Centre for Youth Mental Health - Research Publications

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    Teachers of Psychiatry Meeting in Chengdu
    Li, Y ; Sartorius, N ; Herrman, H ; Mian-Yoon, C ; Li, T ; Yi, H ; Heok, KE (WILEY, 2017-12)
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    Moderated online social therapy for depression relapse prevention in young people: pilot study of a "next generation' online intervention
    Rice, S ; Gleeson, J ; Davey, C ; Hetrick, S ; Parker, A ; Lederman, R ; Wadley, G ; Murray, G ; Herrman, H ; Chambers, R ; Russon, P ; Miles, C ; D'Alfonso, S ; Thurley, M ; Chinnery, G ; Gilbertson, T ; Eleftheriadis, D ; Barlow, E ; Cagliarini, D ; Toh, J-W ; McAlpine, S ; Koval, P ; Bendall, S ; Jansen, JE ; Hamilton, M ; McGorry, P ; Alvarez-Jimenez, M (WILEY, 2018-08)
    AIM: Implementation of targeted e-mental health interventions offers a promising solution to reducing the burden of disease associated with youth depression. A single-group pilot study was conducted to evaluate the acceptability, feasibility, usability and safety of a novel, moderated online social therapy intervention (entitled Rebound) for depression relapse prevention in young people. METHODS: Participants were 42 young people (15-25 years) (50% men; mean age = 18.5 years) in partial or full remission. Participants had access to the Rebound platform for at least 12 weeks, including the social networking, peer and clinical moderator and therapy components. RESULTS: Follow-up data were available for 39 (92.9%) participants. There was high system usage, with 3034 user logins (mean = 72.2 per user) and 2146 posts (mean = 51.1). Almost 70% of users had ≥10 logins over the 12 weeks, with 78.5% logging in over at least 2 months of the pilot. A total of 32 (84%) participants rated the intervention as helpful. There was significant improvement between the number of participants in full remission at baseline (n = 5; none of whom relapsed) relative to n = 19 at 12-week follow-up (P < 0.001). Six (14.3%) participants relapsed to full threshold symptoms at 12 weeks. There was a significant improvement to interviewer-rated depression scores (Montgomery-Asberg Depression Rating Scale (MADRS); P = 0.014, d = 0.45) and a trend for improved strength use (P = 0.088, d = 0.29). The single-group design and 12-week treatment phase preclude a full understanding of the clinical benefits of the Rebound intervention. CONCLUSIONS: The Rebound intervention was shown to be acceptable, feasible, highly usable and safe in young people with major depression.
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    Social media and suicide prevention: findings from a stakeholder survey.
    Robinson, J ; Rodrigues, M ; Fisher, S ; Bailey, E ; Herrman, H ( 2015-02-25)
    BACKGROUND: Suicide is a leading cause of death, particularly among young adults. The rapid growth of social media and its heavy use by young adults presents new challenges and opportunities for suicide prevention. Social media sites are commonly used for communicating about suicide-related behavior with others, which raises the possibility of using social media to help prevent suicide. However, the use of social media varies widely between different suicide prevention advocates. The role this type of intervention should play in a community's overall suicide prevention strategy remains a matter of debate. AIM: Explore the ways in which stakeholders use social media for suicide prevention and assess their views about the potential utility of social media as a suicide prevention tool. METHODS: A 12-week stakeholder consultation that involved the online administration and completion of surveys by 10 individuals who conduct research about suicide and social media, 13 organizations that use social media for suicide prevention purposes, and 64 users of social media. RESULTS: Social media was seen as a useful means of delivering a range of suicide prevention activities. Respondents reported that the key benefits of social media were the opportunity to obtain emotional support from others, to express one's feelings, to talk to others with similar problems, and to provide help to others. The social media site believed to hold most potential for delivering suicide prevention activities was Facebook. There were concerns about potential risks of social media, but respondents felt the potential benefits outweighed the risks. CONCLUSIONS: Social media was recognized by different types of stakeholders as holding potential for delivering suicide prevention activities. More research is required to establish the efficacy and safety of potential social media-based interventions and ethical standards and protocols to ensure that such interventions are delivered safely need to be developed and implemented.
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    Moderated Online Social Therapy: A Model for Reducing Stress in Carers of Young People Diagnosed with Mental Health Disorders
    Gleeson, J ; Lederman, R ; Koval, P ; Wadley, G ; Bendall, S ; Cotton, S ; Herrman, H ; Crisp, K ; Alvarez-Jimenez, M (FRONTIERS MEDIA SA, 2017-04-03)
    Family members caring for a young person diagnosed with the onset of mental health problems face heightened stress, depression, and social isolation. Despite evidence for the effectiveness of family based interventions, sustaining access to specialist family interventions is a major challenge. The availability of the Internet provides possibilities to expand and sustain access to evidence-based psychoeducation and personal support for family members. In this paper we describe the therapeutic model and the components of our purpose-built moderated online social therapy (MOST) program for families. We outline the background to its development, beginning with our face-to-face EPISODE II family intervention, which informed our selection of therapeutic content, and the integration of recent developments in positive psychology. Our online interventions for carers integrate online therapy, online social networking, peer and expert support, and online social problem solving which has been designed to reduce stress in carers. The initial version of our application entitled Meridian was shown to be safe, acceptable, and feasible in a feasibility study of carers of youth diagnosed with depression and anxiety. There was a significant reduction in self-reported levels of stress in caregivers and change in stress was significantly correlated with use of the system. We have subsequently launched a cluster RCT for caregivers with a relative diagnosed with first-episode psychosis. Our intervention has the potential to improve access to effective specialist support for families facing the onset of serious mental health problems in their young relative.
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    Moderated online social therapy for carers of young people recovering from first-episode psychosis: study protocol for a randomised controlled trial
    Gleeson, J ; Lederman, R ; Herrman, H ; Koval, P ; Eleftheriadis, D ; Bendall, S ; Cotton, SM ; Alvarez-Jimenez, M (BIOMED CENTRAL LTD, 2017-01-17)
    BACKGROUND: First-episode psychosis most often has its onset during late adolescence. In caring for the young person, families endure high levels of stress and depression. Meanwhile, the social networks of families often erode. Our group has previously shown that family cognitive behaviour therapy (CBT) leads to significantly improved perceived stress compared with specialist first-episode treatment as usual; however, there are well-known barriers to the dissemination of effective family interventions. To address this, we have developed a novel online intervention entitled 'Altitudes' that fully integrates purpose-built online social networking, expert and peer moderation, and evidence-based psychoeducation within a single application. The primary aim of this trial is to evaluate the effectiveness of Altitudes in reducing stress in carers over a 6-month period. METHODS/DESIGN: We describe here a single-blinded cluster randomised controlled trial (cRCT) with permutated blocks. The clusters comprise individual families. The two treatment conditions include Altitudes plus Specialist Treatment as Usual (STAU) and STAU alone. Altitudes involves participation in our novel online programme whereas STAU comprises specialist family work at the Early Psychosis Prevention and Intervention Centre (EPPIC), Melbourne, Australia. We aim to recruit 160 family members of young, 15-27 year-old, patients registered for treatment for first-episode psychosis (FEP) at EPPIC. The design includes two assessment time points, namely, baseline and 6-month follow-up. The study is due for completion within 2 years including an 18-month recruitment period and a 6-month treatment phase. The primary outcome is carers' perceived stress at 6 months. Secondary outcome measures include a biomarker of stress, depressive symptoms, worry, substance use, loneliness, social support, satisfaction with life, and a range of measures that tap into coping resources. We seek to gain a dynamic picture of carer stress through our Smartphone Ecological Momentary Assessment (SEMA) tool. DISCUSSION: This is the first randomised controlled trial designed to evaluate an online intervention for carers of young people recovering from FEP. It has the potential to produce evidence in support of a highly novel, accessible, and cost-effective intervention to reduce stress in carers who are providing support to young people at a critical phase in their recovery from psychosis. TRIAL REGISTRATION: Australian New Zealand Clinical Trial Registry, identifier: ACTRN12616000968471 . Retrospectively registered on 22 July 2016.
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    Women in psychiatry.
    Herrman, H (Cambridge University Press (CUP), 2010-07)
    Borrowing books was a privilege introduced for women by several academic institutions and libraries in England in the 19th century. Cambridge University accepted women on equal terms with men in 1948. Various objectors before that feared that higher education would have untoward effects on women's bodies and minds. The eminent 19th-century psychiatrist Henry Maudsley was convinced it would make them infertile (Robinson, 2009). Yet women played an important role in the founding of many Islamic educational institutions from the first millennium, and Christian religious orders fostered education for girls and women in Europe before the modern era.
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    The 5/95 gap in the indexation of psychiatric journals of low- and middle-income countries
    Mari, JJ ; Patel, V ; Kieling, C ; Razzouk, D ; Tyrer, P ; Herrman, H (WILEY-BLACKWELL PUBLISHING, INC, 2010-02)
    OBJECTIVE: To investigate the relationship between science production and the indexation level of low- and middle-income countries (LAMIC) journals in international databases. METHOD: Indicators of productivity in research were based on the number of articles produced over the 1994-2004 period. A survey in both Medline and ISI/Thomson was conducted to identify journals according to their country of origin. A WPA Task Force designed a collaborative process to assess distribution and quality of non-indexed LAMIC journals. RESULTS: Twenty LAMIC were found to present more than 100 publications and a total of 222 indexed psychiatric journals were found, but only nine were from LAMIC. The Task Force received 26 questionnaires from editors of non-indexed journals, and concluded that five journals would meet criteria for indexation. CONCLUSION: Barriers to indexation of journals contribute to the difficulties in achieving fair representation in the main literature databases for the scientific production in these countries.
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    Mental health promotion for the widows of injecting drug users in north-east India.
    Herrman, H ; Kermode, M ; Devine, A ; Chandra, P (Cambridge University Press (CUP), 2009-07)
    The prevalence of HIV is high in the north-east Indian states of Manipur and Nagaland. The major route of HIV transmission is injecting drug use. Most injecting drug users (IDUs) are male and about 40% are married. The widows of IDUs are among the most disadvantaged people. Many are HIV-infected and experiencing poverty, poor health, social isolation and discrimination, all factors likely to compromise their mental health. Some widows are engaging in HIV risk behaviours, including alcohol and drug misuse, sex work and unprotected sex. There is increasing recognition of the links between poverty and mental health status and risk of HIV infection. People with poor mental health are more likely to engage in HIV risk behaviours.
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    Some peace of mind: assessing a pilot intervention to promote mental health among widows of injecting drug users in north-east India
    Kermode, M ; Devine, A ; Chandra, P ; Dzuvichu, B ; Gilbert, T ; Herrman, H (BMC, 2008-08-22)
    BACKGROUND: HIV prevalence in north-east India is high and injecting drug use (IDU) is common. Due to HIV-related deaths there are increasing numbers of IDU widows, many of whom are HIV infected, and experiencing poor health, social isolation, discrimination and poverty, all factors likely to be compromising their mental health. There is increasing recognition of the links between HIV and mental health. METHODS: The aim of this study was to pilot a peer-facilitated, participatory action group (PAG) process and assess the impact of the intervention on the mental health of participants. The intervention consisted of 10 PAG meetings involving 74 IDU widows. Changes in quality of life (WHOQOL-BREF), mental health (GHQ12) and somatic symptoms were assessed. The value of the intervention from the perspective of the participants was captured using a qualitative evaluation method (Most Significant Change). RESULTS: Participants' quality of life, mental health and experience of somatic symptoms improved significantly over the course of the intervention, and the women told stories reflecting a range of 'significant changes'. CONCLUSION: This pilot intervention study demonstrated that a participatory approach to mental health promotion can have a positive impact on the lives of vulnerable women, and the potential to contribute to HIV prevention. Further investigation is warranted.
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    Mental Disorders among Homeless People in Western Countries
    Herrman, H (PUBLIC LIBRARY SCIENCE, 2008-12)
    Helen Herrman discusses the implications of a new systematic review and meta-analysis of the prevalence of mental disorders in homeless people in Western countries.