Matthew Spittal

Public Service Announcements to Change Attitudes about Youth Suicide: A Randomized Controlled Trial

Publisher: Informa UK Limited

Date: 06-2021

DOI: 10.1080/13811118.2020.1765929

Impact of tobacco control policies and mass media campaigns on monthly adult smoking prevalence

Publisher: American Public Health Association

Date: 08-2008

DOI: 10.2105/AJPH.2007.128991

Abstract: Objectives. We sought to assess the impact of several tobacco control policies and televised antismoking advertising on adult smoking prevalence. Methods. We used a population survey in which smoking prevalence was measured each month from 1995 through 2006. Time-series analysis assessed the effect on smoking prevalence of televised antismoking advertising (with gross audience rating points [GRPs] per month), cigarette costliness, monthly sales of nicotine replacement therapy (NRT) and bupropion, and smoke-free restaurant laws. Results. Increases in cigarette costliness and exposure to tobacco control media c aigns significantly reduced smoking prevalence. We found a 0.3-percentage-point reduction in smoking prevalence by either exposing the population to televised antismoking ads an average of almost 4 times per month (390 GRPs) or by increasing the costliness of a pack of cigarettes by 0.03% of gross average weekly earnings. Monthly sales of NRT and bupropion, exposure to NRT advertising, and smoke-free restaurant laws had no detectable impact on smoking prevalence. Conclusions. Increases in the real price of cigarettes and tobacco control mass media c aigns broadcast at sufficient exposure levels and at regular intervals are critical for reducing population smoking prevalence.

Cohort profile: Ten to men (the Australian longitudinal study on male health)

Publisher: Oxford University Press (OUP)

Date: 29-09-2017

DOI: 10.1093/IJE/DYW055

Intellectual disability and patient activation after release from prison

Publisher: Wiley

Date: 16-01-2017

DOI: 10.1111/JIR.12349

Abstract: Intellectual disability and patient activation may be important drivers of inequities in health service access and health outcomes for people with intellectual disability transitioning from prison to the community. We assessed the association between intellectual disability and patient activation after prison release and examined whether this association varied, depending on whether intellectual disability was identified prior to prison release. Overall, 936 prisoners were screened for intellectual disability by using the Hayes Ability Screening Index and completed the Patient Activation Measure (PAM) within 6 weeks of prison release and again at 1, 3 and 6 months post-release. We estimated the association between intellectual disability status and PAM scores by using a multilevel linear model, adjusting for sociodemographic, behavioural, health and criminogenic factors. We used propensity score matching to estimate the impact of being identified with intellectual disability prior to release from prison on the change in mean PAM score after prison release. Compared with those who screened negative for intellectual disability, ex-prisoners who screened positive, both with and without prior identification of intellectual disability, had significantly decreased mean PAM scores [(B = -4.3 95% CI: -6.3, -2.4) and (B = -4.5 95% CI: -6.8, -2.3), respectively] over 6 months of follow-up. Among those who reported being identified with intellectual disability prior to release from prison, a significant increase in PAM score at the 6-month follow-up interview (B = 5.89 95% CI: 2.35, 9.42 P = 0.001) was attributable to being identified with intellectual disability prior to release. Ex-prisoners screening positive for possible intellectual disability have decreased patient activation for at least 6 months after release from prison. However, in iduals whose possible intellectual disability is unidentified appear to be particularly vulnerable. Incarceration is a pivotal opportunity for the identification of intellectual disability and for initiating transitional linkages to health and intellectual disability-specific community services for this marginalised population.

Self-harm following release from prison: A prospective data linkage study

Publisher: SAGE Publications

Date: 29-09-2017

DOI: 10.1177/0004867416640090

Abstract: Prisoners are at increased risk of both self-harm and suicide compared with the general population, and the risk of suicide after release from prison is three times greater than for those still incarcerated. However, surprisingly little is known about the incidence of self-harm following release from prison. We aimed to determine the incidence of, identify risk factors for and characterise emergency department presentations resulting from self-harm in adults after release from prison. Cohort study of 1325 adults interviewed prior to release from prison, linked prospectively with State correctional and emergency department records. Data from all emergency department presentations resulting from self-harm were secondarily coded to characterise these presentations. We used negative binomial regression to identify independent predictors of such presentations. During 3192 person-years of follow-up (median 2.6 years per participant), there were 3755 emergency department presentations. In all, 83 (6.4%) participants presented due to self-harm, accounting for 165 (4.4%) presentations. The crude incidence rates of self-harm for males and females were 49.2 (95% confidence interval: [41.2, 58.7]) and 60.5 (95% confidence interval: [44.9, 81.6]) per 1000 person-years, respectively. Presenting due to self-harm was associated with being Indigenous (incidence rate ratio: 2.01 95% confidence interval: [1.11, 3.62]), having a lifetime history of a mental disorder (incidence rate ratio: 2.13 95% confidence interval: [1.19, 3.82]), having previously been hospitalised for psychiatric treatment (incidence rate ratio: 2.68 95% confidence interval: [1.40, 5.14]) and having previously presented due to self-harm (incidence rate ratio: 3.91 95% confidence interval: [1.85, 8.30]). Following release from prison, one in 15 ex-prisoners presented to an emergency department due to self-harm, within an average of 2.6 years of release. Demographic and mental health variables help to identify at-risk groups, and such presentations could provide opportunities for suicide prevention in this population. Transition from prison to the community is challenging, particularly for those with a history of mental disorder mental health support during and after release may reduce the risk of adverse outcomes, including self-harm.

Structural intervention at one bridge decreases the overall jumping suicide rate in Victoria, Australia

Publisher: Cambridge University Press (CUP)

Date: 2023

DOI: 10.1017/S2045796023000720

Evaluating the effectiveness of a website about masculinity and suicide to prompt help‐seeking

Publisher: Wiley

Date: 10-03-2019

DOI: 10.1002/HPJA.237

Abstract: A website was designed to form the core of a multimedia strategy surrounding the Man Up documentary - a three-part documentary that aimed to address the problem of male suicide in Australia. Together these formed a media-based, public health intervention that explored the link between masculinity and suicide and promoted help-seeking. This is of great importance given the demonstrated link between masculine norms, men's reduced help-seeking and suicidal thinking. This study assesses the website's effectiveness in facilitating help-seeking and fostering conversations about suicide, mental health and help-seeking. Help-seeking indicators included website clicks to helping organisations, downloads of health information from the website and request for help received via emails. Google Analytics data, emails to the Man Up team received through the website and open-ended responses to an online survey were analysed. The website reached 43 140 users. Indictors of help-seeking activity on the website included 307 outbound clicks to helping organisations and 802 downloads of health information. Qualitative analysis of emails received and responses to the survey demonstrated that Man Up's messages resonated with viewers and provided further evidence of help-seeking. The findings demonstrate that the website provided an important opportunity for people to engage with Man Up and seek help. SO WHAT?: Media-based public health interventions offer enormous potential to provide suicide prevention interventions and promote help-seeking. The website evaluation findings provide insight into the ways in which websites can be used as part of a multimedia strategy to address the problem of male suicide.

Opiate substitution treatment to reduce in-prison drug injection: A natural experiment

Publisher: Elsevier BV

Date: 09-2013

DOI: 10.1016/J.DRUGPO.2013.01.004

Abstract: There is emerging evidence that opiate substitution treatment (OST) in prison is associated with reduced injecting drug use (IDU). In Australia OST is available in prison for men and women in all jurisdictions except Queensland, where it is available only for women. The aim of this study was to examine the association between in-prison OST and in-prison IDU in New South Wales (NSW) and Queensland. Cross-sectional survey of Australian prisoners in NSW (N=1128) and Queensland (N=1325). Lifetime IDU and in-prison IDU measured by self-report. Lifetime history of IDU was significantly more common among females than males in both jurisdictions. Among those with a lifetime history of IDU, the lifetime prevalence of in-prison IDU was significantly higher for males than females in both jurisdictions, however the magnitude of this sex difference was considerably greater in Queensland than in NSW. Provision of OST in prison is associated with a reduced lifetime prevalence of in-prison drug injection, among those with a lifetime history of IDU. Irrespective of OST policies, women with a history of IDU are less likely than their male counterparts to inject in prison reasons for this novel and replicable sex difference require further examination.

The relationship between working conditions and self-rated health among medical doctors: evidence from seven waves of the Medicine In Australia Balancing Employment and Life (Mabel) survey

Publisher: Springer Science and Business Media LLC

Date: 29-08-2017

DOI: 10.1186/S12913-017-2554-Z

Comparison of accredited person and medical officer discharge decisions under the Mental Health Act of NSW: A cohort study of deliberate self-poisoning patients

Publisher: SAGE Publications

Date: 05-05-2022

DOI: 10.1177/00048674211009613

Abstract: The Accredited Persons Programme was introduced in 2003. The relevant Mental Health Acts (NSW) authorised reviews by appropriately credentialed non-medical health professionals as part of the process of detaining and treating a person without consent: an authority previously held by medical officers. Evaluations of the Programme are needed. To compare discharge decisions for hospital-treated deliberate self-poisoning patients made by an Accredited Person and Medical Officers. For a 10-year cohort (2003–2012) of index hospital-treated deliberate self-poisoning admissions at the Calvary Mater Newcastle, we compared Accredited Person and Medical Officer discharge decisions from the general hospital. We specifically examined discharges to the psychiatric hospital under a Mental Health Act certificate (used as an index of the Accredited Person’s use of the authority under the Accredited Persons Programme) compared to any other discharge destination. Unadjusted and adjusted logistic regression models and a propensity score analysis were used to explore the relationship between clinician type and discharge destination. There were 2237 index assessments (Accredited Person = 884 Medical Officer = 1443). One-quarter (27%) were referred for assessment under the Act at the psychiatric hospital, with the Accredited Person significantly more likely (32%) to require this compared to the Medical Officers (24%) Risk Difference: 8.3% (4.5 to 12.1). However, after adjusting for patient characteristics Risk Difference: −3.0% (−5.9 to −0.1) and for propensity score, Risk Difference: −3.3% (−6.7 to 0.1), the Accredited Person and Medical Officer likelihood of discharging for an assessment under the Act was similar. The Accredited Person assessed more clinically complex patients than the Medical Officers. After adjusting for clinical complexity and propensity score, the likelihood of referral for involuntary psychiatric hospital care was similar for Accredited Person and Medical Officers. Our evaluation of the Accredited Person programme in the general hospital was favourable, and wider implementation and evaluation is warranted.

Neonatal abstinence syndrome and other neonatal outcomes for the infants of women experiencing incarceration

Publisher: Wiley

Date: 16-10-2023

DOI: 10.1002/AJS4.296

The Australian longitudinal study on male health-methods

Publisher: Springer Science and Business Media LLC

Date: 10-2016

DOI: 10.1186/S12889-016-3698-1

High rates of general practice attendance by former prisoners: a prospective cohort study

Publisher: AMPCo

Date: 07-2017

DOI: 10.5694/MJA16.00841

Abstract: To determine the rates at which people recently released from prison attend general practitioners, and to describe service users and their encounters. Prospective cohort study of 1190 prisoners in Queensland, interviewed up to 6 weeks before expected release from custody (August 2008 - July 2010) their responses were linked prospectively with Medicare and Pharmaceutical Benefits Scheme data for the 2 years after their release. General practice attendance was compared with that of members of the general Queensland population of the same sex and in the same age groups. Rates of general practice attendance by former prisoners during the 2 years following their release from prison. In the 2 years following release from custody, former prisoners attended general practice services twice as frequently (standardised rate ratio, 2.04 95% CI, 2.00-2.07) as other Queenslanders 87% of participants visited a GP at least once during this time. 42% of encounters resulted in a filled prescription, and 12% in diagnostic testing. Factors associated with higher rates of general practice attendance included history of risky opiate use (incidence rate ratio [IRR], 2.09 95% CI, 1.65-2.65), having ever been diagnosed with a mental disorder (IRR, 1.32 95% CI, 1.14-1.53), and receiving medication while in prison (IRR, 1.82 95% CI, 1.58-2.10). Former prisoners visited general practice services with greater frequency than the general Queensland population. This is consistent with their complex health needs, and suggests that increasing access to primary care to improve the health of former prisoners may be insufficient, and should be accompanied by improving the quality, continuity, and cultural appropriateness of care.

Outcomes of the Victorian Safewards trial in 13 wards: Impact on seclusion rates and fidelity measurement

Publisher: Wiley

Date: 27-09-2017

DOI: 10.1111/INM.12380

Abstract: Restrictive practices are used in response to conflict and aggression in psychiatric inpatient settings. Reducing such practices is the focus internationally of policy and legislative change, many initiatives, and a growing body of research. Safewards is a model and a set of 10 interventions designed to reduce conflict and containment in inpatient services. In the current study, we aimed to assess the impact of implementing Safewards on seclusion in Victorian inpatient mental health services in Australia. The study used a before-and-after design, with a comparison group matched for service type. Thirteen wards opted into a 12-week trial to implement Safewards and 1-year follow up. The comparison group was all other wards (n = 31) with seclusion facilities in the jurisdiction, matched to service type. Mandatorily-reported seclusion event data for all 44 wards over a 15-month period were analysed using negative binomial regression. Adherence to Safewards was measured via fidelity checklists at four time points: twice during the trial, post-trial, and at 1-year follow up. Seclusion rates were reduced by 36% in Safewards trial wards by the 12-month follow-up period (incidence rate ratios (IRR) = 0.64,) but in the comparison wards seclusion rates did not differ from baseline to post-trial (IRR = 1.17) or to follow-up period (IRR = 1.35). Fidelity analysis revealed a trajectory of increased use of Safewards interventions after the trial phase to follow up. The findings suggest that Safewards is appropriate for practice change in Victorian inpatient mental health services more broadly than adult acute wards, and is effective in reducing the use of seclusion.

Weekend Sun Protection and Sunburn in Australia. Trends (1987-2002) and Association with SunSmart Television Advertising

Publisher: Elsevier BV

Date: 02-2008

DOI: 10.1016/J.AMEPRE.2007.09.024

Abstract: The Australian state of Victoria has run a population-based skin cancer prevention program called SunSmart since 1988, incorporating substantial public education efforts and environmental change strategies. Trends over 15 years in behavioral risk factors for skin cancer were examined in a population exposed to the SunSmart program. Whether outcomes were associated with extent of SunSmart television advertising was then assessed. In nine cross-sectional surveys from 1987 to 2002, 11,589 adults were interviewed by telephone about their sun exposure and sun protection during outdoor activities on summer weekends. Analyses completed in 2007 adjusted for ambient temperature and ultraviolet radiation. Sun protection and sunburn show substantial general improvement over time, but have stalled in recent years. Use of hats and sunscreens significantly increased over time and peaked during the mid to late 1990s, compared with the pre-SunSmart baseline. The mean proportion of unprotected skin was reduced and was lowest in the summer of 1997-1998. Summer sunburn incidence declined over time and was 9.1% in 2002, almost half baseline (OR=0.53 95% CI=0.39-0.73). Higher exposure to SunSmart advertising in the 4 weeks before the interview increased: (1) preference for no tan, (2) hat and sunscreen use, and (3) proportion of body surface protected from the sun. The general improvement in sun-protective behaviors over time highlight that a population's sun-protective behaviors are amenable to change. Population-based prevention programs incorporating substantial television advertising c aigns into the mix of strategies may be highly effective in improving a population's sun-protective behaviors.

Evaluating the Effectiveness of Components of National Suicide Prevention Strategies

Publisher: Hogrefe Publishing Group

Date: 07-2023

DOI: 10.1027/0227-5910/A000887

Abstract: Abstract. Background: National suicide prevention strategies support development of suicide prevention activities and their evaluation. Aims: To describe components included in national suicide prevention strategies and analyze the potential contribution of in idual components to reduce suicide rates. Method: We conducted a narrative review and statistical analysis of national suicide prevention strategies. The narrative review was based on a framework of 12 components and included 29 countries (14 lower middle-income countries [LMICs] and 15 high-income countries [HICs]) with a national suicide prevention strategy. The statistical analyses covered suicide mortality data for 24 countries with a national strategy (9 LMICs and 15 HICs). Results: The number of components adopted in national strategies ranged from 4 to 11, and training and education were included in 96.5% of strategies. Estimated period effects for total suicide rates in in idual countries ranged from a significant decrease in the yearly suicide rate (RR = 0.80 95% CI 0.69–0.93) to a significant increase (RR = 1.12 95% CI 1.05–1.19). There were no changes in suicide mortality associated with in idual components of national strategies. Limitations: The limitations of existing suicide mortality data apply to our study. Conclusion: Further detailed evaluations will help identify the specific contribution of in idual components to the impact national strategies. Until then, countries should be encouraged to implement and evaluate comprehensive national suicide prevention strategies.

Mechanisms of brief contact interventions in clinical populations: a systematic review

Publisher: Springer Science and Business Media LLC

Date: 08-06-2016

DOI: 10.1186/S12888-016-0896-4

Letters, green cards, telephone calls and postcards: systematic and meta-analytic review of brief contact interventions for reducing self-harm, suicide attempts and suicide

Publisher: Royal College of Psychiatrists

Date: 03-2015

DOI: 10.1192/BJP.BP.114.147819

Abstract: There is growing interest in brief contact interventions for self-harm and suicide attempt. To synthesise the evidence regarding the effectiveness of brief contact interventions for reducing self-harm, suicide attempt and suicide. A systematic review and random-effects meta-analyses were conducted of randomised controlled trials using brief contact interventions (telephone contacts emergency or crisis cards and postcard or letter contacts). Several sensitivity analyses were conducted to examine study quality and subgroup effects. We found 14 eligible studies overall, of which 12 were amenable to meta-analyses. For any subsequent episode of self-harm or suicide attempt, there was a non-significant reduction in the overall pooled odds ratio (OR) of 0.87 (95% CI 0.74–1.04, P = 0119) for intervention compared with control. The number of repetitions per person was significantly reduced in intervention v. control (incidence rate ratio IRR = 066, 95% CI 0.54–0.80, P ). There was no significant reduction in the odds of suicide in intervention compared with control (OR = 0.58, 95% CI 0.24–1.38). A non-significant positive effect on repeated self-harm, suicide attempt and suicide and a significant effect on the number of episodes of repeated self-harm or suicide attempts per person (based on only three studies) means that brief contact interventions cannot yet be recommended for widespread clinical implementation. We recommend further assessment of possible benefits in well-designed trials in clinical populations.

Identification of doctors at risk of recurrent complaints: a national study of healthcare complaints in Australia

Publisher: BMJ

Date: 10-04-2013

DOI: 10.1136/BMJQS-2012-001691

Testing the Impact of the #chatsafe Intervention on Young People’s Ability to Communicate Safely About Suicide on Social Media: Protocol for a Randomized Controlled Trial

Publisher: JMIR Publications Inc.

Date: 17-02-2023

DOI: 10.2196/44300

Abstract: Suicide is the leading cause of death among Australians. One commonly cited explanation is the impact of social media, in particular, the ways in which young people use social media to communicate about their own experiences and their exposure to suicide-related content posted by others. Guidelines designed to assist mainstream media to safely report about suicide are widespread. Until recently, no guidelines existed that targeted social media or young people. In response, we developed the #chatsafe guidelines and a supporting social media c aign, which together make up the #chatsafe intervention. The intervention was tested in a pilot study with positive results. However, the study was limited by the lack of a control group. The aim of this study is to assess the impact of the #chatsafe social media intervention on young people’s safety and confidence when communicating on the web about suicide. The study employs a pragmatic, parallel, superiority randomized controlled design. It will be conducted in accordance with the Consolidated Standards of Reporting Trials statement over 18 months. Participants will be 400 young people aged 16-25 years (200 per arm). Participants will be recruited via social media advertising and assessed at 3 time points: time 1—baseline time 2—8-week postintervention commencement and time 3—4-week postintervention. They will be asked to complete a weekly survey to monitor safety and evaluate each piece of social media content. The intervention comprises an 8-week social media c aign including social media posts shared on public Instagram profiles. The intervention group will receive the #chatsafe suicide prevention content and the control group will receive sexual health content. Both groups will receive 24 pieces of content delivered to their mobile phones via text message. The primary outcome is safety when communicating on the web about suicide, as measured via the purpose-designed #chatsafe online safety questionnaire. Additional outcomes include willingness to intervene against suicide, internet self-efficacy, safety, and acceptability. The study was funded in November 2020, approved by the University of Melbourne Human Research Ethics Committee on October 7, 2022, and prospectively registered with the Australian New Zealand Clinical Trials registry. Trial recruitment began in November 2022 and study completion is anticipated by June 2024. This will be the first randomized controlled trial internationally to test the impact of a social media intervention designed to equip young people to communicate safely on the web about suicide. Given the rising rates of youth suicide in Australia and the acceptability of social media among young people, incorporating social media–based interventions into the suicide prevention landscape is an obvious next step. This intervention, if effective, could also be extended internationally, thereby improving web-based safety for young people not just in Australia but globally. Australian New Zealand Clinical Trials Registry ACTRN12622001397707 anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384318 DERR1-10.2196/44300

What impact have tobacco control policies, cigarette price and tobacco control programme funding had on Australian adolescents' smoking? Findings over a 15-year period

Publisher: Wiley

Date: 21-06-2011

DOI: 10.1111/J.1360-0443.2011.03429.X

Abstract: To assess the impact of tobacco control policies relating to youth access, clean indoor air and tobacco advertising at point-of-sale and outdoors, in addition to cigarette price and per capita tobacco control spending, on adolescent smoking prevalence. Repeated cross-sectional surveys. Logistic regression analyses examined association between policies and smoking prevalence. Australia, 1990-2005. A nationally representative s le of secondary students (aged 12-17 years) participating in a triennial survey (s le size per survey range: 20 560 to 27 480). Students' report of past-month smoking. In each jurisdiction, extent of implementation of the three policies for the year of the survey was determined. For each survey year, national per capita tobacco control spending was determined and jurisdiction-specific 12-month change in cigarette price obtained. Extent of implementation of the three policy areas varied between states and over the survey years. Multivariate analyses that adjusted for demographic factors, year and all tobacco control variables showed that 12-month cigarette price increases [odds ratio (OR): 0.98, 95% confidence interval (CI): 0.97-0.99], greater per capita tobacco control spending (OR: 0.99, 95% CI: 0.98-0.99) and stronger implementation of clean indoor air policies (OR: 0.93, 95% CI: 0.92-0.94) were associated with reduced smoking prevalence. Adult-directed, population-based tobacco control policies such as clean indoor air laws and increased prices of cigarettes, implemented as part of a well-funded comprehensive tobacco control programme are associated with lower adolescent smoking.

Suicides in Australia following media reports of the death of Robin Williams

Publisher: SAGE Publications

Date: 21-11-2019

DOI: 10.1177/0004867419888297

Abstract: This study assessed the extent to which local reporting of Robin Williams’ suicide (on 11 August 2014) was associated with suicide in Australia. It followed several studies in the United States which showed that there were significant increases in suicide following media reports of Williams’ death and that those media reports were less than optimal in terms of adherence to best-practice guidelines. In a previous study, we demonstrated that Australian media reports of Williams’ suicide were largely adherent with our Mindframe guidelines on responsible reporting of suicide, so we speculated that there would be no increase in suicide following the reporting of Williams’ suicide in Australia. We extracted data on Australian suicides from the National Coroners Information System for the period 2001 to 2016. We conducted interrupted time series regression analyses to determine whether there were changes in suicides in the 5-month period immediately following Williams’ suicide. Our hypothesis that there would be no increase in suicides in Australia following Williams’ highly publicised suicide was not supported. There was an 11% increase in suicides in the 5-month period following Williams’ death, largely accounted for by men aged 30–64 and by people who died by hanging (the method Williams used). It may be that Australians were exposed to reports that contravened safe reporting recommendations, particularly via overseas media or social media, and/or that some Australian reports may have had unhelpful overarching narratives, despite largely adhering to the Mindframe guidelines. The Mindframe guidelines constitute international best practice but consideration should be given to whether certain recommendations within them should be further reinforced and whether more nuanced information about how stories should be framed could be provided. Future revision and augmentation of the Mindframe guidelines should, as always, involve media professionals.

Predictors of suicides occurring within suicide clusters in Australia, 2004–2008

Publisher: Elsevier BV

Date: 10-2014

DOI: 10.1016/J.SOCSCIMED.2014.08.005

Abstract: A number of studies have investigated the presence of suicide clusters, but few have sought to identify risk and protective factors of a suicide occurring within a cluster. We aimed to identify socio-demographic and contextual characteristics of suicide clusters from national and regional analyses of suicide clusters. We searched the National Coroners Information System for all suicides in Australia from 2004 to 2008. Scan statistics were initially used to identify those deaths occurring within a spatial-temporal suicide cluster during the period. We then used logistic regression and generalized estimation equations to estimate the odds of each suicide occurring within a cluster differed by sex, age, marital status, employment status, Indigenous status, method of suicide and location. We identified 258 suicides out of 10,176 suicides during the period that we classified as being within a suicide cluster. When the deceased was Indigenous, living outside a capital city, or living in the northern part of Australia (in particular, Northern Territory, Queensland and Western Australia) then there was an increased likelihood of their death occurring within a suicide cluster. These findings suggest that suicide clustering might be linked with geographical and Indigenous factors, which supported sociological explanations of suicide clustering. This finding is significant for justifying resource allocation for tackling suicide clustering in particular areas.

Railway suicide clusters: how common are they and what predicts them?

Publisher: BMJ

Date: 18-11-2016

DOI: 10.1136/INJURYPREV-2016-042029

Abstract: A growing number of studies have sought to detect clusters of all suicides, but few have sought to identify clusters of method-specific suicides. Data on railway suicides occurring in Victoria, Australia, between 2001 and 2012 were obtained from the National Coronial Information System. We used the Poisson discrete scan statistic to identify railway suicides that occurred close together in space and/or time. We then used a case-control design to compare clustered railway suicides with non-clustered railway suicides on a range of in idual and neighbourhood factors. We detected four spatial clusters that accounted for 35% of all railway suicides. Railway suicides by in iduals who were hospitalised for mental illness had nearly double the odds of being in a cluster compared with those in iduals who had never been hospitalised (OR 1.80, 95% CI 1.02 to 3.18). Higher frequency train services were associated with increased odds of being in a cluster (OR 1.11, 95% CI 1.03 to 1.19). No other predictors were associated with being in a cluster. Railway suicides that occur in clusters warrant particular attention because of the ripple effect they can have for communities and the risk that they may lead to copycat acts. Railway suicide prevention strategies should consider the fact that these suicides can occur in clusters, particularly among in iduals who had previous hospitalisations for mental illness or live in areas with high-frequency train services.

Children's sun exposure and sun protection: Prevalence in Australia and related parental factors

Publisher: Elsevier BV

Date: 06-2012

DOI: 10.1016/J.JAAD.2011.06.015

Abstract: Reducing childhood exposure to ultraviolet radiation is important to minimize lifetime skin cancer risk. We sought to describe the prevalence of children's sun-related behaviors and associated parental and other factors. In weekly cross-sectional telephone interviews during summer, 1140 parents/guardians of children aged 0 to 11 years were recruited. Parents provided proxy reports for one of their children. Key questions related to weekend sun protection and sunburn, parent's sun-related attitudes, and demographic characteristics. Potential predictors of children's sun protection and sunburn were analyzed adjusting for covariates including weather conditions on the previous weekend. On summer weekends, 73% of children spent longer than 15 minutes outdoors in peak ultraviolet radiation periods. Of these, 64% were protected by a hat and 58% by sun-protection factor 15 or higher sunscreen, 32% stayed under shade, and 18% wore three-quarter or long-sleeved tops. Overall, 8% of children had sunburn. Parental attitudes were typically supportive of children's sun protection. Parental use of hats (odds ratio [OR] 3.1 95% confidence interval [CI] 1.6-6.2), shade (OR 9.6 95% CI 4.4-20.8), sunscreen (OR 12.6 95% CI 5.2-30.4), longer leg cover (OR 10.3 95% CI 4.4-24.0), and two or more protective behaviors (OR 5.7 95% CI 2.8-11.9) increased the odds of their children practicing these behaviors, as did some parental attitudes. We relied on cross-sectional parent reports. Although children's sun protection was favorable, there was room for improvement. Health promotion to improve sun-protection practices in adults may benefit children's sun-safe behaviors.

Predictors of using trains as a suicide method: Findings from Victoria, Australia

Publisher: Elsevier BV

Date: 07-2017

DOI: 10.1016/J.PSYCHRES.2017.03.057

Abstract: This study aimed to investigate the factors associated with the choice of trains over other means of suicide. We performed a case-control study using data on all suicides in Victoria, Australia between 2009 and 2012. Cases were those who died by rail suicide and controls were those who died by suicide by any other means. A logistic regression model was used to estimate the association between the choice of trains and a range of in idual-level and neighbourhood-level factors. In iduals who were never married had double odds of using trains compared to in iduals who were married. Those from areas with a higher proportion of people who travel to work by train also had greater odds of dying by railway suicide compared to those from areas with a relatively lower proportion of people who travel to work by train. Prevention efforts should consider limiting access to the railways and other evidence-based suicide prevention activities.

Effectiveness of online and mobile telephone applications ('apps') for the self-management of suicidal ideation and self-harm: a systematic review and meta-analysis

Publisher: Springer Science and Business Media LLC

Date: 15-08-2017

DOI: 10.1186/S12888-017-1458-0

Patterns and Predictors of Primary Mental Health Service Use Following Bushfire and Flood Disasters

Publisher: Cambridge University Press (CUP)

Date: 14-04-2015

DOI: 10.1017/DMP.2015.23

Abstract: To examine patterns and predictors of primary mental health care service use following 2 major Australian natural disaster events. Utilizing data from a national minimum dataset, descriptive and regression analyses were conducted to identify levels and predictors of the use of the Access to Allied Psychological Services (ATAPS) program over a 2-year period following 2 major Australian bushfire and flood/cyclone disasters. The bushfire disaster resulted in significantly greater and more enduring ATAPS service volume, while service delivery for both disasters peaked in the third quarter. Consumers affected by bushfires (IRR 1.51, 95% CI 1.20–1.89), diagnosed with depression (IRR 2.57, 95% CI 1.60-4.14), anxiety (IRR 2.06, 95% CI 1.21-3.49), or both disorders (IRR 2.15, 95% CI 1.35-3.42) utilized treatment at higher rates. The substantial demand for primary mental health care services following major natural disasters can vary in magnitude and trajectory with disaster type. Disaster-specific ATAPS services provide a promising model to cater for this demand in primary care settings. Disaster type and need-based variables as drivers of ATAPS use intensity indicate an equitable level of service use in line with the program intention. Established service usage patterns can assist with estimating capacity requirements in similar disaster circumstances. ( Disaster Med Public Health Preparedness. 2015 :275-282)

Clusters of suicides and suicide attempts: detection, proximity and correlates

Publisher: Cambridge University Press (CUP)

Date: 09-06-2016

DOI: 10.1017/S2045796016000391

Abstract: A suicide cluster is defined as a higher number of observed cases occurring in space and/or time than would typically be expected. Previous research has largely focused on identifying clusters of suicides, while there has been comparatively limited research on clusters of suicide attempts. We sought to identify clusters of both types of behaviour, and having done that, identify the factors that distinguish suicide attempts inside a cluster from those that were outside a cluster. We used data from Western Australia from 2000 to 2011. We defined suicide attempts as admissions to hospital for deliberate self-harm and suicides as deaths due to deliberate self-harm. Using an analytic strategy that accounted for the repetition of attempted suicide within a cluster, we performed spatial-temporal analysis using Poisson discrete scan statistics to detect clusters of suicide attempts and clusters of suicides. Logistic regression was then used to compare clustered attempts with non-clustered attempts to identify risk factors for an attempt being in a cluster. We detected 350 (1%) suicide attempts occurring within seven spatial-temporal clusters and 12 (0.6%) suicides occurring within two spatial-temporal clusters. Both of the suicide clusters were located within a larger but later suicide attempt cluster. In multivariate analysis, suicide attempts by in iduals who lived in areas of low socioeconomic status had higher odds of being in a cluster than those living in areas of high socioeconomic status [odds ratio (OR) = 29.1, 95% confidence interval (CI) = 6.3–135.5]. A one percentage-point increase in the proportion of people who had changed address in the last year was associated with a 60% increase in the odds of the attempt being within a cluster (OR = 1.60, 95% CI = 1.29–1.98) and a one percentage-point increase in the proportion of Indigenous people in the area was associated with a 7% increase in the suicide being within a cluster (OR = 1.07, 95% CI = 1.00–1.13). Age, sex, marital status, employment status, method of harm, remoteness, percentage of people in rented accommodation and percentage of unmarried people were not associated with the odds of being in a suicide attempt cluster. Early identification of and responding to suicide clusters may reduce the likelihood of subsequent clusters forming. The mechanisms, however, that underlie clusters forming is poorly understood.

Identification of young females at high risk of suicide following hospital-treated self-harm in Victoria, Australia

Publisher: SAGE Publications

Date: 07-04-2023

DOI: 10.1177/00048674231165226

Abstract: We conducted a data linkage study in Victoria, Australia, to determine the proportion of young females who are treated in hospital for self-harm who go on to die by suicide within 5 years and to identify factors associated with increased suicide risk in this same cohort. We undertook a cohort study following 3689 female patients aged 10–24 years, who were initially treated in hospital for self-harm during the 2-year period January 2011 to December 2012. We followed each patient for 5 years unless they died first, in which case, they were followed until their date of death. We used inpatient admissions from the Victorian Admitted Episodes Dataset and emergency department presentations from the Victorian Emergency Minimum Dataset linked to death data from two sources, the Victorian Suicide Register and the National Death Index. Twenty-eight in iduals (0.76% of the total cohort) died by suicide within 5 years of their index admission. In multivariate survival analysis, only suicide ideation at the time of self-harm (hazard ratio = 4.59 95% confidence interval: 1.70, 12.38) and a decreasing time between successive self-harm episodes (hazard ratio = 4.38 95% confidence interval: 1.28, 15.00) were associated with increased suicide risk. Although the vast majority of young females who present to hospital for self-harm do not die by suicide within 5 years, our results suggest young females expressing suicide ideation and those presenting frequently with decreasing time between successive episodes should be prioritised for suicide-prevention efforts.

Does Gender Explain the Relationship Between Occupation and Suicide? Findings from a Meta-Analytic Study

Publisher: Springer Science and Business Media LLC

Date: 17-05-2015

DOI: 10.1007/S10597-015-9889-X

Abstract: This report investigated whether suicide risk by occupational groups differed for males and females. We examined this using a sub-set of articles examined in a recent meta-analysis and stratified by gender. For certain occupational groups, males and females had a similar risk of suicide (the military, community service occupations, managers, and clerical workers). There was some indication of gender differences for other occupations (technicians, plant and machine operators and ship's deck crew, craft and related trades workers, and professionals), although these did not reach statistical significance. These findings highlight the complexity of the relationship between occupation and suicide and suggest the possible role of a range of in idual, work-related and social-environmental risk factors that may differ for males and females.

Improving access to primary mental health care for Australian children

Publisher: SAGE Publications

Date: 30-09-2016

DOI: 10.1177/0004867416671412

Abstract: This study examines the uptake by children aged predominantly 0–11 years of an Australian primary mental health service – the Access to Allied Psychological Services programme – which began in 2001. In particular, it considers access to, and use of, the child component of Access to Allied Psychological Services, the Child Mental Health Service, introduced in 2010. Using routinely collected programme data from a national minimum dataset and regional population data, we conducted descriptive and regression analysis to examine programme uptake, predictors of service reach and consumer- and treatment-based characteristics of service. Between 2003 and 2013, 18,631 referrals for children were made and 75,178 sessions were scheduled via Access to Allied Psychological Services, over 50% of which were via the Child Mental Health Service in its first 3 years of operation. The rate of referrals for children to the Child Mental Health Service was associated with the rate of Access to Allied Psychological Services referrals for consumers aged 12+ years. The Child Mental Health Service has increased services provided within the Access to Allied Psychological Services programme for children with emotional and behavioural issues and their families, and is potentially filling a service gap in the area of prevention and early intervention for children who have significant levels of need but are unable to access other mental health services. Our findings are policy-relevant for other developed countries with a similar primary mental health care system that are considering means of improving service access by children.

Suicide Prevention Public Service Announcements (PSAs): Examples from Around the World

Publisher: Informa UK Limited

Date: 16-06-2016

DOI: 10.1080/10410236.2016.1140269

Abstract: Media c aigns have received increased attention as an intervention for combating suicide. Suicide prevention c aigns involving public service announcements (PSAs) have not been well described and have been subject to minimal evaluation. This study aimed to identify suicide prevention PSAs from around the world and analyze and describe their content. We searched the Internet for short, English-language PSAs that had been screened as part of suicide prevention c aigns and identified 35. Most commonly, these PSAs focused on the general population and/or people who might be at risk of suicide, and had a particular emphasis on young people. Almost 60% promoted open discussion about suicide, around 50% indicated that the life of a suicidal person was important, about 40% acknowledged the suffering associated with suicidal thoughts and feelings, about 25% stressed that suicide is preventable, and about 20% focused on the devastating impact of suicide for those left behind. Most PSAs promoted some sort of support for people at risk of suicide, usually a helpline or website. Although these messages appeared appropriate and practical there is a lack of research on the impact that they may have on people with varying degrees of suicide risk. Further work is needed to ensure that they are consistent with theories of behavior change, and that they are having their desired impacts.

Maternal incarceration increases the risk of self-harm but not suicide

Publisher: Cambridge University Press (CUP)

Date: 2023

DOI: 10.1017/S2045796023000264

Abstract: Children of incarcerated mothers are at increased risk of experiencing multiple adversity such as poverty, mental illness and contact with child protection services (CPS), including being taken into out of home care (OOHC). However, little is known about whether these children are at increased risk of suicide or self-harm compared to children not exposed to maternal incarceration or about the factors that may contribute to this. We aimed to investigate differences in the risk of suicide and self-harm between children exposed to maternal incarceration and those not exposed and examine how socio-demographic factors, maternal mental illness and CPS contact (with or without OOHC) may affect these outcomes. We used a retrospective matched cohort study design, comparing 7674 children exposed to maternal incarceration with 7674 non-exposed children. We used multivariable Cox proportional hazards regression to compare the risk of suicide and self-harm between exposed and non-exposed groups, controlling for geographical remoteness, CPS contact and maternal mental illness. There was no significant difference in the rate of suicide (rate ratio [RR] = 1.49 95% confidence interval [CI]: 0.78, 2.87) or risk of suicide (adjusted hazard ratio [aHR] = 0.92 95% CI: 0.43, 1.96) between the two groups. However, the exposed group had a significantly higher rate of self-harm (RR = 2.83 95% CI: 2.50, 3.21) and a significantly higher risk of self-harm (aHR = 1.74 95% CI: 1.45, 2.09) compared to those non-exposed. CPS contact with or without OOHC was independently associated with an increased risk of self-harm for both groups. Children exposed to maternal incarceration are at an increased risk of self-harm and should be prioritized to receive targeted, multimodal support that continues after the mother’s release from prison. The association between CPS contact and self-harm warrants further research.

Outcomes of Victorian Prevention and Recovery Care Services: A matched pairs comparison

Publisher: SAGE Publications

Date: 11-01-2021

DOI: 10.1177/0004867420983473

Abstract: In Victoria, Prevention and Recovery Care Services have been established to provide a partial alternative to inpatient admissions through short-term residential mental health care in the community. This study set out to determine whether Prevention and Recovery Care Services are achieving their objectives in relation to reducing service use and costs, fostering least restrictive care and leading to positive clinical outcomes. We matched 621 consumers whose index admission in 2014 was to a Prevention and Recovery Care (‘PARCS consumers’) with 621 similar consumers whose index admission in the same year was to an acute inpatient unit and who had no Prevention and Recovery Care stays for the study period (‘inpatient-only consumers’). We used routinely collected data to compare them on a range of outcomes. Prevention and Recovery Care Services consumers made less subsequent use of acute inpatient services and, on balance, incurred costs that were similar to or lower than inpatient-only consumers. They were also less likely to spend time on an involuntary treatment order following their index admission. Prevention and Recovery Care Services consumers also experienced positive clinical outcomes over the course of their index admission, but the magnitude of this improvement was not as great as for inpatient-only consumers. This type of clinical improvement is important for Prevention and Recovery Care Services, but they may place greater emphasis on personal recovery as an outcome. Prevention and Recovery Care Services can provide an alternative, less restrictive care option for eligible consumers who might otherwise be admitted to an acute inpatient unit and do so at no greater cost.

High prevalence of health and social risk behaviours among men experiencing suicidal thoughts and behaviour: The imperative to undertake holistic assessments

Publisher: SAGE Publications

Date: 23-05-2020

DOI: 10.1177/0004867420924098

Abstract: We aimed to examine whether suicidal thoughts and behaviour were independently associated with a wide range of health and social risk behaviours. We conducted cross-sectional analyses of data collected from 13,763 adult males who participated in The Australian Longitudinal Study on Male Health. We fit generalised linear models to estimate the relative risk of engaging in a range of health and social risk behaviours across several domains by suicidal thoughts and behaviour status. Men with recent suicidal ideation (relative risk range, 1.10–5.25) and lifetime suicide attempts (relative risk range, 1.10–7.65) had a higher risk of engaging in a broad range of health and social risk behaviours. The associations between suicidal thoughts and behaviour and health and social risk behaviours were typically independent of socio-demographics and in many cases were also independent of depressive symptoms. Suicidal thoughts and behaviour overlaps with increased risk of engagement in a wide range of health and social risk behaviours, indicating the need for an alignment of broader public health interventions within clinical and community-based suicide prevention activities. The experience of suicidality may be an important catalyst for a broader psychosocial conversation and assessment of health and social risk behaviours, some of which may be modifiable. These behaviours may not carry an imminent risk of premature death, such as from suicide, but they carry profound health and social consequences if left unaddressed.

Antismoking television advertising and socioeconomic variations in calls to Quitline

Publisher: BMJ

Date: 04-2007

DOI: 10.1136/JECH.2005.043380

Trajectories of psychological distress after prison release: implications for mental health service need in ex-prisoners

Publisher: Cambridge University Press (CUP)

Date: 09-11-2015

DOI: 10.1017/S0033291715002123

Abstract: Understanding in idual-level changes in mental health status after prison release is crucial to providing targeted and effective mental health care to ex-prisoners. We aimed to describe trajectories of psychological distress following prison discharge and compare these trajectories with mental health service use in the community. The Kessler Psychological Distress Scale (K10) was administered to 1216 sentenced adult prisoners in Queensland, Australia, before prison release and approximately 1, 3 and 6 months after release. We used group-based trajectory modeling to identify K10 trajectories after release. Contact with community mental health services in the year following release was assessed via data linkage. We identified five trajectory groups, representing consistently low (51.1% of the cohort), consistently moderate (29.8%), high increasing (11.6%), high declining (5.5%) and consistently very high (1.9%) psychological distress. Mood disorder, anxiety disorder, history of self-harm and risky drug use were risk factors for the high increasing, very high and high declining trajectory groups. Women were over-represented in the high increasing and high declining groups, but men were at higher risk of very high psychological distress. Within the high increasing and very high groups, 25% of participants accessed community mental health services in the first year post-release, for a median of 4.4 contact hours. For the majority of prisoners with high to very high psychological distress, distress persists after release. However, contact with mental health services in the community appears low. Further research is required to understand barriers to mental health service access among ex-prisoners.

Taxation Reduces Social Disparities in Adult Smoking Prevalence

Publisher: Elsevier BV

Date: 04-2009

DOI: 10.1016/J.AMEPRE.2008.11.013

Abstract: The CDC, the WHO, and the World Bank promote increases in the price of cigarettes as an effective and important tobacco-control strategy. This study was designed to assess the extent to which the association between the price of cigarettes and smoking prevalence, as measured monthly, varies by income group. Australian population survey data collected monthly from January 1991 to December 2006 were used to estimate Poisson regression models to assess the impact of the price of cigarettes on smoking prevalence across three income groups. Analyses were conducted in 2008. There was strong evidence that real price and prevalence were negatively associated (p<0.001) and that the association was stronger in lower-income groups (p<0.001). One Australian dollar increase in price was associated with a decline of 2.6%, 0.3%, and 0.2% in the prevalence of smoking among low-, medium-, and high-income groups, respectively. Increasing the price of cigarettes not only is an effective tobacco-control strategy to lower smoking prevalence in the general population, but also may provide a means of reducing social disparities in smoking.

Masculinity and suicidal thinking

Publisher: Springer Science and Business Media LLC

Date: 26-12-2016

DOI: 10.1007/S00127-016-1324-2

Abstract: Males feature prominently in suicide statistics, but relatively little work has been done to date to explore whether endorsement of dominant masculinity norms heightens the risk of or is protective against suicidal thinking. This paper aimed to further knowledge in this area. We used baseline data from 13,884 men (aged 18-55) in the Australian Longitudinal Study on Male Health (Ten to Men) cohort. These men filled in self-complete questionnaires in 2013/14 which covered a range of topics, including conformity to dominant masculinity norms and suicidal thinking. We conducted logistic regression analyses to estimate the strength of association between these two variables. After controlling for other key predictors of suicidal thinking, one characteristic of dominant masculinity-self-reliance-stood out as a risk factor for suicidal thinking (AOR 1.33 95% CI 1.25-1.42). It suggests that one particular element of dominant masculinity-being self-reliant-may place men at increased risk of suicidal thinking. This finding resonates with current theories of how suicidal thinking develops and leads to action. It also has implications for the full gamut of suicide prevention approaches that target males in clinical settings and in the general population, and for our broader society. Further work is needed, however, to confirm the direction of the relationship between self-reliance and suicidality, and to unpack the means through which self-reliance may exert an influence.

Clinical Improvement after Treatment Provided Through the Better Outcomes in Mental Health Care (BOiMHC) Programme: Do Some Patients Show Greater Improvement Than Others?

Publisher: SAGE Publications

Date: 04-2011

DOI: 10.3109/00048674.2010.539195

Abstract: Objective: Australia's Better Outcomes in Mental Health Care (BOiMHC) programme enables GPs to refer patients with common mental disorders to allied health professionals for time-limited treatment, through its Access to Allied Psychological Services (ATAPS) projects. This paper considers whether patients who receive care through the ATAPS projects make clinical gains, if so, whether particular patient-related and treatment-related variables are predictive of these outcomes. Method: Divisions of General Practice (Divisions), which run the ATAPS projects, are required to enter de-identified data into a minimum dataset, including data on patients’ socio-demographic and clinical characteristics, the sessions of care they receive, and their clinical outcomes. We extracted data from January 2006 to June 2010, and examined the difference between mean pre- and post-treatment scores on the range of outcome measures being used by Divisions. We then conducted a linear regression analysis using scores on the most commonly-used outcome measure as the outcome of interest. Results: Pre- and post-treatment outcome data were available for 16 700 patients from nine different outcome measures. Across all measures, the mean difference was statistically significant and indicative of clinical improvement. The most commonly-used measure was the Kessler-10 (K-10), and pre- and post-treatment K-10 data were available for 7747 patients. After adjusting for clustering by Division, outcome on the K-10 was associated with age, levels of income and education, previous receipt of mental health care, number of sessions, treatment received and pre-treatment K-10 score. The benchmark was sufficiently high, however, that even the groups that fared relatively less well still showed strong improvement in absolute terms. Conclusions: Patients who receive care through the ATAPS projects are making considerable clinical gains. A range of socio-demographic, clinical and treatment-based variables are associated with the levels of outcomes achieved, but improvements are still substantial even for those in the relatively disadvantaged groups.

Compensation seeking and disability after injury: The role of compensation-related stress and mental health

Publisher: Physicians Postgraduate Press, Inc

Date: 26-08-2015

DOI: 10.4088/JCP.14M09211

The effectiveness of suicide prevention delivered by GPs: A systematic review and meta-analysis

Publisher: Elsevier BV

Date: 03-2017

DOI: 10.1016/J.JAD.2016.12.035

Abstract: The aim of this review was to assess whether suicide prevention provided in the primary health care setting and delivered by GPs results in fewer suicide deaths, episodes of self-harm, attempts and lower frequency of thoughts about suicide. We conducted a systematic review and meta-analysis using PRIMSA guidelines. Eligible studies: 1) evaluated an intervention provided by GPs 2) assessed suicide, self-harm, attempted suicide or suicide ideation as outcomes, and 3) used a quasi-experimental observational or trial design. Study specific effect sizes were combined using the random effects meta-analysis, with effects transformed into relative risk (RR). We extracted data from 14 studies for quantitative meta-analysis. The RR for suicide death in quasi-experimental observational studies comparing an intervention region against another region acting as a "control" was 1.26 (95% CI 0.58, 2.74). When suicide in the intervention region was compared before and after the GP program, the RR was 0.78 (95% CI 0.62, 0.97). There was no evidence of a treatment effect for GP training on rates of suicide death in one cRCT (RR 1.07, 95% CI 0.79, 1.45). There was no evidence of effect for the most other outcomes studied. All of the studies included in this review are likely to have a high level of bias. It is also possible that we excluded or missed relevant studies in our review process CONCLUSIONS: Interventions have produced equivocal results, which varied by study design and outcome. Given these results, we cannot recommend the roll out of GP suicide prevention initiatives.

Age Matters: Exploring Correlates of Self-Rated Health Across Four Generations of Australian Males

Publisher: Informa UK Limited

Date: 23-06-2016

DOI: 10.1080/08964289.2015.1121132

Abstract: The importance of addressing health disparities experienced by boys and men reached tangible prominence in Australia with adoption of the 2010 National Male Health Policy and the establishment of a national longitudinal study on male health-Ten to Men. Ten to Men is based on a holistic model of health with a strong focus on social determinants and health and well-being over the life course. Given the life course focus, we set out to assess if health-related characteristics and the correlates of self-rated health differ across the life course among four sociologically defined generations of Australian males. While some differences in the correlates of good or excellent health were observed across generations, addressing obesity and depression appear to be important for improving the health of Australian males of all ages.

Frequent callers to telephone helplines: new evidence and a new service model

Publisher: Springer Science and Business Media LLC

Date: 31-05-2016

DOI: 10.1186/S13033-016-0076-4

Confidence and Intentions to Help a Person at Risk of Suicide

Publisher: Wiley

Date: 24-07-2020

DOI: 10.1111/SLTB.12575

Abstract: We aimed to identify Australian adults' current level of confidence and intentions to help a person close to them in distress or at risk of suicide to inform the content and targeting of suicide prevention messages aimed at family and friends of those at risk. We conducted a nationally representative computer-assisted telephone survey of confidence and intentions to help someone in distress or at risk of suicide (n = 3,002). We used logistic regression to determine whether sociodemographic and exposure variables predicted confidence and intentions to help. Confidence to help was high. About half of the respondents had intentions inconsistent with best practice. Listening and talking, and encouraging the person to seek professional help were the most common types of intended helping actions. Intentions to ask suicide risk assessment questions were least common. Men were more likely than women to have intentions to carry out nonrecommended actions, and less likely to have intentions to carry out recommended actions. Suicide prevention messaging aimed at family and friends could encourage them to ask direct questions about suicide risk and could include messages about "what not to do." Suicide prevention messages aimed specifically at men are indicated.

Preliminary evidence for the role of newsprint media in encouraging males to make contact with helplines

Publisher: Computers, Materials and Continua (Tech Science Press)

Date: 15-03-2017

DOI: 10.1080/14623730.2017.1307774

Patterns and predictors of primary mental health service use following bushfire and flood disasters

Publisher: Informa UK Limited

Date: 12-2014

DOI: 10.3402/EJPT.V5.26527

Abstract: Mental health care services play an important role following disasters (Reifels et al., 2013). The aim of this study is to examine patterns and predictors of primary mental health care service use, following two major Australian natural disaster events. Utilizing referral and session data from a national minimum dataset, descriptive and regression analyses were conducted to identify levels and predictors of the use of the Access to Allied Psychological Services (ATAPS) program over a 2-year period following two major Australian bushfire and flood/cyclone disasters. Predictor variables examined in negative binomial regression analysis included consumer (age, gender, household structure, previous mental health care history, and diagnosis) and event characteristics (disaster type). The bushfire disaster resulted in significantly greater service volume, with more than twice the number of referrals and nearly three times the number of sessions. Service delivery for both disasters peaked in the third quarter. Consumers affected by bushfires, diagnosed with depression, anxiety, or both of these disorders utilized sessions at significantly higher rates. The substantial demand for primary mental health services following disaster can vary with disaster type. Disaster type and need-based variables as key drivers of service use intensity indicate an equitable level of service use. Established usage patterns assist with estimating future service capacity requirements. Flexible referral pathways can enhance access to disaster mental health care. Future research should examine the impact of program- and agency-level factors on mental health service use and factors underpinning treatment non-adherence following disaster.

The effect of leaving employment on mental health: testing ‘adaptation’ versus ‘sensitisation’ in a cohort of working-age Australians

Publisher: BMJ

Date: 02-12-2013

DOI: 10.1136/OEMED-2013-101759

Abstract: To investigate the 'adaptation' versus 'sensitisation' hypotheses in relation to mental health and labour market transitions out of employment to determine whether mental health stabilised (adaptation) or worsened (sensitisation) as people experienced one or more periods without work. The Household Income and Labour Dynamics of Australia (HILDA) longitudinal survey was used to investigate the relationship between the number of times a person had been unemployed or had periods out of the labour force (ie, spells without work) and the Mental Component Summary (MCS) of the Short Form 36 (SF-36). Demographic, health and employment related confounders were included in a series of multilevel regression models. During 2001-2010, 3362 people shifted into unemployment and 1105 shifted from employment to not in the labour force. Compared with participants who did not shift, there was a 1.64-point decline (95% CI -2.05 to -1.23, p<0.001) in scores of the MCS SF-36 among those who had one spell of unemployment (excluding not in the labour force), and a 2.56-point decline (95% CI -3.93 to -1.19, p<0.001) among those who had two or more spells of unemployment after adjusting for other variables. Findings for shifts from employment to 'not in the labour force' were in the same direction however, effect sizes were smaller. These results indicate that multiple spells of unemployment are associated with continued, though small, declines in mental health. Those who leave employment for reasons other than unemployment experience a smaller reduction in mental health.

Effects of mass media campaign exposure intensity and durability on quit attempts in a population-based cohort study

Publisher: Oxford University Press (OUP)

Date: 05-07-2011

DOI: 10.1093/HER/CYR054

Spatial suicide clusters in Australia between 2010 and 2012: a comparison of cluster and non-cluster among young people and adults

Publisher: Springer Science and Business Media LLC

Date: 22-11-2016

DOI: 10.1186/S12888-016-1127-8

Spatial analysis of suicide mortality in Australia: Investigation of metropolitan-rural-remote differentials of suicide risk across states/territories

Publisher: Elsevier BV

Date: 10-2012

DOI: 10.1016/J.SOCSCIMED.2012.04.008

Abstract: Studies of suicide epidemiology in regions of Australia have been conducted, but the spatial pattern in the whole country has not been fully investigated. This study aimed at visualizing the sex-specific suicide pattern over the country from 2004 to 2008, and studying the metropolitan-rural-remote differentials of suicide across all states/territories. We applied a Poisson hierarchical model to yield smoothed sex specific, age standardized mortality ratios of suicide in all postal areas, and compiled the age-standardized suicide rates across different levels of remoteness and different jurisdictions. We identified the area variation of suicide risk across states/territories, and metropolitan-rural-remote differential with rates higher in rural and remote areas for males. Spatial clusters of some high risk postal areas were also identified. Socio-economic deprivation, compositional factors, high risks for Indigenous people and low access to mental health service are the underlying explanations of the elevation of suicide risk in some areas. These findings suggest that it is important to take geographical variations in suicide risk into account in national policy making. Particular suicide prevention interventions might be targeted at males living in remote areas, and some localized areas in metropolitan zones.

Looking for the ‘active ingredients’ in a men’s mental health promotion intervention

Publisher: Informa UK Limited

Date: 25-09-2018

DOI: 10.1080/18387357.2018.1526095

Mandatory reports of concerns about the health, performance and conduct of health practitioners

Publisher: AMPCo

Date: 11-09-2014

DOI: 10.5694/MJA14.00210

Abstract: To describe the frequency and characteristics of mandatory reports about the health, competence and conduct of registered health practitioners in Australia. Retrospective review and multivariate analysis of allegations of "notifiable conduct" involving health practitioners received by the Australian Health Practitioner Regulation Agency (AHPRA) between 1 November 2011 and 31 December 2012. Statutory grounds for reports, types of behaviour reported, and incidence of notifications by profession, sex, age, jurisdiction and geographic area. Of 819 mandatory notifications made during the study period, 501 (62%) related to perceived departures from accepted professional standards, mostly standards of clinical care. Nurses and doctors dominated notifications: 89% (727/819) involved a doctor or nurse in the role of notifier and/or respondent. Health professionals other than the respondents' treating practitioners made 46% of notifications (335/731), and the profession of the notifier and respondent was the same in 80% of cases (557/697). Employers made 46% of notifications (333/731). Psychologists had the highest rate of notifications, followed by medical practitioners, and then nurses and midwives (47, 41 and 40 reports per 10 000 practitioners per year, respectively). Incidence of notifications against men was more than two-and-a-half times that for women (46 v 17 reports per 10 000 practitioners per year P < 0.001) and there was fivefold variation in incidence across states and territories. Although Australia's mandatory reporting regime is in its infancy, our data suggest that some of the adverse effects and manifest benefits forecast by critics and supporters, respectively, have not materialised. Further research should explore the variation in notification rates observed, evaluate the outcomes of reports, and test the effects of the mandatory reporting law on whistleblowing and help-seeking behaviour.

Factors predicting coroners’ decisions to hold discretionary inquests

Publisher: CMA Joule Inc.

Date: 30-01-2012

DOI: 10.1503/CMAJ.110865

The effectiveness of installing trackside fencing in preventing railway suicides: a pre-post study design in Victoria, Australia

Publisher: BMJ

Date: 14-08-2023

DOI: 10.1136/IP-2023-044897

Suicide by occupation: Systematic review and meta-analysis

Publisher: Royal College of Psychiatrists

Date: 12-2013

DOI: 10.1192/BJP.BP.113.128405

Abstract: Previous research has shown that those employed in certain occupations, such as doctors and farmers, have an elevated risk of suicide, yet little research has sought to synthesise these findings across working-age populations. To summarise published research in this area through systematic review and meta-analysis. Random effects meta-analyses were used to calculate a pooled risk of suicide across occupational skill-level groups. Thirty-four studies were included in the meta-analysis. Elementary professions (e.g. labourers and cleaners) were at elevated risk compared with the working-age population (rate ratio (RR) = 1.84, 95% CI 1.46–2.33), followed by machine operators and deck crew (RR = 1.78, 95% CI 1.22–2.60) and agricultural workers (RR = 1.64, 95% CI 1.19–2.28). Results suggested a stepwise gradient in risk, with the lowest skilled occupations being at greater risk of suicide than the highest skill-level group. This is the first comprehensive meta-analytical review of suicide and occupation. There is a need for future studies to investigate explanations for the observed skill-level differences, particularly in people employed in lower skill-level groups. None.

Suicide among health professionals in Australia: A retrospective mortality study of trends over the last two decades

Publisher: SAGE Publications

Date: 19-01-2023

DOI: 10.1177/00048674221144263

Abstract: To examine the relative risk of suicide among healthcare professionals compared to other occupations and examine changes in suicide rates over time. Suicide cases were identified using the National Coronial Information System and were included if they were recorded as a death by intentional self-harm between 2001 and 2017 and were by an employed adult aged 20–69 with a known occupation at the time of death. Suicide methods were reported descriptively. Workforce data at the population level was extracted from the Australian Bureau of Statistics 2011 Census. Age-standardised suicide rates per 100,000 person-years for each of the four occupational groups were calculated using direct standardisation and using the Australian Bureau of Statistics population-level data from the 2011 Census. Negative binomial regression was used to estimate suicide risk by healthcare employment status and profession, to investigate differences by sex and to examine trends in suicide rates over time, using rate ratios and 95% confidence intervals. Healthcare professionals were at increased risk of suicide compared to other occupations (rate ratio = 1.30, 95% confidence interval = [1.19, 1.42], p 0.001), controlling for age, sex and year of death. Nurses and midwives were identified as being at significantly increased risk of suicide (rate ratio = 1.95, 95% confidence interval = [1.73, 2.19], p 0.001). Suicide rates among female medical practitioners increased substantially over time ( p = 0.01). Health professionals are at significantly increased risk of suicide, though the relative risk of different groups is changing over time. There has been a substantial increase in the risk of suicide among female medical practitioners with rates of suicide in this group more than doubling over the last two decades. Findings highlight the need for targeted suicide prevention initiatives for healthcare professionals.

Frequent callers to crisis helplines: Who are they and why do they call?

Publisher: SAGE Publications

Date: 27-06-2014

DOI: 10.1177/0004867414541154

Abstract: Frequent callers present a challenge for crisis helplines, which strive to achieve optimal outcomes for all callers within finite resources. This study aimed to describe frequent callers to Lifeline (the largest crisis helpline in Australia) and compare them with non-frequent callers, with a view to furthering knowledge about models of service delivery that might meet the needs of frequent callers. Lifeline provided an anonymous dataset on calls made between December 2011 and May 2013. We assumed calls from the same (encrypted) phone number were made by the same person, and aggregated call level data up to the person level. In iduals who made 0.667 calls per day in any period from 1 week to the full 549 days for which we had data (i.e. 4.7 calls in 7 days, 20 calls in 30 days, 40 calls in 60 days, etc.) were regarded as frequent callers. Our analysis dataset included 411,725 calls made by 98,174 in iduals, 2594 (2.6%) of whom met our definition of frequent callers. We identified a number of predictors of being a frequent caller, including being male or transgender, and never having been married. The odds increased with age until 55–64 years, and then declined. Suicidality, self-harm, mental health issues, crime, child protection and domestic violence issues all predicted being a frequent caller. Collectively, frequent callers have a significant impact on crisis lines, and solutions need to be found for responding to them that are in everybody’s best interests (i.e. the frequent callers themselves, other callers, telephone crisis supporters who staff crisis lines, and those who manage crisis lines). In striking this balance, the complex and multiple needs of frequent callers must be taken into account.

Geographic variation in inquest rates in Australia

Publisher: Elsevier BV

Date: 11-2012

DOI: 10.1016/J.HEALTHPLACE.2012.08.002

Abstract: This paper examines the relationship between the remoteness of locations in which deaths occur and coroners' decisions to hold inquests. We analysed 16,242 deaths investigated by coroners in three Australian states over 7.5 yrs. We used a choropleth map to show inquest rates in each remoteness locality (excluding deaths for which inquests were mandated by statute). We then used adjusted logistic regression to assess the association between the remoteness of a death's location and the odds coroners would select it for investigation by inquest. We found the remoteness of a death's location strongly and positively predicts the chance that an inquest will be held. Like analogous findings in the delivery of health services, this small-area variation in legal decision making raises questions of appropriateness.

Which types of televised anti-tobacco campaigns prompt more quitline calls from disadvantaged groups?

Publisher: Oxford University Press (OUP)

Date: 29-06-2011

DOI: 10.1093/HER/CYR048

Abstract: To examine the efficacy of different types of mass media ads in driving lower socio-economic smokers (SES) to utilize quitlines. This study collected all 33 719 calls to the Victorian quitline in Australia over a 2-year period. Negative binomial regressions examined the relationship between weekly levels of exposure to different types of anti-smoking ads and quitline calls, after adjusting for covariates. Interaction terms were added to determine whether relationships differed by SES. In total, smokers were exposed 88.39 times to anti-smoking ads over the 2-year period, as estimated by target audience ratings points. Higher emotion narrative ad exposure had the strongest association with quitline calls, increasing call rates by 13% for every additional ad exposure per week (per 100 points, rate ratio = 1.132, P = 0.001). Substantially, greater increases in calls to quitline from lower SES groups were observed when higher emotion narrative ads were on air compared with when other ad types were on air, and this advantage was not as strong among higher SES groups. Airing higher emotion narrative anti-smoking ads may contribute to reducing, but not eliminating, socio-economic disparities in calls to the quitline through maximizing the responses of the lower SES smokers.

Mass media campaign improves cervical screening across all socio-economic groups

Publisher: Oxford University Press (OUP)

Date: 02-04-2009

DOI: 10.1093/HER/CYP023

Abstract: Low socio-economic status (SES) has been associated with lower cervical screening rates. Mass media is one known strategy that can increase cervical screening participation. This study sought to determine whether a mass media c aign conducted in Victoria, Australia, in 2005 was effective in encouraging women across all SES groups to screen. Data were obtained from the Victorian Cervical Cytology Registry for each Pap test registered during 2005 and categorized into SES quintiles using the Index of Socio-Economic Advantage/Disadvantage. Negative binomial regression was used to determine the impact of the c aign on the weekly number of Pap tests and whether the media c aign had a differential effect by SES, after adjusting for the number of workdays per week, age group and time since previous test. Cervical screening increased 27% during the c aign period and was equally effective in encouraging screening across all SES groups, including low-SES women. Mass media c aigns can prompt increased rates of cervical screening among all women, not just those from more advantaged areas. Combining media with additional strategies targeted at low-SES women may help lessen the underlying differences in screening rates across SES.

The effectiveness of structural interventions at suicide hotspots: a meta-analysis

Publisher: Oxford University Press (OUP)

Date: 15-03-2013

DOI: 10.1093/IJE/DYT021

Abstract: Certain sites have gained notoriety as 'hotspots' for suicide by jumping. Structural interventions (e.g. barriers and safety nets) have been installed at some of these sites. In idual studies examining the effectiveness of these interventions have been underpowered. We conducted a meta-analysis, pooling data from nine studies. Following the interventions, there was an 86% reduction in jumping suicides per year at the sites in question (95% CI 79% to 91%). There was a 44% increase in jumping suicides per year at nearby sites (95% CI 15% to 81%), but the net gain was a 28% reduction in all jumping suicides per year in the study cities (95% CI 13% to 40%). Structural interventions at 'hotspots' avert suicide at these sites. Some increases in suicide are evident at neighbouring sites, but there is an overall gain in terms of a reduction in all suicides by jumping.

Violence-related morbidity among people released from prison in Australia

Publisher: Wiley

Date: 12-09-2022

DOI: 10.1111/DAR.13380

Abstract: People released from prison have an increased risk of morbidity, including from nonfatal violence. We examined the incidence and predictors of violence‐related morbidity after release from prison and investigated whether there are differences according to sex and Indigenous status. Baseline data were collected from 1325 people within 6 weeks of release from prisons in Queensland, Australia, between 1 August 2008 and 31 July 2010. Data were linked to state‐wide health (ambulance, emergency department and hospital) and prison records, and national death records until 31 July 2012. Predictors were identified using a multivariable Andersen‐Gill model. Differences according to sex and Indigenous status were investigated using effect modification. A total of 225 (18.2%) people experienced 410 violence‐related events that were recorded in health records. The incidence was 12.8 per 100 person‐years [95% confidence interval (CI) 11.7, 14.1]. Risk factors for violence‐related morbidity included diagnosed mental illness [hazard ratio (HR) = 2.0, 95% CI 1.1, 3.8], substance use disorder (HR = 1.6, 95% CI 1.1, 2.3) or dual diagnosis (HR = 3.2, 95% CI 2.2, 4.8) high‐risk alcohol use (HR = 2.1, 95% CI 1.5, 2.8) being Indigenous (HR = 1.7, 95% CI 1.2, 2.5) and two or more prison releases (HR = 1.7, 95% CI 1.2, 2.6). Indigenous status modified the risk of violence‐related morbidity, with Indigenous men having twice the risk of non‐Indigenous men (HR = 1.9, 95% CI 1.3, 2.8). Approximately one in five people released from prisons in Queensland experienced violence‐related morbidity. Coordinated and continuous mental health and substance use treatment from prison to the community may reduce the risk of violence‐related morbidity in this population.

Associations between workers’ compensation and self-harm: a retrospective case-series study of hospital admissions data

Publisher: Elsevier BV

Date: 2023

DOI: 10.1016/J.LANWPC.2022.100614

Application of Scan Statistics to Detect Suicide Clusters in Australia

Publisher: Public Library of Science (PLoS)

Date: 14-01-2013

DOI: 10.1371/JOURNAL.PONE.0054168

Individual and community factors for railway suicide: a matched case–control study in Victoria, Australia

Publisher: Springer Science and Business Media LLC

Date: 30-03-2016

DOI: 10.1007/S00127-016-1212-9

Abstract: This study aims to simultaneously examine in idual- and community-level factors associated with railway suicide. We performed a case-control study in Victoria, Australia between 2001 and 2012. Data on cases of railway suicide were obtained from the National Coronial Information System (a database of coronial investigations). Controls were living in iduals randomly selected from the Household, Income and Labour Dynamics in Australia study, matching to cases on age groups, sex and year of exposures. A conditional logistic regression model was used to assess the in idual-level and community-level influences on in idual odds of railway suicide, controlling for socioeconomic status. In idual-level diagnosed mental illness increased railway suicide odds by six times [95 % confidence interval (CI) 4.5, 9.2]. Community-level factors such as living in an area with a presence of railway tracks [odds ratio (OR) 1.8, 95 % CI 1.2, 2.8], within a city (OR 3.2, 95 % CI 1.9, 5.4), and with a higher overall suicide rate (OR 1.02, 95 % CI 1.01, 1.04) were independently associated with greater in idual odds of railway suicide compared to living in an area without a presence of railway tracks, outside a city, and with a relatively lower overall suicide rate. The effects of mental illness and high incidence of overall suicides are prominent, but not specific on railway suicide. The effects of presence of railway tracks and city residence suggest the importance of accessibility to the railways for in idual risk of railway suicide. Prevention efforts should focus on vulnerable people live in areas with easy access to the railways.

Cluster Suicides Among Unemployed Persons in Australia Over the Period 2001–2013

Publisher: Springer Science and Business Media LLC

Date: 21-03-2017

DOI: 10.1007/S11205-017-1604-6

Time series analysis of the impact of tobacco control policies on smoking prevalence among Australian adults, 2001–2011

Publisher: WHO Press

Date: 18-03-2014

DOI: 10.2471/BLT.13.118448

Community mental health care after self-harm: A retrospective cohort study

Publisher: SAGE Publications

Date: 12-11-2017

DOI: 10.1177/0004867416676366

Abstract: Presentation to hospital after self-harm is an opportunity to treat underlying mental health problems. We aimed to describe the pattern of mental health contacts following hospital admission focusing on those with and without recent contact with community mental health services (connected and unconnected patients). We undertook a data linkage study of all in iduals admitted as a general or psychiatric inpatient to hospital after self-harm in New South Wales, Australia, between 2005 and 2011. We identified the proportion of admissions where the patient received subsequent in-person community mental health care within 30 days of discharge and the factors associated with receipt of that care. A total of 42,353 in iduals were admitted to hospital for self-harm. In 41% of admissions, the patient had contact with a community mental health service after discharge. Patients connected with community mental health services had 5.33 (95% confidence interval = [5.09, 5.59]) times higher odds of follow-up care than unconnected patients. Other factors, such as increasing age and treatment as a psychiatric inpatient, were associated with lower odds of follow-up community care. Our study suggests that full advantage is not being taken of the opportunity to provide comprehensive mental health care for people who self-harm once they have been discharged from the inpatient setting. This is particularly the case for those who have not previously received community mental health care. There appears to be scope for system-level improvement in the way in which those who are treated for self-harm are followed up in the community.

Substance use and risk of death in young offenders: A prospective data linkage study

Publisher: Wiley

Date: 25-07-2021

DOI: 10.1111/DAR.12179

Abstract: Young offenders are at increased risk of preventable death after release from custody, but risk factors for death in this population are poorly understood. Despite their poor health profiles, no studies have examined mortality outcomes in young people who have served community-based orders. The aims of this study were to describe the causes and identify risk factors for death in a cohort of young offenders in Victoria, Australia. We interviewed young people serving a custodial (n = 273) or community-based order (n = 242) in Victoria, Australia in 2002-2003. Measures included demographics and family history, offence history, experience of victimisation, mental illness, self-harm and substance use. Deaths up to 31 December 2011 were identified through a probabilistic linkage with the National Death Index. The all-cause crude mortality rate was 4.2 (95% confidence interval 2.7-6.8) per 1000 person years and was not significantly different for those who had served custodial and community-based orders. Most deaths were due to drug overdose, traffic accidents or suicide. Adjusting for age, sex and order type, risk factors for death from the baseline interview included weekly use of opioids, sleeping pills or painkillers, polydrug use and injecting drug use. Young people who have served community-based and custodial orders are at an increased risk of preventable death. Those engaging in risky substance use, particularly injecting drug use and use of multiple central nervous system depressants, are at greatest risk. There is an urgent need to develop and rigorously evaluate preventive interventions.

Low Control and High Demands at Work as Risk Factors for Suicide: An Australian National Population-Level Case-Control Study

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 04-2017

DOI: 10.1097/PSY.0000000000000389

Abstract: Previous research suggests that psychosocial job stressors may be plausible risk factors for suicide. This study assessed the relationship between psychosocial job stressors and suicide mortality across the Australian population. We developed a job exposure matrix to objectively measure job stressors across the working population. Suicide data came from a nationwide coronial register. Living controls were selected from a nationally representative cohort study. Incidence density s ling was used to ensure that controls were s led at the time of death of each case. The period of observation for both cases and controls was 2001 to 2012. We used multilevel logistic regression to assess the odds of suicide in relation to 2 psychosocial job stressors (job control and job demands), after matching for age, sex, and year of death/survey and adjusting for socioeconomic status. Across 9,010 cases and 14,007 matched controls, our results suggest that low job control (odds ratio [OR], 1.35 95% confidence interval [CI], 1.26–1.44 p .001) and high job demands (OR, 1.36 95% CI, 1.26–1.46 p .001) were associated with increased odds of male suicide after adjusting for socioeconomic status. High demands were associated with lower odds of female suicide (OR, 0.81 95% CI, 0.72–0.92 p = .002). It seems that adverse experiences at work are a risk factor for male suicide while not being associated with an elevated risk among females. Future studies on job stressors and suicide are needed, both to further understand the biobehavioral mechanisms explaining the link between job stress and suicide, and to inform targeted prevention initiatives.

“Hotspots” and “copycats”: a plea for more thoughtful language about suicide – Authors' reply

Publisher: Elsevier BV

Date: 2016

DOI: 10.1016/S2215-0366(15)00548-9

Why do surgeons receive more complaints than their physician peers?

Publisher: Wiley

Date: 09-09-2017

DOI: 10.1111/ANS.14225

Abstract: Compared with other doctors, surgeons are at an increased risk of medicolegal events, including patient complaints and negligence claims. This retrospective study aimed to describe the frequency and nature of complaints involving surgeons compared with physicians. We assembled a national data set of complaints about surgeons and physicians lodged with medical regulators in Australia from 2011 to 2016. We classified the complaints into 19 issues across four domains: treatment and procedures, other performance, professional conduct and health. We assessed differences in complaint risk using incidence rate ratios (IRRs). Finally, we used a multivariate model to identify predictors of complaints among surgeons. The rate of complaints was 2.3 times higher for surgeons than physicians (112 compared with 48 complaints per 1000 practice years, P < 0.001). Two-fifths (41%) of the higher rate of complaints among surgeons was attributable to issues other than treatments and procedures, including fees (IRR = 2.68), substance use (IRR = 2.10), communication (IRR = 1.98) and interpersonal behaviour (IRR = 1.92). Male surgeons were at a higher risk of complaints, as were specialists in orthopaedics, plastic surgery and neurosurgery. Surgeons are more than twice as likely to attract complaints as their physician peers. This elevated risk arises partly from involvement in surgical procedures and treatments, but also reflects wider concerns about interpersonal skills, professional ethics and substance use. Improved understanding of these patterns may assist efforts to reduce harm and support safe practise.

Interventions to reduce suicides at suicide hotspots: a systematic review and meta-analysis

Publisher: Elsevier BV

Date: 11-2015

DOI: 10.1016/S2215-0366(15)00266-7

Use of sun-protective clothing at outdoor leisure settings from 1992 to 2002: Serial cross-sectional observation survey

Publisher: American Association for Cancer Research (AACR)

Date: 02-2008

DOI: 10.1158/1055-9965.EPI-07-0369

Abstract: Background: Previous population-based surveys to monitor sun protection behavior over time have relied on self-report, which can be subject to recall and misclassification bias and social desirability bias. The present study aimed to describe the prevalence and determinants of teenagers' and adults' observed sun protection behavior while engaged in outdoor leisure activities on summer weekends, over a decade of the SunSmart skin cancer prevention program, which involved public education and advocacy. Method: Serial cross-sectional observational field surveys of teenagers and adults at leisure were undertaken during summer weekends between 11 a.m. and 3 p.m., from 1992 to 2002 (N = 46,810). The four types of setting for observation were parks and gardens, golf courses, tennis courts, and pools and beaches, located within a 25-km radius of Melbourne city center, Australia. The main outcome measure was a binary clothes cover index representing persons above or below the median level of body cover for each type of leisure setting. The index was based on the proportion of body surface covered by the type of hat, shirt, and leg cover garments worn. Results: Body cover varied by environmental factors and the activity demands and demographic characteristics of in iduals. After adjusting for covariates, significant improvements in the extent of body cover occurred over the decade, such that the odds of the proportion of people wearing clothes cover above the median level increased by 3% per year (95% confidence interval, 2-4%). Conclusion: Results suggest that significant gains in sun-protective behavior have occurred, coincident with the conduct of an ongoing comprehensive skin cancer prevention program. (Cancer Epidemiol Biomarkers Prev 2008 (2):428–34)

Characteristics of suicide decedents with no federally funded mental health service contact in the 12 months before death in a population‐based sample of Australians 45 years of age and over

Publisher: Wiley

Date: 10-11-2023

DOI: 10.1111/SLTB.12928

Abstract: More than half of suicide decedents have no contact with mental health services 12 months before death. It is uncertain if they have different characteristics than decedents who use mental health services. A case‐series design. Participants 45 years and older, who died by suicide (2006–2018). Comparisons were made between those who did and did not have contact with mental health services, using in idually linked data from federal services in the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS). Of 186 cases, 71% had no contact with mental health services. Physical health services were used equally by 75%. Psychiatric medication use was uncommon, except for antidepressants, 50% with mental health service contact and 20% with no contact. Older age, lower income, involuntarily unemployed, firearms as suicide method, greater physical disability, less functional impairment due to emotional problems and lesser proportions with mental illness, were associated with no contact with mental health services. For suicide prevention, middle‐older aged adults may have less requirement for mental health intervention, and greater requirement for the development of complementary interventions focused on physical health and social issues, which are not necessarily best delivered by clinical mental health services.

Somatic symptom severity association with healthcare utilization and costs in surgical inpatients with an episode of abdominal pain

Publisher: Oxford University Press (OUP)

Date: 07-07-2022

DOI: 10.1093/BJSOPEN/ZRAC046

Abstract: Somatic syndromes are present in 30 per cent of primary healthcare populations and are associated with increased health service use and health costs. Less is known about secondary care surgical inpatient populations. This was a prospective longitudinal cohort study (n = 465) of consecutive adult admissions with an episode of non-traumatic abdominal pain, to the Acute General Surgical Unit at a tertiary hospital in New South Wales, Australia. Somatic symptom severity (SSS) was dichotomized using the Patient Health Questionnaire (PHQ)-15 with a cut-off point of 10 or higher (medium–high SSS) and compared pre-admission and during admission. Total healthcare utilization and direct costs were stratified by a PHQ-15 score of 10 or higher. Linear regression was used to examine differences in costs, and a multivariable linear regression was used to examine the relationship of PHQ-15 scores of 10 or higher to total costs, reported as mean total costs of care and percentage difference (95 per cent confidence intervals). Fifty-two per cent (n = 242) of participants had a medium–high SSS with greater pre-admission and admission interval health service costs. Mean total direct costs of care were 25 per cent (95 per cent c.i. 8 to 44 per cent) higher in the PHQ-15 score of 10 or higher group: mean difference €1401.93 (95 per cent c.i. €512.19 to €2273.67). The multivariable model showed a significant association of PHQ-15 scores of 10 or higher (2.1 per cent 0.2–4.1 per cent greater for each one-point increase in score) with total hospital costs, although the strongest contributions to cost were older age, operative management, and lower socioeconomic level. There was a linear relationship between PHQ scores and total healthcare costs. Medium to high levels of somatic symptoms are common in surgical inpatients with abdominal pain and are independently associated with greater healthcare utilization.

How do employment conditions and psychosocial workplace exposures impact the mental health of young workers? A systematic review

Publisher: Springer Science and Business Media LLC

Date: 17-04-2021

DOI: 10.1007/S00127-021-02077-X

Complaint risk among mental health practitioners compared with physical health practitioners: a retrospective cohort study of complaints to health regulators in Australia

Publisher: BMJ

Date: 12-2019

DOI: 10.1136/BMJOPEN-2019-030525

Abstract: To understand complaint risk among mental health practitioners compared with physical health practitioners. Retrospective cohort study, using incidence rate ratios (IRRs) to analyse complaint risk and a multivariate regression model to identify predictors of complaints. National study using complaints data from health regulators in Australia. All psychiatrists and psychologists (‘mental health practitioners’) and all physicians, optometrists, physiotherapists, osteopaths and chiropractors (‘physical health practitioners’) registered to practice in Australia between 2011 and 2016. Incidence rates, source and nature of complaints to regulators. In total, 7903 complaints were lodged with regulators over the 6-year period. Most complaints were lodged by patients and their families. Mental health practitioners had a complaint rate that was more than twice that of physical health practitioners (complaints per 1000 practice years: psychiatrists 119.1 vs physicians 48.0, p .001 psychologists 21.9 vs other allied health 7.5, p .001). Their risk of complaints was especially high in relation to reports, records, confidentiality, interpersonal behaviour, sexual boundary breaches and the mental health of the practitioner. Among mental health practitioners, male practitioners (psychiatrists IRR: 1.61, 95% CI 1.39 to 1.85 psychologists IRR: 1.85, 95% CI 1.65 to 2.07) and older practitioners (≥65 years compared with 36–45 years: psychiatrists IRR 2.37, 95% CI 1.95 to 2.89 psychologists IRR 1.78, 95% CI 1.47 to 2.14) were at increased risk of complaints. Mental health practitioners were more likely to be the subject of complaints than physical health practitioners. Areas of increased risk are related to professional ethics, communication skills and the health of mental health practitioners themselves. Further research could usefully explore whether addressing these risk factors through training, professional development and practitioner health initiatives may reduce the risk of complaints about mental health practitioners.

Ensuring older Australians remain socially connected during the COVID-19 isolation period

Publisher: SAGE Publications

Date: 23-07-2021

DOI: 10.1177/0004867420945780

Remedies sought and obtained in healthcare complaints.

Publisher: BMJ

Date: 22-08-2011

DOI: 10.1136/BMJQS-2011-000109

Abstract: In the wake of adverse events, injured patients and their families have a complex range of needs and wants. The tort system, even when operating at its best, will inevitably fall far short of addressing them. In Australia and New Zealand, government-run health complaints commissions take a more flexible and expansive approach to providing remedies for patients injured by or disgruntled with care. Unfortunately, survey research has shown that many patients in these systems are dissatisfied with their experience. We hypothesised that an important explanation for this dissatisfaction is an 'expectations gap' discordance between what complainants want and what they eventually get out of the process. Analysing a s le of complaints relating to informed consent from the Commission in Victoria (Australia's second largest state, with 5.2 million residents), we found evidence of such a gap. One-third (59/189) of complainants who sought restoration received it 1 in 5 complainants (17/101) who sought correction received assurances that changes had been or would be made to reduce the risk of others suffering a similar harm and fewer than 1 in 10 (3/37) who sought sanctions saw steps taken to achieve this outcome initiated. We argue that bridging the expectations gap would go far toward improving patient satisfaction with complaints systems, and suggest several ways this might be done.

Understanding the characteristics and mechanisms underlying suicide clusters in Australian youth: a comparison of cluster detection methods

Publisher: Cambridge University Press (CUP)

Date: 2020

DOI: 10.1017/S2045796020000645

Abstract: There is currently no gold-standard definition or method for identifying suicide clusters, resulting in considerable heterogeneity in the types of suicide clusters that are detected. This study sought to identify the characteristics, mechanisms and parameters of suicide clusters using three cluster detection methods. Specifically, the study aimed to: (1) determine the overlap in suicide clusters among each method, (2) compare the spatial and temporal parameters associated with different suicide clusters and (3) identify the demographic characteristics and rates of exposure to suicide among cluster and non-cluster members. Suicide data were obtained from the National Coronial Information System. N = 3027 Australians, aged 10–24 who died by suicide in 2006–2015 were included. Suicide clusters were determined using: (1) poisson scan statistics, (2) a systematic search of coronial inquests and (3) descriptive network analysis. These methods were chosen to operationalise three different definitions of suicide clusters, namely clusters that are: (1) statistically significant, (2) perceived to be significant and (3) characterised by social links among three or more suicide descendants. For each method, the demographic characteristics and rates of exposure to suicide were identified, in addition to the maximum duration of suicide clusters, the geospatial overlap between suicide clusters, and the overlap of in idual cluster members. Eight suicide clusters (69 suicides) were identified from the scan statistic, seven (40 suicides) from coronial inquests and 11 (37 suicides) from the descriptive network analysis. Of the eight clusters detected using the scan statistic, two overlapped with clusters detected using the descriptive network analysis and one with clusters identified from coronial inquests. Of the seven clusters from coronial inquests, four overlapped with clusters from the descriptive network analysis and one with clusters from the scan statistic. Overall, 9.2% (12 suicides) of in iduals were identified by more than one method. Prior exposure to suicide was 10.1% ( N = 7) in clusters from the scan statistic, 32.5% ( N = 13) in clusters from coronial inquest and 56.8% ( N = 21) in clusters from the descriptive network analysis. Each method identified markedly different suicide clusters. Evidence of social links between cluster members typically involved clusters detected using the descriptive network analysis. However, these data were limited to the availability information collected as part of the police and coroner investigation. Communities tasked with detecting and responding to suicide clusters may benefit from using the spatial and temporal parameters revealed in descriptive studies to inform analyses of suicide clusters using inferential methods.

Does tobacco-control mass media campaign exposure prevent relapse among recent quitters?

Publisher: Oxford University Press (OUP)

Date: 04-09-2013

DOI: 10.1093/NTR/NTS134

An investigation of neighborhood-level social, economic and physical factors for railway suicide in Victoria, Australia

Publisher: Elsevier BV

Date: 09-2015

DOI: 10.1016/J.JAD.2015.05.006

Observed use of sunglasses in public outdoor settings around Melbourne, Australia: 1993 to 2002

Publisher: Elsevier BV

Date: 04-2006

DOI: 10.1016/J.YPMED.2006.01.003

Abstract: Wearing sunglasses may reduce the risk of cataract and of skin cancer in the periorbital area. Understanding predictors of sunglasses use may help identify groups with lower usage patterns. An annual observational field survey of teenagers and adults at leisure at outdoor venues around Melbourne, Australia was conducted between 11 am and 3 pm on mainly sunny, summer weekends (n=42,207). The serial cross-sectional survey assessed sun protection behaviors, including use of sunglasses from 1993 to 2002, and other variables hypothesized to predict sun-related behavior (sex, age, SES, activity level and setting, size of social group, and weather conditions). Predictors of use of sunglasses were assessed using multivariate logistic regression. 36.2% of those observed wore sunglasses, and this increased only slightly over the years. Sunglasses use was most common among those observed on sunny days, in no or partial shade, in parks/gardens and at pools/beaches, less active people and people on their own or in pairs, people observed in higher socio-economic areas, females, people 20-50 years of age, and people wearing head and clothes cover. Sunglasses use should be encouraged among the population in general and especially among golfers, tennis players, teenagers, males, and people in lower SES areas.

Testing the Impact of the #chatsafe Intervention on Young People’s Ability to Communicate Safely About Suicide on Social Media: Protocol for a Randomized Controlled Trial (Preprint)

Publisher: JMIR Publications Inc.

Date: 17-11-2022

DOI: 10.2196/PREPRINTS.44300

Abstract: uicide is the leading cause of death among Australians. One commonly cited explanation is the impact of social media, in particular, the ways in which young people use social media to communicate about their own experiences and their exposure to suicide-related content posted by others. Guidelines designed to assist mainstream media to safely report about suicide are widespread. Until recently, no guidelines existed that targeted social media or young people. In response, we developed the #chatsafe guidelines and a supporting social media c aign, which together make up the #chatsafe intervention. The intervention was tested in a pilot study with positive results. However, the study was limited by the lack of a control group. he aim of this study is to assess the impact of the #chatsafe social media intervention on young people’s safety and confidence when communicating on the web about suicide. he study employs a pragmatic, parallel, superiority randomized controlled design. It will be conducted in accordance with the Consolidated Standards of Reporting Trials statement over 18 months. Participants will be 400 young people aged 16-25 years (200 per arm). Participants will be recruited via social media advertising and assessed at 3 time points: time 1—baseline time 2—8-week postintervention commencement and time 3—4-week postintervention. They will be asked to complete a weekly survey to monitor safety and evaluate each piece of social media content. The intervention comprises an 8-week social media c aign including social media posts shared on public Instagram profiles. The intervention group will receive the #chatsafe suicide prevention content and the control group will receive sexual health content. Both groups will receive 24 pieces of content delivered to their mobile phones via text message. The primary outcome is safety when communicating on the web about suicide, as measured via the purpose-designed #chatsafe online safety questionnaire. Additional outcomes include willingness to intervene against suicide, internet self-efficacy, safety, and acceptability. he study was funded in November 2020, approved by the University of Melbourne Human Research Ethics Committee on October 7, 2022, and prospectively registered with the Australian New Zealand Clinical Trials registry. Trial recruitment began in November 2022 and study completion is anticipated by June 2024. his will be the first randomized controlled trial internationally to test the impact of a social media intervention designed to equip young people to communicate safely on the web about suicide. Given the rising rates of youth suicide in Australia and the acceptability of social media among young people, incorporating social media–based interventions into the suicide prevention landscape is an obvious next step. This intervention, if effective, could also be extended internationally, thereby improving web-based safety for young people not just in Australia but globally. ustralian New Zealand Clinical Trials Registry ACTRN12622001397707 anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384318 ERR1-10.2196/44300

Ambulance attendances resulting from self-harm after release from prison

Publisher: Springer Science and Business Media LLC

Date: 07-04-2017

DOI: 10.1007/S00127-017-1383-Z

Abstract: Incarcerated adults are at high risk of self-harm and suicide and remain so after release into the community. The aims of this study were to estimate the number of ambulance attendances due to self-harm in adults following release from prison, and to identify factors predictive of such attendances. Baseline surveys with 1309 adults within 6 weeks of expected release from prison between 2008 and 2010 were linked prospectively with state-wide correctional, ambulance, emergency department, hospital and death records in Queensland, Australia. Associations between baseline demographic, criminal justice and mental health-related factors, and subsequent ambulance attendances resulting from self-harm, were investigated using negative binomial regression. During 4691 person-years of follow-up (median 3.86 years per participant), there were 2892 ambulance attendances in the community, of which 120 (3.9%) were due to self-harm. In multivariable analyses, being Indigenous [incidence rate ratio (IRR): 2.10 (95% CI 1.14-3.86)], having previously been hospitalised for psychiatric treatment [IRR: 2.65 (95% CI 1.44-4.87)], being identified by prison staff as being at risk of self-harm whilst incarcerated [IRR: 2.12 (95% CI 1.11-4.06)] and having a prior ambulance attendance due to self-harm [IRR: 3.16 (95% CI 1.31-7.61)] were associated with self-harm attendances. Ambulance attendances resulting from self-harm following release from prison are common and represent an opportunity for tertiary intervention for self-harm. The high prevalence of such attendances, in conjunction with the strong association with prior psychiatric problems, reinforces the importance of providing appropriate ambulance staff training in the assessment and management of self-harm, and mental health problems more broadly, in this vulnerable population.

A systematic review and meta-analysis of moderate-to-vigorous physical activity levels in elementary school physical education lessons.

Publisher: Elsevier BV

Date: 05-2016

DOI: 10.1016/J.YPMED.2015.11.018

Abstract: To examine elementary school students' moderate-to-vigorous physical activity (MVPA) levels during physical education (PE) lessons. A systematic search of nine electronic databases was conducted (PROSPERO2014:CRD42014009649). Studies were eligible if they were in English published between 2005-April 2014 assessed MVPA levels in PE lessons of elementary school children (aged four-12years) and used an objective MVPA measure. Two reviewers retrieved articles, assessed risk of bias, and performed data extraction. The findings were synthesised using a meta-analysis. The search yielded 5132 articles. Thirteen studies from nine countries met the inclusion criteria. Eight studies measured MVPA through observational measures, five used accelerometry and one used heart rate monitoring. The percentage of PE lesson time spent in MVPA ranged between 11.4-88.5%. Meta-analysis of seven studies (4 direct observations 4 accelerometers) found that children spent a mean (95% CI) 44.8 (28.2-61.4)% of PE lesson time in MVPA. When measured using direct observation and accelerometers, children spent 57.6 (47.3-68.2) and 32.6 (5.9-59.3)% of PE lesson time in MVPA, respectively. The review has limitations the search strategy was restricted to studies in English theses, dissertations and conference abstracts were excluded and six studies that provided insufficient data were excluded from the meta-analysis. MVPA levels during elementary school PE lessons do not meet the United States Centre for Disease Control and Prevention and the United Kingdom's Association of Physical Education recommendation (50% of lesson time), but is higher than estimated in the previous review (34.2%). Interventions to increase MVPA in PE lessons are needed.

Calls to helplines in Australia following media reports of Robin Williams’ suicide

Publisher: Wiley

Date: 24-07-2020

DOI: 10.1111/SLTB.12661

Socio-Economic Position and Suicidal Ideation in Men

Publisher: MDPI AG

Date: 31-03-2017

DOI: 10.3390/IJERPH14040365

Relationship between stressfulness of claiming for injury: Compensation and long-term recovery: A prospective cohort study

Publisher: American Medical Association (AMA)

Date: 04-2014

DOI: 10.1001/JAMAPSYCHIATRY.2013.4023

Abstract: Each year, millions of persons worldwide seek compensation for transport accident and workplace injuries. Previous research suggests that these claimants have worse long-term health outcomes than persons whose injuries fall outside compensation schemes. However, existing studies have substantial methodological weaknesses and have not identified which aspects of the claiming experience may drive these effects. To determine aspects of claims processes that claimants to transport accident and workers' compensation schemes find stressful and whether such stressful experiences are associated with poorer long-term recovery. Prospective cohort study of a random s le of 1010 patients hospitalized in 3 Australian states for injuries from 2004 through 2006. At 6-year follow-up, we interviewed 332 participants who had claimed compensation from transport accident and workers' compensation schemes ("claimants") to determine which aspects of the claiming experience they found stressful. We used multivariable regression analysis to test for associations between compensation-related stress and health status at 6 years, adjusting for baseline determinants of long-term health status and predisposition to stressful experiences (via propensity scores). Disability, quality of life, anxiety, and depression. Among claimants, 33.9% reported high levels of stress associated with understanding what they needed to do for their claim 30.4%, with claim delays 26.9%, with the number of medical assessments and 26.1%, with the amount of compensation they received. Six years after their injury, claimants who reported high levels of stress had significantly higher levels of disability (+6.94 points, World Health Organization Disability Assessment Schedule sum score), anxiety and depression (+1.89 points and +2.61 points, respectively, Hospital Anxiety and Depression Scale), and lower quality of life (-0.73 points, World Health Organization Quality of Life instrument, overall item), compared with other claimants. Adjusting for claimants' vulnerability to stress attenuated the strength of these associations, but most remained strong and statistically significant. Many claimants experience high levels of stress from engaging with injury compensation schemes, and this experience is positively correlated with poor long-term recovery. Intervening early to boost resilience among those at risk of stressful claims experiences and redesigning compensation processes to reduce their stressfulness may improve recovery and save money.

The Australian longitudinal study on male health sampling design and survey weighting: implications for analysis and interpretation of clustered data

Publisher: Springer Science and Business Media LLC

Date: 10-2016

DOI: 10.1186/S12889-016-3699-0

Modifiable risk factors for external cause mortality after release from prison: a nested case-control study.

Publisher: Cambridge University Press (CUP)

Date: 25-09-2017

DOI: 10.1017/S2045796017000506

Abstract: People released from prison are at higher risk of mortality from potentially preventable causes than their peers in the general population. Because most studies of this phenomenon are reliant on registry data, there is little health and behavioural information available on those at risk, h ering the development of targeted, evidence-based preventive responses. Our aim was to identify modifiable risk and protective factors for external cause and cause-specific mortality after release from prison. We undertook a nested case–control study using data from a larger retrospective cohort study of mortality after release from prison in Queensland, Australia between 1994 and 2007. Cases were 286 in iduals who had died from external causes (drug overdose, suicide, transport accidents, or violence) matched with 286 controls on sex, Indigenous status, and release date. We extracted data from detention, case-management, and prison medical records. Factors associated with increased risk of external cause mortality included use of heroin and other opioids in the community [odds ratio (OR) = 2.20, 95% CI 1.41–3.43, p 0.001], a prescription for antidepressants during the current prison sentence (OR = 1.94, 95% CI 1.02–3.67, p = 0.042), a history of problematic alcohol use in the community (OR = 1.54, 95% CI 1.05–2.26, p = 0.028), and having ever served two or more custodial sentences (OR = 1.51, 95% CI 1.01–2.25, p = 0.045). Being married (OR = 0.45, 95% CI 0.29–0.70, p 0.001) was protective. Fewer predictors were associated with cause-specific mortality. We identified several behavioural, psychosocial, and clinical markers associated with mortality from preventable causes in people released from prison. Emerging evidence points to interventions that could be targeted at those at increased risk of external cause mortality. These include treatment and harm reduction programmes (for substance use), improving transitional support programmes and continuity of care (for mental health), ersion and drug reform (for repeat incarceration) and nurturing stable relationships during incarceration. The period of imprisonment and shortly after release provides a unique opportunity to improve the long-term health of ex-prisoners and overcome the disadvantage associated with imprisonment.

Socioeconomic Disadvantage, Mental Health and Substance Use in Young Men in Emerging Adulthood

Publisher: Informa UK Limited

Date: 26-06-2021

DOI: 10.1080/08964289.2019.1622504

Abstract: Emerging adulthood is a neglected phase of the life course in health research. Health problems and risk behaviors at this time of life can have long-term consequences for health. The 2016 Lancet Commission on Adolescent Health and Wellbeing reported that the influence of socioeconomic factors was under-researched among adolescents and young adults. Moreover, the influence of socioeconomic factors on health has been little researched specifically in emerging adult men. We aimed to investigate associations between socioeconomic disadvantage and mental health, suicidal behavior, and substance use in young adult Australian men. Logistic regression was used to examine the association between Year 12 (high school) completion and area disadvantage on mental health, suicidal behavior, and substance use in 2,281 young men age 18-25 participating in the Australian Longitudinal Study on Male Health (Ten to Men). In unadjusted analysis both Year 12 non-completion and area disadvantage were associated with multiple adverse outcomes. In adjusted analysis Year 12 non-completion, but not area disadvantage, was associated with poorer mental health, increased odds of suicidal behavior, and substance use. Retaining young men in high school and developing health-promotion strategies targeted at those who do exit education early could both improve young men's mental health and reduce suicidal behavior and substance use in emerging adulthood.

Does legislative change affect the use and duration of compulsory treatment orders?

Publisher: SAGE Publications

Date: 18-11-2018

DOI: 10.1177/0004867418812683

Abstract: Victoria, Australia, introduced reformed mental health legislation in 2014. The Act was based on a policy platform of recovery-oriented services, supported decision-making and minimisation of the use and duration of compulsory orders. This paper compares service utilisation and legal status after being on a community treatment order under the Mental Health Act 1986 (Vic) with that under the Mental Health Act 2014 (Vic). We obtained two distinct data sets of persons who had been on a community treatment order for at least 3 months and their subsequent treatment episodes over 2 years under the Mental Health Act and/or as an inpatient for the periods 2008–2010 (Mental Health Act 1986) and 2014–2016 (Mental Health Act 2014). The two sets were compared to assess the difference in use, duration and odds of having a further admission over 2 years. We also considered the mode of discharge – whether by the treating psychiatrist, external body or through expiry. Compared with the Mental Health Act 1986, under the Mental Health Act 2014, index community treatment orders were shorter (mean 227 days compared with 335 days) there was a reduction in the mean number of community treatment orders in the 2 years following the index discharge − 1.1 compared with 1.5 (incidence rate ratio (IRR) = 0.71, 95% confidence interval = [0.63, 0.80]) – and a 51% reduction in days on an order over 2 years. There was a reduction in the number of subsequent orders for those whose order expired or was revoked by the psychiatrist under the Mental Health Act 2014 compared to those under the Mental Health Act 1986. The number of orders which were varied to an inpatient order by the authorised psychiatrist was notably greater under the Mental Health Act 2014. The reformed Mental Health Act has been successful in its intent to reduce the use and duration of compulsory orders in the community. The apparent increase in return to inpatient orders raises questions regarding the intensity and effectiveness of community treatment and context of service delivery.

Secondhand smoke exposure (PM2.5) in outdoor dining areas and its correlates

Publisher: BMJ

Date: 21-10-2010

DOI: 10.1136/TC.2009.030544

Abstract: This study assessed the magnitude of secondhand smoke (SHS) exposure when people smoke in outdoor dining areas and explored conditions influencing exposure levels. Data were gathered from 69 outdoor dining areas in Melbourne, Australia, during April/May 2007. Sitting at tables within 1 metre of an active smoker, the authors measured the concentration of particulate pollution (PM(2.5)) using TSI SidePak Personal Aerosol Monitors. PM(2.5) data were recorded by the monitor at 30-second intervals, and data were collected over an average of 25.8 minutes per venue. Information was collected about the presence of overhead coverings and the number of patrons and lit cigarettes. The average background level of PM(2.5) was 8.4 microg/m(3) (geometric mean (GM)=6.1 microg/m(3)), increasing to an average of 17.6 microg/m(3) (GM=12.7 microg/m(3)) over the observational period and 27.3 microg/m(3) (GM=17.6 microg/m(3)) during the time that cigarettes were actively smoked near the monitor. There was substantial variation in exposure levels, with a maximum peak concentration of 483.9 microg/m(3) when there were lit cigarettes close to the monitor. Average exposure levels increased by around 30% for every additional active smoker within 1 metre of the monitor. Being situated under an overhead cover increased average exposure by around 50%. When in iduals sit in outdoor dining venues where smokers are present it is possible that they will be exposed to substantial SHS levels. Significant increases in exposure were observed when monitors were located under overhead covers, and as the number of nearby smokers increased. The role of outdoor smoking restrictions in minimising exposure to SHS must be considered.

Age and gender patterns in health service utilisation: Age-Period-Cohort modelling of linked health service usage records

Publisher: Springer Science and Business Media LLC

Date: 12-05-2023

DOI: 10.1186/S12913-023-09456-X

Abstract: Health service utilisation changes across the life-course and may be influenced by contextual factors at different times. There is some evidence that men engage less with preventive health services, including attending doctors’ clinics, however the extent to which this varies temporally and across different age groups is unclear. This study aimed to describe age or cohort effects on engagement with GPs among employed mothers and fathers in Australia, and differences in these trends between men and women. We linked data from the ‘Growing up in Australia: The Longitudinal Study of Australian Children’ with administrative health service records from Medicare. We used a small-domain estimation Age-Period-Cohort method to describe patterns in health service use among working-age male and female parents in Australia while adjusting for employment status and controlling for time-invariant factors. Our small-domain method assumes a smooth response surface of Age, Period and Cohort. Male parents have lower health service engagement than women of the same age at the same time period. Men’s pattern of health service use across time is likely explained entirely by ageing. That is, we find that patterns in health service utilisation among men are largely driven by age effects, with no evidence of periods or cohort effects in health service engagement for men between 2002 and 2016. Differences in health service utilisation between male and female parents at all age-period-cohort combinations highlight a need for more research to examine the extent to which this level of health service use among Australian men meets men’s health needs, as well as barriers and enablers of health service engagement for men. Absence of evidence for period effects suggests that there is little shift in gendered patterns of health service utilisation during the observed period.

Violence-related deaths among people released from incarceration

Publisher: Elsevier BV

Date: 11-2021

DOI: 10.1016/J.ECLINM.2021.101162

Looking for boomerang effects: A pre–post experimental study of the effects of exposure of youth to television advertising for nicotine replacement therapy and Zyban®

Publisher: Elsevier BV

Date: 12-2006

DOI: 10.1016/J.ADDBEH.2006.02.020

Abstract: In the context of concerns about unintended "boomerang" influences of advertising, this study aimed to examine effects of nicotine replacement therapy (NRT) and Zyban advertising on youth perceptions of the ease of quitting, health risks of smoking and future intentions to smoke. 718 youth aged 14-16years were randomly allocated to view four television ads promoting either: NRT Zyban non-pharmaceutical cessation services (telephone Quitline) or non-cessation messages on sun protection. Questionnaire measures were administered before and after viewing ads. There were no effects of advertising exposure on perceived health effects of smoking or intentions to smoke. Compared with the sun protection ads, but not the Quitline ads, those exposed to NRT ads reported stronger perceptions about the ease of quitting, but non-susceptible non-smokers primarily drove this difference. This study suggests that exposure to NRT and Zyban advertising in an experimental context does not reliably influence youth smoking-related beliefs, especially those vulnerable to becoming regular smokers.

Assessing population-wide behaviour change: Concordance of 10-year trends in self-reported and observed sun protection

Publisher: Springer Science and Business Media LLC

Date: 22-03-2014

DOI: 10.1007/S00038-013-0454-5

Abstract: Increases in socially desirable responses in self-reports might occur in the context of ongoing public education. We examine concordance of trends in two long-term studies monitoring population impact for SunSmart. One study employed telephone interviews of Melbourne residents the other entailed observations at public recreation venues across Melbourne. The studies assessed people's sun protection on identical weekend dates (Nw = 33 dates). Data from five summers between 1992 and 2001 (n ~ 23,000 in iduals) were analysed. A body cover index score was calculated for participants on each date. Outcomes were aggregated separately for Saturdays and Sundays by date and year. Regression analyses tested whether these trends differed by survey method. The pattern of change in body cover over time was similar for both surveys. Self-reported body cover was consistently higher than observed body cover, suggesting that social desirability bias may be present. Regression analyses showed no ergence between self-reported and observed trends in mean body cover, suggesting no evidence of significant increased social desirability bias in self-reporting over time. Findings suggest that self-report offers a valid means of assessing change in a population's sun protection compliance over time, at least when self-reports are precisely focussed for time and activity context.

In response to ‘Correspondence: Identification of doctors at risk of recurrent complaints: a national study of healthcare complaints in Australia’

Publisher: BMJ

Date: 18-09-2013

DOI: 10.1136/BMJQS-2013-002340

Life stress and suicidal ideation in Australian men - cross-sectional analysis of the Australian longitudinal study on male health baseline data

Publisher: Springer Science and Business Media LLC

Date: 10-2016

DOI: 10.1186/S12889-016-3702-9

Why do men go to the doctor? Socio-demographic and lifestyle factors associated with healthcare utilisation among a cohort of Australian men

Publisher: Springer Science and Business Media LLC

Date: 10-2016

DOI: 10.1186/S12889-016-3706-5

Validity of a Job-Exposure Matrix for Psychosocial Job Stressors: Results from the Household Income and Labour Dynamics in Australia Survey

Publisher: Public Library of Science (PLoS)

Date: 06-04-2016

DOI: 10.1371/JOURNAL.PONE.0152980

Does sexual orientation vary between disabled and non-disabled men? findings from a population-based study of men in Australia

Publisher: Informa UK Limited

Date: 03-12-2019

DOI: 10.1080/09687599.2019.1689925

Using the Patient Health Questionnaire to estimate prevalence and gender differences of somatic symptoms and psychological co-morbidity in a secondary inpatient population with abdominal pain

Publisher: SAGE Publications

Date: 04-09-2021

DOI: 10.1177/00048674211044639

Abstract: Somatic disorders and somatic symptoms are common in primary care populations however, little is known about the prevalence in surgical populations. Identification of inpatients with high somatic symptom burden and psychological co-morbidity could improve access to effective psychological therapies. Cross-sectional analysis ( n = 465) from a prospective longitudinal cohort study of consecutive adult admissions with non-traumatic abdominal pain, at a tertiary hospital in New South Wales, Australia. We estimated somatic symptom prevalence with the Patient Health Questionnaire-15 at three cut-points: moderate (⩾10), severe (⩾15) and ‘bothered a lot’ on ⩾3 symptoms and psychological co-morbidity with the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 at standard (⩾10) cut-points. We also examined gender differences for somatic symptoms and psychological co-morbidity. Prevalence was moderate (52%), female predominance (odds ratio = 1.71 95% confidence interval = [1.18, 2.48]), severe (20%), no gender difference (1.32 [0.83, 2.10]) and ‘bothered a lot’ on ⩾3 symptoms (53%), female predominance (2.07 [1.42, 3.03]). Co-morbidity of depressive, anxiety and somatic symptoms ranged from 8.2% to 15.9% with no gender differences. Somatic symptoms were common and psychological triple co-morbidity occurred in one-sixth of a clinical population admitted for abdominal pain. Co-ordinated surgical and psychological clinical intervention and changes in clinical service organisation may be warranted to provide optimal care.

Patients’ experiences of restrictive interventions in Australia: Findings from the 2010 Australian survey of psychosis

Publisher: American Psychiatric Association Publishing

Date: 09-2017

DOI: 10.1176/APPI.PS.201600300

Abstract: The authors used survey data to investigate patients' experiences of restrictive interventions in inpatient settings. The 2010 Australian Survey of High Impact Psychosis (N=1,825) asked about restrictive interventions experienced during a mental health admission in the previous year (N=428), ranging from restrictions on leaving a ward to seclusion. The authors explored the relationship between perceived benefit (good or limited versus no benefit) and the number of different types of restrictive interventions experienced. Twenty-three percent had recently experienced one or more restrictive interventions of these, 42% had experienced forced medication and 35% had experienced seclusion. Although most reported some benefit, perceptions of benefit were lower among those who experienced a greater number of interventions. People with psychosis who experienced a greater number of restrictive interventions were less likely to find restrictions justified or beneficial. The cumulative effect of increased numbers of restrictions may also lead to worsening perceptions of benefit.

Using the ‘presenting problem’ field in emergency department data improves the enumeration of intentional self-harm in NSW hospital settings

Publisher: SAGE Publications

Date: 17-12-2021

DOI: 10.1177/0004867420981413

Suicide numbers during the first 9-15 months of the COVID-19 pandemic compared with pre-existing trends: An interrupted time series analysis in 33 countries

Publisher: Elsevier BV

Date: 09-2022

DOI: 10.1016/J.ECLINM.2022.101573

Discovery Projects - Grant ID: DP190101360

Start Date: 06-2019

End Date: 12-2024

Amount: $427,234.00

Funder: Australian Research Council

Discovery Projects - Grant ID: DP140102333

Start Date: 01-2014

End Date: 12-2017

Amount: $390,000.00

Funder: Australian Research Council

ARC Future Fellowships - Grant ID: FT180100075

Start Date: 2019

End Date: 12-2022

Amount: $910,709.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP190100968

Start Date: 12-2020

End Date: 12-2025

Amount: $1,357,136.00

Funder: Australian Research Council