Thread by @coopesdetat

Final session today is on the interplay of DV, substance use, trauma & MH. Chaired by @DrWilliams, with @ManjulaOConnor, Sathya Rao & Carole Warshaw; @croakeynews is at the veterans and first responders MH stream #RANZCP2021

First up is @ManjulaOConnor, on gender, social power & restrictive norms, leading to disparities and inequities #RANZCP2021

Gender is a system defining men and women in opposition and distributing power accordingly, privileging masculinity says O'Connor #RANZCP2021

O'Connor says process of gendering begins in utero, with the expectant family readying an environment reflecting constructs. By age 10, children have internalised notions of hazardous masculinity & toxic femininity, setting the stage for a range of health behaviours #RANZCP2021

These reinforce ideas of natural bodies being inadequate, predicating bodily manipulation. For many women, their bodies are the subject of gatekeeping and policing by others, she says #RANZCP2021

Interesting reflections on feminist psychology from @ManjulaOConnor and Jean Baker Miller's relational model of human behaviour, and how it can be used to understand damaging models of masculinity #RANZCP2021

How does feminist theory understand the factors leading to family and domestic violence? The socio-political context of women must be key #RANZCP2021

Carole Warshaw is speaking next. She is Director of the National Center on Domestic Violence, Trauma & Mental Health #RANZCP2021

Warshaw giving some valuable history on reluctance by FDV survivors and activists to speak about MH or substance use consequences due to its weaponisation by perpetrators to further harm (to deny access to custody, housing, legal assistance) #RANZCP2021

There is a well established link #RANZCP2021

It's a double-edged phenomenon, says Warshaw. FDV increases risk of developing MH &SU issues; and people with these issues are also more vulnerable to FDV. They are also a form of coercive control for perpetrators #RANZCP2021

On the need for an integrated trauma, social justice & DV approach. Our services must not retraumatise #RANZCP2021

Really interesting - reframing BPD around complex trauma, an adaptive response. For many, trauma is not or ever 'post' #RANZCP2021

Now hearing from Spectrum director Sathya Rao #RANZCP2021

40% of people with BPD are in abusive relationships, 2/3 have childhood abuse experiences, 1/3 have experienced this in adulthood says Rao #RANZCP2021

Rao says there is an unfounded stigma around BPD and perpetration of violence, when there is more of an association with being subjected to it, except in the case of comorbidity with anti social personality disorder #RANZCP2021

Closing the session is a patient story from @drwilliams about 'Jenny'. An all too common and sobering story of a system failing to understand trauma and how it impacts a person and their life. When 1 in 4 of us are survivors of childhood trauma, this needs to change #RANZCP2021

These statistics are heartbreaking. One quarter of children hospitalised from FDV will have a brain injury, says @drwilliams #RANZCP2021

The scale of this problem in our country cannot be overstated #RANZCP2021

FDV is a health issue #RANZCP2021

Discussion around women's only police stations. @drwilliams says around 30% of police are perpetrators of FDV #RANZCP2021

@drwilliams says in mental health we should assume everyone has a history of trauma and acknowledge it in broad terms when doing an assessment, give an opening #RANZCP2021

@drwilliams says it can be cruel to invite people to discuss their trauma when there are currently just not enough specialist services to assist with recovery, but as psychiatrists it's essential to keep advocating for this, and for patients #RANZCP2021

That's the end of our final Monday session. Thanks to everyone tweeting from Hobart and from home, it's been a great day of discussions. We'll be back tomorrow to bring you the latest! #RANZCP2021