Search

Objective: Psychiatrists may become involved in circumstances where a child is seeking termination of pregnancy. Potential roles include capacity advice and advocacy, but ethical and legal uncertainties abound. This paper uses illustrative cases, in an Australian jurisdiction, to exemplify the issues.Conclusion: Termination of pregnancy at the youthful extreme raises unique challenges for all involved. [ABSTRACT FROM AUTHOR]

Objectives: The poor mental health of asylum seekers and refugees in immigration detention has consistently been reported in peer-reviewed literature internationally; however, data on the mental health of asylum seekers and refugees detained in Australian immigration has been very limited.Methods: We re-analysed mental health screening data obtained by the Human Rights Commission.Results: Longer time in detention was associated with higher self-reported depression scores, with female individuals being more vulnerable to time in detention than those of male gender. Approximately one-half of the refugee group who agreed to complete the Harvard Trauma Questionnaire had post-traumatic stress disorder symptoms. On clinician-rated measures, one-third of the children, adolescents and adults suffered with clinical symptoms requiring tertiary outpatient assessment.Conclusions: This paper consolidates the findings of the 2014 Australian Human Rights Commission report and it provides an argument for public reporting of refugee data. [ABSTRACT FROM AUTHOR]

Objective: To review and summarise the evidence about and consequences of Australia's policy of mandatory indefinite detention of children and families who arrive by boat to seek asylum.Methods: This paper will summarise the accumulated scientific evidence about the health and mental health impacts of immigration detention on children and compare methodologies and discuss the political reception of the 2004 and 2014 Australian Human Rights Commission (AHRC) Inquiries into Immigration Detention of children.Results: The conclusions of the 2004 and 2014 Inquiries into Immigration Detention of Children are consistent with Australian and international research which demonstrates that immigration detention has harmful health, mental health and developmental consequences for children and negative impacts on parenting.Conclusion: The evidence that prolonged immigration detention causes psychological and developmental harm to children and families and is in breach of Australia's human rights obligations is consistent. This is now partially acknowledged by the Government. Attempts to limit public scrutiny through reduced access and potential punishment of medical witnesses arguably indicates the potency of their testimony. These harmful and unethical policies should be opposed. [ABSTRACT FROM AUTHOR]

Objective: This paper proposes a framework for a systematic evaluation of the Better Access Program, the largest single component of mental health reform announced under the Council of Australian Governments National Action Plan on Mental Health 2006-11. Method: The article explores the genesis of the Program and considers extant data sets and information available with which to establish the impact of the Program on consumers and service providers. Results: There are useful data available in Australia from which to derive pre- and post-implementation analysis about the impact of the Better Access Program. There is doubt as to whether these data form part of the Federal Government's current approach to evaluation of the Program. Conclusions: Anything less than a genuine and comprehensive evaluation will leave Australia unable to assess the real impact of the Better Access Program. The merit of further expenditure in the vital area of primary mental health care will be in doubt as a consequence. [ABSTRACT FROM AUTHOR]

Objectives: There is an increasing interest in conducting research within indigenous communities among indigenous and non-indigenous researchers alike. This paper offers the critical reflections of one Native Hawaiian researcher and the process of engaging in research as both an insider-outsider.Conclusions: Community-based, participatory research (CBPR) offers one model for outsiders to work effectively with indigenous communities, but CBPR also offers valuable principles for insiders who desire to work with their own communities. [ABSTRACT FROM AUTHOR]

Objectives: Conversations between anthropologists and psychiatrists have led to new theoretical trajectories, research agendas and clinical practices as social scientists and medical practitioners forged new understandings about the interaction of culture, personhood and illness. However, the demands of global mental health, coupled with health service provision requirements, mean that mental health interventions set up with the best intentions can fail to take into account the knowledge and expertise that social sciences can contribute to a programme's success. In this paper, I reflect on conversations between an anthropologist and mental health professionals in direct reference to data analysis of an AusAID mental health capacity-building programme undertaken in the Pacific region.Conclusions: Social and cultural perspectives embedded within programmes can provide richer, more contextualised interventions. In drawing on the combined expertise of anthropology and psychiatry, new taken-for-granted reference points embedding cultural approaches form the basis for delivery of global mental health programmes. These perspectives include: Locating mental health programmes within development critiques. Situating the subjects of development within contextualised settings, acknowledging and respecting local knowledge, understandings and practices. A focus on interdisciplinarity as the basis for future practice in global mental health projects. [ABSTRACT FROM AUTHOR]

Objective: The tripartite framework for principled practice was developed as part of the Wundargoodie Aboriginal Youth and Community Wellbeing Programme. The programme engages natural helpers to enhance critical health literacy. This paper examines the importance of translational research to enhancing critical health literacy for this group of de facto health workers using the work of the Australian Indigenous HealthInfoNet as an example. Translational research provides workforce support for those who are time poor and overburdened. Connecting these concepts and natural helpers will make a positive difference to Aboriginal health outcomes.Conclusions: There is a need for the development of translational research products that enhance the critical health literacy of natural helpers. The tripartite framework for principled practice supports reflective and accountable practice in the intercultural space to build trust and confidence between Aboriginal and non-Aboriginal people to enhance the opportunity for authentic knowledge production and transfer. [ABSTRACT FROM AUTHOR]

Objective: This paper explores novel training opportunities that the Expanded Setting Training Program (ESTP) provides for advanced psychiatry trainees. It is a reflection of a trainee's learning experiences during a year-long posting in Aboriginal Perinatal Mental Health, working alongside the Aboriginal Family Birthing Program, coupled with reflection and supervision.Conclusions: ESTP provided a fertile area to hone an advanced trainee's skills in the niche areas of Aboriginal mental health, perinatal mental health, culture and psychiatry. In addition, it provided skills in the area of leadership, health advocacy and the establishment and maintenance of successful programs in disadvantaged, culturally and linguistically diverse communities. The ESTP Aboriginal Mental Health rotation provides a unique experience for training, and the learning opportunities are limited only by the creativity of the trainee and supervisor. [ABSTRACT FROM AUTHOR]

Objective: In the aftermath of the double suicide of two teenage girls in 2007, the media linked the themes of 'emo' music and the girls' mental state. But it is not just emo music that has been the subject of scrutiny by the media. Rap music, country, and heavy metal have also been blamed for antisocial behaviours including violence, theft, promiscuity and drug use. It remains an important research and clinical question as to whether music contributes to the acting out of behaviours described in the music lyrics or whether the preferred music represents the already existing behavioural tendencies in the subject. This paper surveys and discusses the relevant literature on music preference and adolescent music listening behaviours, and their links with adolescent mental health. Conclusion: Studies have found a relationship between various genres of music and antisocial behaviours, vulnerability to suicide, and drug use. However, studies reject that music is a causal factor and suggest that music preference is more indicative of emotional vulnerability. A limited number of studies have found correlations between music preference and mental health status. More research is needed to determine whether music preferences of those with diagnosed mental health issues differ substantially from the general adolescent population. [ABSTRACT FROM AUTHOR]

Presents instructions for authors contributing articles to the "Australasian Psychiatry" journal. Manuscript to be created in Word; Copyright; Maximum lengths; Structured abstracts; Key words; Case reports or case material; Pejorative language; Abbreviations; References; Illustrations; Proofs; Author material archive policy.

Objective: The literature on mental health in the workplace largely focuses on the negative impacts of work and how work may contribute to the development of mental disorders. The potential mental health benefits of employment have received less attention.Method: A systematic search of reviews or meta-analyses that consider the benefits of work in regards to mental health was undertaken using academic databases. All relevant reviews were subjected to a quality appraisal.Results: Eleven reviews were identified as meeting the inclusion criteria, with four deemed to be of at least moderate quality. The available evidence supports the proposition that work can be beneficial for an employee's well-being, particularly if good-quality supervision is present and there are favourable workplace conditions. The benefits of work are most apparent when compared with the well-documented detrimental mental health effects of unemployment.Conclusions: The potential positive effects of good work and the role work can play in facilitating recovery from an illness and enhancing mental well-being need to be highlighted and promoted more widely. Future research should aim to further investigate what constitutes a 'good' workplace or a 'good' job in terms of mental health outcomes. [ABSTRACT FROM AUTHOR]

Objective: There is little published research about mental health and climate change in the Pacific, including Solomon Islands. Solomon Islands has one of the highest rates of sea-level rise globally. The aim of this research was to document mental health issues related to sea-level rise for people in East Malaita, Solomon Islands.Method: A cross-sectional study was carried out in six low-lying villages in East Malaita, Solomon Islands. The researcher travelled to villages by dugout canoe. In addition to quantitative, closed-ended questions, open-ended questions with villagers explored individual and community responses to rising sea level.Results: Of 60 people asked, 57 completed the questionnaire. Of these, 90% reported having seen a change in the weather patterns. Nearly all participants reported that sea-level rise is affecting them and their family and is causing fear and worry on a personal and community level. Four themes emerged from the qualitative analysis: experience of physical impacts of climate change; worry about the future; adaptation to climate change; government response needed.Conclusion: Given predictions of ongoing sea-level rise in the Pacific it is essential that more research is conducted to further understand the human impact of climate change for small island states which will inform local, provincial and national-level mental health responses. [ABSTRACT FROM AUTHOR]

Objectives: To pilot an art and mental health project with Samoan and Australian stakeholders. The aim of this project was to provide a voice through the medium of art for people experiencing mental illness, and to improve the public understanding in Samoa of mental illness and trauma.Methods: Over 12 months, a series of innovative workshops were held with Samoan and Australian stakeholders, followed by an art exhibition. These workshops developed strategies to support the promotion and understanding of mental health in Samoa. Key stakeholders from both art making and mental health services were engaged in activities to explore the possibility of collaboration in the Apia community.Results: The project was able to identify the existing resources and community support for the arts and mental health projects, to design a series of activities aimed to promote and maintain health in the community, and to pilot these programs with five key organizations.Conclusions: This project demonstrates the potential for art and mental health projects to contribute to both improving mental health and to lowering the personal and social costs of mental ill health for communities in Samoa. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to examine management practices that support the wellbeing of health professionals working in remote regions, which may improve workforce retention.Method: An online questionnaire was distributed to health professionals working in remote regions of the Kimberley and North Queensland. A response rate of 20% was achieved.Results: The findings suggest that, for health professionals working in remote regions of northern Australia, accessing adequate support is one of the most challenging aspects of working in remote regions. Hence, in remote regions where turnover is high, retention of competent health professionals may benefit from management practices that provide improved personal and professional support.Conclusions: Health professionals working in remote Australia face unique pressures due to their geographical and professional isolation. Therefore, providing support improves their professional competence and personal wellbeing, and promotes workforce stability, which benefits the remote community through better access to health services. [ABSTRACT FROM AUTHOR]

Objective: This study examines pregnancy and early infant outcomes of pregnant women with a clinical diagnosis of Borderline Personality Disorder presenting for obstetric services to a major metropolitan maternity hospital in Victoria, Australia.Method: A retrospective case review of pregnancy and early infant outcomes on 42 women who had been diagnosed with Borderline Personality Disorder via psychiatric assessment using DSM-IV-R criteria was undertaken. Outcomes were compared with a control group of 14,313 consisting of women and infants of non-affected women from the same hospital over the same period of time.Results: Women presenting for obstetric services with a clinical diagnosis of Borderline Personality Disorder experienced considerable psychosocial impairment. They anticipated birth as traumatic and frequently requested early delivery. High comorbidity with substance abuse was found and high rates of referral to child protective services. Mothers with Borderline Personality Disorder were significantly more likely to have negative birth outcomes such as lowered Apgar scores, prematurity and special care nursery referral when compared with controls.Conclusions: These findings offer preliminary evidence to be considered by clinicians in developing treatments and services for the perinatal care of women with Borderline Personality Disorder and their infants. Further research is required in order to develop evidence informed clinical guidelines for the management of women with Borderline Personality Disorder and their infants. [ABSTRACT FROM AUTHOR]

The article focuses on a study which explores several issues concerning the emergence of problematic internet use (PIU) in childhood and youth. It uses relevant literature-search methodology as well as using the key terms of PIU, internet addiction, and youth mental health. The use of common internet search engines is discussed.

Objective: Firstly, to demonstrate the involvement of Aboriginal people in caring-for-country as a case study of how appropriately targeted non-medical primary preventative health strategies can be a cost-effective approach to addressing chronic disease among Indigenous people. Secondly, to demonstrate the use of an analogous approach in addressing the global chronic disease pandemic.Method: A review of prior biomedical and economic research based on the involvement of Aboriginal people in caring-for-country is used to: (a) exemplifying the cost effectiveness of a non-medical preventative health intervention; and (b) the process by which such an approach might be applied across a broader context.Results: The presented results demonstrate one non-medical primary preventative health approach to addressing the health burden affecting Indigenous peoples.Conclusions: The suggested steps in optimising the cost effectiveness of such an approach demonstrate how it could be applied in addressing the global chronic disease pandemic. [ABSTRACT FROM AUTHOR]

Objective: To describe a course for trainee psychiatrists, designed to encourage critical thinking within an interdisciplinary framework. Trainees’ responses to the course, and the implications of these for teaching, learning and clinical practice, are considered. Method: Trainees were interviewed, and their responses subjected to content analysis. Results: To some extent, the course appears to have met its objectives. However, some trainees found parts of the course content threatening, and reported negative perceptions of teaching staff and the process of critical appraisal. Conclusions: Challenging taken for granted beliefs in psychiatry is a fundamental skill, which should be fostered in trainee psychiatrists if the profession is to move forwards as an intellectual and clinical discipline. The lessons learned from the course we describe may be useful to others who wish to pursue integrated, interdisciplinary teaching methods. [ABSTRACT FROM AUTHOR]

Objective: To briefly describe my own development from medical student, through junior resident and psychiatry registrar and finally qualified psychiatrist, to feeling the need to undertake psychoanalytic training in order to grapple with the complexities of treatment of personality disorders. Conclusions: My encounter with the concepts developed by the Viennese physician, Sigmund Freud, as represented by a number of significant teachers and clinicians was a formative experience in my early career. My subsequent development as a psychiatrist and psychoanalyst was highly influenced by the understandings of human mental development and function set in train by Freud’s clinical findings and ground-breaking thinking in the early 20th century. It is hoped that registrars-in-training and young psychiatrists may be particularly interested in how things ‘once were’ in NSW Mental Health Services which permitted this course of development. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the functioning of a trauma and dissociation unit that has run for the past 8 years in a private hospital, with particular regard to operating philosophy, operating parameters, challenges encountered, research and educational initiatives, and the applicability of the treatment model to other settings.Conclusions: Despite the challenges associated with significant difficulties in the corporate management of a private health-care system, it has been possible to operate an inpatient and day hospital programme tailored to the needs of patients in the dissociative spectrum, and the lessons learnt from this experience are valid considerations in the future planning of mental health services overall. [ABSTRACT FROM AUTHOR]

Objective: To record observations made by the authors on a series of visits between December 2001 and March 2002 to two of Australia’s immigration detention centers and to consider the mental health consequences of Australia’s policy of mandatory immigration detention of asylum seekers for families and children. Conclusions: Parents and children in immigration detention are often vulnerable to mental health problems before they reach Australia. Experiences in prolonged detention add to their burden of trauma, which has an impact not only on the individual adults and children, but on the family process itself. Immigration detention profoundly undermines the parental role, renders the parent impotent and leaves the child without protection or comfort in already unpredictable surroundings where basic needs for safe play and education are unmet. This potentially exposes the child to physical and emotional neglect in a degrading and hostile environment and puts children at high risk of the developmental psychopathology that follows exposure to violence and ongoing parental despair. Psychiatrists have a role in advocating for appropriate treatment of these traumatized and vulnerable parents and children. [ABSTRACT FROM AUTHOR]

Focuses on a study which explored the psychiatric and psychological issues associated with being deaf and hearing impaired among children from non-English speaking backgrounds in Australia. Demographics and definitions; Psychiatry and childhood deafness; Exploration of deafness in the context of the theory of mind; Analysis and discussion on two case studies.

The article discusses the need to perform a psychiatric screening followed by treatment of patients with end-stage kidney failures. Topics discussed include the treatment of kidney patients at dialysis centers, the findings of the psychiatric evaluation of patients, along with information of the research funding.

Objective: To examine the elements of the Aboriginal tea ceremony and its relevance to psychiatric practice. Conclusions: Through the Aboriginal tea ceremony, the mental health professional is able to convey that care and concern balance experience and expertise. These underpinning principles have wide application. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the authors discuss various reports within the issue on topics including mental health work benefits, benefits of the patients' education about their medication, and the goals of patients with schizophrenia.