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Your child may have issues that you 'can't put your finger on'. For example, it may seem more to you than simply a "drug problem" or an "intellectual disability". There may be personality issues, serious behavioural problems, or problems related to brain damage that you are dealing with as well.
You may have been trying to get help for them for many years, starting from when they were a difficult baby or child. There may have been no help, or the help you got may have been of little use or not enough. Sometimes the problems have come up later in development, but there still seem to be no services which are able to help.
It may seem that no-one can really help you understand what is going on.
There are others out there like you. Many parents and family members have tried so hard on their own for many years to deal with their child's difficulties. Often, they have reached many dead ends when it comes to professional help. It can be very distressing for families to watch a child, for example, end up in the criminal system when they have not received the help they needed earlier.
Hopefully some of the information in this help sheet will make things a little clearer and identify some new avenues to try for help.
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Many families are dealing with young people who have complex problems, and it is often difficult to find suitable help. |
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Sometimes, what makes a problem "complex" for parents, is not knowing that a behaviour or issue is occurring, e.g. drug use or mental health issues. |
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When a young person has both a drug problem and a mental health problem it is called a Dual Diagnosis. Sometimes it can be difficult to find help for people who are experiencing both drug and mental health issues. |
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When problems are of a mild nature, it is often more difficult to get help, as the problem doesn't fit neatly into a service system. |
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When a family has done all it can, it may be time to focus on looking after themselves and setting clear and firm boundaries around the young person's behaviour. |
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The Victorian Department of Human Services¹ describes people with complex problems as having:
- problems which cut across different service areas
- needs which are not met or managed by existing services
- challenging behaviours that place themselves or others at risk
- require a long-term response from a range of services
Other community services define a person with 'complex problems' as having more than one difficulty to deal with and being more 'at risk'. Problems may include, for example: drug use, mental health problems, homelessness, criminal behaviour, sexuality issues, physical or intellectual disability, behavioural problems, child abuse.
A young person may be dealing with any, or a combination of, the following issues. Sometimes, the "complex" part for parents lies in simply not knowing that these are the issues that are affecting the young person.
If you suspect that your young person may be using drugs talk to professionals or other parents who may be able to shed some light on the situation for you.
If drug use is confirmed, your young person will be able to access Drug Treatment Services. Whether they are willing to receive help and are motivated enough to make changes, is another matter.
They may fall through the gaps if they are highly substance affected and their behaviour is difficult to manage. Psychiatric services may say that a young person is not suitable for their service if they see the young person's problem as drug use. They are required to respond, however, if the person is a risk to himself/herself or another person.
Police may be more willing to attend and assist in some circumstances (see: Understanding Drug Use).
If you are not aware of different types of mental health problems, a young person's behaviour may seem strange and irrational to you. You may see their looks change, or their mannerisms or the way they talk. They may seem more paranoid, or suspicious of people. Early psychosis can be especially hard to identify and things may get quite bad before you realise that the young person needs help.
Once they have received a Psychiatric Assessment, however, a diagnosis may be made and treatment will be recommended. Once again, it may be up to the young person to agree to take medication or to accept other help.
A young person may fall through the gaps if their mental health problems are not serious enough at this time, or if it is seen that their difficulties relate more to drug use. Drug use should not, however, prevent them receiving support for a psychiatric condition. See: Dual Diagnosis - below.
Many families have had trouble getting suitable support when their child has been suicidal. The Psychiatric Services Crisis and Assessment Teams should be able to respond or to refer you to more suitable assistance. They are based at your local hospital. Ring them immediately if you are concerned that your child is threatening suicide.
To find out about mental health services near you, phone: 1300 767 299 or 03 9616 7571 or go to www.health.vic.gov.au/mentalhealth/services/index.htm.
Personality disorders are a type of mental illness that often make a person particularly difficult to deal with. Personality disorders involve ongoing behaviour patterns, which affect the way a person operates, and their relationships. For more information go to: www.personalitydisorders.mentalhelp.net
There are a number of different types of personality disorders. Borderline Personality Disorder is one type that is often seen in professional practice. It often involves problems with emotions, feelings, moods, thinking and relationships. Victoria has a Borderline Personality Disorder service called Spectrum, phone: 03 9871 3900 or go to www.spectrum-bpd.com. See also: Understanding Mental Health.
Children with an intellectual disability may have delayed development or may have significant difficulty learning. The Victorian Department of Human Services' Disability Services cater for people with an Intellectual Disability and their families. Your young person may fall through the gap if their difficulty is not serious enough to be classified as an Intellectual Disability, or warrant having a case-manager or other assistance.
To find a service near you, phone: 1800 641 038
Congenital brain damage is present at birth. Depending on the nature of the condition, the person may have a physical disability, intellectual disability, personality or behavioural difficulty or all of these.
Brain injury which occurs during birth or at a later time is called 'acquired brain injury'. It may happen, for example, through heavy or long-term drug use (for example Korsakoff's Syndrome for long-term alcoholics), or due to an impact to the brain during an accident. Where the brain is damaged will make a difference to the effects on the person's ability to function and behaviour. Again, this may lead to physical, intellectual or personality or behavioural difficulties.
There are services available to assess and to respond to these situations. ARBIAS are based in Fitzroy, Victoria and provide services for people who suspect they have acquired brain injury, and their carers. This service provides assessment and recommends strategies, and they may provide further assistance or refer on to other services.
Contact ARBIAS on 03 9417 7071 or go to: www.arbias.org.au
People can use drugs to deal with mental health problems, or they may develop mental health problems after using drugs. When these two problems happen together, it is called a Dual Diagnosis. Having both conditions can make it harder to treat each condition on its own.
There are now Dual-Diagnosis Teams available to Drug Treatment and Psychiatric Services. They offer help to people with both these difficulties and to prevent them from falling through the gaps. Treatment usually involves help for both conditions in a coordinated way.
Contact an Alcohol and other Drug Service, or Psychiatric Service, as above.
Dual Diagnosis is also a term used when someone has both mental health problems and an intellectual disability. This can also be complex, as it may not be clear when the person does not understand something, or when they are not thinking straight due to mental illness. It can be challenging to manage behaviours.
Psychiatric Services may say they don't cater for people with Intellectual Disabilities, however there are codes of behaviour between the two services.
Contact Disability Services or Psychiatric Services - details above.
This combination may be a hard situation to deal with. Disability Services have Behaviour Intervention Strategies Teams (BIST) available to assist people to cope with these situations.
Some families find they need more intensive support to deal with the very difficult behaviours they are managing. Alternative accommodation may be a good option.
Contact Disability Services - details above.
When problems are extreme or serious, it can sometimes be easier to identify what the problem is and to get help. Sometimes when problems are milder, people fall through the gaps. They don't quite fit into mainstream services and yet they don't fit into the services for those with more serious problems. Even though problems may be mild, they may bring with them significant challenges in coping in everyday life. Families are often left to carry the load.
The help sheets in other sections of this website suggest strategies to cope with a young person's difficult behaviours. They may help with ways to handle behaviours at home, regardless of the level of support from services.
Your young person may not match any of the official diagnoses described above, and yet they may have significant behavioural difficulties. For example, they may:
- behave in unpredictable ways
- be very impulsive (act without thinking)
- be constantly demanding of you or aggressive
- have very poor emotion-regulation (for example, trouble managing anxiety of anger)
- have poor reasoning/logical abilities.
Families may need to try to gain support from a range of services until they get the help they need. Sometimes, families may come to realise that they can't do anymore for the young person at this stage. They may need to focus on looking after themselves. At home, clear and firm boundaries need to be set in place around the young person's behaviour.
If a child is under 16, at-risk due to their problems and behaviour, and unable to receive the support they need, the Victorian Department of Human Services, Child Protection Services may be able to advocate for you with other services. It can be worth making inquiries. They job is to assist families where children and young people are at risk.
Department of Human Services' General Inquiry Ph: 1300 650 172
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