Anna Machlin

Aim: This paper aims to report on effective approaches for, and early impacts of, implementing and delivering services for youth with, or at risk of, severe mental illness commissioned by 10 Primary Health Network (PHN) Lead Sites (reform leaders) in Australia. Methods: The following qualitative data sources were analyzed using a thematic approach: focus group consultations with 68 Lead Site staff and 70 external stakeholders from Lead Site regions; and observational data from one Lead Site meeting with a focus on services for youth with, or at risk of, severe mental illness and one national symposium that was attended by Lead Site staff and service providers. Results: The Lead Site staff described common effective strategies for implementing and delivering youth enhanced services as follows: building on existing youth services, establishing effective linkages with other local youth enhanced services, and providing complementary clinical and non-clinical services. Early impacts of youth enhanced services that were described by Lead Site staff and external stakeholders included: improved service quality and access, positive effects on consumers and/or carers (e.g., reduced symptomology), and sector-wide impacts such as improved service integration. Staff members from two Lead Sites also mentioned negative impacts (e.g., uncertainty of continued funding). Suggestions for future improvements by Lead Site staff and external stakeholders included: involving young people in service design and planning, improving service access, addressing clinical workforce shortages, improving data collection and usage, and establishing greater service integration. Conclusions: These findings highlight the necessity for collaborative and localized responses as well as service models that combine clinical and non-clinical care to address the needs of young people with, or at risk of, severe mental illness. Early impacts that were reported by stakeholders indicated that PHN-commissioned youth-enhanced services had positive impacts for consumers, carers, and the wider service sector.

Suicide is a major public health concern in Australia and globally, requiring targeted research efforts to build the evidence base for its effective prevention. We examined current and future priorities in Australian suicide prevention research during the period 2010–2017, and compared these to 1999–2006 baseline data. We classified current research priorities in terms of the type of research published in 424 journal articles and 36 grants and fellowships funded during 2010–2017. A questionnaire administered to 390 stakeholders identified future research priorities. The total number of suicide prevention focussed journal articles and the value of funded grants increased dramatically. Congruent with baseline data, current research priorities in 2010–2017 reflected a strong emphasis on epidemiological studies, while funding for intervention studies declined. This is despite the fact that stakeholders continually identified intervention studies as being the highest future research priority. If we are to make real advances in suicide prevention, we need to know what works, and identify and test effective interventions. This study highlighted the existing dearth and continued need for intervention research. Mechanisms to support future intervention research in suicide prevention are likely to lead to significant gains in knowledge and population health.

Introduced in July 2001, Australian Access to Allied Psychological Services (ATAPS) was the inaugural national policy initiative to provide community access to government-funded psychological services in primary care. Our aim was to examine the achievements of ATAPS in relation to its stated objectives using a set of indicators that largely drew on data from a minimum data set that we designed for the evaluation of ATAPS. We used de-identified professional-, consumer- and session-level data from the minimum dataset, and secondary analyses of our quantitative and qualitative data collected for a series of specific evaluation studies. Available data covered the period from 1 July 2003 to 31 December 2012. Approximately 350,000 referrals were made to the ATAPS program over the 9.5 year analysis period, 79 % of which resulted in services. Over 1.4 million sessions were offered. Overall, 29 % of consumers were male, 4 % children, and 3 % Aboriginal people; 54 % of consumers had depression and 41 % an anxiety disorder; at least 60 % were on low incomes; and around 50 % resided outside of major cities. The most common interventions delivered were cognitive and behavioural therapies. Selected outcome measures indicated improvement in mental health symptoms. Access to Allied Psychological Services achieved its objectives within a decade of operation. The program delivered evidence-based services to a substantial number of consumers who were disadvantaged and historically would not have accessed services. Importantly, where data were available, there were indications that ATAPS achieved positive clinical outcomes for consumers. This suggests that ATAPS carved an important niche by successfully addressing unmet need of hard-to-reach consumers and through means that were not available via other programs. It will be interesting to see the effects from July 2016 of the reform of ATAPS, which will see ATAPS subsumed under psychological services commissioned by regional primary care organisations.

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.

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The Gap Park Self‐Harm Minimisation Masterplan project is a collaborative attempt to address jumping suicides at Sydney's Gap Park through means restriction, encouraging help‐seeking, and increasing the likelihood of third‐party intervention. We used various data sources to describe the Masterplan project's processes, impacts, and outcomes. There have been reductions in reported jumps and confirmed suicides, although the trends are not statistically significant. There has been a significant increase in police call‐outs to intervene with suicidal people who have not yet reached the cliff's edge. The collaborative nature of the Masterplan project and its multifaceted approach appear to be reaping benefits.

Summary: There is a substantial literature which demonstrates that irresponsible reporting of suicide can lead to copycat acts and, as a result, many countries have developed guidelines for media professionals. Some of the recommendations in these guidelines draw directly on the evidence and describe how reporting can be done in a measured fashion that minimises any likely negative influence. Other recommendations relate more to good journalistic practice and are about showing respect for the bereaved in their time of grieving. The study by Chapple et al, in this issue, indicates that there may sometimes be tensions between what media guidelines recommend and what those bereaved by suicide believe is important. We would argue that in such cases common ground can be reached.

Background: Media reporting of suicide has attracted public health attention because of its potential to trigger “copycat” acts. Aims: To determine the factors associated with an individual suicide featuring in the media. Method: We identified from the National Coroners Information System (NCIS) all suicides that occurred in Australia over a 1-year period and established those that were reported in the Australian media using data from our earlier Media Monitoring Project. Available variables were used to examine factors associated with a suicide being reported in the media. Results: Of the 2,161 suicides, 29 were reported in the media. Suicides by younger individuals were particularly likely to be reported, as were suicides by gunshot and other violent methods, suicides in commercial areas (e.g., office buildings and hotels) and medical/residential facilities and other institutions (e.g., detention centers), and suicides that occurred in the context of multiple fatality events (e.g., homicide-suicides and suicide pacts). Conclusions: Striking the right balance in terms of media reporting of suicide is crucial. The current study suggests that the reported suicides tend to be those that may either heighten the risk of lethal imitative behaviors or serve to distort public perceptions about suicide.

Background: The Australian Mental Health Professionals Network (MHPN) is fostering a collaborative, interdisciplinary approach to mental health care through the establishment of local interdisciplinary networks of mental health professionals. This paper reports on those factors seen by MHPN participants and staff as having affected the formation and continuation of interdisciplinary networks, and therefore the likely sustainability of these groups. Method: The paper draws on qualitative data from focus groups with mental health professionals participating in MHPN activities and MHPN staff. Results: The findings suggest that MHPN’s approach to establishing sustainable interdisciplinary networks has been influenced by a number of factors at the micro-, meso-and macro levels. At the micro-level, factors such as clarity and structure of ongoing meetings, individual dynamics and the role of ‘champions’ can promote or constrain sustainability of ongoing networks. Those networks that had established following an initial workshop and had continued to meet as an interdisciplinary network tended to be led by well-respected co-ordinators, involve members who are enthusiastic and keen to learn from each other, have a flexible structure and meet regularly for a well-defined purpose. These features are underpinned by good communication between network members and with MHPN administration. At the meso- and macro-levels, the key issue relates to resourcing, as well as the wider policy context. Conclusions: The support and practical resources provided by MHPN have been crucial in guiding successful networks as they form and continue to meet on a regular basis. The networks have also required internal leadership and support, and a clear purpose in order to form and to continue their activities. These findings are consistent with the literature, which states that sustainability of programs is reliant on factors at the project design and implementation level, as well as on factors inherent within the host organization and at the wider community level.