Search

Objectives: Current mental health practices for people living in residential aged care (RAC) facilities are poor. In Australia, there are no mechanisms to monitor and promote mental health for people living in RAC, including those who experience changed behaviours and psychological symptoms. The aim of this study is to improve current practices and mental health outcomes for people living in RAC facilities by codesigning a Mental Health benchmarking Industry Tool for residential aged Care (MHICare Tool)., Methods: A two-stage sequential and mixed methods codesign methodology will be used. Stage 1 will include qualitative interviews and focus groups to engage with residents, family/care partners and RAC staff to ascertain mental healthcare practices and outcomes of greatest significance to them. Adapted concept mapping methods will be used to rank identified issues of concern in order of importance and changeability, and to generate draft quality indicators. Stage 2 will comprise a Delphi procedure to gain the wider consensus of expert panel views (aged care industry, academic, clinical) on the performance indicators to be included, resulting in the codesigned MHICare Tool., Ethics and Dissemination: This study has been reviewed and approved by the University of Queensland Human Research Ethics Committee (HREC/2019002096). This project will be carried out according to the National Statement on Ethical Conduct in Human Research (2007). The study's findings will be published in peer-reviewed journals and disseminated at national and international conferences and through social media., Conclusion: This protocol reports structured methods to codesign and develop a mental health performance indicator tool for use in Australian RAC., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Informal care can exert adverse effects on the mental health of young people. Bullying victimisation is an important determinant of mental disorders. Young carers are at elevated risk of bullying. We quantify the mental health effects of informal care among Australian adolescents and the extent to which these effects are transmitted through school bullying. We used data from the Longitudinal Study of Australian Children. Participants were classified as non-carers, light carers (caring for < 10 h/week) and moderate-to-heavy carers (caring for 10 + h/week). Mental health was measured using the Kessler Psychological Distress Scale (K10). Using a counterfactual approach to mediation analysis, total effects (TE) of informal care on mental health were decomposed into natural direct effects (NDE-mental health effects not transmitted through school bullying) and natural indirect effects (NIE-mental health effects transmitted through school bullying). The TE of informal caring was 0.71 (95%CI - 0.03, 1.49) for light carers and 1.72 (95%CI 0.45, 3.02) for moderate-to-heavy carers. While school bullying explained 27% of the TE among moderate-to-heavy carers (NIE: 0.46; 95%CI 0.12, 0.91) there was weak evidence of mediation for light carers. Our findings indicate that the mental health effects of moderate-to-heavy caregiving can be reduced by school bullying interventions., (© 2023. Springer Nature Limited.)

Recent years have seen an increasing emphasis on the role of teachers in promoting and supporting student mental health. It is thus important to understand how teachers' attitudes towards mental health impacts the efficacy of school mental health programs. The aim of this paper was to evaluate, based on a comprehensive review of existing literature, the relationship between teachers' attitudes and the success of school-based mental health interventions. Results indicated that teachers' attitudes towards mental health is a critical moderator of the success of related programs in schools. When teachers are supportive of, engaged in, and understand the importance of, mental health programs, students are more likely to participate in these programs and experience positive outcomes. The specific type of efforts that should be made to educate teachers about the importance of mental health and to provide them with the tools and resources necessary to effectively support student mental health in the classroom are discussed. The paper also highlights the importance of careful selection in terms of the mental health initiatives introduced within schools, and how this choice may impact teacher attitudes.

Background: Mental health concerns prevent positive well-being and are key challenges for Australian children and young people. Arts organisations play a role in enhancing the positive mental health of children and young people. This paper describes the involvement of young people and their parents in the development of a resource for arts organisation's intentional support of social and emotional well-being. Methods: Six focus groups were conducted with 19 young people who participate in dance, drama, and circus programs, and 17 of their parents. Questions explored how the arts currently, and potentially, support their social and emotional well-being. Results: Three overarching themes: "Connecting with Others;" "Being Myself;" and "Teaching Methods," plus 14 sub-themes were identified. Conclusion: A framework of well-being factors and pedagogies was developed to guide the creation of a resource to help support the social and emotional well-being of young people participating in arts programs.

This scoping review explores the role of school leadership in the improvement of teacher well-being by utilizing the Locus of Control (LOC) Framework identified by psychologist Julian Rotter in 1954. The internal and external environments impacting teacher well-being were explored, and the specific responsibilities of school leadership were identified. The literature reports that while teachers are responsible for many aspects of their well-being, school leaders can improve a teacher's mental health and create a positive school culture by taking responsibility for factors external to the teacher's LOC. This paper outlines school leadership responsibilities in actively implementing strategies to improve staff well-being in the school environment.

A caring school community can enhance whole-school wellbeing including the wellbeing of school staff, which directly impacts on student academic, social and emotional wellbeing. This study firstly examines the validity and reliability of a proposed wholeschool staff wellbeing evaluation tool which uses a set of whole-school wellbeing indicators to identify strengths and areas for improvement within the school environment which may be impacting on staff wellbeing. Secondly, the association between factors found within the whole-school staff wellbeing tool with staff self-reported mental health are examined, and finally, the influence of person characteristics and role of factors on perceived whole-school staff wellbeing are determined. Cross-sectional data were collected from 801 school staff from six non-government schools in Australia as part of the School Staff Wellbeing Project. Results confirmed and validated the hypothesised structure of the whole-school staff wellbeing evaluation tool with staff relationships (leadership, staff), staff engagement (active, supported), staff emotional wellbeing (supported through policies and opportunities) and school climate (culture and values) found to be significant predictors of mental health. Prioritising resources to building supportive staff relationships, school climate, and providing opportunities to promote staff emotional wellbeing, were found to have the greatest impact on staff mental health. Characteristics such as age, gender, education, role, and length of time working in schools predicted perceptions of the whole-school's general wellbeing. The whole-school staff wellbeing evaluation tool provides a useful screening and self-evaluation measure to identify whole-school staff wellbeing strengths and areas for improvement in staff wellbeing.

International students from culturally and linguistically diverse countries travel to Australia because of the opportunity to study courses in the English language with some coming to this country just to study the language itself. Such desires moreover create students to engage in creative strategies to improve their language skills. This paper, however, suggests that the desire to be skilled in English through immersion in an English-speaking country like Australia creates challenges to the mental wellbeing of international students. Reporting on interview data with 47 international students of Asian descent in the Australian city of Melbourne, this paper reveals these challenges to include lived and perceived notions of self and belonging, as well as loneliness.

A substantial amount of research has documented the negative impact technology has on young people's lives: particularly cyberbullying and the negative mental health outcomes associated with it. Research examining how technology could promote mental health and wellbeing in young people however, needs further investigation. This paper reports on a mixed methods study, which involved quantitative online surveys (N=229), and face to face interviews (N=30), across eight South Australian high schools. This paper will only address the quantitative results. The study involved young people aged 12 to 17 years. This paper discusses the importance of social connectedness and the use of technology to promote social connectedness among young people. A key finding was that young people who were more socially connected, were more likely to cope actively in response to frequent cyber victimisation. They were more likely to seek help and have positive mental health as a consequence. Findings from this study could aid policy development, social media campaigns, and the education of health professionals, teachers, and parents about the benefits of technology and the importance of staying connected.

Boarding schools, by definition, house students in residence either on campus or close by in residential facilities - where the sleep environment is likely to differ from their home environment. For boarders, being in the boarding environment occurs alongside a convergence of psychosocial and physiological factors likely to impact adolescent sleep. This paper comprises a review of the literature on sleep and boarding students in the Australian context. We also propose recommendations aligned with the scientific evidence base that can be used to promote healthy sleep in Australian boarding school students, focusing on staff training and sleep knowledge, daily routines, sleeping arrangements, and student mental health and wellbeing. It must be noted that these recommendations should be considered interim recommendations until further research is performed in the area. Further, we suggest the development of standardised practice guidelines, to ensure that student sleep is supported appropriately within the Australian boarding context.

During COVID-19, rates of mental health issues, particularly anxiety, rose significantly in university students. In the scramble to adapt to online learning, university professors were overwhelmed with material aimed at facilitating a supportive learning experience and preserving student academic performance in online contexts yet were ill-equipped to cope with the increased volume of mental health issues encountered. Many studies attest to the association between poor mental health and academic performance. It has been shown that students often report their mental health issues to university professors who are called upon to cope with these issues as best they can. This paper outlines strategies undertaken, in the context of a novel undergraduate mental health program, to address emergent mental health issues during COVID-19 student isolation. These practical, cost effective interventions can be used to successfully give voice to ongoing student mental health issues in a post-COVID world and to help professors feel equipped and empowered enough to contribute to stemming the tide of rising rates of mental illness meaningfully, appropriately and professionally. [Note: The page range (69-81) shown on the PDF is incorrect. The correct page range is 69-79.]

The COVID-19 pandemic has been a major disrupter in the Australian early childhood education (ECE) sector. ECE educators had to respond quickly to frequent surprises and risky challenges. Their stressful, exhausting experiences as they constantly managed change are explored in this paper. The study used an interpretive social constructionist approach to interview six ECE leaders in order to construct a shared understanding of their beliefs and experiences during this time. The results indicate an increased risk of mental and physical health problems, and some impaired service quality. Although the results are indicative of historical treatment, the consequences of government neglect have resulted in a staffing crisis and closed services. Lessons need to be learned in how we treat educators and services if we want future generations of children educated and cared for by resilient educators who are not at risk of feeling they are in "burnout central."

International students leave their countries to pursue their educational goals in a different country and must adapt to succeed. However, they may face challenges when adapting to and learning a new culture. This study investigates the challenges common to international students in their host countries and summarizes the publishing trends. A literature search of peer-reviewed articles published in Scopus, Taylor & Francis, EBSCO Host, Web of Science, Springer, PubMed, and Wiley Online over 21 years (2002-2022) was done for data collection. After the screening, a total of 175 articles were included in this review and analyzed with content analysis. The findings show that the top four destinations for international students (USA, UK, Australia, and Canada) produced the most articles about international students' challenges. Additionally, most papers investigated more than one challenge, and sociocultural (82.9%) and academic challenges (82.3%) were the most researched, with language issues as the primary cause. The results also show no changes or improvement in the challenges of international students in 21 years, and areas such as psychological and economic challenges need more research. These challenges and other trends found in the articles are discussed and directions for future research are suggested.

Faced with broad scale cancellation of allied health student placements due to COVID-19, placement coordinators at The University of Melbourne Department of Rural Health established remote, online work-integrated learning placements across a range of settings, including a primary school, specialist school, kindergarten association and a homelessness sector organization. To ensure safe and high-quality placements, the evidence for telepractice and placement innovation was reviewed and integrated with existing knowledge of developing quality service-learning placements and COVID-safe guidelines from professional associations. This paper describes how placements were established, how student learning needs were aligned with host site objectives, and critically analyses the benefits and challenges of the online placement format. Partnerships, communication, and planning with all stakeholders were critical in placement redesign. The outcome is that students have enhanced their clinical and professional skills and provided community services to clients that would otherwise not have been provided during a pandemic.

Objective: To generate outcomes for the development of a culturally appropriate mental health treatment model for Indigenous Australians with depression., Methods: Three focus group sessions and two semi-structured interviews were undertaken over six months across regional and rural locations in South West Queensland. Data were transcribed verbatim and coded using manual thematic analyses. Transcripts were thematically analysed and substantiated. Findings were presented back to participants for authenticity and verification., Results: Three focus group discussions (n=24), and two interviews with Elders (n=2) were conducted, from which six themes were generated. The most common themes from the focus groups included Indigenous autonomy, wellbeing and identity. The three most common themes from the Elder interviews included culture retention and connection to Country, cultural spiritual beliefs embedded in the mental health system, and autonomy over funding decisions., Conclusions: A treatment model for depression must include concepts of Indigenous autonomy, identity and wellbeing. Further, treatment approaches need to incorporate Indigenous social and emotional wellbeing concepts alongside clinical treatment approaches. Implications for public health: Any systematic approach to address the social and cultural wellbeing of Indigenous peoples must have a community-led design and delivery., (© 2021 The Authors.)

There is an ever-increasing focus on the importance of addressing the mental health of students across the higher education sector. Measuring psychological distress or symptoms of common mental disorders as a proxy for mental health does however provide a limited picture of someone's mental health status. There is a need to comprehensively measure mental health via outcomes of psychological distress combined with "positive" and "adaptive" states of mental health such as mental wellbeing and resilience. This paper describes a study of 905 students in which an online mental health and wellbeing platform was used to measure the mental health of students, all the while providing realtime individual reports to each individual student. The data provides evidence of high levels of psychological distress (i.e. anxiety) and low levels of mental wellbeing and resilience in students, relative to population norms, with merely 18.6% of students demonstrating optimal scores on all outcomes. Contrary to predictions we found no evidence of poorer wellbeing amongst international students when compared to domestic students. The results indicate that complimenting measurement of distress with measurement of positive and adaptive states can more comprehensively capture the precarious mental status of our tertiary students. Providing this measurement in a scalable and targeted way provides universities and its students the opportunity to provide and use mental health interventions based on the needs of particular cohorts of students, moving beyond resource-intense but intermittent or untargeted approaches to intervention.

People seeking asylum in Australia face complex and significant barriers accessing higher education. Due to the temporary nature of their visa, their only pathway to university is being granted admission as an international student, which is financially prohibitive. This paper focuses on the lived experience of people seeking asylum with regard to accessing higher education, and identifies six major themes: the importance of accessing studies; the stress of struggling to meet living expenses while studying; mental health issues; support for people with disabilities, health challenges, and family responsibilities; the importance of language support and navigational brokers; and the role of higher education in the settlement of people seeking asylum. The research indicates that more university and community support is needed to foster access and participation, but the priority should be on addressing the Australian Federal Government policies that underpin the most significant barriers facing people seeking asylum in accessing higher education. This recommendation is most pressing in light of the re-election of the Coalition Government in May 2019, which has committed to continue these restrictive policies.

This paper explores existing evidence on indicators of risk to the mental health status of Chinese students studying in Australian universities prior to the COVID-19 pandemic. Studies published from January 1999 to January 2020 were considered. Findings indicated that Chinese students routinely report increased levels of fear, stress, anxiety, depression and social problems, as well as decreased levels of general well-being, while studying in Australia. Numerous factors may exacerbate the issues confronted by Chinese university students studying in Australia, including language barriers; social, academic and financial difficulties; challenges associated with the different education systems of the two countries; and their own underuse of available mental health services. Recommendations for further practice and research are presented based on these findings.

This review aims to address the major sources of stress experienced by international students, the role of individual differences, the chronology of their stress levels and wellbeing over time, and gaps in the existing literature. Two electronic databases (PubMed and Psych Info) were searched for English peer-reviewed articles using eight search terms. Thirty-eight studies were included in this paper and divided into themes and sub-themes including sources of stress, individual differences and mental health including stress, depression and wellbeing. The findings highlight major stressors and show mixed results in some areas due to the lack of homogenous samples based on country of origin or ethnicity and sometimes context differences concerning the country or university social dynamics. Limitations were identified in the methodology, and several recommendations for future research are included.

Objectives: To report rates of perinatal mental health screening from 2000 to 2017 and investigate factors associated with not being screened both antenatally and postnatally more recently (2013-2017)., Methods: A longitudinal community-based study of self-reported perinatal mental health screening with a national sample of 7,566 mothers from the Australian Longitudinal Study on Women's Health reporting on 9,384 children. The main outcome measure was whether mothers were asked about their emotional wellbeing by a health professional, including completing a questionnaire., Results: From 2000 to 2017, the percentage of women not screened decreased from 40.6% to 1.7%. The percentage of women screened both antenatally and postnatally increased from 21.3% to 79.3%. From 2013 to 2017, women who were older (aOR, 0.65; 95%CI, 0.52-0.81) or had reported emotional distress (aOR, 0.77; 95%CI, 0.60-0.99) were less likely to have been screened both antenatally and postnatally., Conclusions: Despite improvements, perinatal mental health screening is not yet universal. One-in-five women are not screened both antenatally and postnatally, including women in high-risk populations such as those who have reported emotional distress. Implications for public health: Women are in regular contact with health professionals in the perinatal period. This opportunity to detect women at risk of perinatal mental health issues is too important to be missed., (© 2020 The Authors.)

Objective: To assess the effect of the Australian Disability Support Pension (DSP) on the symptomology of depression and anxiety over and above the effects of reporting a disability itself., Methods: We used the Household Income Labour Dynamics in Australia (HILDA) survey from 2004 to 2017. We used fixed effects regression to understand mental health differences (using the Mental Health Inventory-5 [MHI-5]) when a person reported: i) a disability; or ii) a disability and receiving the DSP) compared to when they reported no disability. The models controlled for time-varying changes in the severity of the disability and other time-related confounders., Results: There was a 2.97-point decline (95%CI -3.26 to -2.68) in the MHI-5 when a person reported a disability compared to waves in which they reported no disability and 4.48-point decline (95%CI -5.75 to -3.22) when a person reported both a disability and being on the DSP compared to waves in which they reported neither., Conclusions: Results suggest that accessing and being in receipt of the DSP can impact the mental health of people with disabilities. Implications for public health: Government income support policies should address the unintended adverse consequences in already vulnerable populations., (© 2020 The Authors.)

In this paper, the author argues for a more humanistic approach to children and young people who face difficulties in their personal and social lives. Increasingly, young people in the developed world who are troubled or troublesome in school or in their neighbourhoods are categorised and labelled in terms of psychiatric disorder. The number of children taking psychotropic drugs is increasing rapidly in the most affluent countries. The need for wider markets for drug manufacturers suggests that this phenomenon will soon become even more widespread. While it may sometimes be appropriate to prescribe medication for children with mental health problems, in countries like Britain, the USA and Australia this solution can often be too quickly reached. In this paper, the author argues for the development of a multi-dimensional model which recognises that individual young men and women have their own subjectivities and may have personal troubles; but she also acknowledges that the way such troubles are expressed and described reflects the enmeshing of the individual experience with a complex range of social factors.

Background: Anxiety and depressive disorders typically emerge in adolescence and can be chronic and disabling if not identified and treated early. School-based universal mental health screening may identify young people in need of mental health support and facilitate access to treatment. However, few studies have assessed the potential harms of this approach. This paper examines some of the potential mental health-related harms associated with the universal screening of anxiety and depression administered in Australian secondary schools. Methods: A total of 1802 adolescent students from 22 secondary schools in New South Wales, Australia, were cluster randomised (at the school level) to receive either an intensive screening procedure (intervention) or a light touch screening procedure (control). Participants in the intensive screening condition received supervised self-report web-based screening questionnaires for anxiety, depression and suicidality with the follow-up care matched to their symptom severity. Participants in the light touch condition received unsupervised web-based screening for anxiety and depression only, followed by generalised advice on help-seeking. No other care was provided in this condition. Study outcomes included the increased risk of anxiety, depression, psychological distress, decreased risk of help-seeking, increased risk of mental health stigma, determined from measures assessed at baseline, 6 weeks post-baseline, and 12 weeks post-baseline. Differences between groups were analysed using mixed effect models. Results: Participants in the intensive screening group were not adversely affected when compared to the light touch screening condition across a range of potential harms. Rather, participants in the intensive screening group were found to have a decreased risk of inhibited help-seeking behaviour compared to the light touch screening condition. Conclusions: The intensive screening procedure did not appear to adversely impact adolescents' mental health relative to the light touch procedure. Future studies should examine other school-based approaches that may be more effective and efficient than universal screening for reducing mental health burden among students. Trial registration Australian and New Zealand Clinical Trials Registry (ACTRN12618001539224) https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375821. [ABSTRACT FROM AUTHOR]

With an interdisciplinary focus on creativity, inclusion and wellbeing, this paper provides a conceptual argument for additional and reimagined arts education programs in schools that incorporate creative arts therapies. Based on a review of literature in this field, it documents the practices and value of creative art therapies, for students currently experiencing or at risk of mental health problems. In a global context where mental health issues are on the rise, an emotional curriculum is discussed that includes awareness of mental health issues, promotion of wellbeing and incorporation of inclusivity to enhance positive outcomes for individuals and communities. A philosophy is presented that aims to connect students and teachers through art experiences in a way that meaningfully and effectively addresses the strengths and needs of a diverse range of students. Drawing on the authors' different practices, positive psychology and poststructural theory, this philosophy seeks to maximise students' potential to flourish as individuals and classroom members, whilst acknowledging that we all experience life and learning differently.

The impact of COVID-19 on the mental health and wellbeing of adolescents is a major concern. Most research has been conducted only in more economically developed countries. Using data from two similar surveys administered during July-September, 2020 in Australia (a high-income country) and Cambodia (a low-middle income country), this paper examined the impact early in the pandemic on the mental health and wellbeing of adolescents in the two countries. We found that COVID-19 had mostly negative impacts on participants' mental health; threats to personal safety; education; support for schooling; basic necessities such as food, income, employment, and housing; and responsibilities at home. This finding suggests that even short-term disasters may have negative repercussions, and regardless of differences in wealth, culture, and government response. We found that threats to personal safety appeared to be more prevalent in Cambodia than in Australia, the impact on mental health of the Cambodian participants may have been greater than reported, and that, in both countries, support for online or distance schooling during periods of lockdown was wanting, particularly at the state and school levels. This study will contribute to our understanding of the impact of major disruptive global events on young people in both more economically developed and developing countries., Competing Interests: The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Van Dyke, Keo and de Courten.)

The Faculty of Engineering in an Australian university collaborated with a central academic/educational development unit to design and deliver a teaching development program for all engineering teaching assistants (TAs). This paper discusses the approach taken to promote inclusive education in engineering in a situation with competing priorities. One of the strategies employed in the program aimed at enhancing the TAs' awareness of the diversity of learning styles and abilities within their student cohort with particular reference to students with a learning disability or a mental health condition. Research (Mortimore, 2003) has shown that certain learning styles can be characteristic of a learning disability or mental health condition. A standard learning styles inventory tool was introduced so TAs could identify their own preferences and realize the learning environment can be "disabling" when there is a mismatch between a learning preference and teaching style. Through discussions and activities, TAs developed inclusive teaching strategies which could facilitate learning for all students. The program provided opportunities to discuss other issues related to diversity among students and other members of the university community, and effective communication skills. Changes in the attitude of the engineering TAs and faculty towards this program are discussed.

More than 800,000 Australians every year are affected by depression. Despite evidence that depression is manageable, that people can be successfully treated in individually appropriate ways and that earlier identification and treatment are associated with more rapid recovery, depression appears to be poorly recognised and understood. In this paper, I focus on depression in the workplace. Semi-structured interviews were conducted with human resource managers in eight organisations within the deregulated information and computing technology sector in South Australia. I focus on managers' ability to access information about depression, and their beliefs about the value of work-based education about the illness. I also report on managers' understandings of prevailing attitudes towards depression and mental health education in their workplaces. The analysis is conducted within a qualitative, interpretive framework. (Contains 1 table.)

A variety of developments in nursing education in Australia including some innovative and exciting models, educational enterprises between education and industry, and evidence of developing strengths in research and professional alliances on a national level have been discussed recently. This paper presents Simulation to Practice as an example of an educational program that can maximise skill mastery for nurses in mental health fields as practised by Deakin University in Victoria, Australia. The program is multimodal and is under-pinned by a problem-solving approach and has an online presentation. The extension of nursing skills through this approach encourages nurses to take theoretical skills to practice during these scenarios which help student nurses to gain experience through simulated real life characters. These sessions, while challenging at the time, were highly valued by students and seen as a beneficial part of their learning as a beginning nurse and often instrumental in moving comprehensively trained students into mental health careers.

Background: The gaps in healthy life expectancy (HLE) between Indigenous and non-Indigenous Australians are significant. Detailed and accurate information is required to develop strategies that will close these health disparities. This paper aims to quantify and compare the causes and their relative contributions to the life expectancy (LE) gaps between the Indigenous and non-Indigenous population in the Northern Territory (NT), Australia. Methods: The age-cause decomposition was used to analyse the differences in HLE and unhealthy life expectancy (ULE), where LE = HLE + ULE. The data was sourced from the burden of disease and injury study in the NT between 2014 and 2018. Results: In 2014–2018, the HLE at birth in the NT Indigenous population was estimated at 43.3 years in males and 41.4 years in females, 26.5 and 33.5 years shorter than the non-Indigenous population. This gap approximately doubled the LE gap (14.0 years in males, 16.6 years in females) at birth. In contrast to LE and HLE, ULE at birth was longer in the Indigenous than non-Indigenous population. The leading causes of the ULE gap at birth were endocrine conditions (explaining 2.9–4.4 years, 23–26%), followed by mental conditions in males and musculoskeletal conditions in females (1.92 and 1.94 years, 15% and 12% respectively), markedly different from the causes of the LE gap (cardiovascular disease, cancers and unintentional injury). Conclusions: The ULE estimates offer valuable insights into the patterns of morbidity particularly useful in terms of primary and secondary prevention. [ABSTRACT FROM AUTHOR]

This article describes one school's response to the inclusion and education of refugee and asylum seeker students within a mainstream educational setting. Australian government statistics released on 31 March 2016 stated that there were presently 50 children being held on Nauru, 17 children held in detention on the mainland and 317 children held in community detention on the mainland (ChilOut, 2016). Refugee and asylum seeking students are subject to the impact of war and conflict; the cumulative time spent in detention may severely limit a young person's access to formal education. Whilst it is understood that children will benefit from access to education, the reality is that "little appears to have been written on asylum seekers" in an educational context (Reakes, 2007, p. 94). This represents a concern when it is acknowledged that "sustaining teachers in culturally and linguistically diverse schools has been a prominent issue for years" (Williams, Edwards, Kuhel, & Lim, 2016, p. 17). This article responds to the limitations of current literature by articulating considerations that would likely assist other schools seeking to establish similar inclusive frameworks. Specifically, the thematic grouping of staff observations seek to articulate the cultural considerations that likely influence the sustainability of an inclusive and liberating approach to integrative school enrolment. This paper draws on the authors' observations and experiences in schools, the published literature and the observations of the two authors--specifically, drawing on their educational and therapeutic expertise. These observations are then grouped into themes outlined by Akinsulure-Smith and O'Hara (2012) as key reasons for therapeutic referral, namely: employment barriers, medical challenges, language barriers, social services and legal challenges.

Objectives: The Future Proofing Study (FPS) was established to examine factors associated with the onset and course of mental health conditions during adolescence. This paper describes the design, methods, and baseline characteristics of the FPS cohort. Methods: The FPS is an Australian school‐based prospective cohort study with an embedded cluster‐randomized controlled trial examining the effects of digital prevention programs on mental health. Data sources include self‐report questionnaires, cognitive functioning, linkage to health and education records, and smartphone sensor data. Participants are assessed annually for 5 years. Results: The baseline cohort (N = 6388, M = 13.9 years) is broadly representative of the Australian adolescent population. The clinical profile of participants is comparable to other population estimates. Overall, 15.1% of the cohort met the clinical threshold for depression, 18.6% for anxiety, 31.6% for psychological distress, and 4.9% for suicidal ideation. These rates were significantly higher in adolescents who identified as female, gender diverse, sexuality diverse, or Aboriginal and/or Torres Strait Islander (all ps < 0.05). Conclusions: This paper provides current and comprehensive data about the status of adolescent mental health in Australia. The FPS cohort is expected to provide significant insights into the risk, protective, and mediating factors associated with development of mental health conditions during adolescence. [ABSTRACT FROM AUTHOR]

Background: Historically, researchers have been apt at conducting research on, rather than with, the people who are the focus of their efforts. Such approaches often fail to effectively support and benefit the populations they are intended to. This study aimed to explore the preferences of people with lived experience for engagement with research either as research participants within studies, or through active involvement in mental health research., Methods: Data for this paper were collected in three separate lived experience agenda-setting studies conducted over a 9-year period from 2013 to 2022; two group discussions and an open-ended online survey. Data were combined and thematic analysis undertaken., Results: Participants described the inclusion of lived experience as a critical ingredient and the highest level of knowledge and expertise in mental health research that should lead to knowledge generation and research agendas. Participants discussed the importance and value of research that enables sharing experiences and stories, expressed a need for flexibility in research methods for choice and agency, and support for greater active involvement of people with lived experience across all stages of research. Participants also spoke to the need for perspective and knowledge generated from people with lived experience to have equal power in research, making space for lived experience voices across multiple aspects of research, and greater respect and recognition of the value of lived experience., Conclusion: Lived experience in mental health research is coming of age, but dedicated, cocreated development is needed to get it right. People with lived experience increasingly understand the value their experiential knowledge brings to the mental health research effort, and describe a wide range of ways that researchers can support them to be research participants, and to get actively involved. Power-sharing, respect and recognition of lived experience as central to effective mental health research are the keys to 'keeping it real'., Patient or Public Contribution: People with lived experience of mental health problems or distress either personally, and/or as carers, family and kinship group members, were involved in the coideation and codesign of this research. All authors identify as people with lived experience., (© 2023 The Authors. Health Expectations published by John Wiley & Sons Ltd.)

Suicide in children is a significant and growing problem. The "zero suicide" framework (ZSF) is one approach to suicide prevention used in health services for adults and children. This paper reports on the introduction of the first suicide prevention pathway (SPP) based on ZSF at a Child and Youth Mental Health Service (CYMHS) in Australia. It begins by describing the adaptations made to elements of the SPP originally designed for adults to meet the needs of children. Lessons learned in applying the SPP in the service are then discussed. The aim is to inform and improve practice in the use of zero suicide approaches in child and youth mental health settings in Australia and worldwide. [ABSTRACT FROM AUTHOR]

Suicide has a devasting and far-reaching effect on our communities. In developed countries, most people who die by suicide are male. Understanding men's mental health and what they experience in a suicidal state is key to preventing future attempts. Our paper explores how a group of 37 men in Australia describe the leadup to their suicidality. Underpinned by interpretive phenomenological analysis, interview transcripts were examined for phrases that the investigative team subjectively identified as profound. Our approach considered language and expression that evoke reactions to the sometimes contradictory nature of suicide. The process enabled our team to identify the emotions, rationales, and motivations for and against suicide that give rise to and arise during suicidal states. One man's source of strength may be another's cause of anguish, so any single, one-size-fits-all pathway to suicide prevention is unlikely to succeed, signaling the need for a tailored approach to suicide prevention. [ABSTRACT FROM AUTHOR]

Background: Doctors with a history of mental health or substance use challenges face barriers accessing treatment and are difficult to recruit for research. This makes understanding their experiences challenging, yet essential. Overcoming barriers to research participation among unwell doctors is critical to advancing their overall health and wellbeing. Methods: A qualitative interview study of 21 allegedly impaired doctors in Australia and Aotearoa New Zealand who were subject to regulatory processes relating to their health. Based in an interpretative phenomenological paradigm, this paper examines participants' motivations for participation in this study and their reactions to participating. It highlights wider implications for sensitive research involving doctors and marginalised groups. Results: Participants were strongly motivated to participate in our research for their own benefit (desire to be heard, catharsis, and empowerment) and to benefit others (to change the system, and to avoid other doctors experiencing what they experienced). Careful planning and communication of unique legal risks fostered a trusting researcher-participant relationship. To assist other researchers undertaking sensitive qualitative research with vulnerable participants, we describe our research protocol, challenges, and successes in detail. Conclusions: Despite ethical concerns about research risk, researchers can and should pursue qualitative research into the experiences of under-represented groups, including allegedly impaired doctors. Without involving them in research that examines issues directly impacting on them, we may be inadvertently perpetuating the barriers and stigma that also hinder them from accessing treatment and support. This also deprives us of knowledge that can be used to improve doctors' health. This paper has broader relevance for anyone doing research with doctors, people in vulnerable positions, people disempowered by institutional or social systems, people who are stigmatised or shamed, and people who have experienced trauma. [ABSTRACT FROM AUTHOR]

Background: The Unmind Index is a 26-item, 7-subscale measure of mental health and wellbeing designed for use on the Unmind digital workplace mental health platform. The Unmind Index was developed and validated in the UK but is used internationally. This paper reports further psychometric validation of this measure for use in USA, Australia, and New Zealand (ANZ)., Methods: Participants in four countries completed the Unmind Index and a battery of existing measures. In Study 1 (N = 770), we validated the Unmind Index separately in USA and in ANZ. In Study 2 (N = 600), we used multiple group confirmatory factor analysis to test the measurement invariance of the Unmind Index across the UK, USA, and ANZ., Results: Study 1 establishes the factor structure, reliability, convergent and discriminant validity, and measurement invariance by age and gender of the Unmind Index separately for USA and for ANZ. Study 2 further demonstrates measurement invariance across locations, and establishes benchmark scores by location, age, and gender., Conclusions: We conclude that the Unmind Index is valid and reliable as a measure of mental health and wellbeing in these locations., Competing Interests: Authors ET and HB are employees of and hold stock options in Unmind Ltd. Authors LS and BSL are employees of the University of Cambridge Psychometrics Centre, which received payment from Unmind Ltd for consultancy services delivered by the authors. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2023 Travers et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Aims: The primary aim of the review was to provide an overall assessment of residential parenting services in Australia, by describing the characteristics of infants and parents using residential parenting services, their prior service use and reasons for admission, referral pathways for access and parenting and infant outcomes. The secondary aims were to explore parent and staff perception of the programmes. Design: An integrative literature review. Methods: A systematic and comprehensive search of health and social sciences databases was conducted for studies related to residential parenting services (published between 1st January 1990–31st December 2019). Six hundred and eleven peer‐reviewed papers were identified, after which 301 duplicates were removed and an additional 256 papers excluded after titles/abstracts were read. Of the remaining 54 abstracts/papers, a further 14 were omitted as not relevant. Forty papers were independently reviewed by four authors. ENTREQ and MOOSE checklists were applied. Results: Thirty studies were quantitative, nine were qualitative, and one was mixed methods. All studies originated from in Australia. Women and babies admitted to residential parenting services were found more likely to be: older, Australian born, from higher socio‐economic groups, and first‐time mothers, and having labour and birth interventions and a history of mental health disorders. The babies were more likely to be twins, male and admitted with sleep disorders and dysregulated behaviour. Studies reporting postintervention outcomes demonstrated improvements to maternal mental health, breastfeeding, parenting confidence and sleep quality, and infant sleeping and behaviour. [ABSTRACT FROM AUTHOR]

Multiculturalism is a familiar concept in many developed countries. While cultural competency training is part of most medical curricula, training in cultural psychiatry at the undergraduate level is typically minimal. It is important that medical graduates are both culturally competent and able to respond to the mental health needs of patients from diverse cultures. This paper provides an overview of the teaching of cultural competency and cultural psychiatry to medical students, and discusses aspects of cultural psychiatry that could be included in medical courses. It was concluded that there needs to be more attention given to teaching of cultural psychiatry in the undergraduate curriculum. The challenge for medical curricula is in the provision of cultural psychiatry content to ensure that students are able effectively to communicate, assess and treat patients from different cultural backgrounds by the time they graduate and begin their professional careers.

Background: Indigenous children living in high income countries have a consistently high prevalence of mental health problems. We aimed to identify psychosocial risk and protective factors for mental health in this setting. Methods: A systematic review of studies published between 1996 and 2016 that quantitatively evaluated the association between psychosocial variables and mental health among Indigenous children living in high income countries was conducted. Psychosocial variables were grouped into commonly occurring domains. Individual studies were judged to provide evidence for an association between a domain and either good mental health, poor mental health, or a negligible or inconsistent association. The overall quality of evidence across all studies for each domain was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) guidelines. Results: Forty-seven papers were eligible (mainland US 30 [64%], Canada 8 [17%], Australia 7 [15%], Hawaii 4 [9%]), including 58,218 participants aged 4-20 years. Most papers were cross-sectional (39, 83%) and measured negative mental health outcomes (41, 87%). Children's negative cohesion with their families and the presence of adverse events appeared the most reliable predictors of increased negative mental health outcomes. Children's substance use, experiences of discrimination, comorbid internalising symptoms, and negative parental behaviour also provided evidence of associations with negative mental health outcomes. Positive family and peer relationships, high self-esteem and optimism were associated with increased positive mental health outcomes. Conclusions: Quantitative research investigating Indigenous children's mental health is largely cross-sectional and focused upon negative outcomes. Indigenous children living in high income countries share many of the same risk and protective factors associated with mental health. The evidence linking children's familial environment, psychological traits, substance use and experiences of discrimination with mental health outcomes highlights key targets for more concerted efforts to develop initiatives to improve the mental health of Indigenous children. [ABSTRACT FROM AUTHOR]

The people-related intentions enumerated in the 2013 White Paper are timely, appropriate and sensible, and will help the Australian Defence Force (ADF) to adjust to an impending era of lower pace and a more nebulous threat. The White Paper asserts the need to maintain personnel numbers, push on with integration and inclusiveness, improve management of education and training, and strengthen support for both families and the treatment and management of mental health and post-traumatic stress. The major cause for concern is the White Paper's excessive emphasis on using 'programs' as the major vehicles for organisational change, rather than relying more on simply improving basic, commonsense ways of doing things. This article argues that, with the right people systems and the right leadership, the ADF can turn many of the challenges of adjusting to a lower tempo era to its advantage. [ABSTRACT FROM AUTHOR]

Background: Primary healthcare services have principal responsibility for providing child and youth wellbeing and mental health services, but have lacked appropriate measurement instruments to assess the wellbeing of Indigenous children and youth or to evaluate the effectiveness of programs and services designed to meet their needs. This review assesses the availability and characteristics of measurement instruments that have been applied in primary healthcare services in Canada, Australia, New Zealand and the United States (CANZUS countries) to assess the wellbeing of Indigenous children and youth. Methods: Fifteen databases and 12 websites were searched in December 2017 and again in October 2021. Pre-defined search terms pertained to Indigenous children and youth, CANZUS country names, and wellbeing or mental health measures. PRISMA guidelines were followed, with eligibility criteria guiding screening of titles and abstracts, and selected full-text papers. Results are presented based on the characteristics of documented measurement instruments assessed according to five desirability criteria: development for Indigenous youth populations, adherence to relational strength-based constructs, administration by child and or youth self-report, reliability and validity, and usefulness for identifying wellbeing or risk levels. Results: Twenty-one publications were found that described the development and or use by primary healthcare services of 14 measurement instruments, employed across 30 applications. Four of the 14 measurement instruments were developed specifically for Indigenous youth populations, four focused solely on strength-based wellbeing concepts but none included all Indigenous wellbeing domains. Conclusion: There is a diversity of measurement instruments available, but few fit our desirability criteria. Although it is possible that we missed relevant papers and reports, this review clearly supports the need for further research to develop, refine or adapt instruments cross-culturally to measure the wellbeing of Indigenous children and youth. [ABSTRACT FROM AUTHOR]

The Australian construction industry is facing a mental health crisis; poor mental health indicators are significantly higher than the all-industry average. Despite a growing body of research into the mental health of the industry's workforce, concerns have been raised about its alignment with regulatory developments in this area. This raises questions about the relevance of research to support mental health policy development in Australia and evidence-based research on mental health policy relating to the construction industry. However, there has been no research to explore the extent of this problem. This paper addresses this knowledge gap by reporting the results of a systematic review of peer-reviewed mental health research using the PRISMA scoping review methodology. The results reveal significant misalignment between existing research and Australian government regulation in this area. A particularly low level of research–policy alignment is found in the areas of: violence and traumatic events at work, financial concerns, poor organizational change management, workplace injustice, and social support. The paper concludes with recommendations for new avenues of mental health research to address these gaps, enabling closer alignment between mental health research and regulatory reform. It is concluded that this will facilitate more relevant research and improved evidence-based decision-making in this important field of research and policy development. [ABSTRACT FROM AUTHOR]

Introduction: Many parents and carers experience mental health challenges during pregnancy and early postpartum years, and there are cumulative shortfalls in the identification, follow-up, and treatment of those experiencing perinatal and infant mental health (PIMH) challenges. ForWhen is a new national navigation programme in Australia that aims to improve outcomes for families by supporting parents and carers to access PIMH services that best meet their needs. This paper presents the protocol of an evaluation of the ForWhen programme, to be conducted over the first 3 years of its implementation. The specific objectives of the evaluation include examining the characteristics of navigation service delivery, its implementation and clinical impact, and identifying potential moderators of change., Methods and Analysis: Utilising a mixed-methods design, this evaluation will incorporate three phases that reflect the stages of the programme life-cycle: (1) programme description, (2) implementation evaluation and (3) outcomes evaluation. The evaluation will use a mix of quantitative and qualitative data including deidentified routinely collected service data, participant observations, semistructured interviews, surveys and questionnaires, and a resource audit., Discussion: Evaluation findings will be used to inform the development of a refined clinical navigation model, identify barriers and facilitators to successful navigation programme implementation, examine the impact of the ForWhen programme on client clinical outcomes and health service utilisation, understand how the programme is/can be best embedded in the evolving service system, and assess the cost-effectiveness and sustainability of a national navigation programme in improving health outcomes for PIMH in Australia., Ethics and Dissemination: This research was approved by South Western Sydney Local Health District Human Research Ethics Committee (2021/ETH11611). This study was registered on the Australian New Zealand Clinical Trials Registry (ACTRN12622001443785). Results will be disseminated at conferences, in scientific journals, and in a final evaluation report., Competing Interests: Competing interests: JK works in a cofunded academic position with UNSW and Karitane (ForWhen lead agency)., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Communities of practice (CoPs) are frequently used in health settings to enhance knowledge and support action around public health issues. Yet, most are ineffective and often at risk of not delivering on this promise. To prevent loss of time and resources by organisations, facilitators, and members, this paper argues for a reliable assessment of the needs of people who intend to join and to set realistic expectations to assure effective communities of practice. This research proposes a valid and reliable needs assessment and analysis tool for starting communities of practice, by presenting the results of using such a tool. Methods: Inception needs assessments were developed, tested and administered to 246 respondents entering five communities of practice that focused on one of three public health issues: health literacy, mental health literacy and trauma-informed care. One community of practice had a global audience, four were based in Australia. Data from the needs assessments were analysed qualitatively and supplemented with descriptive statistics. Results were used to develop an analysis tool to support future communities of practice. Results: The short-term expectations of respondents included seeking to increase their knowledge and getting to know other members of the community of practice. Long-term expectations shifted towards undertaking action, collaborating and improving health outcomes. While respondents learning expectations included a wide range of topics, they articulated very specific knowledge they expected to share with others. There were high expectations of receiving practical support from the facilitator and a strong preference for meetings with synchronous interaction. Most respondents who planned to join focused initially on the direct and individual benefits and participation they expected from others, whereas they indicated limited intention to actively contribute to the learning needs of other community members. Respondents appeared to need to take time to build self-confidence and trust, and frequently applied a wait-and-see attitude. Conclusions: The findings of this study suggest that an inception needs assessment allows members to express their needs and expectations, which directly informs the direction and structure of a community of practice, gives voice to members, and supports facilitators in managing expectations. [ABSTRACT FROM AUTHOR]