Australasian Psychiatry最新文献

There are many identified challenges for mental healthcare services in Australia and New Zealand including design, infrastructure and workforce shortfalls. In the 2024 RANZCP Workforce Report over 75% of trainees and psychiatrists endorsed symptoms of burnout, and over 80% reported that workforce shortages contributed. There is a need for effective leadership to reform and renew healthcare services. Clinical expertise is necessary, but not sufficient for leadership of mental healthcare services through substantial cultural and organisational renewal. Expertise and prosocial skills are needed for effective cultural leadership, based upon expressed generosity and kindness that leads to a corresponding reputation that empowers cooperation. Leaders will need such skills to effect change and improve mental healthcare delivery and patient experiences.

Background: Government mandated quarantine outside the home was implemented to mitigate COVID-19 in some countries. Individual studies report that this can result in psychological distress. Investigating levels of distress and associated risk factors across different settings would inform public health models of care during future pandemics. However, no previous systematic reviews have been conducted on the topic. Therefore, we systematically reviewed international research on the prevalence and risk factors of psychological distress within supervised quarantine facilities during the COVID-19 pandemic.

Methods: A systematic review of the literature was conducted using Medline, Psychological and Behavioural Sciences, Psych Info, Cochrane databases and Google Scholar from January 2020 until June 2023. Relevant quantitative studies published in English were included.

Results: 13 studies (pooled participants n = 4366) were included in this review. The prevalence of psychological distress varied widely across the included studies (depression 4%-63%; anxiety 4%-100%; stress 1%-68%). Associated risk factors identified were also heterogeneous between studies and facilities.

Conclusion: In future pandemics, the benefits of infection mitigation need to be weighed against the risk of psychological distress. Models of care utilising specifically designed facilities, with greater freedoms, increased comfort and ease of access to mental health services may limit psychological distress.

Objective: The aim of this study was to conduct an in-depth survey of psychiatric care provided for children and young people (CYP) in general hospital settings in New Zealand (NZ).

Method: As part of a larger national survey of Consultation-Liaison Psychiatry (CLP) services across the lifespan, a 44-question survey was emailed to clinicians who were involved in providing psychiatric care for CYP at each of the 24 public general hospitals with specialist paediatric services.

Results: Responses were obtained from all four paediatric CLP teams that cover the four specialist children's hospitals, and 16 of the 23 child and adolescent community mental health services that provide hospital inreach. These services were found to be under-resourced, utilise variable service models, and rely heavily on inreach.

Conclusion: Escalating presentation rates for young people and increasingly complex paediatric presentations pose major challenges for the psychiatric care of CYP in general hospital settings. Utilising international staffing standards and service models, proposals are made to evolve more consistent and effective paediatric CLP services in NZ.

Objectives: To review the challenges to developing and sustaining the Pacific mental health workforce for future planning.

Conclusion: Emerging from a colonial mental health service and training paradigm, contemporary Pacific Island Countries and Territories confront significant workforce education and training challenges that require solutions relevant to regional circumstances.