Journal articles on the topic 'Mentally ill Victoria'
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1
Castle, David J. "Letter from Australia: mental healthcare in Victoria." Advances in Psychiatric Treatment 17, no. 1 (January 2011): 2–4. http://dx.doi.org/10.1192/apt.bp.110.008375.
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SummaryMental health services in the state of Victoria, Australia, have undergone enormous change over the past 15 years, with the closure of all stand-alone psychiatric hospitals and a shift of resources and services into the community. Although successful overall, various areas cause concern, including pressure on acute beds, a paucity of alternative residential options, and suboptimal integration of government and non-government agencies concerned with the care of people with mental illnesses. Certain groups, notably those with complex symptom sets such as substance use and mental illness, intellectual disability and forensic problems, remain poorly catered for by the system. Finally, community stigma and lack of work inclusion for mentally ill individuals are ongoing challenges.
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Perera, Carlyle, and Beth Wilson. "The treatment and care of mentally ill offenders in Victoria, Australia." Psychiatry, Psychology and Law 3, no. 1 (April 1996): 47–61. http://dx.doi.org/10.1080/13218719609524874.
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Dharwadkar, Nitin. "Effectiveness of an Assertive Outreach Community Treatment Program." Australian & New Zealand Journal of Psychiatry 28, no. 2 (June 1994): 244–49. http://dx.doi.org/10.1080/00048679409075635.
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The purpose of this paper is to describe an Adult Community Treatment (ACT) program in Dandenong, Victoria, and its effect upon admission rates and time in hospital for 50 of the serviceapos;s most disturbed patients. The implementation of the program was associated with a reduction in the annual re-admission rate from 38% (1989–90) to 21% (1990–91); the total length of hospital stay was also significantly reduced. The results support the value of community support programs in the management of the seriously mentally ill.
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Davis, William B. "Music Therapy in Victorian England." Journal of British Music Therapy 2, no. 1 (June 1988): 10–16. http://dx.doi.org/10.1177/135945758800200103.
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The purpose of this article was to trace the growth and development of the Guild of St. Cecilia. This late nineteenth century organisation was founded by Frederick Kill Harford in London to provide music therapy to hospitalised patients. All information was derived from letters written by Harford and editorials that appeared in British medical and music periodicals. Initially, the Guild enjoyed great success and was endorsed by important people such as Florence Nightingale and Sir Richard Quain, physician to Queen Victoria. The Rev. Harford was astute in his observations that the effects of music must be tested to find the most beneficial ways for it to be used as therapy. He envisaged an association that would provide live and transmitted music via telephone to London's hospitals. Ultimately, due to the lack of support from the press, limited financial resources and Harford's ill health the organisation failed to prosper. Despite this, the Guild of St. Cecilia remains important because it kept alive the idea that music could be used therapeutically to benefit physically and mentally ill people.
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Kenny, Amanda, Susan Kidd, Jenni Tuena, Melanie Jarvis, and Angela Roberston. "Falling Through the Cracks: Supporting Young People with Dual Diagnosis in Rural and Regional Victoria." Australian Journal of Primary Health 12, no. 3 (2006): 12. http://dx.doi.org/10.1071/py06040.
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Research has indicated that people with a dual diagnosis of mental illness and substance abuse are more difficult to manage than any other group of mentally ill clients. For young people with a dual diagnosis, particularly in rural and regional areas, there are significant barriers to the provision of optimal care. Currently, a lack of communication between mental health, drug and alcohol services and consumers results in the inadequate provision of treatment for young people, with a resultant significant service gap. Dual diagnosis programs that focus on both substance abuse and mental health issues demonstrate greatly improved client outcomes. Developing a peer education program provides one constructive way of involving dual diagnosis consumers in developing more responsive health services. It provides a highly structured and supported way of involving consumers who ordinarily find mental health services bewildering and inaccessible. By drawing on the knowledge and skills of young people with dual diagnosis, and involving them as peer educators, the notion of expertise in lived experience is captured and harnessed to provide the establishment of a consumer-focused service that better meets the needs of this complex, often neglected, client group.
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Tobin, Margaret J. "Rural Psychiatric Services." Australian & New Zealand Journal of Psychiatry 30, no. 1 (February 1996): 114–23. http://dx.doi.org/10.3109/00048679609076079.
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Objective: The objective was to describe and evaluate a community mental health service developed during 1991–1992 in an attempt to meet the mental illness needs of an isolated rural community. The setting was the Grampians health region in Western Victoria: this region has an area of 45,000 square kilo-metres and a population of 182,000. Method: The method involved firstly describing the evolution of the service delivery model. This comprised a team of travelling psychiatrists and community psychiatric nurses which succeeded in providing a combined inpatient and outpatient service which was integrated with general practitioners. Secondly, diagnostic and case load descriptions of patients receiving service were compared for both the inpatient and outpatient settings. Results: The results were that reduced reliance on inpatient beds and increased consumer satisfaction were achieved. Conclusion: It was concluded that on initial evaluation of the service it was seen to be meeting its objective of treating the seriously mentally ill in an isolated rural community based setting.
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Maylea, Christopher, and Christopher James Ryan. "Decision-making capacity and the Victorian Mental Health Tribunal." International Journal of Mental Health and Capacity Law 2017, no. 24 (March 13, 2018): 87. http://dx.doi.org/10.19164/ijmhcl.v2017i24.685.
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<p>The United Nations Convention on the Rights of Persons with Disabilities (CRPD) has led to a re-thinking of traditional mental health law around the world. Since Australia’s ratification of the CRPD, all but one of its eight jurisdictions have introduced reforms to mental health legislation. These are aimed, in part, towards compliance with the Conventions articles. This paper examines the meaning and operation of the reforms introduced in Australia’s second most populous state – Victoria.</p><p><br />We first describe the criteria for involuntary treatment set out in the new <em>Mental Health Act 2014</em> (Vic) (Austl.) (the Act). We then argue that when making an order for Involuntary Treatment, the Victorian Mental Health Tribunal (the Tribunal) is obliged to carefully consider a person’s decision-making capacity as part of ensuring that treatment is provided in the least restrictive way, and to only authorise the involuntary treatment over a person’s competent objection in very limited circumstances.</p><p><br />Having established the way in which the Act <em>should</em> operate, we then present two empirical studies which analyse the decisions of the Statements of Reasons of the Tribunal to gain some appreciation of how the Act is working. These indicate that seldom does the Tribunal consider the decision-making capacity of people brought before it, and that, even when this is considered, the relevant information is not being used protectively so as to uphold a right to competently refuse treatment. Instead, the Tribunal uses the presence or absence of decision-making capacity, insight or poor judgement, to determine if a person is mentally ill or if treatment is required to prevent serious harm. We conclude that the Tribunal’s practice is inconsistent with the principles of the Act and consequently the intention of Parliament.</p>
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Beveridge, Allan, and Edward Renvoize. "The presentation of madness in the Victorian novel." Bulletin of the Royal College of Psychiatrists 12, no. 10 (October 1988): 411–14. http://dx.doi.org/10.1192/pb.12.10.411.
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The major novelists of the Victorian era enjoyed a large readership amongst the general public. They dealt with the pressing social issues of the day and their work both reflected and shaped society's attitudes to contemporary problems. The 19th century saw fundamental changes in society's response to the mentally ill with the creation of purpose-built asylums throughout the country. The Victorians were ambivalent in their reaction to the mentally disturbed. Whilst they sought to segregate the insane from the rest of the population, they were also terrified by the prospect of the wrongful confinement of sane people. The trial of Daniel McNaughton in 1843 for the assassination of Sir Robert Peel's Private Secretary, and the subsequent legislation, provoked general public debate about the nature of madness.
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Sumathipala, Athulo, and Raveen Hanwella. "The evolution of psychiatric care – a spiral model." Psychiatric Bulletin 20, no. 9 (September 1996): 561–63. http://dx.doi.org/10.1192/pb.20.9.561.
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The present trend towards community care with the continuing closure of the old Victorian institutions has given rise to much argument for and against community care. Incidents of violence by mentally ill patients against members of the public have resulted in some backlash against community care. There are fears of a return to the days of the institution. It is proposed that these changes can be predicted from a model that we have called the ‘spiral model’. An understanding of this model might help to prevent history from repeating itself.
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Musson, Jeremy. "Hospital cases." Psychiatric Bulletin 15, no. 12 (December 1991): 765–66. http://dx.doi.org/10.1192/pb.15.12.765.
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It could be said that one of the chief architectural legacies of the late 20th century, when it comes to be considered retrospectively, will be the wanton destruction and dispersal of buildings constructed in the previous century for the public benefit. Churches, schools and hospitals have been systematically sold off, and a good number of them, if not totally demolished, have lapsed into a pathetic state of limbo, particularly in this time of economic recession. Some of the worst cases of this known to the Victorian Society are hospitals of great architectural quality, constructed for the treatment of the mentally ill, then known as lunatic asylums.
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Ramsay, Rosalind. "Psychiatrists and the public." Psychiatric Bulletin 15, no. 12 (December 1991): 795. http://dx.doi.org/10.1192/pb.15.12.795.
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One hundred and fifty years on, how, Professor Clare asked an invited audience of eminent non-psychiatrists at the Royal Society of Medicine, do we fare? Is there really a more positive attitude to mental illness, now than in the nineteenth century, or even the 1960s? The Victorian public image of madness was characterised by ignorance, intolerance and fear and the mentally ill regarded as less than human, available to be exploited or used to entertain; and also, dangerous and incurable, best put away in large mental hospitals or ‘bins’. The media colluded in maintaining such attitudes: a leader in The Times in 1900, commenting on the 30-fold increase in the mental hospital population, was anxious that soon the mad might outnumber the sane!
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Ford, Natalie Mera. "Spectral Sterility in Bucknill and Tuke’s A Manual of Psychological Medicine and Bulwer Lytton’s A Strange Story." Humanities 8, no. 1 (March 23, 2019): 59. http://dx.doi.org/10.3390/h8010059.
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This essay identifies and examines a narrative structure—here called the sterility plot—that is shown to recur in British mid-19th century psychiatric texts and imaginative literature engaging mental science. Treating physicians Bucknill and Tuke’s A Manual of Psychological Medicine and novelist Bulwer Lytton’s A Strange Story as influential case studies, it explores in particular the Gothic-styled spectralisation used by both Victorian medical and literary authors to characterize females whose mental disorders are depicted as bound with a short- or long-term inability to reproduce. The narratives thereby gender, pathologize, and suspensefully dramatize the plot trajectory of mentally ill patients’ clinical and fictional case histories, which, taken together, is argued to reveal mid-century medico-cultural anxieties about the health of Britain’s imperial future being threatened by potentially sterile Englishwomen.
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Flis, Nathan. "Images of the Toronto Provincial Asylum, 1846-1890." Scientia Canadensis 32, no. 1 (July 7, 2009): 21–50. http://dx.doi.org/10.7202/037628ar.
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Abstract Built in 1850, the Toronto Provincial Asylum was once the largest mental hospitals in Canada. The main building was demolished in 1975, and the property is now home to the Queen Street branch of the Centre for Addiction and Mental Health. Although there are remnants of the nineteenth-century institution, including most of the perimeter wall, the only lasting visual reminder of the property as a whole is a small group of images. By the last quarter of the nineteenth century, perhaps in order to ease public concern over the increasingly custodial function of the institution, Victorian media sources repeatedly presented an unchanging or immutable depiction of the Toronto Asylum. Drawing upon the architectural concept drawings of the 1840s, which contained an ideal vision for the building, pictures from the 1870s, 80s and 90s depict the asylum as the new, clean, and proud-looking structure it was when it opened. Arguably, these images are what the Victorian public wanted to see: they preserved the early-century optimism that such institutions would yield high cure rates and they supported the view that the care of the mentally ill belonged in the hands of the medical profession.
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Salah Shaalan, Ban. "The Sick Heroine in Charlotte Perkins Gilman’s The yellow Wallpaper." ALUSTATH JOURNAL FOR HUMAN AND SOCIAL SCIENCES 59, no. 2 (June 15, 2020): 1–10. http://dx.doi.org/10.36473/ujhss.v59i2.1089.
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This study attempts to put Charlotte Perkins Gilman‘s The yellow wallpaper in the context of contemporary theory of Sandra M. Gilbert and Susan Gubar’s psycho-feminist scholarship The Madwoman in the Attic: The Women Writers and the Nineteenth-Century Literary Imagination (2000). The two critics focus on the image of the imprisoned mad women in the attic like Bertha Mason, the mentally ill wife of Mr. Edward Rochester, in Charlotte Bronte’s Jane Eyre (1847). The image of the sick woman forced into domestic confinement of colors, shapes and wallpapers in an entire seclusion continued right into the twentieth century into the literary product of some of the women writers. According to Gilbert and Gubar, some of those women Victorian writers tried to give voice to those women descending into sickness and mental diseases throughout their endeavor to oppress their awareness of the inner creative power which comes as a part of their desire to accept the limited social role they are trapped in.
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Dedman, Paul. "Community Treatment Orders in Victoria, Australia." Psychiatric Bulletin 14, no. 8 (August 1990): 462–64. http://dx.doi.org/10.1192/pb.14.8.462.
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It is one of the failures of contemporary psychiatry that many patients who respond well to neuroleptic medication given to them when they are in-patients relapse after discharge due to not taking any further medication. Those working closely with the acute psychiatric patient in the community are often forced to stand by powerlessly as a patient deteriorates, causing damage to himself and his social milieu until such a point is reached when he is again ill enough to warrant compulsory admission and treatment. This process is, of course, devastating for a patient's family and also disheartening for professionals involved, and is perhaps partly responsible for the high turnover of staff involved in front line services. Even if assertive outreach methods are employed such as those involved in a number of comprehensive community-based programmes (Stein & Test, 1980; Borland et al, 1989) so that contact with the patient is not lost, it is not possible without the necessary legislation to enforce treatment in the community.
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Taylor, Barbara. "THE DEMISE OF THE ASYLUM IN LATE TWENTIETH-CENTURY BRITAIN: A PERSONAL HISTORY." Transactions of the Royal Historical Society 21 (November 4, 2011): 193–215. http://dx.doi.org/10.1017/s0080440111000090.
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ABSTRACTMental health care in Britain was revolutionised in the late twentieth century, as a public asylum system dating back to the 1850s was replaced by a community-based psychiatric service. This paper examines this transformation through the lens of an individual asylum closure. In the late 1980s, I spent several months in Friern mental hospital in north-east London. Friern was the former Colney Hatch Asylum, one of the largest and most notorious of the great Victorian ‘museums of the mad’. It closed in 1993. The paper gives a detailed account of the hospital's closure, in tandem with my personal memories of life in Friern during its twilight days. Friern's demise occurred in an ideological climate increasingly hostile to welfare dependency. The transfer of mental health care from institution to community was accompanied by a new ‘recovery model’ for the mentally ill which emphasised economic independence and personal autonomy. Drawing on the Friern experience, the paper concludes by raising questions about the validity of this model and its implications for mental healthcare provision in twenty-first century Britain.
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Wright, David, Shawn Day, Jessica Smith, and Nathan Flis. "A Janus-Like Asylum: The City and the Institutional Confinement of the Mentally Ill in Victorian Ontario." Urban History Review 36, no. 2 (January 2008): 43–52. http://dx.doi.org/10.7202/1019170ar.
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Roberts, Susan B., Christine A. Hill, Brian Dean, Nicholas A. Keks, Ken Opeskin, and David L. Copolov. "Confirmation of the Diagnosis of Schizophrenia after Death Using DSM-IV: A Victorian Experience." Australian & New Zealand Journal of Psychiatry 32, no. 1 (February 1998): 73–76. http://dx.doi.org/10.3109/00048679809062709.
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Objective: This study examines the reliability of antemortem diagnoses of schizophrenia using DSM-IV criteria. Method: The case histories of 83 subjects with a provisional diagnosis of schizophrenia at autopsy were retrospectively reviewed using a semi-structured chart review and application of DSM-IV criteria. Agreement between antemortem and postmortem diagnoses of schizophrenia was examined, as well as the concordance between DSM-IV diagnoses and previously obtained diagnoses using DSM-Ill-R and ICD-10 criteria for schizophrenia. Results: According to DSM-IV, 30.1% of cases did not have schizophrenia, compared to 36.1% using DSM-Ill-R criteria and 51.8% of cases using ICD-10 criteria. Concordance between DSM-IV and DSM-Ill-R diagnoses of schizophrenia was excellent (k = 0.81), but only fair between DSM-IV and ICD-10 (k = 0.57). Of the cases that did not meet the formal criteria for schizophrenia, the majority were reassigned diagnoses of schizoaffective disorder and affective disorder. Conclusions: The use of human brain tissue in postmortem studies of schizophrenia must be linked to standardised diagnostic assessment procedures. Diagnoses can be upgraded with the development of new criteria, providing sufficient clinical data is available in case histories.
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Draper, Brian. "Melancholia in late life in New South Wales and Victoria, Australia, 1871–1905: symptoms, behaviours and outcomes." History of Psychiatry 33, no. 4 (November 19, 2022): 467–74. http://dx.doi.org/10.1177/0957154x221117000.
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In the late nineteenth century, the prognosis of late-life melancholia was believed to be poor. The medical casebooks of 40 patients aged 60+years, admitted to two Hospitals for the Insane in New South Wales with melancholia between 1871 and 1905, were examined. Psychosis (87.5%), depressed mood (80%), suicidal behaviour (55%), physical ill health (55%), restlessness (50%) and fears of harm to self (50%) were identified. Main outcomes were discharge (40%) and death (37.5%). Victoria’s Kew Hospital patient register for 1872–88 revealed 669 melancholia admissions with 30 aged 60+. Outcomes worsened significantly with age (chi square = 16.19, df = 4, p < 0.005), mainly due to higher mortality. Nineteenth-century late-life melancholia was a severe disorder despite many cases recovering.
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Seiler, Natalie, Matthew Ng, Midya Dawud, Subhash Das, Shu-Haur Ooi, and Astrid Waterdrinker. "Demographic and clinical factors associated with psychiatric inpatient admissions during the COVID-19 pandemic." Australasian Psychiatry 30, no. 2 (December 6, 2021): 229–34. http://dx.doi.org/10.1177/10398562211052903.
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Objective: The COVID-19 pandemic may cause a major mental health impact. We aimed to identify demographic or clinical factors associated with psychiatric admissions where COVID-19 was attributed to contribute to mental state, compared to admissions which did not. Methods: A retrospective cohort study was undertaken of inpatients admitted to Northern Psychiatric Unit 1, Northern Hospital in Melbourne, Victoria, Australia during 27/02/2020 to 08/07/2020. Data were extracted for participants who identified COVID-19 as a stressor compared to participants who did not. Fisher’s exact test and Mann-Whitley rank sum test were used. Results: Thirty six of 242 inpatients reported the COVID-19 pandemic contributed to mental ill health and subsequent admission. Reasons given included social isolation, generalized distress about the pandemic, barriers to support services, disruption to daily routine, impact on employment, media coverage, re-traumatization, cancelled ECT sessions, loss of loved ones, and increased drug use during the lockdown. Chronic medical conditions or psychiatric multimorbidity were positively associated and smoking status was negatively associated with reporting the COVID-19 pandemic as a contributor to mental ill health. Conclusion: Screening and identifying vulnerable populations during and after the global disaster is vital for timely and appropriate interventions to reduce the impact of the pandemic worldwide.
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Fulford, Megan, and John Farhall. "Hospital Versus Home Care for the Acutely Mentally Ill? Preferences of Caregivers Who Have Experienced Both Forms of Service." Australian & New Zealand Journal of Psychiatry 35, no. 5 (October 2001): 619–25. http://dx.doi.org/10.1080/0004867010060510.
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Objective: Demonstration studies of community treatment as an alternative to hospitalization have reported high degrees of satisfaction by family carers. We aimed to determine the extent of carer preference for hospital versus community treatment for acute mental illness in a routine setting where carers had experienced both service types. Method: Patients who had contact with both a hospital inpatient service and a Crisis Assessment and Treatment (CAT) team within the previous 5 years were identified. Seventy-seven family carers of these patients completed a questionnaire which identified their preference for services, and psychological and demographic variables likely to be predictive of their choice. Results: Only half the carers preferred a CAT service to treat their relative in the event of a future relapse. Psychological variables were better predictors of choice than were demographic variables. Conclusions: The proportion of caregivers who prefer community treatment for acute psychosis may be smaller than previously thought. The lower carer satisfaction found here may be associated with the short-term interventions of Victoria's CAT teams, the severity of acute relapses and the duration of the patient's mental health problem.
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Laslett, Anne-Marie, Robin Room, and Paul Dietze. "Substance misuse, mental health problems and recurrent child maltreatment." Advances in Dual Diagnosis 7, no. 1 (March 5, 2014): 15–23. http://dx.doi.org/10.1108/add-11-2013-0026.
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Purpose – The purpose of this paper is to determine whether the diagnosis of both carers’ mental health problems and substance misuse increase the likelihood of recurrent child maltreatment over and above the individual effects of these factors. Design/methodology/approach – Retrospective secondary data analysis of 29,455 children where child maltreatment was confirmed in the Victorian child protection system between 2001 and 2005. Recorded mental health, alcohol misuse and other drug misuse variables were entered into multivariate logistic regression models predicting repeated child maltreatment. Interactions and a range of other child, carer and socio-economic factors were included in these models. Findings – Carer alcohol misuse, other drug misuse and mental ill health all independently predicted recurrent child maltreatment. The presence of both other drug misuse and mental ill health increased the likelihood that recurrent child abuse was recorded over the likelihood that mental health alone predicted recurrent child maltreatment, and while alcohol misuse had an effect when there was no mental health condition recorded it did not have an additional effect when there was evidence of mental health problems. Research limitations/implications – Children in families where there is both mental health problems and other drug use problems are at greater risk of repeated maltreatment than where there is evidence of mental health problems or other drug use alone. Where there was evidence of carer mental health problems, alcohol misuse did not add to this likelihood. However, the effect of mental health and other drug use was similar in size to the effect of alcohol misuse alone. Originality/value – These findings add to understandings of the effects of co-occurring mental health problems and substance misuse on recurrent child maltreatment and differentiate between cases that involve alcohol and other drug misuse.
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Leckie, Jacqueline. "Insanity in a Sea of Islands: Mobility and Mental Health in Aotearoa New Zealand’s Pacific Sphere." Journal of New Zealand Studies, NS32 (June 30, 2021). http://dx.doi.org/10.26686/jnzs.ins32.6871.
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This article builds upon the fragmentary historical evidence of mental illness and mental health within South Pacific societies to explore the nexus with migration and mobility. The focus is on the Pacific territories that were under Aotearoa New Zealand’s jurisdiction. The article explores concepts of mental health and mobility within Pacific societies that became entangled with European concepts to designate insanity. The paper then discusses how mental illnesses were exacerbated or induced through migration and travel across the Pacific. The last section explores the transfer of mentally ill patients from some Pacific islands to Aotearoa. This article is based upon the 2018 J. D. Stout Lecture at Victoria University of Wellington.
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Buder, Sara. "Failures of the M’Naghten Rules: Women and the Insanity Defence in Victorian England." Inquiry@Queen's Undergraduate Research Conference Proceedings, May 24, 2018. http://dx.doi.org/10.24908/iqurcp.11525.
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This paper examines the medicolegal insanity defence in criminal trials in Victorian England. It analyzes the test for criminal liability embodied in a set of rules called the M’Naghten rules that followed the trial and acquittal of Daniel M’Naghten in 1843. The paper examines the difficulties in upholding the rules in criminal case law in the middle decades of the 19th century. The research question that will be addressed is: what role did gender play when determining the mental condition of the accused in Victorian society? Moreover, how did gender affect the treatment and the punishment of mentally ill individuals who had been convicted of crimes, and how did the stigma of mental illness shape treatment and punishment? Rather than being labelled as insane, people suffering from mental illnesses were sometimes given the titles "missing," "absent," and "unconscious." What happened to those who did not meet the legal criteria to be tried as mentally insane? Finally, what difficulties did the courts and testifying physicians face while interpreting criminal responsibility? The paper will investigate key legal cases and trial narratives in several Victorian novels to draw conclusions about the cultural history of the insanity defence.
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Callegari, Emma T., Nicola Reavley, Suzanne M. Garland, Alexandra Gorelik, John D. Wark, and On behalf of The Safe-D study team. "Vitamin D status, bone mineral density and mental health in young Australian women: the Safe-D study." Journal of Public Health Research 4, no. 3 (November 30, 2015). http://dx.doi.org/10.4081/jphr.2015.594.
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<em>Background</em>. Vitamin D deficiency has been associated with both poor bone health and mental ill-health. More recently, a number of studies have found individuals with depressive symptoms tend to have reduced bone mineral density. To explore the interrelationships between vitamin D status, bone mineral density and mental-ill health we are assessing a range of clinical, behavioural and lifestyle factors in young women (Part A of the Safe-D study). <br /><em>Design and methods.</em> Part A of the Safe-D study is a cross-sectional study aiming to recruit 468 young females aged 16-25 years living in Victoria, Australia, through Facebook advertising. Participants are required to complete an extensive, online questionnaire, wear an ultra-violet dosimeter for 14 consecutive days and attend a study site visit. Outcome measures include areal bone mineral measures at the lumbar spine, total hip and whole body, as well as soft tissue composition using dual energy x-ray absorptiometry. Trabecular and cortical volumetric bone density at the tibia is measured using peripheral quantitative computed tomography. Other tests include serum 25-hydroxyvitamin D, serum biochemistry and a range of health markers. Details of mood disorder/s and depressive and anxiety symptoms are obtained by self-report. Cutaneous melanin density is measured by spectrophotometry. <br /><em>Expected impact.</em> The findings of this cross-sectional study will have implications for health promotion in young women and for clinical care of those with vitamin D deficiency and/or mental ill-health. Optimising both vitamin D status and mental health may protect against poor bone health and fractures in later life.
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Green, Rachael, Penelope Fay Mitchell, Kira Lee, Ella Svensson, Jia-Wern Toh, Carolyn Barentsen, Michala Copeland, J. Richard Newton, Kari Christine Hawke, and Lisa Brophy. "Key features of an innovative sub-acute residential service for young people experiencing mental ill health." BMC Psychiatry 19, no. 1 (October 23, 2019). http://dx.doi.org/10.1186/s12888-019-2303-4.
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Abstract Background Numerous studies across international settings have highlighted a need to improve the appropriateness and continuity of services for young people experiencing mental ill health. This paper examines key features of a sub-acute youth mental health residential service model, Youth Prevention and Recovery Care (Y-PARC) service. Y-PARC provides up to 4 weeks care to 16 to 25 year-olds at risk of hospitalisation and to those transitioning out of hospital inpatient units. The research was conducted at one of three Y-PARCs located in Victoria, Australia. Methods This paper presents findings from analysis of two data sources collected during evaluation of a Y-PARC service in 2015–17. Routinely collected administrative data of Y-PARC residents (n = 288) were analysed and semi-structured interviews were conducted with 38 participants: a) former residents (n = 14); b) family members of group a) (n = 5); key stakeholders (n = 9); and, Y-PARC staff (n = 10 respondents in 3 group interviews). Analysis of the qualitative data was thematic and structured by the interview guide, which covered the key service aims. Results Consistent with the aims of the service, respondents described practice at Y-PARC that aligns with recovery-oriented care. Key features emphasised were: a safe and welcoming environment for residents and families; provision of person-centred care; promotion of autonomy and self-help; informal interactions with staff allowing for formation of naturalistic relationships; time spent with other young people with similar experiences; and, assurance upon exit that the ‘door is always open.’ High levels of satisfaction were reported. Outcomes described included: improved resilience; better understanding of mental health; the importance of seeking help; and, stronger connections to therapeutic services. Longer and multiple stays were associated with progressive and sustained change. Family members and stakeholders widely reported that the service fills a gap between community services and acute inpatient mental health hospital wards. Some challenging areas of practice identified included: integration of evidence-based psychosocial interventions; provision of care within a model that blends clinical and psychosocial support services; and, negotiation of family-inclusive practice. Conclusions The Y-PARC service model shows promise with young people experiencing mental ill health, particularly in improving the range and availability of options across a spectrum of need.
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Sega, Steven P., Lachlan Rimes, and Leena Badran. "Need For Treatment, A Less Restrictive Alternative To Hospitalization, And Treatment Provision: The Utility Of Community Treatment Orders." Schizophrenia Bulletin Open, December 16, 2022. http://dx.doi.org/10.1093/schizbullopen/sgac071.
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Abstract Background Provision of involuntary care is an abridgement of civil rights and a source of controversy. Its circumstances require continued monitoring. This study asks four questions: Whether, in an era focused on allowing patients with capacity to refuse community-treatment-order (CTO)-assignment, CTO use decreased. And whether CTOs fulfilled three statute mandates: Were CTO-assigned patients in greater need-of-treatment than other psychiatric-inpatients? Was CTO-assignment a less-restrictive-alternative to psychiatric-hospitalization? and Did CTO-assignment provide needed-treatment at internationally- recommended levels with consequences for patient-outcomes? Method All 214,388 Victoria, Australia mental health admissions between 2000- 2017 were reviewed. Two cohort-samples were drawn and followed through 2019—i.e. all 7,826 hospitalized-patients first placed on CTOs from 2010-2017 and 13,896 hospitalized-patients without CTO-placement. Logistic Regression was used to specify determinants of CTO-assignment from the psychiatric inpatient-population. OLS Regression with propensity score control to evaluate study questions. Results In the 2010-17-decade, initial CTO-assignments decreased 3.5%, and initial hospitalizations increased 5.9% compared to the 2000-09-period. At hospital admission and discharge, based on Health of the Nations Score ratings, the CTO-cohort’s need-for-treatment exceeded that of non-CTO-patients. CTO-patients had 3.75 fewer days in average inpatient episode duration than other inpatients, when adjusted for CTO-assignment determinants, the ratio of patients to community case managers, and patient housing status. CTO-patients needing rehospitalization spent 112.68 more days in the community than re-hospitalized non-CTO-patients. Patient to case manager ratios falling above recommended levels and the patient marginal housing-status contributed to longer hospital stays and reduced community tenure. Conclusions Victoria relied less on CTOs as an LRA, consequently, experiencing increased initial hospitalizations. CTO-patients were in greater need-of-treatment than non-CTO-patients, yet, with required oversite had shorter hospitalizations and more time out of hospital prior to rehospitalization than the less severely ill non-CTO-group. Patient LRA outcomes were adversely affected by higher than recommended community patient to case-manager ratios limiting needed treatment provision to hospital.