Australian e-Journal for the Advancement of Mental Health最新文献

{"title":"The role of an Indigenous Health Worker in contributing to equity of access to a mental health and substance abuse service for Indigenous young people in a youth detention centre","authors":"S. Stathis, Paul Letters, Eva Dacre, Ivan Doolan, K. Heath, B. Litchfield","doi":"10.5172/jamh.6.1.26","DOIUrl":"https://doi.org/10.5172/jamh.6.1.26","url":null,"abstract":"Abstract Indigenous youth in detention have been identified as a priority category in national and state policies in relation to their mental health and drug and alcohol service needs. This article describes the development of the role of Indigenous Health Worker in the Mental Health Alcohol Tobacco and Other Drugs Service (MHATODS) at a youth detention centre. It provides an account of the process as well the outcomes achieved to date. A retrospective and descriptive account is given of the development of the role, and of strategies aimed at improving access to MHATODS for Indigenous young people. Over a one-year period, data were compiled on all young people admitted to a Queensland youth detention centre, which was then cross referenced with MHATODS’ own service records to determine the proportion of Indigenous young people who had been referred and subsequently received a service. The Indigenous Health Worker has decreased barriers to access for Indigenous young people who require treatment for mental health or substance abuse problems while in detention. There was no significant difference in referral or service provision rates for Indigenous compared to non-Indigenous youth. Indigenous young people were statistically more likely to refuse an assessment by MHATODS, though given the low rates of refusal the clinical significance was small. MHATODS’ use of an Indigenous Health Worker significantly contributes to the needs of Indigenous young people in youth detention by reducing barriers to access for the assessment of mental health problems and substance misuse. MHATODS has achieved equity in referral and service provision between Indigenous and non-Indigenous youth admitted into detention. Clinical and cultural supervision play an important part in the development and maintenance of the Indigenous Health Worker role.","PeriodicalId":358240,"journal":{"name":"Australian e-Journal for the Advancement of Mental Health","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116067708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the family therapist and health professional in mental health promotion and youth suicide prevention","authors":"A. Woodhouse","doi":"10.5172/jamh.6.3.204","DOIUrl":"https://doi.org/10.5172/jamh.6.3.204","url":null,"abstract":"Abstract Youth suicide is complex and remains an issue of concern to all of us who work with families, including family therapists and health professionals. Having worked within a child, adolescent and family mental health service as a family therapist, psychiatric nurse and Mental Health Promotion Officer in Gippsland, Victoria, the author is in an interesting position to reflect upon and integrate each of these approaches into a whole population health approach to youth suicide prevention. These views are presented in three parts, beginning with an overview of youth suicide, depression and the current suicide prevention strategy. Then, the role and effectiveness of family therapy in working with these issues is presented. Finally, integration of mental health promotion with family therapy is reviewed. The challenges and opportunities for family therapists and other health professionals in striving to achieve integration in mental health promotion and youth suicide prevention are discussed. Practice examples from the author’s rural region are included to demonstrate the fit of this approach with current youth suicide prevention strategies and research.","PeriodicalId":358240,"journal":{"name":"Australian e-Journal for the Advancement of Mental Health","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116616630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AIMHI NT ‘Mental Health Story Teller Mob’: Developing stories in mental health","authors":"T. Nagel, C. Thompson","doi":"10.5172/jamh.6.2.119","DOIUrl":"https://doi.org/10.5172/jamh.6.2.119","url":null,"abstract":"Abstract The Australian Integrated Mental Health Initiative in the Northern Territory is one of a number of sites funded by the National Health and Medical Research Council. The project has been working with Aboriginal Mental Health Workers (AMHWs), and the Top End Division of General Practice (TEDGP) to adapt mental health information to the Aboriginal and Torres Strait Islander context through development of mental health stories. The stories focus on personal strengths and family support, and use local artwork and images, local language, metaphors and music. The concepts have been incorporated into service provider training and psychoeducation resources in the Northern Territory. Development and evaluation of mental health literacy initiatives is important in the context of high rates of mental illness and burden of disease in the Aboriginal and Torres Strait Islander community.","PeriodicalId":358240,"journal":{"name":"Australian e-Journal for the Advancement of Mental Health","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130053724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Aboriginal Mental Health Worker Program: The challenge of supporting Aboriginal involvement in mental health care in the remote community context","authors":"A. Harris, G. Robinson","doi":"10.5172/jamh.6.1.15","DOIUrl":"https://doi.org/10.5172/jamh.6.1.15","url":null,"abstract":"Abstract This paper draws on our experience as evaluators of the Aboriginal Mental Health Worker Program that has been operating in eight remote communities across the Top End of the Northern Territory, Australia, for over four years. The program aimed to fund the placement of Aboriginal Mental Health Workers (AMHWs) in remote community health centres, to work under the clinical leadership of General Practitioners and to contribute to development of a culturally appropriate community based mental health care service for Indigenous people. In this paper, we examine the key features of the AMHW program and the originating partnership, the degree of integration of AMHWs in health centre processes and the provision of support for the development of the AMHW role in community mental health work. While there are many examples in this program of AMHWs providing highly valued services within their communities, the evaluation showed that the program did not achieve clear commitments to develop mental health practice around the AMHWs’ role. In addition there was variability in levels of local managerial support for the AMHWs, vulnerability to staff turnover and other discontinuities, as well as tensions in views about what the role of the AMHWs should be. Should it be culturally informed, clinically-related mental health work or community ‘wellbeing work’, and how should each role be supported? Together these factors undermined the sustainability of positive achievements within the program.","PeriodicalId":358240,"journal":{"name":"Australian e-Journal for the Advancement of Mental Health","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128341187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief intervention for Post Traumatic Stress Disorder with combined use of Cognitive Behaviour Therapy and Eye Movement Desensitisation Reprocessing","authors":"Malkanthi Hettiarachchi","doi":"10.5172/jamh.6.1.36","DOIUrl":"https://doi.org/10.5172/jamh.6.1.36","url":null,"abstract":"Abstract This case study is of a 23 year old female diagnosed with Post Traumatic Stress Disorder (PTSD) in Sri Lanka, six months following the Asian Tsunami of December 2004. The intervention was conducted in a village clinic on the southern coast of the country. Treatment involved the use of Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation Reprocessing (EMDR). The Beck Anxiety Inventory (BAI) was used to monitor levels of anxiety. The Impact of Event Scale (IES) was administered to assess level of intrusion and avoidance (Horowitz, Wilner & Alvarez, 1979). Subjective Units of Distress Scores (SUDS) were obtained to assess level of distress and the Validity of Cognition Scale (VOC) used to assess accuracy of positive beliefs (Shapiro, 2001). A significant reduction in trauma symptoms, levels of distress, intrusion and avoidance were noted at post-treatment. Treatment gains were maintained at one month and nine month follow-up. The combined treatment protocol may be an effective brief intervention to use in situations that require rapid treatments to alleviate personal psychological distress in the aftermath of large scale disasters.","PeriodicalId":358240,"journal":{"name":"Australian e-Journal for the Advancement of Mental Health","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128622986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring hope: Its meaning for adults living with depression and for social work practice","authors":"S. Houghton","doi":"10.5172/jamh.6.3.186","DOIUrl":"https://doi.org/10.5172/jamh.6.3.186","url":null,"abstract":"Abstract Mental health consumers are increasingly challenging deficit focussed constructions of mental illness, which conceptualise depression as a psychopathology with associated connotations of abnormality and disease. The emergence of the recovery paradigm facilitates the possibility, indeed the hope, of recovery from serious mental illness. Social work has much to offer this shifting mental health context, drawing as it does on holistic understandings of individuals and on perspectives such as strengths, resilience and empowerment. This changing practice environment supports the need to examine individual consumer experiences of depression and recovery in order to better inform the helping relationship. This paper informs this area of practice by exploring meanings and constructions of hope from the perspective of mental health consumers with depression. The research suggests that by incorporating hopefulness into interactions between mental health consumers and clinicians, there is the potential to enhance both the wellbeing of the consumer and the quality of the consumer/clinician relationship.","PeriodicalId":358240,"journal":{"name":"Australian e-Journal for the Advancement of Mental Health","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124385008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomised controlled trial of a group intervention to reduce engulfment and self-stigmatisation in first episode schizophrenia","authors":"E. McCay, H. Beanlands, R. Zipursky, P. Roy, M. Leszcz, J. Landeen, K. Ryan, Gretchen Conrad, Donna M. Romano, D. Francis, J. Hunt, L. Costantini, Eugene Y. Chan","doi":"10.5172/jamh.6.3.212","DOIUrl":"https://doi.org/10.5172/jamh.6.3.212","url":null,"abstract":"Abstract Young people coping with first episode schizophrenia may be predisposed to illness engulfment whereby the illness entirely defines self-concept. They require psychosocial intervention to preserve an identity distinct from illness, promote hopefulness, and minimise the impact of stigma, enabling them to embrace a healthy sense of self and an optimistic future. The purpose of this study was to evaluate a group intervention designed to promote healthy self-concepts by reducing self-stigmatisation and engulfment among young adults recovering from first episode schizophrenia. Participants at two first episode psychosis clinics, one in Toronto and one in Ottawa, were assigned to one of two groups: intervention plus treatment as usual, or a control with only treatment as usual. A repeated measures analysis revealed that immediately post-intervention, the treatment group significantly improved on engulfment, hope, and quality of life measures compared with the control. No improvement was observed in self-concept, self-esteem, self-efficacy, and stigma. Intervening early in the course of the illness to address engulfment and self-stigmatisation may enable young people to acquire positive attitudes toward themselves and the future. Future longitudinal data are needed to determine whether this intervention will prevent the development of chronicity and demoralisation over time.","PeriodicalId":358240,"journal":{"name":"Australian e-Journal for the Advancement of Mental Health","volume":"325 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124590684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the occupational therapist in adolescent mental health: A critical review of the literature","authors":"L. Hardaker, E. Halcomb, R. Griffiths, N. Bolzan, K. Arblaster","doi":"10.5172/jamh.6.3.194","DOIUrl":"https://doi.org/10.5172/jamh.6.3.194","url":null,"abstract":"Abstract There are substantial bodies of literature focusing on mental health and the mental health of young people. There is also a growing body of knowledge relating to the professional role of the occupational therapists in mental health. However, there is a marked gap that brings these areas together. Adolescence is a time of heightened stress, with as many as one in four young people experiencing a mental health problem; appropriate care is required to reduce the impact of mental illness on their transition into adulthood and subsequent adult life. Whilst the effectiveness of the multidisciplinary team in providing interventions has been well demonstrated in this client group, the roles and impact of the individual health professionals are less well understood. A review of the literature was conducted to better understand the current and potential role for occupational therapists working with young people with mental health issues.","PeriodicalId":358240,"journal":{"name":"Australian e-Journal for the Advancement of Mental Health","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134401304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing risk factors for adolescent behavioural and emotional problems: A pilot randomised controlled trial of a self-administered parenting intervention","authors":"H. Stallman, A. Ralph","doi":"10.5172/jamh.6.2.125","DOIUrl":"https://doi.org/10.5172/jamh.6.2.125","url":null,"abstract":"Abstract Parenting practices and parent-child relationships affect adolescent adjustment. This study examined the efficacy of a self-directed parenting intervention for 51 parents of early adolescents (aged 12–14 years), who reported experiencing difficulties with their adolescent’s behaviour. Two levels of intensity of a self-directed intervention (self-directed alone and self-directed plus brief therapist telephone consultations) were compared with a waitlist control group. At post-intervention, parents in the enhanced condition reported significantly fewer adolescent behavioural problems and less use of over-reactive parenting strategies than parents in either the standard or waitlist conditions. Improvements were maintained at 3-month follow-up. This research suggests that a self-directed behavioural family intervention with minimal therapist contact may be an effective early intervention for adolescent problems. It has implications for providing minimally sufficient interventions for parents using a multilevel approach to intervention as well as for making interventions more accessible for families.","PeriodicalId":358240,"journal":{"name":"Australian e-Journal for the Advancement of Mental Health","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116308205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A post-Jungian perspective on 55 Indigenous suicides in Central Australia; deadly cycles of diminished resilience, impaired nurturance, compromised interiority; and possibilities for repair","authors":"L. Petchkovsky, Nigel Cord-Udy, Laurencia Grant","doi":"10.5172/jamh.6.3.172","DOIUrl":"https://doi.org/10.5172/jamh.6.3.172","url":null,"abstract":"Abstract On a 15 month Consultant Psychiatric placement in Central Australia the senior author learned that Indigenous suicide rates in this region over 2001 to 2006 were almost ten times as high as European ones. What accounts for this, and what can be done to reduce it? Within the limits imposed by organisational and service delivery priorities, the authors conducted an opportunistic qualitative study, investigating hospital records, opinions of colleagues, interviews with survivors, and Coroners’ and Psychiatric reports, in an attempt to address these questions. Basic data patterns were similar to those in other Indigenous suicide studies; reflecting dire overall levels of chronic stress, and indicating an undermining of resilience. Canvassed opinions of medical colleagues, informed by contemporary epigenetic perspectives, developed this hypothesis further. Chronic deprivation and stress may have resulted in a transgenerational cascade of epigenetically impaired resilience to stress, mediated by the impact of stressed infant nurturing, resulting in Hypophyseal Pituitary Adrenal (HPA) Axis dysfunction and its behavioural sequelae (depression, anxiety, substance abuse, violence, suicide; but also impaired capacities for nurturance). The authors wondered about the impact of this on the development of that prefrontallymediated interiority (capacity for reflective inner life) that authors like Fonagy (2004) associate with the ability to deal with extreme emotional states. Survivor vignettes reflected something of the interior process of suicidees. The suicide gestures could be read as expressions of social powerlessness and implicit pleas for the kind of nurturance that might facilitate development of a capacity for reflectiveness that might lessen impulsive emotional acting out. The developing individual’s impaired capacity for an inner life may be repaired to some extent, in psychotherapy, by the application of an empathic reflective nurturance (Fonagy, 2004; Meares, 2000). What is required in a social tragedy of this magnitude goes way beyond the psychotherapist’s rooms. Informed by a post-Jungian sensibility, the authors extend this model of therapeutic nurturance, as heuristic metaphor, to the notion of the larger Euro-Australian milieu as failed nurturer, with a particular focus on psychiatric and forensic services. In an attempt to see how organisations might become more effective nurturers, we used a Leximancer ‘concept analysis’ of Coroners’ Reports to explore organisational ‘collective countertransference’. The Leximancer data suggested slippage between collective intentions and outcomes, prompting a discussion of ways of enhancing the nurturing capacities in organisations/services (in this case, Psychiatry and the Law). A ‘Kanyini/nurturance’ project of repair is outlined.","PeriodicalId":358240,"journal":{"name":"Australian e-Journal for the Advancement of Mental Health","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133809466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}