Australasian Psychiatry最新文献

Objective: Diabetes mellitus is a sequelae of antipsychotic medication in people of Indian descent with schizophrenia. The Indian socio-cultural context amplifies challenges of managing chronic illness. The aim of this study was to explore Indian mental health service users' perspectives of managing comorbid psychosis and diabetes mellitus, specifically culture-related difficulties.

Methods: In this exploratory study, people with an Indian cultural background recruited from community mental health clinics were interviewed by an Indian psychiatrist using a semi-structured questionnaire. Interviews were professionally transcribed. Reflexive thematic analysis was used to develop central organising concepts and identify themes.

Results: Four themes were identified: culture-specific views on comorbidity, preferences for tailoring education to Indian language and culture, changes in interpersonal relationships within extended family and relationships with healthcare professionals. Advice from hospital services was not specific to Indian culture and there were wider impacts of illness for wider family.

Conclusion: Indian New Zealanders have challenges in managing dual mental and physical illnesses. Further research is needed to develop approaches to care that emphasise service users' culture as core to understanding illness and treatment. This includes consideration of gender roles, families, communities, food, language, lifestyle and barriers to treatment.

Objective: To investigate the demographic characteristics associated with mental health recovery measures among individuals accessing the Housing and Accommodation Support Initiative (HASI) program over a 19-year period.

Methods: This was a retrospective cohort study conducted from January 2004 to October 2023. The Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) and Recovery Assessment Scale (RAS) were used as measures of mental health recovery.

Findings: A total of 2350 people with an average age of 42 years old were included. Female accounts for 46.0% of the total. The proportion of unmet needs in the CANSAS reduced from a median of 33.3% of the first follow-up to 5.8% in the 20^th follow-up. The average RAS scores were above three, indicating agree and strongly agree in all domains and improved in each follow-up. First Nations were associated with higher unmet needs in 'psychotic symptoms', 'safety to others' and 'transport' CANSAS domains, and LGBTI had reduced RAS scores in all domains.

Conclusion: HASI program engagement is associated with the reduction of unmet needs and improvement of the recovery of individuals with severe mental illness. Age, sex, gender, LGBTI, First Nations and country of birth were associated with changes in the CANSAS and RAS outcomes.

In multicultural healthcare settings, language barriers pose significant challenges, particularly in mental health where nuanced communication is vital. This manuscript examines the impact of limited English proficiency (LEP) on mental healthcare in New Zealand, where a substantial portion of the population and healthcare workforce are foreign-born. Despite official recommendations, professional interpreter use remains low, compromising care quality for LEP patients. The paper explores interpreters' roles beyond interpretation, including cultural mediation, while noting limitations in interpreter-mediated consultations. It also addresses communication difficulties arising from strong accents and dialects, even when a common language is shared. Multifaceted strategies to improve communication are proposed, including enhanced cultural competency training, patient-centered protocols, and language matching in healthcare teams. Emphasizing a polycultural approach, the manuscript advocates for comprehensive interventions addressing linguistic, cultural, and cognitive aspects of communication in mental healthcare. It calls for further research and policy changes to integrate language access and cultural competency into healthcare quality assessments, aiming to reduce disparities and improve outcomes for diverse patient populations.

The haemorrhage of psychiatrists from the NSW state-funded mental health system parallels losses throughout Australia, and internationally. The lack of workforce cripples the capacity to provide adequate care. There has been persistently neglectful under-resourcing of the care of people with severe mental illness. A sense of horror exists due to the inability to provide high-quality care as a result of lack of infrastructure, staff, and time. This horror has driven psychiatrists to exit a dysfunctional state-funded health system, and an urgent remedy, although needed, appears absent.

Objective: The Australian Institute of Health and Welfare publishes statistical indicator reports on the specialised mental health workforce. These include data for 2022-2023 on psychiatrists, mental health nurses, mental health occupational therapists, psychologists and mental health social workers. We provide a brief commentary on these reports, reflecting upon the implications of such changes for psychiatric practice and patient care.

Conclusions: Overall, there are fewer mental health workers with increasing distance from urban centres. There are insufficient rural psychiatrists with the NT and Queensland having higher rates per 100,000 in outer regional and remote areas. Psychologists and mental health nurses have the highest rates per 100,000 in rural areas. Though low in absolute rates per 100,000, mental health social workers are better distributed in rural compared to urban areas. Further data on public, private and non-governmental sector employment would be useful.

Objective: The aim of this paper is to summarise the findings of a virtual workshop at the Creating Futures 2023 Conference held on October 18 with 45 participants attending from Fiji, PNG, Solomon Islands, the Federated States of Micronesia, Cook Islands, Australia and New Zealand. Brief presentations about future mental health needs of Pacific children & young people were followed by small group discussions. These focussed on how island nation participants could "make it real" by considering actions to promote mental health and wellbeing in their communities.

Conclusions: A wide variety of actions and strategies were recommended, spanning the implementation of national plans, integrating culture, preventing suicide, including the voice of children and managing trauma. The small group discussions found that the range of responses to meet future needs demanded a broad public health response, significant workforce development and the promotion of mental health.

Objective: To describe the Police Communication Centre Mental Health Liaison Service (PCC MHLS), a novel mental health service embedded in a Queensland Police Service (QPS) communication centre which provides real-time information and advice to police as first responders to people in mental health crisis.

Methods: A retrospective analysis of referrals received from 1st January 2023 to 31st December 2023 was conducted. Descriptive statistics were calculated for consumer and service episode characteristics and reported outcomes.

Results: The service received 3549 referrals with a daily mean of 9.97. Mean age at referral was 38.11 years (SD 15.86, range 6-102), and most consumers were male (60.4%). 41 percent did not have a current or historic psychiatric diagnosis and 28.1% were open to the public mental health service. The most reported presenting problem was suicide/self-harm (45.2%). An Emergency Examination Authority was enacted in 28.3% of cases, and 20.9% of consumers were referred to mental health services.

Conclusion: Results suggest some consumers may be experiencing psychological distress rather than diagnosed mental illness. The PCC MHLS connects consumers with the most appropriate services beyond hospital emergency departments and provides a novel and effective mechanism for real-time support for first responses to people in mental health crisis.

Background: Using long-acting injectable (LAI) antipsychotics is crucial for treating psychiatric illnesses, particularly those within the schizophrenia spectrum. Through bibliometric analysis, our study aimed to provide an understanding of the changes in research trends related to LAIs over the past 40 years.

Methods: We collected the publications from 1983 to 2023 related to research studies on LAIs included in the Web of Science database. Two thousand four hundred and twelve publications were selected based on specific criteria and analyzed using the VOSviewer software and the Biblioshiny app. We obtained and presented data on institutional analysis, country analysis, author and co-authorship analysis, journal analysis, funding agencies, and keyword citation numbers.

Results: From the period 1983-1992 to 2014-2023, the number of total publications showed a significant growth of 4.91. The majority (approximately 90%) of publications were produced in high-income countries. The private sector may play a significant role in research. The most crucial keywords were schizophrenia and risperidone.

Conclusions: The trend in LAI research is currently dynamic and ongoing. There seems to be an increasing connection between studies and LAIs that contain second-generation antipsychotics. The number of studies relating to the private sector is noteworthy.

Objective: The federal Australian government has introduced legislation to require social media platforms to restrict access to their platforms for young people under 16 years of age. Amongst the conversations about protecting the health and wellbeing of young people, we have yet to see discussion on the impact of alcohol imagery as a pervasive 'unhealthy' industry on social media. This is problematic because young people consume a large amount of social media content and are exposed to glamorised alcohol depictions and targeted advertising.Conclusions: According to current regulations, the sponsoring of social media posts by alcohol companies should be declared, but enforcement of these requirements is challenging and most alcohol posts (whether sponsored or not) tend to glorify alcohol use. Better regulation, but not necessarily a social media ban, is needed to protect young viewers from pervasive alcohol exposure on social media.