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There is growing national and international concern about the mental health of children and young people, and in countries such as England there is now a political and policy commitment to developing whole-school approaches to mental health. This paper presents new evidence on how pupils' mental health is being addressed in schools using learning activities associated with physical education, sport and physical activity, as part of a school-based sport- and mental health-themed programme ('Tackling the Blues') for pupils aged 6–16 years old in north-west England. In particular, we examine how pupil-centred learning activities have been used in weekly multi-sport activity sessions and related classroom-based workshops, and draw upon insight from 29 focus groups to explore pupils' (n = 116) mental health awareness and associated socio-emotional learning (SEL). The learning activities led pupils to focus on the impact personal relationships with family and friends, feelings and emotions, and experiences of stress, anger and entrapment can have on mental health. It is argued that embedding socially relevant learning activities into the content, organisation and delivery of school curricula may help improve pupils' sense of enjoyment, participation and achievement which are important for enhancing their knowledge and awareness of mental health, and developing SEL. However, we conclude that the effectiveness of whole-school approaches also depends, perhaps to a greater degree, on the wider educational systems in which schools are located and especially the widening social, economic and health inequalities which have profound impacts on child development, educational and other outcomes, and mental health. [ABSTRACT FROM AUTHOR]

There are growing concerns over young people's mental health, the academic pressures they face, and the association between school-related stress and health. Given this, alongside the known benefits of physical activity for psychological health, the need for school-based interventions with a physical activity focus seems justified. This paper reports on findings from the evaluation of a pilot of 'Get to the Start Line', an innovative school-based programme designed to address adolescents' school-related stress and anxiety. The research adopted a mixed-methods approach and a pre- and post- design. Six schools from the East Midlands, UK, and selected year 11 pupils (aged 15–16) identified as experiencing examination-related stress and anxiety, participated in the programme. The programme was coordinated by a school champion (a staff member), delivered by an athlete mentor, and comprised six workshops. Data were collected from school champions and athlete mentors via an online survey following each workshop, and via semi-structured focus groups and interviews with pupils and school champions, respectively, pre-, mid- and post-intervention. Schools also provided relevant pupil data. The findings revealed the programme to be positively received by most pupils and to result in positive outcomes such as reported reductions in examination-related stress and anxiety for some, and fewer pupil well-being referrals. However, various challenges and limitations of the programme were identified, and recommendations were made for its future development. Therefore, whilst some of the findings were encouraging, further research into the implementation and impact of this and other such programmes is needed. [ABSTRACT FROM AUTHOR]

In the past decade or more, improving young people's mental health has been identified as a priority for policy-makers in many countries, including Norway. Physical education, as a setting for physical activity, is increasingly viewed as having a potentially significant role to play in addressing mental health among the young. This paper reports the findings from a study of 148 Norwegian youngsters (68 girls and 80 boys) from the 10th grade (15–16 years old) in eight secondary schools in Norway in 2017. It explores Norwegian youngsters' experiences of physical education in relation to aspects of their mental health – specifically, being judged and, by extension, 'othered'. The findings suggest that physical education may undoubtedly serve to generate positive feelings associated with physical activity and games and, in doing so, bolster some youngsters' self-esteem and self-identities. On the other hand, however, for those less competent in sporting terms, and whose bodily self-image is not particularly positive, the public nature of physical education and the nature of the activities that constitute the subject can give rise to unplanned and unintended harm to some youngsters' mental health – especially in countries, such as Norway, where sport is a significant aspect of the group habitus and collective 'we-group' identity. [ABSTRACT FROM AUTHOR]

Objective: Patients admitted to mental health services may exhibit behaviours of concern (BOCs) such as aggression, self-harm, absconding and sexual harm. BOCs can lead to restrictive interventions, which have adverse effects on patients, carers and staff. This paper aims to explore the nature and outcome of BOCs within an adult inpatient mental health setting.Methods: A retrospective audit was conducted at a metropolitan inpatient service between 1 August 2016 and 31 July 2017. The frequency, nature and outcomes of BOC episodes were described and thematic analysis was used to summarise BOC antecedents.Results: A BOC was documented for 179 (18.2%) patients who also showed high rates of drug abuse, homelessness and longer admission. Most self-harm and sexual harm events occurred outside of normal business hours. Medications and verbal de-escalation were commonly used interventions. Episodes of deliberate self-harm were likely to result in patient and staff injury or mechanical restraint, whereas aggression was associated with seclusion. Mental state, care engagement, physiological stress and situational stressor were identified as BOC antecedents.Conclusion: Multiple forms of BOCs were experienced with mental state, physical and interpersonal contributors identified. Improving multidisciplinary input into early assessment and treatment of BOC causes is needed to improve safety. [ABSTRACT FROM AUTHOR]

Objective: The rapidly growing number of people in prison in Australia, combined with the high prevalence of mental disorder in this population, results in high demand for mental health services in prison settings. Despite their critical role as part of a national mental health response, prison mental health services (PMHS) in Australia have been poorly characterised. In this paper, we describe findings of the first national survey of PMHS in Australia.Methods: We distributed a survey to key representatives of PMHS in all Australian states and territories in 2016.Results: Our method constitutes a replicable process for quantifying and comparing PMHS in Australia. We describe the structure, governance and staffing models in seven jurisdictions. When compared against international recommendations, only one Australian jurisdiction (the ACT) is funded to provide services at a level equivalent to mental health services provided in the community.Conclusion: Prison mental health services in Australia are delivered by a complex mix of government, private sector and non-government services. Services appear to be severely under-resourced when compared with the available benchmarks. [ABSTRACT FROM AUTHOR]

Background: Nurses experience moral distress when they cannot do what they believe is right or when they must do what they believe is wrong. Given the limited mechanisms for managing ethical issues for nurses in Japan, an Online Ethics Consultation on mental health (OEC) was established open to anyone seeking anonymous consultation on mental health practice. Research objective: To report the establishment of the Online Ethics Consultation and describe and evaluate its effectiveness. Ethical considerations: The research was conducted in accordance with the Declaration of Helsinki. Research design: This evaluation describes the outcomes of 5 years of operation of the Online Ethics Consultation on mental health in Japan Participants: The Online Ethics Consultation received 12 emails requesting consultation. Consultees included mental health nurses, psychiatrists, and service users. Findings: The most common questions directed to the service were about seclusion and physical restraint. Response time from receipt of email to sending a reply was between 1 and 14 days. Despite the disappointing number of consultations, feedback has been positive. Discussion: The Online Ethics Consultation was established to assist morally sensitive nurses in resolving their ethical problems through provision of unbiased and encouraging advice. Mental health care in Japan has been less than ideal: long-term social hospitalization, seclusion, and restraint are common practices that often lead to moral distress in nurses and the questions received reflected this. The head of the Online Ethics Consultation sent a supportive, facilitative response summarizing the opinions of several consultants. Conclusion: This study provides key information for the establishment of an online ethics resource the adoption of which has the potential to improve the experience of nurses, allied health and clients of mental health services. This paper has implications for services concerned with improving patient care, managing nurses' moral distress, building ethics into decision-making. [ABSTRACT FROM AUTHOR]

Objective: This paper highlights the significant mental health vulnerabilities of people who have sought asylum in Australia and their additional adversities as a result of the Covid-19 pandemic. Conclusions: Australia's policies in relation to asylum seekers result in multiple human rights violations and add significantly to mental health vulnerabilities. Despite a majority being identified as refugees, people spend years in personal and administrative limbo and are denied resettlement in Australia. Social isolation and other restrictions associated with Covid-19 and recent reductions in welfare and housing support compound their difficulties. The clinical challenges in working with people impacted by these circumstances and the role of psychiatrists and the RANZCP in advocacy are identified. [ABSTRACT FROM AUTHOR]

The aim of the systematic review described in this article was to determine the outcomes for individuals exposed to severe neglect in congregate care institutions such as orphanages. In this context, severe neglect refers to failure to meet children's basic physical, developmental, and emotional needs due to inadequate resources. In this systematic review of previous systematic reviews and meta-analyses, searches of 10 databases were conducted, 18 papers that met inclusion and exclusion criteria were selected for review, their quality was assessed, and data were extracted and synthesized. The 550 primary studies included in the 18 systematic reviews and meta-analyses were relatively well designed, allowing confidence to be placed in their results. Severe neglect was associated with a wide range of problems in the domains of physical development, cognitive development, attachment, and mental health. The severity of adverse outcomes was partly influenced by the duration and severity of deprivation and a constellation of risk and protective factors. Prevention policies should aim to eliminate large underresourced congregate care institutions for infants. In taking steps toward this, policies should aim to adequately resource congregate care institutions to meet children's developmental needs for nutrition, stimulation, and attachment to a stable primary caregiver with adequate parenting skills and training. Early placement in adoptive or foster families, with access to routine physical and mental health-care service available in developed countries, is the most viable effective intervention for child survivors of severe neglect. [ABSTRACT FROM AUTHOR]

This paper focuses on a collection of objects deliberately concealed beneath the verandah of a ward for middle-class, female, paying patients at Australia's longest continuously operating mental health institution, the Royal Derwent Hospital in Tasmania. Cached in small discrete mounds across an area of some 50 square metres, the collection was probably concealed in the mid-20th century and contains over 1000 items of clothing, ephemera and other objects dating from 1880 to the mid-1940s. In achieving a possessional territory of such magnitude, this patient achieved a level of personal self-expression that is rarely encountered archaeologically, particularly within an institutional context. Analysis of this collection as an 'underlife' illuminates both functional aspects of the hospital and the hopes and desires of this particular, though still anonymous, patient and her vibrant world of things. [ABSTRACT FROM AUTHOR]

While the college years present an ideal time for chronic disease prevention, students often do not seek services or perceive themselves to be at health risk. Researchers at Bowling Green State University have been exploring the health patterns of first-year university students for several years, initially as a health-based research study (August 2012 to May 2016) and currently through a first-year seminar course for students transitioning from high school to college (August 2016 to present). This article describes the evolution of data sharing techniques from passively presented paper feedback sheets (focusing on individual health assessments) to highly interactive classroom discussions stemming from viewings of animated case study videos (designed based on whole group themes). Qualitative feedback from students and faculty has been positive, suggesting that animated case study videos are an effective strategy for engaging students in critical thinking about physical and mental health concerns affecting their peer group. Practical recommendations for using animated case studies in diverse educational settings are provided. [ABSTRACT FROM AUTHOR]

Objective: Borderline personality disorder (BPD) is frequently accompanied by low mood, the features of which may satisfy the diagnostic criteria for major depressive disorder (MDD). Treatment of depressive symptoms in the absence of BPD-appropriate treatment is less effective and may cause iatrogenic harm. This paper briefly reviews the co-occurrence of BPD and depressive disorder and suggests ways of differentiating these disorders and optimising treatment within the Australian Mental Health context.Conclusions: Depressive symptoms are present in the majority of people with BPD. To address the difficulty differentiating clinically distinct MDD from depressive symptoms that are integral to BPD psychopathology, it is suggested that depressive symptoms arising from a primary diagnosis of BPD (i) may exhibit transience and be stress reactive, (ii) lack a robust clinical response to antidepressant medication and/or electroconvulsive treatment and (iii) are responsive to BPD-appropriate psychotherapy. [ABSTRACT FROM AUTHOR]

Objectives: This paper reviews the major findings of the Victorian Psychiatry Attraction, Recruitment and Retention Needs Analysis Project and considers some of the implications for the psychiatrist workforce working in public sector psychiatry.Conclusions: The report provides a snapshot of the issues that are impairing the ability of Victorian psychiatrists to comprehensively treat those in our community who have severe mental illness. As the report shows, the issues impacting the profession are multi-faceted and complex, yet surmountable. [ABSTRACT FROM AUTHOR]

Performing autoethnography is a dynamic and dialogic exercise, transgressing and exceeding traditional expectations of academic papers. In this freely spoken piece—of narratives, thoughts, poems, and reflections—you will meet three international mental health scholar-researchers seeking and deepening connection through friendship. The article began as a single story and developed, as stories often do, to become many stories. It is conversational, shifting discursively across many topics, including diagnosis, medication, mental health demedicalization and recovery, cultural colonization, language, narrative and human abuse, identity, human connection, being outside the academic mainstream, ethnicity, time, and transitions. It is a story of telling stories. [ABSTRACT FROM AUTHOR]

Objective: To critically examine a recent decision of the Victorian Supreme Court that found that the Mental Health Tribunal and the Victorian Civil and Administrative Tribunal erred in the application of the capacity test in the Mental Health Act 2014 (Vic) and that compulsory electroconvulsive therapy would infringe upon the human rights of two patients who had no insight into their chronic schizophrenia.Conclusions: After considering the concepts of insight and capacity to consent to treatment, the paper concludes that the decision in NJE and PBU v Mental Health Tribunal [2018] VSC 564 is problematic clinically. [ABSTRACT FROM AUTHOR]

Objective: The aims of this paper are to describe a Māori approach to assessment and intervention planning using the Māori creation narrative Te Ara a Tāne (The Journey of Tāne) and to outline an evaluation one year after the model was implemented.Conclusions: Te Ara Waiora a Tāne is a kaupapa Māori (Māori-centred) mental-health engagement, assessment, goal setting and planning approach designed to enhance the mana (spiritual and personal authority) of whānau (individuals and family/families) at the point they enter a Māori service and during ongoing mental-health work. Preliminary evaluation indicated that staff considered the model user-friendly and helpful for whānau. Further evaluation is needed to assess the impact of this approach on Māori whānau engagement with services. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to evaluate the effectiveness of ongoing physical health monitoring for Indigenous Australians with mental health issues in the Kimberley region of Western Australia.Method: This longitudinal, within-groups investigation assessed physical health parameters such as blood pressure and blood glucose levels at baseline and at 18 months for the same cohort. No standardised intervention was in place, but action was taken if results were found to be abnormal.Results: Most measures of physical health remained stable, with mean lipid and fasting glucose levels remaining abnormal over the entire assessment period. Systolic blood pressure showed a significant improvement.Conclusions: More needs to be done to improve the physical health of Indigenous mental health patients - culturally appropriate and secure interventions incorporating holistic models of care are needed. [ABSTRACT FROM AUTHOR]

Objective: An expert reference group met on four occasions to consider ways forward in terms of Indigenous mental health. This paper summarises the discussion and recommendations.Conclusion: While the negative effects of colonisation and trans-generational trauma continue, we propose renewed emphasis on improving access, cultural orientation and trauma-informed care, and a focus on the needs of young Indigenous Australians. [ABSTRACT FROM AUTHOR]

Refugees and asylum seekers are more prone to posttraumatic stress disorder (PTSD) than the general population. This systematic review aims to determine which psychosocial interventions effectively treat PTSD among refugees and asylum seekers in low- and middle-income countries (LMIC). Relevant papers were retrieved from the bibliographic databases. PTSD symptoms post-intervention was the primary outcome. Ten studies were selected with 1981 participants. In meta-analyses of Randomised control trials (RCTs), psychosocial interventions for PTSD (SMD −0.60, 95% CI −0.96 to −0.23; I2 = 91%; 95% CI 75–100; nine studies, 1789 participants) were shown to be clinically effective. Also, in case of depression (SMD −0.59, 95% CI −0.95 to −0.22; I2 = 84%; 95% CI 50–90; seven studies, 1248 participants). Eye Movement Desensitization and Reprocessing (EMDR) had the greatest effect size among psychosocial therapies for this demographic. However, the number of studies is small, and their methodological rigour is limited, thus future study should concentrate on performing more rigorous trials. [ABSTRACT FROM AUTHOR]

Dear Editor, Chanen is highly critical of our paper which heightened awareness of unproven psychotherapies for adolescent borderline personality disorder (BPD).[1],[2] Our aim was to protect traumatised young people from treatments without demonstrated efficacy that might otherwise cause harm. The early detection of BPD is unreliable because the categorical BPD diagnosis produces heterogeneous groups with high comorbidity needing differing approaches. [Extracted from the article]

The new RANZCP guidelines for the treatment of schizophrenia and related disorders highlights what we know works. In this paper, we examine why patients so often fail to benefit from this knowledge and why clinical practice falls so far short of the recommended standard. Instead of the continuous improvement that we expect of health care in general, in psychiatry we face an accelerating decline in systems of care. There has been a sustained underinvestment in public mental health care and a shared failure by State and Federal governments to construct and commit to a governance and funding model that can deliver the standard of care that is available in other major non-communicable diseases, and which we know is equally possible for severe mental illness. This paper sets out some of the reasons for the poor quality of care received by many people with schizophrenia and related disorders in Australia, and describes ways that care could be improved. In particular, we recommend an explicit statement of what constitutes an adequate standard of care, for people at all stages of these illnesses. This would help provide transparency about whether the care provided by mental health services achieves these benchmarks, and enable publication of results comparing the performance of different states and regional services. Patients and families, as well as professional, consumer and carer organizations would then be able to see clearly where the deficits are and demand resources and care that match the recommendations. [ABSTRACT FROM AUTHOR]

This paper uses the unique collection of Scottish outsider art, labelled Art Extraordinary, as a window into the often neglected small spaces of asylum care in the early twentieth century. By drawing upon materials from the Art Extraordinary collection and its associated archives, this paper demonstrates the importance of incorporating small and everyday spaces of care -- such as gardens, paths, studios and boats -- into the broader historical narratives of psychiatric care in Scotland. Examples of experiential memorialization and counterpoints to asylum surveillance culture will be illuminated. The significance of using 'outsider' art collections as a valuable source in tracing geographical histories will be highlighted. [ABSTRACT FROM AUTHOR]

Objective: Mental Health Act 2016 (Qld) (MHA 2016) includes many 'less restrictive ways' to minimise involuntary/compulsory treatment. One such measure, the statutory health attorney, has been adopted from the Powers of Attorney Act 1998 (Qld). This paper analyses the statutory health attorney provision against the human rights framework adopted by the United Nations Convention on the Rights of Persons with Disabilities (CRPD). Method: The statutory health attorney provision was analysed against the CRPD article 12 (equal recognition before the law). Results: The statutory health attorney provision is not based on the will and preferences of the individual, is not free from conflict of interest and is not subject to the required safeguards. Conclusion: The use of a statutory health attorney brings mental health and physical health under the same provision (the fusion law/proposal). However, the statutory health attorney provision is not compatible with the contemporary human rights framework adopted by the CRPD. [ABSTRACT FROM AUTHOR]

In the United States, the National Institute of Mental Health (NIMH) is seeking to encourage researchers to move away from diagnostic tools like the Diagnostic and Statistical Manual of Mental Disorders (the DSM). A key mechanism for this is the "Research Domain Criteria" (RDoC) initiative, closely associated with former NIMH Director Thomas Insel. This article examines how key figures in US (and UK) psychiatry construct the purpose, nature, and implications of the ambiguous RDoC project; that is, how its novelty is constituted through discourse. In this paper, I explore and analyze these actors' accounts of what is new, important, or (un)desirable about RDoC, demonstrating how they are constituted through institutional context and personal affects. In my interviews with mental health opinion leaders, RDoC is presented as overly reliant on neurobiological epistemologies, distant from clinical imaginaries and imperatives, and introduced in a top-down manner inconsistent with the professional norms of scientific research. Ultimately, the article aims to add empirical depth to current understandings about the epistemological and ontological politics of contemporary (US) psychiatry and to contribute to science and technology studies (STS) debates about "the new" in technoscience. Accordingly, I use discussions about RDoC as a case study in the sociology of novelty. [ABSTRACT FROM AUTHOR]

Since the completion of the Human Genome Project, personalized medicine has become one of the most influential visions guiding medical research. This paper focuses on the politics of personalized medicine in psychiatry as a medical specialty, which has rarely been investigated by social science scholars. I examine how this vision is being sustained and even increasingly institutionalized within the mental health arena, even though related research has repeatedly failed. Based on a document analysis and expert interviews, this article identifies discursive strategies that help to sustain this vision and its promises: "complexity talk," "extension," and "boundary work." These practices secure its plausibility, protect it from criticism, and maintain stakeholder support. [ABSTRACT FROM AUTHOR]

Background: Like other integrated health systems, the US Department of Veterans Affairs has widely implemented telehealth during the past decade to improve access to care for its patient population. During major crises, the US Department of Veterans Affairs has the potential to transition healthcare delivery from traditional care to telecare. This paper identifies the types of Veterans Affairs telehealth services used during Hurricane Sandy (2012), and examines the patient characteristics of those users.Methods: This study conducted both quantitative and qualitative analyses. Veterans Affairs administrative and clinical data files were used to illustrate the use of telehealth services 12 months pre- and 12 months post- Hurricane Sandy. In-person interviews with 31 key informants at the Manhattan Veterans Affairs Medical Center three-months post- Hurricane Sandy were used to identify major themes related to telecare.Results: During the seven-month period of hospital closure at the Manhattan Veterans Affairs Medical Center after Hurricane Sandy, in-person patient visits decreased dramatically while telehealth visits increased substantially, suggesting that telecare was used in lieu of in-person care for some vulnerable patients. The most commonly used types of Veterans Affairs telehealth services included primary care, triage, mental health, home health, and ancillary services. Using qualitative analyses, three themes emerged from the interviews regarding the use of Veterans Affairs telecare post- Hurricane Sandy: patient safety, provision of telecare, and patient outreach.Conclusion: Telehealth offers the potential to improve post-disaster access to and coordination of care. More information is needed to better understand how telehealth can change the processes and outcomes during disasters. Future studies should also evaluate key elements, such as adequate resources, regulatory and technology issues, workflow integration, provider resistance, diagnostic fidelity and confidentiality, all of which are critical to telehealth success during disasters and other crises. [ABSTRACT FROM AUTHOR]

Psychiatrist Édouard Toulouse (1865–1947) is known today for his 1896 psychometric study of the novelist Émile Zola, and his contributions to mental hygiene, sexology, eugenics, and labour efficiency in inter-war France. This paper examines research undertaken in Toulouse's Laboratory of Experimental Psychology at the Villejuif asylum near Paris. In 1905, Toulouse created a test that could differentiate between dementia and mental confusion, a test that could aid in the classification of patients at the overcrowded Villejuif facility. By 1920, however, the test's early promise was undercut by unforeseen, 'machinic' resistance that emerged in the experimental process. This case study demonstrates the non-linear nature of scientific practice and limits of even the most innovative asylum reforms in this period. [ABSTRACT FROM AUTHOR]

This mixed-methods, exploratory study investigates the gambling activities of street youth in Mumbai, India. Data from surveys and brief interviews of 70 youth aged 12–24, two focus groups, and ethnographic observations offer descriptive snapshots of the gambling behavior of participants. The article includes details about games played, popular venues, initiation patterns, time spent gambling, and interactions with the police. Street youth gamble for social benefits, such as group membership and fun; it is also a leisure activity enabling time to go by quickly. Individual benefits include intermittent rewards and a high after winning or being referred to as a gambler. The inability to save, the lack of recreation options, living in groups, and the environment of the streets structure and sustain gambling. This study discusses the group and social dimension of gambling among street youth, and how this dimension makes their participation different from adolescent gambling in general and General Addictions Theory. It contributes to the literature by emphasizing that for street youth the social/group aspects of gambling predominate the psychological. The paper concludes with a discussion of the implications for practice, highlighting the need to develop recreational, income-saving, and educational awareness programs. [ABSTRACT FROM AUTHOR]

Despite making a substantial contribution to the development of mental health services in colonial Australia, until now the story of Dr Patrick Hill's (1794–1852) life has been overlooked by historians. This paper reviews primary sources including clinical notes, patient lists, letters, government documents and newspaper articles which reveal that Dr Hill was a dedicated physician who played a vital role in the development of Australian mental healthcare. He was held in such esteem that by the time of his sudden death in 1852 he had been elevated to the most senior medical office in New South Wales. Dr Hill's career serves to exemplify how the local practice of individual colonial doctors helped build the reputation of medicine in the modern era. [ABSTRACT FROM AUTHOR]

Objective: This paper reports on substance use, mental health problems, and mental health service utilisation in an early adolescent school-based sample.Method: Participants were 1,360 grade 7 and 8 students from 4 regions of Ontario, Canada. Students completed an in-class survey on mental health and substance use. The sampling strategy and survey items on demographics, substance use, service utilisation, and distress were adapted from the Ontario Student Drug Use and Health Survey. Internalising and externalising mental health problems were assessed using the Global Assessment of Individual Needs - Short Screener. Distress was defined as fair or poor self-rated mental health.Results: Rates of internalising and/or externalising problems above the threshold exceeded 30%; yet, fewer than half had received mental health services in the past 12 mo. Substance use was associated with increased odds of internalising and externalising problems above the threshold and distress. Youth using cannabis had 10-times the odds of exceeding the threshold for internalising or externalising problems. The use of substances other than alcohol or cannabis was associated with increased odds of fair or poor self-rated mental health among grade 8 students. Of the youth who confirmed at least a substance use problem, most also reported mental health problems; this association was stronger among girls than boys.Conclusions: Early adolescent substance use was associated with concurrent self-reported mental health problems in a non-clinical sample. The low levels of service utilisation reported highlight the need for improved access to early identification and intervention to prevent the development of concurrent disorders. [ABSTRACT FROM AUTHOR]

Objective:: The purpose of this paper is to provide some learnings for the NDIS from the referral pattern and cost of implementing the Partners in Recovery initiative of Gippsland.Method:: Information on referral areas made for each consumer was collated from support facilitators. Cost estimates were determined using budget estimates, administrative costs and a literature review and are reported from a government perspective.Results:: Sixty-three per cent of all referrals were made to organisations that provided multiple types of services. Thirty-one per cent were to Mental Health Community Support Services. Eighteen per cent of referrals were made to clinical mental health services. The total cost of providing the service for a consumer per year (set-up and ongoing) was estimated to be AUD$15,755 and the ongoing cost per year was estimated to be AUD$13,434. The cost of doing nothing is likely to cost more in the longer term, with poor mental health outcomes such as hospital admission, unemployment benefits, prison, homelessness and psychiatric residential care.Conclusions:: Supporting recovery in persons with Severe and Persistent Mental Illness is likely to be economically more beneficial than not doing so. Recovery can be better supported when frequently utilised services are co-located. These might be some learnings for the NDIS. [ABSTRACT FROM AUTHOR]

Objective: To assess depression literacy, help-seeking and help-offering to others in members of the police force in the state of Victoria, Australia. Methods: All staff in police stations involved in a cluster randomised controlled trial of an integrated workplace mental health intervention were invited to participate. Survey questions covered sociodemographic and employment information, recognition of depression in a vignette, stigma, treatment beliefs, willingness to assist co-workers with mental health problems, help-giving and help-seeking behaviours, and intentions to seek help. Using the baseline dataset associated with the trial, the paper presents a descriptive analysis of mental health literacy and helping behaviours, comparing police station leaders and lower ranks. Results: Respondents were 806 staff, comprising 618 lower-ranked staff and 188 leaders. Almost 84% of respondents were able to correctly label the problem described in the vignette. Among those who had helped someone with a mental health problem, both lower ranks and leaders most commonly reported ‘talking to the person’ although leaders were more likely to facilitate professional help. Leaders’ willingness to assist the person and confidence in doing so was very high, and over 80% of leaders appropriately rated police psychologists, general practitioners, psychologists, talking to a peer and contacting welfare as helpful. However, among both leaders and lower ranks with mental health problems, the proportion of those unlikely to seek professional help was greater than those who were likely to seek it. Conclusion: Knowledge about evidence-based interventions for depression was lower in this police sample than surveys in the general population, pointing to the need for education and training to improve mental health literacy. Such education should also aim to overcome barriers to professional help-seeking. Interventions that aim to improve mental health literacy and help-seeking behaviour appear to be suitable targets for better protecting police member mental health. [ABSTRACT FROM AUTHOR]

Many longitudinal studies have investigated whether self‐esteem predicts depressive symptoms (vulnerability model) or the other way around (scar model) in adolescents. The most common method of analysis has been the cross‐lagged panel model (CLPM). The CLPM does not separate between‐person effects from within‐person effects, making it unclear whether the results from previous studies actually reflect the within‐person effects or whether they reflect differences between people. We investigated the associations between self‐esteem and depressive symptoms at the within‐person level, using random intercept cross‐lagged panel models (RI‐CLPMs). To get an impression of the magnitude of possible differences between the RI‐CLPM and the CLPM, we compared the results of both models. We used data from three longitudinal adolescent samples (age range: 7–18 years; study 1: N = 1948; study 2: N = 1455; study 3: N = 316). Intervals between the measurements were 1–1.5 years. Single‐paper meta‐analyses showed support for small within‐person associations from self‐esteem to depressive symptoms, but not the other way around, thus only providing some support for the vulnerability model. The cross‐lagged associations in the aggregated RI‐CLPM and CLPM showed similar effect sizes. Overall, our results show that over 1‐ to 1.5‐year time intervals, low self‐esteem may negatively influence depressive symptoms over time within adolescents, but only weakly so. © 2018 The Authors. European Journal of Personality published by John Wiley & Sons Ltd on behalf of European Association of Personality Psychology [ABSTRACT FROM AUTHOR]

Objective: This paper identifies publicly available data about the use of involuntary treatment orders within Australia and considers whether this reporting is sufficient given the gravity of the intervention.Method: A search of mental health tribunal, health department and justice department annual reports was conducted to determine the use of involuntary treatment orders in Australia.Results: Reporting of involuntary treatment orders varied significantly across jurisdictions; for example, South Australia reported 11,570 distinct orders made during a 12-month period while the Australian Capital Territory reported 627 for the same period.Conclusion: The publicly available data for involuntary treatment orders in Australia is inadequate for jurisdictional comparisons. This concern should be addressed to enable transparent public reporting and facilitate benchmarking. [ABSTRACT FROM AUTHOR]

Objectives: This paper reports a pilot study exploring the benefits of offering sensory modulation within a mental health emergency setting for consumers experiencing distress during a psychiatric presentation.Methods: Seventy-four consumers with a mental health presentation reported on their sensory modulation use experiences during their stay in a South Australian tertiary teaching hospital emergency department. An evaluation form was used to document use of items, self-reported distress pre and post sensory modulation use, and other consumer experiences.Results: Consumers used between one and six sensory items for a median duration of 45 min. There was a statistically significant reduction ( t(73) = 15.83, p < .001) in self-reported distress post sensory modulation use, and consumers also reported that use was helpful, distracting, calming and assisted in managing negative emotions and thoughts.Conclusions: The results demonstrate the potential value of sensory-based interventions in reducing behavioural and emotional dysregulation in an emergency setting whilst also promoting consumer self-management strategies. [ABSTRACT FROM AUTHOR]

The accident at Fukushima Daiichi nuclear power plant occurred following the huge tsunami and earthquake of 11 March 2011. After the accident, there was considerable uncertainty and concern about the health effects of radiation. In this difficult situation, emergency responses, including large-scale evacuation, were implemented. The Fukushima Health Management Survey (FHMS) was initiated 3 months after the accident. The primary purposes of FHMS were to monitor the long-term health of residents, promote their well-being, and monitor any health effects related to long-term, low-dose radiation exposure. Despite the severity of the Fukushima accident and the huge impact of the natural disaster, radiation exposure of the public was very low. However, there were other serious health problems, including deaths during evacuation, increased mortality among displaced elderly people, mental health and lifestyle-related health problems, and social issues after the accident. The Nuclear Emergency Situations - Improvement of Medical and Health Surveillance (SHAMISEN) project, funded by the Open Project For European Radiation Research Area, aimed to develop recommendations for medical and health surveillance of populations affected by previous and future radiation accidents. This paper briefly introduces the points that have been learned from the Fukushima accident from the perspective of SHAMISEN recommendations. [ABSTRACT FROM AUTHOR]

The article presents a paper, a part of a planned series of Elements of Care papers, focusing on identifying common elements which are important for providing appropriate psychiatric care in different models of care in Canada. It focuses on direct patient care or service for payment in traditional care model and also discusses indirect services involved in such models, like diagnostic assessment or patient management. It also focuses on involvement of family or caregivers in indirect services.

We conducted a scoping review of the literature on the clinical applications of videoconferencing. Electronic searches were performed using the PubMed, Embase and CINHAL databases to retrieve papers published from 2002 to 2012 that described clinical applications of videoconferencing. The initial search yielded 4923 records and after removing the duplicates and screening at title/abstract level, 505 articles met the inclusion criteria and were reviewed at full-text level. The countries with the highest number of papers were the US, Australia and Canada. Most studies were non-randomised controlled trials. The discipline with highest number of published studies (39%) was mental health, followed by surgery (7%) and general medicine (6%). The type of care delivered via video comprised acute, sub-acute and chronic care, but in 44% of the papers, the intervention was used for a combination of these purposes. Videoconferencing was used for all age groups but more frequently for adults (20%). Most of the papers (91%) reported using videoconferencing for several clinical purposes including management, diagnosis, counselling and monitoring. The review showed that videoconferencing has been used in a wide range of disciplines and settings for different clinical purposes. The practical value of published papers would be improved by following standard guidelines for reporting research projects and clinical trials. [ABSTRACT FROM PUBLISHER]

Objective: In inpatient forensic settings, a psychiatrist is expected to wear 'Two Hats', as a treating physician and as an expert to provide risk assessments and expert advice to the judicial authorities for leave and release decisions. Although dual roles have long been accepted as an inevitable part of independent forensic practice, there are additional ethical challenges for the treating psychiatrist to provide an expert opinion. This paper examines the specific ethical ambiguities for a treating psychiatrist at the interface of legal process related to leave and release decisions in the treatment of forensic patients.Conclusions: While respect for justice is the prevailing ethical paradigm for court-related forensic work, the medical paradigm should remain the key ethical framework for psychiatrists in treatment settings. Thus, psychiatrist should be aware of possible adverse consequences in acting as forensic experts for their patients. A conscientious adherence to clinical facts and awareness of the 'Two Hats' ethical pitfall can serve as important reference points in framing the psychiatric evidence in the decision-making process and safeguard treating psychiatrist's role. [ABSTRACT FROM AUTHOR]

1. This article aims to provide a long-term update 2 years on from our initial paper and summarises service evaluation data collected from 21 pain management programmes, using a solution-focused approach in a community pain service. 2. An examination of the larger baseline and subsequent follow-up data suggests an improvement in participants' function, pain self-efficacy and mental well-being following CPS PMP, and corroborates the findings of the earlier dataset. 3. Additional findings suggest that CPS PMP may help pain interfere less in participants' lives (post-PMP and at 10-week follow-up) and that improvements in mental well-being and self-efficacy are maintained on a long-term basis (at 6- and 12-month follow-up). Limitations of the data are discussed. 4. The article also discusses the nature of community healthcare services for chronic pain, including how we view PMP treatment intensity, deliver cost effectiveness, measure outcomes and support patients post-PMP. 5. It is suggested that effective, meaningful PMPs can be facilitated successfully by multi-professional teams in the community, at arguably lower cost than secondary/tertiary settings, while enabling convenient and long-lasting integration of self-management into people's lives. [ABSTRACT FROM AUTHOR]

Objectives: Animal-assisted therapy (AAT) is a growing field in Australia, and therapy dogs are becoming increasingly common in clinical settings. This paper aims to highlight the current issues facing AAT in Australia and to make recommendations on how to progress the field. We acknowledge that there are several ways that therapy dogs may enhance treatment outcomes for clients, such as reductions in stress and acute anxious arousal, and improvements in engagement and rapport. These psychological and physiological advantages, however, may not be sustained once interaction with the dog ceases. Clinicians require adequate training and support to develop and implement interventions that are based on sound theoretical foundations, and take advantage of the adjunctive benefits of animal presence.Conclusions: A series of recommendations are made for the professionalisation of AAT, including the development of consensus definitions, clinical governance, accreditation, research and evaluation. [ABSTRACT FROM AUTHOR]

Objectives: Suicide is a leading cause of premature death and, despite significant investment, the prevalence rate has remained relatively stable for more than a decade. Theoretically, the use of 'safety planning' as a response to suicidality likely maintains suicide as a potential solution for vulnerable people. This paper describes a theoretically-supported paradigm shift from safety planning to 'coping planning' to improve patient outcomes and improve the confidence and competence of clinicians working with people with suicidality.Conclusions: Coping planning is a strategy used to support people with acute distress. Its components of 'caring', 'collaborating' and 'connecting' reinforce existing strengths, promote self-efficacy and link people with more intensive supports, as needed. Coping planning overcomes the limitations of existing approaches. It reframes suicide prevention from managing patients disclosing suicidality to ensuring patients have minimally sufficient temporary support to help them cope. This approach has the potential to promote coping self-efficacy and prevent deterioration that leads to suicide. [ABSTRACT FROM AUTHOR]

During the First World War injured servicemen were constructed as a better class of patient than civilians, and their care was prioritized in social and political discourses. For the mentally disordered servicemen themselves, however, these distinctions were permeable and transient.This article will challenge the reality of the ‘privileged’ service patient in civil asylums in Scotland. By examining the impact of the war on asylum structures, economies and patient health, this study will explore exactly which patients were valued in these difficult years. In so doing, this paper will also reveal how the lives of institutionalized ex-servicemen and the civilian insane inside district asylums were not quite as distinct as political and social groups would have liked. [ABSTRACT FROM AUTHOR]

Despite its enduring insights, Durkheim’s theory of suicide fails to account for a significant set of cases because of its overreliance on structural forces to the detriment of other possible factors. In this paper, we develop a new theoretical framework for thinking about the role of culture in vulnerability to suicide. We argue that by focusing on the cultural dynamics of excessive regulation, particularly at the meso level, a more robust sociological model for suicide could be offered that supplements structure-heavy Durkheimian theory. In essence, we argue that the relevance of cultural regulation to suicide rests on the (1) degree to which culture is coherent in sociocultural places, (2) existence of directives related to prescribing or proscribing suicide, (3) degree to which these directives translate into internalized meanings affecting social psychological processes, and (4) degree to which the social space is bounded. We then illustrate how our new theory provides useful insights into three cases of suicide largely neglected within sociology: specifically, suicide clusters in high schools, suicide in the military, and suicides of “despair” among middle-aged white men. We conclude with implications for future sociological research on suicide and suicide prevention. [ABSTRACT FROM AUTHOR]

Night terrors are phenomena that emerge in the phase of deep sleep in children and that are extremely disturbing for the parents. While research suggests that they tend to resolve by middle childhood, in children where these persist and cause dysfunction, behavioral interventions have proved to be useful. The paper presents the case report of an 8-year-old boy, who presented with night terrors and a decline in academic performance. In therapy along with using behavioral techniques and parent management strategies, creative modalities including art-work and play were employed. The child though vocal could not describe vocally the nighttime events or his understanding of possible stresses. With the use of projective techniques in assessment and semi-structured techniques in therapy, several difficult and possibly traumatic life events were understood and resolved with the child. [ABSTRACT FROM AUTHOR]

IN EARLY CHILDHOOD EDUCATION and care (ECEC) settings, the mental wellbeing of educators is likely to be crucial to delivering high-quality care. Hence, this paper uses a contextual understanding of educators' mental health, and its evaluation by both educators and management, to reveal areas of the National Quality Framework that require critical revision. Drawing on Hochschild's (2012) theory of emotional labour, we report on the analysis of semi-structured interviews with family day care educators (n = 16) and ECEC sector key informants (n = 18). Results demonstrate widespread belief that educator mental wellbeing affects care quality and the children attending care. In response to job stressors and perceived surveillance, educators use emotional labour to hide negative feelings and manage risks associated with low mental wellbeing. In this context, making individual educators fully responsible for performing good mental health to meet the National Quality Standard may increase job stress and emotional labour, further distancing the aims of high-quality care. Our findings suggest that revising the NQS to improve working conditions, and addressing educator mental wellbeing are essential approaches for supporting high-quality ECEC practice. [ABSTRACT FROM AUTHOR]

Objectives: Evaluation of physical activity (PA) programs among populations with severe mental illness (SMI) has predominately focused on efficacy and therapeutic benefits. There is now strong evidence to support the benefits of PA in people with SMI. What remains is a gap in the implementation of pragmatic and sustainable PA interventions in mental-health settings. The current paper provides examples of interventions that have been successfully implemented in Australian settings, identifies key components of successful PA interventions and outlines practical strategies that can assist with widespread implementation of PA interventions in mental-health settings.Conclusions: There is an emergence of PA interventions being imbedded within a variety of mental-health settings. These interventions vary in terms of mode and intensity of service delivery. Yet, all aim to increase PA and reduce sedentary behaviour. Adopting the identified strategies may help facilitate successful implementation and increase access to PA interventions for mental-health service users. [ABSTRACT FROM AUTHOR]

Objective: The mass media may increase stigma against people with mental health problems by reinforcing common stereotypes. Media professionals thus represent a target group for antistigma interventions. This paper aims to review available literature on antistigma interventions for mass media professionals, seeking to clarify what kind of interventions have been found to be effective in reducing mental health stigma among mass media professionals.Method: Six electronic databases (MEDLINE, PsycINFO, Embase, Cochrane Reviews Library and Cochrane Central Register of Controlled Trials, Web of Science, and Applied Social Sciences Index & Abstracts) were systematically searched through March 2017 for studies addressing antistigma interventions on mass media professionals.  Results: A total of 27 studies on antistigma interventions targeted to media professionals were found. Reviewed articles were classified into 3 categories: media-monitoring projects/reporting guidelines ( n = 23), interventions for educating journalists ( n = 2), and interventions for educating journalism students ( n = 2). Overall, antistigma interventions for media professionals seem to have some effect in improving reporting style, thus providing a more balanced portrayal of people with mental health problems: the most promising interventions are contact-based educational approaches and the provision of guidelines by authoritative institutions.Conclusion: It should be useful to promote and disseminate contact-based educational interventions targeted to journalists and to include specific modules on mental health topics in the training curricula of journalism students. However, as research in the field suffers from several limitations, high-quality studies exploring the long-term effect of antistigma interventions for media professionals are needed. [ABSTRACT FROM AUTHOR]

The past one decade has witnessed a boom in the availability of Internet-based self-help apps in the field of mental health. Several apps have emerged that aim to provide information and strategies to empower individuals with self-help approaches to deal with issues and concerns related to mental health. A large number of these apps in developing countries are likely to be those which depend entirely on the users to go over the self-help program on their own (unguided internet-based self-help). Only a few apps add a component of periodic professional contact/technical support through phone/email or other means to supplement the self-help strategies suggested in the app that the user is expected to utilize. This scenario poses several challenges in use of unguided self-help apps for mental health. This paper enumerates some of these challenges for potential users of the apps from the perspective of clinicians. These range from difficulties in choosing the right app, limited scope for contextualization, and motivation management to awareness about when to step up to a higher intensity intervention. Despite these challenges, unguided self-help apps can serve important purposes, and hence we propose a few recommendations to address such challenges. [ABSTRACT FROM AUTHOR]

Objective: This paper aims to analyse in a philosophically informed way the recent National Institute of Mental Health proposal for the Research Domain Criteria (RDoC) framework.Conclusion: Current classification systems have helped unify psychiatry and the conditions that it is most concerned with. However, by relying too much on syndromes and symptoms, they too often do not define stable constructs. As a result, inclusions and removals from the manuals are not always backed by sound reasons. The RDoC framework is an important move towards ameliorating matters. This paper argues that it improves the current situation by re-referencing constructs to physical properties (biomarkers for disorders, for example), by allowing theoretical levels within the framework, and by treating psychiatry as a special case of the cognitive sciences. [ABSTRACT FROM AUTHOR]

This paper is an initial attempt to collate the literature on psychiatric inpatient recovery- based care and, more broadly, to situate the inpatient care sector within a mental health reform dialogue that, to date, has focused almost exclusively on outpatient and community practices. We make the argument that until an evidence base is developed for recovery- oriented practices on hospital wards, the effort to advance recovery-oriented systems will stagnate. Our scoping review was conducted in line with the 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (commonly referred to as PRISMA) guidelines. Among the 27 papers selected for review, most were descriptive or uncontrolled outcome studies. Studies addressing strategies for improving care quality provide some modest evidence for reflective dialogue with former inpatient clients, role play and mentorship, and pairing general training in recovery oriented care with training in specific interventions, such as Illness Management and Recovery. Relative to some other fields of medicine, evidence surrounding the question of recovery-oriented care on psychiatric wards and how it may be implemented is underdeveloped. Attention to mental health reform in hospitals is critical to the emergence of recovery-oriented systems of care and the realization of the mandate set forward in the Mental Health Strategy for Canada. [ABSTRACT FROM AUTHOR]