Social Work - Research Publications
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ItemImproving access to mental health interventions for children from birth to five years: A Scoping Review(Wiley, 2024-02)BACKGROUND: In spite of infants and children aged 0-5 years experiencing mental health difficulties being estimated to be in the range of 6%-18% globally, the mental health care needs for this age group are often overlooked in the design of specialist mental health services. Although there is increasing recognition of the importance of infant mental health services and treatments for younger children, access remains a barrier. Mental health services specifically designed for children 0-5 years are vital; however, little is known about how these services ensure access for infants at risk of mental health difficulties and their families. This scoping review seeks to address this knowledge gap. METHODS: A scoping review methodology framework was used to search for relevant articles published between January 2000 and July 2021, identified using five databases: MEDLINE, CINAHL, PsycINFO, SocIndex and Web of Science. The selection of studies was based on empirical research about access to infant mental health services and models of care. A total of 28 relevant articles met the eligibility criteria for inclusion in this review. RESULTS: Findings can be summarised under five broad themes: (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. CONCLUSIONS: The findings from this scoping review highlight barriers to access and provision of infant mental health services. Future infant mental health service design, informed by research, is needed to improve access for infants and young children with mental health difficulties and their families.
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ItemNo Preview AvailableAnger Following the Victorian Black Saturday Bushfires: Implications for Postdisaster Service Provision(ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2024-04-02)
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ItemFamily-centred care for children with traumatic brain injury and/or spinal cord injury: a qualitative study of service provider perspectives during the COVID-19 pandemic(BMJ PUBLISHING GROUP, 2022-06)OBJECTIVES: COVID-19 has led to rapid changes in rehabilitation service provision for young people living with traumatic brain and/or spinal cord injury. The aim of this project was to understand the experiences of rehabilitation service providers during the acute response stage of the COVID-19 pandemic. Specifically, we aimed to identify innovative approaches to meeting the ongoing needs of young people with traumatic brain and/or spinal cord injury during this time. SETTING: This study was conducted at a research institute and involved remote interviews with key informants around Australia and internationally. PARTICIPANTS: Key informants from 11 services supporting children and/or adolescents with traumatic brain injury and/or spinal cord injury were interviewed using a semistructured interview guide. Interviews were transcribed and analysed using inductive thematic analysis. RESULTS: Three key themes emerged: (1) recognising and responding to the experiences of families during the pandemic, (2) the impact of greater use of telehealth on care delivery, and (3) realising opportunities to enhance family-centred care. CONCLUSIONS: These themes capture shifting perspectives and process changes relevant to longer term practice. Research findings suggest opportunities for future service development, enabling service delivery that is more family centred, flexible and efficient in meeting the needs of families. Understanding these experiences and the changed nature of service delivery provides important insights with implications for future service improvement.
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ItemNo Preview AvailableThriving After Disaster: A new way to think about support programs for kids(Natural Hazards Center, 2019)Commissioned report based on our our team's program of work in disaster recovery research. This report draws together work from several projects.
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ItemNo Preview AvailableStressors and Supports in Postdisaster Recovery: Experiences After the Black Saturday Bushfires(ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2021-07-03)Many studies show that long-term poor mental health outcomes for disaster-affected people are predicted by postdisaster stressors. Despite this finding, existing recovery frameworks vary in how these stressors are conceptualised. This paper examines community members’ subjective perceptions of what they found problematic and useful in their recoveries after the Australian 2009 Black Saturday bushfires, and considers them in the light of these frameworks. We report the findings from responses to semi-structured survey questions as part of the Beyond Bushfires study, 3–4 years after these bushfires (n =811). Participants identified the biggest problems as managing rebuilding processes and managing their own mental health, memories of the Black Saturday fires, and their concerns for family members. The four most useful supports were family, friends, rebuilding resources, and their community. We found a complex interplay of the same factors operating as both stressors and supports, particularly in relation to family levels of coping. IMPLICATIONS Disaster recovery efforts require the simultaneous management of physical rebuilding and human processes. Families, friends, and neighbours are underestimated resources in postdisaster recovery. Given the complex interplay of the same factors operating as both stressors and supports, interventions are needed that maximise the positive dimensions of these factors. To manage this complexity, multiple frameworks are needed to guide disaster recovery.
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ItemNo Preview AvailableHierarchies of affectedness after disasters(ELSEVIER SCI LTD, 2021-11)Disasters result in a range of impacts that significantly disrupt the health and wellbeing of those affected. After disasters, a hierarchy of affectedness may be explicitly or implicitly developed, where those affected are compared to each other, and to people affected by disasters in other locations. When an individual's sense of place is so significantly disrupted, these hierarchies are critical to improving the understanding of recovery trajectories, including mental health and well-being outcomes. These hierarchies have practical implications that influence the health outcomes of those affected, including eligibility for disaster aid, support services, and the way that people affected by disasters relate to others in their community. This paper expands the 'hierarchy of affectedness' concept coined by Andersen (2013) using findings from a qualitative study in Australia and New Zealand. Using a letter writing research method, twenty people who had been impacted by a range of disasters in different locations described what they considered helpful and unhelpful in the recovery. One emergent finding in this study was that hierarchies of affectedness are negotiated between impacted individuals, others affected in the same community, and outsiders. These hierarchies served as a helpful sense-making tool for some people impacted by disasters, while causing considerable secondary stress for others. Based on these findings, we offer an expansion to Andersen's existing model of hierarchies of affectedness in post-disaster settings.
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ItemThe subjective effect of antipsychotic medication on trauma-related thoughts, emotions, and physical symptoms: A qualitative study with people who have experienced childhood trauma and psychosis(WILEY, 2022-03)OBJECTIVES: Among people with psychosis, those with a history of childhood trauma are likely to experience trauma-related symptoms, such as trauma memory intrusions. Irrespective of whether these individuals continue to remember and re-experience trauma, their treatment very often includes alleviating psychotic symptoms through the use of antipsychotic medication. Antipsychotics, while primarily used to treat psychotic symptoms, can influence non-psychotic symptoms and alter how people think and feel. We thus aimed to explore how people with childhood trauma and psychosis experience the effects that antipsychotics have on their (1) thoughts, images, and memories, (2) emotions, and (3) physical responses, related to their childhood trauma. DESIGN: A qualitative phenomenological research design using semi-structured interviews was implemented. METHODS: Data were analysed using interpretative phenomenological analysis. RESULTS: Nineteen participants were interviewed. Two super-ordinate themes were conceptualized. Many participants spoke about the impact of antipsychotics on trauma-related experiences (Theme 1). Some indicated that antipsychotics alleviated the intensity and frequency of trauma-related thoughts, emotions, and physical symptoms. A few others reported that their trauma-related flashbacks, thoughts, and physical symptoms intensified while taking antipsychotics. Participants spoke about the role of antipsychotics in confronting and processing trauma (Theme 2). A few participants reported that by suppressing trauma-related thoughts and emotions antipsychotics prevented them from confronting their trauma. CONCLUSIONS: The effects of antipsychotics can be subjectively experienced as beneficial or detrimental depending on how they influence trauma-related thoughts, emotions, and physical responses. Intervention studies are needed to determine how people with childhood trauma and psychosis respond to antipsychotic drugs. PRACTITIONER POINTS: Antipsychotics may alter the way in which people with childhood trauma and psychosis remember and re-experience trauma. These alterations can be beneficial or detrimental, and thus play a role in whether people consider their medication helpful. By suppressing trauma-related thoughts and emotions, antipsychotics can prevent people from confronting their trauma. This may be considered beneficial to some, but other people may need or want to confront their trauma to heal. The effectiveness of trauma-focused psychological therapies may be influenced by the emotional, cognitive, and physiological effects of antipsychotic medications. The ability of antipsychotics to suppress people's trauma memories may contribute to post-traumatic avoidance. People with post-traumatic stress symptoms and psychosis should be provided with psycho-education about post-traumatic avoidance and its role in the maintenance of post-traumatic stress disorder.
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ItemBeing a Parent after a Disaster: The New Normal after the 2009 Victorian Black Saturday Bushfires(OXFORD UNIV PRESS, 2021-07)Abstract This article explores parental experiences over nearly seven years that followed catastrophic Australian bushfires in 2009. Principles of pragmatism and the constructionist tradition guided the use of semi-structured interviews with parents (nineteen mothers and three fathers) and inductive thematic analysis to distil what participants said about the trauma, loss and disruption caused by the fires, and ways in which they responded as parents. Changes described in their parenting role and family life were themed as ‘losing normal’ which encompassed managing additional exposures, losing fun and living at their capacity. Parents then evinced the struggle of settling and seeking to regain a sense of normal. This theme highlighted tensions, pressures and expectations they faced (their own and external) in trying to get back to normal, along with extended recovery timeframes. Participants valued strategies to provide stability, familiarity and manage their own emotions. The analysis highlights the influence of the parental role on an experience of trauma, the range of losses and the extended experience of disaster recovery for parents. Insights for social work practice are discussed, including the potential to inform expectations of recovery timeframes and supporting parents and their families to reconstruct their sense of normal in their new, post-disaster context.
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ItemAnger Dimensions and Mental Health Following a Disaster: Distribution and Implications After a Major Bushfire(WILEY, 2021-02)Anger is an important dimension of affect and a prominent feature of posttraumatic mental health, but it is commonly overlooked in postdisaster settings. We aimed to examine the distribution and implications of significant anger problems in the aftermath of a natural disaster, via analyses of Beyond Bushfires survey data from 736 residents of rural communities 5 years after the 2009 Black Saturday bushfires in Victoria, Australia. Assessments included the five-item Dimensions of Anger Reaction (DAR-5) scale along with measures of PTSD, depression, and significant mental illness, and indicators of life satisfaction, suicidality, hostile aggressive behavior, and violence exposure. The results indicated that approximately 10% of respondents from areas highly affected by the bushfires scored above the provisional cutoff criteria for significant anger problems on the DAR-5, which was a more than 3-fold increase, OR = 3.26, relative to respondents from areas of low-to-moderate bushfire impact. The rates were higher among women, younger participants, and those who were unemployed, and co-occurred commonly, although not exclusively, with other postdisaster mental health problems. Anger problems were also associated with lower life satisfaction, β = -.31, an 8-fold increase in suicidal ideation, OR = 8.68, and a nearly 13-fold increase in hostile aggressive behavior, OR = 12.98. There were associations with anger problems and violence exposure, which were reduced when controlling for covariates, including probable PTSD. The findings provide evidence indicating that anger is a significant issue for postdisaster mental health and should be considered routinely alongside other posttraumatic mental health issues.
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ItemPublic reassurance following a collective trauma event: a scoping review of the evidence to inform police practice(EMERALD GROUP PUBLISHING LTD, 2021-10-05)Purpose This paper examines the empirical research on police reassurance following a collective trauma event (CTE). Design/methodology/approach Using a scoping review methodology, this paper sought to establish the extent, range and nature of published literature on policing responses to collective traumatic events, and to identify key features of this form of direct practice. Included papers needed to focus on police responses oeassurance with the public related to events (pre-or post) that could be regarded as collective trauma events by nature or scale. Searches were conducted using the Web of Science, SCOPUS and PsychINFO databases for literature published between January 2000 and December 2019. Findings Fourteen articles met the inclusion criteria. The key themes identified: (1) measuring the impact of reassurance and community policing; (2) community attitudes to policing and social disorder/critical events; (3) police workforce responses to traumatic events; and (4) interventions to support police to respond to their community. Research limitations/implications Future research needs to examine the elements that create a robust organisational infrastructure that can withstand the demands of policing in ordinary and extraordinary times. Fundamental to the studies in this review is the relationship between the police agencies and the community. The nature of this relationship and how it can be strengthened to ameliorate the negative impact of CTEs in communities needs further exploration. Originality/value This paper provides important findings that can inform future reassurance policing practice and research.