Mental Health and Social and Emotional Wellbeing

CURRENT

2017-2018   

Northern Rivers community recovery after the flood

Staff involved: Professor Ross Bailie; Dr Veronica Matthews; Associate Professor James Bennett-LevyDr Judy Singer; Dr Sabrina Pit, Dr Megan Passey; Dr Jo Longman; Associate Professor Geoff Morgan; Dr Margaret Rolfe; Ms Lee Duncan; Ms Maddie Braddon

Through a population-based survey, this cross-sectional study aims to measure the impact on mental health and wellbeing of residents (16 years and older) in Northern Rivers’ communities six months after the April 2017 flood. It will examine relationships between mental health and wellbeing and the: degree of flood impact; perceptions of the adequacy of the pre-flood mitigation/warning systems and relief service response (government, community and insurance organisations); and level of personal and community resilience.

The survey examines, in a rural context, the degree of mental health distress by different exposure groups (flooded/ disrupted without flooding/unaffected); and in particularly vulnerable groups including the homeless, older people, young adults, Aboriginal people, farmers, and business owners. We are using validated measures to assess anxiety, depression and post-traumatic stress disorder to better inform existing and future service provision required in response to natural disasters.

The findings will inform current mental health service needs and policy and service response mechanisms for future preparedness planning for natural disaster events. It will specifically inform the design of: a) community-based mental health and wellbeing interventions to mitigate the impact of the recent (and future) flood events; b) more in-depth research to inform strengthening of disaster relief responses; and c) a prospective cohort study to monitor community mental health and wellbeing in the medium (1-2 years) and longer-term (3-5 years).

Collaborators:

Northern NSW Local Health District, University of Western Sydney, University of Wollongong, NSW Office of Environment & Heritage, Rekindling the Spirit, Salvation Army, Social Futures, Red Cross, St Vincent de Paul, Winsome Soup Kitchen, Lifeline, NSW Department of Primary Industries, NSW Department of Premier & Cabinet, Thomas George’s office, North Coast Primary Health Network, Lismore Chamber of Commerce & Industry, Lismore City Council, Helping Hands, Southern Cross University, Interrelate, North Coast Community Housing, Richmond Tweed Library Network, Northern Rivers Community Gateway, Real Art Works, Thrive 2484, NSW State Emergency Service, Tweed Shire Council, Murwillumbah & District Business Chamber, Tumbulgum Community Association, Ocean Shores Community Association, Murwillumbah Community Centre, Mullumbimby Neighbourhood Centre, Jullums Aboriginal Medical Service.

Funding:

University Centre of Rural Health

University of Sydney

Western Sydney University

University of Wollongong

Northern NSW LHD

NSW Office of Environment & Heritage

 

2017-2018

Compassion Focused Therapy groups for Aboriginal clients

Staff Involved: Professor James Bennett-Levy; Natalie Roxburgh

The impact of 200 plus years of colonisation, and resulting social determinants, has meant that Aboriginal and Torres Strait Islanders continue to experience high levels of trauma and grief, with consequent high levels of mental health and drug and alcohol problems. Alongside of these issues, high levels of self-criticism and shame are thought to underpin many of these problems. Recent developments in research suggest that the development of self-compassion skills can be a powerful antidote to shame and self-criticism. This project, trialling compassion focused therapy with Aboriginal clients, is a pilot to determine the value of this approach in three different health services. There is also a health workforce component to the project, as it involves training Aboriginal Health Workers in compassion focused therapy strategies.

Collaborators:

Rekindling the Spirit; Bunjum Corporation; Namatjira Haven

Funding:

North Coast Primary Health Network $118000

 

2013-2019   

Aboriginal e-Social and Emotional Wellbeing Project

Staff involved: Professor James Bennett-Levy; Ms Darlene Rotumah; Dr Judy Singer; Ms Liz Lewis; Kelly Hyde; Sasha Harrington; Simon Dubois; David Edwards

As part of a national federally funded ‘e-mental health project (eMHPrac)’, the UCRH is working with local Aboriginal and Torres Strait Islander service providers and community members to promote the use of ‘e-mental health/e-social and emotional wellbeing (e-SEWB) programs

e-SEWB programs’ include social and emotional wellbeing apps and online mental health programs. We have developed and conducted training programs for Aboriginal health professionals and others working with Aboriginal and Torres Strait Islander people to promote and support the use of e-wellbeing programs with their clients.

As part of recent funding, the training will now be extended to other regions of NSW during 2018-19. To date, three papers have been published from this project (Singer et al., 2015; Bennett-Levy et al., 2017; Bird et al., 2017).

Collaborators:

Lismore and Tweed Advisory Groups; Queensland University Technology; Menzies School of Health Research; the Royal Flying Doctor Service; the Black Dog Institute (UNSW)

Funding:

Department of Health and Aging: nation al $12 million funded project (e-MHPrac); to UCRH $1.9 million

 

2008-Ongoing              

Facilitators and Barriers to the Use of Imagery-based Interventions by cognitive-behaviour therapists

Staff involved: Associate Professor James Bennett-Levy

Research over the past 10 years has shown Imagery-based interventions to be one of the effective types of therapeutic intervention with certain types of psychological disorder (e.g. Post-traumatic stress disorder, social anxiety, abuse problems etc.).

However, it has become clear that therapists often have reservations about using imagery-based interventions in their therapy (e.g. “it might get out of control” – “I feel like I don’t know what I’m doing”). We are conducting qualitative and quantitative studies to determine what the main barriers are to therapists using imagery interventions, and identifying strategies that may help to facilitate their use.

Collaborators:

Bolton University (UK)

 

2008-Ongoing              

The impact of self-practice of Cognitive Behaviour Therapy (CBT) techniques and self-reflection on skill acquisition in CBT therapists

Staff involved: Associate Professor James Bennett-Levy

Self-practice/self-reflection (SP/SR) training for aspiring CBT therapists was developed by James Bennett-Levy (Bennett-Levy et al., 2001), and has been trialled with promising results in New Zealand, UK, Ireland, Germany and Austria.

Until recently, studies have been largely qualitative. Recent collaborative studies have asked: Can positive effects of SP/SR training be demonstrated quantitatively? What factors facilitate participants’ engagement with SP/SR? Can we identify what elements of the reflective process result in the most positive skill development? To date, three papers (2014-15), two book chapters (2009, 2014) and an SP/SR workbook (Guilford Press, due Feb 2015) have resulted from this project.

Collaborators:

University of Newcastle (UK), Cumbria NHS Trust (UK), Northumberland NHS Trust (UK), Massey University (NZ), Flinders University.

COMPLETED

2013-2015   

Evaluation of the Bowraville Safe Families Project

Staff involved: Dr Megan Passey; Ms Elizabeth (Liz) Rix

The incidence of serious injury among Aboriginal communities is significantly higher than in non-Aboriginal populations. The Bowraville Safe Families Project provided a whole of community, strengths-based program utilising education, community capacity building and increased community awareness to address family violence within the Aboriginal Community.

This project aimed to improve the wellbeing of Aboriginal people within the Bowraville, NSW Community. The UCRH was contracted to evaluate the project. The evaluation assessed evidence of the implementation and effectiveness of the project, how well it engaged with diverse sectors of the Bowraville Aboriginal community, and whether it may be transferable to other Aboriginal communities.

Collaborators:

Miimi Aboriginal Corporation; Nambucca Valley Phoenix; NSW Ministry of Health; Department of Aboriginal Affairs; Education Centre Against Violence (ECAV); NAPCAN; North Coast Institute of TAFE; Mid North Coast Local Health District; NSW Police – Northern Region; Interrelate Family Centre.

Funding:

NSW Ministry of Health, $250,788 for project; $50,000 to UCRH for evaluation (2013-2015)

 

2012                

Evaluation of the Nimbin Integrated Services project

Staff involved: Dr Jo Longman; Ms Frances Barraclough; Dr Margaret Rolfe; Dr Gao Yu; Professor Lesley Barclay

This project evaluated an innovative mental health service based in Nimbin on the far North Coast of NSW. The evaluation provided evidence of the effectiveness of the service as well as appraising the extent to which the model might be applied to other rural sites.

Collaborators:

All steering committee members of the Nimbin Integrated Services project, in particular including the Northern NSW LHD and Department of Premier and Cabinet.

Funding:

NSW Department of Premier and Cabinet $30,000

UCRH internal funds (2012)

 

2011-2012   

beyondblue: Development of an Action Research Design and Implementation Plan for a Men’s Specific Low-Intensity Psychological Support Service

Staff involved: Professor James Bennett-Levy; Dr Judy Singer

This scoping study explored a new kind of self-help mental health approach, designed specifically for men, called low intensity cognitive behaviour therapy (LI-CBT). People engaged in LI-CBT are supported to use internet-based or written self-help materials. The study consulted consumers and service providers as to how this service might work to best effect, exploring possible advantages and disadvantages, what might encourage or discourage men to use it, and how LI-CBT fits with current service activities and culture.

The outcome of this study was used to help design a pilot a program ‘New Access’, implemented by beyondblue in 2014 across three sites, including within the North Coast Medicare Local.

Collaborators:

Queensland University of Technology

Funding:

beyondblue $140,000

 

2011                

A randomised trial of a low intensity intervention model within a university health service to improve the mental health of students

Staff involved: Professor James Bennett-Levy

Low intensity CBT interventions are a way to greatly increase access to evidence-based psychological therapies. Instead of one-to-one therapy with a specialist therapist, low intensity therapies package the ‘therapeutic expertise’ within online or book-based materials, and provide ‘guided self-help’ to support the person doing a low intensity therapy program.

This project, led by UQ and QUT, evaluated the impact of low intensity interventions in a student counselling service, with support provided by graduate psychologists. The random controlled trial demonstrated a positive impact of the intervention.

Collaborators:

University of Queensland, QUT

Funding:

Australian Rotary Health $78,000

 

2009-2012   

Aboriginal Cognitive Behavioural Therapy project

Staff involved: Associate Professor James Bennett-Levy; Dr Judy Singer

The objective of the study was to investigate whether cognitive behavioural therapy (CBT) might be an effective therapeutic approach for enhancing the mental health of Aboriginal Australians. Five university-educated Aboriginal counsellors received in-depth training in CBT. Over the following year they used CBT strategies with their clients, and met 10 times as a participatory action research group.

The group addressed three key questions:

  • Does CBT appear to be useful for Aboriginal Australians?
  • If so, what elements of CBT are perceived to be effective?
  • What adaptations might be made to CBT to enhance its effectiveness with Aboriginal Australians?

The resulting qualitative data were transcribed and analysed. Counsellors perceived CBT to be very useful for their Aboriginal clients and for themselves. They reported that it enhanced their clients’ wellbeing, their own clinical skills, their own wellbeing, and it reduced burnout. The qualities of CBT that were perceived to be effective were its adaptability, pragmatic here-and-now approach, capacity for low intensity interventions, safe containing structure, promotion of self-agency, and valuable techniques. It was suggested that the prime requirement for adaptations to CBT were that they would need to fit different social and cultural contexts.

Collaborators:

Flinders University

 

2009                

beyondblue: Increased Access to Psychological Therapies (IAPT) Study

Staff involved: Associate Professor James Bennett-Levy; Dr Judy Singer

The advent of new technologies has opened the way for new forms of mental health services that can potentially increase access and choice for people with mild to moderate depression and anxiety, especially those in remote and rural communities. These services are known as ‘low intensity cognitive behavioural therapy’ (LI-CBT) interventions. This feasibility study aimed to establish the framework and procedures for the implementation of a LI-CBT service in a rural Australian context by consulting with local service providers and consumers.

The outcomes of this study informed the design and implementation of the 2011-2012 beyondblue study and the ‘New Access’ program delivered through the North Coast Medicare Local in 2014.

Collaborators:

Flinders University

Funding: 

beyondblue $292,000