Parody Not Specified Profile picture
May 17, 2021 29 tweets 17 min read Twitter logo Read on Twitter
Our first keynote at #RANZCP2021 today will be from Carole Warshaw, director of the US National Center on Domestic Violence, Trauma & Mental Health
Warshaw talking emergence of trauma theory and how powerful it was for survivors - DV not a psychiatric condition but has many MH and substance use related effects. Reframing #RANZCP2021
Coercive control at the heart of DV, physical violence may be a threat to enforce but not always most prominent aspect, says Warshaw. Like being in a hostage situation, aided and abetted by systems - legal, migration and medical #RANZCP2021
How are MH, trauma and DV interconnected? Warshaw says psychiatrists may not always join the dots, particularly political and structural forms of trauma. Importance of a social justice approach #RANZCP2021
DV has many downstream effects for MH #RANZCP2021
Risk factors for suicidality for those experiencing DV #RANZCP2021
What are the narrated experiences of DV among survivors? #RANZCP2021
Often we make the mistake about underlying psychology making people prone to being in abusive relationships, but this is not borne out by the data Warshaw says. These figures are Australian #RANZCP2021
IPV has associations with psychotic symptoms too - esp threats and sexual violence #RANZCP2021
The #SDOH also exacerbates risk profile - poverty, unsafe living, says Warshaw. Lack of gender/trauma specific treatment creates even greater barriers #RANZCP2021
Warshaw also stressing the importance of historical, intergenerational trauma and structural violence in this space. Notes an epidemic of murdered and missing Indigenous women in the US, and these patterns mirrored in Australia #RANZCP2021
Warshaw presenting data on MH and coercion. Gaslighting and weaponising distress #RANZCP2021
Some of the ways this plays out for survivors in the psychiatric/therapeutic space #RANZCP2021
Data on DV, coercion & substance use #RANZCP2021
Abusive partners introducing victims to substances, using them to control. Experiences of survivors #RANZCP2021
Amid an opioid epidemic in the US, Warshaw says it is a powerful form of coercive control #RANZCP2021
More on opioids & women experiencing IPV #RANZCP2021
Amplificatory effects of #COVID19 for DV #RANZCP2021
Warshaw highlighting how #COVID19 and telehealth has been a risk for survivors - how do you treat people isolated at home with their abuser? #RANZCP2021
Important lessons for clinical practice #RANZCP2021
Always think about safety. There are multiple risks, some of which may not immediately come to mind when treating survivors. Are you in danger from another person? #RANZCP2021
Telehealth safety. So important in this era #RANZCP2021
Warshaw says one of the most things to important to remember is survivors are very attuned to power imbalances. Do not assume or demand responses #RANZCP2021
Opening conversations around coercion and substance use #RANZCP2021
Acknowledge and affirm disclosures. Engage in safety planning. Talk about coping strategies, never convince someone to leave an abuser as it may increase their risk of harm #RANZCP2021
Lots of evidence and treatment gaps in this space #RANZCP2021
Focus on strengths & cultural strengths critical. Abuse and coercion strips away - treatment should rebuild. Even the 'what happened to you' paradigm diminishes survivors. Remember to document carefully and sensitively given potential litigious dimension of this space #RANZCP2021
Psychiatrists have a responsibility to challenge the conditions that perpetuate violence in our society, not just a clinical duty to survivors. Strong words to close from Warshaw #RANZCP2021
Does our preoccupation with diagnosis cloud our ability to consider social, cultural and political drivers asks @DrVinayLakra. Warshaw says we must always come back to the context #RANZCP2021

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More from @coopesdetat

May 18, 2021
Greatly looking forward to the next two sessions at #RANZCP2021 on Maori and Aboriginal and Torres Strait Islander mental health, feat Helen Milroy (WA Australian of the Year and Australia's first-ever Indigenous MD), Allister Bush, Mark Lawrence & Wiremu NiaNia
First up Palyku woman Helen Milroy, paying respects to elders. Will be speaking about complexities in Aboriginal MH #RANZCP2021
How do cultural perspectives cross over with illness experiences? Milroy sharing some examples #RANZCP2021
Read 62 tweets
May 18, 2021
Will be tweeting in a thread below from the joint @ranzcp-JSPN symposium on patient rights next #RANZCP2021
Our first speaker Neeraj Gill #RANZCP2021
Gill setting the scene #RANZCP2021
Read 23 tweets
May 17, 2021
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
Read 24 tweets
May 17, 2021
This afternoon I will be tweeting from #RANZCP2021 sessions on mental health workforce, and DV, trauma & substance use. John Allan getting us underway now. @croakeynews will be covering sessions on ADHD, and the MH of veterans and first responders
The psychiatry workforce is ageing, and about 50:50 public vs private says Allan. Stressors include too much work to do with not enough time to do it #ranzcp2021
Just 6 psychiatrists in Australia service very remote regions. SIX! Versus 2,671 in the cities. Significant rural maldistribution #RANZCP2021
Read 28 tweets
May 17, 2021
Back on deck at #RANZCP2021, tweeting from a session on the @ozprodcom inquiry into mental health. Discussions chaired by Harvey Whiteford from @QCMHR, who was associate commissioner. @CroakeyNews will be covering the session on aged care
Intros to Whiteford. First psychiatrist ever appointed to the @WorldBank, first advisory psychiatrist to the federal government. Will be talking to us about the @ozprodcom inquiry and last week's federal budget #RANZCP2021
Inquiry spanned 18 months from Oct 2018 to June last year, with report released in Nov. Was the biggest @ozprodcom inquiry ever, 1300 submissions from a spectrum of stakeholders, says Whiteford #RANZCP2021
Read 31 tweets
May 16, 2021
We'll be hearing from @kgelber next on hate speech and its consequences. A problem she says is increasing in prominence and scope #RANZCP2021
Gelber talks about the mainstreaming in modern politics of hate speech and its threat to democracy
#RANZCP2021. Political leaders including Trump engaging directly in these discourses. Australia not immune. Scale of problem is huge
Hate or the presence of hate or dislike is not the key determinant of hate speech - discrimination is, says @kgelber. Hate speech is an act of discrimination that you carry out with your words. Doesn't have to be vituperative or epithet-laden #RANZCP2021
Read 26 tweets

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