Psychiatry - Research Publications
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ItemPostsecondary education: Kindling opportunities for people with mental illness(WILEY, 2014-06)Education is recognized in many sectors of society as essential for empowerment and better lives, and postsecondary education is increasingly a prerequisite for many occupations. Given its onset in late adolescence and early adulthood, mental illness frequently disrupts secondary or tertiary education, and resulting lower educational attainment contributes to reduced lifetime employment and earning potential. Yet, supporting people with mental illnesses to pursue postsecondary education offers pathways to vocational qualifications and more diverse opportunities for employment and career advancement. While substantial efforts have been made to develop evidence-based interventions to improve employment outcomes for people with mental ill health, less is known about the best ways to enable people with mental illness to successfully return to study and to pursue their educational goals. This paper briefly discusses supported education, an approach designed to provide pathways and supports for reengagement in education; it highlights the potential of modeling educational support on Individual Placement and Support principles used in supported employment programs; and calls for greater efforts in research and practice to enable youth or adults with mental illness to reengage in education so as to improve their educational outcomes and career prospects.
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ItemPrevalence and impact of childhood abuse in people with a psychotic illness. Data from the second Australian national survey of psychosis(ELSEVIER, 2014-10)Child abuse has been associated with risk of mental illness, including schizophrenia and other psychotic disorders and, among those with mental illness, with a more severe clinical profile. Using an extensively characterised and epidemiologically representative sample of 1825 Australians with a psychotic illness aged 18-64 years and in contact with mental health services, we estimated the proportion of individuals with psychotic disorders who self-reported child abuse and examined its relationship with clinical and other characteristics. The prevalence of child abuse in this nationally representative sample of people with psychotic illness was 30.6%. Women were almost three times more likely to report child abuse compared to males (OR, 2.8, 95% CI 2.3-3.4). When adjusted for age at interview and socio-economic status, there was no significant relationship between self-reported child abuse and type of psychosis or course of illness. Participants with child abuse were significantly more likely to have subjective thought disorder, lifetime suicide attempt and premorbid personality disorder (females only) and anxiety (males only). Our findings demonstrate that child abuse is relatively common across the range of psychotic disorders, with an elevated risk for women in particular, compounding the already high burden associated with psychotic illness. Clinicians need to inquire routinely about child abuse in order to develop appropriate treatment plans tailored to individual needs.
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ItemPsychosis prevalence and physical, metabolic and cognitive co-morbidity: data from the second Australian national survey of psychosis(CAMBRIDGE UNIV PRESS, 2014-07)BACKGROUND: There are insufficient data from nationwide surveys on the prevalence of specific psychotic disorders and associated co-morbidities. METHOD: The 2010 Australian national psychosis survey used a two-phase design to draw a representative sample of adults aged 18-64 years with psychotic disorders in contact with public treatment services from an estimated resident population of 1 464 923 adults. This paper is based on data from 1642 participants with an International Classification of Diseases (ICD)-10 psychotic disorder. Its aim is to present estimates of treated prevalence and lifetime morbid risk of psychosis, and to describe the cognitive, physical health and substance use profiles of participants. RESULTS: The 1-month treated prevalence of psychotic disorders was 3.10 cases per 1000 population aged 18-64 years, not accounting for people solely accessing primary care services; lifetime morbid risk was 3.45 per 1000. Mean premorbid intelligence quotient was approximately 0.5 s.d.s below the population mean; current cognitive ability (measured with a digit symbol coding task) was 1.6 s.d.s below the population mean. For both cognitive tests, higher scores were significantly associated with better independent functioning. The prevalence of the metabolic syndrome was high, affecting 60.8% of participants, and pervasive across diagnostic groups. Of the participants, two-thirds (65.9%) were current smokers, 47.4% were obese and 32.4% were sedentary. Of the participants, half (49.8%) had a lifetime history of alcohol abuse/dependence and 50.8% lifetime cannabis abuse/dependence. CONCLUSIONS: Our findings highlight the need for comprehensive, integrative models of recovery to maximize the potential for good health and quality of life for people with psychotic illness.
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ItemMental Health Professional Online Development (MHPOD): a web-based training tool for the non-government community mental health workforce(EMERALD GROUP PUBLISHING LTD, 2014)Purpose – The purpose of this paper is to evaluate the usefulness and relevance of the Mental Health Professional Online Development (MHPOD) training package in further developing the skills in mental health and recovery-informed practice of the Australian non-government community mental health workforce. MHPOD is an evidence-based, self-paced, online learning resource that consists of 58 mental health topics. Design/methodology/approach – A total of 349 e-learners were recruited from seven non-government community mental health services across Australia. E-learners were invited to complete up to twelve online surveys, a baseline survey, a topic completion survey for each completed topic, and a follow-up survey towards the end of the pilot. Findings – The majority of e-learners indicated that MHPOD was useful for professional development and relevant to their current employment. E-learners identified that MHPOD led to significant improvement in their knowledge and confidence in their ability. A number of enabling factors such as managerial and organizational supports, technical supports and up-to-date and relevant content materials need to be present for the successful implementation of online programs such as MHPOD. Originality/value – Online training packages such MHPOD that a relatively easy to use are helpful in developing knowledge, and confidence in the skills of the mental health workforce. The evaluation findings suggest that MHPOD is a relevant and appropriate training tool for the non-government community mental health sector within Australia.