Psychiatry - Research Publications
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ItemMental health and integration in Asia Pacific.(Royal College of Psychiatrists, 2018-11)This brief report examines the extent to which community-based treatment and integration support are provided for people living with mental illness across 15 selected Asia-Pacific economies. Some of the key findings are discussed in light of the diversity of economies and cultural contexts.
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ItemStimulating curriculum and teaching innovations to support the mental wellbeing of university students(Australian Government Department of Education and Training, 2017)The aim of the project Stimulating Curriculum and Teaching Innovations was to build the capacity of university educators to develop policies, curriculum, and teaching and learning environments that enhance student mental wellbeing. The growing prevalence and severity of mental health difficulties across student populations in higher education is an issue of significant concern for universities. This project aimed to foster sector wide conversations, promote a whole-of-institution approach to promoting student mental wellbeing in universities and develop a suite of research-informed resources to help academic educators identify curriculum and teaching approaches that can promote and support students’ mental wellbeing.
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ItemNo Preview AvailableNational Physical Activity Guidelines for older Australians with Mild Cognitive Impairment and Subjective Cognitive Decline(Dementia Collaborative Research Centres, 2018)
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ItemCognitive Dementia and Memory Service Best Practice Guidelines: Service Guidelines for Victorian Cognitive Dementia and Memory Services.(State of Victoria, Department of Health, 2013)Cognitive Dementia and Memory Services (CDAMS) operate under Victorian Department of Health’s suite of Health Independence Programs and are one of a suite of specialist clinics within subacute and ambulatory care service. CDAMS were first developed in the 1990s and since this time they have grown in number to cover all regions within the state of Victoria. CDAMS’ primary aim is to provide timely and expert multidisciplinary assessment, diagnosis, treatment, support, referral and information for people experiencing undiagnosed cognitive difficulties and dementia and their family/carers. To achieve this, CDAMS uses a person and family-centred process involving an interdisciplinary team of experienced and skilled clinicians, including specialist medical, neuropsychology, nursing and/or allied health professionals. Services may be delivered face to face, via telephone or using telehealth. People presenting with concerns about their cognition or memory may self-refer or be referred by their family/carers, services, medical professionals and other advocates. During the in-take of referrals, information is collected about the person (known as the client) and their difficulties to identify their initial needs, determine their appropriateness for and prioritise CDAMS involvement. One CDAMS clinician will act as the client’s primary contact throughout the CDAMS process, usually this is the nominated key worker. With the client’s consent, CDAMS request their general practitioner (GP) forward details of their medical history and organise dementia screening tests. The CDAMS key worker completes an initial assessment which may involve a home visit. During the initial assessment, more detailed information is collected from the client and their family/carer(s) to obtain a comprehensive understanding of the changes in the client’s cognition and functioning. This includes assessment of the client’s cognitive difficulties, medical and psychiatric histories, educational and employment histories, functioning, home environment, social situation, cultural background and language, supports, future care plan arrangements, and the needs of the family/carers. The CDAMS medical assessment builds on the initial assessment and medical information and tests from the GP and includes physical and psychiatric examinations in addition to formal assessments of cognition, mood and behaviour. Additional pathology, imaging and other tests may be requested where necessary for diagnostic purposes. A neuropsychology assessment may be completed when a diagnosis cannot be made, is borderline or the client’s presentation is unusual or complex. Following completion of the assessments, an interdisciplinary case conference is held to discuss the findings and establish consensus regarding the client’s diagnosis, prognosis, capabilities, pharmacological and non-pharmacological management options, preventative and care strategies, referrals and need for future CDAMS involvement. Feedback meetings are held with clients and their families/carers to discuss the diagnosis and care plan. The CDAMS key worker assists with implementation of the care plan by providing follow up contact and assistance with arranging services (where required) and reviewing and adapting the care plan as needed. Where a diagnosis is unclear or prognosis uncertain, clients are offered a review assessment by CDAMS. CDAMS is responsive to the issues, needs and identity of clients with identified diverse needs and endeavours to provide them with relevant, meaningful and easily accessible services. This includes people who are Gay, Lesbian, Bi-Sexual, Transgender and Intersex, people who identify as Aboriginal and/or Torres Strait Islanders, clients from culturally and linguistically diverse communities, clients with younger onset dementia, clients with intellectual disabilities suspected of having developed dementia and families/carers. CDAMS actively coordinates and integrates with the client’s existing services and engages additional services as needed to ensure continuity of care. The client’s GP is engaged throughout the assessment process and provided with results of the CDAMS assessment and the care plan. The GP remains the client’s primary care provider. In addition to the diagnostic and treatment role, CDAMS provides consultancy through the dementia pathway, assists in building awareness of cognitive impairment and dementia, and provides information, advice and education. CDAMS also maintains strong links with community services. Each CDAMS has a dedicated manager/coordinator/team leader who is responsible for ensuring provision of quality and evidence based services. CDAMS managers/coordinators/team leaders participate in regular state-wide coordinators meetings. New staff members receive a comprehensive orientation to CDAMS and are supported to acquire proficiency within the service. Quality activities are regularly completed to facilitate continuous improvement. The CDAMS Best Practice Guidelines provide evidence based and best practice standards, criteria and guidelines for the operation and delivery of high quality CDAMS clinics. The guidelines may be used to assist in setting up new CDAMS clinics, evaluating practice standards in existing CDAMS and streamlining practices across clinics.
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ItemNo Preview AvailableUsing reminiscence with people with dementia in sub-acute and acute care(The Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, 2017)Dementia was made a National Health Priority in Australia in 2012 in recognition of the growing population diagnosed and living with the condition. In 2013, an estimated 322,000 people with dementia were living in Australia. This figure is projected to increase substantially to 400,000 by 2020 and 900,000 by 2050. Between 2009 and 2011, dementia was the third leading underlying cause of death in the country. Compared to those without dementia, those with dementia are more likely to be admitted to hospital, their length of stay is more likely to be longer, the costs associated with hospitalisation tend to be higher and they are more likely to experience negative health outcomes. A study conducted in NSW on dementia care in hospitals found that 35% of the health budget was spent on providing care to those with dementia. Improving the care experience of those with dementia is of growing concern. Admission to hospital can be confusing and frightening for a person with dementia as they struggle to understand what is happening and where they are. Reminiscence provides a practical and easy to use approach that enables family, carers and staff to engage more meaningfully with the person with dementia. This manual provides practical information that staff and volunteers can use to adopt and implement reminiscence within everyday care of people with dementia who are hospitalised.
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ItemFrequent Callers to Lifeline(University of Melbourne, 2015)