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Background: This paper explores the mental health and wellbeing outcomes of a massed community choir program in Australia. Methods: This study employed a mixed methods approach. Data were collected via a survey of choir participants (N = 305), four qualitative interviews and focus groups with facilitators and participants (N = 22), and two workshops with organising staff (N = 5). Questions were derived from a co-designed program logic, and data were triangulated and analysed thematically. Results: Participants reported feeling a sense of connectedness (psychological), but also experiencing connection (social) with their fellow singers. Psychological outcomes included the sensations of affect, arousal, and affirmation. Social outcomes included experiencing belonging, inclusion, and sharing. These positive psycho- social experiences promoted positive mental health and wellbeing outcomes in the large group of participating singers. Conclusions: This paper addresses gaps in our understanding about the mental health and wellbeing outcomes fostered by community choirs at scale. [ABSTRACT FROM AUTHOR]

Emergency situations such as pandemics typically widen inequities, and Australian children and young people with disability already face significant inequities in the education system. In this paper we draw on survey data from over 700 respondents exploring education experiences during the COVID-19 pandemic. Many families reported being left behind, finding it difficult to access education remotely, and that this was having a significant impact on wellbeing and mental health. We find that of all support offered by schools, social supports have a stronger association with learner engagement than educational interventions. This finding indicates the importance of social and emotional supports in learning. The COVID-19 pandemic has significantly disrupted education for most learners; There is good evidence to suggest this impact is felt more keenly by students with disability, because there is disability discrimination in the Australian education system; This paper reports survey responses from over 700 families of students with disability exploring the impact of COVID-19 on education; Many families report being left behind and that students found it difficult to learn away from the school campus, which for many students and families led to poorer wellbeing and mental health; Our results suggest that supporting students to have social contact with peers made the biggest impact on students with disability feeling engaged with learning during this time. This shows it is important for teachers and schools to pay attention to social as well as educational aspects of school life when thinking about how to educate students with disability. [ABSTRACT FROM AUTHOR]

Under the Victorian 2014 Mental Health Act (MHA14), Victorians have a right to advance statements. While there have been initiatives to support uptake, under 3% of consumers have done so. In March 2021, the Royal Commission into Victoria's Mental Health System (the Commission) released its report, including a call to repeal MHA14 and enact a new Act no later than mid-2022. In this paper, we discuss the role of advance planning documentation and instruments used in Australian legislation. Drawing on the Commission's recommendations, models of advance planning in Australia and the Victorian legislative context, this paper proposes a model of both binding and non-binding advance directives. This model would bring the rights of Victorian consumers into alignment with rights provided under the Medical Treatment, Planning and Decisions Act 2016 (Vic) and assist in bringing the new Act into compatibility with the Charter of Human Rights and Responsibilities Act 2006 (Vic). [ABSTRACT FROM AUTHOR]

Many countries, including Australia, have laws that enable criminal prosecution of an individual based on reckless or intentional transmission of HIV to another person. Previous research has suggested that criminalisation of HIV may serve to hamper public health efforts by inhibiting HIV status disclosure or testing. Limited research to date has sought to examine the broader impact of criminalisation on the health and wellbeing of people living with HIV, which this paper aims to address. Drawing on cross-sectional data from 895 people living with HIV in Australia, this paper describes associations between standard measures of mental health and resilience with a newly devised scale measuring anxiety about HIV criminalisation. Findings suggest that laws criminalising HIV transmission have a broadly negative impact on wellbeing of people living with HIV, a situation that is exacerbated for gay and bisexual men, and other people living with HIV who may face intersecting forms of marginalisation based on race, gender or class. There is little justification for these laws being applied in Australia and the findings add weight to advocacy seeking to overturn criminalisation across the world. [ABSTRACT FROM AUTHOR]

Analysing survey data from 1,304 LGBTQ + young people in Australia collected in 2016, this paper considers key distinctions between the experiences of bisexual and pansexual participants, and lesbian and gay participants in relation to social media use and aspects of connection, harassment and mental health. Presenting quantitative data, illustrated by qualitative extracts, we found broad similarities in motivations for using social media and how participants connected to peers and communities. There were some statistically significant differences, however, in respondents' motivations for using social media and who they connected with on these platforms. Importantly, bisexual and pansexual participants reported more negative experiences of harassment and exclusion across all major social media platforms when compared to their lesbian and gay peers. Bisexual and pansexual respondents also reported poorer mental health experiences. These findings speak to the different impacts of discrimination and oppression that young people experience in everyday life. There is a need for focused attention on bisexual and pansexual young people in academic, policy and youth-work domains. Young people will benefit from more substantial school-based education on LGBTQ + identities - beyond the experiences of gay and lesbian people - to 'usualise' varieties of difference in gender and sexual identity. [ABSTRACT FROM AUTHOR]

Post-traumatic stress disorder (PTSD) is characterised by a range of symptoms including acute stress, flashbacks and avoidance of situations that trigger trauma. Women from Arabic-speaking backgrounds have been shown to have a higher likelihood of developing PTSD due to life stressors experienced. This paper aimed to provide an overview of the experiences and social circumstances of Arab women experiencing PTSD in Australia. Family, gender roles, religion, mental health stigma, trauma, re-settlement challenges, acculturation and discrimination were some of the factors explored in this review. The paper also aimed to review evidence-based treatment for PTSD such as cognitive behavioural therapy, narrative exposure and eye movement desensitisation therapy and whether these westernised approaches can extend to women from Arab backgrounds. Directions for culturally appropriate interventions and how to adapt treatments to suit the needs of individuals from the Arab community experiencing PTSD are discussed as well as considerations for specifically supporting women from Arab backgrounds who need treatment. Future avenues for research are canvassed and discussed within. KEY POINTS What is already known about this topic: (1) Women from Arabic speaking backgrounds in Western countries have been shown to have a higher likelihood of developing PTSD due to the life stressors that they have experienced. (2) Particular life stressors include migration and acculturation stressors, marginalisation, financial concerns, family responsibilities and for some, family violence which can exacerbate distress and contribute to the expression of PTSD symptoms. (3) No effective PTSD treatments for Arab populations in general, let alone Arab women have been identified in research. What this topic adds: (1) Effective mental health treatment for Arab women must take into consideration certain cultural values such as family, women's role/status and stigmas around mental health. (2) Some of the main factors to consider include beliefs and values, communication and language, shame, strict gender roles and religious healing. (3) There is a significant need for immediate future research to be conducted for this community. [ABSTRACT FROM AUTHOR]

This paper presents a systematic review that assessed the different types of mental health programs and interventions available for young people from Culturally and Linguistically Diverse (CALD) backgrounds in Australia, and identified core elements of practice for supporting the mental health of CALD youth, and key barriers that preclude CALD youth from engaging with mental health services. A total of 19 articles met inclusion criteria and a total of six distinct practices were identified: (1) personalization, identity and recognition of trauma; (2) creative expression; (3) cultural competence; (4) self-efficacy and empowerment; (5) social connections and relationships; and (6) information and content delivery. Key barriers related to engagement with CALD youth mental health programs included language and literacy barriers, stigma and shame, and service providers' limited cultural competency, and lack of diverse understandings of wellbeing. The findings from this review suggest several avenues for ensuring practice that effectively meets the unique mental health needs of CALD young people and reduces barriers to their access and engagement. [ABSTRACT FROM AUTHOR]

Evaluate the utility of brief online training for facilitating mental health professionals' perceived knowledge, confidence, and comfort in working with non-binary clients, and building positive attitudes. Baseline participants were 79 Australian registered mental health professionals, of whom 38 completed online training and a one-week follow-up assessment. Participants completed an assessment of attitudes, comfort, confidence, and perceived knowledge pertaining to non-binary people before and after completing online training. The training (30-minute average completion time) provided information on non-binary people's lives using text, images, embedded video, and links to optional resources. Follow-up measures completed one-week post-intervention indicated engagement in the training may lead to increased perceived knowledge, confidence and comfort. Attitudes were positive at baseline and were not significantly different at follow-up. Providing brief online training for working with non-binary people in mental health might improve practitioner perceived knowledge, confidence and competence at low cost and with easy access. Future research is required to account for limitations and build on current outcomes. Key Points What is already known on this topic: Little is known about the effects of brief online training regarding non-binary genders on mental health practitioner's attitudes, confidence, comfort, and perceived knowledge. Previous research has shown that brief training can increase positive attitudes for, knowledge of, behavioural intent, and cultural competence for working with sexual and gender minorities, though has not specifically focused on non-binary people. Previous literature has highlighted positive associations between practitioner knowledge and the well-being of non-binary people accessing health services. What this paper adds: This paper adds to the ongoing genesis of options for training mental health practitioners about non-binary people and relevant issues. Findings suggest beneficial outcomes from both prior professional training in this area and the brief training used in the study. The brief online training used in the study was associated with higher perceived knowledge, confidence, and comfort for working with non-binary clients, but further research is needed to understand reasons for change in these variables. [ABSTRACT FROM AUTHOR]

This paper explores the environmental, interpersonal, and personal outcomes of music performance in a hospital oncology setting. An original, qualitative research study examined the impact of live music for staff, patients, and carers. Data were collected using a multi-method approach of observations and semi-structured interviews and were analysed using inductive and theory-driven theming that was shaped by a determinants of health framework. The research found that live music promoted stronger relationships and calmer environments, among other environmental, social and individual outcomes. Improved communication between staff through the creation of a more supportive environment was a pertinent finding of the research. No negative effects were reported. We discuss research findings in the context of relevant literature and suggest recommendations for future hospital-based live music programs. Results of this study indicate that live music interventions impacted individual, interpersonal, social and environment factors that led to health and wellbeing outcomes for participants. [ABSTRACT FROM AUTHOR]

Trans and non-binary youth (TNBY) face high levels of interpersonal and social adversity as well as disproportionate rates of mental health issues such as depression, self-harm and suicidal ideation. Among protective factors, context plays a key role. In addition to parental support, access to gender-affirming medical care begins to emerge as crucial for young people needed them. This paper compares, through thematic analysis, the experiences of TNBY with regard to access and experiences to care in Canada, Switzerland, England, and Australia. It identifies similarities and differences in barriers to access to care, as well as impacts of gender affirming care on young people and their well-being. The article concludes with a discussion on the importance of prompt and easier access to gender-affirming medical care, of training of professionals, and a hypothesis about the role of context in TNBY well-being. [ABSTRACT FROM AUTHOR]

The continuity of Australian First Nations (Aboriginal and Torres Strait Islander) culture has been threatened by colonisation and effects of this continue to have devastating impacts on their social emotional wellbeing [SEWB], especially mental health. This review analyses cultural interventions aiming to improve mental health outcomes for First Nations Australians (e.g., mood, self-esteem, suicide-attempts, self-harm, risky behaviours) to uncover the effectiveness and key components of such interventions. Databases PsycINFO, CINAHL, EMBASE, EMCARE, LIt.search tool from Lowitja Inst, Australian Indigenous Health InfoNet and Google Scholar were searched. Studies published between 2000 and 2021 which reported the impact of cultural interventions on the mental health of First Nations Australians were included. From 172 studies, only eight studies met inclusion criteria and all improved measured domains of SEWB. Six studies evaluated culturally adapted interventions (i.e., Western interventions adapted to be culturally appropriate) and two evaluated culturally grounded interventions (i.e., interventions developed by First Nations Australians). Participants called for more cultural components in culturally adapted interventions. The most successful studies used collaborative and participatory approaches in the designs, included First Nations members in their research teams and presented culturally grounded interventions. The paucity of literature limit findings. There was a limited ability to identify key mechanisms of change across some intervention studies, and large outcome variations across studies meant some aspects could not be compared. Nonetheless, this review concludes that culturally grounded interventions are the most promising and successful mental health interventions currently available for First Nations Australians which has many implications for practice and funding. What is already known about this topic: First Nations Australians experience poorer mental health and wellbeing than non-indigenous Australians. Previous attempts to improve the mental health of First Nations Australians utilising Western therapeutic interventions have been largely unsuccessful. More recent attempts to improve mental health for First Nations Australians utilising culture appear promising, that is, culturally adapted and culturally grounded therapeutic interventions. What this paper adds: (1) Culturally grounded interventions are effective, preferable over culturally adapted interventions, and best to use for improving the mental health and wellbeing of First Nations Australians. (2) Limited evaluations of cultural interventions have been conducted that provide empirical data showing the effectiveness of the intervention on mental health and wellbeing for First Nations Australians. (3) Successful forms of intervention evaluations with First Nations Australians utilise participatory and collaborative research approaches. [ABSTRACT FROM AUTHOR]

Yoga is increasing in popularity. As a holistic practice, it is being applied and researched as a healing modality for physical ailments, assisting with mental health issues, and addressing traumatic symptoms. However, little is known about how social workers understand and include Yoga in their personal lives or professional practice. As part of a larger narrative study, practitioners in an Australian regional centre were asked: "What, if any, impact do embodied practices like Yoga have on your experience and your clients' experience?" This paper explores the stories told by three of the practitioners interviewed both individually and in focus groups. The dominant themes that emerged highlight that: a personal Yoga practice can be varied; the impact it has on professional outcomes is difficult to quantify; there is a lack of theoretical discussion about the body and embodied experience in social work; the challenges associated with introducing Yoga into social work practice are complex. Embodied practices such as Yoga provide social workers opportunities to increase self-awareness, their capacity to engage with clients and self-care. Theoretical understandings of the body and embodiment need to be better articulated in social work if embodied practices like Yoga are to be included in the professional conversation. [ABSTRACT FROM AUTHOR]

Up to one third of adults who receive mental health services in Australia are parents. Psychologists in private practice are one of the largest groups within the Australian mental health workforce who support parents experiencing mental ill-health. Parents have specific support needs relating to their parenting role and "treatment as usual" may not address their integrated parenting and mental health concerns. The service experiences of parents in this setting have not been studied. This qualitative study addresses this knowledge gap through investigation of the experiences of Australian mothers who received support from a psychologist in private practice. Semi-structured interviews were conducted with 14 mothers and interviews were analysed using Interpretive Phenomenological Analysis. Three overarching themes were identified in relation to (i) participants' need to feel understood and heard as a parent, (ii) their need for a nonjudgmental therapeutic space and (iii) their desire for practical parental support from psychologists. These findings corroborate the value of family-focused practices when supporting parents with a mental health condition. The results include ways in which family-focused practices have been incorporated by clinicians in private practice settings which may have application in other mental health service contexts. What is already known about this topic: Psychologists in private practice make up a substantial group within the Australian mental health workforce who support parents with a mental health condition. Parents who receive mental health care in tertiary mental health settings report a lack of dedicated parenting support and resources. Family-focused practices are effective in supporting parenting and recovery for parents with a mental health condition who receive mental health care in tertiary mental health settings. What this paper adds: Psychologists who support parents in private practice should collaborate with their clients to identify which aspects of their parenting may be relevant to the therapeutic work and provide targeted support for parenting difficulties. Most participants expected that their psychologist would provide targeted support for parenting difficulties, and they felt disappointed when this did not occur. The lived experiences of parents with mental ill-health in private practice psychology services are highlighted, addressing a key knowledge gap in the literature. [ABSTRACT FROM AUTHOR]

A clear understanding of the nature and extent of suicidal behaviour and other mental health issues in Aboriginal and Torres Strait Islander populations has been limited by the national failure to develop clinically and culturally valid assessments and to ensure the cultural competence of practitioners. The default position for Australian mental health researchers is to continue to adapt existing mainstream assessments. The problem with this approach is it doesn't enable researchers to determine culture-specific symptoms or phenomena that are critical to establishing true cultural validity. The mental health field needs culturally co-designed psychometric tools to capture culture-specific expression and manifestation of symptoms, and to capture culture-specific symptoms. Two such tools exist: the WASC-Y and WASC-A. However, there are few data on their psychometric properties beyond the initial developmental research reported in the test manuals. This needs to be a focus for future research. What is already known about this topic: Aboriginal and Torres Strait Islander people in Australia have suicide rates that are at least twice that of non-Indigenous Australians. Research into Aboriginal and Torres Strait Islander people's mental health is limited by the continued failure to use culturally valid, psychometrically sound, and clinically valid screening tools. For decades researchers have been drawing attention to the need for screening tools and other psychological assessments to be specifically validated for use with Aboriginal and Torres Strait Islander people. What this paper adds: Some attempts have been made to develop culturally valid tools or to validate mainstream instruments for use with Aboriginal and Torres Strait Islander people, but these tools are significantly limited. Attempting to validate mainstream instruments with Aboriginal and Torres Strait Islander people fails to determine unique aetiologies and explain the over-representation of Indigenous people in suicide deaths. The Westerman Aboriginal Symptom Checklists are culturally and clinically valid screening tools that warrant further exploration of their value in addressing the unacceptable gaps in understanding the nature and extent of mental health problems and suicidal behaviour among Aboriginal people. [ABSTRACT FROM AUTHOR]

Student evaluation of teaching (SET) has become a ubiquitous feature of higher education. The attainment and maintenance of positive SET is essential for most teaching staff to obtain and maintain tenure. It is not uncommon for teachers to receive offensive and non-constructive commentary unrelated to teaching quality. Regular exposure to SET contributes to stress and adversely impacts mental health and well-being. We surveyed Australian teaching academics in 2021, and in this paper, we explore the perceived impacts of SET on the teaching and learning experience, academic standards and quality. Many respondents perceived that SET contributes to an erosion of standards and inflation of grades. A thematic analysis of open-ended questions revealed potential mechanisms for these impacts. These include enabling a culture of incivility, elevating stress and anxiety in teaching staff, and pressure to change approaches to teaching and assessment to achieve the highest scores. Playing the SET game involves balancing a commitment to quality and standards with concessions to ensure optimal student satisfaction. Anonymous SET is overvalued, erodes standards and contributes to incivility. The process of SET needs urgent reform. [ABSTRACT FROM AUTHOR]

The relationship between religiosity and mental health is a relatively well-researched field within North America, covering numerous domains of religiosity, including: religion, spirituality, prayer, church attendance, church affiliation and belief in God or a higher power. Considering the Australian literature, there are few papers that explore these dimensions of religiosity and their relationship with health, and in particular, very little research into the field of religiosity and mental health. Using systematic literature review methods, this study explores the Australian research into relationships between religiosity, mental health, and treatment outcomes for psychiatric illness and suicidal behaviour. [ABSTRACT FROM AUTHOR]

Within the National Rugby League (NRL), the elite competition body across Australia & New Zealand, clubs are mandated to report concerns to the NRL Integrity Unit for possible misconduct, on or off the field. This includes returning a positive illicit drug test leading to players needing to attend counseling that promotes behavioral change; ranging from alcohol and other drugs usage, mental health issues, anger management and family work. This paper strives to understand the purpose of psychological support and interventions as a reflective case study across professional rugby league settings, whilst looking at the role of counseling theories and practices. [ABSTRACT FROM AUTHOR]

This paper summarises a consultation–liaison nurse's journey as a senior mental health clinician working within the general hospital setting. It begins with a brief history of consultation–liaison nursing (CLN) and covers the CLN experience in both the general hospital and the emergency department showing how the role evolved to become more focused on the needs of the general hospital. It shares some experiences during a stimulating, challenging and rewarding career where clinical supervision is seen as essential not only to reflect on and improve practice but to assist the CL nurse in working through the emotional demands of the role. The paper aims to increase knowledge of the CLN experience and promote interest in this specialist area of mental health nursing which is developing rapidly internationally and in Australia. [ABSTRACT FROM AUTHOR]

This paper contributes insights into the role of tenure in modifying the relationship between housing affordability and health, using a cross-national comparison of similar post-industrial nations—Australia and the United Kingdom—with different tenure structures. The paper utilises longitudinal data from the Household, Income and Labour Dynamics in Australia Survey and British Household Panel Survey to examine change in the mental health of individuals associated with housing becoming unaffordable and considers modification by tenure. We present evidence that the role of tenure in the relationship between housing and health is context dependent and should not be unthinkingly generalised across nations. These findings suggest that the UK housing context offers a greater level of protection to tenants living in unaffordable housing when compared with Australia, and this finds expression in the mental health of the two populations. We conclude that Australian governments could improve the mental health of their economically vulnerable populations through more supportive housing policies. [ABSTRACT FROM AUTHOR]

Recent social work literature has stressed the importance of considering culture when working with individuals with mental health problems. This paper presents my personal experience, journaling, reflections, and research as a mental health social work practitioner and researcher working with refugee clients with mental health problems from a Muslim background. It also draws on my research experience in cross-cultural mental health. The paper emphasizes the significance of building rapport especially in the earlier stages of the professional relationship. [ABSTRACT FROM AUTHOR]

A healthy built environment is one which connects citizens together to create a sense of community. These are influential determinants of good mental and physical health. This paper presents an overview of key research on how the built environment supports the development of community as part of creating and sustaining places for health and well-being. Formal public places such as town squares, plazas, parks and gardens cultivate community in numerous ways. Informal public places such as those in between buildings, on the street, at the train station and bus stop are also important for social encounters and interaction. Careful design of open space, neighbourhood streets and buildings can encourage human interaction as part of community creation. Evidence is presented here as a ‘Places Framework’ to illuminate the ways in which place strengthens community. The paper concludes by discussing and critically evaluating policy implications for urban planners and designers. Major gaps in the research are identified and suggestions made for future investigative work to strengthen the evidence for building healthy communities through built environment interventions. [ABSTRACT FROM PUBLISHER]

Apprenticeships are a common pathway for young people transitioning from education to employment, and adolescence to adulthood. Apprenticeships have undergone considerable reform, and since the 1990s labour market priorities in Australia have resulted in weakening of protections offered to workers through the award system and trade unions. At the same time, mental health issues have increased, with young people carrying a disproportionate burden. The aim of this study was to explore challenges that young apprentices in urban Australian settings face in relation to their mental health. Focus groups were conducted with 54 apprentices, who described a pervasive sense of disposability and poor working conditions as the main challenges to their mental health. These conditions included long work hours, low wages, job insecurity, poor quality education, unrealistic expectations, workplace hierarchies and bullying. Amidst social and economic precarity, apprentices resigned themselves to silently endure poor treatment in their work placements. Findings from this study are especially troubling because, as young people, apprentices simultaneously face a series of life transitions that require support and guidance. This paper brings attention to the workplace conditions that may contribute to young apprentices' vulnerability to mental health problems, highlighting possibilities for structural changes led by policy reform. [ABSTRACT FROM AUTHOR]

Objectives: Group singing has been reported to enhance quality of life (QoL) and mental health in older people. This paper explored whether there are differences in the effects of group singing intervention on people with Parkinson's (PwPs) in Australia, UK and South Korea. Methods: The study included PwPs (N = 95; mean age = 70.26; male 45%) who participated in a standardised 6-month weekly group singing programme. Parkinson's health-related QoL measure (PDQ39) and mental health assessment (DASS) were administered at baseline and follow-up. ANOVAs were performed with significance set as p <.05. Results: ANOVAs revealed main effects of Time on the Stigma and Social Support subscales of PDQ39; both showed a small but significant improvement over time. However, the social support reduction was moderated by country; social support was improved only in South Korean participants. The reduction in stigma was greater than previously reported minimal clinically important differences, as was the social support reduction in South Korean participants. In terms of mental health, ANOVAs revealed that the scores of Anxiety and Stress domains of DASS significantly decreased from pre-test to post-test with small effect sizes. Conclusion: This first international singing study with PwPs demonstrated that group singing can reduce stigma, anxiety and stress and enhance social support in older adults living with Parkinson's. The findings are encouraging and warrant further research using more robust designs. [ABSTRACT FROM AUTHOR]

There are circumstances where ethics overload may be counterproductive to the successful achievement of research outcomes, especially for disempowered client groups. This paper describes and questions the complex time-consuming nature of seeking ethical approval from multiple Human Research Ethics Committees (HRECs) for a comorbidity research project in South Australia. Applications for ethical approval of a major research project involving surveys and interviews of managers and clinicians from mental health and alcohol and other drug services, community advocates and other relevant services were submitted to three major HRECs. Collectively, it took a duration of 10 months to receive full approvals from these HRECs. In addition, a number of Site-Specific Assessments were needed and further approvals were required from multiple Non-Government Organisations (NGOs). Each review process required a detailed application, sometimes followed by lengthy negotiation periods and amendments. These cumbersome, often duplicated processes took a considerable amount of researcher and committee time from a three-year project funding period, thereby delaying the project by almost a year. We discuss the impact of these delays on the timing, progress and potential quality of the research, and on the research team, employed staff, doctoral students involved, and the research budget. We also discuss the additional complexities and inconsistencies of involving two vulnerable populations, Aboriginal Australians and people from refugee backgrounds. This paper informs researchers and funding bodies about this major issue, and offers some suggestions for more effective ethical review processes. [ABSTRACT FROM PUBLISHER]

Objective Australian Aboriginal and Torres Strait Islander social and emotional wellbeing ( SEWB) is a multifaceted concept that acknowledges that a person's wellbeing is determined by a range of inter-related domains: body, mind and emotions, family and kinship, community, culture, Country, and spirituality. This paper explores the meaning of these seven domains of SEWB. Method A thematic analysis of qualitative data obtained from the National Empowerment Project (NEP) was conducted, along with a literature review of each domain. Results Findings from the NEP, together with relevant literature, indicate that implementing strategies that focus on strengthening SEWB is important for individual, family, and community wellbeing. Addressing the social determinants of Indigenous disadvantage is also shown to have an important role in strengthening the SEWB of individuals, families, and communities. Conclusion It is important for all practitioners and policymakers involved with improving Indigenous health to recognise the seven inter-related domains of SEWB and to acknowledge and support people in addressing the social determinants of wellbeing. [ABSTRACT FROM AUTHOR]

Australian community arts and mental health is described through its 40-year history with peaks of activity coinciding with federal labor governments and the establishment of four independent health promotion agencies from the late 1980s. The paper then takes a thematic approach to discussing the development of national approaches to supporting arts and health practice, data sources, current research and evaluation and advocacy challenges. The paper concludes by suggesting that under the current federal labor government arts and health may benefit from increasing recognition of the intrinsic benefits of arts participation and cultural rights. [ABSTRACT FROM AUTHOR]

Climate change awareness has taken a dramatic turn in Australia, intensifying debate over the meaning of prolonged drought for rural futures, with critical implications for rural mental health. This paper is drawn from research on perceptions of Australian climate during a period of marked shift in public awareness of climate change (2004–2007). It utilises oral histories gathered in dryland farm communities of the semiarid Victorian Mallee at the edge of the nation's commercial cropping zone—in particular, the stories of women's health workers—to highlight the interdependency of environmental, economic, political and mental health concerns in rural and remote communities. Focusing on lived experience, the paper explores the narratives through which people have apprehended drought and climate change—in discourse of endurance, uncertainty and putative adaptation—revealing advocacy and local resolve in the provision of rural mental health services, and, fundamentally, a paradigm of embodiment in rural social work. [ABSTRACT FROM AUTHOR]

Research on working mothers to date has largely focused on particular aspects of the work-lift balance, such as investigating family and work roles or the interaction between work and family lift. This paper explores the use of cluster analysis to simultaneously consider the different aspects of the work-lift nexus. Utilising Household, Income and Labour Dynamics in Australia (HILDA) survey data, six major homogenous groups of working mothers were identified, each with a distinctive profile in terms of their work-family experience. Subsequent descriptive analysis of the six groups found systematic differences between the groups in terms of their characteristics and circumstances. The research found that the majority of working mothers managed their work-lift balance successfully. Furthermore, women's aspirations for being a working mother were not consistently associated with how well they coped. Instead, work-lift conflict was associated with long working hours, work overload and lack of support from others. Just under 30% of mothers experienced a high level of work-lift conflict, and the strong association of work-lift balance strain with poor physical and mental health and low satisfaction with work and family lift was evident. The paper also explores future use of these clusters in forthcoming longitudinal analysis of the work-lift nexus. [ABSTRACT FROM AUTHOR]

In recent times in Australia there has been a slow but steady trend among mental health services to employ generic mental health workers from a variety of professional backgrounds. These workers undertake the jobs that were traditionally assigned to social workers. Although many social workers compete successfully for these positions, a question that needs to be explored in the contemporary service and policy context is social work's distinct contribution to the field of mental health. The present paper argues that social work's distinct contribution may lie in the area of psychiatric recovery, especially those areas that link mental health with broader social issues, such as employment and education. The present paper will discuss the role of social work in two areas of recovery, namely supported employment and education. These are emerging areas of practice and social workers must take advantage of these opportunities. [ABSTRACT FROM AUTHOR]

There is growing recognition of the importance of addressing the mental health needs of young people attending university. Anonymous, scalable, and evidence-based online interventions can help to reduce burden on university services and increase access to care for marginalised or disconnected students. This paper reports the participatory design methods used to develop the Uni Virtual Clinic (UVC), a comprehensive online programme that was designed to prevent and treat mental health problems and related issues in university students. Data evaluating the participatory design process is also presented. The potential for the implementation of the UVC within university-based counselling services is strong, and has potential to reduce the prevalence of mental disorders in a high-risk group of young people. [ABSTRACT FROM AUTHOR]

Objective: This paper describes a Training and Mentoring Program, designed to enhance research capacity for social workers based in community and inpatient settings in Australia. Method: Twenty-one social workers participated in the multiday training and follow-up mentoring program (small group and individual) over a 24-month period. Outlined is a mixed-method quasi-experimental evaluation of the approach. Results: Quantitative data showed an increase in self-reported research capacity including knowledge, confidence, behaviour and satisfaction. The mentoring approach appeared to be a crucial component for participants – for their engagement with research, willingness or ability to bypass perceived and real hurdles, and completion of an individual research project. A significant barrier to research was a lack of available research time during their clinical role and forcing participants to complete research projects in their own time. Additionally, personal challenges such as health and family commitments on time available to undertake research after hours impacted on engagement and research project completion. Discussion: Social workers are critical contributors to practice-based evidence development in health and mental health settings. However, many report a lack of knowledge, confidence and skills in service evaluation and research. The findings demonstrate that social workers are keen to take on practitioner-research roles, that research capacity is enhanced through training particularly with follow-up mentoring to support individual research project development and implementation, and that large system changes need to occur to support social workers to engage in research activities in their work context. [ABSTRACT FROM AUTHOR]

Objectives: Weight‐based stigma is often experienced by individuals who are overweight and obese, and is associated with a range of deleterious physical and mental health outcomes. Research is lacking on the mechanisms through which these relationships occur. This paper examines two potential mechanisms: internalised weight stigma and self‐compassion. Method: A sample of 147 overweight and obese Australian females aged between 18 and 45 years completed a series of self‐report questionnaires measuring: experienced weight stigma, internalised weight stigma, self‐compassion, psychological distress, body shame, loneliness, and life satisfaction. Results: Internalised weight stigma mediated the relationship between experienced weight stigma and body shame such that greater experienced weight stigma led to greater internalised weight stigma, which in turn led to greater body shame. Additionally, self‐compassion mediated the relationship between experienced weight stigma and several psychosocial factors such that greater experienced weight stigma led to lower self‐compassion, which led to greater psychological distress, higher perceived loneliness, and lower satisfaction with life. Conclusions: Findings support previous research indicating that internalised weight stigma plays a mediating role in the relationship between experienced weight stigma and adverse outcomes. This study extends upon prior research by investigating previously unexamined outcome variables and exploring the simultaneous mediating role of self‐compassion. The findings suggest that both internalised weight stigma and self‐compassion each play a different but important role in the way in which weight stigma impacts on overweight and obese women. Results from this study have implications in terms of psychological intervention for overweight and obese individuals in clinical practice. [ABSTRACT FROM AUTHOR]

Mental health court liaison services (CLS) are a key component of the forensic mental health sector in Australia with a service present in each state and territory to identify and treat those with mental illness in contact with the courts. To date, limited research has been undertaken into how these services are delivered and which model is most effective. This paper describes the process and outcomes of the first national collaboration to trial a set of key performance indicators (KPIs) for Australian mental health court liaison services (CLS) using a benchmarking model. A set of nationally endorsed KPIs were found to be useful and relevant to policy and practice in terms of enabling services to compare resources and highlight areas for quality improvement. Wide variation in performance across services was observed. The ability of smaller services to provide data emerged as an issue, with several identifying the need to improve reporting capability. Benchmarking of specialised forensic mental health services was found to be a valuable process for services. Future collaborations for CLS may include refinements to the KPIs and will continue to enhance the knowledge base of this specialised area of forensic mental health service provision. [ABSTRACT FROM AUTHOR]

This paper presents a transformative approach to understanding and working with the problems of early childhood. The approach takes as its starting point the recognition that the most enduring outcomes in clinical work involve a shift not only in the behaviour of the child but also a change in the parents' perspective of themselves and their personal history. Parents are perceived as ‘growing into their own childhood’ at the critical point that they become parents. The paper describes through clinical examples how the common problems of early childhood such as sleeping, feeding, toileting and behavioural problems can be conceptualized as zonal, geographic and task confusions that throw light on the interactive nature of the relationship between young children and their parents. The paper, written by a child psychotherapist working in Australia, goes on to reflect on the implications of separation, loss and trauma from the perspective of a country founded by indigenous Aborigines and migrants from many cultures [ABSTRACT FROM AUTHOR]

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Objective: This paper presents a case study of a strength-based and recovery-focused parenting program designed for parents with a mental illness. Method: The face-face program was delivered at a regional health organisation in Victoria, Australia and consisted of interactive and reflective weekly modules. Data were gathered using an interpretivist case study design, using a small sample of 4 parents and 2 program facilitators. Participating parents completed weekly reflective activities and program facilitators were interviewed about the implementation of the program. Results: Findings indicated that parents particularly valued the opportunity to meet with other parents with a mental illness and found aspects of the program covering communication strategies, reducing stress and setting routines most useful. Strengths identified by facilitators included increased group cohesion and flexibility in the program which could be adapted to the group's needs. Discussion: While recruitment to the program was difficult, this was possibly due to stigma around mental illness. However, although participant numbers were low, a small group size allowed for a personalised and tailored implementation of the program, meeting the particular needs of each parent. [ABSTRACT FROM AUTHOR]

Statistics on causes of death gathered by the Australian Bureau of Statistics (2010) report that suicide was the leading cause amongst young men in Australia between the ages of 15-24. The figures have been similarly high for over a decade. In Australia these alarming statistics have led to the funding of a range of programmes tackling youth suicide and more recently programmes that are aimed at improving help-seeking behaviours of young men. The programme reported in this paper is one such programme that is working with young men in the building and construction industry who are regarded at even greater risk of poor mental health outcomes. The research that was undertaken uncovered some of the impact of a universal programme on improving the protective factors of young men in this industry. Young men can present themselves in a very positive light as robust and resilient human beings, contrary to much of the research that has been undertaken with a focus on young men in building and construction and living in rural and remote communities. This paper discusses the data and uses the material to consider how resilient young men in this industry can become key informants and informal peer mentors. [ABSTRACT FROM AUTHOR]

Australia is a signatory to a number of United Nations conventions and protocols which prescribe the responsibilities of nations which receive asylum-seekers. While Australia receives very few asylum-seekers in a global context, its policy of mandatory immigration detention, for those who arrive by boat, has unnecessarily led to long-lasting and devastating mental health consequences. This treatment results in Australia systemically breaching a range of recognised human rights agreements, conventions and protocols. It is a matter of concern that these human rights violations have historically received bi-partisan political support. Reactions to this treatment have seen some asylum-seekers participate in hunger strike protests. This has revealed a lack of appropriate procedures for managing these non-violent protests, which has resulted in further human rights violations. This research paper importantly examines Australia's human rights obligations to asylum-seekers, finds that their treatment is inconsistent with these obligations and discusses the hunger strike protests which result from this treatment. [ABSTRACT FROM AUTHOR]

Objective: Integrated care has been identified as means of managing the demands on the healthcare budget while improving access to and quality of services. It is particularly pertinent to rural health services, which face limited access to specialist and support services. This paper explores the capacity of three rural communities in South Australia to deliver integrated mental health support for older people. Methods: Thirty-one interviews were conducted with local health and social service providers from mental health, community health, general practice, residential aged care, private practice, NGOs and local government as part of a larger action research project on service integration. Results: Participants highlighted differences in service delivery between the communities related to size of the community and access to services. Three structural barriers to delivery of integrated care were identified. These are as follows: fragmentation of governmental responsibility, the current funding climate, and centralisation and standardisation of service delivery. Conclusion: We conclude that despite a focus upon integrated care in mental health policy, many features of current service delivery undermine the flexibility and informal relationships that typically underpin integration in rural communities. [ABSTRACT FROM AUTHOR]

Context: Health practitioner registration boards require health professionals to evaluate and maintain “fitness to practice” (FTP). This encompasses the professional behavior, clinical competence, and freedom from impairment required for safe and effective service provision. We developed and implemented policies to promote student self-assessment and support of FTP that were pre-emptive and designed to be helpful and sought clinician feedback on this initiative.Method: An innovative student-centered FTP approach was devised with consideration of defensible ethico-legal practice. A survey explored clinical educators’ perceptions of the FTP policy and the associated education and support. Closed and open survey questions were analyzed using descriptive statistics, qualitative evaluation, and thematic analysis.Results: Seventy-nine physiotherapy clinical educators from 34 sites across eight Australian health services returned surveys. Educators had positive perceptions of policy components, particularly incorporating professionalism as a hurdle requirement and the attendance and incident reporting policies.Conclusions: The benefits of a student-centered FTP approach included clarity and consistency in managing FTP issues and facilitation of student awareness through active engagement in maintaining their FTP. To our knowledge, this paper is the first to report a comprehensive approach to the range of FTP issues incorporating student self-declaration of issues that may affect desirable progression through clinical placements. The policy and program of education and support are likely to be generalizable to health professional training programs that utilize workplace training. [ABSTRACT FROM PUBLISHER]

Existing research demonstrates that mean health care costs incurred by those experiencing homelessness are high. However, high mean health care costs mask the fact that a sizeable number of people experiencing homelessness incur low costs and that very high costs are driven by a minority of the homeless population. This paper examines health care costs estimated from two Australian surveys of those experiencing homelessness undertaken by the authors. It demonstrates three important findings. First, higher health care costs are most strongly associated with diagnosed mental health disorders, followed by long-term physical health conditions. Second, having a current drug or alcohol dependency, but no diagnosed mental health disorder or long-term physical health issue, is not associated with higher level health care costs. Finally, higher health care costs are incurred by those with long periods of rough sleeping. The findings of this research provide a significant economic argument for government intervention to break the cycle of homelessness as they reveal significant potential savings to effective interventions for homeless people with diagnosed mental health disorders and longterm rough sleeping. [ABSTRACT FROM AUTHOR]

Tourism is an engine of economic growth, but its capacity to contribute to good health is only starting to be documented. This paper describes a forthcoming research project with the Ethiopian immigrant community in the Australian state of Victoria. The project aims to discover if writing about positive holiday experiences that involve visits to friends and relatives improves the community's mental health – alleviates depression levels and increases levels of happiness. The role of holidays in improving mental health is of increasing interest to the tourism industry. This research note highlights the importance of understanding the benefits of holidays for individual well-being; this paper outlines a methodological approach for investigating these benefits. [ABSTRACT FROM AUTHOR]

Considerable investment over the last decade in strategies to improve mental health and wellbeing in Australia has seen a notable increase in the availability and awareness of youth-specific mental health services as well as an increase in mental health literacy among young people. However, national statistics do not reflect a corresponding increase in help-seeking behaviour among young people. There is limited understanding of how services can promote effective help-seeking in young people - particularly those young people experiencing marginalisation or high levels of psychological distress. In this paper we examine the potential for online mental health services to address the persistent challenge of facilitating help-seeking in young people. This paper presents findings from a study of young people's use of the online service, ReachOut.com, to examine if and how the service promotes help-seeking. We find that ReachOut.com effectively engages young people - particularly those who are experiencing high levels of psychological distress and supports young people to become service ready. Targeted strategies for young men and other hard-to-reach groups as well as further integration with on and offline clinical services are likely to strengthen and systematise the role of ReachOut.com as a gateway service, supporting young people to seek professional support. [ABSTRACT FROM AUTHOR]

This paper examines the mental health consultation–liaison nursing (MHCLN) role and links this to the interpersonal relations theory of nurse theorist Hildegard Peplau. The paper argues that, as mental health nursing care around the world is increasingly focused upon meaningful therapeutic engagement, the role of the MHCLN is important in helping to reduce distressing symptoms, reduce the stigma for seeking help for mental health problems and enhancing mental health literacy among generalist nurses. The paper presents a small case exemplar to demonstrate interpersonal relations theory as an engagement process, providing patients with methodologies which allow them to work through the internal dissonance that exists in relation to their adjustment to changes in life roles precipitated by physical illness. This dissonance can be seen in the emergence of anxiety, depression and abnormal/psychogenic illness behaviours. This paper concludes arguing for considerable effort being given to the nurse–patient relationship that allows for the patient having freedom to use strategies that may help resolve the dissonance that exists. [ABSTRACT FROM AUTHOR]

Over the past three decades, thousands of young families have moved from large cities to non-metropolitan areas of Australia. This is one of the major demographic shifts underway in Australia and demands urgent policy attention. Despite the various impetuses towards relocation, little is known about how these families fare in their new environments. This paper draws on a 3-year study of the experiences of young families who move to regional, rural and remote areas conducted in two states using interviews with parents and service providers. The parent interviews suggest that relocation, regardless of the reason for migration, has the potential to adversely affect mental well-being (through loss of social connections and exclusion from their new community). This is even more so for those with pre-existing mental health problems due to their non-acceptance by the new community and inadequate access to support services. Service providers indicated that the migration of young families to rural and remote communities is placing additional demand on already stretched health and other services. The paper concludes with a discussion of potential strategies to lessen the negative impacts on the mental and social well-being of young families moving to non-metropolitan areas. [ABSTRACT FROM AUTHOR]

The role of family carers in the delivery of mental health services in Australia has become more than an advantage over not having this sort of participation. Increasingly the involvement of non-paid carers (family members and significant others) has been recognised as central to the smooth delivery of care and treatment. Notwithstanding this acknowledgment, there is very little discussion of carer participation in mental health care delivery within the literature. The limited research in this area suggests that carers recognize very little opportunity for genuine participation, even less than is available to consumers. This paper presents part 1 of the findings of an exploratory, qualitative study seeking an in-depth understanding of the attitudes of carers from rural Victoria, Australia toward opportunities for participation with specific emphasis on the role of psychiatric nurses in encouraging or discouraging participation. The themes of respect and communication will be described in this paper. These findings demonstrate the variable experiences of carers in their opportunities to participate and the important role nurses can assume in supporting both carers and consumers through this process. [ABSTRACT FROM AUTHOR]

National data on the provision of services to Australians with a disability under the Commonwealth/State Disability Agreement (CSDA) have been gathered since 1995 using the Minimum Data Set (MDS). This paper analyses MDS data on residential services for people with intellectual disability between 1995 and 1999. Notable national trends include: (a) a steady growth in the number of recipients of CSDA-funded residential services; (b) a slow but consistent decline in the proportion of people housed in large residentials; (c) a gradual increase in the number of people served in community group homes; and (d) a more rapid growth in outreach/drop-in services such as semi-independent living. Population-adjusted comparisons with residential provision for people with intellectual disability in England and the USA showed that these countries provided between 22 and 71% more places per person than Australia. There appears to be an urgent need in Australia to increase the provision of residential services to people with intellectual disability. [ABSTRACT FROM AUTHOR]

Restrictive interventions such as seclusion may occur during an acute mental health crisis. Such interventions are experienced by people as traumatic and counter to recovery. The current study aimed to investigate the use of seclusion and who was secluded amongst patients presenting with psychotic symptomology. All acute inpatient admissions were examined across a 12-month period January–December 2013. Electronic and paper records were accessed and audited for all 655 admissions. There were 91 admissions that included a seclusion and 200 seclusion events. There were 79 unique patients who experienced seclusion. For those experiencing seclusion: two-thirds were male, 49% were either homeless or had no fixed abode, 32% received case management in the community prior to their inpatient stay, and 56% were unemployed or not in the workforce. The median and mode duration of seclusion was 4 h. By understanding seclusion interventions better, changes can be made to enhance practice. This descriptive research into seclusion has clarified the demographics of who is most likely to experience seclusion, for how long, and the implications for reducing restrictive interventions. How the social work role could contribute to reforms to protect and enhance the rights and well-being of marginalized members of our communities, at their most vulnerable, is considered. [ABSTRACT FROM AUTHOR]

Purpose: In 2017, international students contributed almost $32 billion to Australia's economy, more than half of which was attributable to students from China. Despite its historical popularity as a study destination, research suggests that these students confront numerous obstacles in pursuing their studies within Australia. In this study, the perspectives of these students were explored. The dominant issues raised by these students related to mental health and emotional wellbeing. Methods: Nineteen students in one Australian university participated in one-on-one in-depth semi-structured interviews. Data were analysed using grounded theory approaches. Three broad themes were generated in the study: psychological stress (which was linked to language barriers, shifts in pedagogy, and changes in lifestyle); perceived safety (which was linked to lack of security, safety and perceived racial discrimination); and social isolation (linked to reduced sense of belonging; lacking close personal connections; and feelings of loneliness and homesickness). Conclusions: Results suggested that a tripartite model of interactive risk factors may be appropriate for exploring how international students fare emotionally with their new environments. [ABSTRACT FROM AUTHOR]

This paper starts from the premise that embodied knowledge is critical to understanding health policy implementation. We explore this notion through a qualitative investigation of the way that knowledge has functioned in the implementation of an Australian mental health policy, Partners in Recovery (PIR). Analysis uses the theoretical lens of interpretive policy analysis and the 'embodied, inscribed, enacted' knowledge schema developed by Freeman and Sturdy [(2014a). Introduction: Knowledge in policy – embodied, inscribed, enacted. In R. Freeman & S. Sturdy (Eds.), Knowledge in policy: Embodied, inscribed, enacted (pp. 1–19). Bristol: Policy Press]. Our analysis reveals a policy problem centred around difficulties of coordination where the inscribed solution lies in individuals who must implement the PIR program in local areas. Our interviews with PIR consortium members and stakeholders show that this implementation happens through the enactment of embodied knowledge. However this implementation is not straightforward and we point to difficulties arising from the centrality of embodied processes in implementation, related to the localisation of systems knowledge in individuals and structural devaluation of certain types of knowledge over others. [ABSTRACT FROM AUTHOR]