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This paper uses secondary analysis to understand how COVID-19 shaped people's experiences with psychosocial support services in Australia. Data are drawn from questionnaires (n = 66) and semi-structured interviews (n = 62), conducted for a national service evaluation, with 121 people living with enduring mental health conditions and using psychosocial support services. Data relating to COVID-19 were inductively coded and analysed using constant comparative analysis. Most people's experiences included tele-support. While some people described minimal disruption to their support, many reported reduced engagement. People's wellbeing and engagement were influenced by: their location, living situation and pre-COVID lifestyles; physical health conditions; access to, comfort with, and support worker facilitation of technology; pre-COVID relationships with support workers; and communication from the organisation. The findings can help services prepare for future pandemics, adjust their services for a 'COVID-normal' world, and consider how learnings from COVID-19 could be incorporated into a flexible suite of service delivery options. [ABSTRACT FROM AUTHOR]

Reported rates of mental illness continue to climb amongst young Australians. In a family environment the carers of these young people play a highly influential role in their recovery process, however this responsibility can also have significant emotional, financial and health impacts on carers. This paper details the findings of an evaluation project examining the impact and effectiveness of a newly developed and implemented Family Peer Support Work model. Benefits were found which included: family care-givers receiving emotional support and empathy; reduced stress, loneliness, isolation and stigma; bridging between the family and the clinical care team; helping families to navigate through the complexities of the care system; and connecting families to other services. Clarity on role definition for the FPSWs evolved over the course of implementation along with a clearer articulation of the model of care and emergent knowledge on useful elements of training, ongoing professional development, mentoring and wellbeing. [ABSTRACT FROM AUTHOR]

This paper provides Australian population-level estimates of the prevalence of parental self-reported lifetime mental disorders and past 12 month mental disorders in their children. It leverages unique data from the 2013-2014 Australian Child and Adolescent Survey of Mental Health and Wellbeing (Young Minds Matter) (n = 6310). Mental disorders were assessed in 4-17 year-olds using the Diagnostic Interview Schedule for Children Version IV. Primary carer (PC) and secondary carer mental health was based on PC-reported lifetime diagnoses. Over one-third of 4-17 year-olds had a PC with a lifetime diagnosis. The prevalence of all disorders was significantly higher amongst these children than children whose PC reported no diagnoses, and highest when the PC had comorbid and more severe disorders. Assessing mental health needs at a family level is important to identify children who are particularly vulnerable to developing mental disorders, to develop targeted interventions, and to understand the intergenerational transmission of risk. [ABSTRACT FROM AUTHOR]

Recovery-orientated practice is crucial to mental health care services—consistently identified in policy, service delivery guidelines and national mental health action plans. An essential component to systems reform and the adoption of recovery-orientated practice is the inclusion of peer support workers as practice leaders to support shifting culture in mental health service delivery. Designated peer support roles operate as healthcare professionals who utilise their lived and living experience of mental health difficulty to support those on their recovery journey through mutual understanding of shared experience. This research sought to explore the experiences of peer support workers integrating into mental health teams and identify organisational actions to facilitate successful recognition, integration and acceptance by colleagues; therefore, promoting sustainability of the peer support role. Qualitative interviews were undertaken with 18 peer support workers employed across four Australian states within 12 different government and non-government organisations. Study findings reveal three key areas for organisational change with seven main themes to assist organisations to better facilitate the successful integration of peer support workers into mental health service teams. These included robust induction, training for existing staff, clear referral pathways into the service, consistent supervision and debriefing, leadership support, professional development pathways and involving peer workers through change processes. These themes were grouped into three key areas for change including preparation, process and structural changes, and cultural change actions for sustainability. This article makes recommendations for organisations to consider when implementing peer support roles into mental health services. [ABSTRACT FROM AUTHOR]

Adolescent violence in the home is a growing public health issue and remains under reported and under-researched. The focus of the present research is to investigate factors that may contribute to adolescent violence in the home, among acohort of young people with co-occurring early psychosis. Data relates to 50 young people (16 females, 33 males, 1 nonbinary) aged from 16-25 who were clients at a youth early psychosis service in Melbourne, Australia. Results from a discriminant function analysis revealed the two major contributing factors to whether someone used violence in the home, were whether a young person had a coexisting neurodevelopmental or intellectual disability and whether they used violence outside the home. The findings provide preliminary evidence that engaging in violence outside the home and the presence of a neurodevelopmental or intellectual disability may make it more likely for young people with early psychosis to use violence in the home., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Suicide is a global concern with rates in Australia continuing to increase. Effective post-suicidal care is critical for reducing persistent suicidal behaviour. One model of care is that adopted by Alfred Health, delivering a multidisciplinary, hybrid clinical and non-clinical (psycho-social support), assertive outreach approach. This study measured improvements in resilience and wellbeing, changes to distress and suicidal ideation at least 6-months post-discharge from care. Thirty-one consumers participated including a one-on-one interview to gather qualitative feedback. There was a significant change on all outcome measures with large effect sizes. Participants had significantly reduced suicidal ideation and distress and increased coping self-efficacy, hope and well-being. The qualitative findings indicated that a key component to recovery was the staff. Limitations included a low sample size, and broad time range of follow-up data collection. Providing assertive, multidisciplinary, collaborative and outreach-focused post-suicidal care can increase and sustain protective psychological factors and reduced suicidal ideation in most individuals. [ABSTRACT FROM AUTHOR]

This observational study compared the outcomes of consumers receiving community-based residential mental health rehabilitation support in Australia under a clinical staffing model and an integrated staffing model where Peer Support Workers are the majority component of the staffing profile. Reliable and clinically significant (RCS) change between admission and discharge in functional and clinical assessment measures were compared for consumers receiving care under the clinical (n = 52) and integrated (n = 93) staffing models. Covariate analyses examined the impact of known confounders on the outcomes of the staffing model groups. No statistically significant differences in RCS improvement were identified between the staffing models. However, logistic regression modelling showed that consumers admitted under the integrated staffing model were more likely to experience reliable improvement in general psychiatric symptoms and social functioning. The findings support the clinical and integrated staffing models achieving at least equivalent outcomes for community-based residential rehabilitation services consumers. [ABSTRACT FROM AUTHOR]

Conventional mental health services are frequently criticized for failing to support people and communities in their care. Open Dialogue is a non-conventional humanistic approach to mental health care, which has been implemented in many different settings globally. At two Australian public health care services, implementation of the approach led to positive client outcomes and sustained organizational and clinical change. The aim of the study was to identify and explore the organizational, management, leadership and cultural factors that contributed to sustained implementation in these complex systems. We conducted nine individual semi-structured interviews of health care leaders and managers from the two sites. Transcriptions of the interviews were analyzed thematically. Leaders facilitated a gradual development of clinical and organizational legitimacy for the non-standardized Open Dialogue approach by holding the anxiety and frustration of practitioners and parts of the administration, cultivating cultural change and adaptation and by continually removing organizational obstacles. [ABSTRACT FROM AUTHOR]

Psychoeducational groups have been used to address many health needs. Yet, there are few such options available for people who have attempted suicide. This study presents preliminary findings from an open trial of Eclipse, an 8-week closed, psychoeducational group for people who have attempted suicide. It examined the effectiveness of the Eclipse program in reducing suicidal ideation, depressive symptoms, perceived burdensomeness and thwarted belongingness, and increasing resilience and help-seeking. Results showed statistically significant improvements in depressive symptoms, perceived burdensomeness, resilience and help-seeking from baseline (T1) to immediate post-test (T2), and in perceived burdensomeness from T1 to 1-month follow-up (T3). A pervasiveness analysis showed that over half of the participants reported improvements in key study outcomes, respectively, as a result of participating in the Eclipse group. Psychoeducational support groups could provide broad application for those who have previously attempted suicide in decreasing severity of suicidal thinking by reductions in depressive symptoms, burdensomeness, and thwarted belongingness. [ABSTRACT FROM AUTHOR]

Despite increased participation and multiple workforce roles of those with lived experience in suicide prevention, there are no evaluated training programs to support this population. This study evaluated a training program aimed to prepare people for these important roles. Survey data at pre-, post- and at three- and 12-month follow-up were used measuring knowledge, attitudes, and self-efficacy, as well as psychological distress as a safety measure. Participants experienced significant gains in knowledge after training, although not all aspects of knowledge were maintained at follow-up. Self-efficacy was examined through confidence and empowerment. Confidence gains were significant at immediate and longer-term follow-up but gains in empowerment were not maintained over time. Participants' positive attitudes improved but this was not significant. There was no indication of increases in psychological distress in participants throughout the training and follow-up periods. Implications of these outcomes are discussed. [ABSTRACT FROM AUTHOR]

Social prescribing, also known as "community referral", is a means of referring individuals living in the community to existing local non-clinical health, welfare, and social support services. International evidence demonstrates that social prescribing improves biopsychosocial quality of life, and burden on health services. Australia's first social prescribing pilot program for individuals with mental illness (mood and psychotic spectrum disorders) was implemented in Sydney in 2016/2017; this study evaluates that program. Participants included 13 adults who were assessed at baseline and six-month follow-up. Outcomes included self-perceived quality of life, welfare needs, health status, loneliness, social participation, and economic participation. Results indicate significant improvements in quality of life and health status. This pilot program demonstrates that social prescribing may improve participant outcomes. It fits well within Australian health policy and funding models which focus on bolstering community care, and may be scalable, particularly in geographically isolated communities. [ABSTRACT FROM AUTHOR]

This study tested a new program for helping smokers with severe mental illness to reduce their tobacco use, together with determining the feasibility of such research in community mental health settings in Australia. Five Neami National sites trialled a Consumer Centred Tobacco Management program called Kick the Habit (n = 34). The intervention included two weeks of free Nicotine Replacement Therapy (patches only) but participants also used a variety of self-funded delivery types in addition or as an alternative to the subsidised nicotine patch. At the 3-month follow-up, Kick the Habit participants had reduced their number of daily cigarettes, dependency levels and average weekly expenditure on tobacco. Although a larger study is required, Kick the Habit represents a promising intervention for tobacco management in community mental health services. The challenges and lessons learnt for scaling up to a larger trial and integration into business-as-usual practice across multiple sites are discussed. [ABSTRACT FROM AUTHOR]

This study examined the rates and types of trauma reported by consumers utilising an inner city mental health service in Sydney, Australia. The study also explored whether consumers felt that it had been helpful to be asked about their experience of trauma, whether they thought that these questions should be asked routinely and if they wanted to talk about these experiences. Ninety-one consumers from an inner city mental health service were assessed. Eighty-eight percent of the consumers assessed reported that they had experienced at least one traumatic event, while 79% reported having experienced two or more events. A majority of consumers identified that they thought it was helpful to be asked about trauma and that it should be part of an assessment. However, less than one-third of these consumers surveyed wanted to talk about the trauma at the time of assessment. Concerns that clinicians may have in regards to addressing trauma in mental health assessment are not matched by consumers' expressed beliefs on the issue. [ABSTRACT FROM AUTHOR]

This study examines whether social network factors influence individual’s depression and anxiety outcomes at different life stages. Data was drawn from the Household, Income and Labour Dynamics in Australia survey. Hierarchical regression modelling was applied to examine the effects within and across different life stages. The depression and anxiety measures were taken from the Kessler Psychological Distress Scale (K10) and the social network factors were taken from the self-completion questionnaire. With the exception of social trust in seniors, the social network factors were significant predictors of depression and anxiety. This has practical implications for the design of social policy initiatives. [ABSTRACT FROM AUTHOR]

Little is known about the types of work accommodations and natural supports that are useful for people experiencing severe mental illness working in social businesses. We conducted an exploratory, descriptive and cross-sectional investigation in Australia, Canada and Italy to study the nature of work accommodations and natural supports available in social businesses. Study findings are drawn from survey responses of a convenience sample of 90 employees with self-reported psychiatric disabilities. Results showed that, regardless of the country, social businesses provide many work accommodations and natural supports, especially those linked to schedule flexibility and support, while work accommodations related to training and schedule flexibility were linked to longer job tenure. Overall, this study advances our knowledge about the spectrum of work accommodations and natural supports that are available in social businesses for people with severe mental illness. Also, it highlights the type of work accommodations that are likely to support this population to sustain employment. [ABSTRACT FROM AUTHOR]

This study aimed to explore four mental health consumers' experiences of completing self-report outcome measures in a research project. Participants were recruited from a community mental health organisation in Melbourne and were interviewed upon completion of a mixed methods research study where they were asked to complete a series of self-report outcome measures. Descriptive phenomenological micro-analysis was used to analyse interview data and is presented along with the researchers' observations during the data collection process. Results revealed that participants found the outcome measures cognitively challenging and the language used in the measures did not support the empowering intentions of mental health recovery. The authors suggest that the value of completing surveys for people with severe mental illness needs to be carefully considered so that the research process does not diminish other benefits of participation. [ABSTRACT FROM AUTHOR]

Poor mental health has previously been associated with risky sexual health behaviours among young people internationally and in clinical samples, but little is known about this relationship in non-clinical settings. We conducted a cross-sectional survey with a convenience sample of 1345 Australians aged 15-29. Multivariable logistic regression was used to identify sexual health behaviours independently associated with recent poor mental health including contraception use, STI testing, sexting and age at first sexual intercourse. Recent poor mental health was reported by 29.7 % of participants and independently associated with female gender (OR 1.8; 95 % CI 1.4-2.4), not identifying as heterosexual (OR 3.0; 95 % CI 2.1-4.4) and young age at first sexual intercourse among female participants (OR 1.4; 95 % CI 1.0-2.0). Results suggest mental health is largely driven by variables other than sexual health behaviours, although youth mental health services should consider inclusion of sexual health promotion within the scope of their services. [ABSTRACT FROM AUTHOR]

Thoughts about suicide are a risk factor for suicide deaths and attempts and are associated with a range of mental health outcomes. While there is considerable knowledge about risk factors for suicide ideation, there is little known about protective factors. The current study sought to understand the role of perceived mattering to others as a protective factor for suicide in a working sample of Australians using a cross-sectional research design. Logistic regression analysis indicated that people with a higher perception that they mattered had lower odds of suicide ideation than those with lower reported mattering, after controlling for psychological distress, demographic and relationship variables. These results indicate the importance of further research and intervention studies on mattering as a lever for reducing suicidality. Understanding more about protective factors for suicide ideation is important as this may prevent future adverse mental health and behavioural outcomes. [ABSTRACT FROM AUTHOR]

Despite the recognised importance of accurate mental illness information in help-seeking and improving recovery, little is known about the dissemination of such information to people with depression. With a view to informing effective communication to those most in need, we explored the extent to which mental illness information is received by people with depression, its perceived helpfulness and we characterise those who do not receive such information. Using data from the Australian National Survey of Mental Health and Wellbeing we observed that mental illness information was received by 54.7 % of those with depression. Most (76.7 %) found it helpful. Pamphlets were the most frequently cited source of information. People who did not receive information were less educated, unlikely to have accessed mental health services and unlikely to believe they had mental health needs. Targeted information campaigns which shape perceptions of need in relation to depression have the potential to reduce the resultant disease burden. [ABSTRACT FROM AUTHOR]

Services have been increasingly directed at supporting carers of people living with mental illness but it is difficult to evaluate the impact of service change where benchmarks for carer functioning are sparse. Sixty Australian carers were assessed regarding their quality of life, psychological distress, social isolation and caregiving experience. Their scores were compared with two matched community samples and previous studies. Carers were ten times more likely to be socially isolated and quality of life was significantly less than matched community samples. Over 40 % of the carer sample met criteria for probable psychiatric disorder. Comparison of caregiving experiences with a study 15 years ago showed no improvement in negative caregiving experiences. Carers still face considerable challenges to their wellbeing as they support people living with mental illness, in spite of progress in the development of policy and services. [ABSTRACT FROM AUTHOR]

Helpful strategies for communicating news of a serious mental health diagnosis are poorly understood. This study explored service users' preferences for how they would like clinicians to deliver such news when a diagnosis of mental illness is made. Qualitative interviews were conducted with forty-five individuals identifying with serious mental illness in eleven community based mental health facilities. Inductive thematic analysis resulted in eight primary themes. Five themes related to the structure and content of the discussion; including a focus on information exchange, using an individualized collaborative partnership paradigm, addressing stigma, balancing hope with realism, and recognizing the dynamic nature of diagnosis. The remaining themes related to the involvement of others; including the importance of clinicians' communication and relationship skills, involvement and education of carers, and offering an opportunity for peer support. The product of the synthesis of themes is a step-wise model for communicating news of mental health diagnosis. [ABSTRACT FROM AUTHOR]

There is a burgeoning literature on first-episode psychosis, the focus of which is early intervention. Little emphasis has been placed on the responses of young people to their experiences of psychosis. This study, therefore, aimed to describe and explain the responses of young people to their first episode of psychosis. Data obtained from ten young people who attended a community early intervention recovery program in Perth Western Australia were analysed using a grounded theory method. The results revealed that the basic psychosocial problem experienced by participants was loss of control resulting in disrupted lives and that the core variable, harnessing resilience, accounted for most of the variance in their behaviour to overcome this problem. The resultant framework described and explained how participants resiled and established direction in their lives. Although there are limitations with this qualitative study, such as the small size and the demographics of the sample, the findings have potential implications for approaches to service provision and phase specific interventions. [ABSTRACT FROM AUTHOR]

Transitional housing programs aim to improve living skills and housing stability for tenuously housed patients with mental illness. 113 consecutive Transitional Housing Team (THT) patients were matched to 139 controls on diagnosis, time of presentation, gender and prior psychiatric hospitalisation and compared using a difference-in-difference analysis for illness acuity and service use outcomes measured 1 year before and after THT entry/exit. There was a statistically significant difference-in-difference favouring THT participants for bed days (mean difference in difference −20.76 days, SE 9.59, p = 0.031) and living conditions (HoNOS Q11 mean difference in difference −0.93, SE 0.23, p < 0.001). THT cost less per participant (I$14,024) than the bed-days averted (I$17,348). The findings of reductions in bed days and improved living conditions suggest that transitional housing programs can have a significant positive impact for tenuously housed patients with high inpatient service usage, as well as saving costs for mental health services. [ABSTRACT FROM AUTHOR]

Development of a mental health education package for community pharmacy staff should be informed by mental health consumers/carers' needs, expectations and experiences, and staff knowledge, skills and attitudes. This review (1) explored research on community pharmacy practice and service provision for mental health consumers/carers, and (2) identified validated methods for assessing staff knowledge, skills and attitudes about mental illness to inform the development of a training questionnaire. A literature scan using key words knowledge, skills, attitudes, and beliefs combined with community pharmacy, pharmacist, and pharmacy support staff, and mental illness, depression, anxiety was conducted. A small number of studies were found that used reliable methods to assess pharmacists' training needs regarding mental illness and treatment options. There was little published specifically in relation to depression and anxiety in community pharmacy practice. No studies assessed the training needs of pharmacy support staff. A systematic analysis of pharmacy staff learning needs is warranted. [ABSTRACT FROM AUTHOR]

Carers are important to the recovery of their relatives with serious mental disorder however, it is unclear whether they are aware of, or endorse recent conceptualisations of recovery. This study compared carers' and mental health workers' recovery attitudes, and undertook multivariate predictions of carers' wellbeing, hopefulness and recovery attitudes. Participants were 82 Australian family members caring for a relative with psychosis. Carers' average recovery attitudes were less optimistic than for previously surveyed staff. Carers' recovery attitudes were predicted by perceptions that their relative's negative symptoms were more severe. Hopefulness and wellbeing was predicted by more positive and less negative caregiving experiences. Hopefulness was also predicted by less frequent contacts with their affected relative, and unexpectedly, by perceptions of more severe psychotic symptoms. Carers' wellbeing was further predicted by having a partner and having no lifetime history of a mental disorder. Hope and wellbeing are affected by everyday challenges and positive experiences of caregiving. [ABSTRACT FROM AUTHOR]

The impact of variable implementation of the Assertive Community Treatment (ACT) model on patient outcomes is increasingly recognised. We conducted the first study of four established Australian ACT teams, examining team composition, processes and model fidelity, using previously validated questionnaires. Demographic and clinical details of patients and their own experiences of ACT were gathered from staff. Associations between burnout and work experiences were examined. All teams were ACT-like (mean DACTS score = 3.7, SD = 0.3) with few significant patient differences between teams, except diagnosis (schizophrenia 61-93%, co-morbid substance abuse 16-33%) and proportion living alone (23-72%). Clinicians were fairly satisfied, but inter-team differences in staffing profile and experience emerged and one team scored highly on emotional exhaustion. Increased burnout was associated with greater stress due to taking a team approach. Inter-team differences suggested that attention to effective team working and leadership, as well as model fidelity, may be warranted. [ABSTRACT FROM AUTHOR]

This study sought to replicate Parslow and Jorm's (Aust N Z J Psychiatry 34(6): 997-1008, ) research on need, enabling and predisposing factors as predictors of mental health service use, with the addition of childhood trauma as a predisposing factor. It utilised a non-treatment seeking epidemiological sample of Australian adults (N = 822) to examine 25 variables covering psychiatric disorder, socio-demographics, physical health problems, and childhood trauma as predictors of mental health visits to general practitioners (GP's), mental health specialists and non-mental health specialists. A consistent multivariate predictor of mental health visits to all types of professionals was psychological distress. Presence of an affective disorder, age, and number of health problems were additional predictors of visiting a GP. Being female, divorced, and exposure to childhood trauma predicted use of a mental health specialist, while rural living was associated with lower use of these services. Results highlight the importance of general psychological distress and need factors in seeking help for mental health, and reinforce the lifelong disadvantage arising from adverse childhood experiences and the need to address these issues in adult mental health services. [ABSTRACT FROM AUTHOR]

The aim of this paper was to examine the acceptability and use of mental health services in an Arab sample. An Internet survey was made available to Arab people worldwide and enquired about the acceptability of traditional face-to-face and internet-delivered mental health services. Five hundred and three participants were recruited via media and Facebook promotions. Of those surveyed, 36% (183/503), 46% (233/503), and 73% (365/503) reported that they would be willing to consult a mental health professional, take prescription medication and try an internet-delivered psychological treatment, respectively. Moderate to high acceptability rates for mental health services were found in this sample of Arab people. High acceptability of internet-delivered treatments among the current Arab sample, provides the opportunity for directing resources to the development of internet-delivered interventions to help reduce the stigma and burden of mental disease in the Arab world.

Training for health services staff often focuses on improving individual practitioner's knowledge and skills, with less emphasis given to the broader organizational context, in particular those elements that support successful implementation of changes post-training. This paper compares the effectiveness of a standard training model for suicide prevention to an enhanced training model. The training involved the public mental health workforce throughout the State of Queensland, Australia and was developed in collaboration with the State health department and as such took place within a policy and practice context. The standard training involved participation in a one-day training workshop, which provided information on evidence-based suicide prevention strategies. The enhanced model took an organizational development approach and incorporated a focus on creating and strengthening networks to enhance the capacity of mental health service staff to undertake preventive strategies. Findings suggest that multi-component organizational approaches for suicide prevention produces benefits that should now be trialled through experimental approaches.

This paper examines Australian psychiatric nurses' evaluations of expanded nursing roles in community mental health programs and psychiatric hospitals. Factor analysis uncovered three expanded roles: two community based and one hospital based. Subsequent regression analysis found that psychiatric nurses with tertiary education and a high level of organizational commitment were more likely to favorably evaluate the expanded nursing roles. Experience related variables such as length of employment, age and rank were negatively associated with evaluations of such roles.