Background: Prevention and Recovery Care services are residential sub-acute services in Victoria, Australia, guided by a commitment to recovery-oriented practice. The evidence regarding the effectiveness of this service model is limited, largely relying on small, localised evaluations. This study involved a state-wide investigation into the personal recovery, perceived needs for care, well-being and quality-of-life outcomes experienced by Prevention and Recovery Care services' consumers.
View Article and Find Full Text PDFGiven the frequent exposure of humanitarian migrants to traumatic or stressful circumstances, there exists a potential predisposition to mental illness. Our objective was to pinpoint the trends and determinants of mental illness among humanitarian migrants resettled in Australia. This study considered five waves of longitudinal data involving humanitarian migrants resettled in Australia.
View Article and Find Full Text PDFIt is important to be able to differentiate mindfulness-based programs in terms of their model, therapeutic elements, and supporting evidence. This article compares mindfulness-based cognitive therapy (MBCT), developed for relapse prevention in depression, and mindfulness-integrated cognitive behavior therapy (MiCBT), developed for transdiagnostic applications, on: (1) origins, context and theoretical rationale (), (2) program structure, practice and, professional training (), and (3) evidence (). While both approaches incorporate behavior change methods, MBCT encourages behavioral activation, whereas MiCBT includes various exposure procedures to reduce avoidance, including a protocol to practice equanimity during problematic interpersonal interactions, and a compassion training to prevent relapse.
View Article and Find Full Text PDFBeing a close relative of a person with depression can take a heavy toll on the former, but these relatives are increasingly made responsible for taking on extensive carer roles. Research on relatives of people with depression is currently dominated by a focus on "carer burden" and although such a focus can explain many relatives' experiences and daily lives, it provides very limited insight into the everyday life of a person living with someone with depression. Therefore, we scoped qualitative research on people who are relatives of people living with depression and identified knowledge gaps caused by explicit or implicit theoretical or methodological assumptions.
View Article and Find Full Text PDFBackground: The use of recovery-oriented practice (ROP) can be challenging to implement in mental health services. This qualitative sub-study of the Principles Unite Local Services Assisting Recovery (PULSAR) project explored how consumers perceive their recovery following community mental health staff undertaking specific ROP training.
Methods: Using a qualitative participatory methodology, 21 consumers (aged 18-63 years) participated in one-on-one interviews.
Background: At the beginning of the COVID-19 pandemic, it was foreseen that the number of face-to-face psychiatry consultations would suffer a reduction. In order to compensate, the Australian Government introduced new Medicare-subsidized telephone and video-linked consultations. This study investigates how these developments affected the pre-existing inequity of psychiatry service delivery in Australia.
View Article and Find Full Text PDFAims: The climate emergency will likely prove this century's greatest threat to public health within which mental health effects need consideration. While studies consistently show the majority of Australians are very concerned about the impacts of climate change, there is limited evidence from nation-wide research linking climate change with mental health burden in sub-populations. This study aimed to understand the impact of climate change on mental health in the Australian population and identify populations who are most at risk of climate-related mental health burden.
View Article and Find Full Text PDFObjectives: This study investigated the effectiveness of a group-based 8-week intervention, Mindfulness-integrated Cognitive Behavior Therapy (MiCBT), to decrease psychological distress and increase wellbeing in a heterogeneous population in primary health care. MiCBT focuses on the importance of interoception and its interaction with cognition in emotional experience. These interactions are represented in the co-emergence model of reinforcement, in which non-reactivity (equanimity) to interoceptive signals facilitates adaptive behavior.
View Article and Find Full Text PDFInt J Environ Res Public Health
April 2022
Background: Monitoring and reporting mental health is complex. Australia's first National Mental Health Strategy in 1992 included a new national commitment to accountability and data collection in mental health. This article provides a narrative review of thirty years of experience.
View Article and Find Full Text PDFPurpose: To examine Australian psychological distress trends from 2001 to 2017/18, including analysis by age, sex, location, and household income.
Methods: Secondary analysis of the working age population (18-64 years) in six successive representative national health surveys. Measures were prevalence of psychological distress at very-high symptom level (defined by a Kessler Psychological Distress Scale (K10) score of 30 or more) and combined high/very-high level (K10 score of 22 or more).
J Clim Chang Health
August 2021
Australia experienced two public health emergencies in 2020 - the catastrophic bushfires and the global coronavirus (COVID-19) pandemic. Whilst these were separate events, both have similar drivers arising from human pressures on the natural environment. Here we report on relative personal concerns of Australians in a survey implemented during the global COVID-19 pandemic.
View Article and Find Full Text PDFAustralian general practitioners (GPs) are pivotal in mental health care. The REFOCUS-PULSAR (Principles Unite Local Services Assisting Recovery) primary care study aimed to improve personal recovery outcomes in adults with mental health problems consulting GPs. Modified from an intended stepped-wedge cluster study, an exploratory (pre- and post-intervention) design employed cross-sectional surveys of patients consulting GPs.
View Article and Find Full Text PDFAust N Z J Psychiatry
December 2021
Objective: In Victoria, Prevention and Recovery Care Services have been established to provide a partial alternative to inpatient admissions through short-term residential mental health care in the community. This study set out to determine whether Prevention and Recovery Care Services are achieving their objectives in relation to reducing service use and costs, fostering least restrictive care and leading to positive clinical outcomes.
Methods: We matched 621 consumers whose index admission in 2014 was to a Prevention and Recovery Care ('PARCS consumers') with 621 similar consumers whose index admission in the same year was to an acute inpatient unit and who had no Prevention and Recovery Care stays for the study period ('inpatient-only consumers').
Background: The purpose of this pilot study was to determine the feasibility, acceptability and the potential clinical utility of a novel mindfulness and compassion program (MAC-P) designed for youth with a range of psychotic experiences.
Method: A non-randomised, non-controlled prospective follow-up study was conducted. Eighteen participants who either met criteria for the 'at risk mental state' or were experiencing a psychotic episode or had a recent diagnosis of schizophrenia attended the 8-week program.
Objective: A spreadsheet-based model for supporting equitable mental health resource distribution in Australia was developed, based on the Australian Health Survey (AHS) psychological distress findings associated with area socio-economic disadvantage (SED). An illustrative application is presented.
Method: Stratum-specific psychological-distress rates for area SED quintiles are applied to local government areas, catchment areas and local health networks (LHNs).
Background: There is an emerging international literature demonstrating clinical and cost-effectiveness of sub-acute residential mental health services. To date, however, there is limited information on the profile of consumers accessing these models of care. This study aimed to understand the profile of the population served by adult sub-acute residential mental health services in Victoria, Australia (known as Prevention and Recovery Care; PARC) and to compare PARC service consumers with consumers admitted to psychiatric inpatient units within public hospitals.
View Article and Find Full Text PDFAripiprazole, brexpiprazole and cariprazine differ from all other second-generation antipsychotics due to partial agonism at the dopamine D2 and D3 receptors. In contrast to aripiprazole, brexpiprazole has lower intrinsic dopamine D2 activity and higher affinity for the serotonin 5-HT1A and 5-HT2A receptors, while cariprazine has the highest affinity for the dopamine D3 receptor, and the longest half-life. The main adverse effect of dopamine receptor partial agonists (DRPAs) is akathisia of low-to-moderate severity, which occurs in a small proportion of patients, usually in the first few weeks of treatment.
View Article and Find Full Text PDFAfter publication of our article [1] the authors have notified us that one of the names has been incorrectly spelled.
View Article and Find Full Text PDFIntroduction: Depression is a common and debilitating condition. In Australia, general practitioners (GPs) are the key providers of depression care. However, available evidence suggests that case finding for depression in primary care is poor.
View Article and Find Full Text PDFBackground: Effective transdiagnostic treatments for patients presenting with principal or comorbid symptoms of anxiety and depression enable more efficient provision of mental health care and may be particularly suitable for the varied population seen in primary healthcare settings. Mindfulness-integrated cognitive behavior therapy (MiCBT) is a transdiagnostic intervention that integrates aspects of CBT, including exposure skills targeting avoidance, with training in mindfulness meditation skills adopted from the Vipassana or insight tradition taught by the Burmese teachers U Ba Khin and Goenka. MiCBT is distinguished from both cognitive therapy and mindfulness-based cognitive therapy by the use of a theoretical framework which proposes that the locus of reinforcement of behavior is the interoceptive experience (body sensations) that co-arises with self-referential thinking.
View Article and Find Full Text PDFAs refugee numbers grow worldwide, understanding prevalence and determinants of mental illness in this population becomes increasingly important. We used longitudinal data to examine the initial years of resettlement in Australian refugees with a focus on ethnic-like social support. Three annual waves from a longitudinal, nationally representative cohort of 2,399 humanitarian migrants recently resettled in Australia were examined for two mental illness outcomes: post-traumatic stress disorder indicated by positive PTSD-8 screen and "high risk of severe mental illness" (HR-SMI) by Kessler Psychological Distress Scale (K6) ≥19.
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