Rethinking mental health care

By Rachel Czech

The timely panel discussion, From the Frontline: Rethinking Mental Health Treatment and Care, provided listeners with insight into future directions for mental health in Australia. The panel comprised three Monash University speakers: Professor Jayashri Kulkarni AM, Professor Suresh Sundram and Professor Kim Cornish.

The webinar was opened by Professor Stephen Jane,  Dean of the Sub-Faculty of Translational Medicine and Public Health. ‘I’m absolutely delighted to welcome you all today to discuss what I’m sure we all agree is a critical area of medicine and health care in our society, which has really been highlighted over the last eight to ten months.’

In a brief introduction, special guest, Professor Christina Mitchell, Dean of the Faculty of Medicine, Nursing and Health Sciences, confirmed that  ‘At Monash University we are working hard to address one of the greatest challenges of our community: mental illness’.

Professor Mitchell emphasised the difficulties presented to Australians in 2020, and especially Victorians, that have worsened mental health issues in the community. The bushfires earlier this year, the COVID-19 pandemic, economic downturn and social isolation are all having an effect on individuals as well as families, she explained.

‘We’re thinking about a new playing field, a new horizon in terms of nurturing wellbeing and implementing the most impactful mental health care,’ Professor Mitchell said.

Professor Jayashri  Kulkarni, Head of the Department of Psychiatry at the Central Clinical School at the Alfred Hospital, was the first speaker. She gave an impassioned presentation about the impacts of COVID on gender and trauma on mental health.

Through the story of a young woman named Suzie, Professor Kulkarni illustrated how fragmented the mental health system is and how it often fails those who need help.

‘We believe in a unified mental health approach because that’s going to take us further,’ she said.

She explained that her research at the Alfred Hospital centres on two pillars: trauma and gender. ‘These two factors together are new approaches to look at mental ill health,’ she said.

‘We really believe that a new approach is required so that we can provide new understanding, new treatments, and new services for people experiencing mental ill health. We propose a holistic approach using trauma and gender as the main platforms underpinning this work.’

Professor Suresh Sundram also spoke of the need to transform the way we approach mental health treatment. Professor Sundram, who is Head of the Department of Psychiatry,School for Clinical Sciences opened his address by discussing the advances that have been made in cancer research and treatment. A similar approach can be applied to mental health treatment, he said.

He talked about his work in creating the Translational Molecular Psychiatry Program as a joint venture between Monash University and Monash Health.

‘What we intend to do is to be able to take clinical material from patients and families, collect their DNA and undertake whole genome sequencing. This will enable us to identify genetic risks which predispose particular people to the development of these serious mental illnesses.’

This information allows researchers to determine whether these disorders resulted in changes in the brain, said Professor Sundram. The data is then modelled in animals to find the genetic pathway that has been altered by the initial genetic variation.

‘We believe that neuroscience and personalised medicine is now poised to be able to transform the way we understand, manage and treat these disorders.’ 

‘The revolution that occurred in cancer and other disorders 30-40 years ago can now be applied to our understanding of mental disorders,’ concluded Professor Sundram.

The final speaker, Professor Kim Cornish Director of the Turner Institute for Brain and Mental Health, spoke in her address about the need to promote resilience in children as a result of the pandemic.

Like Professor Kulkarni,  Professor Cornish illustrated the difficulties faced by children through a story; in this case the story of Mollie, a prep student who home schooled during the lockdown in a troubled family.

‘Children who are especially vulnerable to developing poor mental health are at a substantive risk of poor academic outcomes.’

They are also at risk of psychological disorders, substance abuse and early school dropout leading to reduced employment opportunities, Professor Cornish explained.

Professor Cornish highlighted the importance of early intervention to treating mental health issues in children. Building a coordinated network of cognitive capacities in children is key in embedding resilience in children, she said.

She further spoke about her work on The Pillar Project at the Turner Institute which uses computer games to research three facets of child psychology: inhibitory control, working memory and cognitive flexibility.

‘Developing and protecting the cognitive and mental health is a fundamental priority for our nation,’ said Professor Cornish. 

All speakers demonstrated how philanthropy can assist to fast track and support a new approach to mental health care in Australia. They gave the audience three lenses through which to view the pandemic’s effect on mental health and the way forward.