Australasian Psychiatry最新文献

IntroductionHealthcare organisations are increasingly adopting Just Culture (JC) and Restorative Just Culture (RJC) to improve safety, staff well-being, and accountability. JC distinguishes between human error, at-risk, and reckless behaviours to promote fairness without blame, while RJC incorporates restorative practices to address emotional harm and rebuild trust. This review synthesised empirical evidence on JC/RJC implementation in healthcare, with emphasis on mental health settings.MethodsSystematic searches of MEDLINE, EMBASE, and PsycINFO (2011-2024) identified 23 eligible qualitative, quantitative, and mixed-methods studies. Due to heterogeneity in design and measures, a narrative synthesis was undertaken.ResultsCommon strategies included leadership engagement, tailored staff training, non-punitive reporting systems, and multidisciplinary collaboration. Outcomes reported across settings included improved incident reporting, enhanced safety culture, reduced adverse events, greater staff competence, and economic benefits. Mental health studies demonstrated reductions in repeated suicide attempts and improved psychological safety. Implementation was challenged by inconsistent definitions, lack of standardised measures, and resistance to change.ConclusionJC/RJC approaches are associated with cultural, clinical, and economic benefits, particularly in high-risk environments such as mental healthcare. Sustainable implementation requires integrated leadership commitment, transparent reporting systems, and targeted research - especially in mental health - to strengthen evidence and guide best practice.

ObjectivesEncouraging interest in specialist practice in psychiatry is a key aim of both public psychiatric practice and medical student training. We describe the ongoing development and benefits of an accredited trainee position in academic psychiatry based in public mental health services and a graduate medical school. This is discussed in the context of relevant research evidence on psychiatry training and fostering interest in psychiatry.ConclusionsThe benefits of an accredited trainee position in academic psychiatry extend beyond the skills gained by the trainee, with flow on effects to medical student teaching, attraction to the local training scheme, and fostering a broader culture of academic engagement and activity. The challenges include maintaining funding for a position over nearly two decades, balancing specialist training requirements with clinical and academic service, and also tailoring the roles for the different interests and skills of academic trainees.

Emancipated by investigative journalism and a free press, the calls for the safety and quality of Australian healthcare are now being heard, despite repression by politicised public sector healthcare administrators and their masters. Action is needed for protected disclosure of workplace and patient safety hazards by all healthcare workers. Healthcare administrators, and Ministers are responsible, and should be accountable for the psychosocial safety and wellbeing of patients and healthcare workers. There is also evidence of similar concerns in the private sector. Regular assessments of healthcare workplace safety and wellbeing must be reviewed and acted upon in a quality audit cycle.

ObjectiveThis viewpoint paper explores the development of a new online subculture known as involuntary celibates or 'incels'. The emergence of this online community will be discussed, with reference to foundations within the wider men's rights movement. The incel worldview, core beliefs underlying this culture, demographics and how this ideology relates to mental illness, personality construct and offending behaviour will be explored. Illustrative scenarios are provided of clinical situations where psychiatric assessment of incel ideology can provide valuable insights and inform healthcare and risk assessment. Lastly, consideration will be given as to how incel culture and beliefs may impact young Australians.ConclusionsThe incel movement is a concerning phenomenon of relevance to psychiatrists. We offer some clinical recommendations for those working with young men expressing incel-related beliefs.

PurposeThe COVID-19 pandemic significantly impacted mental health, particularly in individuals with pre-existing conditions and in younger people. However, long-term mental health trajectories beyond the acute phase remain unclear. This study examined distress levels and quality of life (QoL) in individuals with mental and/or physical health conditions, and across different age groups between 2020 and 2024.MethodsUsing data from the COLLATE project - a series of online mental health surveys of the Australian public - we conducted general linear models to assess demographic parameters and risk factors associated with distress and QoL in 2,134 participants.Major FindingsMental and physical health conditions were associated with higher distress and lower QoL throughout 2020 to 2024. Having both conditions had a compounding effect on QoL but not distress, which was primarily influenced by mental health conditions. Younger people reported higher distress across this period. Overall, QoL was lower in 2024 than 2020.ConclusionPoorer mental health in those with mental and physical health conditions, and younger age groups, persisted from 2020 to 2024. This is concerning considering extensive literature demonstrating disproportionately greater impacts of COVID-19 on the mental health of priority populations and highlights groups that may require ongoing psychosocial support.

ObjectiveThe objective of this systematic review and meta-analysis is to determine the prevalence of anxiety and depression among individuals diagnosed with gestational trophoblastic disease (GTD), considering the significant emotional toll associated with miscarriage, surgical procedures, and prolonged β-hCG monitoring.MethodsWe systematically searched for studies published up to February 2024 that reported on the prevalence of anxiety and depression in GTD. The databases included PubMed, ScienceDirect, Cochrane Library, EBSCOHost, ProQuest, and Google Scholar. Data from the included studies were independently extracted by four researchers and analyzed using MedCalc v19.5.1. This study was registered with PROSPERO (registration number CRD42024525746).ResultsOur analysis included seven studies involving a total of 462 participants. The findings revealed an overall prevalence of anxiety at 34.9% and depression at 22.2%, indicating a significant psychological impact on patients with GTD.ConclusionThe high prevalence of anxiety and depression underscores the necessity for physicians to provide comprehensive psychological support to patients with GTD. Educating patients about their disorder, treatment options, and potential consequences is crucial for managing the psychological aspects of GTD.