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1 – 3 of 3Benjamin J.R. Stewart, Natasha Sindicich, Deborah Turnbull, Jane M. Andrews and Antonina A. Mikocka-Walus
– The purpose of this paper is to assess changes in rates of mental health problems and service utilisation for Australian regular injecting drug users (IDUs) from 2006 to 2012.
Abstract
Purpose
The purpose of this paper is to assess changes in rates of mental health problems and service utilisation for Australian regular injecting drug users (IDUs) from 2006 to 2012.
Design/methodology/approach
Data were taken from Illicit Drug Reporting System national surveys with 914 regular IDUs in 2006 and 883 in 2012. Changes in rates of self-reported mental health problems and service use were assessed.
Findings
Rates of self-reported mental health problems increased from 38.3 per cent in 2006 to 43.7 per cent in 2012 – mainly due to increases in anxiety rates. Conversely, there was a decrease in mental health service use from 70.2 to 58.4 per cent by 2012. However, there was a proportional increase in the use of psychologists. These trends remained after controlling for socio-demographic and medical differences between the 2006/2012 samples. K10 scores for 2012 participants validated the use of the self-report measures.
Practical implications
Reductions in stigma, improvements in mental health literacy, and modest increases in anxiety may explain increases in self-report of mental health problems. Stagnant service utilisation rates in an expanding population willing to self-report may explain decreasing service use. The introduction of key mental health reforms also may have contributed, particularly with the increase in psychologist access. This paper highlights the need for improved population monitoring of mental health in disadvantaged groups such as IDUs.
Originality/value
This paper is the first to assess changes in mental health outcomes over time in Australian IDUs. This examination covered a critical era in the mental health landscape, with significant increases in public awareness campaigns and major mental health reforms.
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Stacey L. McCallum, Antonina A. Mikocka-Walus, Hannah Keage, Owen Churches and Jane Andrews
This paper describes the development of a novel integrative self-directed treatment tool which uses cognitive behavioural therapy techniques to reduce anxiety symptoms in patients…
Abstract
Purpose
This paper describes the development of a novel integrative self-directed treatment tool which uses cognitive behavioural therapy techniques to reduce anxiety symptoms in patients presenting to treatment for alcohol-related problems. More specifically, the purpose of this paper is to explore patient and health practitioner perceptions of the booklet, in order to determine its suitability and utility in the context of existing alcohol treatment services. The extent of cross-informant agreement between patient and health practitioner responses is also examined.
Design/methodology/approach
This research utilises a cross-sectional qualitative research design using semi-structured interview methods with patients presenting to hospital for alcohol-related diseases/illnesses/accidents/injuries (n=15) and practitioners (n=10) working at inpatient, outpatient and residential substance treatment facilities.
Findings
The present study found that the majority of patients (80 per cent) and practitioners (90 per cent) expressed a motivation to utilise the proposed booklet, agreeing that the booklet was a practical, achievable and educational resource for patients suffering from co-occurring anxiety symptoms in substance abuse facilities. Participants outlined limitations of the resource, suggesting that the booklet would be most suitable for patients with moderate to high cognitive ability, who also exhibit a motivation to change alcohol consumption and have access to additional support.
Practical implications
Findings from the present study suggest that the booklet may be most effective in improving treatment accessibility and patient treatment seeking behaviours; rather than reducing practitioner-patient contact.
Originality/value
This paper focuses on the development and utility of a novel resource suitable for substance abuse treatment facilities. The findings and feedback produced from the present study can assist with modifications of the intervention and in improving the effectiveness of future trials.
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Andrea Louise Fielder, Antonina Mikocka-Walus, Stacey McCallum, Benjamin Stewart, Pasquale Alvaro and Adrian Esterman
The purpose of this paper is to test the effectiveness of a self-directed cognitive behavioural therapy (CBT) booklet allowing immediate access to treatment for anxiety during…
Abstract
Purpose
The purpose of this paper is to test the effectiveness of a self-directed cognitive behavioural therapy (CBT) booklet allowing immediate access to treatment for anxiety during alcohol use disorder (AUD) interventions.
Design/methodology/approach
Parallel pilot randomised controlled trial: 69 individuals in AUD treatment, continued to receive treatment alone (control: n=29) or in addition, a self-directed, four week CBT booklet to manage anxiety (intervention: n=40). Primary outcome measures were changes in state (SAnx) and trait anxiety (TAnx) at four weeks. Secondary outcome measures were changes in adaptive (ACop), maladaptive (MCop) coping and quality of life (QoL, physical (PHQoL), psychological (PSQoL), social (SQoL), environment (EQoL)) at four weeks.
Findings
Participants had significantly higher SAnx (p < 0.01) and TAnx (p < 0.01) baseline scores compared to the general population. There were no statistically significant group changes in SAnx or TAnx (p > 0.05). Control group allocation predicted improvement in ACop (p < 0.01), MCop (p < 0.05), PHQoL (p < 0.01), PSQoL (p < 0.05) and SQoL (p < 0.01); CBT group allocation predicted improvement in EQoL (p=0.05). All effect sizes were small to moderate (Cohen’s d < 0.50). Percentage of book completion did not determine changes in anxiety, coping or quality of life.
Originality/value
A four week self-directed CBT booklet did not significantly reduce anxiety during AUD treatment. Larger sample sizes will determine the most suitable treatment delivery mode for this type of CBT.
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