Development of an online education and support program for family and friends: A collaboration between eheadspace, Bouverie Centre and Psychosocial Research Centre
This project will explore factors to consider when developing an online family psycho- education support program specifically for family and friends (FAF). eheadspace is Australia’s national online and phone support service, staffed by experienced youth mental health professionals. Family and friends of young people who may be struggling with mental health issues also engage with the service.
A recent internal review of the service discovered that what was offered to FAF, though responsive, could be improved. Consequently, the overarching goal of the project is to enhance the support currently provided by eheadspace to the FAF of young people (12-25yrs) who may be struggling with mental health issues.
Four focus groups will be conducted with family and friends using, or eligible for, the service, both in the metropolitan area and in the regional area. Key questions will be asked to inform and guide the development of 2 hours of online content as follows:
- What has prompted you to contact eheadspace in the past?
- What would you like to see tackled by the intervention?
- What would be the optimum organization of the intervention (relative contribution of phone, email, discussion boards and other on-line modalities such as self-directed learning, professional or peer facilitation), from your point of view?
An additional focus group will involve mental health clinicians who have interacted with FAF during the previous 3 years.
In addition, an audit of routinely-collected eheadspace records – specifically examining contact made by family and friends of young people (12-25yrs) will be analysed.
The Assertive Cardiac Care Trial (ACT). Can a co-produced intervention reduce cardiovascular risk in people with severe mental illness in primary care settings?
The Assertive Cardiac Care Trial aims to reduce cardiovascular risk in community-living people with severe mental illness (SMI) by bringing together two complementary evidence-based models from mental health: Assertive Community Treatment and Motivational Interviewing. These will be incorporated in a novel nurse-led intervention to reduce absolute cardiovascular disease risk, using guideline level cardiovascular care.
People with severe mental illness (SMI), such as schizophrenia, bipolar disorder, major depression with psychosis, are at greater risk of developing a cardiovascular disease than those without a severe mental illness.
Key factors that contribute to this are:
- antipsychotic medications
- lifestyle factors
- uptake and adherence to treatments
- communication challenges
- inequalities in access to care
- misconception that mental health care is provided predominantly in acute settings not primary care
This intervention is designed to address these multiple factors and deliver tailored, intensive, and proactive care in the primary care setting.
The protocol paper is currently being submitted for publication.
Mental Health Professional Online Development (MHPOD)
The MHPOD Learning Portal is funded through a collaborative arrangement between Australian states, territories and Commonwealth to provide training and education for Australia’s public mental health workforce and associated workforces that support individuals to maintain their mental health and wellbeing. It aims to support Australia’s broader public health workforce involved in delivering mental health and associated services i.e. social services and improve access to evidence-based educational programs.
The MHPOD Learning Portal’s current suite of content has been written by the Psychosocial Research Centre at the University of Melbourne and North West Mental Health. Originally produced by CADRE Design Pty. Ltd (now non-existent) and the Psychosocial Research Centre (University of Melbourne) for the Mental Health Professional Online Development (MHPOD) Project Steering Committee, on behalf of the Mental Health Workforce Advisory Committee (MHWAC).
The MHPOD Program is managed on behalf of all funders through the Victorian Department of Health and Human Services. The MHPOD Program engages with a broad range of multidisciplinary experts located throughout Australia. All content is developed through engagement with expert groups including consumer and carer representatives, clinicians and academics as part of a quality assurance process.
MHPOD is an evidence-based online learning resource for people working in mental health. Currently, there are over 100 hours of material across 68 topics, written and produced in Australia. The topics range from recovery to legislation and dual disability. Each topic includes an overview, activity, in-practice section, and resources such as checklists, templates, or links to further information. The content of MHPOD is linked to the National Practice Standards for the Mental Health Workforce.
MHPOD was originally designed for nurses, social workers, occupational therapists, psychiatrists and psychologists working in mental health in Australia, particularly those in their first two years of practice in Australian clinical mental health services. While this remains the case, it is expected that other people, including general practitioners (GPs), consumer workers, carer workers, Aboriginal health workers, and other allied health workers will also find it useful.
The project has taken the National Practice Standards for the Mental Health Workforce and turned them into an on-line curriculum for the national mental health workforce. The broad project team, like the workforce, is multidisciplinary and located throughout Australia.
The project aims include supporting the mental health workforce and improving access to evidence-based educational programs. An important underpinning theme is the curriculum’s recovery-oriented stance. Learners are encouraged to reflect on their own and other’s attitudes towards people with mental illness, their family and carers with an ongoing emphasis on values and attitudes in this curriculum.
Evidence-based mental health content has been transformed into engaging multimedia through the use of interactive simulations, case studies, animations, audio, video and graphics. MHPOD is delivered online (https://elearning.mhpod.gov.au) and is publicly available. Users register, log in and choose relevant topics.
Following completion of a technical upgrade in October 2019, the MHPOD Program will move to review and build additional content to reflect current practice and standards, as well as enhance the range of topics and accessibility. Moving forward, the MHPOD Program is seeking to expand MHPOD’s audience to sit within the broader public health and human service system i.e. social services and those professions whose clientele are at risk of developing a mental illness.
Improving mental health for young people in out-of-home care: Providing participatory evidence-based mental health care across services
Victoria’s Prevention and Recovery Care (PARC) services are sub-acute residential services that aim to minimise time in hospital for people with severe mental disorder. This NHMRC Partnershp Project aims to explore the appropriateness, effectiveness and efficiency of Victoria’s adult PARC services. Findings from the project will provide important information for service improvement and help shape future directions for PARC-type services in Australia. The investigation is being conducted by a team of independent researchers from the University of Melbourne, Monash University, La Trobe University and Deakin University alongside partners from all the current Mental Health Community Support Services (MHCSS): Break Thru, Ermha, Life Without Barriers, Cohealth, Wellways (formerly MIF), Mind Australia and Neami National. The project is a series of seven inter-related mixed methods studies which will use several different data sources. A detailed typology and comprehensive mapping of adult PARC services has been carried out. Mental health service data collected by the Victorian Government Department of Health and Human Services is being used to fully understand PARC service delivery in the context of mental health service provision in Victoria. The final study places a strong emphasis on cosumer perspectives by following a large number of consumers over a one-year period starting from their admission to a PARC service. A series of individual interviews, surveys and focus groups will also be conducted with a smaller group of consumers and carers. Recruitment of consumers from each PARC service for individual interviews was completed in October 2017. Between February and May 2018, a second group of consumers were recruited to participate in an individual interview, survey or focus group. FIndings are currently being written up for publication.
Building Family Skills Together (BFST) Mind
Building Family Skills Together (BFST) Mind provides an in-home evidence-based service to families who live in Northern Melbourne that have an adult family member who has a serious mental illness, such as schizophrenia, bipolar affective disorder and major depression. The service provides Behavioural Family Therapy, offering assistance to families by sharing information about the illness, finding easier ways to talk to each other and ways to manage difficulties when they arise. The aim is to improve family relationships, reduce stress, support recovery and deal with day-to-day challenges. The evaluation of BFST Mind showed that half the consumers receiving the service were born overseas along with one third of the carers, suggesting the program was successful in reaching hidden culturally and linguistically diverse (CALD) families. The evaluation, which compared assessments conducted before and after receipt of the service, showed improved mental health and quality of life and family functioning amongst consumers and decreased burden for their families, confirming the effectiveness of this family psycho-education approach. The evaluation also detected a higher percentage of consumers who reported satisfaction with their lives following the program, while the percentage of carers reporting a need for more assistance decreased
Survey of High Impact Psychosis (SHIP)
The second Australian national survey of psychosis (also known as the Survey of High Impact Psychosis (SHIP)) was a prevalence study of psychotic mental illness across Australia conducted in 2010, plus an in-depth analysis of factors influencing the daily lives of people living with psychosis, with a focus on those amenable to change. It was a follow up of the “Low Prevalence Study” in 1998. The NWAMHS national survey dataset has comprehensive data on consumer characteristics and service usage, including evidence-based psychosocial interventions (their availability from both consumer and case manager perspectives along with case manager views on barriers to their availability and whether similar interventions are being delivered). These NWAMHS data have been benchmarked against the other national survey sites and provided a gap analysis that informed the local community services re-design and its accompanying evaluation. Analysis of data from the second national survey of psychosis is continuing: over fifty articles (published or in press/submission) have already been generated by PRC staff and their collaborators.
A Survey of Caregivers of People with Psychosis in the Australian Survey of High Impact Psychosis (SHIP): The relationship between caregiver experience and consumer characteristics
This recently submitted PhD research project aimed to explore and better understand the grief, health and well-being, quality of life, social connectedness and caregiving consequences of carers of people with psychosis within a prevalence framework. This research took place in the context of the Australian National Survey of High Impact Psychosis (SHIP) in Victoria, with results which are likely to be representative of carers of people with psychosis. Ninety eight carers participated in this study; these carers experienced moderate grief and poorer social connectedness and higher psychological distress than people in the general population, according to population norms. CALD carers have even poorer mental health and quality of life than Australian-born carers. There were few changes for carers over the course of 1 year other than a worsened perception of their quality of life related to their physical health, suggesting a pressing need to assess and improve carers’ physical health. The carers’ perceptions of higher functioning of their relatives with psychosis at baseline led to better social connection, less grief and higher satisfaction in psychological health for carers at follow-up, suggesting increased efforts to improve consumer functioning through rehabilitation and recovery-informed approaches could impact positively on carer health and wellbeing.
Assessing mortality and morbidity in people with psychotic disorders
An empirical framework for assessing mortality and morbidity in people with psychotic disorders: A 7-year prospective and 10-year retrospective follow-up of 2075 participants in the Survey of High Impact Psychosis (SHIP) using linked registers.
It is well established that physical morbidity and premature mortality are elevated in schizophrenia. The CIs/AIs who collaborated on the 2010 National Survey of High Impact Psychosis (SHIP), have cross-sectional data revealing rates of physical morbidity among SHIP participants well above population rates and exposing a very high cost burden. However there is a critical need for longitudinal data.
This NHMRC project grant funding study builds on a unique opportunity to use an innovative dual-methods strategy. 17 years (2000-2017) of mortality and physical morbidity outcome data from state and national administrative registers will be extracted. We will add these register data to previously-collected survey data for a large, nationally representative and comprehensively characterised sample of 2075 people aged 18-64 years with psychotic disorders who took part in SHIP.
The aims are to:
- Estimate rates of 7-year mortality and morbidity in people with a psychotic illness with separate estimates for:
- mortality due to natural versus unnatural causes
- potentially avoidable morbidity in order to establish much needed Australian benchmarks for assessing the impact of changes in public health policies.
- Examine the impact of sets of risk factors on 7-year mortality and morbidity in order to move beyond estimation of rates to understanding the aetiology of adverse physical health outcomes in psychotic disorders and informing clinical practice.
- Develop and validate predictive risk equations for cardiovascular disease (CVD) for use with people with psychotic disorders in order to address a clinical need for CVD predictive risk equations appropriate for use in this subpopulation.
- Calculate the economic burden of severe and acute physical morbidity in addition to mental health impacts in order to meet a service planning need for scarce and accurate data on costs of physical morbidity in psychotic disorders.