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Purpose: A cancer diagnosis can result in a considerable financial burden to individuals and their households. This study aimed to investigate this problem in patients treated for melanoma brain metastases. Methods: An economic evaluation was conducted as a sub-study of a randomised controlled trial of whole brain radiotherapy (WBRT) versus observation following surgery and/or stereotactic radiosurgery (SRS) for 1-3 melanoma brain metastases. Employment status and pre-tax household income were measured at baseline and every 2 months for 12 months. Outcomes included changes in employment status or household income category at 12 months. Results: Of 125 patients, 64 were included in the analysis, 31 randomised to WBRT and 33 to observation, 61 patients were excluded because they were not in the workforce at baseline (42) or were unsure about their income (19). Mean age was 61 years (range 27-88), 37 (58%) completed employment questionnaires and 61 (96%) completed income questionnaires at baseline. Prior to treatment, 39% worked full-time, 8% part-time and 53% were unemployed. At 12 months, 23%, 12% and 65% individuals were employed full-time, part-time and unemployed, respectively. Job status change and household income at 12 months were not significantly different between the two treatment groups (p=0.18 and 0.87, respectively). Conclusions: A substantial proportion of patients experienced job loss after treatment of melanoma brain metastases, however this was similar for those undergoing WBRT or observation alone. Strategies to reduce the impact for both groups (e.g., financial counselling, employment rehabilitation) could be implemented by clinicians and allied health workers.

Purpose News reporting on mental illness can perpetuate stigma. An understanding of the current picture of such reporting is important to identify areas for improvement. This study investigated the quality of Australian news media coverage of complex mental illness in the context of crime and violence over a 2-year period, prior to the release of new media guidelines. Methods This research utilised a systematic search of Australian news articles that were published between July 2018 and July 2020 and reported on mental illness in relation to violent crime. Researchers developed a Mental Illness and Crime Reporting Quality Framework to determine quality scores for news articles according to 11 relevant factors in media guidelines. An additional 11 characteristics of articles were extracted for further descriptive analysis. Results One-hundred and twenty-eight Australian news articles met inclusion criteria. The average quality score was 50 (SD = 13.91) out of a possible maximum score of 100 (range 11 – 78). Strengths and weaknesses were identified as some criteria were consistently met, and other criteria were met rarely or not at all. There were emerging trends between quality scores and article characteristics, including publication source, though these analyses were not statistically significant. Conclusion The findings indicate that Australian news coverage of complex mental illness and violent crime met half of the criteria of reporting guidelines that minimises risk of perpetuating or reinforcing stigma. This demonstrates significant opportunity to improve the overall quality of media reporting on crime and mental illness. Future research should evaluate the impact of the guidelines on the quality of news reporting after their implementation by utilising a similar methodology, using these findings as a baseline measure.