Social Work - Research Publications

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    Vulnerabilities and life stressors of people presented to emergency departments with deliberate self-harm; consolidating the experiences to develop a continuum of care using a mixed-method framework
    Devassy, SM ; Scaria, L ; Varghese, J ; Benny, AM ; Hill, N ; Joubert, L (FRONTIERS MEDIA SA, 2023-01-11)
    OBJECTIVE: Suicide is a crucial public health concern. However, the interactions between bio psychosocial vulnerabilities and stressors leading to deliberate self-harm behavior remain unexplored, especially in the Indian context. This study examined the experiences leading to self-harm behavior among people who presented to emergency departments with suicidal attempts. METHODS: In this mixed-methods study, we enrolled 44 patients who presented with self-harm behavior at three tertiary health care facilities between October and December 2019. To collect quantitative data, we employed standardized tools: General Health Questionnaire (GHQ-28), General Help-Seeking Questionnaire, Mini International Neuropsychiatric Interview, and the Brief Resilience Scale. Further, we conducted semi-structured interviews to qualitatively explore participants' life experiences and other risk factors. Qualitative analyses were performed using thematic analysis and quantitative descriptive and inferential statistics were performed using STATA software. RESULTS: The mean age of subjects were 29.8 years. The mean suicidality score for the patients was 26 (±8.7). In univariate analysis, depression and anxiety were positively associated with suicidality. While help-seeking behavior and resilience were negatively associated with suicidality. Qualitative results were centered on three major themes; life stressors, family related stressors, and social support-related vulnerabilities. The subjects' lived experiences were introduced in the backdrop of the interplay of vulnerabilities and stressors. CONCLUSION: The biopsychosocial vulnerabilities remain dormant until it is activated by life stressors resulting in severe self-harm behaviors. Mental health team-driven assertive engagement, positive coping, and social support interventions would help prevent reattempts in people with self-harm behaviors.
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    Integrating interprofessional electronic medical record teaching in preregistration healthcare degrees: A case study
    Lokmic-Tomkins, Z ; Gray, K ; Cheshire, L ; Parolini, A ; Sharp, M ; Tarrant, B ; Hill, N ; Rose, D ; Webster, M ; Virtue, D ; Brignell, A ; Waring, R ; Broussard, F ; Tsirgialos, A ; Cham, KM (ELSEVIER IRELAND LTD, 2023-01)
    BACKGROUND: Electronic medical record (EMR) adoption across healthcare necessitates a purposeful curriculum design to prepare graduates for the delivery of safe and effective patient care in digitally-enabled environments. OBJECTIVE: To describe the design and development of an Interprofessional Electronic Medical Record (iEMR) subject that introduces healthcare students to its utility in clinical settings. METHODS: A six-stage design-based educational research framework (Focus, Formulation, Contextualisation, Definition, Implementation, Evaluation) was used to instigate the iEMR design and development in nursing and five allied health graduate entry to practice (preregistration) degrees at an Australian university. RESULTS: In the Focus process, the concept and interdisciplinary partnerships were developed. The Formulation process secured grant support for subject design and development, including a rapid literature review to accommodate various course and curriculum structures. Discipline-specific subject themes were created through the Contextualisation process. During the Definition process, learning objectives and content resources were built. The Implementation process describes the pilot implementation in the nursing program, where assessment tasks were refined, and interdisciplinary clinical case studies originated. DISCUSSION: The design and development of an iEMR subject is underpinned by internal support for educational innovation and in alignment with digital health strategies in employer organisations. Identified barriers include faculty-level changes in strategic support for teaching innovation, managerial expectations of workload, the scope of work required by academics and learning designers, and the gap between the technology platform required to support online learning and the infrastructure needed to support simulated EMR use. A key discovery was the difficulty of finding EMR software, whether designed for teaching purposes or for clinical use, that could be adapted to meet the needs of this project. CONCLUSION: The lessons learned are relevant to educators and learning designers attempting a similar process. Issues remain surrounding the sustainability of the iEMR subject and maintaining academic responsibility for ongoing curriculum management.
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    Do Social Media Impact Young Adult Mental Health and Well-Being? A Qualitative Study
    Dodemaide, P ; Merolli, M ; Hill, N ; Joubert, L (OXFORD UNIV PRESS, 2022-12-02)
    Abstract The Social Work profession recognises the ethical and educational implications of social media usage but remains cautious in embracing the technology in the context of clinical practice. Social media platforms allow their users to share thoughts, opinions, experiences, information, develop online communities and access social and emotional support. Social media-focused research in the mental health context has described the risk of vulnerable populations using social media. However, there is a dearth of research examining the lived experiences of young adult social media users or addressing both the perceived risks and benefits. Social Work clinicians need to understand the experience of clients and be able to respond to questions or challenges that service users using social media experience. Deploying inductive thematic content analysis, this study presents the qualitative findings of an online survey eliciting the experience of young adult social media users. Young adults reported varying perspectives, including preferences for anonymity, how social media is employed and consideration that specific platforms are either helpful or harmful. Results are discussed with consideration given to existing literature. This article contributes to the evidence-base for social work and other disciplines, allowing for a greater phenomenological understanding of young adults’ use of social media.
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    Subjective Experiences of Mental Health Crisis Care in Emergency Departments: A Narrative Review of the Qualitative Literature
    Roennfeldt, H ; Wyder, M ; Byrne, L ; Hill, N ; Randall, R ; Hamilton, B (MDPI, 2021-09)
    Mental health presentations to the emergency department (ED) have increased, and the emergency department has become the initial contact point for people in a mental health crisis. However, there is mounting evidence that the ED is not appropriate nor effective in responding to people in mental health crises. Insufficient attention has been paid to the subjective experience of people seeking support during a mental health crisis. This review aims to describe the qualitative literature involving the subjective experiences of people presenting to the ED during a mental health crisis. The method was guided by Arksey and O'Malley's framework for scoping studies and included keyword searches of PsycINFO, CINAHL, Medline and Embase. A narrative analysis, drawing on the visual tool of journey mapping, was applied to summarise the findings. Twenty-three studies were included. The findings represent the experience of accessing EDs, through to the impact of treatment. The review found points of opportunity that improve people's experiences and characteristics associated with negative experiences. The findings highlight the predominance and impact of negative experiences of the ED and the incongruence between the expectations of people presenting to the ED and the experience of treatment.
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    Can a social media intervention improve online communication about suicide? A feasibility study examining the acceptability and potential impact of the #chatsafe campaign
    La Sala, L ; Teh, Z ; Lamblin, M ; Rajaram, G ; Rice, S ; Hill, NTM ; Thorn, P ; Krysinska, K ; Robinson, J ; Arteaga, A (PUBLIC LIBRARY SCIENCE, 2021-06-15)
    There is a need for effective and youth-friendly approaches to suicide prevention, and social media presents a unique opportunity to reach young people. Although there is some evidence to support the delivery of population-wide suicide prevention campaigns, little is known about their capacity to change behaviour, particularly among young people and in the context of social media. Even less is known about the safety and feasibility of using social media for the purpose of suicide prevention. Based on the #chatsafe guidelines, this study examines the acceptability, safety and feasibility of a co-designed social media campaign. It also examines its impact on young people's willingness to intervene against suicide and their perceived self-efficacy, confidence and safety when communicating on social media platforms about suicide. A sample of 189 young people aged 16-25 years completed three questionnaires across a 20-week period (4 weeks pre-intervention, immediately post-intervention, and at 4-week follow up). The intervention took the form of a 12-week social media campaign delivered to participants via direct message. Participants reported finding the intervention acceptable and they also reported improvements in their willingness to intervene against suicide, and their perceived self-efficacy, confidence and safety when communicating on social media about suicide. Findings from this study present a promising picture for the acceptability and potential impact of a universal suicide prevention campaign delivered through social media, and suggest that it can be safe to utilize social media for the purpose of suicide prevention.
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    Suicide by young Australians, 2006-2015: a cross-sectional analysis of national coronial data
    Hill, NTM ; Witt, K ; Rajaram, G ; McGorry, PD ; Robinson, J (WILEY, 2021-02)
    OBJECTIVE: To assess the demographic, social, and clinical characteristics of young Australians who die by suicide. DESIGN: Retrospective analysis of National Coronial Information System (NCIS) data. SETTING, PARTICIPANTS: People aged 10-24 years who died by suicide in Australia during 2006-2015. MAIN OUTCOME MEASURES: Demographic, social, and clinical characteristics of young people who died by suicide; circumstances of death recorded in the NCIS. RESULTS: 3365 young people died of suicide during 2006-2015 (including 2473 boys and men, 73.5%); 1292 people (38.4%) lived in areas of greater socio-economic disadvantage. Free text reports were included in the NCIS for 3027 people (90%), of whom 1237 (40.9%) had diagnosed mental health disorders and 475 (15.7%) had possible mental health disorders. Alcohol consumption near the time of death was detected in 1015 of 3027 cases (33.5%); histories of self-harm were recorded in 940 cases (31.1%) and of illicit substance misuse in 852 (28.1%). Adverse life events included history of abuse or neglect (223, 7.4%), suicide of relatives, friends, or acquaintances (202, 6.7%), and financial difficulties (174, 5.8%). CONCLUSIONS: Three-quarters of the young people who died by suicide were boys or young men, and 57% had diagnosed or possible mental health disorders, suggesting that the mental health and wellbeing of young Australians should be a key target for youth suicide prevention. To reduce the number of youth suicides, it is imperative that prevention strategies target the mental health and psychosocial stressors that lead to suicidal crises in young people.
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    Peer support work for people experiencing mental distress attending the emergency department: Exploring the potential
    Brasier, C ; Roennfeldt, H ; Hamilton, B ; Martel, A ; Hill, N ; Stratford, A ; Buchanan-Hagen, S ; Byrne, L ; Castle, D ; Cocks, N ; Davidson, L ; Brophy, L (WILEY, 2022-02)
    OBJECTIVE: This study explored the benefits and limitations of employing peer support workers, who utilise their own lived experience of mental distress and recovery, to support people experiencing mental distress who are attending the ED. METHODS: This co-produced qualitative study utilised four phases: (i) assemble a collaborative multi-disciplinary research team and Expert Panel, of which at least half identified as having lived experience; (ii) a site visit to an ED; (iii) focus groups with consumers, support persons and ED staff; and (iv) a learning workshop for peer workers. RESULTS: Focus groups were run for consumers (n = 7), support persons (n = 5) and ED staff (n = 7). Eleven consumer peer workers participated in the learning workshop. Four themes were identified and triangulated: the individual in distress, peer support work, a 'Peers in EDs' service and the ED context. Overall, findings suggest that peer support workers contribute important skills including listening, de-escalation, relationship-building and empathy. CONCLUSIONS: This study identified that peer support workers would bring important skills to an ED (e.g. empathetic support, de-escalation). However, significant workforce and organisational support would be required.