An exploration into suicide prevention initiatives for mental health nurses : a systematic literature review
- Authors: Dabkowski, Elissa , Porter, Joanne
- Date: 2021
- Type: Text , Journal article , Review
- Relation: International Journal of Mental Health Nursing Vol. 30, no. 3 (2021), p. 610-623
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- Description: Mental health and suicide prevention are national health priorities in Australia, with research currently focussed towards the ZERO Suicide (ZS) initiative. The aim of this review was to evaluate the impact of suicide prevention programmes, in particular the ZS prevention initiative. A systematic review using the PRISMA guidelines was conducted using six EBSCO Host databases; Academic Search Complete, Australian/New Zealand Reference Centre, CINAHL Complete, MEDLINE, APA PsycINFO, and APA Psyc Articles. The data extracted from the eligible papers were analysed using a thematic approach. The final data set consisted of fourteen (n = 14) peer-reviewed articles meeting the eligibility criteria, which included quantitative (n = 10), mixed methods (n = 2), and qualitative studies (n = 2). Results indicated variances between suicide prevention programmes with some papers examining single workshops and others assessing multimodal, organizational interventions. Five major themes were produced from this review including measuring the success of suicide prevention programmes, improvements to the delivery of suicide prevention programmes, barriers to implementing changes, cultural considerations, and further research required for suicide prevention programmes. This review concludes that further long-term research is required to evaluate the implementation and efficacy of suicide prevention programmes in health care. Cultural awareness in suicide prevention training is another area that may benefit from further research. A growing body of evidence establishes the need for multimodal and organizational approaches for suicide prevention initiatives. © 2021 John Wiley & Sons Australia, Ltd
Chinese mental health professionals’ perceptions of shared decision-making regarding people diagnosed with schizophrenia : a qualitative study
- Authors: Huang, Chongmei , Lam, Louisa , Zhong, Yaping , Plummer, Virginia , Cross, Wendy
- Date: 2021
- Type: Text , Journal article
- Relation: International Journal of Mental Health Nursing Vol. 30, no. 1 (2021), p. 189-199
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- Description: The implementation of shared decision-making regarding people diagnosed with schizophrenia is limited, although it is reported to have a positive impact on improving treatment adherence, therapeutic relationships and saving medical costs. The successful implementation of it is mainly dependent on the active engagement of mental health professionals. This study aims to identify mental health professionals’ perceptions of shared decision-making regarding people diagnosed with schizophrenia in collectivist cultures such as Chinese culture. A qualitative descriptive approach was used, involving ten individual interviews with psychiatrists and four focus groups with twenty-three mental health nurses from the psychiatry department of a tertiary hospital in mainland China. An inductive thematic approach was used to analyze the data. Two main themes with five subthemes generated: willingness to engage in shared decision-making and perceiving shared decision-making as unachievable. The last theme included five subthemes: (i) deference to authority, (ii) tension between family decision-making and patient autonomy, (iii) uncertainty of trusting therapeutic relationships, (iv) implicit persuasion and (v) insufficient consultation time. Patients often lack opportunity and support to engage in decision-making. Mental health nurses in other countries need to be aware that Chinese patients and patients with a similar background are not knowledgeable about or value shared decision-making to the extent that other countries might. They need to evaluate and support them, including encouraging them to engage in decision-making as well as providing appropriate information. Mental health nurses need to collaborate with patients and their families to achieve patient-centred care when family involvement is expected. © 2020 Australian College of Mental Health Nurses Inc.
COVID-19 : factors associated with psychological distress, fear, and coping strategies among community members across 17 countries
- Authors: Rahman, Muhammad Aziz , Banik, Biswajit , Salehin, Masudus , Joseph, Bindu , Lam, Louisa , Watts, Mimmie , Cross, Wendy
- Date: 2021
- Type: Text , Journal article
- Relation: Globalization and Health Vol. 17, no. 1 (2021), p.
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- Description: Background: The current pandemic of COVID-19 impacted the psychological wellbeing of populations globally. Objectives: We aimed to examine the extent and identify factors associated with psychological distress, fear of COVID-19 and coping. Methods: We conducted a cross-sectional study across 17 countries during Jun-2020 to Jan-2021. Levels of psychological distress (Kessler Psychological Distress Scale), fear of COVID-19 (Fear of COVID-19 Scale), and coping (Brief Resilient Coping Scale) were assessed. Results: A total of 8,559 people participated; mean age (±SD) was 33(±13) years, 64% were females and 40% self-identified as frontline workers. More than two-thirds (69%) experienced moderate-to-very high levels of psychological distress, which was 46% in Thailand and 91% in Egypt. A quarter (24%) had high levels of fear of COVID-19, which was as low as 9% in Libya and as high as 38% in Bangladesh. More than half (57%) exhibited medium to high resilient coping; the lowest prevalence (3%) was reported in Australia and the highest (72%) in Syria. Being female (AOR 1.31 [95% CIs 1.09-1.57]), perceived distress due to change of employment status (1.56 [1.29-1.90]), comorbidity with mental health conditions (3.02 [1.20-7.60]) were associated with higher levels of psychological distress and fear. Doctors had higher psychological distress (1.43 [1.04-1.97]), but low levels of fear of COVID-19 (0.55 [0.41-0.76]); nurses had medium to high resilient coping (1.30 [1.03-1.65]). Conclusions: The extent of psychological distress, fear of COVID-19 and coping varied by country; however, we identified few higher risk groups who were more vulnerable than others. There is an urgent need to prioritise health and well-being of those people through well-designed intervention that may need to be tailored to meet country specific requirements. © 2021, The Author(s). **Please note that there are multiple authors for this article therefore only the name of the Federation University Australia affiliates are named “Muhammad Aziz Rahman, Biswajit Banik, Masudus Salehin, Joseph Bindu, Louisa Lam, Mimmie Watts and Wendy Cross” are provided in this record**
COVID-19 related psychological distress, fear and coping : identification of high-risk groups in Bangladesh
- Authors: Rahman, Muhammad Aziz , Rahman, Shaila , Wazib, Amit , Salehin, Masudus , Cross, Wendy
- Date: 2021
- Type: Text , Journal article
- Relation: Frontiers in Psychiatry Vol. 12, no. (2021), p. 718654
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- Description: Background: The COVID-19 pandemic has imposed psychological distress and fear across the globe; however, factors associated with those issues or the ways people cope may vary by country or context. This study aimed to investigate the factors associated with psychological distress, fear, and coping strategies for people living in Bangladesh during the COVID-19 pandemic. Methods: A cross-sectional study conducted in August-September 2020 using online platforms in Bangladesh. People residing in Bangladesh, aged ≥18 years, who were proficient in English and able to respond to online questionnaire. The Kessler Psychological Distress Scale was used to assess the psychological stress. Level of fear was assessed using the Fear of COVID-19 Scale, and strategies to cope were assessed using the Brief Resilient Coping Scale. Results: Of the 962 participants, half of them were aged between 30 and 59 years. Being born in Bangladesh, having graduate education, perceived distress due to employment change, effect of COVID-19 on financial situation, having multiple comorbidities, and visiting a healthcare provider in the last 4 weeks were associated with higher levels of both psychological distress and fear of COVID-19. Furthermore, higher psychological distress was associated with being a female (AOR 1.81, 95% CI 1.33–2.47, p < 0.001), being a frontline worker (AOR 1.50, 95% CI 1.04–2.15, p < 0.05), having pre-existing psychiatric problems (AOR 4.03, 95% CI 1.19–13.7, p < 0.05), being a smoker (AOR 2.02, 95% CI 1.32–3.09, p < 0.01), providing care to a known/suspected COVID-19 patient (AOR 1.96, 95% CI 1.40–2.72, p < 0.001), having a recent overseas travel history and being in self-quarantine (AOR 4.59, 95% CI 1.23–17.2, p < 0.05), self-isolation without COVID-19 (AOR 2.63, 95% CI 1.68–4.13, p < 0.001) or being COVID-19 positive (AOR 2.53, 95% CI 1.19–5.34, p < 0.05), and having high levels of fear of COVID-19 (AOR 3.27, 95% CI 2.29–4.66, p < 0.001). A higher level of fear was associated with moderate to high levels of psychological distress (AOR 3.29, 95% CI 2.31–4.69, p < 0.001). People with pre-existing mental health problems were less likely to be resilient (AOR 0.25, 95% CI 0.11–0.54, p < 0.01), whereas those with having an income were more likely to be resilient (AOR 1.46, 95% CI 1.02–2.11, p < 0.05). Conclusion: Effective interventions to support the vulnerable groups including improved access to mental health services are of utmost importance during the pandemic. © Copyright © 2021 Rahman, Rahman, Wazib, Arafat, Chowdhury, Uddin, Rahman, Bahar Moni, Alif, Sultana, Salehin, Islam, Cross and Bahar. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Muhammad Aziz Rahman, Masudus Salehin, Wendy Cross" is provided in this record**
The immediate and durable effects of yoga and physical fitness exercises on stress
- Authors: Tong, Jiajin , Qi, Xin , He, Zhonghui , Chen, Senlin , Cooley, Dean
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of American College Health Vol. 69, no. 6 (2021), p. 675-683
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- Description: Objective: This study aimed to examine the effects of yoga and physical fitness exercises on stress and the underlying mechanisms. Participants: Healthy undergraduates from four yoga and four fitness classes participated in Study 1 (n = 191) and Study 2 (n = 143), respectively (in 2017 Fall). Methods: Study 1 evaluated the immediate effect (a 60-minute practice) while Study 2 evaluated the durable effect (a 12-week intervention). Results: Results showed that immediate stress reduction was more salient in the yoga group than that in the fitness group in Study 1. Yoga group had a greater increase in mindfulness, which predicted stress reduction. Similar observations were made in Study 2 showing the durable effect of yoga on stress reduction through mindfulness. Conclusions: Yoga intervention is better than fitness exercises in helping undergraduates cultivate mindfulness and reduce stress. These findings may guide future interventions in stress management in college students. © 2020 Taylor & Francis Group, LLC.
Protocol for the development and validation of a measure of persistent psychological and emotional distress in cardiac patients : the cardiac distress inventory
- Authors: Jackson, Alun , Rogerson, Michelle , Le Grande, Michael , Thompson, David , Ski, Chantal , Alvarenga, Marlies , Amerena, John , Higgins, Rosemary , Raciti, Michela , Murphy, Barbara
- Date: 2020
- Type: Text , Journal article
- Relation: BMJ Open Vol. 10, no. 6 (2020), p.
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- Description: Introduction Distress is experienced by the majority of cardiac patients, yet no cardiac-specific measure of distress exists. The aim of this project is to develop and validate the Cardiac Distress Inventory (CDI). Using the CDI, health professionals will be able to identify key clusters of psychological, emotional and social concern to address with patients, postcardiac event. Methods and analysis An item pool will be generated through: identification of items by a multidisciplinary group of clinician researchers; review of generic and condition-specific distress measures; focus group testing with cardiac rehabilitation professionals; feedback from patients. The COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) criteria will be used to inform the development of the methodology for determining the CDI's psychometric properties. The item pool will be tested with 400 cardiac patients and responses subjected to exploratory factor analysis, Rasch analysis, construct validity testing and latent class analysis. Receiver operating characteristic analysis will be used to identify the optimal CDI cut-off score for distinguishing whether a person experiences clinically significant distress. Ethics and dissemination Approved by the Monash Health Human Research Ethics Committee (approval number - RES-19-0000631L-559790). The CDI will be made available to clinicians and researchers without charge. The CDI will be translated for use internationally. Study findings will be shared with cardiac patient support groups; academic and medical communities via publications and presentations; in the training of cardiac secondary prevention professionals; and in reports to funders. Authorship for publications will follow the uniform requirements for manuscripts submitted to biomedical journals. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Psychological flexibility : positive implications for mental health and life satisfaction
- Authors: Lucas, James , Moore, Kathleen
- Date: 2020
- Type: Text , Journal article
- Relation: Health promotion international Vol. 35, no. 2 (2020), p. 312-320
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- Description: New wave therapies such as Acceptance and Commitment Therapy aim to cultivate people's psychological flexibility in order for them to live a satisfying life. Psychological flexibility has also a role in promoting mental health, which may mediate the relationship with life satisfaction. The aim of this study was to determine whether mental health mediates the effect of psychological flexibility on life satisfaction. A convenience sample of 140 adults (32 males, M = 36.50 years, SD = 12.22; 107 females, M = 38.46 years, SD = 12.81; and a 45-year-old person of unknown gender) completed an online questionnaire assessing psychological flexibility, mental health and life satisfaction. Three of the four hypothesized components of psychological flexibility (experiential acceptance, cognitive alternatives and cognitive control) contributed to the latent construct of psychological flexibility, but cognitive defusion failed to contribute. Psychological flexibility had a direct, positive effect on life satisfaction and the hypothesis that mental health would mediate this relationship was supported. The results suggest that psychological flexibility is important for one's mental health and that both are integral to life satisfaction. The results also support a continued focus on third-wave therapies in cultivating psychological flexibility. © The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Openness to help-seeking for mental illness among Greek-Cypriots
- Authors: Alexi, Nektarios , Moore, Kathleen , Argyrides, Marios
- Date: 2018
- Type: Text , Journal article
- Relation: Health Promotion International Vol. 33, no. 6 (2018), p.990-998
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- Description: The aim of this study was to test a model of people’s willingness to seek help for mental illness whether currently diagnosed or not. A cross-sectional design was used to test this model in a non-clinical convenience sample of Greek-Cypriots. Participants were 196 Greek-Cypriots living in Cyprus (age M = 34.50 years, SD = 14.16). They provided demographic data on their age, gender, SES and whether diagnosed or not with a mental illness, from whom they have/would seek help for a mental illness, and their willingness to seek help. They completed the Inventory of Attitudes towards Seeking Mental Health Services, the Multidimensional Scale of Perceived Support, and the Practical Barriers in Seeking Mental Health Services Scales, translated into Greek for this study. Approximately 24% of the sample reported being diagnosed with a mental illness within the past 12 months, and around a third of these people were taking prescribed medication. Willingness to seek help across all participants was predicted negatively by stigma and positively by openness to help. The findings of the current study extend our previous limited understanding of the factors affecting people’s willingness to seek help or their intentions towards the use of mental health services among Greek-Cypriots. Future research should consider whether there are any differences in help-seeking behaviours and motivations across people experiencing different disorders. Despite this limitation in the current data, these results can, in general terms, be used to inform policy in Cyprus for mental health promotions and interventions especially with respect to fostering an open attitude towards mental illness.
Physical deterioration in an acute mental health unit : A quantitative retrospective analysis of medical emergencies
- Authors: Porter, Joanne , Cant, Robyn , Missen, Karen , Raymond, Anita , Churchill, Anne
- Date: 2018
- Type: Text , Journal article
- Relation: International Journal of Mental Health Nursing Vol. 27, no. 5 (2018), p. 1364-1370
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- Description: Nursing management of physical deterioration of patients within acute mental health settings is observed, recorded, and actively managed with the use of standardized Adult Deterioration Detection System (ADDS) charts. Patient deterioration may require the urgent assistance of a hospital rapid response or Medical Emergency Team. A five-and-a-half-year (2011–2016) audit of hospital-wide Medical Emergency Team attendances was conducted in an acute mental health unit of a single large 250 bed regional hospital in Victoria, Australia. Data were extracted from the hospitals’ quality and patient safety program, RISKMan, and entered into a statistical data program for analysis. A total of 140 patient records were analysed, and the ‘Worried’ category (34%, n = 47) was the principle reason for a Medical Emergency Team call in a mental health ward, followed by hypotension (23%, n = 31) and a low Glasgow Coma Score (16%, n = 22). Upon further investigation of the ‘Worried’ category, the most common conditions recorded were an altered conscious state (22%, n = 9), low oxygen saturation (20%, n = 8), or chest pain (17%, n = 7). Activation of Medical Emergency Team calls predominantly occurred in the daylight morning hours (6am–12md). When data were compared to the general hospital patients, the context of the physiological deterioration of the mental health patients was strikingly similar. Further research is recommended to ascertain the extent and frequency with which staff working in mental health units are performing vital signs monitoring as an essential component of detection of early signs of physiological deterioration.
Improving mental health of adolescents with Type 1 diabetes: protocol for a randomized controlled trial of the nothing ventured nothing gained online adolescent and parenting support intervention
- Authors: Hackworth, Naomi , Matthews, Jan , Burke, Kylie , Petrovic, Zvezdana , Klein, Britt , Northam, Elisabeth , Kyrios, Michael , Chiechomski, Lisa , Cameron, Fergus
- Date: 2013
- Type: Text , Journal article
- Relation: BMC Public Health Vol. 13, no. 1 (2013), p. 1185.1 -1185.10
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- Description: Management of Type 1 diabetes comes with substantial personal and psychological demands particularly during adolescence, placing young people at significant risk for mental health problems. Supportive parenting can mitigate these risks, however the challenges associated with parenting a child with a chronic illness can interfere with a parent’s capacity to parent effectively. Interventions that provide support for both the adolescent and their parents are needed to prevent mental health problems in adolescents; to support positive parent-adolescent relationships; and to empower young people to better self-manage their illness. This paper presents the research protocol for a study evaluating the efficacy of the Nothing Ventured Nothing Gained online adolescent and parenting intervention which aims to improve the mental health outcomes of adolescents with Type 1 diabetes.
Physical and mental health perspectives of first year undergraduate rural university students
- Authors: Hussain, Rafat , Guppy, Michelle , Robertson, Suzanne , Temple, Elizabeth
- Date: 2013
- Type: Text , Journal article
- Relation: BMC Public Health Vol. 13, no. 1 (2013), p.
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- Description: Background: University students are often perceived to have a privileged position in society and considered immune to ill-health and disability. There is growing evidence that a sizeable proportion experience poor physical health, and that the prevalence of psychological disorders is higher in university students than their community peers. This study examined the physical and mental health issues for first year Australian rural university students and their perception of access to available health and support services. Methods. Cross-sectional study design using an online survey form based on the Adolescent Screening Questionnaire modeled on the internationally recognised HEADSS survey tool. The target audience was all first-year undergraduate students enrolled in an on-campus degree program. The response rate was 41% comprising 355 students (244 females, 111 males). Data was analysed using standard statistical techniques including descriptive and inferential statistics; and thematic analysis of the open-ended responses. Results: The mean age of the respondents was 20.2 years (SD 4.8). The majority of the students lived in on-campus residential college style accommodation, and a third combined part-time paid work with full-time study. Most students reported being in good physical health. However, on average two health conditions were reported over the past six months, with the most common being fatigue (56%), frequent headaches (26%) and allergies (24%). Mental health problems included anxiety (25%), coping difficulties (19.7%) and diagnosed depression (8%). Most respondents reported adequate access to medical doctors and support services for themselves (82%) and friends (78%). However the qualitative comments highlighted concerns about stigma, privacy and anonymity in seeking counselling. Conclusions: The present study adds to the limited literature of physical and mental health issues as well as barriers to service utilization by rural university students. It provides useful baseline data for the development of customised support programs at rural campuses. Future research using a longitudinal research design and multi-site studies are recommended to facilitate a deeper understanding of health issues affecting rural university students. © 2013 Hussain et al.; licensee BioMed Central Ltd.
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An evaluation of 'Reach Out Central': An online gaming program for supporting the mental health of young people
- Authors: Shandley, Kerrie , Austin, David , Klein, Britt , Kyrios, Michael
- Date: 2010
- Type: Text , Journal article
- Relation: Health Education Research Vol. 25, no. 4 (2010), p. 563-574
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- Description: The objective of this study was to conduct an evaluation of Reach Out Central (ROC), an online gaming program designed to support the mental health of people aged 16-25. The evaluation sought to determine the benefit of playing ROC on alcohol use, use of coping strategies, psychological distress, resilience and satisfaction with life. Changes in mental health literacy, mental health stigma and willingness to seek help and program satisfaction were also investigated. A single group (N=266) quasi-experimental repeated measures (pre-, post-program, 2-month follow-up) design was employed. The results demonstrated positive improvements across all outcome measures for females; however, a non-significant worsening effect was observed for males on seeking support, avoidance and resilience. Improvements for both genders were observed on mental health literacy and help-seeking. However, literacy levels and help-seeking were significantly higher, and stigma significantly lower for females. Program satisfaction ratings were high irrespective of gender. Although some inconsistencies between genders were noted, ROC appears to enhance protective factors for the prevention or early intervention of mental health disorders. The results of this study need to be viewed with its limitations in mind, specifically, the use of an open trial methodology and the small number of male participants. © The Author 2009. Published by Oxford University Press. All rights reserved.
Sense of belonging to the general and gay communities as predictors of depression among Australian Gay Men
- Authors: McLaren, Suzanne , Jude, Belinda , McLachlan, Angus
- Date: 2008
- Type: Text , Journal article
- Relation: International Journal of Men's Health Vol. 7, no. 1 (2008), p. 90-99
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- Description: Sense of belonging has been regarded as important for mental health. This study investigated sense of belonging to the general community and sense of belonging to the gay community as predictors of depression among self-identified Australian gay men (N = 137). Participants completed the Psychological subscale of the Sense of Belonging Instrument and the Depression subscale of the Depression Anxiety Stress Scales. Results offered support for the additive model and suggested that sense of belonging to the general community partially mediated the relation between sense of belonging to the gay community and depression, as well as the reverse, that sense of belonging to the gay community partially mediated the relation between sense of belonging to the general community and depression. Findings failed to support a moderation effect model. Results indicate that increasing a sense of belonging to both communities will be associated with a decrease in levels of depression reported by gay men. [ABSTRACT FROM AUTHOR] Copyright of International Journal of Men's Health is the property of Men's Studies Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Social geography and rural mental health research
- Authors: Boyd, Candice , Parr, H
- Date: 2008
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 8, no. (2008), p. 1-5
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- Description: C1
Issues in rural adolescent mental health in Australia
- Authors: Boyd, Candice , Aisbett, Damon , Francis, Kristy , Kelly, Melinda , Newnham, Karyn , Newnham, Krystal
- Date: 2006
- Type: Text , Journal article
- Relation: Rural and Remote health Vol. 6, no. 501 (2006), p. 1-9
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- Description: The mental health of adolescents living in rural Australia has received little research attention. In this article, the extant literature on rural adolescent mental health in Australia is reviewed. Given the lack of literature on this topic, the review is centered on a vignette presented at the beginning of the article. The case represented by the vignette is that of a young Australian growing up in a rural area. The issues raised – including the nature of mental health issues for rural adolescents and barriers to seeking professional help – are then discussed in terms of the available literature. The article concludes with a future focus for research efforts in the area of rural adolescent mental health.
- Description: C1
- Description: 2003001815
Promoting the psychosocial function of young adults through psychiatric residential rehabilitation: A qualitive evaluation of the making a significant change (MASC) program
- Authors: Kelly, Melinda , Boyd, Candice
- Date: 2006
- Type: Text , Journal article
- Relation: International Journal of Psychosocial Rehabilitation Vol. 10, no. 2 (2006), p. 139-153
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- Description: This research evaluated the Making a Significant Change (MASC) program - the only residential psychosocial rehabilitation program for young adults in the Grampians region of Victoria, Australia. The program provides intensive support and rehabilitation services to young people aged 16 to 24 years who have a mental illness and are at risk of developing further mental health disabilities. This evaluation aimed to establish a holistic view of the program with a focus on the process descriptive data for key stakeholders in the service so that the impact of intervention approaches could be gauged.
- Description: C1
- Description: 2003003401
Rural adolescents' attitudes to seeking help for mental health problems
- Authors: Francis, Kristy , Boyd, Candice , Aisbett, Damon , Newnham, Karyn , Newnham, Krystal
- Date: 2006
- Type: Text , Journal article
- Relation: Youth Studies Australia Vol. 25 , no. 4 (2006), p. 42-49
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- Description: Little research has been undertaken into the barriers facing rural adolescents seeking help and support for mental health problems. This study presented students from rural secondary schools in Victoria with hypothetical scenarios of an adolescent living in a rural area with a mental disorder and posed questions inorder to create group discussion. The results revealed a range of perceived barriers to help-seeking that could be considered unique to rural settings. However, adolescents also expressed positive attitudes and identified a range of professional help sources available to them. The findings support recent moves towards providing school-based mental health services to young people in rural areas.
- Description: C1
- Description: 2003001811