant to youth mental health including and not limited to SYMH annual conference, Webinars on topics relevant to youth, and local branch meetings. Explore other opportunities and ideas which might advance this agenda.
• Commence planning for Youth Mental Health Conference 2023.
• Determined to continue to strongly support the Certificate of Advanced Training in Youth Psychiatry and to promote and facilitate the training of registrars, junior doctors, and others in the speciality field of Youth Mental Health.
• Maintain a register of available Youth Mental Health appropriate training posts.
• Seek to identify an outstanding trainee in Youth Mental Health each year deserving of an award recognising their achievements in training.

5. Committee meetings and functions

• Meetings to be focused on achieving objectives.
• Invite RANZCP Policy to attend meetings biannually to contribute to discussion around policy issues relevant to the Section.
• Clarify within the committee which projects individuals are working on.

6. Service Standards and Development

• Start to contemplate how to better define the key practice principles related to the delivery of mental health care in the context of a youth population.
• Look to develop a set of guiding principles which speak to what defines quality care as it relates to working with youth, their family, carers, and support systems. Consider developing a process to recognise organisations which adhere to these principles. (A “tick” of approval or endorsement)
• Work to develop a process whereby the SYMH might contribute to supporting services to deliver best practice care to Youth populations.

7. Advocacy and Communication Strategy

• Develop a register of special interests and content experts, by peer or self-nominations.
• Ongoing efforts to improve communication within the membership, between membership and the committee, and the section and the college.
• Review what membership needs from the section newsletter.

Survey of SYMH members

We will shortly be sending out a survey for all SYMH members.

Congratulations to these exceptional Youth Psychiatrists!

It has been an extraordinary few months for some of our amazing colleagues. Please join me in congratulating:

Jackie Curtis – The Margaret Tobin Award

Named in honour of the late Dr Margaret Tobin, this award is made to the RANZCP Fellow who has made the most significant contribution to administrative psychiatry in Australia and New Zealand over the preceding five years.

Jackie is internationally recognised for her work on improving the cardiometabolic outcomes, and thereby improving the health and lengthening the lives of many of our consumers. Jackie will deliver the annual Margaret Tobin Oration at the 2023 Congress.

Andrew Chanen – The Ian Simpson Award

Established in 1976 to honour Dr Ian Simpson, who was a foundation member of the ANZCP and who became ANZCP President in 1966. The award acknowledges the most outstanding contributions to clinical psychiatry through service to patients and the community.

Andrew received the award on account of his major development of services for borderline personality disorder and research work. I hope many of you saw Andrew’s recent presentation at the SYMH Webinar last week.

Astha Tomar – RANZCP President Elect

Astha has recently been elected as the President Elect of the RANZCP and will play a key role in continuing transformation of mental care across Australia and New Zealand. Her term commences on May 31, and she will take over the Presidency at Congress 2025.

Astha has also been appointed as Orygen’s new Director of Clinical Services. This role will provide clinical leadership for the primary and specialist clinical programs and leadership of Orygen’s Acute Care Programs.

ARTICLE - E-Cigarette Position Statement

‘Smoke and mirrors: Support from psychiatrists for nicotine e-cigarette availability in Australia,’ McKeon and Scott (2022), Australian and New Zealand Journal of Psychiatry,

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) Position Statement 97 on e-cigarettes and vaporisers supports increased regulated availability of nicotine-containing e-cigarettes in Australia.  McKeon & Scott (2022) critiqued the position statement and called for an urgent review. The position statement which was released in 2018 identified three areas of uncertainty. An update of literature on each of these areas was provided by McKeon and Scott (2022):

1. The long-term health effects of e-cigarettes. Relative to combustible cigarettes, e-cigarettes are safer. However, there are areas of emerging and unknown health hazards associated with e-cigarettes, with the most concerning being that young people who use e-cigarettes are at increased risk of combustible cigarette-use.

2. The effectiveness of e-cigarettes as smoking cessation tools. E-cigarettes are effective for smoking cessation in people who are dependent on combustible cigarettes. However. There is no evidence to show they are effective smoking cessation tools in those diagnosed with serious mental illness, and there is evidence of a high risk of dual use of combustible cigarettes and vaping products.

3. The use of electronic cigarettes by youth. The health emergency of youth e-cigarette use is now indisputable. Young adolescents are now becoming nicotine dependent- an emerging problem that is resulting directly from e-cigarettes. 

Based on available evidence, McKeon and Scott (2022) advocate for the retraction of RANZCP Position Statement 97 (2018). The RANZCP’s position is now incongruent with that held by other specialist medical representative organisations, the World Health Organization, and recommendations from the Therapeutic Goods Administration.  Whilst the position statement was originally written to support people with serious mental illness to quit smoking, the current evidence shows that E-Cigarettes are doing enormous harm to Australian youth. The RANZCP is out of touch with community concerns. Contact Dr Sue Mackersey (sue.mackersey@ranzcp.org) the Chair of the Practice, Policy and Partnerships Committee if you have a view on the RANZCP e-cigarette position statement.

References

McKeon G, Scott JG. Smoke and mirrors: Support from psychiatrists for nicotine e-cigarette availability in Australia. Aust N Z J Psychiatry. 2023 Feb;57(2):169-180. doi: 10.1177/00048674221126458

Royal Australian and New Zealand College of Psychiatrists (2018). Position Statement 97: e-cigarettes and vaporisers. Available at: https://www.ranzcp.org/news-policy/policy-and-advocacy/position-statements/e-cigarettes-and-vaporisers (accessed 3/4/2023).

Thank you for reading the latest Section of Youth Mental Health Psychiatry newsletter.

Dr. Daniel Pellen
Chair, Bi-national Section of Youth Mental Health Committee