A thematic analysis of the personal factors influencing mental health help-seeking in farmers

PURPOSE

It is crucial to understand the micro-level personal factors that impact farmer mental health help-seeking, given that farmers are at increased risk of suicide yet show reduced mental health help-seeking behaviors.

METHODS

Ten farmers, 10 farmers' partners, and 8 general practitioners (ie, family physicians) from Australia completed qualitative semi-structured interviews. Braun and Clarke's method of thematic analysis was used to analyze the data.

FINDINGS

The analysis resulted in 4 themes: "mental health literacy," "stigma of mental illness and help-seeking," "support, the partners' role in help-seeking," and "the intersectionality between being a farmer, age, and gender." Farmers' knowledge and understanding of mental health and treatments was varied. Stigma was reported to be reducing, but still present toward both mental illness and mental health help-seeking. Support from a partner was reported to facilitate help-seeking if delivered tactfully. Lastly, being older and male were reported to negatively impact farmer mental health help-seeking.

CONCLUSION

The findings contribute to understanding farmer mental health help-seeking and could inform quantitative research and the development and implementation of interventions to promote mental health help-seeking in this group.

Risks to mental health of higher degree by research (HDR) students during a global pandemic

The COVID-19 pandemic has affected university students globally. Our study investigated mental health indicators among higher degree by research (HDR) students at a regional university in Queensland, Australia. A total of 231 HDR students (female = 137, male = 94) completed the Brunel Mood Scale to assess the constructs of Tension, Depression, Anger, Vigor, Fatigue, and Confusion. A subset of 11 students participated in three focus groups to explore their experiences. Results showed that reported mood among HDR students was generally more negative than population norms, although more positive than moods reported previously during the pandemic. A total of 52 participants (22.5%) reported mood profiles that indicated elevated risk of mental ill-health. Mood profiles varied significantly by gender, age, study mode (full-time/part-time), location (on-campus/online), and citizenship (domestic/international). Quantitative data were supported by focus group findings, which identified mental health and wellbeing as key themes of concern to HDR students. Our findings indicate that support mechanisms to safeguard the mental health and wellbeing of HDR students should be a priority for universities.

Transition approaches for autistic young adults: A case series study

The aim of this study was to evaluate the experience of autistic young adults aged 18 to 25 years old over a 12-month transition period from 2016 to 2017. Data was collected through a longitudinal repeated measures case series design with assessments conducted at 2 time points, at baseline then 12 months later. Assessments included self-report evaluations of transition planning and intervention received at high school, engagement in post-secondary education and access to employment, living circumstances, and social support. Examination of 9 cases showed family and social support was an important facilitator of successful transition whilst low independence was a risk factor associated with unsuccessful transition. In-depth analysis of cases showed a lack of engagement in post-secondary education and unemployment were associated with poor quality of life whilst skills development, work experience placements, and support from service providers were associated with improved quality of life. Implications of the findings highlight the need for educational and socially inclusive interventions to support the heterogeneity in individual, social, communication, and behavioural challenges in autistic young adults.

"Just Ask Me": The Importance of Respectful Relationships Within Schools

An inclusive approach to education requires schools and educators to address the support needs and individual predispositions of all students. Our research highlights the crucial importance of effective and respectful communication with autistic students to facilitate their successful participation in schools. This paper explores the experiences of 24 autistic individuals aged 16-67 years, through synchronous semi-structured interviews and written responses. The research team comprised both autistic and allistic (non-autistic) researchers, who worked together to design the overall project, collect interview data, and analyse the data. Relationships were frequently discussed by participants and the importance of positive relationships was positioned as key to successful participation within educational contexts. Particularly damaging were assumptions made by teachers concerning individual ability based on labels given. Participants recalled ongoing challenges with resisting stereotypes and managing stigma, while trying to craft a positive autistic identity and advocate for rightful supports for their education. At the core of these negotiations were positive relationships, and teachers who asked participants what their needs were, and then listened and proactively responded to their answers. Recommendations for more positive schooling engagements with autistic young people are provided.

"Don't … Break Down on Tuesday Because the Mental Health Services are Only in Town on Thursday": A Qualitative Study of Service Provision Related Barriers to, and Facilitators of Farmers' Mental Health Help-Seeking

The suicide rate of farmers is approximately double that of the general Australian population, yet farmers employ fewer help-seeking behaviours (Arnautovska et al. in Soc Psychiatry Psychiatr Epidemiol 49:593-599, 2014; Brew et al. in BMC Public Health 16:1-11, 2016). Therefore, it is crucial to understand if, and how health services and system might influence farmer help-seeking. To shed light on this, the current study employed qualitative semi-structured interviews with 10 farmers, 10 farmers' partners and 8 medical practitioners. Thematic analysis, guided by Braun and Clarke's (Qual Res Psychol 3:77-101, 2006) techniques, was used to analyse the data. Three themes were devised concerning the interaction between farmers and health services, including 'health service interactions', 'services are provided within a complex system' and 'emerging technologies: the users, practitioners, and systems'. The findings underscore the importance of interactions between a farmer and a service provider, with farmers wanting their provider to have an understanding of farming life. Help-seeking was also shaped by access, availability, and practitioner constancy. Lastly, a complex relationship between digital mental health services and farmer help-seeking was reported, with factors related to the farmers, the practitioners and the infrastructure/systems discussed. The outcomes have implications for health service and policy reform, developing and providing interventions for farmers to promote health services interaction as a way of mental health help-seeking.

Parental Experiences of Engaging With the National Disability Insurance Scheme for Their Children: A Systematic Literature Review

The Australian National Disability Insurance Scheme (NDIS) reached full national implementation in July 2019. It supports Australians with disabilities via individualized funding packages for disability-specific services and assistive technology. This systematic review of literature presents research describing the experiences of parents of children with disabilities in accessing and participating in the fledgling NDIS and makes recommendations to assist the Agency in better supporting new participant families.

HIV Point of Care Testing (PoCT) at Late-Night Sex on Premises Venues (SOPV) for Gay and Bisexual Men and Other Men Who Have Sex with Men (GBMSM): A Mixed Methods Analysis

The aim of this study was to establish 'proof of concept' for a novel approach to HIV and STI testing at a sex on premises venue (SOPV) for gay and bisexual and other men who have sex with men (GBMSM) during late night group sex theme parties. A mixed-methods approach was used, and the study aimed to: (1) Build upon existing SOPV funded service delivery and establish 'proof of concept' for this unique setting within an SOPV; (2) evaluate the uptake and feasibility/acceptability of routine HIV/STI testing for GBMSM during theme parties in SOPV; and (3) identify beliefs/perceptions regarding this health promotion activity and venue suitability. The characteristics of patrons utilising PoCT (Point of Care Testing) were established to help further reach potentially stigmatised, highly sexually adventurous GBMSM. The findings support further PoCT endeavours within MSM communities to target harder to reach communities to reduce the rate of new transmissions of HIV. Findings can inform future health promotion, screening and interventions, as well as to identify a successful method to engage harder to reach GBMSM that need further focused targeting for HIV and STI testing to reduce transmission.

Profiling Autism Symptomatology: An Exploration of the Q-ASC Parental Report Scale in Capturing Sex Differences in Autism

The Questionnaire for Autism Spectrum Conditions (Q-ASC) was developed by Attwood et al. (2011) to identify gender-sensitive profiles of autism symptomatology; prioritise and adjust the direction of clinical interventions; and support positive psychosocial outcomes and prognosis into adulthood. The current research piloted the Q-ASC with parents of 238 children with a clinical diagnosis of ASD-Level 1 (without intellectual or language impairment). Data analysis revealed eight interpretable and reliable components of the Q-ASC using Principle components analysis. Comparisons across age and gender groups found statistically significant mean differences of parent-reported characteristics. The findings from this study aim to identify improvements in the Q-ASC towards the future assessment of the sensitivity and diversity of presentations of autism among female children and adolescents.

Point-of-care testing (POCT) for HIV/STI targeting MSM in regional Australia at community 'beat' locations

BACKGROUND

Innovative health promotion strategies are needed to improve access to HIV testing among regional people in Australia, particularly for men who have sex with men (MSM). This project aimed to establish proof of concept for point-of-care-testing (POCT) via a mobile van clinic at community 'beat' locations. Surveys evaluated client satisfaction, characteristics and testing preferences among 'early adopters'. Sequential mixed-methods approach was used which included secondary qualitative analysis of field notes written by peer-testers (i.e., trained lay providers from the key population being targeted; to extend the contextualise the pilot evaluation), documenting barriers/facilitators and innovations, per action research and to guide recommendations for future health promotion initiatives.

METHODS

A POCT 'proof of concept' project (2, 3-hourly sessions/week; 20 weeks) was delivered in a regional town by peer-testers using a mobile clinic van, recruited by geosocial 'apps' targeting MSM. Clients completed surveys regarding demographics, and testing satisfaction, frequency and preferences. Peer-testers completed detailed field notes for each session including client characteristics and impressions, salient events, concerns and recommendations.

RESULTS

The program resulted in 34 online health promotion conversations with MSM and 34 POCT tests (19 HIV, 15 Syphilis; 18 unique client visits; 17 identified as MSM, with 1 heterosexual female. Rates of satisfaction among early adopters of POCT was high. Analysis of field notes revealed three major themes: 1) Practical challenges; 2) Barriers to engagement; and 3) Recruitment method/project promotion.

CONCLUSIONS

Amongst early adopters satisfaction was high, with 47% of clients reported infrequent testing (over 12 months ago) or having 'never tested'. No tests were reactive. Challenges associated with this health promotion initiative and recommendations for future HIV testing promotion and programs were outlined.

Inactive lifestyles in peri-urban Australia: A qualitative examination of social and physical environmental determinants

ISSUE ADDRESSED

Australians living in peri-urban areas are insufficiently active, sedentary and experience poorer health than people in major cities. There are health benefits attributable to active lifestyles that could contribute to the improved health and well-being of this population. To support the adoption of active lifestyles, it is important to understand the unique context in which behaviour occurs.

METHODS

The aim of this study was to identify characteristics of the social and physical peri-urban environment that may impact active lifestyles. Semi-structured interviews were conducted in peri-urban southern Queensland. Data were analysed by thematic analysis.

RESULTS

The natural environment, weather, distance, accessibility and walkability were features of the physical environment relevant to active lifestyles. Social factors included social capital and crime. Activity-supportive characteristics (eg, community spirit) were identified, in addition to active lifestyle barriers (eg, lack of public transport).

CONCLUSIONS

Despite activity-supportive social and environmental characteristics, most participants reported inactive lifestyles. The barriers to active lifestyles in peri-urban environments may negate these activity-supportive features. Some barriers are difficult to modify (eg, distance and accessibility). However, some may be alleviated through the adoption of activity-supportive policy and urban design (eg, pedestrian mobility infrastructure). SO WHAT?: Strategies to support active lifestyles in peri-urban environments must take into account unmodifiable contextual barriers, whilst encouraging utilisation of existing activity-supportive infrastructure and resources. The enhancement of activity-supportive environments through improved neighbourhood walkability and the usability of public transport may encourage some peri-urban residents to undertake more active forms of transport and recreational physical activity.

“What’s the point of having friends?”: Reformulating Notions of the Meaning of Friends and Friendship among Autistic People

<span style="font-family: Times New Roman; font-size: small;"> </span><p class="MsoNormal" style="margin: 0cm 0cm 10pt; line-height: 200%;"><span style="line-height: 200%; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; font-size: 12pt; mso-bidi-font-family: &quot;Times New Roman&quot;; mso-bidi-theme-font: minor-bidi;" lang="EN-US">In this paper we discuss the notion of 'autistic friendship'. Drawing on articles published in the Swedish advocacy magazine <em>Empowerment</em>,&nbsp;</span><span style="line-height: 200%; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; font-size: 12pt; mso-bidi-font-family: &quot;Times New Roman&quot;; mso-bidi-theme-font: minor-bidi;" lang="EN-US">written for and by autistic people, a thematic analysis explores two interrelated themes: the meaning and performance of friendship in non-autistic (NT) and autistic (AS) worlds and the meaning of space in social interaction and community. Articles published in the magazine frequently discuss autistic only spaces as safe places in which to make friends with other autistic people and also in which to perhaps learn how to manage social interactions with the dominant non-autistic (NT) culture.</span></p><span style="font-family: Times New Roman; font-size: small;"> </span>

Investigating interoception and body awareness in adults with and without autism spectrum disorder

This study aimed to investigate the current gap in the literature with regard to how adults with and without Autism Spectrum Disorder (ASD) interpret elements of the interoceptive sense, which includes thirst, hunger, temperature, satiety, and the prediction of onset of illness. Adults with a diagnosed ASD (n = 74; 36 males, 38 females) were compared to a control group (n = 228; 53 males, 174 females, 1 unspecified) in their self-reported perceptions of body awareness utilizing the Body Awareness Questionnaire (BAQ) and thirst awareness using the Thirst Awareness Scale (TAS). Those in the ASD group reported a clinically significant lower body and thirst awareness compared to the control group, and this was a large effect (BAQ; d = -1.26, P < 0.001; TAS; d = -1.02, P < 0.001). These findings are of clinical importance, as difficulty with sensing internal bodily states could theoretically impact on the physical and mental health, social interactions and self-awareness of adults with ASD.

Deficit and asset identity constructions of single women without children living in Australia: An analysis of discourse

Construction of adult life course and identity has typically been built around norms of partnering and parenting, placing single women who do not have children outside the norm. Studies undertaken with single women have found that relationship status was a key factor in their identity construction. In this study, we conducted semi-structured interviews with five single women without children living in Australia. Drawing on critical discursive psychology, we found that participants negotiated two contesting discourses to construct their identities: the Heterosexual Relationship and Family Life discourse and the Independent Single Woman discourse. In crafting identities, tensions were identified between the positioning of self and the positioning of self by others, particularly with respect to the Heterosexual Relationship and Family Life discourse. This was evident in some women contesting the positions afforded by the discourse, instead drawing on an asset identity. This asset identity enabled the women to pursue positive life opportunities.

Re-presenting autism: the construction of 'NT syndrome'

Autism is a widely researched area and much emphasis has been placed in research on the differences between the autistic and non-autistic populations. Such research commonly draws on proposed deficits within people with autism in order to explain differences. This paper seeks to present an alternative understanding of differences and draws on writings of people with autism in such a discussion. The construction of 'Neurologically Typical syndrome' (NT) will be presented as an inverted construction of diagnosis, which serves to challenge the dominant position of 'NTs' and 'NT traits' over autistic traits. It will be argued that such an alternative representation of people with and without autism has important implications for our construction of and understanding of autism.

Presenting the self: negotiating a label of autism

BACKGROUND

An important element in the experiences of people with autism is the key role played by therapeutic interventions. This paper examines the role of therapeutic intervention and the construction of individuals with autism in the therapeutic relationship.

METHOD

The contributions to four online asynchronous discussion lists were analysed using discourse analysis over a 3-month period.

FINDINGS

Two key themes identified in the data are presented. These comprise issues concerning therapeutic intervention and issues related to the employment opportunities of adults with autism.

CONCLUSIONS

In this paper the notion that people with autism must change in order to accommodate the non-autistic world is discussed. The author seeks to present an alternative construction of autism as a difference rather than a deficit or deviance and to examine the negotiation of a place for a person with autism within a neurologically typical dominated society.

Representations of autism: implications for community healthcare practice

The work presented in this paper is part of a larger project in which online asynchronous discussion groups were employed to examine how a range of contributors--including people with autism, parents of people with autism, and professionals working within the field of autism--view and understand autism. In this paper, we focus on the voices of people with autism. The terminology used in the paper takes its lead from the writings of people with autism, who frequently use the term 'AS' to refer to autistic spectrum and Asperger syndrome and 'NT', which refers to neurologically typical people without autism. We examine a key theme identified in the online discussion groups--the representation of individuals with autism as occupying a separate world of autism. In doing so, we question an apparent goal of therapeutic interventions--to bring people with autism out of their 'separate world' and integrate them into a more typically 'social world'. We present an alternative understanding of autism that argues for valuing diversity and viewing autism as a difference rather than a deficit. We will discuss some of the implications that this may have for working with people with autism in health and social care practice.

Constructing an Autistic Identity: AS Voices Online

Excerpts from current research with people who have autism using online discussion groups are provided. Two major themes emerged that focus on "expert" knowledge of autism and identity. In contrast to the image of people with autism being unable to speak for themselves, our research on chat rooms has demonstrated that these individuals are finding a voice in an online environment, and the Internet may be a powerful tool in enabling this voice to be heard. The challenge that experiential knowledge poses to scientific knowledge is discussed in light of diagnosis, and the positive nature of an autism spectrum (AS) identity is highlighted as a common thread in discussions.