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ItemNo Preview AvailableInfant Access Program Evaluation( 2022-03-30)This project was commissioned by the Eastern Health Foundation to evaluate the implementation of the ‘Infant Access Program’ (IAP). The IAP seeks to improve access to specialist infant mental health services for children aged 0-5 years with mental health difficulties in the Maroondah City and Yarra Ranges local government areas. This report provides an overview of the evaluation method, key findings, and recommendations for future IAP research and program development to build the evidence base in infant mental health service provision. The program evaluation project used a mixed methods approach to evaluate the implementation of the Infant Access Program (IAP). The aims of the project were: - To identify existing models and programs designed to improve access to mental health services for children aged 0-5 years that have been implemented nationally and internationally in health and mental health sectors. - To evaluate if the IAP facilitates access to mental health services for children aged 0-5 years with mental health difficulties and their families. - To assess if the IAP is delivering mental health services to the target population: children at-risk of mental health difficulties. - To understand the experiences of clinicians who implemented the IAP. Findings: Despite the lack of specific research on this topic, the scoping review identified several broad themes for IAP to consider: (1) accessibility for at-risk populations (2) the importance of early detection of infants in need of mental health services and interventions; (3) the promotion of culturally responsive services and interventions; (4) ensuring the sustainability of IMH services and programs; and (5) the integration of innovative interventions to improve existing practice models. A total of ten participants (CYMHS clinicians and EMCH nurses) consented into this evaluation. The participants provided mental health and nursing services to three local government areas in the Melbourne’s eastern region. During the implementation period (May – October 2021), two CYMHS clinicians and four EMCH nurses collected IAP activity data related to thirteen infants and young children and their families who were consulted or referred to the program. Following the Infant Access Program Evaluation implementation period, semi-structured qualitative focus groups were conducted with the ten CYMHS clinicians and EMCH nurses to gain an understanding of their experiences of implementing the IAP in practice. The analysis of the IAP activity data and focus group discussions demonstrate that the IAP does facilitate access to mental health services for children aged 0-5 years with mental health difficulties and their families. Access to specialist mental health support for most children and families was rapid, with most children meeting the CYMHS clinician at a first joint home visit only 14 days after the initial consultation with the EMCH nurse. This rapid response demonstrates the IAP is nimble and flexible in offering infant mental health services in a time sensitive manner. The program received referrals for infant mental health services for its intended target population: infants and children and their families experiencing known risk factors for poor mental health outcomes. Families with a range of complex psychosocial risk factors can often experience significant challenges in accessing specialist services such as infant mental health intervention for their child despite having concerns about their social and emotional development. The IAP managed the initial engagement with families by leveraging the existing relationship the family had with the EMCH nurse, however, there were challenges with maintaining engagement and delivering mental health interventions. Although the initial access to the IAP is a strength of the current design, further consideration is needed as to the ways in which to meaningfully engage with families of infants and children with mental health difficulties that are acceptable and sustainable. The IAP had the full support of all the CYMHS clinicians and EMCH nurses who were involved during the implementation phase of this evaluation. The experience of clinicians and nurses working in partnership, bringing skills sets of mental health clinicians and maternal child health together was considered a strength of the IAP design. The access and rapid response from the CYMHS clinicians to consult and meet with the families was also valued. This ensured a timely response to the needs of infants and children with mental health difficulties and capitalised on the readiness and willingness of families to engage with mental health services. The clinicians and nurses recognised the challenges of working with a population that is at-risk in our community. Establishing trust with the families was identified as the key to successful engagement with IAP. Creative ways of engaging families were also important, offering choice for when and where to meet the IAP clinician.
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ItemNo Preview AvailableFamily Violence and Abuse against Non-Parental Caregivers: An Australian Perspective(SAGE Publications Ltd, 2021)There has been significant discourse around the use of language in the context of domestic and family violence and inconsistencies in language present in policy, legislation, practice, and research. This has resulted in the lack of agreement on a definitive and overarching description of domestic and family violence (Tinning, 2010; Boxall et al., 2015). The Australian Government has adopted the United Nations (1993: 3) definition which states that violence against women is gender-based and results in or is likely to result in physical or psychological harm.
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ItemIdentifying the Patterns of Family Contact for Children in Care(ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2022-01-02)Contact between children in care and family members is complex and often emotionally difficult for all concerned. In the context of a wider Australian cross-jurisdictional intervention trial, focusing on contact between children in long-term care and their parents, a snapshot survey of 901 children in Victorian foster care and kinship care placements was undertaken. The aim was to determine which children had seen parents, siblings or extended family members within a 12-month period, and how practitioners explained lack of contact between children and their parents. The study found that most children had had contact with parents or other family members, though children in long-term care were less likely to have seen their parents than those where reunification was still a possibility. Practitioners’ views on why parental contact had not occurred for 18% of the sample illustrate the complexity of the issues involved in contact. IMPLICATIONS To support children’s best interests, professionals should be clear about the purpose of family contact and provide support appropriate to that purpose. With children in long-term care less likely to see their parents, professionals have a role in helping these parents adjust to a new role. Developing strategies to maintain meaningful connections between children in long-term care and their parents may be more effective for children’s best interests than the current emphasis on actual visits.
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ItemEducation in youth-friendly genetic counseling(WILEY, 2021-08)Genetic counselors have long recognized the challenges of working with adolescents and young adults (AYA) and their families. In 2010, a framework of Youth-friendly Genetic Counseling was developed by an expert reference group with the aim to improve both care for AYAs and the experience of health professionals delivering that care. Subsequently, an education workshop was developed aimed to upskill genetic health professionals in youth-friendly genetic counseling. The workshop was piloted with genetic counselors in Australia and New Zealand. A purpose designed, pre- and post-workshop survey and post-workshop focus group was utilized for evaluation. Mean confidence scores increased pre- and post-workshop. Participants also demonstrated increases in knowledge regarding: adolescent development; developmental theory; social factors impacting on health; the needs of young people; practice challenges; youth-friendly engagement, communication, consent and confidentiality; practice approaches; principles of adolescent healthcare; ethical issues; and available services and resources. Focus group data revealed several themes relating to practice challenges, learning gains, barriers, and enablers to clinical translation and workshop feedback. Results demonstrate utility of the workshop in up-skilling genetic health professionals in the provision of youth-friendly genetic counseling. Consideration of adaptation and sustainability, by embedding this theoretical and skills-based workshop as a module within genetic counseling education, is required to ensure practice competence and the best health outcomes for young people and their families.
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ItemNo Preview AvailableIt’s time to rethink residential aged care(University of Melbourne, 2022)In partnership the University of Melbourne and MacKillop Institute are calling for a whole of sector rethink about the delivery of residential aged care in Australia. The researchers believe the system – widely considered unsustainable in its existing form – should move beyond its current ‘nursing’ model. In contrast, we should conceptualise residential settings as ‘intentional communities’ that provide a home ‘sanctuary’ for residents.
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ItemSeeking Safety: Aboriginal Child Protection Diversion Trials Evaluation Final Report(University of Melbourne, 2022-12-16)Victorian Aboriginal children are currently 17 times more likely to be in out-of-home care compared to non-Aboriginal children. This is because Aboriginal children are more likely than non-Aboriginal children to be reported to Child Protection, and because Child Protection cases involving Aboriginal children are more likely to progress to Court and out of-home care after a decision has been made that a child needs protection. Aboriginal families and communities are disproportionally affected by traumatic experiences and their associated negative consequences, including unemployment, educational disadvantage, poverty, homelessness, and intergenerational trauma. This puts Aboriginal children at greater risk of adverse childhood experiences and for being reported to Child Protection. Visibility to mandatory reporters and implicit bias in the decisions of mandatory reporters may also contribute to differences in Child Protection reports. Aboriginal people also under utilise mainstream prevention and early intervention services, and avoid working with social service professionals, due to fear of child protection intervention or because mainstream services do not meet their cultural needs.
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ItemNo Preview AvailableCircus activities as a health intervention for children, youths, and adolescents: a scoping review protocol(LIPPINCOTT WILLIAMS & WILKINS, 2022-01)OBJECTIVE: This scoping review aims to map the evidence on circus activities described and/or evaluated as a health intervention for children, youths, and adolescents. Increased understanding of how these interventions work, and gaps identified, will allow researchers and practitioners to advance the science behind these approaches. INTRODUCTION: Circus activities are proposed in the literature as a health intervention, due to their variety, non-competitive nature, and potential to develop fundamental physical and social skills. For the purposes of this review, circus activities as a health intervention are defined as aerial, acrobatic, equilibristic, and manipulation skills taught to participants to maintain, improve, or modify health, functioning, or health conditions. INCLUSION CRITERIA: English-language evidence will be considered where circus activities as a health intervention are described and/or evaluated for participants up to 24 years of age, or who are defined as children, youths, or adolescents. Literature will be excluded where the focus of the intervention is clowning, magic, or drama games, or where circus activities are not the therapeutic part of the activity. METHODS: MEDLINE (Ovid), CINAHL Complete (EBSCO), Scopus (Elsevier), PsycINFO (Ovid), ProQuest Dissertations and Theses Global, and Google Scholar will be searched for peer-reviewed and gray literature. No restriction on dates, type, methodology, or setting will be imposed, but limits will include "human" and "English language." Screening and data extraction will be performed by two independent reviewers. Reference lists of included sources will be screened. Results will be presented in diagrammatic or tabular format, alongside a narrative description, under headings aligning with the research sub-questions.
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ItemPublic Health Directives in a Pandemic: Paradoxical Messages for Domestic Abuse Victims in Four Countries(MDPI, 2022-11)When the COVID-19 pandemic manifested urgent concerns were raised around the globe about the increased risk that public health restrictions could pose for victims of domestic abuse. Governments, NGOs and community services swiftly responded to convey the message that services for victims were operational and restrictions did not apply to those fleeing harm. This paper reports on the various approaches used to communicate this public health messaging during COVID-19, further highlighting strengths and learning which could inform future crises messaging. It utilises data gathered through a rapid review and mapping of policy and practice initiatives across 4 high-middle income countries: UK, Australia, South Africa and Ireland. Four themes were identified: (1) Top-down: National media messaging; (2) Top-down: Political leadership; (3) Traditional media vs. social media and (4) Bottom-up messaging: Localised, community-based messaging. It was found that a strong, clear top-down stance on domestic abuse was perceived as beneficial during COVID-19. However, a stronger focus on evaluation, reach and impact, particularly for minority groups may be required. Newer forms of media were shown to have potential in conveying messaging to minority groups. Community and grassroots organizations demonstrated their experiential knowledge in reaching target audiences. Harnessing this expertise for future crises messaging may be valuable.
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ItemRisks and Barriers in Substitute Care for the Children of Parents with Serious Mental Illness: A Mixed-Method Study in Kerala, India(MDPI, 2022-12)BACKGROUND: Mental illness in parents impairs their parenting capability, which has a lifelong detrimental impact on their children's physical and psychological health. In the current Indian context, due to weak social security nets, family is the only plausible intervention to ensure adequate substitute child care. Therefore, this study explores various risk factors and barriers to providing substitute family care. METHODS: We used a mixed-method approach to gather information from 94 substitute family caregivers. Quantitative screening data were collected from four hospitals using a clinical data mining tool and an interview guide to gather caregiver perspectives on economic, familial, and social risks and barriers associated with caring. We used thematic analysis to consolidate the qualitative findings. RESULTS: Most of the substitute caregivers were females from low-income households. The study identified 11 sub-themes and 23 specific themes associated with risks and barriers to substitute care. These themes fell into four broad areas: economic, familial, school-related risks, and specific cultural and service access barriers. Focus on economic interventions is likely to result in strengthening the substitute family caregiver. CONCLUSION: The paradigmatic shift of treatment focus from the patient to the entire household would benefit the children just as it does the patient.
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ItemNo Preview AvailableAll-of-family responses to children, mothers and fathers accessing services for domestic and family violence in Victoria, Australia: Policy and Practice Discussion Paper(Safer Families Centre. University of Melbourne, 2022)