ORCID Profile
0000-0002-8560-6399
Current Organisation
The University of Sydney Brain and Mind Centre
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Materials engineering | Functional materials | Nanotechnology not elsewhere classified
Publisher: Wiley
Date: 08-10-2021
DOI: 10.1111/JORA.12684
Abstract: Although adolescents’ perspective on the parent‐adolescent relationship uniquely predicts their mental health and wellbeing, there is limited research using qualitative methodologies to explore rich descriptions of adolescents’ expectations, attitudes, and beliefs towards parents. The current study qualitatively analyzed adolescent narratives regarding their relationships with their parents. Seventy‐two adolescents (68% female M age = 16.56) provided three‐minute speech s les that were examined using thematic analysis to understand key themes in adolescent–parent relationships from adolescents’ perspectives. Overall, adolescents valued positive relationships with parents (involving emotional support and companionship), respected their authority, and looked to parents to role‐model–valued traits. Mentions of negative interactions were mostly absent or justified as normal. Thus, normative adolescent–parent relationships are largely positive and valued by adolescents.
Publisher: BMJ
Date: 10-2023
Publisher: Elsevier BV
Date: 10-2024
Publisher: JMIR Publications Inc.
Date: 12-2022
Abstract: s the demand for youth mental health care continues to rise, managing wait times and reducing treatment delays are key challenges to delivering timely and quality care. Clinical staging is a heuristic model for youth mental health that can stratify care allocation according to an in idual’s risk of illness progression. The application of staging has been traditionally limited to trained clinicians, yet if digital technologies could be leveraged to apply clinical staging, then this could increase the scalability and utility of this model in services. he aim of this proof-of-concept study is to validate a digital algorithm to accurately differentiate young people at lower and higher risk of developing mental disorders. he cohort comprised 131 young people, aged between 16 to 25 years, who presented to youth mental health services in Australia for the first time between November 2018 to March 2021. Clinical stages (either stage 1a or stage 1b+) were allocated independently by expert psychiatrists and compared to the digital algorithm based on a multidimensional self-report questionnaire. f the 131 participants, the mean (SD) age was 20.3 (2.4) years and 94 (71.8%) were female. Ninety-one percent of clinical stage ratings were concordant between the digital algorithm and the expert ratings with a substantial interrater agreement (κ=0.67, P .001). The algorithm demonstrated 90.8% (95% CI 85.6 – 95.2%, P=0.03) accuracy, 80.0% sensitivity, 92.8% specificity, and F1-score of 72.7%. Of the agreement, 16 young people were allocated to stage 1a, while 103 were assigned to stage 1b+. Among the 12 discordant cases, eight participants with lower levels of depressive mood (P .001) and anxiety (P .001) were rated lower (stage 1a) by the algorithm compared to the experts. his novel digital algorithm is sufficiently robust to be used as an adjunctive decision support tool to stratify care and assist with demand management in youth mental health services. This work could transform care pathways and expedite care allocation for those in early stages of common anxiety and depressive disorders. Between 11% and 27% of young people presenting for care may be suitable for low intensity online or brief interventions, creating additional clinical capacity to be directed towards those who are stage 1b+ for further assessment and intervention.
Publisher: Wiley
Date: 11-10-2021
DOI: 10.1002/JTS.22596
Abstract: We undertook a systematic review to assess the efficacy of exposure‐based writing therapies (WTs) for trauma‐exposed adults with subthreshold or clinical levels of posttraumatic stress disorder. Four databases (PsycINFO, Medline, Wiley Online, PILOTS) were searched for randomized controlled trials (RCTs) of exposure‐based WTs. A total of 13 RCTs that reported on results from 17 WT versus control comparisons were included. The primary outcomes were posttraumatic stress symptom severity at posttreatment and/or clinical response. An overall unclear or high risk of bias was identified in 84.6% of studies. In comparison to both waitlist k = 3, Hedges’ g = −0.97, 95% CI [‐1.20, ‐0.73], and placebo writing conditions, k = 9, Hedges’ g = −0.48, 95% CI [‐0.87, ‐0.08], WTs were more beneficial to participants. There was no evidence of a difference between WTs that were longer in duration compared to other psychotherapy, k = 2 pooled OR = 1.42 95% CI [0.83, 2.43]. These findings indicate that exposure‐based WTs are effective when compared to waitlist and placebo writing control conditions. The evidence needs to be considered in the context of the modest number of studies conducted to date, the high methodological heterogeneity between the studies, and the high or unclear risk of bias across many studies. Further research is needed to increase the evidence base regarding the efficacy of WTs for posttraumatic stress. Future research should also measure the mediators and predictors of outcomes to further develop protocols and understand which variants of WTs work for different populations or in iduals.
Publisher: JMIR Publications Inc.
Date: 08-09-2023
DOI: 10.2196/45161
Publisher: Wiley
Date: 17-05-2023
DOI: 10.1111/HEX.13777
Abstract: Despite increasing support for stakeholder inclusion in research, there is limited evaluative research to guide safe (i.e., youth‐friendly) and meaningful (i.e., non‐tokenistic) partnerships with young people with lived experience of mental ill‐health in research. This paper describes a pilot evaluation and iterative design of a Youth Lived Experience Working Group (LEWG) protocol that was established by the Youth Mental Health and Technology team at The University of Sydney's Brain and Mind Centre, based on the results of two studies. Study one consisted of a pilot evaluation of the extent to which youth partners felt empowered to contribute, to qualitatively explore how LEWG processes could be improved. Youth partners completed online surveys, and results were shared over two LEWG meetings in 2021 to empower youth partners to collectively identify actions of positive change regarding LEWG processes. These meetings were audio‐recorded and transcripts were subsequently coded using thematic analysis. Study two assessed whether LEWG processes and proposed improvements were acceptable and feasible from the perspective of academic researchers via an online survey in 2022. Quantitative and qualitative data collected from nine youth partners and 42 academic researchers uncovered initial learnings regarding facilitators, motivators, and barriers to partnering with young people with lived experience in research. Implementing clear processes for youth partners and academic researchers on effective partnership strategies, providing training opportunities for youth partners to develop research skills, and providing regular updates on how youth partner contributions led to research outcomes were identified as key facilitators. This pilot study provides insight into a growing international field on how to optimise participatory processes so that researchers and young people with lived experience can be better supported and engaged to make meaningful contributions to mental health research. We argue that more transparency is needed around participatory research processes so that partnerships with young people with lived experience are not merely tokenistic. Our study has also been approved by and reflects the concepts and priorities of our youth lived experience partners and lived experience researchers, all of whom are authors of this paper.
Publisher: American Psychological Association (APA)
Date: 12-2020
DOI: 10.1037/FAM0000787
Publisher: JMIR Publications Inc.
Date: 18-12-2022
Abstract: s the demand for youth mental health care continues to rise, managing wait times and reducing treatment delays are key challenges to delivering timely and quality care. Clinical staging is a heuristic model for youth mental health that can stratify care allocation according to an in idual’s risk of illness progression. The application of staging has been traditionally limited to trained clinicians, yet if digital technologies could be leveraged to apply clinical staging, then this could increase the scalability and utility of this model in services.` he aim of this study is to validate a digital algorithm to accurately differentiate young people at lower and higher risk of developing mental disorders. he cohort comprised 131 young people, aged between 16 to 25 years, who presented to youth mental health services in Australia for the first time between November 2018 to March 2021. Expert psychiatrists independently assigned clinical stages (either stage 1a or stage 1b+), which were then compared to the digital algorithm’s allocation based on a multidimensional self-report questionnaire. f the 131 participants, the mean (SD) age was 20.3 (2.4) years and 94 (71.8%) were female. Ninety-one percent of clinical stage ratings were concordant between the digital algorithm and the expert ratings with a substantial interrater agreement (κ=0.67, P .001). The algorithm demonstrated an accuracy of 90.8% (95% CI 85.6 – 95.2%, P=0.03), sensitivity of 80.0%, specificity of 92.8%, and F1-score of 72.7%. Of the concordant ratings, 16 young people were allocated to stage 1a, while 103 were assigned to stage 1b+. Among the 12 discordant cases, the digital algorithm allocated a lower stage (stage 1a) to eight participants compared to the experts. These in iduals had significantly milder symptoms of depressive mood (P .001) and anxiety symptoms (P .001) compared to those with concordant stage 1b+ ratings. his novel digital algorithm is sufficiently robust to be used as an adjunctive decision support tool to stratify care and assist with demand management in youth mental health services. This work could transform care pathways and expedite care allocation for those in early stages of common anxiety and depressive disorders. Between 11% and 27% of young people seeking care may be benefit from low-intensity, online or brief interventions. Finding of this study suggests the possibility of redirecting clinical capacity to focus on in iduals in stage 1b+ for further assessment and intervention. >
Publisher: Public Library of Science (PLoS)
Date: 29-03-2018
Publisher: JMIR Publications Inc.
Date: 27-09-2022
Abstract: ighly personalized care is substantially improved by technology platforms that assess and track patient outcomes. However, evidence regarding how to successfully implement technology in real-world mental health settings is limited. his study aimed to naturalistically monitor how a health information technology (HIT) platform was used within 2 real-world mental health service settings to gain practical insights into how HIT can be implemented and sustained to improve mental health service delivery. n HIT (The Innowell Platform) was naturally implemented in 2 youth mental health services in Sydney, Australia. Web-based surveys (n=19) and implementation logs were used to investigate staff attitudes toward technology before and after implementation. Descriptive statistics were used to track staff attitudes over time, whereas qualitative thematic analysis was used to explore implementation log data to gain practical insights into useful implementation strategies in real-world settings. fter the implementation, the staff were nearly 3 times more likely to agree that the HIT would i improve care for their clients /i (3/12, 25% agreed before the implementation compared with 7/10, 70% after the implementation). Despite this, there was also an increase in the number of staff who disagreed that the HIT would improve care (from 1/12, 8% to 2/10, 20%). There was also decreased uncertainty (from 6/12, 50% to 3/10, 30%) about the willingness of the service to i implement the technology for its intended purpose /i , with similar increases in the number of staff who agreed and disagreed with this statement. Staff were more likely to be uncertain about whether i colleagues in my service are receptive to changes in clinical processes /i ( i not sure /i rose from 5/12, 42% to 7/10, 70%). They were also more likely to report that their service i already provides the best mental health care /i (agreement rose from 7/12, 58% to 8/10, 80%). After the implementation, a greater proportion of participants reported that the HIT enabled shared or collaborative decision-making with young people (2/10, 20%, compared with 1/12, 8%), enabled clients to proactively work on their mental health care through digital technologies (3/10, 30%, compared with 2/12, 16%), and improved their response to suicidal risk (4/10, 40% compared with 3/12, 25%). his study raises important questions about why clinicians, who have the same training and support in using technology, develop more polarized opinions on its usefulness after implementation. It seems that the uptake of HIT is heavily influenced by a clinician’s underlying beliefs and attitudes toward clinical practice in general as well as the role of technology, rather than their knowledge or the ease of use of the HIT in question.
Publisher: JMIR Publications Inc.
Date: 25-07-2023
DOI: 10.2196/42993
Abstract: Highly personalized care is substantially improved by technology platforms that assess and track patient outcomes. However, evidence regarding how to successfully implement technology in real-world mental health settings is limited. This study aimed to naturalistically monitor how a health information technology (HIT) platform was used within 2 real-world mental health service settings to gain practical insights into how HIT can be implemented and sustained to improve mental health service delivery. An HIT (The Innowell Platform) was naturally implemented in 2 youth mental health services in Sydney, Australia. Web-based surveys (n=19) and implementation logs were used to investigate staff attitudes toward technology before and after implementation. Descriptive statistics were used to track staff attitudes over time, whereas qualitative thematic analysis was used to explore implementation log data to gain practical insights into useful implementation strategies in real-world settings. After the implementation, the staff were nearly 3 times more likely to agree that the HIT would improve care for their clients (3/12, 25% agreed before the implementation compared with 7/10, 70% after the implementation). Despite this, there was also an increase in the number of staff who disagreed that the HIT would improve care (from 1/12, 8% to 2/10, 20%). There was also decreased uncertainty (from 6/12, 50% to 3/10, 30%) about the willingness of the service to implement the technology for its intended purpose, with similar increases in the number of staff who agreed and disagreed with this statement. Staff were more likely to be uncertain about whether colleagues in my service are receptive to changes in clinical processes (not sure rose from 5/12, 42% to 7/10, 70%). They were also more likely to report that their service already provides the best mental health care (agreement rose from 7/12, 58% to 8/10, 80%). After the implementation, a greater proportion of participants reported that the HIT enabled shared or collaborative decision-making with young people (2/10, 20%, compared with 1/12, 8%), enabled clients to proactively work on their mental health care through digital technologies (3/10, 30%, compared with 2/12, 16%), and improved their response to suicidal risk (4/10, 40% compared with 3/12, 25%). This study raises important questions about why clinicians, who have the same training and support in using technology, develop more polarized opinions on its usefulness after implementation. It seems that the uptake of HIT is heavily influenced by a clinician’s underlying beliefs and attitudes toward clinical practice in general as well as the role of technology, rather than their knowledge or the ease of use of the HIT in question.
Publisher: Wiley
Date: 12-01-2021
DOI: 10.1002/JTS.22643
Abstract: Thompson‐Hollands et al.’s (2020) commentary on our systematic review of exposure‐based writing therapies for subthreshold and clinical posttraumatic stress symptoms (Dawson et al., 2020) emphasizes important questions about the impact of heterogeneity in drawing inferences from evidence reviews. In this reply, we discuss (a) our rationale for undertaking a systematic review that was broad rather than narrow in scope and (b) provide clarifications on how heterogeneity was considered in the meta‐analyses that were conducted. We also strongly agree with Thompson‐Hollands et al.’s recommendation that future research should focus on better understanding the mechanisms by which exposure‐based writing therapies help reduce posttraumatic stress symptoms.
Publisher: SAGE Publications
Date: 10-04-2023
DOI: 10.1177/10398562231167681
Abstract: This study utilised digital technology to assess the clinical needs of young people presenting for care at headspace centres across Australia. 1490 young people (12–25 years) who presented to one of 11 headspace services from four geographical locations (urban New South Wales, urban South Australia, regional New South Wales, and regional Queensland) completed a digital multidimensional assessment at initial presentation. Characteristics were compared between services and geographical locations. We identified major variation in the demographics, and the type and severity of needs across different services. In iduals from regional services were more likely to be younger, of Aboriginal and Torres Strait Islander origin, and present with psychotic-like symptoms and suicidality, while those in urban areas were more likely to have previously sought help and have problematic alcohol use. Further differences in age, distress, depressive symptoms, psychotic-like experiences, trauma, family history, alcohol use, education/employment engagement, and days out of role were identified between different urban sites. The variability between services provides insight into the heterogeneity of youth mental health populations which has implications for appropriate early intervention and prevention service provisions. We propose that integrating digital technologies has the potential to provide insights for smarter service planning and evaluation.
Start Date: 2023
End Date: 12-2027
Amount: $5,000,000.00
Funder: Australian Research Council
View Funded Activity