Mental health research focus day
Overview of mental health care in the ACT
Dr Elizabeth Moore
Coordinator-General, Office for Mental Health and Wellbeing, ACT Health Directorate
Dr Denise Riordan
Director Clinical Services Mental Health, and Clinical Director CAMHS, Justice Health, Alcohol and Drug Service, ACT Health Directorate
Clinical Senior Lecturer, ANU Medical School
This session will set the scene with an overview of the current and planned Mental Health service system in the ACT and the work of the Office for Mental Health and Wellbeing. Promotion, prevention and early intervention are important aspects of reducing the Burden of Disease, as is access to a range of acute and recovery focussed community and inpatient services. Partnerships with consumers and carers, the PHN and non-government services are important enablers of good patient outcomes and present opportunities to improve access and responsiveness.
Lived experience research
Associate Professor Michelle Banfield
Centre for Mental Health Research, The Australian National University
Associate Professor Michelle Banfield will speak about her role as a lived experience researcher at ANU, and her program of research that is driven by lived experience priorities and actively incorporates others with lived experience in the research process. This includes work conducted in partnership with ACT Health and Canberra Health Services to develop peer work roles in the ACT.
Mental health across the lifecourse
Professor Peter Butterworth
Professor, Research School of Population, The Australian National University
Honorary Professorial Fellow, Melbourne Institute of Applied Economic and Social Research, University of Melbourne
This presentation draws upon high quality, nationally representative data to examine the prevalence of common mental disorders and psychological distress in Australia. The analysis considers differences in prevalence across the lifecourse, and examines whether the observed results are best explained as age or cohort differences. The presentation will also consider claims that levels of distress and mental ill-health have been increasing in the Australian community, particularly among adolescents and young adults. We will reflect on the different pattern of results obtained using different research methods and what implications this may have for monitoring of population mental health.
Improving the trajectory of people with personality disorder, self-harm, and suicidal risk from acute to community mental health services: Findings from the Project Air Strategy randomised controlled trial of a whole of service stepped care model
Senior Professor Brin Grenyer
Director of the Project Air Strategy for Personality Disorders and Senior Professor of Psychology, University of Wollongong
People with personality disorders are prevalent in emergency and inpatient mental health services. We present findings from a randomised controlled trial implementing a stepped-care intervention that diverted people away from hospital and into brief intervention clinics. We report that demand on hospital services reduced significantly in the stepped-care site, compared to the TAU site. Patients at the stepped-care site experienced a significantly larger reduction in the number of bed days, and were 1.3 times more likely to experience a reduction in re-presentations to the emergency department and the approach led to direct cost savings. Therapy at the clinics demonstrated patient gains in wellbeing and reduced suicidal risk. Using a stepped-care model of treatment for personality disorder significantly reduced the demand on hospital services and improved patient outcomes.
The spectrum of interventions – mental health promotion, prevention, early intervention
Professor Debra Rickwood
Faculty of Health, University of Canberra
Chief Scientific Advisor, Headspace National Youth Mental Health Foundation
Reducing the prevalence and impact of mental illness requires action across the entire spectrum of interventions, from mental health promotion to recovery-focused continuing care. A targeted focus on promotion, prevention, and early intervention is required to, over time, reduce the burden of mental illness, yet there are many systemic forces that work against this focus. This presentation describes the spectrum of interventions, giving examples of each approach for youth mental health. It considers how research informs understanding of effectiveness and efficacy across the spectrum and the specific challenges for promotion, prevention, and early intervention.
Neurostimulation – evidence and challenges for mental health
Dr Suneel Chamoli
Director TMS Specialists Clinics and Neuropsytech Pty Ltd
Senior Lecturer, School of Medicine, University of Queensland
Neurostimulation has rapidly emerged as the science of non-convulsive techniques to modulate the activity of central and peripheral neural tissues in a non-invasive manner. It has vast applications in medicine such as investigation of the complex brain mechanisms and treatment of a range of neurological and psychiatric disorders. Repetitive Transcranial Magnetic Stimulation (rTMS), transcranial Direct Current Stimulation (tDCS), transcranial Alternate Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) have been a focus of intensive research in the last decade. Of these techniques, rTMS and tDCS have made entry into routine clinical practice. The question we face is whether the regulatory, training and health care delivery organisations are ready to accept it in clinical care and what are the challenges to its successful adoption.
The role and effectiveness of mental health prevention programs in school
Professor Alison Calear
Professor, Centre for Mental Health Research, The Australian National University
Anxiety and depression are common in children and adolescents and identifying ways to prevent mental health problems in this population is important. Schools have been identified as an ideal setting in which to deliver mental health prevention programs, given their universal access to young people. This presentation will highlight the benefits of delivering mental health prevention programs in schools and present the outcomes of two trials assessing the effectiveness of the MoodGYM and SPARX-R online depression prevention programs in Australian secondary schools.
Aged care facilities
Associate Professor Kasia Bail
Associate Professor of Nursing, Faculty of Health, University of Canberra
The promotion of mental health and the suitable recognition of mental illness in residential aged care is challenging, with multiple phenomena converging in relation to normalisation of deterioration, social ageism, categorisation of behaviours, complex working environments, and a minimalization of the contributions of the older population to their own and broader social wellbeing. This presentation will provide an overview of current mental health services for residents living in aged care and conceptualisation of human rights frameworks in relation to restrictive practices and other risk averse decision making; discuss documentation burdens, the role of health professionals; as well as outlining opportunities for supported decision making and other avenues for promoting agency and quality in residential aged care.
Associate Professor Simon Rosenbaum
Associate Professor, School of Psychiatry, UNSW Sydney
From depression to schizophrenia, anxiety to post-traumatic stress – physical activity is an evidence-based strategy to reduce symptoms and promote recovery from various mental disorders. Addressing motivational deficits and overcoming barriers, especially for those that are most unwell remains an ongoing challenge to the routine implementation of physical activity as a component of mental health care. This presentation will use examples of established clinical exercise in mental health programs, with a focus on novel strategies, including staff interventions that can help facilitate culture change and physical activity adoption within mental health facilities.
Forensic mental health: Challenging people or challenging transitions?
Dr Joey Le
Forensic and Child and Adolescent Psychiatrist, Forensic Mental Health Services, Mental Health, Justice Health and Alcohol and Drug Services, ACT Health Directorate
Mental illness, problem behaviour and offending are inextricably linked to a complex psychosocial matrix characterised by poor access to services which presents as a significant contributing factor to poor outcomes for people with mental ill health. Those with mental illness who intersect with the criminal justice system have additional barriers to care that exist because of systems that were not designed for changes in complex needs across the lifespan, let alone changes in context. These challenges with transitions arguably entrench problem behaviour, but existing systems are ill placed to address them. Can we do better?
Digital technologies in mental health
Professor Rhonda Wilson
Professor of Nursing, Deputy Head of School – Central Coast, Head of Indigenous, School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle
The rapid advancement of incorporating digital technology in mental health care delivery profoundly challenges dominant health paradigms Traditional biomedical psychiatric discourses are shifting, as too, are the assumptions that have evolved with them over time. This presentation will discuss some of the shifts that have occurred and highlight some of the benefits that have resulted as we pursue future digital mental health solutions.
Default gendered and privileged assumptions underlying the development, clinical trial and implementation of therapeutic interventions should be re-examined, with digital mental health facilitating a turning of the tide where women, older peoples and priority groups are beneficiaries. This presentation will draw examples from a current portfolio of research that explores topics such as: First Nations accessibility; tailored approaches to precision digital dosing; digital health recommendations arising from mental health inquires; AI (Artificial Intelligence) solutions; telehealth for older people; and innovation to support women during menopause. Together, supporting the notion that digital technological mental health solutions improve capacity to address equity, disadvantage and health outcomes for priority groups.
Health services and community research in suicide prevention
Associate Professor Fiona Shand
Associate Professor and Head of Suicide Prevention Research, Black Dog Institute, UNSW Sydney
In this session, Fiona will draw on her suicide prevention research at the Black Dog Institute to describe what we know about community and health services suicide prevention strategies, their effectiveness, and the extent to which these strategies have been implemented in Australia. This presentation will also provide an overview of research recently conducted in the ACT on the experiences of people seeking help for suicidal distress, and offer some insights into how these findings align with new health service and suicide prevention developments in the ACT.
Innovation in regional and rural health care for mental health: Focusing on community strengths
Professor Christine Phillips
Associate Dean (Health Social Science), College of Health and Medicine, The Australian National University
There are national shortages in specialised health professionals for mental health. This presentation addresses innovative models for health care using primary care and community to develop strengths and resilience. Drawing on decades of work in areas with highly traumatised people, and reflecting on current experiences of sustained community trauma, this talk addresses models of community strengthening and mental health care in general and ambulatory care in regional Australia as potential best practice models.
Aboriginal and Torres Strait Islander mental health
Dr Graham Gee
Clinical Psychologist and senior Research Fellow, Murdoch Children’s Research Institute
Dr Graham Gee will briefly introduce an Aboriginal and Torres Strait Islander perspective of mental health and social and emotional wellbeing, and related current national data. He will then talk about some Aboriginal-led research on mental health related patterns of distress, and present some of his own work that has involved investigating complex trauma outcomes, psychological distress, and associations with a range of resilience and cultural determinants of wellbeing. Graham will conclude with some reflections about ways forward and practice considerations when working in the area of Aboriginal and Torres Strait Islander mental health and wellbeing.
Peer recovery worker
Associate Professor Michelle Banfield
Senior Fellow, Centre for Mental Health Research, The Australian National University
Associate Professor Michelle Banfield and the Lived Experience Research Unit at the ANU have been conducting a number of projects on the development and implementation of peer work roles across multiple organisations including NSW Health, Canberra Health Services and NGOs. This presentation will describe work in partnership with ACT Health and Canberra Health Services to develop the Peer Recovery Worker role and explore early experiences with its implementation.
Transition(ing) through mental health care
The panel will explore key issues emerging from the presentations on this day.
Facilitator: Dr Elizabeth Moore
Co-Facilitator: Prof Debra Rickwood
Panellists: Dr Graham Gee, A/Prof Michelle Banfield, Prof Alison Calear, A/Prof Simon Rosenbaum