Promising results for online depression therapy

Published in the NursingReview Online
10 July 2012
Australian National University researchers say online interventions can have important flow on effects to a patient’s quality of life and physical health.

Online depression therapy programs can have a positive impact on more than just depressive symptoms, according to a new study.

Dr Lou Farrer, from the ANU Centre for Mental Health Research, trialled the effectiveness of online programs MoodGYM and BluePages with users of Lifeline’s telephone crisis line.

She found that the online programs had a positive influence across a range of problems, such as alcohol use.

“In addition to reducing depression symptoms, we found that the online programs were effective in reducing hazardous alcohol use in Lifeline callers. There was a significant drop in alcohol use among those who used MoodGYM and BluePages,” she said.

“The results also showed that people who used the online programs had a marked increase in their quality of life, as measured by a scale that assessed satisfaction with different areas of daily living.”

The research was recently published online in the Journal of Medical Internet Research.
Read the full article here

Advocates ramp up Headspace campaign

Thomas O'Byrne and Michelle Speirs
The Guardian - Northern Victoria  

SWAN Hill Rural City Council and local health care workers have stepped up their campaign to improve mental health outcomes for young people in the municipality.  With time of the essence, council is penning a letter to Federal Minister for Mental Health Mark Butler seeking an urgent meeting with him to argue the case as to why a Headspace facility should be established in Swan Hill as a priority.

Headspace centres are a Federal Government funded initiatve dedicated to improving the mental health and well-being of Australia's youth.

Spearheading the campaign is councillor Yvonne Jennings who said she raised the issue during a recent trip to Canberra, where she spoke with Minister for Early Childhood and Youth Peter Garrett.

While talks of a Headspace facility were outside his portfolio, the minister said he would personally convey council's concerns to Mr Butler provided they were put forward in writing.

At last week's council meeting, councillors voted to write to Mr Butler as a matter of urgency with all councillors supporting the move.

"We've all seen the statistics and they are frightening," councillor Greg Cruickshank said.

"The community is largely ignorant as to what is happening out there."

Mental health statistics put forward in Southern Mallee Primary Care Partnership's 2009/12 strategic plan revealed that, in some cases, Swan Hill had much higher figures than the rest of Victoria.

Read the full article here

Depression a global problem: It’s not just Westerners who get the blues

Depression and anxiety are found in every society in the world, debunking old theories that only Westerners get depressed.

These new findings come from the world's most comprehensive study of anxiety and depression research to date, published by researchers at The University of Queensland.

In two separate studies of anxiety disorders and major depressive disorder (that is, clinical depression) study authors found that surveys of clinical anxiety and depression have been conducted across 91 countries, involving more than 480,000 people.

They show that clinical anxiety and depression are serious health issues all around the world.

Anxiety disorders were more commonly reported in Western societies than in non-western societies, even those that are currently experiencing conflict.

Clinical anxiety affected around 10 per cent of people in North America, Western Europe and Australia/New Zealand compared to about 8 per cent in the Middle East and 6 per cent in Asia.

Source: UQ News, read the full article here

Preventing obesity and poor physical health through assessment and ongoing monitoring

Dr Susanne Stanley aims to highlight the poor physical health of the mentally ill, paying particular attention to the high incidence of obesity, which can lead to complications such as type 2 diabetes and cardiovascular disease.

Whilst obesity is of great concern in the general population, people with a mental illness face additional factors. For example, psychotropic medication effects such as weight gain can lead to obesity in the mentally ill, highlighting the need for vigilance with physical health examination and ongoing monitoring.

The Clinical Guidelines for the Physical Care of Mental Health Consumers: Assessment and Monitoring Package will be outlined, assisting clinicians in the overall care of their patients through the direction of evidence-based procedures and tools to prevent poor physical health, and aide in the recovery process for all mental health patients.

Dr Susanne Stanley, Senior Research Officer, The University of Western Australia will present at the:

13th International Mental Health Conference, "Positive Change -- Investing in Mental Health"  6th to the 8th of August 2012, on the Gold Coast. 

Web: http://anzmh.asn.au/conference Email: conference@anzmh.asn.au

Poverty, Not Mental Illness, Is Source Of Many Poor Mothers' Anxiety: Study

Rutgers University

Poor mothers are more likely to be classified as having the mental illness known as generalized anxiety disorder (GAD) because they live in poverty – not because they are suffering from a psychiatric disorder, according to Rutgers researchers.

Judith C. Baer, an associate professor in the School of Social Work, and her team, in the study, "Is it Generalized Anxiety Disorder or Poverty? An Examination of Poor Mothers and Their Children," published online in Child and Adolescent Social Work, argue that although high levels of stress over long periods can lead to psychological problems, there is no evidence that generalized anxiety disorder in poor mothers is because of an "internal malfunction."

The findings confirm earlier studies that the poorest mothers have the greater odds of being classified as having generalized anxiety disorder. But Baer and her team wrote, "...there is no evidence for a malfunction of some internal mechanism. Rather, "there is a physical need in the real world that is unmet and produces anxiety."

"The distinction is important because there are different ways to treat the problem," Baer said. "While supportive therapy and parent skills-training are often helpful, sometimes the most appropriate intervention is financial aid and concrete services."

Rutgers researchers argue that changing and broadening definitions for GAD have caused, in some cases, mental health experts to categorize the reactions of these mothers to the extreme conditions they face daily as symptoms of the anxiety disorder.

Baer's team has been exploring relationships between poor mothers and their children and whether links between poverty and maternal anxiety might play a part in their offspring developing anxiety of their own.

The latest research by Baer and colleagues MiSung Kim, who completed her doctorate in May, and Bonnie Wilkenfeld, a doctoral candidate, analyzed data from the ongoing Fragile Families and Child Wellbeing Study with 4,898 participants conducted at Princeton University, consisting of surveys and home observations when children were 3-years-old. It confirmed that the poorest mothers had greater odds of being classified as having GAD but that the path from anxiety to parenting stress was not supported.

"This suggests that mothers can be poor and anxious, but still provide positive parenting for their children," Baer said.

Currently, psychiatric diagnoses are based on the Diagnostic and Statistical Manual of Mental Disorders (DSM), which uses symptom-based criteria to determine disorders. Recent versions do not consider context, such as poverty conditions, in determining diagnoses, Baer said.

"Our findings suggest that anxiety in poor mothers is usually not a psychiatric problem but a reaction to severe environmental deficits," she continued. "Thus, assessment should include careful attention to contextual factors and environmental deficits as playing a role in the presentation of symptoms. Labeling an individual with a diagnosis, especially if it is inaccurate, has a serious social stigma."

Media Realease Rutgers University

Australian and New Zealand Mental Health Association
Web:  http://anzmh.asn.au      Email:  education@anzmh.asn.au

Talk is Cheap: The Role of a Speech Pathologist in Mental Health Services

It has been shown that language (e.g. understanding other people, or expressing yourself effectively), social interaction, and literacy disorders are strongly correlated with behavioural and emotional difficulties, and that often these communication disorders are undiagnosed and untreated.

For example, a high profile study in 1996 (Emerson and Enderby) found the prevalence of communication disorders in a mental health service to be 75%. Once in the psychiatric care and/or the criminal justice psychiatric system, people are expected to engage with a variety of interventions, but they are often unable to benefit fully from these without the necessary comprehension, expression and empathy skills.

Ms Woodward will recap the communication difficulties commonly associated with different mental health conditions, then briefly outline the benefits of Speech Pathology input within this field, both direct and indirect interventions.

A Speech Pathologist enables effective communication between patients and peers, staff, families, other professionals and the wider community by assessing, diagnosing and treating communication (speech, language and social interaction/communication) and swallowing difficulties/disorders and providing advice and training to other staff to ensure that the patients’ environment is modified in order maximise effective communication. Input is therefore a combination of direct work with patients, resource making (e.g. supporting written information visually), and liaison/training with other professionals to ensure effective communication throughout the patients’ care, thereby enhancing good practice throughout the service.

This has an impact on the individual, their community, and the efficacy of their rehabilitation, therefore with implications for national policy of healthcare.

Ms Mary Woodward, Specialist Speech Pathologist, Concord Centre for Mental Health will present at the:

13th International Mental Health Conference, "Positive Change - Investing in Mental Health"  6th to the 8th of August 2012, on the Gold Coast. 

Web: http://anzmh.asn.au/conference Email: conference@anzmh.asn.au

Depressed? You've got Buckley's getting insurance

Source: Jill Stark, Health Reporter
The Sunday Age

PEOPLE with a history of depression, insomnia or stress are being denied access to insurance, with health experts accusing the industry of systemic discrimination against those with even mild mental health problems.

A report by beyondblue and the Mental Health Council of Australia reveals many insurers are refusing to offer income protection, life insurance, private healthcare or travel coverage to people who have been depressed or anxious, in some cases claiming they are a suicide risk.

Read the full story here

Australia’s first national e-mental health online portal

Australia’s first national e-mental health online portal has been launched today by the Federal Minister for Mental Health, the Hon Mark Butler MP.

Called mindhealthconnect, this government portal will enable instant access to a variety of clinically-endorsed mental health information, support and therapies.

As pioneers in the field of eHealth, Black Dog Institute researchers played a key advisory role in the development of mindhealthconnect.

“We know that more and more people are turning to the internet to seek help, treatment and support for mental health problems” says A/Prof Judy Proudfoot, Black Dog Director of eHealth and Chief Investigator of the myCompass eHealth program.

“While online mental health services have a significant role to play, the challenge is making sure that the information they provide is both safe and effective.”

“mindhealthconnect will not only facilitate access to quality online programs, information and communities, it will be a simple and confidential gateway for people who may not seek face-to-face help for mental health problems."

Black Dog Executive Director, Professor Helen Christensen, commends the Federal Government for their proactive approach to mental health.

“As a key objective of the Australian e-mental health strategy, the implementation of mindhealthconnect portal is an enormously positive step towards improving the mental health of Australians.”

“Providing Australians with easy access to the best cutting-edge online programs will encourage individuals to feel more in control of their thoughts and behaviours, reducing the burden on our mental health services and, ultimately, saving lives.”

Go to www.mindhealthconnect.org.au for more information on the portal.

The Black Dog Institute will be launching a unique online self-help tool called ‘myCompass’ on the mindhealthconnect portal on 23rd July 2012.

Interviews are available with both Prof Helen Christensen and A/Prof Judy Proudfoot. Contact Gayle McNaught on 0401 625 905 or email g.mcnaught@blackdog.org.au

Australian and New Zealand Mental Health Association
Web:  http://anzmh.asn.au
Email:  education@anzmh.asn.au

Mental health needs high for indigenous

Michelle Henderson, AAP National Medical Writer

Mental health services for Aboriginal people in custody need to be developed urgently, according to a study that found most Queensland indigenous inmates suffered from a mental illness.

The Queensland Forensic Mental Health Services study of 419 indigenous men and women from six high-security prisons found that about 73 per cent of men and 86 per cent of women had a mental health disorder.

Women were more likely than men to report suffering from an anxiety, depressive or psychotic disorder, the study found.

Half the women suffered anxiety, about a third suffered depressive disorders and 23 per cent had a psychotic disorder.

This compared with 20 per cent of men with anxiety, 11 per cent with depression and eight per cent with a psychotic disorder.

The most common anxiety disorder among men and women was post-traumatic stress and the most prevalent depression disorder was major depression.

Most men and women - 66 per cent and 69 per cent respectively - had a substance misuse disorder, usually alcohol or cannabis dependence.

"These findings highlight a critical mental health need for these individuals, both in custody and during the transition back to their communities," the report in the Medical Journal of Australia said.

"There remains an urgent need to develop and resource culturally capable mental health services for indigenous Australians in custody."

Royal Australian and New Zealand College of Psychiatrists president Maria Tomasic said there was a shortage of culturally appropriate mental health services for indigenous people in rural and remote regions and in prisons.

Dr Tomasic said indigenous people experienced significantly higher rates of health problems and mental illness than other Australians.

"With such high rates of indigenous representation in prisons, indigenous mental health is a priority," she said.

Aboriginal and Torres Strait Islander people are 14 times more likely to be jailed than non-indigenous Australians, the report said.

Meanwhile, in a letter published in the MJA, Heart Foundation clinical issues director Robert Grenfell said hospitals needed to improve care of indigenous people experiencing symptoms of heart attack.

He said Aboriginal and Torres Strait Islander people were less likely to receive the diagnostic tests and treatments they need and were therefore more likely to die of heart attack in hospital.

Australian and New Zealand Mental Health Association:  
Web:    http://anzmh.asn.au   Email: conference@anzmh.asn.au

University of New England to lead mental health research

Australian Government joint media release with the Federal Member for New England, Mr Tony Windsor MP


The University of New England is set to become a regional hub for mental health research, thanks to a $4.8 million Collaborative Research Network (CRN) project announced June 4th.

Launching the CRN for Mental Health and Wellbeing in Rural Regions project in Armidale today, Parliamentary Secretary for Higher Education and Skills, Sharon Bird, said the University of New England will work to build world-class research capacity and deliver outcomes in mental health.

"The project will tackle pressing national issues such as high rates of suicide in regional areas, disabilities and sexual health," Ms Bird said.

"Australians living in rural and regional Australia are often faced with drought, flood, unemployment, social isolation and barriers to mental health care services.

"Left untreated, mental health can reduce the wellbeing of rural and regional communities and undermine their resilience and sustainability.

"The research this new initiative will provide will help deliver tangible outcomes to regional communities."

Member for New England, Tony Windsor, said the project was a great opportunity for the University of New England.

"This initiative will see the University of New England work closely with partner universities - La Trobe University, University of Newcastle, University of New South Wales and University of Sydney - as well as the Hunter New England Area Health Service," Mr Windsor said.

"The project will play a key role in positioning the University of New England as a regional hub for mental health research."

Minister for Science and Research, Senator Chris Evans, said the project will lead to direct improvements in the lives of regional Australians.

"The work done as part of this project will be critical in developing an understanding of the rural health workforce, individual self-care, disabilities, health and inclusion, as well as the capacity of biomedical science to better lead to diagnosis and treatment in regional areas," Senator Evans said.

"This targeted research will lead to practical applications in regional communities - and deliver sustainable improvements in health issues that impact people in regional areas across Australia.

The Australian Government is investing $61.5 million in 12 CRN projects across Australia, in fields such as health, medicine, science and research.

Media Contact: Parliamentary Secretary's office, 02 6277 4717

Click here to view release 
View the PRIME7 video

Carer Appraisal Scale - A Carer-Based Assessment of Patient Functioning

Measurement of patient outcomes is an integral part of mental health service evaluation, as well as guiding clinical practice to ensure best outcomes for patients. Despite there existing numerous tools for quantifying patient functioning based on clinician assessments or self-reports, there is a serious paucity of tools available for the carers of patients to appraise their functioning.

Collateral information is well recognised as being integral for assessments of patients, but there are very few structured systems for assessing patients based on the perceptions of carers. This is despite the usually greater lengths of time carers spend with patients than clinicians.

Dr Neil Jeyasingam describes a tool developed for use in a community aged care psychiatric service, which involves four sections:

• a global impression of patient progress,
• a scorable checklist of patient functioning in multiple domains,
• a qualitative section for identifying the most pressing concerns from the carer's perspective, and
• an open-ended feedback on treatment to date.

In this pilot study, Dr Jeyasingam validated the tool against multiple well-recognised clinician assessment tools, and found good correlation in most domains. In addition, there was extensive positive feedback from carers themselves regarding our use of this tool in regular clinical practice.

Dr Jeyasingam feels this tool has the potential for use in other community aged care psychiatric services, as it provides a framework for communication of concerns, assists in prioritising care and adds value to clinician treatment plans, as well as providing another dimension to assessment of the patient.

Practical implications of its use, limitations and potential for modifications to suit other settings will be also discussed.

Dr Neil Jeyasingam, Old Age Psychiatrist, Northern Sydney / Central Coast Area Health Service will present at the:

13th International Mental Health Conference, "Positive Change -- Investing in Mental Health"  6th to the 8th of August 2012, on the Gold Coast. 

Web: http://anzmh.asn.au/conference Email: conference@anzmh.asn.au

Studies suggest that even slight mental decline can harm health

MONDAY, July 16 (HealthDay News)

Even the state of mild cognitive impairment, which often precedes dementia, is associated with a wide array of negative health effects, two new studies suggest.

According to the U.S. National Institutes of Health, mild cognitive impairment (MCI) is defined as "the stage between normal forgetfulness due to aging and the development of dementia." People with MCI -- which does not necessarily progress to dementia -- have mild issues with thinking and memory that do not keep them from daily activities.

The two studies on MCI were to be presented Monday in Vancouver at the annual meeting of the Alzheimer's Association.


Even though it may not seem alarming, mild cognitive impairment should be taken seriously, particularly among patients already struggling to manage other health problems, experts say.

Mental decline "of any kind is serious, and requires increased medical and personal attention," Dr. Ronald Petersen, a member of the Alzheimer's Association Board of Directors, explained in a news release issued by the meeting's organizers.

"These studies validate the challenges of people living with MCI and their families and speak to the need for physician education to better manage their cognitive impairment and its broader impact on a person's physical, mental and social health," Peters said.

One study was conducted by investigators from the Albert Einstein College of Medicine of Yeshiva University in New York City. Led by Mindy Katz, researchers tracked more than 700 men and women over the age of 70 for up to 16 years (the typical patient was tracked for about five years). At the study launch, nearly one-quarter had already developed some form of MCI or full-blown dementia.

Katz' team found that those who had or developed dementia or MCI were "significantly" more likely (roughly two to three times as likely) to die than those who remained mentally healthy.

Read the full article here

Australian and New Zealand Mental Health Association:  
Web:    http://anzmh.asn.au   Email: conference@anzmh.asn.au

The Integration of Resolution with Recovery Principles for the Ageing Person

The “Australian National Standards for Mental Health Services 2010”, in conjunction with the “Implementation guidelines for Public Mental Health Services and Private Hospitals” both inform and guide the development and application of appropriate practices across the lifespan.

Embedded within these standards are the principles of recovery which include “gaining and retaining hope, understanding of one’s abilities and disabilities, engagement in an active life, personal autonomy, social identity, meaning and purpose in life and a positive sense of self.”

Several developmental theorists present conceptual frameworks that describe stages or developmental tasks that arise during the life spectrum and which characterize stages of maturity. The descriptive “Integrity versus Despair” period of Erikson neatly conceptualizes the dilemma faced by the ageing client of successful integration of life challenges and achievements contrasted against the despair of meaninglessness and failure.

Jonathan and Joan address the specific adaptation of recovery principles to the challenge of the resolution of life meaning for the older person.

Applying the principles of recovery for the older person (65 years and older) suffering from mental illness, is a challenge for clinicians at a time when the generative activities of life are often on the wane and at a time when they may begin to dwell on inevitable mortality.

In Western cultures death is not integrated fully into the fabric of life.

Failure to recognize the importance and influence of dying can distort and warp adaptive maturation, giving rise to anxiety disorders, depression and an all pervading sense of hopelessness, thwarting attempts by the mental health worker to engage meaningfully.

A complementary theoretical framework of resolution is presented which integrates principles of recovery into a holistic approach to the unique and complex challenges that present in the later stages of the lifespan. Meaning and self determination are emphasized in this approach, and resolution of life issues is addressed in three domains, namely; resolution of focus, priorities and meaning.

Mr Jonathan Smith & Joan Gavan, Older Persons Mental Health Community Team  will present at the:

13th International Mental Health Conference, "Positive Change -- Investing in Mental Health"  6th to the 8th of August 2012, on the Gold Coast.

Web: http://anzmh.asn.au/conference Email: conference@anzmh.asn.au

Empowering Peer Support Workers in Mental Health Service Delivery

Moving away from a deficits-approach, scholars have described recovery as a journey, in which a person:

(1) makes sense of their experience;
(2) learns to manage their illness;
(3) regains psychological and emotional well-being; and
(4) takes on socially valued roles.

Some authors argue that recovery is best seen in terms of social interaction. It is suggested that peer support is a key component of recovery as it holds negligible assumptions about a person’s capacities and limitations, and avoids hierarchical relationships between health care providers and patients, thus allowing people living with a mental illness to move away from their disability to attempt new, health-enriching behaviours with one another.

Recent mental health policy and funding further reflects the rising importance of the role of Peer Support Workers (PSWs) in addressing the needs of mental health consumers in Western Australia. However, studies on peer support in Australia have been scarce.

Grace presents findings from the first phase of a larger study designed to investigate how peer support facilitates recovery for people with mental illness in Western Australia. Ten interviews were conducted with managers, policy makers, educators and supervisors of peer support workers, from government and non governmental service providers to:

(1) explore the role of peer support in the organisation;
(2) examine how peer support workers are prepared for and supported in their roles and
(3) investigate their perspective of the peer support relationship.

The following themes emerged from the interviews:

(1) working with and through the lived experience of mental illness;
(2) the characteristics of successful PSWs;
(3) recruiting and developing PSWs;
(4) developing peer support as a profession;
(5) embracing PSWs as colleagues in the workplace.

Addressing these issues warrant the attention of policy makers and management, as the establishment of Peer Support services in Western Australia advances.

Mrs Grace Zeng, Lecturer, Curtin University will present at the:

13th International Mental Health Conference, "Positive Change -- Investing in Mental Health"  6th to the 8th of August 2012, on the Gold Coast.

Web: http://anzmh.asn.au/conference Email: conference@anzmh.asn.au

Family Focus: promoting resilience and preventing mental illness in children of parents with depression and anxiety

Improved understanding of the processes that promote resilience in children of parents with a mental illness has resulted in the development of a number of evidence based preventive interventions for this population group.

An example of this is the ‘Family Talk’ intervention, which has been successfully implemented in a number of European health systems. The intervention aims to promote family communication and strengthen the resilience of children of parents with depression.

The success of this approach has lead to a recent Australian adaptation of the preventive intervention by the Children of Parent’s with a Mental Illness (COPMI) national initiative. The adaptation titled ‘Family Focus’ includes a DVD for families and online training for mental health professionals in the preventive intervention. The adaptation of this intervention has been informed by international and national consultation, consumer and carer involvement, and exploration of the enablers to facilitating system–wide implementation of this intervention.

Bradley will provide conference participants with an understanding of the Family Focus program, the international evidence for this approach, strategies undertaken to adapt the intervention for the Australian context and system wide approaches to promote accessibility of this intervention for Australian families Conclusions System-wide strategies to prevent the transfer of mental illness and promote resilience in children of parents with depression and anxiety can be successful.
Building on international experience, Australian families where a parent has depression or anxiety could also benefit from selective prevention strategies that promote child mental health.

Mr Bradley Morgan, Workforce Development Officer, COPMI National Initiative will present at the:

13th International Mental Health Conference, "Positive Change -- Investing in Mental Health"  6th to the 8th of August 2012, on the Gold Coast.

Web: http://anzmh.asn.au/conference Email: conference@anzmh.asn.au

Depression is not a normal part of ageing

Depression is not a normal part of ageing. It’s an illness that can have serious consequences if it isn’t recognised and treated. Depression is often not well recognised or detected in older people.

Symptoms such as sadness, sleep and appetite problems or mood changes may be dismissed as a ‘normal’ part of ageing. These symptoms may also be confused with other conditions such as dementia.

Depression can damage a person’s quality of life and their relationships with friends and family. Severe depression can be life threatening as a risk factor for suicidal thoughts and suicide.

 Depression is often not recognised in older people

Symptoms of depression that would cause concern in a younger person, such as insomnia or social withdrawal, may be disregarded in older people as ‘just old age’. People also sometimes assume that problems with memory or concentration are due to age-related changes in thinking, rather than being due to depression. Older people may also find it difficult to talk about feeling sad or depressed. Depression can affect memory and concentration, particularly in elderly people.

Depression is not a normal part of ageing

Older people do not necessarily suffer higher rates of depression. Recent surveys have found older people in good health and living in their own home have lower rates of depression than people of younger age groups. However, the incidence of depression was higher in older people who were in poor health, living in a care facility or nursing home, or who were otherwise isolated.

Situations such as illness, disability, loss and loneliness are more common for older people. It is normal to grieve when faced with loss or illness, but depression is a more severe and persistent sadness. It is not a normal reaction to these events and should always be investigated and treated appropriately.

Be aware - download the fact sheet here

Australia and New Zealand Mental Health Association Inc
Web:  http://anzmh.asn.au

Life values, active procrastination, and psychological wellbeing

Prof Richard Hicks

People's life values are thought to be inherently positive forces for decision making and giving direction to life. Some values may clash with society or workplace environments. But decision making is not always easy in complex and confusing times. This can lead to delay of decision making, or what many people would call procrastination.

Procrastination in the workplace and among students is thought to be associated generally with negative wellbeing. However, according to recent studies procrastination may be either passive (the 'old-style' procrastination) or active. Little is known about the new approach or whether active procrastination is healthy-- nor is much known about whether purposeful life values (such as those proposed in Acceptance and Commitment Therapy- ACT) are related to active procrastination and/or psychological wellbeing.

Richard will present information on the relationships among life values, active procrastination and wellbeing from a survey of 120 university students. The survey package involved use of the new ACT Values Questionnaire, the 2004 Active and Passive Procrastination Scales, and the Ryff Psychological Wellbeing Scale.

Results show generally positive relationships. Essentially findings suggest traditional (passive) procrastination is unhealthy; and active procrastination may be healthy: strongest relationships are found between life values, meaning and psychological wellbeing. Use of the Values
Questionnaire as part of counselling and psychotherapy to help re-orient decision making and direction may be helpful for many in their personal and work lives.

Prof Richard Hicks, Professor of Psychology, Bond University will present at the:

13th International Mental Health Conference, "Positive Change -- Investing in Mental Health"  6th to the 8th of August 2012, on the Gold Coast.

Web: http://anzmh.asn.au/conference Email: conference@anzmh.asn.au

Examining the impact on adult children caring for elderly parents with mental illness

Caring for elderly parents with mental illness

It was hypothesized that the children of elderly parents with a long-standing mental illness have differing needs when faced with the caring role compared to first-time carers of elderly mentally ill parents.

This research contrasts the experiences of long-term carers of elderly parents who have had a long-standing mental illness and first-time carers of parents who have become mentally unwell or in need of care in older age.

Using a qualitative research methodology and interpretive perspective, eight carers were interviewed using a standardised questionnaire from which salient issues were drawn and analysed.

Long term carers faced issues including a longer duration of care-giver stress, early entry into adult responsibilities of caring, frustrations concerning lack of recognition from mental health services and cumulative stress affecting long-term carer’s significant relationships and own health.

First-time carers sought earlier access to mental health services, specialist information about mental health issues and coping strategies for the care giving role. All carers were able to identify ways to improve support to children caring for ageing mentally ill parents.

Both sets of carers , irrespective of the duration of their sharing experiences, shared complex and competing demands on their physical and emotional resources.

Prof Kuruvilla George, Director of Aged Persons Mental Health and Director of Medical Services, Peter James Centre and Wantirna Health, Eastern Health will present at the:

13th International Mental Health Conference, "Positive Change -- Investing in Mental Health"  6th to the 8th of August 2012, on the Gold Coast.

Web: http://anzmh.asn.au/conference Email: conference@anzmh.asn.au

'Surviving and Thriving' - a new culture in co-location

Who are Stepping Up?

Stepping Up is an awarding winning consortium that consists of four not-for-profit agencies: Interact Australia, Odyssey House Victoria, Task Force and Youth Projects who came together to delivery a number of programs including forensic, mental health, alcohol and other drug treatment services.

Recently Stepping Up have acquired a new therapeutic counselling service ( x3 locations) that celebrates Psychologists, MSW's, RN's Psych and AOD Generalist on an innovated program that is housed inside Match Works employment services.

This has presented itself with many layers of challenges. The marriage of employment and complex behaviours. The staff have many years of experiences however they have never physically sat in a open office shared space with the employment staff.  Let the fun begin.

The Surviving:

• How to build and new service with professional and clinical integrity?
• How to attract and retain highly skill and qualified staff?
• How to create an environment of mentally healthy staff in foreign environment?
• Support is a language not ever heard in Employment Services - for the staff have only to obtain numbers.

The Thriving:

• Talking.
• Breathing.
• Self Reflection.
• Education.
• Preventative approaches - this is before we actually had any face to face sessions with the consumer.
• Attendance at combined staff meetings.
• Providing training and education from a non policing.
• Staff feeling it is their role to embrace a collaboration with a people focused approach.

How can we best service the community from a population approach.

• External Supervision monthly.
• Peer Reviews.
• Individual supervision.
• Coaching and regular discussion about what is working and what are our growth areas.

Ms Shelley Cross, General Manager, Stepping Up Consortium will present at the: 13th International Mental Health Conference, "Positive Change -- Investing in Mental Health"  6th to the 8th of August 2012, on the Gold Coast.

Web: http://anzmh.asn.au/conference Email: conference@anzmh.asn.au

Treatment decision making for young people diagnosed with major depressive disorders: The case for shared decision making

Shared decision making (SDM) is a model of medical or treatment decision making that involves collaboration between a clinician and client. One way of implementing SDM is with the use of decision aids (DA), which have demonstrated effectiveness for non-psychiatric conditions and emerging evidence for adults diagnosed with mental disorders.

A theoretical basis for SDM for young people has been made, yet work in this area is in its infancy.

The aim is to develop an online, evidence-based, preference sensitive DA to support young people facing a choice about treatment for moderate to severe depression.

The DA was based on systematic reviews and semi-structured qualitative interviews that were conducted with clients (n=10), caregivers (n=5) and clinicians (n=22) about their experiences and beliefs about treatment decision making for young people diagnosed with major depressive disorders.

Further consultations were held with medical, consumer and caregiver experts and pilot testing completed the development process.

Data from interviews demonstrated that client preference for involvement in treatment decision making for depression is not static and may vary with different clients and at different times for the same client. Caregiver involvement was seen as optional.

All participants voiced a preference for interactive, evidence-based information to support decision making. Based on this and consultations with expert groups, a DA was developed and pilot tested. Clients and clinicians found the DA to be acceptable and useful, and their feedback was used to refine the DA.

Treatment decision making in this area is a complex process that can be supported with the use of an evidence-based, preference-sensitive DA. The development of this DA contributes to the emerging field of youth SDM and can now be further tested for effectiveness. Approaches such as this DA hold the potential to improve client satisfaction, adherence and clinical outcomes.

Ms Magenta Simmons,  Research Fellow Headspace Centre of Excellence in Youth Mental Health will present at the:

13th International Mental Health Conference, "Positive Change -- Investing in Mental Health"  6th to the 8th of August 2012, on the Gold Coast.

Web: http://anzmh.asn.au/conference Email: conference@anzmh.asn.au