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To examine whether primary care outreach facilitation improves the quality of care for general practice patients from refugee backgrounds. Pragmatic, cluster randomised controlled trial, with stepped wedge allocation to early or late intervention groups. 31 general practices in three metropolitan areas of Sydney and Melbourne with high levels of refugee resettlement, November 2017 ‒ August 2019. Trained facilitators made three visits to practices over six months, using structured action plans to help practice teams optimise routines of refugee care. Change in proportion of patients from refugee backgrounds with documented health assessments (Medicare billing). Secondary outcomes were refugee status recording, interpreter use, and clinician‐perceived difficulty in referring patients to appropriate dental, social, settlement, and mental health services. Our sample comprised 14 633 patients. The intervention was associated with an increase in the proportion of patients with Medicare‐billed health assessments during the preceding six months, from 19.1% (95% CI, 18.6–19.5%) to 27.3% (95% CI, 26.7–27.9%; odds ratio, 1.88; 95% CI, 1.42–2.50). The impact of the intervention was greater in smaller practices, practices with larger proportions of patients from refugee backgrounds, recent training in refugee health care, or higher baseline provision of health assessments for such patients. There was no impact on refugee status recording, interpreter use increased modestly, and reported difficulties in refugee‐specific referrals to social, settlement and dental services were reduced. Low intensity practice facilitation may improve some aspects of primary care for people from refugee backgrounds. Facilitators employed by local health services could support integrated approaches to enhancing the quality of primary care for this vulnerable population. Australian New Zealand Clinical Trials Registry, ACTRN12618001970235 (retrospective).

The article discusses the need for therapists to be alert to the mental health effects of physically generated symptoms in clients. It is noted that while myxoedema is thankfully rare, clients who have been diagnosed with a thyroid issue are often living with challenging physical symptoms that affect their mental state. Some research suggests an element of permanence to a client's psychological state due to its biological origin.

Strategies motivating employers and high‐level management to provide workplace‐based health and well‐being programs are needed. Recognition Schemes, acknowledging organisations for providing a healthy workplace, may help to motivate them. Semi‐structured telephone interviews with representatives of 35 workplaces that had achieved Awards in the Recognition Scheme of a state government Healthy Workplace program. Interviewees were mainly interested in having the work they were already doing recognised by staff and management internally. For some, external recognition was also important. Many were disappointed with the form the recognition took, feeling it did not have the gravitas it needed to be useful. Despite this, most Bronze and Silver Award winners indicated they would reapply in future, though some Gold recipients were not convinced the rigorous process was worthwhile. Recognition schemes may encourage organisations to offer or improve Healthy Workplace programs. This project demonstrated that the form the recognition takes and the way it is awarded is important to recipients, and that the scheme must be well promoted externally if it is to achieve its potential benefits. Effective workplace health and well‐being programs require commitment from high‐level management including providing adequate time and resources. Recognition schemes may lead to greater effort and investment by workplaces, but the Schemes must be well promoted and highly visible for participating workplaces to feel the effort that goes into applying for recognition is worthwhile. If recognition is not valued within and outside organisations, the potential benefits will not be realised.

In the article, the author discusses issues in counselling and psychotherapy professions, particularly how to deal with patients who cannot control their emotions and actions when in distress. She claims that such actions are like those seen in soap operas. Also cited are her claim that such behaviour is often issue-based, the studies on the topic like the Stamford Prison experiment by psychologist Phillip Zimbardo, and the opinion by philosopher Julian Baggini on the concept of self.