Temperament, family environment and anxiety in preschool children.

This research examines the relationship between behavioural inhibition (BI), family environment (overinvolved and negative parenting, parental anxiety and parent-child attachment) and anxiety in a sample of 202 preschool children. Participants were aged between 3 years 2 months and 4 years 5 months, 101 were male. A thorough methodology was used that incorporated data from multiple observations of behaviour, diagnostic interviews and questionnaire measures. The results showed that children categorised as behaviourally inhibited were significantly more likely to meet criteria for a range of anxiety diagnoses. Furthermore, a wide range of family environment factors, including maternal anxiety, parenting and attachment were significantly associated with BI, with inhibited children more likely to experience adverse family environment factors. No interactions between temperament and family environment were found for child anxiety. However, a significant relationship between current maternal anxiety and child anxiety was found consistently even after controlling for BI. Additionally, there was some evidence of a relationship between maternal negativity and child anxiety, after controlling for BI. The results may suggest that temperament and family environment operate as additive, rather than interactive risk factors for child anxiety. This is discussed in the context of theoretical models of child anxiety and directions for future research

Delivering mental health first aid training in Australian workplaces: exploring instructors\u27 experiences

 The impact of common mental illnesses in the workplace can be reduced by encouraging support from co-workers and promoting early professional help-seeking. The Mental Health First Aid (MHFA) course is an evidence-based effective program designed to encourage social support and early help-seeking in the general community. However, little is known about whether the course meets the needs of workplaces. The current study aimed to gain a better understanding of how the course is being delivered in Australian workplaces and invite feedback on how it could be tailored for this delivery setting. This study used a purpose-designed survey to explore 120 MHFA instructors’ experiences of delivering the course in workplaces. The results indicated that MHFA is most commonly deployed in the human service and education sectors to assist workers with helping clients, rather than helping co-workers. The results also suggest ways in which the MHFA course could be tailored for workplaces, as well as further support instructors require to deliver courses in workplace settings

Providing mental health first aid in the workplace: a Delphi consensus study

BACKGROUND: Mental health problems are common in the workplace, but workers affected by such problems are not always well supported by managers and co-workers. Guidelines exist for the public on how to provide mental health first aid, but not specifically on how to tailor one\u27s approach if the person of concern is a co-worker or employee. A Delphi consensus study was carried out to develop guidelines on additional considerations required when offering mental health first aid in a workplace context. METHODS: A systematic search of websites, books and journal articles was conducted to develop a questionnaire with 246 items containing actions that someone may use to offer mental health first aid to a co-worker or employee. Three panels of experts from English-speaking countries were recruited (23 consumers, 26 managers and 38 workplace mental health professionals), who independently rated the items over three rounds for inclusion in the guidelines. RESULTS: The retention rate of the expert panellists across the three rounds was 61.7 %. Of the 246 items, 201 items were agreed to be important or very important by at least 80 % of panellists. These 201 endorsed items included actions on how to approach and offer support to a co-worker, and additional considerations where the person assisting is a supervisor or manager, or is assisting in crisis situations such as acute distress. CONCLUSIONS: The guidelines outline strategies for a worker to use when they are concerned about the mental health of a co-worker or employee. They will be used to inform future tailoring of Mental Health First Aid training when it is delivered in workplace settings and could influence organisational policies and procedures

Development of mental health first aid for workplaces

© 2019 Nataly Eleni BovopoulosBackground Common mental health problems are a rising cause of disability in the workplace. Help-seeking rates are low and there are considerable individual, social and economic impacts. One way to address the impact of mental health problems in the workplace as part of an integrated approach is to improve mental health literacy through training. An existing evidence-informed mental health literacy training program is Mental Health First Aid (MHFA). The MHFA program has a large body of evidence for improving participant mental health first aid knowledge and confidence and reducing stigmatising attitudes. Follow-up studies also indicate that participants go on to use their skills to offer assistance to others they are concerned about. The Standard MHFA course is focused on adults helping other adults and the content is informed by a series of guidelines developed through the Delphi consensus method. Given the MHFA program is widely disseminated internationally, it has good potential for uptake by workplaces wishing to train their workers in how to offer mental health first aid to co-workers. Further research is required to ensure this work is guided by evidence. This thesis aims to build knowledge around mental health first aid in the workplace setting to inform future interventions by: 1. Better understanding how the existing MHFA course is delivered in Australian workplaces and inviting feedback on how the course could be tailored for the workplace setting 2. Developing expert consensus guidelines on how to provide mental health first aid to a co-worker 3. Developing evidence-based recommendations for workplaces wishing to establish formal Mental Health First Aid Officer (MHFAO) roles. Three studies were carried out to fulfil the thesis aims. Study 1 Method The first study focused on exploring the experiences of instructors who had delivered MHFA training to workplaces. One hundred and twenty Australian MHFA instructors completed a purpose designed survey retrospectively reporting on MHFA course delivery in workplaces in the previous 12 months, including the industries, reasons for delivering training and any observed impacts after training. The survey also asked for feedback on how the MHFA course content and mode of delivery could be tailored for workplaces. Finally, instructors reported on the perceived benefits and challenges in delivering workplace training and further support they may require. Results The first study found that MHFA training in workplaces was largely concentrated within three industry areas, more often with a focus on developing skills to help clients rather than co-workers and prompted by an internal policy recommending mental health training. Instructors indicated they most wanted workplace specific content and scenarios added to the course and most endorsed face-to-face delivery to an audience of mixed role types, rather than separate training for employees and managers/leaders. A number of benefits, challenges and support needs were also identified. Study 2 Method The second study used Delphi consensus methodology drawing on the expertise of three groups of panellists from English speaking developed countries; individuals with lived experience of mental illness whilst working, managers and workplace mental health professionals. The study aimed to build consensus amongst the expert panellists on the importance of a series of mental health first aid actions in the workplace drawn from the literature to be included in a guideline document. Results A literature search yielded 246 possible helping statements. Of these, 201 items were agreed to be important or very important to be included in a guideline document by at least 80% of the panellists. These items included actions on how to approach and offer support to a co-worker and additional considerations when the person being offered first aid is a supervisor or manager, or if the person is in a crisis situation such as acute distress or intoxication. The study found that panellists found difficulty in reaching consensus on a number of items related to role delineation, privacy and assisting a person in a more senior position. Study 3 Method The final study explored the experiences of workplaces that had appointed employees trained in MHFA into formal MHFAO roles using qualitative case study methodology. Employees from five diverse workplaces with Australian sites completed semi-structured interviews on their implementation approach and the perceived benefits and challenges experienced. Results The results suggested that organisations tended to differ in their implementation approach based on the amount of experience they had with the MHFAO role. There was strong agreement across organisations on the benefits and challenges experienced with the role. Respondents across all organisations agreed it was important to offer MHFA training to all staff if feasible and identified important differences between the MHFAO role and a traditional first aid officer role. A number of recommendations for future workplaces appointing MHFAOs were developed based on the insights shared by organisational representatives. Discussion The results of these three studies provide new knowledge on mental health first aid in the workplace in a number of ways. The results from the first study highlighted that the dissemination across industries has been relatively narrow to date, suggesting that the current MHFA course may need further tailoring to enable broader reach across industries. The guidelines resulting from the second study provide clear consensus-based strategies on how to offer mental health first aid to a co-worker. There was contention on certain topics, suggesting that providing mental health first aid in a workplace context can be complex possibly due to the constraints of workplace roles and responsibilities. In collaboration with MHFA Australia, the insights provided by instructors and the guidelines have now informed the content and delivery of a tailored MHFA course for the workplace. An important finding from the third study was that organisations appointing MHFAOs found it challenging to provide adequate support to those trained in MHFA, in addition to this being the most cited area of suggested improvement by participants. This suggests that organisations may benefit from being offered guidance when planning their approach to MHFA training in the workplace. An MHFA implementation guide for workplaces has now been developed as a result of the third study. The findings from all three studies can be used to develop further relevant resources and services in order to enhance the well-established benefits of MHFA training. Future work could evaluate the guidelines as a standalone minimal intervention and refine the process of revising the guidelines so that they are more targeted for their intended use. Since this thesis research commenced, the field of workplace mental health has significantly progressed and a number of evaluations of mental health literacy interventions in the workplace have been published. These recent findings are discussed in the context of how a possible workplace specific MHFA intervention informed by the three research studies would be conducted in future. Suggestions for future evaluations include providing implementation support to organisations before and after training, including broader workplace measures to assess impact such as help-seeking behaviours and productivity within the workplace and finally, including MHFA training in an integrated workplace mental health intervention

Cognitive-behavioral treatment versus an active control for children and adolescents with anxiety disorders : a randomized trial

Objective: The current trial examined whether a specific cognitive-behavioral treatment package was more efficacious in treating childhood anxiety disorders than a nonspecific support package. Method: One hundred twelve children (aged 7-16 years) with a principal anxiety disorder were randomly allocated to either a group cognitive-behavioral treatment (CBT) program or a control condition (group support and attention [GSA]). Results: Overall, results showed that CBT was significantly more efficacious compared with the GSA condition: 68.6% of children in the CBT condition did not meet diagnostic criteria for their principal anxiety diagnosis at 6-month follow-up compared with 45.5% of the children in the GSA condition. The results of the child- and parent-completed measures indicated that, although mothers of CBT children reported significantly greater treatment gains than mothers of GSA children, children reported similar improvements across conditions. Conclusions: Specific delivery of cognitive-behavioral skills is more efficacious in the treatment of childhood anxiety than a treatment that includes only nonspecific therapy factors.12 page(s

Additional file 3: of Providing mental health first aid in the workplace: a Delphi consensus study

Final guidelines document. (PDF 1277 kb

Additional file 2: of Providing mental health first aid in the workplace: a Delphi consensus study

Endorsed and rejected items including the survey round that they were endorsed or rejected. (XLSX 166 kb

Additional file 1: of Providing mental health first aid in the workplace: a Delphi consensus study

Copies of the Round 1, 2 and 3 surveys. (PDF 1272 kb