Implementation of the Enhanced Moderated Online Social Therapy (MOST+) Model Within a National Youth E-Mental Health Service (eheadspace): Protocol for a Single Group Pilot Study for Help-Seeking Young People

Background: There is a substantial need for youth electronic mental health (e-mental health) services. In addressing this need, our team has developed a novel moderated online social therapy intervention called enhanced moderated online social therapy (MOST+). MOST+ integrates real-time, clinician-delivered Web chat counseling, interactive user-directed online therapy, expert and peer moderation, and private and secure peer-to-peer social networking. MOST+ has been designed to give young people immediate, 24-hour access to anonymous, evidence-based, and short-term mental health care. Objective: The primary aims of this pilot study were to determine the feasibility, acceptability, and safety of the intervention. Secondary aims were to assess prepost changes in key psychosocial outcomes and collect qualitative data for future intervention refinement. Methods: MOST+ will be embedded within eheadspace, an Australian youth e-mental health service, and will be evaluated via an uncontrolled single-group study. Approximately 250 help-seeking young people (16-25 years) will be progressively recruited to the intervention from the eheadspace home page over the first 4 weeks of an 8-week intervention period. All participants will have access to evidence-based therapeutic content and integrated Web chat counseling. Additional access to moderated peer-to-peer social networking will be granted to individuals for whom it is deemed safe and appropriate, through a three-tiered screening process. Participants will be enrolled in the MOST+ intervention for 1 week, with the option to renew their enrollment across the duration of the pilot. Participants will complete a survey at enrollment to assess psychological well-being and other mental health outcomes. Additional assessment will occur following account deactivation (ie, after participant has opted not to renew their enrollment, or at trial conclusion) and will include an online survey and telephone interview assessing psychological well-being and experience of using MOST+. Results: Recruitment for the study commenced in October 2017. We expect to have initial results in March 2018, with more detailed qualitative and quantitative analyses to follow. Conclusions: This is the first Australia-wide research trial to pilot an online social media platform merging real-time clinical support, expert and peer moderation, interactive online therapy, and peer-to-peer social networking. The importance of the project stems from the need to develop innovative new models for the efficient delivery of responsive evidence-based online support to help-seeking young people. If successful, this research stands to complement and enhance e-mental health services in Australia

Applying workability in the Australian residential aged care context

The study is based on an innovative demonstration project which trialled the implementation of the Finnish ‘workability’ framework and research measures. It aimed, firstly, to test the applicability of the Workability Index (WAI) to the Australian residential aged care workforce, focusing on personal care assistants (PCAs), and secondly, to assess the effectiveness of actions aimed at improving workability. The facility manager implemented multidimensional ‘actions’ according to the workability framework. The Workability Survey (WAS) and WAI and intervention instruments were administered (n = 64). Completed responses to ‘pre’ and ‘post’ instruments formed matched pairs (n = 15) which were analysed. The WAI increased by 3 points after all ‘actions’ were implemented, providing a statistically significant result. The only significant ‘action’ was increasing the number of PCAs in high care. Workability provides a useful research workforce development instrument measuring interactions between aged care workers and organisational demands and the outcomes of ‘actions’

Exploring the role of the nurse unit manager in forensic mental health inpatient units : a qualitative study

Forensic mental health (FMH) inpatient settings are complex working environments at times due to a number of factors including the presence of challenging behaviours that may include violence and aggression, restrictions related to legislation, extended length of stay and the impact of trauma. Nurse unit managers (NUMs) play an important role in managing the unit environment and clinical standards of care to achieve better outcomes for consumers and staff. However, the role of NUMs in an FMH setting is poorly understood. The overall aim of this study was to explore the role of NUMs working within an FMH setting in Victoria, Australia. To our knowledge, this is the first study that has examined the subject. Data were collected via focus groups from n = 32 participants which included NUMs, their managers, staff who work alongside the NUMs and the staff the NUMs manage. Data were analysed using thematic analysis and four themes were interpreted from the data, (i) lack of role clarity, (ii) the importance of clinical Leadership and forensic mental health knowledge, (iii) step up in responsibility and step down in pay and (iv) seeing the difference you make. The role of the NUM within a forensic mental health setting comes with a number of challenges, but also opportunities to enact change. An ongoing effort to better support those employed within the NUM role and make the role desirable for aspiring staff is critical to the sustainability of a skilled clinical workforce and quality of care in this complex setting. © 2023 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd

‘If you are feeling alone and you are not feeling safe, it impacts everything’: a mixed-methods exploration of international students’ accommodation, subjective wellbeing and mental health help-seeking

Background The international education sector is important not only to Australian society, but also to the national economy. There are growing concerns about the potential wellbeing challenges facing international students in their host country, owing to acculturative stress; including loneliness, isolation and experiences of racism. Risks include poor mental health and decreased likelihood to access support due to stigma, language and cultural barriers, not knowing where to seek help, and poor mental health knowledge. Methods This study explored students’ perceptions of their accommodation, subjective wellbeing (through the Personal Wellbeing Index, [‘PWI’]), mental health help-seeking and individual engagement with evidence-based everyday health promotion actions (informed by the ‘5 Ways to Wellbeing’ model) through an online survey (N=375) and three online focus groups (N=19). A mixed-methods approach using descriptive statistics, ANOVA, regression analysis and thematic analysis, were used. Results The PWI of international students in the survey was observed to be substantially lower (M=60.7) than that reported for the Australian population (M=77.5). Accommodation impacted on wellbeing (loneliness, belonging, connectedness) in a number of different ways including through location, safety, and shared accommodation. In terms of help-seeking, international students noted a number of barriers to accessing support for mental health: cost of accessing support, language and cultural barriers, lack of information on where to find support and stigma. Conclusions In the discussion, implications of the findings are considered, including that more could be done to shape policy and practice in service and facility provision around wellbeing, connectedness, and help-seeking for mental health support of international students