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Spring B, Davidson M, Richardson A, Steere M, Gardiner FW, Coleman M. Too far from care? A descriptive analysis of young Australian mental health aeromedical retrievals. Public Health 2024; 236:161-167. [PMID: 39226745 DOI: 10.1016/j.puhe.2024.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 07/01/2024] [Accepted: 07/19/2024] [Indexed: 09/05/2024]
Abstract
OBJECTIVES Young Australians living in rural and remote locations have poorer mental health outcomes and higher rates of self-harm and suicide than their major city counterparts. Significant service gaps and barriers exist in accessing general and youth-specific mental health services. With a lack of access, comes delays in treatment and associated poorer outcomes. This paper describes the characteristics of young people requiring an aeromedical retrieval (AR) for acute inpatient psychiatric care. STUDY DESIGN AND METHODS A retrospective secondary analysis was conducted of Royal Flying Doctor Service ARs for a six-year period from 2016 to 2021. Data were summarised by demographic, geographic, and diagnostic factors. RESULTS The total sample size was 1534 (60% male, 40% female; and 31% aged 12-17 years, 69% aged 18-24 years), with 668 (43.5%) affected by schizophrenia and related disorders. Port Augusta, 300 km north of Adelaide, had the highest proportion of aeromedical retrievals (4.4%). The Women's and Children's Hospital in Adelaide received the highest proportion of retrievals (25.6%). Statistically significant gender and age differences were identified as were specific high-usage geographical locations across several Australian states. CONCLUSIONS AR is essential for young people in accessing specialist acute health services. Developmentally appropriate, responsive, youth mental health services are mostly located in large, already well-resourced major cities. Our study provides valuable information to assist governments, communities, and services to enhance the resources available for young people who live rurally.
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Affiliation(s)
- B Spring
- Royal Flying Doctor Service of Australia, 10-12 Brisbane Avenue, Barton, ACT, Australia; Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Darwin, NT, Australia; Townsville Institute of Health Research and Innovation, Townsville University Hospital, QLD, Australia.
| | - M Davidson
- Great Southern Mental Health Service, Western Australia Country Health Service, WA, Australia
| | - A Richardson
- Australian National University, ACT, Canberra, Australia
| | - M Steere
- Royal Flying Doctor Service of Australia, 10-12 Brisbane Avenue, Barton, ACT, Australia; Charles Darwin University, Darwin, NT, Australia; University of Florida, Gainesville, FL, USA
| | - F W Gardiner
- Royal Flying Doctor Service of Australia, 10-12 Brisbane Avenue, Barton, ACT, Australia; Australian National University, ACT, Canberra, Australia; The Rural Clinical School of Western Australia, The University of Western Australia, WA, Australia
| | - M Coleman
- Great Southern Mental Health Service, Western Australia Country Health Service, WA, Australia; The Rural Clinical School of Western Australia, The University of Western Australia, WA, Australia; Telethon Kids Institute, Nedlands, WA, Australia
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Bowman S, McKinstry C, McGorry P. Youth mental ill health and secondary school completion in Australia: time to act. Early Interv Psychiatry 2017; 11:277-289. [PMID: 27381567 DOI: 10.1111/eip.12357] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 02/01/2016] [Indexed: 12/30/2022]
Abstract
AIM This paper reviews the evidence of youth mental ill health and its impact on secondary school educational attainment. METHODS This narrative review presents the current research related to the mental ill health of young people in urban and rural Australia, their educational attainment and the effectiveness of mental health strategies implemented in secondary schools. RESULTS The prevalence of mental ill health is high for Australian young people and the onset of depression, anxiety, substance-use disorders and first episode psychosis (FEP) commonly occurs when the individual is at school. The prevalence is reported to be higher for rural young people and barriers to treatment exist. Current evidence suggests that 40% of young people experiencing depression or anxiety disorders are not completing secondary school. Further evidence shows that over 50% of individuals who experience FEP do not finish secondary school. Current mental health promotion strategies employed in secondary schools have not been shown to reduce rates of depression or anxiety in adolescence nor identify prodromal or acute FEP. These strategies have not led to interventions that assist young people with mental ill health to finish school. CONCLUSIONS Not completing secondary school can limit employment options, lead to severe levels of disadvantage and increased burden on welfare and healthcare systems. All young people, including those in rural areas, have the right to education and should not be disadvantaged in their educational aspirations because they have an emerging or current mental illness.
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Affiliation(s)
- Siann Bowman
- Department of Occupational Therapy, Community and Clinical Allied Health & LaTrobe Rural Health School, College of Science, Health and Engineering, LaTrobe University, Melbourne, Victoria, Australia
| | - Carol McKinstry
- Occupational Therapy, LaTrobe Rural Health School, LaTrobe University, Bendigo, Victoria, Australia
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
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Cheng C, Dewa CS, Langill G, Fata M, Loong D. Rural and remote early psychosis intervention services: the Gordian knot of early intervention. Early Interv Psychiatry 2014; 8:396-405. [PMID: 23841694 DOI: 10.1111/eip.12076] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 06/02/2013] [Indexed: 11/26/2022]
Abstract
AIM One of the basic challenges of Early Psychosis Intervention (EPI) programs for rural populations is translating best practice which developed for urban high-population density areas to rural and remote settings. This paper presents data from two different models (hub and spoke and specialist outreach) of rural EPI practice in Ontario, Canada. METHODS This cross-sectional study used a convenience sample of clients from two rural EPI programs between 2005 and 2007. Data about client outcomes specific to general functioning, admissions to hospital and emergency room (ER) visits were collected. For all dichotomous variables, chi-square tests were used to test differences between two groups. RESULTS The total clients served in hub and spoke were 457 compared to 91 in specialist outreach. Although not statistically significant, the hub and spoke group showed better functioning in the community. There was a significant difference between the two groups with regard to hospital admissions. Although not significant, there was a greater percentage (58.3%) of specialist outreach clients who visited the ER in the previous 12 months as compared to clients serviced by the hub and spoke model (34.9%). CONCLUSIONS The observed data from these two rural models suggest that there may be differing outcomes. There are limitations to this study, and this paper does not address why there are differences. Future work needs to continue to further explore why differences exist and whether they persist so we can provide equity and quality care for rural and remote populations.
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Affiliation(s)
- Chiachen Cheng
- First Place Clinic and Regional Resource Centre, Canadian Mental Health Association, Thunder Bay, Ontario, Canada; Centre for Research on Employment and Workplace Health (CREWH), Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Cheng C, deRuiter WK, Howlett A, Hanson MD, Dewa CS. Psychosis 101: evaluating a training programme for northern and remote youth mental health service providers. Early Interv Psychiatry 2013; 7:442-50. [PMID: 24164723 DOI: 10.1111/eip.12044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2012] [Accepted: 01/15/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Most of the early psychosis intervention (EPI) training has focused on family physicians participants. In Northern Ontario, there is a shortage of primary care. This paper will present evaluation results of a pilot training programme for rural and remote youth mental health service providers. METHOD A mixed methods approach was used. We evaluated a 2-day workshop about EPI for non-medical mental health workers delivered onsite and simultaneously by videoconferencing. There were 19 participants across four agencies. Seven were onsite and 12 were offsite. Participants' knowledge was measured using a validated questionnaire at pre-intervention and at 3-, 6- and 9-month follow up. A repeated measures ANOVA was used to evaluate knowledge acquisition between the two modes of training. At 6 months, focus group interviews were conducted to explore their experiences of the mode of intervention delivery and evaluation. Emerging themes were iteratively derived through a series of discussions involving independent coders. RESULTS Only 15 complete datasets were available of the 19 original participants. Differences in knowledge acquisition between the two groups did not reach statistical difference. Six-month focus group data indicated that participants improved their relationship with EPI services and they were part of a strengthened network with other providers in the region. Post-intervention, the accuracy of referrals from participating agencies increased dramatically, with an increase in proportion of referrals who were eligible for EPI services. The follow-up process engaged participants in learning and re-engaged them with the material taught during the training session. CONCLUSIONS The results about developing service partnerships and relationship with specialist services are encouraging for policy and service decision-makers to address mental health service needs in northern and remote areas.
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Affiliation(s)
- Chiachen Cheng
- Canadian Mental Health Association - Thunder Bay, First Place Clinic and Regional Resource Centre, Thunder Bay, Ontario, Canada; Centre for Addiction and Mental Health, Centre for Research on Employment and Workplace Health (CREWH), Toronto, Ontario, Canada
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Hunter E, Gynther B, Anderson C, Onnis LA, Groves A, Nelson J. Psychosis and its correlates in a remote indigenous population. Australas Psychiatry 2011; 19:434-8. [PMID: 21995356 DOI: 10.3109/10398562.2011.583068] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The aim of this study was to describe prevalence and characteristics of psychotic disorders in a remote Indigenous population. METHOD Clinical review of all patients with an active diagnosis of a psychotic disorder in remote communities of Cape York and the Torres Strait. RESULTS 170 patients were identified and demographic, social and treatment variables described. CONCLUSIONS Psychotic disorders are common and more so among young adult Aboriginal men, with high rates of comorbid conditions including substance use, intellectual impairment and diabetes. In parallel to this case complexity, there are high rates of coercive treatments. Certain differences by ethnicity and location are described and possible explanations proposed.
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