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Introduction: Mental ill-health, substance use and their co-occurrence among sexuality diverse young people during earlier adolescence is relatively understudied. The preventive utility of positive school climate for sexuality diverse adolescents' mental health is also unclear, as well as the role of teachers in conferring this benefit., Method: Using Wave 8 'B Cohort' data from the Longitudinal Study of Australian children ( N  = 3127, M  = 14.3), prevalence ratios and odds ratios were used to assess prevalence and disparities in mental ill-health and substance use, and multinomial logistic regression for co-occurring outcomes, among sexuality diverse adolescents relative to heterosexual peers. Logistic regression was used to assess associations between school climate and teacher self-efficacy with sexuality diverse adolescents' mental health.age  = 14.3), prevalence ratios and odds ratios were used to assess prevalence and disparities in mental ill-health and substance use, and multinomial logistic regression for co-occurring outcomes, among sexuality diverse adolescents relative to heterosexual peers. Logistic regression was used to assess associations between school climate and teacher self-efficacy with sexuality diverse adolescents' mental health., Results: Mental ill-health prevalence ranged from 22% (suicidal thoughts/behaviour) to 46% (probable depressive disorders) and substance use between 66% (cigarette use) and 97% (alcohol use). Sexuality diverse participants were significantly more likely to report self-harm and high levels of emotional symptoms in co-occurrence with cigarette, alcohol and/or cannabis use. For each 1-point increase in school climate scores as measured by the Psychological Sense of School Membership scale, there was 10% reduction in sexuality diverse adolescents reporting high levels of emotional symptoms, probable depressive disorder, self-harm thoughts/behaviour and suicidal thoughts/behaviour. For each 1-point increase in lower perceived (worse) teacher self-efficacy scores as measured by four bespoke teacher self-efficacy items, odds of sexuality diverse adolescent-reported suicidal thoughts/behaviour increased by 80%., Discussion: Mental ill-health, substance use and especially their co-occurrence, are highly prevalent and pose significant and inequitable health and well-being risks. Schools represent a potential site for focusing future prevention efforts and educating and training teachers on sexuality diversity is a promising pathway towards optimising these., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Few studies have examined associations between gender non-conformity (GNC) in childhood or adolescence and mental health outcomes later in life. This study examined associations between (1) GNC and mental health over multiple time points in childhood and adolescence, and (2) GNC in childhood and/or adolescence and mental health in adulthood., Method: Second generation participants from the Raine Study, a longitudinal cohort from Perth, Western Australia. Data were collected between 1995 and 2018, comprising seven waves: ages 5 ( N = 2236), 8 ( N = 2140), 10 ( N = 2048), 14 ( N = 1864), 17 ( N = 1726), 22 ( N = 1236) and 27 ( N = 1190) years. History of GNC, v. absence of this history, was based on responses to item 110 from the Child Behaviour Checklist (CBCL)/Youth Self Report (YSR) ('wishes to be of opposite sex'). The CBCL/YSR were used to measure internalising and externalising symptoms. Items 18 ('deliberate self-harm [DSH] or attempts suicide') and 91 ('talks/thinks about killing self') were used as measures of suicidal ideation (SI) and DSH. For adults, Depression, Anxiety and Stress Subscales and Kessler Psychological Distress Scale assessed mental health., Results: Child and adolescent GNC was associated with elevated internalising and externalising behaviours and increased odds of DSH. A history of GNC was also associated with vulnerability for severe psychological distress in adulthood in some symptom scales., Conclusion: GNC over the child and adolescent period is associated with significant emotional and behavioural difficulties, and psychological distress. A history of GNC in childhood and/or adolescence also predicts poorer mental health in adulthood on multiple symptom domains.

Objectives: There is limited evidence on the impact of parental mental health problems on offspring's educational outcomes. We investigated the impact of maternal anxiety and depressive symptoms, as well as paternal emotional problems on the educational outcomes of their adolescent and young adult offspring., Methods: We used data from a longitudinal birth cohort recruited between 1989 and 1991 in Australia (the Raine Study). The Depression, Anxiety and Stress Scale was used to assess maternal depressive and anxiety symptoms, and a self-reported question was used to measure paternal mental health problems. Both were assessed when the offspring was aged 10 years. Outcomes included offspring's self-reported education attainment-not completing year 10 at age 17, not attending tertiary education at ages 17 and 22 and primary caregiver's reports of offspring's academic performance at age 17., Results: A total of 1033, 1307 and 1364 parent-offspring pairs were included in the final analysis exploring the association between parental mental health problems and offspring's academic performance at school, completing year 10 and attending tertiary education, respectively. After adjusting for potential confounders, the offspring of mothers with anxiety symptoms were 3.42 times more likely than the offspring of mothers without anxiety symptoms to have poor or below-average academic performance (odds ratio = 3.42; 95% confidence interval = [1.31, 8.92]) and more than 2 times more likely to not attend tertiary education (odds ratio = 2.55; 95% confidence interval = [1.10, 5.5.88]) and not to have completed year 10 (odds ratio = 2.13; 95% confidence interval = [1.04, 4.33]). We found no significant associations between maternal depressive symptoms or paternal emotional problems and offspring educational attainment., Conclusion: Maternal anxiety symptoms, but not depression and paternal emotional problems, are associated with poor educational attainment and achievement in adolescent offspring. The findings highlight that efforts to improve the outcomes of offspring of mothers with anxiety could focus on educational attainment.

It is critical that health service evaluation frameworks include Aboriginal people and their cultural worldviews from design to implementation. During a large participatory action research study, Elders, service leaders and Aboriginal and non-Aboriginal researchers co-designed evaluation tools to test the efficacy of a previously co-designed engagement framework. Through a series of co-design workshops, tools were built using innovative collaborative processes that foregrounded Aboriginal worldviews. The workshops resulted in the development of a three-way survey that records the service experiences related to cultural safety from the perspective of Aboriginal clients, their carer/s, and the service staff with whom they work. The surveys centralise the role of relationships in client-service interactions, which strongly reflect their design from an Aboriginal worldview. This paper provides new insights into the reciprocal benefits of engaging community Elders and service leaders to work together to develop new and more meaningful ways of servicing Aboriginal families. Foregrounding relationships in service evaluations reinstates the value of human connection and people-centred engagement in service delivery which are central to rebuilding historically fractured relationships between mainstream services and Aboriginal communities. This benefits not only Aboriginal communities, but also other marginalised populations expanding the remit of mainstream services to be accessed by many.

Background: Epidemiological data indicate that paternal and maternal mental health difficulties are predictors of conduct disorder (CD) and oppositional defiant disorder (ODD) in offspring. We tested the association between maternal anxiety and depressive symptoms and paternal emotional problems with CD and ODD symptoms in adolescent offspring aged 17., Methods: Data was from the Raine Study, a birth cohort study based in Western Australia. Offspring CD and ODD symptoms at age 17 years were measured using the DSM-oriented scales of the Child Behavior Checklist (CBCL). Depression, Anxiety, and Stress Scale (DASS) was used to assess maternal depressive and anxiety symptoms, and a self-reported questionnaire measured paternal emotional problems when the offspring was 10 years. Negative binomial regression model was used to explore associations., Results: Adjusting for potential confounding factors, we found an increased risk of CD symptoms in the offspring of mothers with anxiety [RR = 1.76 (95%CI; 1.08-2.86)], depressive [RR = 1.40 (95%CI; 1.01-1.95)], and comorbid anxiety and depressive symptoms [RR = 2.24 (95%CI 1.35-3.72)]. We also found an increased risk of ODD symptoms in offspring of mothers with depressive [RR = 1.24 (95%CI 1.02-1.52)], but not anxiety symptoms [RR = 1.23 (95%CI 0.92-1.67)]. No associations were seen with paternal emotional problems., Conclusion: Our study showed that adolescents whose mothers reported anxiety, depressive, and comorbid anxiety and depressive symptoms had a higher risk of CD and ODD symptoms at age 17. The findings have implications for preventive strategies., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: LGBQ+ people (Lesbian, Gay, Bisexual, Queer) are at-risk of discrimination and developing mental health issues within general populations. Limited research has assessed their mental health in emergency services occupations, a population which are known to experience poorer mental health. The current study explores the extent to which sexual orientation is associated with higher rates of mental health issues among emergency personnel., Methods: A stratified random sample of employees from twenty-nine police (N = 8,088), ambulance (N = 3,473), and fire and rescue (N = 2,975) agencies from around Australia participated in a cross-sectional mental health survey (N = 14,536, male = 64.2%, 42.7% over 45 years of age, heterosexual = 92.7%)., Results: Employees with a bisexual/pansexual orientation or those who were not sure about their sexual orientation were significantly more likely to report suicidal thoughts, suicide plans, psychological distress, and illicit drug use when compared with heterosexual employees. LGBQ+ employees reported significantly higher rates of lifetime suicide plans and attempts. Specifically, LGBQ+ fire and rescue personnel were roughly six times more likely to report lifetime suicide attempts, and approximately five times more likely to use illicit drugs weekly than their heterosexual colleagues in the fire and rescue sector. Female LGBQ+ personnel were significantly less likely to consume illicit drugs weekly and monthly than male LGBQ+ personnel., Conclusions: Emergency services personnel are already at-risk of developing pervasive mental health difficulties. It is important that organisations foster positive working environments, particularly for LGBQ+ people who may be more marginalized within organisations., (Copyright © 2021. Published by Elsevier B.V.)

Epidemiological studies indicate that children of parents with mental health problems are at an increased risk of developing anxiety disorders. Few studies have investigated this relationship in young adults. Participants were from the Raine Study, which is a multi-generational birth cohort study in Australia. Maternal anxiety and depression in late childhood were assessed using the Depression, Anxiety, and Stress Scale (DASS-42), and paternal lifetime mental health problems were assessed using a self-reported questionnaire. The short form of DASS-42 (DASS-21) was used to assess anxiety symptoms among offspring at age 20. Negative binomial regression model was used to quantify the association. Data were available for 1,220 mother-offspring and 1,190 father-offspring pairs. After adjusting for potential confounders, we found an increased risk of anxiety in young adult offspring exposed to maternal anxiety in late childhood and paternal lifetime mental health problems. However, we observed no increased risks of anxiety in offspring exposed to maternal depressive symptoms. Our sensitivity analysis based on the log-binomial model (binary outcome) as well as the linear model (log-transformed data) confirmed the robustness of the main results. Our findings suggest there can be value to consider and apply targeted screening and intervention programs of anxiety in the young adult offspring with parental mental health problems., (Copyright © 2021 Elsevier B.V. All rights reserved.)

A significant proportion of trans and gender diverse (TGD) young people report membership of the gaming community and resultant benefits to wellbeing. To date their experiences and needs regarding a key feature of games, the avatar, are largely unexplored, despite increasing interest in the therapeutic role of avatars in the general population. The aim of this study was to better understand the role of the avatar in gaming, its impact on TGD young people's mental health, and their unique needs regarding avatar design. N = 17 TGD young people aged 11-22 years (M = 16.3 years) participated in four focus groups. A general inductive approach was used to thematically analyze the transcribed data. TGD young people report considerable therapeutic benefits of using avatars with positive mental health implications. Importantly, TGD young people use avatars to explore, develop and rehearse their experienced gender identities, often as a precursor to coming out in the offline world. They also report negative experiences of feeling excluded due to the constraints of conventional notions of gender that are widely reflected in game design. Participants described simple design features to better reflect gender diversity, such as increased customization. Such changes would facilitate the positive gains reported by participants and better reflect the diversity of young people who use games. The findings have important implications for both recreational and serious or therapeutic game design.

Background: Trans and gender diverse (TGD) young people worldwide experience high rates of poor mental health; however, these rates were unknown in Australia. In addition, how negative life events affect the mental health of TGD young people has been largely unexplored., Methods: This paper reports on novel mental health findings of Trans Pathways, the largest study ever conducted in Australia with trans (transgender) and gender diverse young people (N = 859; aged 14-25 years). The study was an anonymous online cross-sectional survey undertaken in 2016. Logistic and linear regression models were used to test associations between mental health outcomes and negative life experiences., Results: TGD young people in Australia experience high levels of mental distress, including self-harming (79.7%), suicidal thoughts (82.4%), and attempting suicide (48.1%). Three in four participants had been diagnosed with depression and/or anxiety (74.6% and 72.2%, respectively). Many TGD young people had been exposed to negative experiences such as peer rejection (89.0%), precarious accommodation (22.0%), bullying (74.0%), and discrimination (68.9%). Most poor mental health outcomes were associated with negative experiences. The strongest associations were found for precarious accommodation and issues within educational settings. For example, participants with a prior suicide attempt were almost six times more likely to have experienced issues with accommodation, including homelessness., Conclusions: The current results highlight the urgent need for better mental health care and provide insight into areas for targeted mental health interventions. These findings are pertinent for clinicians working with trans young people and wider society.

Background: Anxiety and depressive symptoms and psychotic experiences constitute common features of emerging mental disorders in young people. Psychotic experiences and the ultra-high risk (UHR) state for psychosis appear to have a particular importance for clinical presentation, progression of symptomatology, quality of life and functioning, but the impact of psychotic experiences in individuals seeking help at non-UHR services, compared to UHR services, is under-researched., Methods: Sixty-nine young people (M age  ± SD at baseline = 20.8 ± 2.6, range 16-26 years, 48 females) presenting to mental health services were grouped according to UHR and non-UHR status. They were assessed at baseline for anxiety and depressive symptoms, psychological distress, psychosocial functioning and quality of life. They were followed up at three, six, and 12 months. Data were analysed using mixed linear modelling., Results: UHR individuals reported higher levels of depressive symptoms and psychological distress, and lower levels of role functioning and quality of life compared to non-UHR individuals. No differences were reported for anxiety symptoms or social functioning. Decline in psychosocial functioning was not associated with clinical deterioration or reduction of quality of life., Conclusions: Psychotic experiences appear to be particularly associated with depressive symptoms and psychological distress, impaired role functioning and quality of life in help-seeking young people in the medium-term. It is therefore important to pay special attention to psychotic experiences in the early stages of mental health problems even if psychotic symptoms are not the main motivation for help-seeking.

Currently, there is little research investigating how schools can support the mental health and social development of young people with cystic fibrosis (CF), given their heightened risk of mental illness. Few studies have examined the relationship between bullying and mental health in populations of children with CF. This study describes the peer bullying experiences of young people with CF, and examines associations between school bullying and the psychological well-being of these young people. A sequential mixed-methods approach was used to collect data from 26 young people with CF (10-16 years of age). These data were compared with large samples of healthy children. Following an online survey, 11 young people, through online focus groups, expanded on the survey findings, describing their experiences within the school environment. Young people with CF reported lower involvement in bullying victimization and perpetration relative to the comparison population. For older adolescents with CF, victimization was associated with less connectedness to school and less peer support, and more school loneliness, anxiety, and depression. Young people with CF reported they generally liked the school environment, and were happy with their friendships, whereas some older adolescents reported that bullying evoked anxiety and mood problems. Reported bullying was primarily verbal and targeted characteristics of their CF, including their coughing, noninvolvement in certain activities because of shortness of breath, use of medication, and being underweight (for boys only). The findings provide some recommendations for interventions to promote mental health and school engagement among young people with CF. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Objective: Type 1 diabetes in youth and community controls were compared on functional outcomes. Relationships were examined between psychosocial variables at diagnosis and functional outcome 12 years later., Research Design and Methods: Participants were subjects with type 1 diabetes (n = 110, mean age 20.7 years, SD 4.3) and control subjects (n = 76, mean age 20.8 years, SD 4.0). The measures used included the Youth Self-Report and Young Adult Self-Report and a semi-structured interview of functional outcomes. Type 1 diabetes participants also provided information about current diabetes care and metabolic control from diagnosis., Results: Type 1 diabetes participants and control subjects reported similar levels of current well-being but for the youth with type 1 diabetes, the mental health referral rates over the previous 12 years were higher by 19% and school completion rates were lower by 17%. Over one-third of clinical participants were not currently receiving specialist care and this group had higher mental health service usage in the past (61 vs. 33%) and lower current psychosocial well- being. Within the type 1 diabetes group, behavior problems, high activity, and low family cohesion at diagnosis predicted lower current well-being, but were not associated with metabolic control history. Poorer metabolic control was associated with higher mental health service usage., Conclusions: Type 1 diabetes participants report similar levels of current psychosocial well-being compared with control subjects, but higher levels of psychiatric morbidity since diagnosis and lower school completion rates. Psychiatric morbidity was associated with poor metabolic control and failure to transition to tertiary adult diabetes care.

Objectives: Children and adolescents with chronic physical health conditions are also at elevated risk of poor mental health; the mechanisms to account for this relationship remain unclear. In this narrative review, we used the socio-ecological model to examine research on experiences of school for children with chronic health conditions and how socio-ecology might be involved in mental health problems. Design: We conducted a scoping review of the existing literature, focused on hearing loss, cystic fibrosis and type 1 diabetes, which examined child and/or adolescent mental health and aspects of the school social setting. Method: PubMed and ScienceDirect databases were searched for the three target conditions; from 353 abstracts, 38 articles were reviewed in detail. Results: Relevant articles that examined social aspects of the experience of school for students with chronic health conditions, including absenteeism due to illness or healthcare, self-perceived difference from peers, stigmatisation and discrimination, bullying and victimisation, and positive aspects of peer support at school were reviewed. Teacher-child aspects including teacher knowledge and/or attitudes about the condition and the possibility of overdependence in the relationship were examined. Each of these processes was considered for its impact on the young person's mental health. Conclusion: School-based social risk processes in the lives of young people with chronic health conditions, in particular in the peer microsystem, are likely to contribute to risk of psychological problems. These risks cannot be disentangled from mesosystemic, exosystemic and macrosystemic influences. Further research is required on the role of teachers and parents in the school social functioning of children with chronic health conditions.

Schools have an important role to play in supporting the psychosocial and physical health of students with Type 1 diabetes (T1D). Good school-based support for students with T1D is related to better diabetes management and quality of life. However, support for students with T1D appears inconsistent across schools in Western Australia. Strategic capacity-building for schools, including attention to policy and practice, is needed to support students with chronic and other health conditions. This project aimed to investigate how schools provide support for the psychosocial wellbeing and disease management of students with T1D. Ten schools, identified by a hospital-to-school transition team as being supportive of students with T1D, participated in this generic qualitative study. Semi-structured interviews were conducted with school staff, students with T1D and their parents at each school. Inductive and deductive thematic analysis identified three overarching themes to encapsulate the various ways schools provided support: (a) school characteristics; (b) interpersonal support; and (c) organisational support, and eleven sub-themes outlined this support. Based on these findings, a conceptual model of support is presented. This can be used as a foundation for a professional learning tool to enhance the capacity of schools to support the wellbeing of students with T1D.

Children and adolescents with type 1 diabetes (T1D) spend a significant portion of their day at school. It is therefore important that schools provide a safe and flexible environment for disease management and psychosocial support. Little is known of the school experiences of children and adolescents with T1D in Western Australia. The aim of this research was to describe the mental health and school experiences of children and adolescents with T1D attending mainstream schools in Western Australia. Using an online questionnaire, 92 parents of children and adolescents with T1D were surveyed. The results suggest elevated levels of emotional difficulties among school students with T1D and variable levels of support from school staff to assist these students to manage their diabetes at school. Increasing teacher knowledge to provide more individualised support and enhancing the quality of communication between parents and school staff may be useful strategies to support the physical and emotional needs of children and adolescents with T1D at school.

Individuals at Clinical High Risk for Psychosis (CHR-P) demonstrate heterogeneity in clinical profiles and outcome features. However, the extent of neuroanatomical heterogeneity in the CHR-P state is largely undetermined. We aimed to quantify the neuroanatomical heterogeneity in structural magnetic resonance imaging measures of cortical surface area (SA), cortical thickness (CT), subcortical volume (SV), and intracranial volume (ICV) in CHR-P individuals compared with healthy controls (HC), and in relation to subsequent transition to a first episode of psychosis. The ENIGMA CHR-P consortium applied a harmonised analysis to neuroimaging data across 29 international sites, including 1579 CHR-P individuals and 1243 HC, offering the largest pooled CHR-P neuroimaging dataset to date. Regional heterogeneity was indexed with the Variability Ratio (VR) and Coefficient of Variation (CV) ratio applied at the group level. Personalised estimates of heterogeneity of SA, CT and SV brain profiles were indexed with the novel Person-Based Similarity Index (PBSI), with two complementary applications. First, to assess the extent of within-diagnosis similarity or divergence of neuroanatomical profiles between individuals. Second, using a normative modelling approach, to assess the 'normativeness' of neuroanatomical profiles in individuals at CHR-P. CHR-P individuals demonstrated no greater regional heterogeneity after applying FDR corrections. However, PBSI scores indicated significantly greater neuroanatomical divergence in global SA, CT and SV profiles in CHR-P individuals compared with HC. Normative PBSI analysis identified 11 CHR-P individuals (0.70%) with marked deviation (>1.5 SD) in SA, 118 (7.47%) in CT and 161 (10.20%) in SV. Psychosis transition was not significantly associated with any measure of heterogeneity. Overall, our examination of neuroanatomical heterogeneity within the CHR-P state indicated greater divergence in neuroanatomical profiles at an individual level, irrespective of psychosis conversion. Further large-scale investigations are required of those who demonstrate marked deviation.

It is likely that young people who are both Aboriginal and Torres Strait Islander and LGBTQA+ would be at increased risk for poor mental health outcomes due to the layered impacts of discrimination they experience; however, there is very little empirical evidence focused on the mental health and wellbeing of Aboriginal and Torres Strait Islander LGBTQA+ young people. The current study represents a qualitative exploration of wellbeing among Aboriginal LGBTQA+ young people. This study consisted of semi-structured interviews and focus groups with Aboriginal LGBTQA+ young people aged 14–25 years old in the Perth metropolitan area of Western Australia. Thematic analysis identified seven major themes that were significant to participants' wellbeing: identity, family, community, visibility, services, stigma and navigating. [ABSTRACT FROM AUTHOR]

The article discusses the use of cannabis and its components, particularly delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), for various medical conditions, including psychiatric disorders.Topics include the use of cannabis and its components for medical purposes; the differences between THC and CBD in terms of psychoactive effects, and the need for more research, particularly randomized controlled trials, to assess the effectiveness and safety of CBD for psychiatric disorders.

Following the outbreak of COVID-19, social distancing restrictions limited access to face-to-face mental health services in Western Australia (WA), necessitating a rapid transition to non-face-to-face alternatives, including telehealth. The current study investigated barriers and facilitators to telehealth access and engagement, and preferences for child and youth mental health service delivery during and beyond COVID-19. Three participant groups were recruited via social media and partner organisations, and completed a tailored online survey: i) young people (14–25 years) who had ever accessed or attempted to access mental health support or services (n = 84), ii) parents of young people with a child aged 0–25 years who had ever accessed or attempted to access mental health support or services with or on behalf of their child (n = 68), and iii) professionals working in the child or youth mental health sector (n = 167). Regarding barriers to engagement, young people were primarily concerned with the privacy implications of telehealth and its efficacy relative to face-to-face alternatives. Parents and clinicians were more concerned with the technological pitfalls of telehealth (e.g., internet-connectivity, picture/sound issues). Telehealth's accessibility was highlighted as a facilitator for all groups. Although certain participant groups were considered to be more suited to telehealth than others, most participants endorsed a blended approach to the future provision of mental health services. To facilitate a blended approach to the delivery of child and youth mental health services, participants recommended more reliable and affordable internet access, implementing funding models that support telehealth delivery, and training for clinical staff. What is already known about this topic: At the time of writing, Western Australia has been fortunate enough to resist a large-scale outbreak of COVID-19, making the state relatively unique in its experience of the pandemic. Despite this, the state has experienced periods of social distancing requirements and associated impact on mental health service provision. Young people have been especially susceptible to mental health decline during the pandemic. Social distancing requirements have necessitated the rapid transition of mental health service provision from face-to-face to non-face-to-face alternatives. What this topic adds: Findings from this study provide localised insights into barriers and facilitators to engagement with non-face-to-face service delivery from the perspective of children and young people, carers and mental health professionals. Despite concerns about the relative efficacy of telehealth compared to traditional face-to-face services and challenges with technology, the majority of young people, parents, and mental health professionals in the study felt that moving forwards, child and youth mental health services should be provided using a flexible, blended approach where both face-to-face and non-face-to-face options are available. [ABSTRACT FROM AUTHOR]

Research has shown that parents of trans children face numerous challenges as they navigate their parenting role, however, little is known about the impact of these challenges on parents' psychological wellbeing. Utilizing an interpretative phenomenological approach and interpretive phenomenological analysis (IPA), the current study aimed to address this gap in the literature by exploring how parents perceive their experience of having a trans child has impacted their psychological wellbeing. Semi-structured in-depth interviews were conducted with Australian parents of trans children aged 17 and under (N = 12). Five major themes were identified in the data: 1) Dyadic factors; 2) Threats to mental health; 3) Personal growth; 4) Support and acceptance; and 5) Coping. Overall, results indicated that experiences of psychological wellbeing were multidimensional, characterized by numerous mental health threats and concurrent positive experiences of personal growth. Findings also highlighted the importance of support and acceptance from others, and various coping strategies employed by parents to protect against mental health threats and enhance their wellbeing. These findings provide an in-depth understanding of factors that both threaten and enhance wellbeing amongst parents of trans children, offering nuanced insight for clinicians and a foundation for future research. [ABSTRACT FROM AUTHOR]

Mainstream youth mental health services struggle to comprehend the connection between colonisation and service provision for Aboriginal young people. This is the consensus agreed by Aboriginal Elders from Perth, Western Australia and young Aboriginal leaders within their communities (Wright, Culbong, Crisp, Biedermann, & Lin (2019). 1–7). What is required is a more nuanced, culturally relevant approach to both an understanding of the impact of colonisation on mental health and help-seeking behaviour if they are to provide equitable access for Aboriginal young people. In this paper, we report on a three-year participatory action research (PAR) project conducted on Whadjuk Nyoongar country in Perth, Western Australia. An innovative model of care framework developed from the project and described in this paper, focuses on key components that both inform and assist service providers in improving service provision to Aboriginal young people. The model, depicted as a tree, symbolises strength and growth, with the 'roots' of the tree, holding trust, culture and spirit. This paper details a culturally-safe co-design process that was held and directed with Elders, in partnership with young people, youth mental health service staff and youth policy staff. [ABSTRACT FROM AUTHOR]

To explore the perceptions of parents who had a child or adolescent (6-18 years) diagnosed with a rare disease who attended a mainstream school in Western Australia. A cross-sectional online survey was conducted with 41 parents of children with a rare disease. Here we report the findings of 14 open-ended questions on their experience of illness-related factors and impact on school-related social activities, such as sports, school camps and leadership roles whilst their child with a rare disease attended a mainstream school in Australia. Responses were analysed using an inductive thematic content approach. We identified three themes (resources, experiences and needs), seven categories (illness, support, knowledge, acceptance, isolation, activities of daily living and adjunctive therapy) and 24 codes from the parents' responses describing the experiences of their child at school. Parents want the government and educational systems to provide the necessary funding and resources to reflect an inclusive curricula and supportive environment that can meet the learning needs of children with a rare disease at a mainstream school. Further research, policy development and interventions are needed to explore how schools can meet the diverse psychosocial physical and emotional needs of children diagnosed with a rare disease who attend a mainstream school in Australia. A child needs to be viewed from a holistic ecological viewpoint; future research with larger representative samples to explore rare disease experiences and a critical review of existing legislation, interventions and initiatives is required. • A child with a rare condition needs to be viewed through a holistic ecological viewpoint. • The needs of many children with a rare disease are not being met at school. • An inclusive school environment requires input through a multi-disciplinary lens. • Future rare disease research with larger representative samples are required. • Educational providers need to be aware of the latest legislation on rare diseases. [ABSTRACT FROM AUTHOR]

There are limited studies on the risk of depressive symptoms in adolescent offspring exposed to parental mental health problems in middle childhood. We investigated the association between parental mental health problems, particularly paternal emotional problems and maternal symptoms of anxiety and depression, and the risk of depressive symptoms in adolescent offspring aged 17. The study included 995 parent-offspring pairs from the 1989–91 birth cohort (the Raine Study) in Western Australia. Log-binomial regression was used to assess the associations. An increased risk of depression symptoms was observed in the adolescent offspring of mothers with depressive [RR 1.45, 95% CI 1.13–1.86] as well as anxiety symptoms [RR 1.43, 95% CI 1.09–1.87].Compared to those non-exposed, offspring whose mothers reported comorbid anxiety and depressive symptoms were more likely to have developed depressive symptoms by late adolescence [RR 1.63, 95%CI 1.11–2.38]. An increased risk of depressive symptoms was also seen in the offspring of fathers with emotional problems [RR 1.29, 95%CI 1.01–1.53]. Our findings suggest an increased risk of depressive symptoms in the adolescent offspring of parents with mental health problems, specifically paternal emotional problems (29%) and maternal anxiety (43%), depression (45%), as well as comorbid anxiety and depressive symptoms (63%). [ABSTRACT FROM AUTHOR]

Increasing young people's physical activity, along with their motivation and confidence to be active, is widely advocated for supporting desirable health outcomes. Trans and gender diverse (henceforth; trans) young people experience significant physical activity-related barriers compared to cisgender (i.e., an individual for whom gender identity and sex presumed at birth are in alignment) peers. This scoping review aimed to synthesise information relating to physical activity, sport, and exercise, as well as participation experiences among trans young people aged 10–25 years. Database searches of CINAHL, Embase, Medline, PsychINFO, and SportDiscus were conducted for publication until August 2023. Broad search terms included exercise, physical activity, sport, transgender, gender diverse, youth, child, and adolescents, with 24 studies identified for full text review. Following title, abstract, and full text review, 12 studies were retained for data extraction. Methodological quality was assessed with scores ranging from 0.14 to 0.95. Eleven studies reported trans young people participated in less physical activity compared to cisgender peers. All 12 studies reported on barriers to exercise participation—resulting from gender-based isolation, exclusion, and rejection in sports or school physical education—that were associated with mental health-related concerns. Findings demonstrate trans young people typically have lower physical activity participation levels, feel less safe while playing sport, and face more barriers to participation than their cisgender peers, resulting in isolation and exclusion. Findings suggest a need to create more inclusive opportunities and harness motivating factors (e.g., gender affirmation, social capital) to assist the adoption of healthy exercise behaviours. • Trans children and adolescents report lower physical activity participation levels than cisgender peers. • Trans children and adolescents experience significant barriers to physical activity compared to cisgender peers. • Trans children and adolescents encounter gender-based isolation in sports, PE, or physical activity resulting in mental health-related concerns. • Physical activity supports trans youth, enhancing wellbeing and affirming positive gender identity. • Inclusive and safe recreational, sport, and school physical education programs are needed. [ABSTRACT FROM AUTHOR]

Background General practitioners (GPs) do not typically receive education regarding gender diversity despite the increasing number of trans, gender diverse and non-binary (TGDNB) patients presenting to general practice. It is important for GPs, as the first point of entry into the healthcare system, to provide a safe and affirming environment for TGDNB patients to reduce ill-health later in life. Objective The aim of this article is to clarify how GPs can improve their care of TGDNB patients to be more inclusive and thereby promote a positive relationship with the health system, assist in gender-affirming care and reduce illness within this population. The authors provide simple suggestions for clinical practice and encourage clinicians to seek professional development in this rapidly developing field. Discussion Care of TGDNB patients extends beyond gender-affirming care to include mental health and community supports to ensure the overall wellbeing of the patient. Central to this care is respect of the patient's gender identity and expression. [ABSTRACT FROM AUTHOR]

Objectives: Children and adolescents with chronic physical health conditions are also at elevated risk of poor mental health; the mechanisms to account for this relationship remain unclear. In this narrative review, we used the socio-ecological model to examine research on experiences of school for children with chronic health conditions and how socio-ecology might be involved in mental health problems. Design: We conducted a scoping review of the existing literature, focused on hearing loss, cystic fibrosis and type 1 diabetes, which examined child and/or adolescent mental health and aspects of the school social setting. Method: PubMed and ScienceDirect databases were searched for the three target conditions; from 353 abstracts, 38 articles were reviewed in detail. Results: Relevant articles that examined social aspects of the experience of school for students with chronic health conditions, including absenteeism due to illness or healthcare, self-perceived difference from peers, stigmatisation and discrimination, bullying and victimisation, and positive aspects of peer support at school were reviewed. Teacher–child aspects including teacher knowledge and/or attitudes about the condition and the possibility of overdependence in the relationship were examined. Each of these processes was considered for its impact on the young person's mental health. Conclusion: School-based social risk processes in the lives of young people with chronic health conditions, in particular in the peer microsystem, are likely to contribute to risk of psychological problems. These risks cannot be disentangled from mesosystemic, exosystemic and macrosystemic influences. Further research is required on the role of teachers and parents in the school social functioning of children with chronic health conditions. [ABSTRACT FROM AUTHOR]

Aim: Aboriginal and Torres Strait Islander young people are more likely to experience mental health issues or end their life by suicide than non‐Aboriginal youth, but are less likely to access mental health services for support. Systemic change is required if mainstream youth mental health services are to be relevant and culturally secure for Aboriginal and Torres Strait Islander young people. Methods: Building Bridges (2017‐2019) is a three‐year participatory action research project being conducted in partnership with the Nyoongar community and three mainstream youth mental health services in Perth, Western Australia. The project involves Nyoongar Elders and Aboriginal and Torres Strait Islander young people working directly with senior management and key staff of youth mental health services to co‐design, implement and evaluate a framework for systems change. The aim of the project is to increase Aboriginal and Torres Strait Islander young people's engagement with services and improve mental health outcomes for young people and their families. Results: This paper outlines the engagement process that underpinned the first phase of the project. Our research methods are premised by an investment in establishing safe spaces for the Elders, young people and service staff to engage in open, honest dialogue. We present two key activities that illustrate this process of building trust and deepening understanding, namely: spending time "On Country" and engaging in a "storying" process. Conclusions: Building Bridges demonstrates the centrality of trusting relationships for systemic change and the way in which meaningful engagement is at the core of both the process and the outcome. [ABSTRACT FROM AUTHOR]

An editorial is presented on the approach taken by RANZCP to trans people as inappropriate and harmful. It outlines the benefits of gender affirming hormones and surgery are well documented in alleviating gender dysphoria and improving mental health and quality of life. An overview of the gender dysphoria is presented.

Objective: This study aimed to characterize the risk of mental health problems among a representative sample of 6,310 4–17-year-olds, 147 of whom had parent-reported hearing problems. Methods: The study used data from the Young Minds Matter survey. The Diagnostic Interview Schedule for Children (DISC-IV) assessed prevalence of mood, anxiety and behavioural disorders. The Strengths and Difficulties Questionnaire (SDQ) assessed social and emotional problems. Logistic regression models were used to estimate odds of having mental health problems adjusting for child factors (speech and language problems, global health, age and gender), family factors (family structure, parent income, education, financial strain and psychological distress) and school-related factors (bullying, school liking, school absence). Results: In unadjusted analyses, children and young people with hearing problems had substantially higher odds of most mental health problems. Hearing problems were not associated with any mental health problem among 4–11-year-olds after adjusting for other child factors. After adjustments for child, family and school-related factors, 12–17-year-olds with a hearing problem remained at greater risk of social phobia and generalized anxiety (DISC-IV), and of peer and emotional problems (SDQ). Conclusions: Clinicians caring for children and young people with hearing problems should be alert for heightened risk of specific mental health problems based on age and the nature of hearing problems. Understanding a wider range of correlates associated with the higher prevalence of mental health problems may allow health professionals to be more informed about the nature of mental health problems that are comorbid to hearing problems. [ABSTRACT FROM AUTHOR]

Objective:Mental health clinicians have struggled to recognise the need to understand an Aboriginal worldview and how human interactions are shaped bysocial relationshipsin kin-based societies. This paper considers the findings of Looking Forward Project, a participatory action research study aimed at investigating the serious disconnection between mental health and drug and alcohol service providers and Aboriginal families living in Perth, Western Australia. Method:Our research methods and knowledge exchange were premised on theshared storytellingbetween Aboriginal Elders, researchers, senior management and clinicians. Study participants included eighteen local Elders and approximately seventy staff across eleven mental health and drug and alcohol organisations, over four years. Elders have been the primary drivers of the research design. This paper is shaped by the storying process. Results:The study revealed the lack of trust between service providers and Aboriginal families is predominantly due to the lack of understanding by service providers of the criticaldifference in social relationships.The lack of trust creates a barrier to accessing services and compromises the quality of response by services. Humility, inquisitiveness and openness are essential qualities for meaningful engagement and sustainable relationships. Discussion:The rebuilding of trust requires the development of meaningful relationships in order to break down the barriers so as to increase access and develop culturally secure responses by services. When clinicians adopt these essential qualities they will develop a reflective practice that enables them to be more adaptable in their work with Aboriginal clients and their families. [ABSTRACT FROM AUTHOR]

Disturbance of hypothalamus–pituitary–adrenal axis activity is commonly reported in a range of mental disorders in blood, saliva and urine samples. This study aimed to look at longer-term cortisol levels and their association with clinical symptoms. Hair strands of 30 young people (16–25 years) presenting with mental health problems ( M age ±SD=21±2.4, 26 females) and 28 healthy controls (HC, M age ±SD=20±2.9, 26 females) were analyzed for cortisol concentrations, representing the past 6 months prior to hair sampling. Clinical participants completed an assessment on psychiatric symptoms, functioning and lifestyle factors. All participants completed the Perceived Stress Scale. Hair cortisol concentrations representing the past 3 (but not 3–6) months were significantly increased in clinical participants compared to HC. Perceived stress in the past month was significantly higher in clinical participants compared to HC, but not significantly correlated with hair cortisol. Hair cortisol levels were not significantly associated with any other measures. Hair segment analyses revealed longer-term increased levels of cortisol in the past 3 months in early mental health problems. Further insight into the role of cortisol on the pathogenesis of mental illnesses requires longitudinal studies relating cortisol to psychopathology and progression of illness. [ABSTRACT FROM AUTHOR]

Many young people are exposed to risk factors that increase their risk of mental illness. Physical activity provision is an increasingly popular approach to protect against mental illness in the face of these risk factors. We examined the effectiveness of physical activity interventions for the promotion of mental health outcomes in at-risk children and adolescents. We searched health databases for randomised and non-randomised intervention studies, with no date restriction, and assessed risk of bias using the Cochrane Risk of Bias tools. We present a narrative synthesis of our results accompanied with a summary of available effect sizes. Thirty-seven reports on 36 studies were included, with multi-sport or yoga interventions the most popular intervention approaches (a combined 50% of included studies). Outcomes measured included internalising, self-evaluative, wellbeing, overall symptomatology, resilience, externalising, and trauma outcomes. We found that 63% of between-groups effects favoured the intervention arm, and 83% of within-groups effects favoured an intervention effect. While recognising high risk of bias, our findings provide evidence in support of the effectiveness of physical activity interventions for promoting mental health outcomes in at-risk young people. We encourage further work designed to better understand the intervention characteristics that may lead to positive benefits. [ABSTRACT FROM AUTHOR]

Background: Young people (aged 12-25 years) with diverse sexuality, gender, or bodily characteristics, such as those who identify as lesbian, gay, bisexual, transgender, intersex, or queer (LGBTIQ+), are at substantially greater risk of a range of mental, physical, and sexual health difficulties compared with their peers. Digital health interventions have been identified as a potential way to reduce these health disparities.Objective: This review aims to summarize the characteristics of existing evidence-based digital health interventions for LGBTIQ+ young people and to describe the evidence for their effectiveness, acceptability, and feasibility.Methods: A systematic literature search was conducted using internet databases and gray literature sources, and the results were screened for inclusion. The included studies were synthesized qualitatively.Results: The search identified 38 studies of 24 unique interventions seeking to address mental, physical, or sexual health-related concerns in LGBTIQ+ young people. Substantially more evidence-based interventions existed for gay and bisexual men than for any other population group, and there were more interventions related to risk reduction of sexually transmitted infections than to any other health concern. There was some evidence for the effectiveness, feasibility, and acceptability of these interventions overall; however, the quality of evidence is often lacking.Conclusions: There is sufficient evidence to suggest that targeted digital health interventions are an important focus for future research aimed at addressing health difficulties in LGBTIQ+ young people. Additional digital health interventions are needed for a wider range of health difficulties, particularly in terms of mental and physical health concerns, as well as more targeted interventions for same gender-attracted women, trans and gender-diverse people, and people with intersex variations.Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42020128164; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=128164. [ABSTRACT FROM AUTHOR]

Research suggests an overrepresentation of autism spectrum diagnoses (ASD) or autistic traits in gender diverse samples, particularly in children and adolescents. Using data from the GENTLE (GENder identiTy Longitudinal Experience) Cohort at the Gender Diversity Service at the Perth Children's Hospital, the primary objective of the current retrospective chart review was to explore psychopathology and quality of life in gender diverse children with co-occurring ASD relative to gender diverse children and adolescents without ASD. The Social Responsiveness Scale (Second Edition) generates a Diagnostic and Statistical Manual of Mental Disorders (DSM-5) score indicating a likely clinical ASD diagnosis, which was used to partition participants into two groups (indicated ASD, n = 19) (no ASD indicated, n = 60). Indicated ASD was far higher than would be expected compared to general population estimates. Indicated ASD on the Social Responsiveness Scale 2 (SRS 2) was also a significant predictor of Internalising behaviours (Anxious/Depressed, Withdrawn/Depressed, Somatic Complaints, Thought Problems subscales) on the Youth Self Report. Indicated ASD was also a significant predictor of scores on all subscales of the Paediatric Quality of Life Inventory. The current findings indicate that gender diverse children and adolescents with indicated ASD comprise an especially vulnerable group that are at marked risk of mental health difficulties, particularly internalising disorders, and poor quality of life outcomes. Services working with gender diverse young people should screen for ASD, and also provide pathways to appropriate care for the commonly associated mental health difficulties. [ABSTRACT FROM AUTHOR]

Introduction: Population‐level, nationally representative data on the prevalence of minority stressors and traumatic events, mental ill‐health effects, and the preventative utility of school climate, among gender and sexuality diverse young people in Australia, is significantly lacking. In this study, we estimated the prevalence and distribution of minority stressors and traumatic events among young people by sexuality identity (gay/lesbian, bisexual, other sexuality, heterosexual), sexuality diversity (sexuality diverse, not sexuality diverse), and gender identity (transgender, cisgender) and assessed associations with mental ill‐health and the moderating role of school climate factors. Methods: Using Wave 8 (2018) follow‐up data from a population‐level, nationally representative longitudinal cohort study, the sample comprised 3037 young people aged 17–19 years in Australia. Prevalence ratios for minority stressors and traumatic events were calculated for gender and sexuality diverse categories using logistic regression models. Linear regression models were used to test associations between traumatic events and minority stressors, and mental ill‐health. Multivariate linear regression tested school climate factors as effect modifier between minority stressors and mental ill‐health among sexuality diverse young people. Results: Rates of traumatic events and minority stressors were highest among bisexual and gay/lesbian young people and were significantly associated with mental ill‐health among all gender and sexuality diverse young people. Highest mental ill‐health effects were observed among trans young people. Among sexuality diverse young people, positive and negative feelings toward school climate were associated with decreased and increased mental ill‐health, respectively. After accounting for sexuality diversity, positive overall school climate appeared protective of mental ill‐health effects of sexuality‐based discrimination. Discussion: Minority stressors, traumatic events, and associated mental ill‐health are prevalent among gender and sexuality diverse young people in Australia, especially trans, bisexual, and gay/lesbian young people. Promotion of affirmative, safe, and inclusive school climate demonstrates significant promise for the prevention and early intervention of mental ill‐health among gender and sexuality diverse young people. [ABSTRACT FROM AUTHOR]

Recent research highlights an overlap of gender diversity and autism spectrum disorders (ASD); however, data on individuals who are trans and also on the autism spectrum are largely from clinical samples and may not be representative of individuals who are trans with ASD in the general population. In addition, there is scant literature on the mental health of these individuals and their experiences in accessing gender-affirming care. We investigated the prevalence of ASD in trans young people, their mental health (psychiatric diagnoses and self-harm and suicidal behaviors) and experiences in accessing gender-affirming care. This is an analysis of data collected in an Australian cross-sectional mixed methods survey (N = 859) of trans young people aged 14–25 years. Overall, 22.5% of participants had ever received a diagnosis of ASD from a health professional. This group was more likely to exhibit current psychopathology, have engaged in self-harming and suicidal behaviors, and was also more likely than the non-ASD diagnosed reference group to have received a psychiatric diagnosis. The ASD-diagnosed group were also more likely to experience barriers in accessing gender-affirming care. This is the first large population-based sample of trans individuals with ASD to report on mental health outcomes and experiences in accessing gender-affirming care. We highlight the necessity for clinicians working with either trans or ASD populations to have awareness of the co-occurrence, and to cultivate skills to work with individuals who are both trans and on the autism spectrum. • The prevalence of ASD within this sample of trans young people is 22.5%. • Young people who are both trans and have ASD are at high risk for mental health issues. • Improved support of trans individuals on the autism spectrum is needed. [ABSTRACT FROM AUTHOR]

"Psychotic-Like Experiences" (PLEs) are common in the general population. While they are usually transient and resolve spontaneously, they can be distressing and signify increased risk for later psychosis or other psychopathology. It is important to investigate factors associated with PLEs which could be targeted to reduce their prevalence and impact. Males and females are known to experience PLEs differently, but any gender differences in the relationships between PLEs and other, potentially targetable, factors are currently unknown. 302 adolescents (175 females, mean age = 16.03, SD = 0.75; 127 males, mean age = 16.09, SD = 0.74) from secondary schools in the West Midlands region of the UK completed baseline self-report measures of positive PLEs, measured by the Community Assessment of Psychic Experiences (CAPE-P), and several potentially related factors including: cannabis use, perceived stress, anxiety, depression, and daily hassles. PLEs were common in this sample, with 67.5% of individuals experiencing at least one CAPE-P item 'often' or 'almost always'. Females reported significantly higher levels of PLEs, and associated distress, than males. Anxiety, depressive, and stress symptoms were similarly associated with PLEs in both genders. However, there was a significant interaction of gender and daily hassles in the association with PLEs. In summary, there were significant gender differences in the experience of PLEs in this sample. Although daily hassles were more common in females, they had a significantly stronger association with PLEs in males. Thus, addressing "daily life stress" in adolescents may require tailoring towards the more emotional perception of stress in females, and towards everyday life hassles in males. [ABSTRACT FROM AUTHOR]

Introduction: Psychosis and mania share conceptual, genetic and clinical features, which suggest the possibility that they have common antecedents. Participants identified to be at-risk for psychosis might also be at-risk for mania. We aimed to identify the rate and predictors of transition to mania in a cohort of youth with clinical or familial risk for psychosis.Methods: Among a cohort of 416 young people with an at-risk mental state for psychosis defined using the Ultra-High-Risk (UHR) criteria, 74.7% were followed up between 5 and 13years from their baseline assessment. We undertook a matched case-control examination of those who developed mania over the follow-up period compared to those who did not develop mania or psychosis. Transition to mania was determined using either a structured clinical interview, or diagnoses from a state-wide public mental health contact registry. Clinical characteristics and risk factors were examined at baseline using information from structured interviews, clinical file notes, rating scales and unstructured assessments.Results: Eighteen participants developed mania (UHR-Manic transition or UHR-M, 4.3%). In comparison with participants matched on age, gender and baseline-study who developed neither mania nor psychosis, more UHR-M participants had subthreshold manic symptoms or were prescribed antidepressants at baseline. They also had lower global functioning.Discussion: In addition to the UHR criteria, features such as subthreshold manic symptoms and antidepressant use may help identify at-risk groups that predict the onset of mania in addition to transition to psychosis. Presence of manic symptoms may also indicate syndrome specificity early in the prodromal phase. [ABSTRACT FROM AUTHOR]

There is a higher incidence of psychotic disorders in more socially deprived neighbourhoods and a higher risk in migrants living in neighbourhoods of low ethnic density. Yet it is unclear at what stage these neighbourhood environmental factors exert an influence on the risk for psychosis. 166 Ultra high risk for psychosis young people were included in this study. Neighbourhood data were obtained from the Australian Bureau of Statistics. There was a trend for UHR individuals to reside in relatively more deprived areas and there was no association between the rate of identification of UHR migrants and neighbourhood ethnic density. [ABSTRACT FROM AUTHOR]

Young adults who are lesbian, gay, bisexual, trans, queer or questioning, intersex, asexual and other diverse genders and sexualities (LGBTQIA+) are more likely to experience mental health difficulties and are at significantly elevated risk of substance abuse, self-harm and suicide, relative to their heterosexual, endosex and cisgender peers. There is a need for effective mental health interventions for LGBTQIA+ young adults. Mindful Self-Compassion training is a promising approach; among LGBTQIA+ individuals, self-compassion accounts for more variation in mental health outcomes than bullying, victimization, and adverse childhood experiences combined. Furthermore, LGBTQIA+ individuals with high self-compassion report more positive identity and happiness, less self-stigma, and lower suicidality than those with low self-compassion. This paper outlines the rationale and protocol for a single-blind CONSORT-compliant randomised controlled trial, comparing group Mindful Self-Compassion to a delayed-treatment waitlist control group, for improving mental health, decreasing self-criticism and increasing self-compassion in LGBTQIA+ young adults (age 18–25 years). Mindful Self-Compassion training is an 8-week group program that focuses on cultivating self-compassion and mindfulness. While typically delivered as a face-to-face program, the proposed trial will investigate efficacy of the program when provided via videoconferencing. Videoconference Mindful Self-Compassion training has the potential to improve the mental health of Australian LGBTQIA+ young adults and provide a possible cost-effective, scalable intervention for this population. The proposed trial will be the first to determine its efficacy for LGBTQIA+ young adults and will provide the first data on the delivery of the program via videoconferencing. [ABSTRACT FROM AUTHOR]