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Young people form the primary target demographic of new 'buy now pay later' (BNPL) and digital credit services. Despite consistent data showing young people as a cohort are particularly vulnerable to unsustainable levels of indebtedness, little is known about how young people define and make sense of the experience of being in debt through consumer credit services. This paper explores how indebtedness is experienced and understood in relation to wellbeing through a qualitative study using interviews alongside arts-based participatory methods of bodymapping and sandboxing with 24 young people in the Hunter region of NSW, Australia. These methods enabled particular attention to the embodied and affective elements related to the experience of indebtedness to understand debt's significance for wellbeing for young people. The embodied and affective registers of indebtedness are integral for understanding the conditions informing how wellbeing is negotiated and felt in this context. This study considers the role of BNPL services in young people's economic lives as part of broader processes of financialisation, and the significance of extended and ubiquitous forms of credit for young people's wellbeing. [ABSTRACT FROM AUTHOR]

The Australian disability workforce has grown, and there is compelling evidence that peer work has a number of valuable impacts. Despite these apparent opportunities, there continue to be high levels of unemployment among people with disability and failure to draw on the assets of people with disability in Australian workplaces. To understand these ostensible missed opportunities, this study examined the ways in which lived experience was described as an asset in disability workforce recruitment. Advertisements for positions in New South Wales, Australia, that referred to lived experience or peer work and disability were collected over a 3‐month period. Through a process of content analysis, we found that there were more employment opportunities for people with lived experience of mental illness than for other types of disability. Community engagement was a key function, and peer workers were described as complementary to professionals. Recruitment processes for lived experience jobs were not necessarily accessible. We recommend systemic reforms to facilitate recognition of lived experience as a valuable criterion for disability sector employment and to harness the benefits of a disability peer workforce. [ABSTRACT FROM AUTHOR]

Objective: This evaluation considered the potential of We‐Yarn, a suicide prevention gatekeeper training workshop, to contribute to Aboriginal suicide prevention in rural New South Wales. Design: A mixed methods approach included surveys, in‐depth interviews and workshop observations. Setting: Aboriginal suicide prevention training in rural New South Wales, Australia. Participants: Attendees at We‐Yarn training. Intervention: We‐Yarn provided culturally safe suicide prevention skills training for Aboriginal people and for those who work with Aboriginal communities and persons in rural New South Wales. Training workshops were delivered across multiple locations for 6 hours in one day. Workshops were facilitated by two facilitators with lived and professional experience; one Aboriginal and one non‐Aboriginal facilitator. We‐Yarn content was developed by staff from the Centre for Rural and Remote Mental Health, and in consultation with Aboriginal Elders and representatives of Aboriginal Medical Services to ensure relevance and cultural appropriateness. Main outcome measures: Pre and post‐workshop surveys captured capacity and participants' confidence in identifying and responding to a person at risk of suicide. Interviews explored participants' experiences of workshops, implementation of learning, and attitudes regarding social and emotional wellbeing and suicide. Observations detailed the workshop environment, participants' engagement, and participants' responses to facilitators and content. Results: We‐Yarn was considered culturally appropriate. Participants responded to facilitators' lived experiences. Participants reported significant improvements in understanding the links between cultural strengths, social and emotional wellbeing and suicide prevention. However, health professionals with existing knowledge wanted a stronger focus on clinical training. Conclusion: We‐Yarn promoted discussion of suicide prevention within a holistic health framework, building on participants' pre‐existing knowledge about social and emotional wellbeing. Importantly, skilful facilitators with lived experience were vital to the success of the workshops. Consideration should be given to attracting people with low suicide prevention knowledge to the workshops, developing tailored workshops for health professionals and ensuring prolonged engagement with communities. Multifaceted and long term responses in addition to this type of training are important. [ABSTRACT FROM AUTHOR]

Objective: Mental health peer support workers draw on lived experience to provide benefit to people experiencing mental distress. People living in rural areas are less likely than their urban counterparts to seek professional help for psychological distress. The aim of this study was to explore the perceived value of rural peer support workers as facilitators to rural mental health help-seeking. Design: Data were gathered through a cross-sectional survey distributed by a social media boosted post. Setting: A total of 349 "small" rural towns in New South Wales as defined by the Modified Monash Model classification system as MMM5. Participants: A total of 765 adult, rural residents completed the survey. Main outcome measure(s): Participants were asked to select, from a list of potential facilitators, those which they felt would make mental health help-seeking easier or harder. Results: Study participants felt that a help provider with lived experience of mental illness or distress would make mental health help-seeking easier. Similarly, rural life experience in a help provider was thought to facilitate help-seeking. Participants also believed that flexible and informal meeting settings would make it easier to seek help for mental distress. Conclusions: Engaging rural mental health peer support workers in a flexible/informal setting, as a complement to conventional health service provision, may increase rural help-seeking for mental distress. Increased mental health help-seeking is likely to have a positive impact on instances of serious mental illness. [ABSTRACT FROM AUTHOR]

Background: The Central Coast Integrated Care Program CCICP is one of three integrated care demonstrator projects within NSW Australia funded for three years to challenge existing service fragmentation within and between health and social care sectors. The district-wide complex intervention focused on vulnerable youth, vulnerable older persons and people with chronic and complex conditions. As part of the formative evaluation of the CCICP, the Project Integrate Framework was used to map integrated care progress. This Framework provides an evidence-based understanding of the key dimensions and items of integrated care associated with successful implementation. Methods: Based upon the Project Integrate dimensions, an online survey of key stakeholders was undertaken. The survey results underpinned a workshop to assist CCICP team reflection and assessment of progress. This exercise enabled future program priorities and strategies to be set. Key stakeholder interviews were mapped to the Project Integrate dimensions for additional perspective. Results: The research results indicated where progress had been achieved, where learnings had been embedded in service delivery and aided the determination of priorities for action. Learnings about the suitability of Project Integrate dimensions and their use in online, interview and workshop formats will enable its use in other Australian and international settings. Discussion: The Project Integrate Framework aims to provide a conceptual basis for reflecting on the design and implementation of integrated care programs/projects. Our research found the survey tool alone was inadequate to assess integrated care progress, with many answers reflecting uncertainty Neither Disagree nor Agree. The data was reviewed in a workshop with the CCICP team to contextualise the uncertainty, particularly given the formative assessment stage. This greatly enhanced the understanding of progress in care integration on the Central Coast. This finding is congruent with the recommendation for the use of the Framework outlined in the original research. The Project Integrate Framework was identified by the CCICP team as a key communication tool, enabling a consistent terminology for integrated care. However, certain terminologies were not always understandable or meaningful to everyone. Group discussions were important to generate collective understanding of the meaning and importance of the dimensions. As with international case examples, progress towards system integration was regarded as poor, with substantial structural barriers beyond the control of the CCICP team. The intervention appears to be tracking more favourably in the dimensions of person-centred care, clinical and professional integration which was linked to sustained efforts to build relationships and enable a shared understanding of what the CCICP was seeking to achieve normative integration. Conclusion: Use of the Project Integrate framework supported by appreciative dialogue has enabled the CCICP team to reflect on progress and spread of integrated care within the Central Coast Local Health District and on what should be their next steps for spreading and building sustainability. The research findings are being used to refine the Project Integrate Framework as a means to support on-line assessments of integrated care to enable programs to have meaningful group discussions on design and implementation, and as a means to facilitate comparative research. [ABSTRACT FROM AUTHOR]

Background: The Project Integrate[i] conceptual framework began with a literature review on conceptual frameworks and relevant aspects of integrated care, from which a new conceptual framework, was built iteratively. This framework provides a standard set of dimensions and sub-elements which can be used to describe any integrated care initiative. As part of the formative evaluation of the Central Coast Integrated Care Program (CCICP), we have employed the Project Integrate Framework to map the integration efforts of the program, provide a consistent and common language, to enable supported self-assessment of progress towards integrated care and to allow for international benchmarking. Methods: An online survey of key stakeholders was undertaken mapping the degree of agreement on progress towards the Project Integrate dimensions. The survey results were used as a support tool in a workshop to assist CCICP team reflection and assessment and build a situational analysis of care integration progress within the program. This exercise was used as the basis to support agreement of future priorities and strategies within the program. Results: The survey results indicated where progress towards care integration had been achieved in the Central Coast. It was then used as a support tool in a workshop setting to assist the CCICP team to reflect and self-assess progress towards integrated care. Reflections regarding international comparators were made, stimulating further discussion, this led to the recognition of progress made to date and a realistic review of where progress should be given the maturity of the intervention. Achievements and opportunities were identified, with priority areas mapped out. A key priority was communication, in particular, building a common and consistent language for integrated care. Workforce and upskilling regarding data warehousing and analysis was also identified as an opportunity for future work. Di scussion: The survey tool alone was inadequate since many answers reflected uncertainty regarding progress (Neither Disagree nor Agree), thus the data required review and further consideration by the team to contextualise the uncertainty, particularly given the formative stage of assessment. The power of the survey results was in the group analysis and the contextualized discussion which ensued and added greatly to the understanding of progress in care integration on the Central Coast. The Project Integrate Framework and its nomenclature was identified by the CCICP team as a key communication tool, to build a consistent terminology for integrated care and its use in reporting, communication and stakeholder engagement. As with international case studies, progress towards system integration was regarded as poor, with substantial structural barriers beyond the control of the CCICP team. However, the intervention appears to be tracking more favourably in the dimension of patient-centred care. Conclusion: Use of the Project Integrate framework has enabled the CCICP team to reflect on progress and spread of integrated care within the Central Coast Local Health District and where their next steps should be for spreading and building sustainability. [ABSTRACT FROM AUTHOR]