Mental illness in itself is often chronic in nature, whether you are talking about depression or anxiety or schizophrenia, it can be episodic and people can have really well times and they can have unwell times as well.
I think in terms of managing mental illness from a chronic disease perspective we need to make sure that our participants are prepared for their worst days.
So we're not setting them up to fail.
When they do have those hard times that they're going through, they've got a plan in place; these are the people that I can contact at the moment if I'm having a really bad day or these are the things that will keep me well or to prevent me from having those bad days so it's about preparation and having a plan for them.
I think setting goals for them, if they've got goals that they're working towards and they're focused on those they've got direction and they're feeling motivated by those things they want to do. I think that is also important in terms of keeping them well.
Chronic disease management at Family Planning can be a bit limited. We don't deal with all of the chronic diseases that are we faced with every day such as rheumatic heart disease, diabetes. We are a specialist service so we do concentrate on the burden of STI which is sexually transmitted infections and we have high rates of that in the Territory. That's because we have a young population and a mobile population.
The other chronic disease management that seems to come through the clinic is a lot of mental health. So we do focus on a lot of people's relationship and the connection with mental health in that environment
The others are very rare, a doctor can still sort out someone's chronic disease management if they're here for another issue and they can try and address some of it, but we tend to refer them onto a GP or to a specialist if it’s needed. We have picked up a number of chronic diseases but it's certainly not something that we specialize in, we're not a full GP service.
The way we do that is through and going back to that education of the workforce ensuring that resources are available making sure that the information that we're providing to clinicians is up to date around self-management
But we also bring it online a Heart Attack Survivor Support online portal which will allow people to form a community and get information around their conditions and also help them manage their conditions as well as their carers and not just the patient
Cancer is the main chronic disease we work with at Cancer Council NT. Cancer being one of the leading causes of death in Australia. We obviously always promote self-management, we are there as a support service and not a case management service.
We promote self-management by encouraging people to receive peer support and encouraging them to question/to ask their doctor, and giving them the information and letting them make the decision once we've given them the proper information.
Whether it be in regard to treatment or different options that they may take, or if they want to access other complementary therapies for instance, and giving them the safest advice in regards to that.
Chronic disease management is our bread and butter here.
Most people have at least three comorbidities so we're talking diabetes, heart disease, renal disease, potentially some cancer, potentially some other issues.
Mental health is a huge elephant in the room half the time.
If people are dealing with mental health issues they have no capacity to be able to put the resources they need to managing any chronic disease, no matter what it is.
So, you know it all works in together and having that general understanding of how they all interrelate is really important because they all propagate each other's problems.
The rewarding aspects of working with patients with chronic disease include obviously seeing a great outcome, seeing someone who has had their cancer surgery or their cancer treatment and that they are now well and they can live hopefully a long life.
I guess the more challenging are the harder cases, people with cancer that is a terminal cancer and trying to support them and their family and friends through the various stages that they’ll go through .
Most rewarding for us is actually seeing that our resources are being widely used and accepted by the primary health care community and that they're actually being passed on to patients.
That our research that we're funding is being translated into real outcomes in terms of cardiovascular disease and that we are getting reach out into with the primary care sector to ensure that we are reaching as many people indirectly
Although we're not a service provider that we are reaching as many people indirectly through the health services.
This is an extremely satisfying job. You get to see people from initial diagnosis, whether it be up in the hospital having a heart attack where they've never had a problem before and they’re shocked
The next thing you know you're working through them with their acute episode.
Then seeing them here, doing cardiac rehab on the outside after they've either had medical management or an intervention like a stent or bypass surgery whatever it is.
Then you're getting them back into, teaching them about safety because most people are so worried about having the next heart attack and not causing more dramas.
Some of the most challenging things when working with people with a chronic disease such as a mental illness which can obviously impact someone over their lifetime would be that when you're working with them sometimes it feels like progress is slow.
From our perspective sometimes if we are working with someone who is unwell, it can seem slow to you and people often suffer setbacks and I can see that sometimes people who are supporting those types of people in the community can get a little bit frustrated by that.
I suppose it is just about realizing that there will always be setbacks; you just have to prepare for that.
Some of the most rewarding things when working with people with chronic disease will be when you do just see them living their best life.
When we talk about recovery and mental illness it doesn't necessarily mean I don't have a mental illness anymore, what it means, I think my understanding is that they've recovered in terms of they are living a really valued life, they are living their best life and that's different for everybody
That's rewarding when you do see someone gain accommodation or you see someone you know gain some employment that they wanted or learn a new skill or just getting out with their friends in the community and enjoying themselves.
Because that sometimes something they have not done for a while, so that is definitely rewarding.