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Objectives: This study investigated associations between sexual orientation and measures of suicidality and non-suicidal self-injury in Australian adults. Previous studies of sexual orientation and suicidality have been limited by unclear conceptualisations of suicidal intent, failure to differentiate between homosexuality and bisexuality, inattention to gender differences and use of convenience-based samples. Methods: A large (N = 10,531) representative national sample of Australian adults was used to investigate associations between sexual orientation (heterosexual, homosexual, bisexual) and (1) suicidal ideation, (2) attempted suicide and (3) non-suicidal self-injury, for males and females separately, in a series of sequentially adjusted logistic regression models. Results: Sexual minority participants were at greater risk of suicidality and self-injury than heterosexuals, after adjusting for age and other covariates, with patterns of risk differing by sexual orientation and gender. Compared with their heterosexual counterparts, gay men, but not bisexual men, were more likely to report suicidal ideation (odds ratio = 3.05, 95% confidence interval = [1.65, 5.60]) and suicide attempts (odds ratio = 4.16, confidence interval = [2.18, 7.93]). Bisexual women, but not lesbian women, were more likely to report suicidal ideation (odds ratio = 4.40, confidence interval = [3.00, 6.37]) and suicide attempts (odds ratio = 4.46, confidence interval = [2.41, 8.24]). Neither bisexual nor gay men were more likely than heterosexual men to report self-injury. However, bisexual women, but not lesbian women, were more likely than heterosexual women to report self-injury (odds ratio = 19.59, confidence interval = [9.05, 42.40]). Overall, bisexual females were at greatest risk of suicidality and self-injury. Conclusion: Clinicians working with sexual minority populations are encouraged to openly discuss suicidal and self-injurious thoughts and behaviours with their clients and may consider using therapeutic strategies to reduce internalised stigma and enhance personal and social resources. [ABSTRACT FROM AUTHOR]

This paper reports on a prospective study exploring risk factors specifically related to the onset of non-suicidal self-injury (NSSI) during adolescence. We examined cumulative incidence and predictors of onset of NSSI over 1 year among 1,973 school-based adolescents (13-19 years old; M = 14.9, SD = 0.96) from five states in Australia. Data showed cumulative incidence of 3.8 % (95 % CI [3.0-4.7 %]) over 1 year. Multiple socio-demographic and psychosocial factors were assessed using sequential logistic regression models. Onset of NSSI was associated with being female (OR = 3.47, 95 % CI [1.48-8.18]), being born outside of Australia (OR = 3.05, 95 % CI [1.10-8.47]), not identifying as religious or spiritual (OR = 1.80, 95 % CI [1.04-3.10]), increased psychological distress (OR = 1.12, 95 % CI [1.08-1.16]), poor social support from family (OR = 0.89, 95 % CI [0.83-0.95]), poor self-esteem (OR = 0.90, 95 % CI [0.83-0.98]), and poor problem-solving coping (OR = 0.90, 95 % CI [0.82-0.99]). These findings may assist to better identify young people more likely to start self-injuring and also highlight issues to provide a focus for prevention initiatives. [ABSTRACT FROM AUTHOR]

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Non-suicidal self-injury (NSSI) and under-age alcohol use are dysfunctional coping behaviors used to alleviate negative feelings. However, little is known regarding what mechanisms lead to engagement in NSSI as opposed to alcohol use, or what might influence co-occurrence of these behaviors. A total of 2,590 secondary school students (aged 12-17) from five Australian states completed self-report questionnaires measuring NSSI, alcohol use and a range of sociodemographic and psychosocial factors. The findings suggest that adolescent engagement in NSSI is associated with more internal factors, such as psychological distress, poor coping and problem-solving skills, whereas alcohol use is associated with age and gender, as well as more external factors, such as social support and coping by turning to others. Co-morbidity between alcohol use and NSSI is associated with a combination of these factors. Implications of these findings will be discussed with regard to prevention and early intervention initiatives. [ABSTRACT FROM AUTHOR]

Background: Collecting population data on sensitive issues such as non-suicidal self-injury (NSSI) is problematic. Case note audits or hospital/clinic based presentations only record severe cases and do not distinguish between suicidal and non-suicidal intent. Community surveys have largely been limited to school and university students, resulting in little much needed population-based data on NSSI. Collecting these data via a large scale population survey presents challenges to survey methodologists. This paper addresses the methodological issues associated with collecting this type of data via CATI. Methods: An Australia-wide population survey was funded by the Australian Government to determine prevalence estimates of NSSI and associations, predictors, relationships to suicide attempts and suicide ideation, and outcomes. Computer assisted telephone interviewing (CATI) on a random sample of the Australian population aged 10+ years of age from randomly selected households, was undertaken. Results: Overall, from 31,216 eligible households, 12,006 interviews were undertaken (response rate 38.5%). The 4-week prevalence of NSSI was 1.1% (95% ci 0.9-1.3%) and lifetime prevalence was 8.1% (95% ci 7.6-8.6). Methodological concerns and challenges in regard to collection of these data included extensive interviewer training and post interview counselling. Ethical considerations, especially with children as young as 10 years of age being asked sensitive questions, were addressed prior to data collection. The solution required a large amount of information to be sent to each selected household prior to the telephone interview which contributed to a lower than expected response rate. Non-coverage error caused by the population of interest being highly mobile, homeless or institutionalised was also a suspected issue in this low prevalence condition. In many circumstances the numbers missing from the sampling frame are small enough to not cause worry, especially when compared with the population as a whole, but within the population of interest to us, we believe that the most likely direction of bias is towards an underestimation of our prevalence estimates. Conclusion: Collecting valid and reliable data is a paramount concern of health researchers and survey research methodologists. The challenge is to design cost-effective studies especially those associated with low-prevalence issues, and to balance time and convenience against validity, reliability, sampling, coverage, non-response and measurement error issues. [ABSTRACT FROM AUTHOR]

For people who self-injure, the internet can provide an anonymous environment where users feel safe to divulge feelings and experiences which are not usually socially sanctioned. However, internet users can encourage each other to engage in self-destructive behaviour. This qualitative study aimed to simulate a typical search an adolescent might perform if he/she was looking for support and information about self-injury. The aim was to determine whether the resulting content was helpful or harmful. Seven queries - 'cutting', 'self injury', 'self-injury', 'self harm', 'self-harm', 'self-mutilation', and 'self mutilation' - were entered into www.google.com and each link from the first webpage from each search was opened and judged for relevancy. Thirty-nine links were analysed and grouped into five categories: websites (n=5); webpages (n=11); book results (n=8); news results (n=11); and other (n=4). Examination of the quality and content of the links obtained from our search showed mainly recovery oriented, supportive information about self-injury. Despite this positive outcome, more specific searches such as 'pro-self-injury' would likely result in less encouraging results. Mental health professionals should be aware that their self-injuring clients have probably used the internet for support and information, and consider how this use might impact on therapy. Mental health professionals could use the results of this study to recommend quality internet sites to their clients. [ABSTRACT FROM AUTHOR]

The author reflects on the aspects of the emergence of self-injury in Australia. He notes the need to consider a wide range of self-injury committed by adolescents to help in promoting treatment programs that will control their emotions and prevent them from injuring themselves. He also points out various studies carried out by researchers to learn insights which factors motivate these young individuals to commit self-injuries, along with exploring the best available therapies for self-injury.

The author reflects on the government's response to the increased suicide rates of students due to bullying in school in Australia. He discusses the task assigned by the government to create a suicide awareness program for the Australian Defense Force Cadets (ADFC). The author believes that a mental health promotion program will reduce suicide risk and will directly solve the issue. He also relates the topic to various research studies.

The author reflects on how to reduce a number of suicide incidents in young people in Australia. He raises several issues such as the role about best practice in crisis work, clinical management, and prevention strategies to limit the possibility of suicidal behaviour. He urges a consistent change in providing mental health services in the country.

Discusses the design of a workshop format designed to educate staff from youth residential centers in Adelaide, South Australia in the recognition and management of depressed and suicidal young people. Issues in suicidal behaviors; Assessment of mental health services; Evaluation of the workshop.

Provides information on the project funded by the National Youth Suicide Prevention Strategy called Out of the Blues to encourage clinicians to provide therapeutic services to young people. Goals of the project; Description of the case study which demonstrates how theory translates into daily one-to-one practice.

Part III. Discusses the clustering phenomenon in which publicity of a student suicide story appears to lead to imitation in a series of student suicides in Australia. Case histories and connections; Tendency of a student to copy the method of a reported suicide case. INSET: Suicide prevention support and resources..

Part II. Examines the effect of completed suicide by a student on another student in Australia. Case history of a 16-year-old female student who jumped from an eight-storey car park roof; Increase in suicides immediately after a suicide story has been published; Postvention strategies in schools following the suicide of a fellow student.

Part I. Examines the effect of completed suicide by a student on another student in Australia. Postvention strategies in the school following the suicide of a fellow student; Phenomenon of clustering in which suicides and attempted suicides appear to be linked to each other; Deliberate self-harm by students.

Objective: We aimed to explore the experiences and perspectives of pregnant women, antenatal healthcare professionals, and system leaders to understand the impact of the implementation of remote provision of antenatal care during the COVID-19 pandemic and beyond. Methods: We conducted a qualitative study involving semi-structured interviews with 93 participants, including 45 individuals who had been pregnant during the study period, 34 health care professionals, and 14 managers and system-level stakeholders. Analysis was based on the constant comparative method and used the theoretical framework of candidacy. Results: We found that remote antenatal care had far-reaching effects on access when understood through the lens of candidacy. It altered women's own identification of themselves and their babies as eligible for antenatal care. Navigating services became more challenging, often requiring considerable digital literacy and sociocultural capital. Services became less permeable, meaning that they were more difficult to use and demanding of the personal and social resources of users. Remote consultations were seen as more transactional in character and were limited by lack of face-to-face contact and safe spaces, making it more difficult for women to make their needs – both clinical and social – known, and for professionals to assess them. Operational and institutional challenges, including problems in sharing of antenatal records, were consequential. There were suggestions that a shift to remote provision of antenatal care might increase risks of inequities in access to care in relation to every feature of candidacy we characterised. Conclusion: It is important to recognise the implications for access to antenatal care of a shift to remote delivery. It is not a simple swap: it restructures many aspects of candidacy for care in ways that pose risks of amplifying existing intersectional inequalities that lead to poorer outcomes. Addressing these challenges through policy and practice action is needed to tackle these risks. [ABSTRACT FROM AUTHOR]

The current study tested whether emotion regulation and rumination moderated and/or mediated the relationship between accumulated adverse life experience and psychological distress in adolescence. In class, Australian high school students (n = 2637, 12–18 years, 68% female) from 41 schools completed well‐validated measures of adverse life experience, emotion regulation, rumination and psychological distress, and were followed up 1 year later (n = 1973, 75% retention rate). Adjusting for age, gender and baseline psychological distress, adverse life experience predicted psychological distress 1 year later. Expressive suppression and rumination were positively associated with psychological distress. Cognitive reappraisal was negatively associated with psychological distress and moderated the relationship between adverse life experience and psychological distress. This relationship was also partially mediated by cognitive reappraisal, expressive suppression and rumination. Promoting cognitive reappraisal and minimizing expressive suppression and rumination may be useful strategies to improve mental health for adolescents who have experienced adverse life events. Future research should examine whether adolescents who have experienced adverse life events can be trained in effective emotion regulation strategies and whether this training can prevent development of psychological maladjustment. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Distinct behaviors such as non-suicidal self-injury (NSSI) and firesetting may represent functionally equivalent attempts to regulate difficult affective/cognitive or social experiences during adolescence. This study examined possible mechanisms leading to NSSI, as opposed to firesetting, as well as co-occurrence of these behaviors. Participants aged 12-18 years ( N = 2,356; 67.5 % female) completed self-report questionnaires measuring NSSI and firesetting, as well as socio-demographic and psychosocial factors including personality traits related to impulsivity and anxiety, negative life events, emotion regulation, and coping. The findings indicated the presence of general risk factors (e.g., negative life events and poor coping) that increase the likelihood that adolescents will engage in any of a range of maladaptive behaviors. The probability of at-risk adolescents engaging in NSSI was increased by psychological states (i.e., rumination and poor self-esteem), whereas socio-demographic and personality traits were associated with firesetting. Implications for prevention and early intervention initiatives are discussed. [ABSTRACT FROM AUTHOR]

Objectives This study explored how cognitive reappraisal, expressive suppression, and facets of ruminative thinking could be brought together in a model to explain non-suicidal self-injury ( NSSI) in the context of experiencing stressful life events and psychological distress. Methods Data from 2,507 participants aged 12-18 years (68% female, mean age 13.93 years) recruited from 40 Australian secondary schools were analysed, including 254 participants with a history of NSSI (72% female, mean age 14.21 years). Participants completed a self-report questionnaire assessing the constructs of interest. Results Although meeting minimum fit indices, our hypothesized model showed poorer fit compared to an empirically derived model. There was little evidence for the mediating role of psychological distress in NSSI, and we found adverse life events, psychological distress, emotion regulation, and two facets of ruminative thinking (counterfactual thinking and anticipatory thoughts) had direct, though weak, relationships with NSSI. Among the subsample of adolescents with a history of NSSI, anticipatory rumination moderated the relationship between psychological distress and NSSI, while cognitive reappraisal demonstrated a direct, although weak relationship with NSSI. Conclusions Our observations suggest that, among adolescents, contextual, social, and behavioural factors may have a strong influence on NSSI and this may suggest that prevention and treatment efforts for NSSI among adolescents need to focus on contextual, social, and behavioural factors. Practitioner points Emotion regulation and repetitively dwelling on current problems and concerns are implicated in non-suicidal self-injury (NSSI) only to the extent they increase or reduce the experience of psychological distress., Prevention and treatment efforts for NSSI among adolescents would be better focused on contextual, social, and behavioural factors than cognitive factors., The cross-sectional nature of the research suggests interpretations regarding the influence of these psychological factors on NSSI can only be speculative and further research is warranted to establish causality., Replication with a larger, more representative sample is warranted. [ABSTRACT FROM AUTHOR]

While researchers are beginning to reach consensus around key psychological correlates of non-suicidal self-injury (NSSI), comparatively less work has been done investigating the role and influence of peers. Given evidence that engagement in this behavior may be susceptible to peer influence, especially during the early stages of its course, the current study prospectively explored whether knowing a friend who self-injures is associated with the onset, severity, and subsequent engagement in NSSI. The moderating roles of adverse life events, substance use and previous suicidal behavior in this relationship also were explored. Self-report data were collected from 1,973 school-based adolescents (aged 12-18 years; 72 % female) at two time points, 1 year apart. Knowing a friend who self-injured, negative life events, psychological distress and thoughts of NSSI differentiated those who self-injured from those who did not, and also predicted the onset of NSSI within the study period. Further, adverse life events and previous thoughts of NSSI moderated the relationship between exposure to NSSI in peers and engaging in NSSI at Time 2. However, the effect of having a friend who self-injures was not related to the severity of NSSI. Having a friend who self-injures appears to be a risk factor for self-injury among youth who are experiencing high levels of distress. Implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Psychotic experiences (PEs) are robustly associated with subsequent non-suicidal self-injury (NSSI) and suicide attempts, but questions remain as to the temporal relation and underlying cause of this association. Most investigations have incorporated only two waves of data, and no study has comprehensively investigated mediating pathways. This study aimed to investigate both the PE-NSSI and PE-suicide attempt association, and their relevant mediators, across three waves of prospective data. Participants were from an Australian prospective longitudinal cohort of 1100 adolescents (12–17 years); data were collected at three time points over 2 years. NSSI and suicide attempts were measured using the Self-Harm Behaviour Questionnaire. Items from the Diagnostic Interview Schedule for Children were used to assess four PE subtypes (auditory hallucinatory experiences [HEs] and three delusional experiences). Potential mediators of interest included: psychological distress, self-reported mental disorders, self-esteem, recent traumatic life events (e.g. bullying, sexual assault), emotion regulation, and impulsivity/other personality traits. Analyses were adjusted for sociodemographics and substance use. Auditory HEs were indirectly associated with future NSSI and suicide attempts via recent traumatic life events, high psychological distress, and low self-esteem, across three waves of data. Other PE subtypes were generally not associated with incident NSSI/suicide attempts at 1- and 2-year follow-up, either directly or indirectly. These findings highlight the importance of screening for auditory HEs when assessing a young person's self-harm/suicide risk. Clinical assessment would be further enhanced by a comprehensive review of recent interpersonal traumatic events, as well as levels of self-esteem and distress. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present study was to clarify the extent to which the recorded marked decline in young male suicide (20–34 years) in Australia since 1998 is attributable to misclassification of cause of death information. Methods: Secular trends in young male suicide rates were investigated for the period 1976–2005. Suicide rates in the period after the peak of the epidemic in this age group (1998) were re-calculated based on published estimates of under-enumeration of suicide data, and misclassification of likely suicide cases to other unintentional and undetermined external causes. Two misclassification scenarios were used to revise young male suicide rates from 1998: previously reported estimates of 9% under-enumeration due to misclassification of unintentional causes of death, and 17% under-enumeration due to misclassification of open cases in addition to unintentional causes of death. All-cause mortality was also examined. Results: Recorded male suicide in the 20–34 year age group increased over the study period, peaking in 1998 at 39 per 100 000, before declining sharply in the period 1999–2005 by 44% to 22 per 100 000 in 2005. Following adjustment for misallocation under the first scenario, suicide rates declined 38% to 24 per 100 000, and under the second scenario declined 33% to 26 per 100 000. Revised suicide rates were not materially different from recorded suicide rates based on 95% confidence intervals over this period. All-cause mortality declined from 1999 due to reductions in suicide and other causes. Conclusion: The recent marked decline in young male suicide in Australia is real. The effects of misallocation of likely suicide cases to other causes did not substantially affect population trends in suicide rates in the period after 1998. There is still a need to account in detail for why young male suicide has declined so substantially during the period after 1998. [ABSTRACT FROM AUTHOR]

Examines the average levels of the adolescent depressive symptomatology in Australia. Increase rates of depression and emotional disorder; Growth of the absenteeism factor; Occurrence of high levels of disruptive behaviors.

In this study we examined the relative risk of Non-Suicidal Self-Injury (NSSI) associated with a history of physical and sexual abuse/assault, poor attachment relationships, and poor emotion regulation among adolescents. A total of 2,637 adolescents (aged 12–15 years) completed questionnaires at 3 time-points: baseline, 12, and 24 months later. Across the study, 9.4% reported a history of NSSI. Each of past or recent abuse/assault, poor attachment relationships, and poor emotion regulation was associated with NSSI. We also observed a potential “high-risk” group among those reporting recent sexual abuse or assault. Knowledge of abuse history, recent sexual assault, attachment, and emotion regulatory ability will enable clinicians to assist adolescents in avoiding some of the more negative outcomes of these, including NSSI. [ABSTRACT FROM PUBLISHER]

Consumers of mental health services have an important role to play in the higher education of nursing students, by facilitating understanding of the experience of mental illness and instilling a culture of consumer participation. Yet the level of consumer participation in mental health nursing programmes in Australia is not known. The aim of the present study was to scope the level and nature of involvement of consumers in mental health nursing higher education in Australia. A cross-sectional study was undertaken involving an internet survey of nurse academics who coordinate mental health nursing programmes in universities across Australia, representing 32 universities. Seventy-eight percent of preregistration and 75% of post-registration programmes report involving consumers. Programmes most commonly had one consumer (25%) and up to five. Face-to-face teaching, curriculum development, and membership-to-programme committees were the most regular types of involvement. The content was generally codeveloped by consumers and nurse academics (67.5%). The frequency of consumer involvement in the education of nursing students in Australia is surprisingly high. However, involvement is noticeably variable across types of activity (e.g. curriculum development, assessment), and tends to be minimal and ad hoc. Future research is required into the drivers of increased consumer involvement. [ABSTRACT FROM AUTHOR]