Search

Objective: The Composite International Diagnostic Interview 3.0 is a standardised diagnostic interview commonly used in population-based mental health surveys, but has not been used in community-residing Indigenous Australians. This paper seeks to determine whether the Composite International Diagnostic Interview 3.0 can produce valid diagnostic information when compared with a diagnostic interview in an urban Indigenous Australian sample. Method: This research was conducted over 10 weeks with adult Indigenous clients of two participating Aboriginal Medical Services in South-East Queensland. Using a cross-sectional, repeated-measures design, participants were administered the Composite International Diagnostic Interview 3.0 by an Indigenous interviewer and within 2 weeks attended a second appointment with an Indigenous clinical psychologist, who produced a diagnostic summary. The Composite International Diagnostic Interview 3.0 diagnoses were compared with the diagnostic summaries and clinical concordance between the two measures was calculated. Results: The diagnostic accuracy of the Composite International Diagnostic Interview 3.0 differed by module. The Post-traumatic Stress Disorder and Major Depression modules had good utility in diagnosing post-traumatic stress disorder and major depressive episodes, respectively; however, the Mania module that provides diagnoses of bipolar disorder was found to be unsuitable for this population. Although there were no identified contraindications for the use of the Generalised Anxiety and Alcohol Use Disorder modules, further research on the diagnostic accuracy of these modules is warranted. Conclusions: The Composite International Diagnostic Interview 3.0 can accurately diagnose some common mental disorders in an Indigenous Australian population, but was found to be unsuitable for others. Given these findings, care should be taken when using the Composite International Diagnostic Interview 3.0 in epidemiological prevalence studies with Indigenous Australian populations. [ABSTRACT FROM AUTHOR]

Objective: To describe the processes undertaken to maximise cultural competence in a complex research project and illustrate how this enhanced the quality of the research and impact of the research outcomes.Methods: An epidemiological survey of the mental health of Indigenous people in custody in Queensland was conducted using culturally informed research processes.Results: The research process that enhanced cultural competence is described. The research outcomes were positive in terms of participant and community experiences, participation rates, publications and other research outputs, capacity building and translation of research findings.Conclusions: This paper describes in practical terms how to conduct culturally informed research and how this approach enhanced the scientific rigour of a complex Indigenous health research project. Indigenous health research should be conducted using a culturally competent method. [ABSTRACT FROM AUTHOR]

Objective: This paper describes the background to, implementation of and evaluation challenges associated with an innovative, arts-based, wellbeing and mental health recovery project in a remote Indigenous setting. Results: Creative Recovery is a community-based arts initiative for Indigenous people with mental health problems. It has been rolled out as a pilot project in a remote Cape York community and is aimed at promoting wellbeing and recovery. The theoretical basis for the initiative is modelled on ideas of the role that social capital plays in improving mental health. This involves both the beneficial impact community participation and the social cohesion it creates can have, not only on an individual's mental health, but also on the social and emotional wellbeing of the communities they are part of. Such initiatives have already been adopted as an integral part of mental health promotion in countries such as the UK, and in other Australian states such as Victoria and Western Australia. The following paper will locate Creative Recovery in the current field of mental health promotion theory and Indigenous social and emotional wellbeing, and will discuss some of the evidence for and challenges inherent in adopting such initiatives. [ABSTRACT FROM AUTHOR]

Objective : Children and adolescents in care experience higher rates of mental illness. No studies have looked at differences in treatment effect amongst age groups for children/young people in care accessing mental health services. This study aims to determine if age is associated with outcomes for children and adolescents in care receiving treatment from a specialist mental health service in Queensland, Australia. Method : This 5-year retrospective cohort study consisted of a sample of 1338 children and adolescents in care aged 0–17 with pre- and post-treatment data. The Children's Global Assessment Scale (CGAS) and the Health of the Nations Outcome Scale for Children and Adolescents (HoNOSCA) were used to assess functioning and mental health outcomes. Results : Data analysis revealed significant differences between the age groups. Age 0–4 also showed significantly greater improvement on a number of domains when compared with older age groups, including overactivity and attention, scholastic and language skills, emotional symptoms, peer relationships, and family life and relationships. Conclusion : This study demonstrated positive outcomes for all ages, yet better outcomes for the younger age groups in a cohort of children and adolescents in care attending a specialist mental health service. It highlights the importance of providing mental health interventions to children/young people in care, particularly age 0–4. Further, it calls for validated measures for young children to be utilised across mental health services to aid research in this area and optimise outcomes for this vulnerable population. [ABSTRACT FROM AUTHOR]

Reproductive coercion is any interference with a person's reproductive autonomy that seeks to control if and when they become pregnant, and whether the pregnancy is maintained or terminated. It includes sabotage of contraceptive methods and intervention in a woman's access to health care. Our study sought to explore the prevalence and associations with reproductive coercion within Queensland, Australia, where legislation addressing domestic violence and abortion are largely state based and undergoing a period of law reform. The study was a retrospective analysis of 3,117 Queensland women who contacted a telephone counseling and information service regarding an unplanned pregnancy. All data were collected by experienced counselors regarding circumstances within a current pregnancy between January 2015 and July 2017. Overall, experience of current domestic violence was significantly more likely to co-occur with reproductive coercion (21.1%) compared with reproductive coercion identified in the absence of other domestic violence (3.1%). Furthermore, significantly more mental health issues were reported by 36.6% of women affected by reproductive coercion, compared with 14.1% of women with no reproductive coercion present. Disclosure for reproductive coercion, violence, and mental health issues was much higher among women who made a repeat contact to the counselors about their pregnancy (17.8%) compared with those who disclosed at first contact (5.9%). These findings demonstrate the importance for health services to ensure that appropriate screening (and re-screening) for reproductive coercion is completed as a distinct part of screening for violence during a health care relationship. [ABSTRACT FROM AUTHOR]

Objective: This paper describes the development of a collaborative group of mental health clinicians who have come together to improve practice in adult acute mental health settings for the inpatient management of schizophrenia. Method: Sixteen acute adult mental health inpatient services across Queensland worked together to develop clinical indicators related to the inpatient treatment of schizophrenia. Data collection was conducted by using information available on existing databases and through statewide chart audits using scannable form technology. Through a secure intranet site, and statewide forums, clinicians were able to access information on clinical indicators enabling them to compare their site data to peer and state data. Results: Available data from 15 of the 16 sites provided information on clinical indicators including average length of stay, 28-day readmission rates, antipsychotic prescribing, medication dose and the use of multiple antipsychotic medications at discharge. Conclusions: The formation of the Mental Health Clinical Collaborative has brought together clinicians across the State to develop clinical indicators and openly discuss ideas to inform and improve clinical practice. This process has been effective in improving the quality of routinely collected information across the State and in engaging clinicians in using health information to drive clinical practice. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to describe the Eating Disorders Outreach Service (EDOS), which supports clinicians in the treatment and management of eating disorder patients across Queensland. EDOS’s mandate is to facilitate intake to the specialist inpatient and outpatient services at the Royal Brisbane and Women’s Hospital (RBWH) and to provide eating disorders education and consultation liaison to clinicians statewide. Method: EDOS provides services in four key areas: intake facilitation, service development, education and training, and consultation liaison. Each area is described in detail. Results: EDOS has grown since its inception to currently comprise a full-time team manager and a number of specialist clinician positions in psychiatry, nursing, dietetics, social work and psychology. The Service has become an integral part of the RBWH Adult Eating Disorders Service, providing statewide assessment and treatment recommendations, consultation liaison services and specialist intervention programs. Conclusions: EDOS has been successful in facilitating patient access to local general medical and psychiatric facilities. EDOS also plays a significant leadership role in the development of effective statewide networking forums for clinicians and key stakeholders, in inservice delivery and in the provision of evidence-based educational opportunities, each of which has contributed to improved access to services for eating disorder patients. [ABSTRACT FROM AUTHOR]

Youth mental health in Australia is concerning with 25% of young people reported as experiencing mental health issues in a 12-month period. Meanwhile, Australian schools march forward with academic improvement agendas. Survey research conducted among primary and secondary school teachers, most drawn from the Australian state of Queensland, revealed that although teachers value student well-being initiatives, they are experiencing very real tensions dealing with student mental health concerns and performance targets, which is complicated by a lack of confidence in the efficacy of well-being programs in schools. These findings raise concerns about the need for government authorities, school leaders, and teacher education providers to further investigate the need for balance between school performance improvement agendas and student well-being concerns. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to overview the history, structure and activities of the Queensland Mental Health Review Tribunal in relation to Indigenous patients. Results: The Mental Health Review Tribunal is an independent statutory body established under the Mental Health Act 2000 (MHA2000) to safeguard the rights of patients receiving involuntary treatment under the Queensland MHA2000. In the period from when the Tribunal commenced in 2002 to end of June 2008, people of Aboriginal and Torres Strait Islander background represent 2.3% of all patient registrations with the Tribunal. The Tribunal has established a range of strategies to encourage Aboriginal and Torres Strait Islander patients to attend and participate in their hearing. This includes widening the Tribunal's body of knowledge, strategies to inform patients about the Tribunal, culturally sensitive hearing practices, and widening the circle of participation in the hearing. Conclusions The future direction for the Tribunal in this strategy will be influenced by more formal evaluation of the outcomes and by further development of a model for the provision of cultural advice. [ABSTRACT FROM AUTHOR]

This project focuses upon the use of jam2jam, a generative computer system, to increase access to improvization experiences for children and to facilitate new kinds of relationships with artists. The network jamming system uses visual and audio cultural materials to enable communities to be expressive with artistic materials that they value as a community. As the system is part of a network, performances can be shared between communities at great distances and recordings of performances can be uploaded to a digital social network () and shared both locally and with the wider community. This paper examines a preliminary project where artwork made by Indigenous mental health clients in Far North Queensland was digitized and given to a group of 8–12-year-old urban Indigenous children to ‘improvize’ with and make music/video clips using the jam2jam instrument. It seeks to generate a discussion and identify applications within creative arts-led community health settings to facilitate new kinds of relationships with self, peers, local community, culture and artists through collaborative improvization. [ABSTRACT FROM AUTHOR]

Objectives: This paper provides an example of a mental health research partnership underpinned by empowerment principles that seeks to foster strength among community organizations to support better outcomes for consumers, families and communities. It aims to raise awareness among researchers and service providers that empowerment approaches to assist communities to address mental health problems are not too difficult to be practical but require long-term commitment and appropriate support. Methods: A collaborative research strategy that has become known as the Priority Driven Research (PDR) Partnership emerged through literature review, consultations, Family Wellbeing Program delivery with community groups and activities in two discrete Indigenous communities. Progress to date on three of the four components of the strategy is described. Results: The following key needs were identified in a pilot study and are now being addressed in a research-based implementation phase: (i) gaining two-way understanding of perspectives on mental health and promoting universal awareness; (ii) supporting the empowerment of carers, families, consumers and at-risk groups through existing community organizations to gain greater understanding and control of their situation; (iii) developing pathways of care at the primary health centre level to enable support of social and emotional wellbeing as well as more integrated mental health care; (iv) accessing data to enable an ongoing process of analysis/sharing/planning and monitoring to inform future activity. Conclusion: One of the key learnings to emerge in this project so far is that empowerment through partnership becomes possible when there is a concerted effort to strengthen grassroots community organizations. These include social health teams and men's and women's groups that can engage local people in an action orientation. [ABSTRACT FROM AUTHOR]

Art therapy encompasses both preventative and curative activities and aims to improve ways of engaging those who might be reticent in seeking more traditional forms of psychological support offered through ‘talking therapies’. The Longreach base of the Royal Flying Doctor Service in Queensland provides mental health support to people living in rural and remote locations in central western Queensland and has been complemented since 2006 by the addition of a full-time art therapist. This paper provides an overview of art therapy and a description of this innovative approach to addressing mental health needs in a rural and remote setting. [ABSTRACT FROM AUTHOR]

Objectives: To examine the relationship between a regional economic downturn (indicated by the rise of population unemployment rate) and the rate of psychoactive-substance-induced psychiatric hospital admissions in the population in a rural/regional setting.Methods: Hospital admission records from January 2013 to December 2016 were reviewed retrospectively. All patients with admissions to the Mackay inpatient psychiatric unit with diagnosis of mental and behavioural disorders due to psychoactive substance use were recorded using (ICD-10) F10-F19 codes. The relationship between the regional unemployment rate and the hospital admission rate was analysed using linear regression analysis.Results: A statistically significant regression was found (F(1,46) = 39.46, p < 0.0001), R2 = 0.46). The predicted number of admissions per 100,000 population in a month was observed to increase on average by 3.13 per month (95% CI = 2.12-4.13, p < 0.0001) for each percentage increase in the regional unemployment rate.Conclusions: There was a statistically significant association between the population unemployment rate and the rate of substance induced psychiatric hospital admissions. Implications for regional Australian service provision and unmet needs were discussed. Further research is required to confirm this observation. [ABSTRACT FROM AUTHOR]

The article focuses on a study which explores the growth of a regionally-based mental health personnel offering services to remote Indigenous communities in north Queensland. It presents several factors that support the development and sustained capacity of integrated mental health groups. An overview of the concept of remote area mental health service is provided.

Ross is a mental health patient representative based in Cairns and has been a member of the Cairns CAG for the past eight years. He has played a significant role in the development of consumer participation in Cairns and at a state level. Ross has sat on a range of committees as a consumer representative and has worked as an accreditor with the Institute of Healthy Communities Australia. Currently he sits on the management committee of the Queensland Voice for Mental Health. Ross was a founding member of the Irukandji Pens writers group, based at the Cairns Mental Health Resource Service. [ABSTRACT FROM AUTHOR]

Purpose: Research identifies the value of animal companionship for people of various ages and with physical and mental health diagnoses. However, there is limited research into the value of animal companionship for the homeless population. Method: This exploratory study aimed to investigate the value that homeless people find in animal companionship; the extent to which homelessness impacts on the ability to have animal companions; and interventions that health professionals can implement to reduce barriers to animal companionship. Twenty-six people were interviewed during Homeless Health Outreach Team outreach. Descriptive analysis of the responses to the semi-structured interviews was carried out. Findings: Results indicated that the majority of participants had given up a pet, and wanted a pet but could not due to their homelessness. The impact of giving up a companion animal was significant. Difficulties associated with pet ownership focused mostly on the living environment and the cost. There were several benefits to having companion animals. Participants viewed that having a pet made a difference to their lives in that it provided friendship and responsibility and contributed to emotional wellbeing. Conclusion: It is suggested that occupational therapists need to be aware of the impact that pet ownership has on the lives of homeless people and to explore ways in which they can assist with this. [ABSTRACT FROM AUTHOR]

Objective: A needs analysis was undertaken to determine the quality and effectiveness of mental health services to Indigenous consumers within a health district of Southern Queensland. The study focussed on identifying gaps in the service provision for Indigenous consumers. Tools and methodologies were developed to achieve this. Method: Data were collected through the distribution of questionnaires to the target populations: district health service staff and Indigenous consumers. Questionnaires were developed through consultation with the community and the Steering Committee in order to achieve culturally appropriate wording. Of prime importance was the adaptation of questionnaire language so it would be fully understood by Indigenous consumers. Both questionnaires were designed to provide a balanced perspective of current mental health service needs for Indigenous people within the mental health service. Results: Results suggest that existing mental health services do not adequately meet the needs of Indigenous people. Conclusions: Recommendations arising from this study indicate a need for better communication and genuine partnerships between the mental health service and Indigenous people that reflect respect of cultural heritage and recognises the importance of including Indigenous people in the design and management of mental health services. Attention to the recommendations from this study will help ensure a culturally appropriate and effective mental health service for Indigenous consumers. [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: A week-long intensive outreach project to the Indigenous community of Napranum was undertaken by a Community Forensic Mental Health Service with the aim of developing the community's capacity for primary and secondary prevention of forensic mental health problems. Method: The process of developing and implementing the project is described. The outcome is evaluated by means of qualitative feedback from community members and participants. Results: The project was requested by the local community; planning involved extensive consultation between Queensland Health, community leaders and local service providers; and it was delivered with extensive contributions from other Queensland Health services, various non-government organizations, Indigenous opinion-leaders and public media, and an NRL football team. The outcomes are sustainable at a local level. Conclusions: This form of community engagement may contribute to destigmatization of mental illness in Indigenous communities, increased engagement beween these communities and mental health service providers, and increased cohesiveness and morale of these communities. [ABSTRACT FROM AUTHOR]