Dissertations / Theses: 'Unemployed Mental health Australia'

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Goddard, Richard C. "Burnout in case managers working with unemployed individuals." Thesis, Queensland University of Technology, 2001. https://eprints.qut.edu.au/36644/1/36644_Digitised%20Thesis.pdf.

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This research program on burnout and work environment perceptions in personnel working directly with unemployed individuals in Australia is reported in three studies. Using a survey methodology and taking a quantitative approach, burnout was investigated using the Maslach Burnout Inventory (MBI; Maslach & Jackson, 1986) on two occasions, before and after the privatisation of Australia's employment services industry (Job Network). The most widely accepted survey instrument measuring burnout (Lee & Ashforth, 1996), the MBI defines this stress related syndrome in terms of three subscales, Emotional Exhaustion, Depersonalisation and Personal Accomplishment. Perceptions of the work environment experienced by employment service staff were concurrently surveyed using the Real form of the Work Environment Scale (Moos, 1994). Heeding advice of researchers from the job stress area (e.g., Mccrae, 1990), this program of research also concurrently investigated the personality trait Neuroticism, the disposition to perceive and report negative experiences. In 1995, burnout in two groups of public sector personnel engaged in assisting individuals experiencing unemployment were compared. Staff employing a case management style of service delivery and staff engaging in an over-the-counter production-line style of service were surveyed and their responses on the MBI, the WES and the Neuroticism subscale of the revised short form edition of the Eysenck Personality Questionnare (EPQR/ s; Eysenck & Eysenck, 1991) compared. As hypothesised, case managers reported significantly higher burnout scores on all three subscales of the MBI, and perceptions of higher work pressure. The personality trait Neuroticism was found to account for significant variance in the burnout scores of the public sector respondents. The second study was conducted in 1999 after the full privatisation of the Australian employment services industry. At this time (T1 ), burnout in case managers throughout Australia was investigated with a postal survey which sampled 86 case managers from 38 different private sector organisations providing case management services to the long-term unemployed. The same respondents were surveyed again after six months (T2}. Study 2 demonstrated that case manager burnout levels in the new Job Network were significant. The design also allowed for the prediction of future burnout (T2) from personality and work environment data collected at an earlier time (T1) to be correctly modelled. As hypothesised Neuroticism was a significant predictor of all three MBI subscales both at T1 and T2. In what amounts to a comparison of public and private sector personnel, the third study compared the burnout levels and work environment perceptions of case managers surveyed in 1995 with the responses of case managers surveyed in 1999. Case managers from the public and private sector reported similar high levels of Emotional Exhaustion and Depersonalisation. Private sector case managers also reported significantly higher mean Personal Accomplishment scores, corresponding to a lower mean burnout level, and significantly higher levels of involvement and commitment to their work than public sector case managers. The results of these studies addressed a significant gap in the burnout literature which had hitherto failed to report investigations into employment service personnel, and highlighted the importance of considering the personality trait of Neuroticism in future burnout research. Results were discussed in the contexts of the evaluation of the current Job Network and the process model of burnout (Leiter, 1993).

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Åhs, Annika. "Health and Health Care Utilization among the Unemployed." Doctoral thesis, Uppsala University, Department of Public Health and Caring Sciences, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7193.

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The number of persons who are not employed has increased in Sweden since the early 1990s. Unemployment has been found to influence health, especially when unemployment rates are low. The extent to which unemployment affects health when unemployment is high is less clear, and this needs to be further studied. To improve health in the population, the health care system should offer equal access to health care according to need. It is important to study whether the employment status hinders the fulfilment of this goal.

This thesis is based on four papers: Paper I and II aimed at analysing self-rated health versus mortality risk in relation to employment status, during one period of low unemployment and one period of high unemployment. Paper III and IV assessed the use of medical health care services and unmet care needs among persons who were unemployed or otherwise not employed. The goal was to analyse what health problems lead people to either seek or abstain from seeking care, and what factors encumber or facilitate this process.

The overall results indicate that being unemployed or outside the labour force was associated with an excess risk of poor self-rated health, symptoms of depression, mental and physical exhaustion and mortality. The differences in self-rated health between the unemployed and employed were larger when unemployment levels were high, than when they were low. More groups of the unemployed were also afflicted with poor health when unemployment was high. Thus, poor health among the unemployed seems to be a public health problem during high levels of unemployment. Lack of employment was related to abstaining from seeking care, despite perceiving a need for care, and this was related to psychological symptoms. To deal with the needs of the unemployed and others who are outside the labour force it would be useful to develop and implement interventions within the health care system. These should focus on psychological and psychosocial problems. Future research should analyse how to facilitate health-promoting interventions among persons who are not anchored in the labour market.

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Åhs, Annika. "Health and health care utilization among the unemployed /." Uppsala : Acta Universitatis Upsaliensis, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7193.

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Foley, Kathleen. "Adaptation of anglophone Montreal youth to prolonged periods of unemployment." Thesis, McGill University, 1989. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=59401.

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This study was an attempt to combine both the psychological and lifestyles approaches and use qualitative research techniques in order to explore how young anglophones living in Montreal adapted to prolonged periods of unemployment. I examined how these young people felt their well-being was influenced by the experience of unemployment, what factors distinguished those who coped well with unemployment from those whose well-being declined, and how the mental health of respondents influenced their ability to adapt their lifestyle to accommodate prolonged periods of unemployment. This study provides detailed data about young people's subjective experience of unemployment and indicates the means by which three variables, social support, attributed cause of unemployment, and commitment to securing employment, interact to influence a person's mental health status. Also, this research highlights how adopting either an active lifestyle or becoming involved in the informal economy can influence a person's ability to cope with prolonged periods of unemployment.

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Creed, Peter A. "Mental health outcomes for unemployed individuals who attend occupational skills / personal development training programs." Thesis, Queensland University of Technology, 1995. https://eprints.qut.edu.au/35859/1/35859_Digitised%20Thesis.pdf.

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Four studies report on outcomes for long-term unemployed individuals who attend occupational skills/personal development training courses in Australia. Levels of distress, depression, guilt, anger, helplessness, positive and negative affect, life satisfaction and self esteem were used as measures of well-being. Employment value, employment expectations and employment commitment were used as measures of work attitude. Social support, financial strain, and use of community resources were used as measures of life situation. Other variables investigated were causal attribution, unemployment blame, levels of coping, self efficacy, the personality variable of neuroticism, the psycho-social climate of the training course, and changes to occupational status. Training courses were (a) government funded occupational skills-based programs which included some components of personal development training, and (b) a specially developed course which focused exclusively on improving well-being, and which utilised the cognitive-behavioural therapy (CBT) approach. Data for all studies were collected longitudinally by having subjects complete questionnaires pre-course, post-course, and (for 3 of the 4 studies) at 3 months follow-up, in order to investigate long-term effects. One of the studies utilised the case-study methodology and was designed to be illustrative and assist in interpreting the quantitative data from the other 3 evaluations. The outcomes for participants were contrasted with control subjects who met the same sel~tion criteria for training. Results confirmed earlier findings that the experiences of unemployment were negative. Immediate effects of the courses were to improve well-being. Improvements were greater for those who attended courses with higher levels of personal development input, and the best results were obtained from the specially developed CBT program. Participants who had lower levels of well-being at the beginning of the courses did better as a result of training than those who were already functioning at higher levels. Course participants gained only marginal advantages over control subjects in relation to improving their occupational status. Many of the short term well-being gains made as a result of attending the courses were still evident at 3 months follow-up. Best results were achieved for the specially designed CBT program. Results were discussed in the context of prevailing theories of Ynemployment (Fryer, 1986,1988; Jahoda, 1981, 1982; Warr, 1987a, 1987b).

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Yang, Jie. "Volunteering Helps Unemployed Older Workers' Mental Health: How, Why, and Does it Work for All?" Thesis, Boston College, 2018. http://hdl.handle.net/2345/bc-ir:108094.

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Thesis advisor: Christina Matz-Costa
Despite the fact that older workers (50+) are much overrepresented among the long-term unemployed and often suffer from multiple mental health problems, the social work literature has rarely tackled this issue. In my dissertation, guided by Jahoda’s Latent Deprivation Theory and the productive aging framework, I examined the positive coping strategies of unemployed older workers. I set out to understand whether engaging in formal volunteering in an organization would buffer the negative impact of unemployment on older workers’ mental health. I also fill out the gap in the literature regarding the mechanism of the positive effect of volunteering on mental health by examining two latent benefits from working as mediators: purpose in life and perceived social status. I used fixed effects modeling for the moderation analysis. I analyzed six waves (12 years) of longitudinal data from the Health and Retirement Study (HRS). I used structural equation modeling and analyzed two waves of HRS for the mediation analysis. I used full information maximum likelihood method to handle missing values. I found that there was a significant moderation between engaging in formal volunteering and unemployment status on older workers’ depressive symptoms. Unemployed older workers who engaged in volunteering fared better than those unemployed workers who did not volunteer. Consistent with previous studies using the HRS, I also found that those unemployed older workers who volunteered over 200 hours/year did not benefit from volunteering compared to those volunteered under 100 hours/year. Mediation analysis results showed that perceived social status and purpose in life mediate the protective effect of volunteering. Both the moderation and mediation results varied by race and ethnicity. Results from this dissertation have important implications for future intervention development. For example, interventions targeting the unemployed older workers may incorporate formal volunteering as one element for participants to gain social contact, purpose in life, and enhance perceived social status. Interventions can also create an environment that mirrors an office to enhance these latent benefits (mediators) in order to improve mental health
Thesis (PhD) — Boston College, 2018
Submitted to: Boston College. Graduate School of Social Work
Discipline: Social Work

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Connell, Mong L. "A study of the cultural appropriateness of service delivery models in the Australian mental health system." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2002. https://ro.ecu.edu.au/theses/714.

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This study is an attempt to examine the cultural appropriateness of the mental health system in relation to the Vietnamese refugee community in Australia. Culture and mental health, as widely acknowledged in the field of transcultural psychiatry, are closely linked. No aspect of the diagnosis or treatment methods can be justified without reference to the cultural traditions of the mental health system and the client. In a country like Australia, where multiculturalism is a dominant feature of the society, the need is even greater in incorporating culture into every aspect of the mental health system, if it desires to provide a culturally appropriate service to all immigrant groups. Every immigrant group brings with them different cultural values and attitudes. Included in these are viewpoints about mental health/illness that can diverge distinctly from those belonging to the more prevalent Anglo-Saxon cultural norms. How the illness is perceived as to its cause, treatment to healing are different in most cultures. According to the Australian Bureau of Statistics (1996), Vietnamese immigrants form one of the largest displaced people ever to be accepted into Australia as refugees. Their history of escape from the communist regime in Vietnam have sparked worldwide concerns about the state of their mental health. Their journey of escape is not without torture and trauma. Once settled into a country like Australia, they face many settlement obstacles. The cultural and social adjustments that they have to undergo have made them one of the most vulnerable and disadvantaged immigrant groups in Australia. Faced with such a group that have a high predisposition to mental stress and anxiety, the question lies in whether the Australian mental health system is sufficiently informed and prepared to provide a service which has relevance and meaning to these people. I argue that the system has not adequately provided a service to such a purpose. Although much progress and research has been done, it still operates very much within a Western philosophy. Its traditions, values and attitudes reflect a worldview that make little cultural sense to these people. Its racist assumptions and attitudes which promote cultural superiority of the West has resulted in a system labelled as culturally inefficient. Racism has been socially constructed and entrenched within the system for many years and it's origins are lost in the history of Western culture. Its mental health system is essentially monocultural. Culturally inappropriate diagnostic and treatment programmes and a shortage of professionals with the necessary linguistic, cultural and clinical competencies are just some of the deficiencies that exist within the system. Many training programmes have failed to evoke practitioners into questioning the effectiveness and cultural appropriateness of these fundamental structures supporting existing models of service delivery. This study is done through a discussion of the history of racism, certain important concepts, for example, culture and mental health/illness and the social, historical and political experience of the Vietnamese. The rest of the research focuses on certain specific barriers of accessibility and concludes with how these barriers can be addressed. In doing so, it advocates for a totally non-racist approach from an international to a personal level of service. Only through this approach can the mental health system claim to provide a service that is culturally sensitive and meaningful.

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Chan, Chi Wai. "The mental health of unemployed and socially isolated middle-aged men in Tin Shui Wai, Hong Kong." Thesis, University of Essex, 2018. http://repository.essex.ac.uk/21556/.

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This study investigates the poor mental health of unemployed middle-aged men (with women as a reference for comparison) in Hong Kong, who were unemployed and isolated socially in what is officially described as a new town, Tin Shui Wai. The study also explores the different aspects of social capital that may improve mental health for middle-aged individuals, drawing on data from ten in-depth interviews with five men and five women, two focus groups with five men and six women and a survey using questionnaires completed by 188 men and 215 women. The results showed that men in the sample had poorer mental health than women. In particular, levels of depression and alcohol abuse were higher in the men than the women. By contrast, women in the sample manifested more anxiety than the men. The findings also showed that unemployment had more negative effects on men than on women, with the men having more free time but nothing to do, feeling stressed, going out less with family members, drinking more alcohol and so on. Drawing on theories of social capital (Lin et al. 1985, McKenzie 2006), I argue that the poor mental health among men was associated with weak social capital. The data showed that for both men and women, social capital could have a positive association with reducing depression and anxiety. In particular, for men, community networks and social support had a positive association with reducing depression and alcohol abuse. For women, group membership, community networks and social cohesion had a positive association with reducing depression and anxiety. Based on these findings, I suggest an approach that focuses on increasing social capital to promote mental health among men and women. The approach argues for the need to introduce policies and strategies to promote social capital at the community and individual level for men, and at the community level for women.

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Mirza, Mahmoudi Milad, and Ljiljana Markovic. "How does physical training affect sedentary long-term unemployed? : An intervention study in association with Halmstad Fastighet AB-Bureau." Thesis, Högskolan i Halmstad, Sektionen för ekonomi och teknik (SET), 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-14511.

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Abstract Introduction: Unemployment cause poor health and poor health leads to unemployment. Those who are sedentary and experience unemployment may also experience negative effects on their physical and mental health such as obesity followed by cardiac illness, reduced muscle strength, chronic pain, anxiety and depression. All these factors can be categorised under physical and mental health, which are the essential factors for an optimal work ability. Methods: Our methods were to assess seven subjects (n = 7) of three male and four females, with the mean age of 35 ± 10 (25–54), who were all sedentary and long-term unemployed. These subjects were all part of a project organised by Halmstad Fastighet AB-Bureau (HFAB-Bureau) were they were undergoing education, coaching for employment and learning to apply for job. Our part in this project was to provide eight weeks of physical training to the subjects to reinforce their physical health which in turn supposed to improve their mental health. They were all assessed for grip strength with JAMAR® hydraulic hand dynamometer which represents overall muscle strength, BMI supplemented with waist circumference, blood pressure determination, self-assessing bodily pain with Visual Analogue Scale (VAS), anxiety and depression levels with Hospital Anxiety And Depression Scale (HADS) – a validated self-assessing questionnaire and Work Ability Index (WAI) by answering the self-assessing questionnaire for WAI. Results: T-test shows significance change in perceived pain over eight weeks of physical training as well as correlation between grip strength and perceived pain as well as anxiety and depression. No significant changes or correlations in remaining variables. Conclusion: Physical training contributes to decrease of chronic pain and physical training may give contribution to prevention of depression while increasing in muscle strength. Key word: Unemployment, mental health, physical health, physical training
Abstrakt Introduktion: Arbetslöshet leder till ohälsa och ohälsa leder till arbetslöshet. De som är inaktiva och arbetslösa kan också uppleva negativa effekter på deras fysiska och psykiska hälsa som fetma, följt av hjärt- och kärlsjukdomar, minskad muskelstyrka, kronisk smärta, ångest och depression. Alla dessa faktorer som kan kategoriseras under fysisk och psykisk hälsa, vilket är väsentliga faktorer för en optimal arbetsförmåga. Metod: Våra metoder för att bedöma sju deltagare (n = 7) varav tre män och fyra kvinnor, med medelåldern 35 ± 10 (25-54), där alla är inaktiva och långtidsarbetslösa. Deltagarna är en del av ett projekt som anordnas av Halmstad Fastighet AB-Byrå (HFAB-byrån), där de genomgår utbildning, coachning till sysselsättning och att lära sig att söka jobb. Vår del i detta projekt var att bidra med friskvård i åtta veckor för att stärka deltagarnas fysiska och mentala hälsa vilket i sin tur kan ha påverkan på deras arbetsförmåga. Samtliga undersöktes för greppstyrka med JAMAR ® hydraulisk dynamometer vilket motsvarar totalt muskelstyrka, BMI kompletteras med midjemått, blodtrycksmätning, självskattning av smärta med visuell analog skala (VAS), ångest och depression nivåer med Hospital Anxiety and Depression Scale (HADS) och Work Ability Index (WAI). Resultat: T-testet visar signifikans i upplevd smärta över åtta veckors fysisk träning samt sambandet mellan greppstyrka och upplevd smärta samt ångest och depression. Inga signifikanta korrelationer eller förändringar i de återstående variablerna. Konklusion: Fysisk träning bidrar till minskad kronisk smärta, samt att fysisk träning kan ha en preventiv effekt på depression så muskel styrkan ökar. Nyckelord: Arbetslöshet, mental hälsa, fysisk hälsa, fysisk träning
Med sikte på arbetslivet, HFAB-Byrån

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Hoare, Patricia Nancey. "The unemployment experience: psychological factors influencing mental health, coping behaviours, and employment outcomes." University of Southern Queensland, Faculty of Sciences, 2007. http://eprints.usq.edu.au/archive/00003600/.

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[Abstract]: A stress and coping framework was used to explore psychological factors influencing coping behaviours, mental health, and employment outcomes among the unemployed. Jahoda’s (1982) deprivation theory was also incorporated in the exploration. Jahoda proposed that unemployment not only deprives individuals of the manifest, or financial benefits, of employment, but it also deprives them of five latent, or psychosocial benefits, including collective purpose, social contact, status, time structure, and activity. Two studies were carried out, the first being a cross-sectional paper-based survey of 371 unemployed participants (214 males and 157 females, aged between 16 and 65 years) from South East Queensland. A follow-up survey was then carried out 6 months later on 115 of those same participants (59 males and 56 females, aged between 17 and 64). At Time 2, 58 participants had found jobs and 57 had remained unemployed. The variables measured in Study One included coping resources, cognitive appraisals, coping behaviours, and mental health. The coping resources included the personal resources of self-esteem, job seeking efficacy, positive affect, negative affect, and employment commitment, along with financial resources, measured by net fortnightly income, and social resources, measured by social contact during leisure. Job seeking efficacy was measured by self-promotion efficacy and task-focused efficacy. The former involves interpersonal tasks, such as promoting oneself to others as a job seeker, whilst the latter is more impersonal and involves tasks such as writing a resume. The cognitive appraisal variables included employment expectation, satisfaction with employment status, leisure meaningfulness, economic deprivation, and perceived access to the five latent benefits of employment, outlined by Jahoda. The coping behaviours included leisure activity and job search behaviours, including job applications, job search intensity, and job search methods. Mental health was measured by the GHQ-12 (Goldberg, 1972). The same variables were measured in Study Two, with the exception of the leisure variables. Other variables measured in Study Two included job satisfaction and job quality. Study One found that the most consistent predictors of job search behaviours were geographic region, employment commitment, and self-promotion efficacy, with participants living in the metropolitan area, those with a higher commitment to work, and those with greater efficacy being more actively engaged in job seeking. Leisure activity was significantly correlated with mental health and was predicted by availability of financial resources, positive affect, time structure, leisure meaningfulness, and level of education. That is, more frequent leisure activity was associated with being less financially restricted, higher positive affect, greater time structure, more meaningful leisure, and higher levels of education. Mental health was predicted by self-esteem, positive affect, negative affect, employment commitment, satisfaction with employment status, and financial hardship. Participants with better personal coping resources, greater satisfaction with their employment status, and less financial hardship were less likely to have clinical symptoms. The aforementioned variables accounted for 56% of the variance in mental health, and the logistic regression model correctly classified over 84% of cases as having clinical or non-clinical symptoms. The same model, with the exception of employment commitment, was tested in Study Two for the 57 continuously unemployed participants. It accounted for 62% of the variance in mental health, with similar classification accuracy to that at Time 1. The mental health of the 58 employed participants at Time 2 was predicted by occupation, collective purpose, activity, positive affect, and negative affect. Participants in higher skilled occupations, with higher collective purpose, greater activity, higher positive affect, and lower negative affect were less likely to have clinical symptoms. Those variables accounted for 62% of the variance in mental health and correctly classified 84.5% of cases as being clinical or non-clinical. One of the consistent predictors of job search behaviours at Time 2 was job search training. Participants who had completed a training program some time during the 6 months of the research project were more actively looking for work. Training did not, however, enhance participants’ job seeking efficacy or employment expectations. Study Two demonstrated that self-promotion efficacy, employment expectations, and job search behaviours had deteriorated over the 6 month research period, whilst task-focused efficacy increased. Employment status (i.e., gaining employment or remaining unemployed) was predicted by age, job applications, satisfaction with employment status, self-promotion efficacy, employment commitment, and time structure. Job acquisition was predicted by being younger, having submitted more job applications, being dissatisfied with employment status, having higher self-promotion efficacy, having higher employment commitment, and having less structured time. The logistic regression model including those variables accounted for 28% of the variance in employment status (employed or unemployed). Results of a mixed design analysis of variance in Study Two demonstrated that self-esteem, negative affect, satisfaction with employment status, financial hardship, financial strain, social contact, time structure, and mental health were all positively influenced by gaining employment, but showed either very little change or deteriorated for participants who remained unemployed. This research identified important predictors of coping behaviours, mental health, and job acquisition that can be used as a guide for developing suitable intervention strategies for the unemployed.

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Murray, Cynthia Lynn. "Unemployment and the mental health of Newfoundland women affected by the fishery closure." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0021/MQ55530.pdf.

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Descoteaux, Jill. "Dancers’ Reflections on Their Healthcare Experiences: Perspectives from Australia and the USA." Ohio University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1530538560639848.

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van, Vliet Helen E. Psychiatry Faculty of Medicine UNSW. "Mental health prevention: design and evaluation of an internet-delivered universal program for use in schools with adolescents." Awarded by:University of New South Wales. School of Psychiatry, 2007. http://handle.unsw.edu.au/1959.4/31899.

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This research describes the design and evaluation of an internet-based universal program for use in schools with adolescent students to prevent common mental disorders and promote mental health. The research began in response to investigations that showed that rates of mental illness in Australian children, teenagers and adults were high, that these illnesses caused significant burden to individuals and society, and that there were insufficient services to treat. When current interventions are unable to alleviate disease burden it is important to focus on prevention. Mental health prevention should target youth before disorders cause disability and restriction of life choices. A review of the mental health prevention literature supported a universal cognitive behavioural approach in schools. Internet delivery was used to maintain content integrity, enable access to people living in regional and remote areas, and to appeal to young people. Internet delivery makes universal prevention cost effective and feasible. The Intervention Mapping approach was used to direct the design of the program. A feasibility study was conducted to gain opinions from students and teaching staff. Changes were made in light of results from this study and 463 students were then exposed to the program in an effectiveness trial. The effectiveness trial was a before-after design with no control group. Results from this trial provided evidence that the program was acceptable and effective for use by teachers in the intervention schools. Also student behaviour and mood changed in beneficial ways after program administration. Specifically, student reported significantly increased knowledge about stress and coping, use of help-seeking behaviours, and life satisfaction, and significantly decreased use of avoidance behaviours, total difficulties and psychological distress. The study design allows causal inferences to be surmised concerning exposure to the intervention and changes in behaviour and mood, but further evidence is needed before firm conclusions about effectiveness can be posited and generalizations made concerning different populations, settings and times. In conclusion, this thesis provides evidence that a computerised, cognitive behavioural mental health prevention program delivered to adolescent school students by teachers can potentially change student coping behaviours and mood in beneficial ways.

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McGough, Shirley-Ann. "Facilitating equity in mental health outcomes for Aboriginal people within mainstream mental health services in Western Australia: A grounded theory study." Thesis, Curtin University, 2015. http://hdl.handle.net/20.500.11937/1275.

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This study developed a substantive theory that explores the provision of culturally safe care in a mental health setting and identified factors that inhibit or facilitate the experience. 28 mental health professionals working in mainstream mental health settings in Western Australian were interviewed for this study. The basic social psychological problem shared by participants was the experience of being unprepared. To address this, participants engage in a basic social psychological process of “seeking solutions by navigating the labyrinth”. The findings of this study have implications for service providers, clinical practice, policy and planning, research, education and Aboriginal patients and other key stakeholders.

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Suggit, Daniel Richard. "A Clever People: Indigenous healing traditions and Australian mental health futures." Thesis, Canberra, ACT : The Australian National University, 2008. http://hdl.handle.net/1885/12051.

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Indigenous Australians are currently hospitalised for mental health disorders at significantly higher rates than members of the non-Indigenous population. In this context, the development of effective Indigenous mental health service delivery models in remote, rural and urban areas continues to be a national priority. Traditional forms of healing are fundamental to Indigenous societies across Australia. Anthropologists, linguists, psychiatrists, psychologists, psycho-analysists and Indigenous healers themselves have recorded and discussed many localised traditions of healing over the last 100 years. This paper presents an overview of this significant Australian heritage and proposes that the challenges which face mental health service delivery within many Indigenous communities may be addressed in part through the recognition of the intellectual, religious and therapeutic bases of Indigenous healing traditions.

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Speldewinde, Peter Christiaan. "Ecosystem health : the relationship between dryland salinity and human health." University of Western Australia. School of Population Health, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0127.

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Australia is experiencing widespread ecosystem degradation, including dryland salinity, erosion and vegetation loss. Approximately 1 million hectares (5.5%) of the south-west agricultural zone of Western Australia is affected by dryland salinity and is predicted to rise to 5.4 million hectares by 2050. Such degradation is associated with many environmental outcomes that may impact on human health, including a decrease in primary productivity, an increase in the number of invasive species, a decrease in the number of large trees, overall decrease in biodiversity, and an increase in dust production. The resulting degradation affects not only farm production but also farm values. This study examines the effects of such severe and widespread environmental degradation on the physical and mental health of residents. Western Australia has an extensive medical record database which links individual health records for all hospital admissions, cancer cases, births and deaths. For the 15 diseases examined in this project, the study area of the south west of Western Australia (excluding the capital city of Perth) contained 1,570,985 morbidity records and 27,627 mortality records for the 15 diseases examined in a population of approximately 460,000. Environmental data were obtained from the Western Australian Department of Agriculture?s soil and landscape mapping database. A spatial Bayesian framework was used to examine associations between these disease and environmental variables. The Bayesian model detected the confounding variables of socio-economic status and proportion of the population identified as Aboriginal or Torres Strait Islander. With the inclusion of these confounders in the model, associations were found between environmental degradation (including dryland salinity) and several diseases with known environmentally-mediated triggers, including asthma, ischaemic heart disease, suicide and depression. However, once records of individuals who had been diagnosed with coexistent depression were removed from the analysis, the effect of dryland salinity was no longer statistically detectable for asthma, ischaemic heart disease or suicide, although the effects of socio-economic status and size of the Aboriginal population remained. The spatial component of this study showed an association between land degradation and human health. These results indicated that such processes are driving the degree of psychological ill-health in these populations, although it remains uncertain whether this 4 is secondary to overall coexisting rural poverty or some other environmental mechanism. To further investigate this complex issue an instrument designed to measure mental health problems in rural communities was developed. Components of the survey included possible triggers for mental health, including environmental factors. The interview was administered in a pilot study through a telephone survey of a small number of farmers in South-Western Australia. Using logistic regression a significant association between the mental health of male farmers and dryland salinity was detected. However, the sample size of the survey was too small to detect any statistically significant associations between dryland salinity and the mental health of women. The results of this study indicate that dryland salinity, as with other examples of ecosystem degradation, is associated with an increased burden of human disease.

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Miraudo, Amanda. "Big boys don't cry : understanding barriers to seeking support for mental health problems among adolescent males." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2003. https://ro.ecu.edu.au/theses/1307.

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This study explored the possible barriers encountered by adolescents in developing and achieving positive mental health. Male adolescents in Perth, Western Australia were consulted in an attempt to provide insight into the motivating and inhibiting factors influencing help-seeking as a coping strategy. Barriers to seeking help for mental health problems were investigated through the inductive process of grounded theory (Glaser & Strauss, 1967) to obtain a more detailed understanding of help-seeking than previous studies have provided; The study found that the coping responses most frequently enacted by the adolescent males sampled included avoidance, diversion, and private resolution. Help-seeking was far less frequently enacted, and was suggested to be the course of last resort. The primary barrier to help-seeking was found to be the interviewees' fear of feeling and appearing incompetent in successfully enacting the traditional male role. This primary barrier appeared to stem from the interviewees' socialised perceptions of the ideal male, their perceptions of available help-sources, and their perceptions of those with mental ill-health. These factors thus constitute possible barriers faced by male adolescents in achieving positive mental health and provide insights into key areas that need to be addressed in social marketing strategies. In addition, practical information and recommendations are directed towards adolescents, parents, and educators.

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Holland, Kate E., and n/a. "Conformity and resistance: Discursive struggles in the Australian mental health field." University of Canberra. Communication, 2007. http://erl.canberra.edu.au./public/adt-AUC20081022.153830.

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This research explores areas of contention in the mental heath field in Australia through a qualitative analysis of voices and practices that can broadly be seen as talking with and talking back to psychiatry. The thesis is informed by key shifts in thinking that underpin postpsychiatry and analyses a set of materials through an interpretive lens of reading psychiatry against the grain (Bracken & Thomas, 2005; Lewis, 2006). In particular, it examines a failed ethics application to conduct research with people diagnosed with a mental illness, an anti-stigma campaign, the practices of some prominent mental health organisations in Australia, a conversation with two members of an emerging consumer/survivor network in Australia, and a television documentary and online discussion forum about an antidepressant medication. The research draws from discourse analytic methods and concepts from social movement framing research to identify factors shaping conformity and resistance to psychiatric doxa in the Australian mental health field. The research identifies the discursive repertoires that characterise the mental health field as a "game" in which competing perspectives vie for recognition. In relation to research ethics committees, the thesis argues that deference to clinical expertise is a potential barrier to cultural studies of psychiatry and a more inclusive agenda in mental heath research and practice. Some practices for ethics committees to consider when reviewing research that involves people who may have been diagnosed with a mental illness are proposed. The research also identifies problematic features of anti-stigma campaigns that direct their efforts toward protecting and promoting the discourse of biomedical psychiatry. A critique of this type of campaign is offered in relation to perspectives from postpsychiatry and social constructionism. On the basis of this research, it is argued that organisations that champion "mental health literacy" are limited in their ability to give voice to the goals and priorities of those who are calling for a more open, reflexive and democratic debate in mental health. The central argument of this thesis is that elevating first-person and postpsychiatry perspectives is necessary in order to interrogate and address the dominance of the medical model in psychiatry and its consequences.

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Gopalkrishnan, Narayan. "Yoga therapy and the health of refugees." Thesis, Curtin University, 2012. http://hdl.handle.net/20.500.11937/2084.

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Refugees settling in Australia have many physical and mental health issues prior to arrival, issues that can be exacerbated by the settlement process. In Australia, the health needs of refugees are largely managed through a biomedical approach involving medication and/or psychotherapy and counseling. This approach stems from a clear separation between systems that deal with physical health issues and those dealing with mental health. The biomedical basis for working with refugee health issues has been useful up to an extent as the framework is very effective at disease control and prevention but is not so effective for chronic disease that is linked to multiple behavioral, socio-cultural as well as biological factors. Further, there are a number of other aspects of refugee health that biomedicine is unable to respond to effectively, such as cultural differences in understandings of health and illness, causality and healing, mind/body duality, as well issues of power relationships and structures. There is increasingly within Western medicine an awareness of the embodied interface between the spiritual, the social, the psychological and the biological being. Scholars argue that an integrated or holistic paradigm that incorporates the different aspects of health, including the biological, the psychological, the social and the cultural, would make for far better outcomes in terms of the health of refugees than the biomedical by itself.This thesis examines the role that yoga therapy, as a complementary therapy, can play in responding to the complex health issues of refugees settling in Australia. The research presented in this thesis utilized qualitative research methodology involving a literature review and document analysis, in-depth interviews and focus groups. The participants included people of refugee background who had taken part in yoga programs in Australia, as well as support workers, medical practitioners and complementary therapists. The thesis describes the perception of the health of refugees settled in Australia among service providers and refugees themselves, and the key factors impacting on this. It further looks at the existing mainstream responses in Australia to the health needs of refugees. It then critically analyses the role that complementary therapies like yoga therapy can play, and concludes that, particularly if they are incorporated within an integrative medicine framework, they have a significant contribution to make towards supporting the health needs of refugees. The thesis argues that holistic systems that address different levels of being and incorporate biomedical systems as well as complementary and alternative medicine systems (CAMs), such as yoga, massage and tai chi, will support the health needs of refugees in a culturally appropriate and effective way. The thesis finally presents recommendations of strategies for future policy and practice.

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Degenhardt, Louisa Psychology Faculty of Science UNSW. "Comorbidity between substance use and mental health in Australia: Relationships of alcohol, tobacco and cannabis use with other substance use and mental disorders." Awarded by:University of New South Wales. School of Psychology, 2001. http://handle.unsw.edu.au/1959.4/18247.

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Research into the comorbidity (or co-occurrence) of mental disorders is a relatively recent phenomenon. Much of this research has been conducted in clinical samples, which are prone to a range of biases that mean that the patterns observed are not representative of the general population. Although population-level research has previously been carried out, this thesis provides the first examination of comorbidity in the Australian population. This thesis examined the comorbidity of substance use and mental disorders among Australian adults. The major empirical work involved an examination of the patterns of homotypic comorbidity (other substance use disorders) and heterotypic comorbidity (mood disorders, anxiety disorders, and psychosis) of alcohol, tobacco and cannabis in the 1997 Australian National Survey of Mental Health and Well-Being (NSMHWB). These drugs were chosen as they are the most commonly used psychoactive substances in the Australian population. The NSMHWB involved a structured diagnostic interview of mental disorders with a representative sample of Australian adults. Three questions were addressed using this data: (1) What patterns of comorbidity exist between tobacco, alcohol and cannabis use, and other substance use and mental disorders?; (2) Are these patterns of comorbidity explained by common factors?; and (3) Does comorbidity affect the likelihood that mental health treatment has been sought? Similar patterns of homotypic comorbidity were observed for all three substances, and they were not explained by the other factors examined (gender, age, education, relationship status, employment and neuroticism). Cannabis dependence was the most strongly associated with other substance use disorders. Heterotypic comorbidity differed between alcohol, tobacco and cannabis use. Tobacco use predicted increased rates of all three groups of mental disorders (mood, anxiety and psychotic disorders). In the case of alcohol, only alcohol dependence was related to increased rates of all groups of mental disorders; alcohol use and abuse were not associated with heterotypic comorbidity. Any level of cannabis involvement was related to a similarly increased risk of mood and anxiety disorders. Cannabis use was linearly related to the risk of screening positively for psychosis. Common factors did not change the patterns of heterotypic comorbidity of tobacco and alcohol use. However, alcohol, tobacco and other drug use appeared to explain the higher rates of mood and anxiety disorders among cannabis users. Treatment seeking was much more likely among alcohol, tobacco and cannabis users when they had comorbid mental disorders. It was moderately increased when they had comorbid substance use disorders. The second piece of empirical work provided a more detailed examination of comorbid substance use problems among persons with psychosis. This topic was selected due to the limited epidemiological research on this issue, and the relatively large burden of disability that psychosis places upon the individual and the community. NSMHWB data were used to examine the prevalence of comorbid substance use disorders among persons who were likely to have met criteria for psychosis (as assessed by a screener used in the NSMHWB). Multiple regression analyses were used to test possible explanations for the higher rates of substance use disorders observed among persons reporting higher numbers of psychotic symptoms. The odds of alcohol dependence and regular tobacco use increased 1.5 times, and the odds of cannabis dependence increased twice, with each additional psychotic symptom reported, after adjusting for other substance use disorders, other mental disorders and demographic characteristics. Given the debate about the reasons for the association between cannabis use and psychosis, the final study used mathematical modelling to test four hypotheses about relationships between cannabis use and psychosis. Specifically, it examined trends in psychosis that would be predicted given the marked increases in the prevalence of cannabis use that have occurred in Australia over the past thirty years. The results suggested that a causal relationship - in which cannabis use caused psychosis among persons who would not otherwise have developed the disorder - is unlikely to explain the association. There was a better fit to the data provided by the other hypotheses examined, namely, that (a) cannabis use precipitates psychosis among vulnerable individuals; (b) cannabis use increases the risk of relapse among persons with psychosis; and (c) persons with psychosis are more likely to become regular cannabis users (without any effect upon the disorder). This thesis has demonstrated that in Australian adults there is significant comorbidity between alcohol, tobacco and cannabis use and other substance use and mental disorders. These patterns differ across the three substances. Some types of heterotypic comorbidity (e.g. between cannabis use and mood/anxiety disorders) are explained by common factors. The limited range of common factors tested here did not explain homotypic comorbidity. This thesis also suggested that mathematical modelling is a useful approach to consider when examining the plausibility of different relationships between risk factors and mental disorders. A number of hypotheses regarding comorbidity could not be tested using NSMHWB data, such as common genetic and other environmental factors. These can best be tested in research with samples of twins, and using longitudinal designs that assess a wide range of social and environmental factors. The findings of this thesis also have implications for treatment, because persons with comorbid disorders are more likely to seek treatment. There is an absence of validated treatments for persons with comorbid substance use and mental disorders, and more research is needed on this issue.

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Wyder, Marianne, University of Western Sydney, College of Social and Health Sciences, and School of Applied Social and Human Sciences. "Understanding deliberate self harm : an enquiry into attempted suicide." THESIS_CSHS_ASH_Wyder_M.xml, 2004. http://handle.uws.edu.au:8081/1959.7/644.

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This study focused on the quantitative and qualitative aspects of suicidal behaviour of 90 people who had come to the attention of the Accident and Emergency Department of Westmead Hospital, Sydney, N.S.W., after an attempt to harm themselves. The risk factors identified in the study were combined with the circumstances and motive of attempt. Participants were regrouped according to whether the problems the respondent described were chronic (longstanding) or acute (pivotal). The participants were further classified according to the persistence of thoughts of self-harm ( impulsive or non-impulsive/deliberate) and the presence or absence of these feelings at the time of the interview (the resolution of the attempt) and the types of problems/situations and triggering events the person described as wanting to escape. By developing strategies and treatments for the problems as they were identified in this study and by raising the awareness that there is help available for these different issues, we may be able to reduce the pain which results in an attempt to self harm.
Doctor of Philosophy (PhD)

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Maude, Phillip M. "The development of community mental health nursing services in Western Australia : A history (1950-1995) and population profile." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1996. https://ro.ecu.edu.au/theses/935.

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This descriptive• study discusses the development of community mental health (CMH) in Western Australia (WA) and describes the current practising population of CMH nurses. The study explores literature pertaining to the emergence of the CMH movement and the deinstitutionalisation of the mentally ill. A conceptual framework was developed by adapting Lewin's change theory. CMH nurses practising in WA (n= 130), were invited to participate in the study and were asked to complete a survey questionnaire. This resulted in a 66% response rate (n = 86). Quantitative data was analysed using the Statistical Package for the Social Sciences (SPSS). Open ended questions were analysed using Colaizzis steps. The study found that mental illness has been treated according to contemporary beliefs. In the 1950s multiple forces within society led to the movement away from institutionalisation of the mentally Ill toward deinstitutionalisation. The first community clinic was established in 1956 to manage the deficit between the ever expanding population needing mental health care and the paucity of available hospital beds. The need for follow up of clients in the community resulted in the development of CMH nursing. The study also provides a profile of the current practicing population of CMH Nurses in WA, demographic details, qualifications, the work environment, educational needs, work role and job satisfaction have been described. Recommendations have been developed from the findings and are directed towards, the dissemination of information, the need for role identification/development, staff development needs, future education needs, industrial issues, clinical practice issues and areas for further nursing research

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Monisse-Redman, Michael. "Using Maslow's hierarchy of needs to improve mental health service provision to high-risk youth : evaluation of the Peel Youth Counsellor Program." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2007. https://ro.ecu.edu.au/theses/254.

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This research focuses on the development, implementation, and evaluation of a youth counselling program with an innovative service delivery model influenced by Maslow's Hierarchy of Needs. The Peel Youth Counsellor Program (PYCP) is a promotion, prevention and early intervention program conceived as a result of an identified local need for a specialised program to work alongside mainstream mental health to provide services to youth aged 15 to 25 years. The PYCP began operation in January 2001 and is administered by the Peel Community Mental Health Service although is located fulltime in a community youth centre. The central service provision framework and understanding of youth engagement is based on youth friendly mental health services and Maslow's research into human motivation and its application to service delivery. The research outlines a comprehensive evaluation that was conducted using Austin's (1982) 'Objectives-Orientated' approach that uses a six step process to guide the implementation and analysis of what the program has achieved. The results suggest that the use of a community based youth counselling program adjunct to mainstream mental health, improves opportunities for promotion and prevention, and early (prodrama) intervention with a range of youth health and mental health issues, especially depression and suicide. With this information it is hoped that consideration will be made about current practice as well as the future development of mainstream mental health both giving priority to "youth" as an important entity in service provision.

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Fenton, Sarah-Jane Hannah. "Mental health service delivery for adolescents and young people : a comparative study between Australia and the UK." Thesis, University of Birmingham, 2016. http://etheses.bham.ac.uk//id/eprint/7111/.

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This thesis explores policy and service delivery for adolescent and young adult or ‘transition age’ mental health service users aged 16-25 across different jurisdictions in the UK and Australia. The study explores the implications that policy formulation and implementation have for service delivery in these different contextual settings; and examines how young people (who are at a vulnerable stage developmentally in terms of mental health), have their access to services affected by the existing policy framework. A policy analysis was conducted along with qualitative interviews in six case sites (three in the UK and three in Australia). The thesis adopted a critical realist approach using a laminated cross-sectional interview strategy that was developed to include interviews with national policy makers; local policy makers and service managers; staff working within services; and the young people whom were accessing services as the recipients of policy. Findings from this thesis explore how young people use risk escalation as a way of managing delays to treatment and how practitioners identify particular difficulties for young people transitioning in services when they are due to ‘step up’ into more acute services, or ‘step down’ to a less intensive service. The thesis explores the implications and unintended consequences for young people of policy including processes of ‘cost-shunting’ and ‘resource envy’ at local and national levels. Finally, the thesis offers some learning for systems working to support 16-25 year olds through demonstrating the importance of the dual role of ‘curing’ and ‘caring’ in mental health services.

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Finn, Michael P. "Perceptions of discharge planning needs : A study of discharge planning in the mental health setting." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1995. https://ro.ecu.edu.au/theses/1158.

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Major mental disorder, with prolonged periods of dysfunction that require long term care, is an issue of concern amongst mental health professionals. Although substantial effort and resources are devoted towards returning mentally ill individuals to the community, one of the most distinctive and consistent features of the persistently mentally ill (PMI) is their high rate of readmission to hospital. Existing studies into discharge planning revealed that no research had been undertaken to determine if this is the case in Western Australia. This study sought to investigate perceptions of discharge planning held by patients, carers, nurses and allied health workers involved in discharge preparation in a major metropolitan psychiatric hospital operated by the Health Department of Western Australia. Eighty one subjects were selected from the four principal groups involved in care in this mental health setting, consisting of patients ( n = 21 ), carers ( n = 20 ), nurses ( n = 22 ) and allied health workers ( n = 18 ). Perceptions of discharge planning of these subjects were evaluated and compared using the Discharge Priorities Rating Scale. Farran, Carr & Maxson's model of goal congruence in discharge planning was used to guide this study. Significant differences were found to exist in the perceptions of discharge planning between patients, carers, nurses and allied health workers. Differences in perceptions are seen to have a detrimental effect on the discharge planning process, resu1ting in unnecessary and frequent readmission to hospital and the perpetuation of institutional dependency. Whilst the results of this study can only be applied to similar institutions, the findings are relevant for the persistently mentally ill who have patterns of frequent readmissions across the public and private mental health service settings. The results obtained indicate that nurses can facilitate effective discharge planning practices by adopting a more assertive role in the hea1th care team, in communicating patients' and their carers' concerns and promoting a more collaborative approach to care.

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Mostafanejad, Karola. "Young adults' experience of living with a mental illness in rural Western Australia: a grounded theory approach." Thesis, Curtin University, 2005. http://hdl.handle.net/20.500.11937/79.

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It is estimated that one in five Australians are affected by a mental disorder, and the associated burden of living with a mental illness will become one of the greatest health care issues during the next 20 years. Since the 1960s, the care of people with mental disorders has been transferred to community settings including to rural areas of Australia through the process of deinstitutionalisation. However, research on young adults living with a mental illness in rural communities is limited, and the multidimensional experience of this group of young adults has not been previously explored. This study, guided by grounded theory methodology, explored young adults' experience of living with a mental illness in rural Western Australia. This thesis presents the findings of interviews with nine participants aged between 18 and 30 and places the findings within the context of relevant scientific literature. The constant comparative method used in grounded theory analysis identified that the basic social psychological problem experienced by all participants was "being shut out". The problem of being shut out consisted of two aspects: "being excluded" and "withdrawing from society". In order to manage the problem of being shut out, participants engaged in the basic social psychological process of "seeking normality". In seeking normality participants moved from a state of being shut out to one whereby they sought to take part in ordinary social activities taken for granted by other members of society. The process of seeking normality consisted of three phases: "floundering", "taking charge", and "moving forward. Phase one of the process occurred primarily in the period prior to experiencing a turning point, which changed the participants' willingness to take control of their life and to take effective steps in reducing their isolation.Participants' experience of being shut out was not related to the duration of their illness but to their experience of seeking normality and the three conditions identified as influencing that experience. The findings, while supporting existing scientific literature, also present a new insight into young adults' experience of living with a mental illness in rural Western Australia. The findings of this study highlight the importance of health professionals' understanding young adults' experience of being shut out and to incorporate the increased knowledge and understanding into their clinical practice. Finally, the findings have implications on public education, healthcare services and healthcare policy in relation to young adults living with a mental illness.

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Steel, Zachary Psychiatry Faculty of Medicine UNSW. "Mental disorder amongst people of Vietnamese background: prevalence, trauma and culture." Publisher:University of New South Wales. Psychiatry, 2008. http://handle.unsw.edu.au/1959.4/40888.

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The role that culture and trauma plays in shaping mental health outcomes continues to dominate debate in the field of transcultural and post-conflict mental health. The broad aim of this thesis is to investigate key issues relevant to these two factors in relation to the Vietnamese. A meta-analysis of international epidemiological research indicated that countries of North and South East Asia appear to manifest low rates of mental disorder compared to English-speaking countries. A meta-regression analysis of research undertaken specifically with refugee and conflict-affected populations, confirmed a robust association between torture and general trauma and risk to mental disorder. The thesis then examines data from three population-based mental health surveys: 1,161 Vietnamese-Australian residents in the state of New South Wales; 3,039 Vietnamese resident in the Mekong Delta region of Vietnam; and 7,961 Australian-born persons drawn from a national survey. All surveys applied the Composite International Diagnostic Interview, with the Vietnamese surveys also applying the Phan Vietnamese Psychiatric Rating Scale, an indigenously-derived measure of mental disorder. The ICD-10 classification system yielded lowest rates amongst Vietnamese in the Mekong Delta, intermediate amongst Vietnamese in NSW; and highest rates amongst the Australian-born population. The Phan Vietnamese Psychiatric Rating Scale added a substantial number of cases in both Vietnamese samples. The findings suggest that sole reliance on a western-derived measure of mental disorder may fail to identify a cases of mental disorder across cultures. Trauma remained a substantial risk factor for mental disorder amongst Australian Vietnamese accounting for a substantial portion of the total burden of mental disorder in that population. The implications of these findings in developing a more refined model for understanding the mental health consequences of mass trauma across cultures are discussed.

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Mostafanejad, Karola. "Young adults' experience of living with a mental illness in rural Western Australia : a grounded theory approach /." Curtin University of Technology, School of Nursing and Midwifery, 2005. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=16160.

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It is estimated that one in five Australians are affected by a mental disorder, and the associated burden of living with a mental illness will become one of the greatest health care issues during the next 20 years. Since the 1960s, the care of people with mental disorders has been transferred to community settings including to rural areas of Australia through the process of deinstitutionalisation. However, research on young adults living with a mental illness in rural communities is limited, and the multidimensional experience of this group of young adults has not been previously explored. This study, guided by grounded theory methodology, explored young adults' experience of living with a mental illness in rural Western Australia. This thesis presents the findings of interviews with nine participants aged between 18 and 30 and places the findings within the context of relevant scientific literature. The constant comparative method used in grounded theory analysis identified that the basic social psychological problem experienced by all participants was "being shut out". The problem of being shut out consisted of two aspects: "being excluded" and "withdrawing from society". In order to manage the problem of being shut out, participants engaged in the basic social psychological process of "seeking normality". In seeking normality participants moved from a state of being shut out to one whereby they sought to take part in ordinary social activities taken for granted by other members of society. The process of seeking normality consisted of three phases: "floundering", "taking charge", and "moving forward. Phase one of the process occurred primarily in the period prior to experiencing a turning point, which changed the participants' willingness to take control of their life and to take effective steps in reducing their isolation.
Participants' experience of being shut out was not related to the duration of their illness but to their experience of seeking normality and the three conditions identified as influencing that experience. The findings, while supporting existing scientific literature, also present a new insight into young adults' experience of living with a mental illness in rural Western Australia. The findings of this study highlight the importance of health professionals' understanding young adults' experience of being shut out and to incorporate the increased knowledge and understanding into their clinical practice. Finally, the findings have implications on public education, healthcare services and healthcare policy in relation to young adults living with a mental illness.

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Lake, Rosalind. "Discrimination against people with mental health problems in the workplace : a comparative analysis." Thesis, Rhodes University, 2006. http://hdl.handle.net/10962/d1005712.

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For a long time the rights of disabled persons have been ignored worldwide. A major obstacle faced by disabled persons is discrimination in the workplace. Due to the development of a social approach to disability and the efforts of the Disability Rights Movement, legislation has been passed throughout the world to improve this dire situation. The thesis considers the efficacy of some of these statutes. It is concluded that stigma and negative stereotypes remain a constant hurdle in overcoming discrimination. The forthcoming UN Disability Convention is demonstrative of the recognition of the importance of the needs and rights of disabled people. The convention proposes some innovative measures to overcome stigma and stereotyping. Mental health problems constitute one of the leading causes of disability. The thesis explores how people with mental health problems fit within the concept of people with disabilities and whether they are included in anti-discrimination legislation and affirmative action measures. Special attention is given to statutory definitions of disability, the different forms of discrimination and the concept of reasonable accommodation. A comparative approach is taken to analyse how South Africa's disability law measures up against that of Britain and Australia in terms of its substantive provisions and enforcement thereof. In considering the South African position American and Canadian jurisprudence is consulted in order to aid in interpretation. It is concluded that although South Africa has a comparatively good legislative framework, it is held back by an overly restrictive and medically focused definition of disability. As a result many individuals with mental health difficulties, desirous of obtaining and retaining employment may be excluded from protection against discrimination in the workplace. It is argued that it will be necessary either to amend the Employment Equity Act or for the courts to adhere strictly to the concept of substantive equality in order to ensure that the rights and dignity of people with mental health difficulties are adequately protected.

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Sonderegger, Robi, and n/a. "Patterns of Cultural Adjustment Among Young Former-Yugoslavian and Chinese Migrants To Australia." Griffith University. School of Applied Psychology, 2003. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20030918.153743.

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Australia is a culturally diverse country with many migrant and refugee families in need of mental health services. Yet, surveys indicate that many culturally diverse community members do not feel comfortable in accessing mental health services, often due to a limited understanding of current western practices and the lack of practitioner cultural sensitivity. Despite the apparent need, few investigations have been conducted with migrant families to understand their different values and needs, and identify how they adjust to a new culture. The paucity of empirical research is largely due to the number of variables associated with the process of cultural change, and the fact that culture itself may lend different meaning to symptom experience, and the expression thereof. Moreover, because migrant adaptation is a complex and multifaceted phenomenon, it is often rendered difficult to investigate. Cultural groups have been observed to exhibit differences in the pathogenesis and expressions of psychological adjustment, thus making culturally sensitive assessment a particularly arduous yet important task. Although the number of studies conducted on cultural adaptation trends of adult migrants is growing, few investigations have examined the acculturation experiences of children and adolescents. Moreover, the link between acculturation and mental health has confounded researchers and practitioners alike. Considering assessment procedures largely influence therapeutic strategies, it is deemed essential that Australian health care professionals understand language, behavioural, and motivational differences between ethnic groups. In response to appeals for empirical data on culture-specific differences and developmental pathways of emotional resiliency and psychopathology, the present research program examines the complex interplay between situational factors and internal processes that contribute to mental health among young migrants and refugees. The research focuses particularly on anxiety, which is not only the most common form of childhood psychopathology but also frequently coincides with stressful life events such as cultural relocation. Two hundred and seventy-three primary and high school students (comprised of former-Yugoslavian and Chinese cultural groups) participated in this research program. Primary (n=131) and high school (n=142) students completed self-report measures of acculturation, internalising symptoms, social support, self-concept/esteem, ethnic identity, and future outlook, and were compared by cultural group, heterogenic ethnicity, school level, gender, and residential duration variables. Specifically, Study 1 aimed to map the cultural adjustment patterns of migrant youth so as to determine both situational and internal process risk and protective factors of emotional distress. The main findings from Study 1 indicate: (1) patterns of cultural adjustment differ for children and adolescents according to cultural background, gender, age, and length of stay in the host culture; (2) former-Yugoslavian migrants generally report greater identification and involvement with Australian cultural norms than Chinese migrant youth; and (3) the divergent variables social support and bicultural adjustment are not universally paired with acculturative stress, as previously indicated in other adult migrant and acculturation studies. These outcomes highlight the importance of addressing the emotional and psychological needs of young migrants from unique age-relevant cultural perspectives. Building on these outcomes, the aim of Study 2 was to propose an organisational structure for a number of single risk factors that have been linked to acculturative stress in young migrants. In recognising that divergent situational characteristics (e.g., school level, gender, residential duration in Australia, social support, and cultural predisposition) are selectively paired with internal processing characteristics (e.g., emotional stability, self-worth/acceptance, acculturation/identity, and future outlook), a top-down path model of acculturative stress for children and adolescents of Chinese and former-Yugoslavian backgrounds was proposed and tested. To determine goodness of model fit, path analysis was employed. Specific cross-cultural profiles, application for the proposed age and culture sensitive models, and research considerations are discussed.

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Phan, Tina. "Breathing New Life: Investigating ways to improve the mental health of people living with chronic obstructive pulmonary disease in Western Australia." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2018. https://ro.ecu.edu.au/theses/2071.

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Anxiety and depression are common comorbidities in people with chronic obstructive pulmonary disease (COPD), contributing to greater morbidity and mortality in an already vulnerable population. Despite the prevalence, few recommendations exist in global management guidelines for the detection and treatment of these comorbidities, reflecting the limited literature available on effective strategies for dealing with mental health issues in COPD populations. There is promising evidence that cognitive behavioural therapy (CBT) improves mental health outcomes in people with COPD. However, investigational studies have commonly reported participants’ lack of transport, lack of time and illness as barriers to recruitment and successful completion. This thesis was undertaken in response to a need identified in the literature for an alternative modality of CBT delivery for people with COPD suffering from psychological symptomatology. Thus, a novel home-based self-management CBT learning resource in a DVD format was developed with an accompanying manual. To investigate the primary aim of this thesis, a randomised controlled trial called the ‘Breathing New Life’ study was conducted to determine the efficacy of CBT to treat anxiety and depression in people living with COPD via two formats: group therapy with a reduced number of sessions or this novel home-based self-management DVD resource, compared to usual care. The secondary aim was to investigate the efficacy of these interventions on improvement in health-related quality of life (HRQoL). This thesis is presented as a series of papers (i.e. PhD with publication) from data collected from the Breathing New Life study (ACTRN12616001039471). Study One investigates the risk factors associated with concomitant anxiety and depression and found younger age and having no previous psychological medical history were risk factors for psychological symptomatology compared to those without psychological symptomatology. Study Two investigates the most suitable screening tool for detecting clinically significant anxiety and depression in COPD populations and found simple modifications to the commonly used Hospital Anxiety and Depression Scale (HADS) improved optimal sensitivity and specificity, whilst the Beck Inventories had acceptable sensitivity and specificity without any modifications. Study Three reports the results from the randomised controlled trial investigating the efficacy of CBT delivered in the two different formats. No significant differences over time between those receiving CBT and usual care for anxiety, depression or HRQoL were found in this COPD cohort. However, opinions of benefit expressed in Study Four—a qualitative investigation into the facilitators and barriers COPD participants face when enrolling and completing CBT—provide support that this population find CBT useful, despite being unable to detect any measureable difference. Globally, this thesis adds new knowledge to the body of literature supporting the importance of early screening and treatment for psychological symptomology in people living with COPD. Despite the inability of CBT to improve anxiety and depression, findings from this thesis have important implications towards industry discussion surrounding routine screening for concomitant anxiety and depression, the continued use of the HADS and Beck Inventories as appropriate screening tools in COPD populations and how best to engage and retain COPD participants in CBT.

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Thielking, Monica, and n/a. "An investigation of attitudes towardss the practice of school-based psychological services." Swinburne University of Technology, 2006. http://adt.lib.swin.edu.au./public/adt-VSWT20060814.091430.

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The provision of school based psychological services in Victorian primary and secondary schools dates back to well before the Second World War. Since then, however, the activities that make up the role of school psychologists have changed substantially. School psychologists' roles have become more varied than the original psychometric focus and reflect a more systemic approach to the conceptualization of student problems. Within Australia, school psychologists can be found servicing single or multiple schools in the government, independent and Catholic school sectors, fulfilling a range of functions and dealing with a diversity of student issues. However, Australian academic research into the professional practice issues associated with the provision of school-based psychological services is rare. Therefore, this thesis sought to investigate a range of professional issues associated with the provision of school-based psychological services for Victorian school psychologists working in single and multiple schools in the government and non-government primary and secondary school sectors. In addition to surveying Victorian school psychologists, principals and teachers were also surveyed in order to ascertain their attitudes towards school-based psychological services. The sample consisted of 81 school psychologists, 21 principals and 86 teachers. The results revealed that school psychologists participate in a variety of activities, including a number of activities that reflect a systemic model of service delivery. They also deal with a broad range of student issues, some of which are quite serious in nature. However, the study also revealed a number of professional issues that were in need of improvement. Some of these included a lack of participation in regular supervision for school psychologists, school psychologists' dissatisfaction with some industrial and professional conditions associated with their role and differences in attitudes between psychologists, principals and teachers regarding the activities and responsibilities of school psychologists. Results from the study provide plausible evidence for the need to support school psychologists in the valuable work that they do within schools through improved industrial conditions, appropriate professional development, and regular supervision. Furthermore the results also reveal a need to educate and participate in dialogue with the educational community in order to increase understanding of school psychologists' roles and professional responsibilities.

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Ibell, Bernadette Mary. "An analysis of mental health care in Australia from a social justice and human rights perspective, with special reference to the influences of England and the United States of America, 1800-2004." Phd thesis, Australian Catholic University, 2004. https://acuresearchbank.acu.edu.au/download/08cd80266073cee2195a33e254f4a9298144ba8d6f3a2eece63325aee6b2021c/3481468/64925_downloaded_stream_150.pdf.

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The aim of this thesis is to analyze mental health care in Australia from a social justice and human rights perspective, in order to demonstrate that social justice as a philosophical manifestation of justice and fairness, is an essential ingredient in the theory and practice of mental health care. It is contended that the needs of the mentally ill would be most appropriately answered by the utilization of a Natural Law model, based on Finnis's Natural Law theory. The Scope of the Thesis.The needs and care of the mentally ill are discussed, together with the treatment meted out to these vulnerable members of society since, approximately, the year 1800. Neither the criminally insane, nor the intellectually disabled are included in this discourse. Each group of people merits a thesis on its own: criminal insanity requires a debate to include the history, psychiatric and legal approaches to the subject, and current management of the insane. The intellectually disabled are not mentally ill; their ability to function as all round, naturally competent individuals is diminished by an inadequacy and/or impairment of their intellectual capacities. The needs of these two groups are far too broad and demanding to be included within the current thesis. Rationale for the Timeframe The timeframe, 1800 until 2004, has been established because it approximates to the transition from the end of the Classical through the Modern Age to the Post Modern Age, together with the predominance of Enlightenment philosophical theories, and the development of a scientific approach to medicine. Further, many politico-economic and social changes were taking place, associated with the Industrial Revolution. All are shown to have affected the introduction of asylumdom, and the institutionalization of those unable to participate actively in the industrial workforce.;Of significant importance to the development of institutionalization for such marginal groups is the philosophy of Jeremy Bentham. Bentham espoused Classical Utilitarianism which will be shown to believe that the ultimate standard of utility is not the individual's happiness but the greatest amount of happiness altogether. The thesis will demonstrate that this philosophical view prevailed from the beginning of the Industrial Revolution, with Benthamism influencing the sequestration of the unemployable into institutional life. Development of the Thesis.The thesis is developed against a background of prevailing philosophical, and other changes as stated above, including the medicalization of mental illness and the development of psychiatry as a branch of medicine. There is manifestation of many social injustices to those incarcerated in the asylum in all three countries under consideration: England, USA, and Australia. It is demonstrated that social justice and human rights of their work forces were disregarded by many employers at the time of the Industrial Revolution. Such values were, therefore, unlikely to prevail with regard to the mentally ill. Asylumdom continued with few changes in its practices until after World War II. It is shown that the predominance of post Enlightenment theories, together with further politico-economic, social and pharmaceutical revolutionary change followed the Second World War. Encouraged also by the founding of the United Nations and World Health Organizations as well as provision of the Declaration of Human Rights, circumstances led to the process of de-institutionalization of the mentally ill. The latter were decanted with apparently unseemly haste into a community ill prepared for such a change, and with little evidence of infra- structure to support the move. Need to conduct a National Inquiry. There was, then, a need to investigate what was now an overt issue of mental health care.;The two subsequent inquiries by the Australian Health Ministers Advisory Council, (AHMAC) and the Burdekin Report, both focused on social justice issues, and addressed epidemiological, economic, sociological and justice considerations. Within the thesis, both investigations are critiqued against a Natural Law model, using Finnis's Natural Law theory. It is demonstrated that contrary to Enlightenment principles of social justice as described by Miller, such a theory is eminently practical, and answers the needs of all members of the community, providing not merely 'the greatest happiness for the greatest number' but the common good of all Conclusion. Evidence shows that such a Natural Law theory is required to give a firm foundation to the needs of the mentally ill, especially at a time when relativism, economic rationalism and negative aspects of globalization prevail. Without such a basis the mentally ill are left insecure, uncertain and adrift in a world uncaring of their plight, while all the earnest exhortations espoused by Reports remain platitudes, subject to the whims of whatever government is in power. Our responsibilities to all our fellow human beings demand better from us than this.

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Ziaian, Tahereh. "The psychological effects of migration on Persian women immigrants in Australia /." Title page, contents and abstract only, 2000. http://web4.library.adelaide.edu.au/theses/09PH/09phz64.pdf.

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Ibell, Bernadette Mary, and res cand@acu edu au. "An Analysis of Mental Health Care in Australia From a Social Justice and Human Rights Perspective, With Special Reference to the Influences of England and the United States of America: 1800-2004." Australian Catholic University. School of Philosophy, 2004. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp113.25102006.

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The aim of this thesis is to analyze mental health care in Australia from a social justice and human rights perspective, in order to demonstrate that social justice as a philosophical manifestation of justice and fairness, is an essential ingredient in the theory and practice of mental health care. It is contended that the needs of the mentally ill would be most appropriately answered by the utilization of a Natural Law model, based on Finnis’s Natural Law theory. The Scope of the Thesis.The needs and care of the mentally ill are discussed, together with the treatment meted out to these vulnerable members of society since, approximately, the year 1800. Neither the criminally insane, nor the intellectually disabled are included in this discourse. Each group of people merits a thesis on its own: criminal insanity requires a debate to include the history, psychiatric and legal approaches to the subject, and current management of the insane. The intellectually disabled are not mentally ill; their ability to function as all round, naturally competent individuals is diminished by an inadequacy and/or impairment of their intellectual capacities. The needs of these two groups are far too broad and demanding to be included within the current thesis. Rationale for the Timeframe The timeframe, 1800 until 2004, has been established because it approximates to the transition from the end of the Classical through the Modern Age to the Post Modern Age, together with the predominance of Enlightenment philosophical theories, and the development of a scientific approach to medicine. Further, many politico-economic and social changes were taking place, associated with the Industrial Revolution. All are shown to have affected the introduction of asylumdom, and the institutionalization of those unable to participate actively in the industrial workforce. Of significant importance to the development of institutionalization for such marginal groups is the philosophy of Jeremy Bentham. Bentham espoused Classical Utilitarianism which will be shown to believe that the ultimate standard of utility is not the individual’s happiness but the greatest amount of happiness altogether. The thesis will demonstrate that this philosophical view prevailed from the beginning of the Industrial Revolution, with Benthamism influencing the sequestration of the unemployable into institutional life. Development of the Thesis.The thesis is developed against a background of prevailing philosophical, and other changes as stated above, including the medicalization of mental illness and the development of psychiatry as a branch of medicine. There is manifestation of many social injustices to those incarcerated in the asylum in all three countries under consideration: England, USA, and Australia. It is demonstrated that social justice and human rights of their work forces were disregarded by many employers at the time of the Industrial Revolution. Such values were, therefore, unlikely to prevail with regard to the mentally ill. Asylumdom continued with few changes in its practices until after World War II. It is shown that the predominance of post Enlightenment theories, together with further politico-economic, social and pharmaceutical revolutionary change followed the Second World War. Encouraged also by the founding of the United Nations and World Health Organizations as well as provision of the Declaration of Human Rights, circumstances led to the process of de-institutionalization of the mentally ill. The latter were decanted with apparently unseemly haste into a community ill prepared for such a change, and with little evidence of infra- structure to support the move. Need to conduct a National Inquiry. There was, then, a need to investigate what was now an overt issue of mental health care. The two subsequent inquiries by the Australian Health Ministers Advisory Council, (AHMAC) and the Burdekin Report, both focused on social justice issues, and addressed epidemiological, economic, sociological and justice considerations. Within the thesis, both investigations are critiqued against a Natural Law model, using Finnis’s Natural Law theory. It is demonstrated that contrary to Enlightenment principles of social justice as described by Miller, such a theory is eminently practical, and answers the needs of all members of the community, providing not merely ‘the greatest happiness for the greatest number’ but the common good of all Conclusion. Evidence shows that such a Natural Law theory is required to give a firm foundation to the needs of the mentally ill, especially at a time when relativism, economic rationalism and negative aspects of globalization prevail. Without such a basis the mentally ill are left insecure, uncertain and adrift in a world uncaring of their plight, while all the earnest exhortations espoused by Reports remain platitudes, subject to the whims of whatever government is in power. Our responsibilities to all our fellow human beings demand better from us than this.

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Howrie, Paul. "How general practitioners and aged care workers perceive incidences of elder abuse." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2000. https://ro.ecu.edu.au/theses/1351.

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As the Australian population is expanding and ageing, there is an associated need for a focus to be placed on the Individual rights of elderly people, and for the general populus to be made more aware of areas related to our older generation. Elder abuse, as an area of concern, developed as an offshoot of investigations into child abuse and general domestic violence, and initially surfaced in the 1970s and 80s. Some sections of the medical profession were made specifically aware of the problem initially in 1975, through a letter that was sent to the British Medical Journal. However, throughout some of the literature, GPs have been criticised about their level of awareness of the issue of elder abuse, and for their lack of involvement in this area. The purpose of this study was to explore how General Practitioners and Aged Care workers perceive incidences of elder abuse. Due to the limited amount of research which has been undertaken on elder abuse within Australia, the study looked at exploring the issue rather than trying to measure its cause, or trying to identify the extent of the problem. The study investigated the perceptions of general practitioners (GPs) toward the area of elder abuse, and looked further to explore how general practitioners were perceived by aged care workers. The approach used for data collection consisted of circulating 100 mailed out questionnaires to general practitioners within metropolitan Perth, and follow up face-to-face interviews with some of the respondents to this questionnaire. Additionally, face-to-face interviews were also held with key informants who worked in the aged care industry, to ascertain their perceptions of elder abuse. The mailed questionnaires were analysed by adding the frequencies of responses given to each question. The data from the face-to-face doctor interviews and the key informant interviews were transcribed verbatim from the tape recordings and then assessed by looking for consistent regularities from each response made, therefore using a cross-case analysis. From this analysis, patterns emerged in the data, from which themes were developed. The recommendations from the data suggest that a clear and concise definition of elder abuse needs to be developed, to assist in clearly Identifying the prevalence of the problem. The data further recommended the need for an awareness campaign on the area of elder abuse to be undertaken. This should focus on raising the awareness of the possible characteristics of individuals who are vulnerable to being abused, as well as the characteristics of likely perpetrators of abuse. This study also recommended that a coordinated approach to dealing with the area of elder abuse should be developed, which should include the development of specific roles that should be undertaken by professional and non-professionals. Training of people across the Human Services field in the area of elder abuse, and in particular, GPs, social workers and paraprofessionals who work with elderly people, was identified as a recommendation of the study. Areas of training should include: awareness of the problem's existence; providing people with the required skills to detect cases of abuse; providing insight to referral agencies who may be able to assist; having a clear and exhaustive list of interventions to use to assist with addressing the problem; and having knowledge of the characteristics that abused individuals, and perpetrators are likely to have. This study also Identified that more research is required to ascertain if the amount of time which GPs spend with elderly people, is sufficient for them to identify cases of elder abuse, and if the allocated time from Medicare is adequate for GPs to Identify elder abuse.

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Melis, Miriam J. "A formative study to develop and test a health promotion strategy for adolescents who experience grief." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2006. https://ro.ecu.edu.au/theses/354.

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The purpose of this research was to develop and test a health promotion intervention designed to minimise unhealthy adolescent grief reactions. A sample of Western Australian adolescents were consulted to identify their perceptions regarding the causes of grief for adolescents, the means by which they manage grief, their perceptions of what constitutes healthy and unhealthy grieving, and the risks associated with unhealthy grieving and the type of grief-management intervention they preferred.

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Munro, Louise Ellen. "The development and evaluation of a culturally affirmative counselling model for deaf clients in Australia." Thesis, Queensland University of Technology, 2010. https://eprints.qut.edu.au/46997/1/Louise_Munro_Thesis.pdf.

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In Australia, there is only one, newly established, dedicated mental health service catering specifically for the signing *Deaf community. It is staffed by four part-time hearing professionals and based in Brisbane. There are currently no Deaf psychologists or psychiatrists and there is no valid or reliable empirical evidence on outcomes for Deaf people accessing specialised or mainstream mental health services. Further compounding these issues, is the fact that there are no sign language versions of the most common standardised mental health or psychological instruments available to clinicians in Australia. Contemporary counselling literature is acknowledging the role of the therapeutic alliance and the impact of 'common factors' on therapeutic outcomes. However, these issues are complicated by the relationship between the Deaf client and the hearing therapist being a cross-cultural exchange. The disability model of deafness is contentious and few professionals in Australia have the requisite knowledge and understanding of deafness from a cultural perspective to attend to the therapeutic relationship with this in mind. Consequently, Deaf people are severely disadvantaged by the current lack of services, resources and skilled professionals in the field of deafness and psychology in this country. The primary aim of the following program of research has been to propose a model for culturally affirmative service delivery and to provide clinicians with tools to evaluate the effect of their therapeutic work with Deaf people seeking mental health treatment. The research document is presented as a thesis by publication and comprises four specific objectives formulated in response to the lack of existing services and resources. The first objective was to explore the use of social constructionist counselling techniques and a reflecting team with Deaf clients, hearing therapists and an interpreter. Following the establishment of a pilot counselling clinic, indepth semi-structured interviews were conducted with two long-term clients following the one year pilot of this service. These interviews generated recommendations for the development of a new 'enriched' model of counselling to be implemented and evaluated in later stages of the research program. The second objective was to identify appropriate psychometric measures that could be translated into Australian Sign Language (Auslan) for research into efficacy, effectiveness and counselling outcomes. Two instruments were identified as potentially suitable; the Outcome Rating Scale (ORS), a measure of global functioning, and the Session Rating Scale (SRS), a measure of therapeutic alliance. A specialised team of bi-lingual and bi-cultural interpreters, native signers and the primary researcher for this thesis, produced the ORS-Auslan and the SRS-Auslan in DVD format, using the translation and back-translation process. The third objective was to establish the validity and reliability of these new Auslan measures based on normative data from the Deaf community. Data from the ORS-Auslan was collected from one clinical and one non-clinical sample of Deaf people. Statistical analyses revealed that the ORS-Auslan is reliable, valid and adequately distinguishes between clinical and non-clinical presentations. Furthermore, construct validity has been established using a yet to be validated sign language version of the Depression, Anxiety and Stress Scale-21 items (DASS-21), providing a platform for further research using the DASS-21 with Deaf people. The fourth objective was to evaluate counselling outcomes following the implementation of an enriched counselling service, based on the findings generated by the first objective, and using the newly translated Auslan measures. A second university counselling clinic was established and implemented over the course of one year. Practice-based evidence guided the research and the ORS-Auslan and the SRS-Auslan were administered at every session and provided outcome data on Deaf clients' global functioning. Data from six clients over the course of ten months indicated that this culturally affirmative model was an effective approach for these six clients. This is the first time that outcome data have been collected in Australia using valid and reliable Auslan measures to establish preliminary evidence for the effectiveness of any therapeutic intervention for clinical work with adult, signing Deaf clients. The research generated by this thesis contributes theoretical knowledge, professional development and practical resources that can be used by a variety of mental health clinicians in the context of mental health service delivery to Deaf clients in Australia.

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Penrose-Wall, Jonine Public Health &amp Community Medicine Faculty of Medicine UNSW. "Evaluating five models of dissemination of NHMRC 'Guideline depression in young people for GP's' through divisions of general practice." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2003. http://handle.unsw.edu.au/1959.4/20445.

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Background: Dissemination of evidence-based mental health clinical practice guidelines had not been studied in Australia prior to the National General Practice Guideline Implementation Program. This naturalistic research reports ten national interventions designed to disseminate the NHMRC 1997 Clinical Practice Guideline Depression in Young People for GPs (GDIYP-GP) through 123 Divisions of General Practice. The guideline covered depression and suicide in young people aged 13 to 20 years. Aim: To evaluate a 'coordinated link agent' and 'enhanced packaged approach' for disseminating a national guideline by engaging 20 Divisions in using 5 dissemination models and to measure Divisions' capacities in performing unfunded local dissemination to GPs. Method: An Implementation Kit was the main national intervention, housing the guidelines and 5 models: Education by the Division; Education by an external provider; 3) Clinical Audit; 4) Segmented Formats and 5) Appraisal. Five studies are reported: 1) an organisational census on guideline-related practices in all topics; 2) a Case Study Database of 3 consecutive interviews of 51 participating Divisions; 3) a Guideline Appraisal study of 9 cohorts of doctors; 4) a Clinical Audit study of 54 doctors involving 1200 patients; and 5) a 'Segmented Formats' documentary analysis of Division communications on GDIYP-GP. Results: Prior dissemination by most Divisions was administrative mail outs rather than planned programs. In all, 70 instead of the pilot 20 organisations participated (57% of the sector) using 10,000 guidelines: 45 participated by 7 weeks and 71 by 35 weeks and the majority used multiple active strategies showing fidelity to the Kit. Education by the Division, Segmented Formats and Appraisal were the most adopted models. GDIYP-GP was acceptable and relevant to the majority of Divisions and to 9 samples of doctors. Conclusion: Divisions are one appropriate system through which evidence-based mental health guidelines can be disseminated to general practitioners. Uptake can be rapid using a flexible enhanced package approach with link-agent support. 3-6 months is needed for organisations to begin effective interventions. Divisions reorient their approach with guidance toward evidence-based dissemination but Division and practice barriers

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Kendall, Garth Edward. "Children in families in communities : a modified conceptual framework and an analytic strategy for identifying patterns of factors associated with developmental health outcomes in childhood." University of Western Australia. School of Paediatrics and Child Health, 2003. http://theses.library.uwa.edu.au/adt-WU2004.0006.

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Mental health reflects an array of causal influences that span biological, psychological, and social circumstances, with resultant underlying causal pathways to poor mental health outcomes in childhood that are complex. Key features of this complexity are reciprocal interactions between person and environment that take place over time. The core of this thesis seeks to attend to the complexity of development to move the field of developmental health forward toward greater explanation, and more successful prediction and prevention. The focal point of the thesis is the psychosocial determinants of childhood mental health, the resource domain of the developing child, and the interplay between characteristics of the individual child, the family, and the community. The eventual goal is to better understand why and how socioeconomic circumstances impact on developmental health. One component of this thesis focuses on the expansion of extant developmental theory. The other component focuses on the development of an analytic strategy that more appropriately reflects the intricacies of this theoretical expansion. In the process, data are analysed, principally as a heuristic strategy, to illustrate the analytical approach needed to support the theoretical framework. The specification of a bioecological conceptual framework suitable to guide research and policy in developmental health is the first principal objective of the thesis. A critical examination of the resource framework proposed by Brooks-Gunn, Brown, Duncan, and Anderson Moore (1995) reveals it to be centred on family and community resources, but otherwise silent with respect to the physical and psychological resources of the child. The quintessential point of this thesis is that theory in developmental health must be able to account for the contribution individuals make to their own development. A modified resource framework is proposed that acknowledges financial, physical, human, and social capital, within the domains of the individual child, the family, and the community. The second principal objective of the thesis, the development of analytical methods that focus on the individual child and the complexity of data generated by this theoretical approach, is then introduced. Theory and method are thus integrated when comprehensive measures of characteristics in multiple domains across developmental periods are modeled using longitudinal data from the Western Australian Pregnancy Cohort (Raine) Study (Newnham, Evans, Michael, Stanley, & Landau, 1993). The mothers of 2,860 children were enrolled at 18 weeks in pregnancy and the children have been followed at birth, one, two, three, five, and eight years of age. Eighty-nine per cent (2,537 /2,860) of families were available for follow-up at eight and 74 per cent (2,126/2,860) of families responded. Extensive demographic, psychological, and developmental data were available for the children and their families and a limited amount of data were available for the communities in which they reside. A measure of mental health morbidity, the Child Behaviour Checklist (Achenbach, 1991), was available for the children at two, five, and eight years of age. In the first instance, dichotomous summary variables are derived for the demographic, psychological, and developmental variables of interest. Variables are then selected for inclusion in one of several explanatory models. To create a mathematical representation of resource characteristics, the information for each child is concatenated as a series of binary strings. Frequency tabulation is then used to aggregate the data and odds ratios are calculated to determine the degree of risk associated with each string of code, or pattern of factors relative to a nominated mental health outcome. The results provided a scaffold from which this theoretical and analytical approach is compared and contrasted with the reviewed literature. Two principal themes of investigation are pursued. The first theme to be examined is the interplay between characteristics of the child, family, and community and the contribution children make to their own development. The specific approach models the interaction between selected characteristics of the child, family and community in each of four developmentally significant time periods. The theoretical position adopted in the present study suggests that the effect of any personal or contextual factor on later development, if a relationship does truly exist, is most likely to be differential. That is, it is a combination of influences that determines developmental outcomes for children, not any single factor acting independently. The modelling process demonstrates that, for the children involved, personal and contextual factors impact mental health differentially depending on various other individual, family and/or community characteristics. The modelling process identifies patterns of factors that impact relatively small, but significant, numbers of children because the models focus on the effect for individual children rather than the effect for the group. For example, one model suggests that the effect of intra-uterine growth restriction for the group as a whole may be minimal, but the impact for some children could be critical depending on the combination of family and community influences, such as the mothers level of education, the family’s experience of significant life stress, and residence in a relatively disadvantaged community. The second theme to be examined is the possibility that the accumulation of resource deficits or risk characteristics, over time, amplifies the likelihood of mental health problems in childhood. The approach models selected characteristics of the child in each of the four periods of development collectively, and it also models selected characteristics spanning each of the four time periods discretely. The results suggest that latency, pathway, and recency effects may operate simultaneously, and that timing and accumulated burden may both be important determinants of risk. For example, with regard to children whose family experienced life stress, these three effects operated in a systematic way to increase the degree of risk of a mental health problem. In summary, the aggregation of data at the individual level is a productive approach in seeking to explain population level social phenomena. While seemingly paradoxical, the identification of the joint, interactive effects between individual, family, and community characteristics, better allows for the quantification of family and community characteristics operating through multiple causal pathways.

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Holmes, Lisa. "Exploring the preparedness of novice (student) paramedics for the mental health challenges of the paramedic profession: Using the wisdom of the Elders." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2018. https://ro.ecu.edu.au/theses/2102.

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This study investigates the preparedness of novice (student) paramedics for the mental health challenges of the paramedic profession and identifies the coping strategies used by veteran paramedics to successfully meet these challenges. The lived experience of veteran paramedics is utilised to provide this important assistance. Initially, two surveys were developed and administered to 16 course coordinators and 302 students of the 16 accredited undergraduate degree paramedicine courses across Australia and New Zealand, to identify the perceived need (for preparation) within the curriculum. In addition, the anticipations, confidence and fears of novice (student) paramedics, course coordinators and veteran paramedics were also collected as a means to facilitate the preparedness through self-evaluation, reflection and discussion. Twenty semi-structured interviews with veteran paramedics, each with a minimum 15 years paramedic experience from across Australia and New Zealand, were conducted to gain an understanding of their experiences, mental health coping strategies and advice for novice (student) paramedics. Results from the interviews were validated by three focus groups comprised of six veteran paramedics each, representative of the geographic spread. All 16 course coordinators and 302 novice (student) paramedics responded to the surveys. Results suggest there is widespread recognition for the need to include preparation for the mental health challenges of the profession within accredited undergraduate paramedic courses with 100% of course coordinators and 97% of students recognising this need. The semi-structured interviews with veteran paramedics provided valuable insights into the experiences and strategies used to aid the survival of the veterans throughout their careers. Within the interviews 70% of participants expressed a sincere love for theparamedic role, and 70% identified black humour as the coping strategy most used by themselves and colleagues. In addition, extensive advice was given to novice (student) paramedics based on the veterans lived experiences. This advice focused comprised of three themes; support, health and the profession. The findings of the study indicate that the preparation of novice (student) paramedics for the mental health challenges of the paramedic profession throughout the undergraduate curriculum could be advantageous. By utilising the relatable data collected on the anticipation, confidence and fears of novices, course coordinators and veterans, the advice offered by the veteran paramedics can be included within undergraduate paramedic curricula and delivered by sharing the lived experiences of the veteran paramedics. These lived experiences are highly credible and an opportunity for veterans to contribute positively to the future of paramedicine. Guidelines for their inclusion to the paramedic curriculum have been prepared to facilitate the knowledge and commence the development of conscious coping strategies by novice (student) paramedics during their learning phase.

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Lynd-Stevenson, Robert MacKay. "Employment status and emotional health." Phd thesis, 1991. http://hdl.handle.net/1885/120831.

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Social psychologists have consistently reported that the unemployed are lower in emotional health than the employed, but have failed to explore the processes associated with unemployment that generate the differences in emotional health between the employed and unemployed groups. Moreover, the emotional impact of unemployment is not uniform, and satisfactory explanations for the individual variation in responses have not been developed. The present study was designed to overcome the absence of process explanations in the unemployment literature by developing social theory in a causal-process form that accounts for the detrimental and differential impact of unemployment. Two strategies were used: first, a causal modelling approach to evaluate causal-process explanations; second, a social cognition perspective in the form of learned-helplessness and frustrated-motivation theory to specify the processes that generate emotional health. A cross-sectional study with 200 young unemployed people was conducted to investigate the impact of unemployment upon emotional health. The data recorded the differences between individuals at one point-in-time and provided the foundation for a causal analysis of interindividual differences. The learned-helplessness theory was used to predict variation in general depression, and frustrated-motivation theory to predict situation-specific levels of anger, frustration and disappointment (“ unemployment frustration” ). The causal model specified by learned-helplessness theory was initially rejected, although post-hoc modifications consistent with the theory provided an acceptable model. In contrast, variables nominated by frustration motivation theory were good predictors of unemployment frustration, but the initial causal structure specifying behavior as a mediating variable failed to match the data. A major amendment with cognition as a mediating variable was proposed and found to be successful. A longitudinal study was also conducted. The longitudinal data recorded the change within individuals over time and provided the opportunity to conduct a causal analysis of intraindividual change that examines the dynamic processes that generate human behaviour. Of the 166 respondents interviewed at follow-up, 100 were employed and 43 were unemployed. The employed and unemployed groups enabled two investigations regarding the relationship between employment status and emotional health. The first was confined to the unemployed group and examined the impact unemployment had upon emotional health. Although the size of the unemployed group at follow-up restricted conclusions, learned-helplessness theory did provide a limited account for the variation in general depression, as did the frustrated motivation theory for unemployment frustration. The second investigation evaluated learned-helplessness theory, originally proposed as an explanation for the negative impact of unemployment, to account for the improvements in emotional health associated with the transition from unemployment to employment. The learned helplessness theory did not, however, explain the changes in emotional health for the newly employed. Two conclusions were drawn. The first was that a causal modelling approach is useful as a means to evaluate social theory in a causal-process form. The second was that the social-cognition perspective, as represented by learned-helplessness and frustrated-motivation theory, provides a viable account for the processes that generate depression and frustration in the unemployed. Learned-helplessness theory failed, however, to account for the variation in depression associated with the transition from unemployment to employment. The benefits of using the social-cognition perspective to provide a focus for preventative and therapeutic programmes are also discussed, along with recommendations for future research.

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Whiteford, Harvey. "Shaping mental health policy in Australia, 1988-2008." Phd thesis, 2015. http://hdl.handle.net/1885/109201.

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This thesis uses the theoretical framework developed by John Kingdon to analyse, from the perspective of the Commonwealth government, the problems, policy solutions and political context that led to the opening of three mental health policy windows in Australia: the adoption of Australia's National Mental Health Policy and first National Mental Health Plan in 1992, the adoption of the Second National Mental Health Plan in 1998 and the adoption of the Council of Australian Governments' National Mental Health Action Plan in 2006. Data was assembled from four sources: firstly political party documents, ministerial speeches, Parliamentary debates and government documents; secondly a systematic review of literature published in academic journals; thirdly interviews with key informants; and fourthly my own observations as an expert key participant in mental health reform. From a thematic analysis of data from the first three sources five themes emerged that describe the issues shaping the mental health policy debates over the twenty year period covered by the thesis. These themes are human rights and community attitudes, community need, service structures, service quality and effectiveness, and resources. For each of the periods that led up to the opening of the policy windows in 1992, 1998 and 2006, the problems confronting the Commonwealth government and the policy solutions proposed were identified in each of the five thematic areas. The political response that occurred at each time is also discussed. For each policy window a set of defined problems and policy solutions, specific to that window, were identified. While taking action suited the political agenda of the government, each occasion was also associated with a highly publicised mental health issue that had dominated the media and demanded a policy response. Over the twenty years mental health became a much more prominent issue and the policy space in mental health much more contested with multiple agendas competing for government attention. Because the Kingdon model was used to organise the information collected it could not be used to also validate the model. However it was not difficult to find, for each policy window, clear problems, policy solutions and a political context within which the opening of the window occurred. The events shaping the political stream were largely independent of those shaping the problem and policy streams, which themselves were not independent of each other. In most cases, the individuals who had identified the problems were also promoting and advocating policy solutions to those problems. While the Kingdon model establishes a preconfigured cyclical dynamic and does not predict when a policy window might open, it did provide a useful framework for identifying and explaining factors important in mental health policy development and adoption.

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Mabela, Constance Sarah. "Mental well-being among the unemployed : the role of government intervention." Thesis, 2012. http://hdl.handle.net/10500/11877.

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The purpose of this study was to determine the impact of unemployment on the mental well-being of the South African working age population. The implication of exploring this relationship is to indicate the importance of good mental health among persons who are not employed. The present study also aimed atinvestigating the role that government can play in mitigating the impact of unemployment on mental health. This part of the research assessed the effectiveness of government’s social security system. The current study employs a mixed research design whereby both quantitative and qualitative methods of data analysis are used. The relationship between unemployment, mental well-being and government intervention is investigated using a cohort group in which the mental health of persons not employed, aged between 15 and 64 years, are followed over the period, 2004 to 2008. The results are presented using two types of data. First, secondary data from Statistics South Africa’s General Household Survey (GHS) were used to measure the impact of unemployment on mental health and to ascertain the impact of government social assistance on affected individuals’ mental well-being. Secondly, in order to explore individual perceptions around government intervention, the research employed a qualitative phenomenological design. This involved conducting semi-structured personal interviews with four unemployed women residing in Gauteng. The results showed that incidences of self-reported mental health illnesses were most likely to be found among individuals who were not employed as compared to those that were employed. This finding proved to be consistent using both descriptive and multivariate statistics which included predictive models. In terms of government intervention, positive mental well-being was shown to be positively related to access of social welfare services (in the form of social grants). This finding was true for all the years of reporting (i.e., 2004 to 2008). In conclusion, although unemployment was found to have a negative impact of mental well-being, government intervention was shown to positively mitigate this impact, thereby giving hope to an otherwise hopeless situation. Unemployment and its impact on mental well-beingalso proved to be a complex subject, requiring multidisciplinary intervening strategies to solving it.
Psychology
D. Litt. et Phil. (Psychology)

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Kelly, Claire. "The mental health literacy of Australian adolescents." Phd thesis, 2005. http://hdl.handle.net/1885/150294.

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Parslow, Ruth Adeline. "A study of Australians' access to health services for common mental health problems." Phd thesis, 2002. http://hdl.handle.net/1885/146160.

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Urry, Kristi Lauren. "Sexuality and Sexual Health in Mental Health Care Settings: Perceptions of Psychologists, Psychiatrists, and Mental Health Nurses in Australia." Thesis, 2020. http://hdl.handle.net/2440/128125.

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Sexuality and sexual health needs are inadequately addressed in mental health settings. This is misaligned with the espoused recovery orientation underpinning mental health services in Australia, and with individuals’ self-identified needs and desire for support. How mental health clinicians currently understand and respond to sexuality and sexual health concerns is still not well understood. In this thesis, I aimed to explore how mental health clinicians in Australia perceived sexuality and sexual health, and to critically examine how they oriented toward these in their work. An exploratory qualitative design was selected to address these aims, guided by social constructionist and critical health psychology frameworks. A single dataset was generated via in-depth interviews with psychologists, psychiatrists, and mental health nurses working in Australia. Four critical thematic analyses were conducted in relation to this dataset, each driven by a different analytic aim. In Chapter Three, I provide a reflexive account of nondisclosure of sexual identity within the research interviews as a lens through which to read the four analyses presented subsequently, contributing to transparency and rigour within this thesis. Participants’ conceptualisations of sexuality and sexual health are presented in Chapter Four. There was no single shared conceptualisation of sexual health within or across disciplines, however conceptualisations were primarily biomedical, reductionist, and risk-oriented with a focus on (primarily heterosexual) sexual intercourse. Sexuality was mostly understood as sexual identity and rarely discussed beyond reference to non-heterosexual identities, contributing to the positioning of hetero-sex as normal. Participants tended to perceive sexuality as relevant within their clinical practice when they also perceived danger or risk in relation to this, and this is explored in Chapter Five. I demonstrate how participants drew on a neoliberal framework of (sexual) health and self-regulation to construct sexual danger, locating this within sexual expression itself or within distressed individuals who were perceived to lack self-regulation. Outside of perceived danger, sexuality was largely omitted from participants’ everyday practice, and this silence is examined across two analyses. In Chapter Six, I demonstrate how participants accounted for omissions of sexuality in their own and their colleagues’ everyday practice by deprioritising sexuality and locating it outside of mental health settings. In Chapter Seven, I examine how the institutional context in which participants learn and work shaped sexuality-related perception and practice, according to their own accounts. I argue that these workplaces and institutions produce and maintain a broader silencing and peripheralisation of sexuality within mental health settings. The discussion in Chapter Eight brings together the results from all four analyses and synthesises these with the broader literature to make recommendations for practice and future research regarding sexuality and sexual health in mental health settings. I argue that improved practice in mental health settings will not be facilitated through a continued focus on biomedical aspects of sexuality and on individual clinicians’ relevant knowledge, comfort, and competence. Rather, there is a need to broaden the approach to sexuality in both clinical practice and research, and to recognise the wider institutional contexts in which sexual and mental health care are conceptualised and delivered.
Thesis (Ph.D.) -- University of Adelaide, School of Psychology, 2020

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Deans, Carolyn. "Non-traumatic stressors in deployed military personnel : impact on mental health." Thesis, 2006. http://hdl.handle.net/1885/150886.

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Chan, Bibiana Chi Wing Public Health &amp Community Medicine Faculty of Medicine UNSW. "Depression through Chinese eyes: a window into public mental health in multicultural Australia." 2007. http://handle.unsw.edu.au/1959.4/40521.

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Under-utilisation of mental health services is widespread globally and within Australia, especially among culturally and linguistically diverse (CALD) communities. Improving service access is a priority, as is the need to deliver culturally competent services to the CALD communities. Having migrated to Australia in waves for approximately 150 years from China and South East Asia for various social, political and economic reasons, the Chinese population in Sydney is now the fastest growing non-English speaking ethnic group. There is a need to better understand the impact of culture on the emotional experiences of these Chinese in Australia. How do Chinese make sense of their depressive episodes? To address this question, this study explored the ways participants reach out for medical and/or non-medical help. Lay concepts of illness underpin these decisions and were thus unveiled. Mixed-method research design provided the opportunity to bring together multiple vantage points of investigation: population mental health, transcultural psychiatry and medical anthropology. A study combining quantitative survey and qualitative focus groups was undertaken in metropolitan Sydney. Narratives on symptoms, explanatory models and help-seeking strategies were articulated by focus group informants. Surveys covered demographics, symptom-recognition, previous depressive experiences and professional help sought. Depression measurement tools were cross-culturally validated. Self-ratings of ethnic identities and the Suinn-Lew Self-Identity Acculturation Scale were used to quantify Chinese participants' acculturation level. This allowed comparisons between 'low-acculturated' Chinese', highly-acculturated' Chinese and Australians. Survey results showed comparable levels of symptom-recognition in all subgroups. Focus group discussions provided rich data on informants' help-seeking strategies. Highly acculturated Chinese closely resembled the Australians in many study variables, yet qualitative data suggested cultural gaps beyond language barriers in influencing service use. Participants believed that trustful relationships could work as the bridge to link services with those in need. The implications for Australia's mental health policy include recognising the importance of rapport-building and the existence of cultural gaps. The study indicated professionals can benefit from acquiring information about the mental health beliefs both of individual clients and the wider ethnic communities in which they belong, and respecting the cultural differences between helper and helped as the first step towards cultural competency.

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Bannister, Justine. "Abuse, attachment, mentalising and mental disorders in youth refuge residents." Thesis, 2006. http://hdl.handle.net/1885/150133.

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Dissertations / Theses on the topic 'Unemployed Mental health Australia'

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