Estimating income-related and area-based inequalities in mental health among nationally representative adolescents in Australia: the concentration index approach

Despite the awareness of the importance of mental health problems among adolescents in developed countries like Australia, inequality has not been widely researched. This study, is therefore, aimed to measure and compare household income-related and area-based socioeconomic inequalities in mental health problems (bullying victimization, mental disorders – single and multiple, self-harm and suicidality – ideation, plan and attempt) among Australian adolescents aged 12-17 years. Young Minds Matter (YMM) - the 2nd national cross-sectional mental health and well-being survey involving Australian children and adolescents conducted in 2013-14, was used in this study to select data for adolescents aged 12-17 years (n=2521). Outcome variables included: bullying, mental disorders, self-harm, and suicidal ideation, plan and attempt. The Erreygers’s corrected concentration index (CI) approach was used to measure the socioeconomic inequalities in mental health problems using two separate rank variables – equivalised household income quintiles and area-based Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) quintiles. The prevalence of mental health problems in the previous 12-months among these study participants were: bullying victimization (31.1%, 95% CI: 29%-33%), mental disorder (22.9%, 95% CI: 21%-24%), self-harm (9.1%, 95% CI: 8%-10%), suicidal ideation (8.5%, 95% CI: 7%-10%), suicidal plan (5.9%, 95% CI: 5%-7%) and suicidal attempt (2.8%, 95% CI: 2%-3%). The concentration indices (CIs) were statistically significant for bullying victimization (CI=-0.049, p=0.020), multiple mental disorders (CI=-0.088, p=<0.001), suicidal ideation (CI=-0.023, p=0.047) and suicidal attempt (CI=-0.021, p=0.002), implying pro-poor socioeconomic inequalities based on equivalized household income quintiles. Similar findings revealed when adolescents mental health inequalities calculated on the basis of area based IRSAD (Index of Relative Socio-economic Advantage and Disadvantage) quintiles. Over-all, adolescents from economically worse-off families experienced more mental health-related problems compared to those from economically better-off families. This has implications for prevention strategies and government policy in order to promote mental health and provide equitable healthcare facility

Obesity, disability and self-perceived health outcomes in Australian adults: a longitudinal analysis using 14 annual waves of the HILDA cohort

Background: Both obesity and disability have been widely recognised as major public health challenges because they play significant roles in determining self-perceived general and mental health. Longitudinal studies of the relationship between obesity and disability with self-reported health outcomes are scarce. Therefore, the objective of the present study is to examine the relationship between obesity and disability with self-perceived general and mental health among Australian adults aged 15 years and above. Methods: Data were extracted from the most recent 14 waves (waves 6 through 19) of the annual individual person dataset of the Household, Income and Labour Dynamics in Australia (HILDA) survey. The longitudinal random-effects logistic regression model was adopted to investigate the relationships between obesity and disability with self-reported health outcomes. Results: The results revealed that obese individuals and adults with some form of disability are more likely to report poor or fair general and mental health. The odds of self-reporting poor or fair general health were 2.40 and 6.07 times higher among obese (aOR: 2.40, 95% CI: 2.22– 2.58) and adults with some form of disability (aOR: 6.07, 95% CI: 5.77– 6.39), respectively, relative to adults with healthy weight and those without disability . The results also showed that self-rated poor or fair mental health were 1.22 and 2.40 times higher among obese adults (aOR: 1.22, 95% CI: 1.15– 1.30) and adults with disability (aOR: 2.40, 95% CI: 2.30– 2.51), respectively, compared to their healthy weight peers and peers without disability. Conclusion: As governmental and non-governmental organisations seek to improve the community’s physical and mental well-being, these organisations need to pay particular attention to routine health care prevention, specific interventions, and treatment practices, especially for obese and/or people with disabilities

Social Safety Net Programs: Contribution to Socio-Economic Resilience of Vulnerable Group

Bangladesh is a disaster affected country due to its geographical location and anthropogenic causes. Every year thousands of people are impacted by different kinds of climate induced environmental stressed. Social Safety Nets (SSNs) are non-contributory programmes that helps the poor and vulnerable community and also to reduce poverty and inequality to cope with disasters. Bangladesh government has taken initiative to alleviate poverty including the most vulnerable segment and poor people under different Safety Net Programmes. This study has been undertaken to assess the impacts of these allowance programs for increasing social and economic resiliency in household level. Both primary and secondary data were used to conduct this study. Primary data were collected through questionnaire survey, focus group discussions, and case study. Secondary data were collected from different sources including books, journals and websites related to the study. This study has also investigated how the allowance allocated to extreme poor widows, elders and disabled people can facilitate their disaster resiliency. It compares the situation of allowance receivers to the situation when they were not getting the allowance. The study found that the program has a positive impact on the basic needs like food, cloth, medicine accessibility of the beneficiaries which make them economically resilient. It also founds that although the allowance amount is relatively small and insufficient to significantly contribute to household’s graduation, it often enables recipients to stabilize their earnings. The study has suggested the need to develop a number of strategies especially for the local government to facilitate successful SSN program including increasing the amount of allowance, distributing money through mobile banking system, proper monitoring in selection process are most urgent in the study area

Understanding the determinants and socioeconomic inequality of behavioural and mental health problems, and services utilization among Australian adolescents

This abstract is currently under embargo

Bullying victimization, mental disorders, suicidality and self-harm among Australian high schoolchildren: Evidence from nationwide data

The effects of bullying on mental health among adolescents are of major public health concern, especially following modern bullying methods that technologically victimize adolescents. However, the independent effects of different forms of bullying (traditional, cyberbullying or both) on different types of mental disorders, suicidality and self-harm are not clear. Using a cross-sectional study design, involving 2166 Australian high schoolchildren (1131 Boys and 1035 Girls) aged 12-17 years, this study examined the associations of bullying victimization (traditional, cyber and both) with mental disorders, suicidality (ideation, plan and attempt) and self-harm. Both bivariate and multivariate analyses were employed to assess the associations. Victims of traditional bullying and cyberbullying incurred a significantly higher risk of major depressive disorder, suicidality and self-harm compared to those who had not encountered such threats. Findings also indicated the need for early identification of bullying victims to prevent the risk of mental disorders, suicidality and self-harm in schoolchildren. Furthermore, this evidence can be utilized to inform decisions regarding the provision of resources to address this important health issue in the context of any developed countries like Australia

Depression and anxiety have a larger impact on bullied girls than on boys to experience self-harm and suicidality: a mediation analysis

Background The mechanism underlying the correlation between bullying victimization, self-harm and suicidality by gender are not well understood. This study, therefore, aimed to investigate whether the mediating effect of mental disorder (depression and anxiety) on the association between bullying victimization, and self-harm and suicidality vary across boys and girls. Methods Overall, 2522 Australian adolescents aged 12–17-year-olds were analyzed from a nationally representative cross-sectional survey: Young Minds Matter. A series of logistic regressions were employed using Baron and Kenny's approach to test the mediating effect of each mental disorder on the relationship between bullying victimization, and self-harm and suicidality across gender. Further, the Sobel test was used to estimate the indirect effect. Results Out of 784 (31.1%) bullied victims, 53.2% were girls and 46.8% were boys. A higher proportion of girls compared to boys experienced depression, anxiety, self-harm and suicidality (p < 0.001 for all). The relationships between bullying victimization, and self-harm and suicidality were mediated by depression (p < 0.05) in both boys and girls. While anxiety disorder mediated the association only in girls (p < 0.05). Limitations Cross-sectional study design does not imply causality. Self-reported data about self-harm and suicidality may be susceptible to social desirability bias. Conclusion Girls were more affected by bullying, self-harm and suicidality than boys. Depression mediated the correlation between bullying, and self-harm and suicidality in both boys and girls. While anxiety influenced only bullied girls to experience self-harm and suicidality. These findings warrant the need for gender-specific prevention programs to combat bullying and subsequently self-harm and suicidality in adolescents

Suicidality, mental disorder and the utilization of mental health services among Australian adolescents

Introduction Suicidality among adolescents continues to be a serious public health concern worldwide, and suicide is the leading cause of death for young Australians. However, to develop effective preventive interventions, it is essential to understand the types and rates of mental health service utilization among adolescents. This study investigated the association between suicidality and mental health service utilization among Australian adolescents, and to test whether service use is affected by the simultaneous presence of suicidality and mental disorders. Method Adolescents aged 13–17 years (n = 2134) were used in this study from The Second Australian Child and Adolescent Mental Health and Wellbeing Survey – Young Minds Matter (YMM), which is a nationwide cross-sectional survey. Data were collected through face-to-face interviews with parents using a structured-questionnaire, while, adolescents completed a computer-based self-reported questionnaire privately. The YMM reported four types of mental health service: (1) health services – any services provided by a qualified health professional, regardless of where that service was provided; (2) school services – any services such as counseling or support programs provided by school or any educational institution; (3) telephone counseling services; and (4) online services. Both bivariate and multivariate analyses were used to assess the relationships between independent variables (suicidality, mental disorder) and their distributions over outcome variables (mental health services), adjusting for relevant sociodemographic and potential risk factors such as age, gender, remoteness, household income, family type, family functioning, parents' education, parents' employment, substance use by the child. An interaction between mental disorders and suicidality were included in the regression to examine whether and to what extent service use is affected if an adolescent has both suicidality and a mental disorder. Results Overall, 168 (8%) adolescents reported suicidality and prevalence of suicidality (ideation, plan and attempt) was higher in adolescents with mental disorders (P < 0.01 for all). Suicidality was high among girls irrespective of mental health condition. Both bivariate and multivariate analyses using child data and parent data showed a strong and significant association between suicidality and mental health service utilization among adolescents. Online service and health services were more likely to be accessed by adolescents with suicidality as reported in child data and parent data, respectively; while, school and telephone counselling service were less utilized within the same population. However, still, a large number of adolescents with suicidality did not access any services, even the incidence of seeking any mental health service was higher among adolescents with suicidality compared to those with a mental disorder. Conclusion The limited number of suicidal adolescents is using mental health services, which is alarming for prevention of suicide. Further research is warranted to understand the quality of service received by adolescents and the factors influencing service utilization due to mental health-related problems. Also, interventions to improve care, prevention and monitoring are solely required for this group of people

Effect of internet use and electronic game‑play on academic performance of Australian children

This study examined the association of internet use, and electronic game-play with academic performance respectively on weekdays and weekends in Australian children. It also assessed whether addiction tendency to internet and game-play is associated with academic performance. Overall, 1704 children of 11–17-year-olds from young minds matter (YMM), a cross-sectional nationwide survey, were analysed. The generalized linear regression models adjusted for survey weights were applied to investigate the association between internet use, and electronic-gaming with academic performance (measured by NAPLAN–National standard score). About 70% of the sample spent > 2 h/day using the internet and nearly 30% played electronic-games for > 2 h/day. Internet users during weekdays (> 4 h/day) were less likely to get higher scores in reading and numeracy, and internet use on weekends (> 2–4 h/day) was positively associated with academic performance. In contrast, 16% of electronic gamers were more likely to get better reading scores on weekdays compared to those who did not. Addiction tendency to internet and electronic-gaming is found to be adversely associated with academic achievement. Further, results indicated the need for parental monitoring and/or self-regulation to limit the timing and duration of internet use/electronic-gaming to overcome the detrimental effects of internet use and electronic game-play on academic achievement

Evaluating risk and protective factors for suicidality and self-harm in Australian adolescents with traditional bullying and cyberbullying victimizations

Purpose: To identify and compare important risk and protective factors associated with suicidality and self-harm among traditional bullying and cyberbullying victims aged 14-17-years in Australia. Design: Cross-sectional population-based study. Setting: Young Minds Matter, a nationwide survey in Australia. Subjects: Adolescents aged 14-17-years (n = 2125). Measures: Suicidality and self-harm were outcome variables, and explanatory variables included sociodemographic factors (age, gender, country of birth, household income, location, family type), risk factors (parental distress, family functioning, family history of substance use, child substance use, mental disorder, psychosis, eating disorders, sexual activity) and protective factors (high self-esteem, positive mental health or resilience, school connectedness, sleep) among 2 types of bullying victims—traditional and cyber. Traditional bullying includes physical (hit, kick, push) or verbal (tease, rumors, threat, ignorance), and cyberbullying includes teasing messages/pictures via email, social medial using the internet and/or mobile phones. Analysis: Bivariate analysis and binary logistic regression models. Statistical metrics include Hosmer-Lemeshow Goodness-of-Fit-test, VIF test, Linktest and ROC curve for model performance and fitness. Results: Overall, 25.6% of adolescents were traditional bullying victims and 12% were cyberbullying victims. The percentages of suicidality (34.4% vs 21.6%) and self-harm (32.8% vs 22.3%) were higher in cyberbullying victims than in traditional bullying victims. Girls were more often bullied and likely to experience suicidal and self-harming behavior than boys. Parental distress, mental disorder and psychosis were found to be significantly associated with the increase risk for self-harm and suicidality among both bullying victims (p < 0.05). While, eating disorder and sexual activity increased the risk of suicidality in traditional bullying victims and self-harm in cyberbullying victims, respectively. Positive mental health/resilience and adequate sleep were found be significantly associated with decreased suicidality and self-harm in both bullying victims. Conclusion: Suicidality and self-harm were common in bullying victims. The findings highlight that the risk and protective factors associated with suicidality and self-harm among adolescent who experienced traditional and cyberbullying victimization should be considered for the promotion of effective self-harm and suicide prevention and intervention programs

Healthcare Avoidance before and during the COVID-19 Pandemic among Australian Youth: A Longitudinal Study

Background: Access to healthcare for young people is essential to ensure they can build a foundation for a healthy life. However, during the COVID-19 pandemic, many people avoided seeking healthcare, adversely affecting population health. We investigated the factors associated with the avoidance of healthcare for Australian young people when they reported that they needed healthcare. We were able to compare healthcare avoidance during the COVID-19 pandemic with healthcare avoidance prior to COVID-19. Methods: We used two recent data collection waves from the Longitudinal Study of Australian Children (LSAC)&mdash;Wave 9C1 during the COVID-19 pandemic in 2020, and Wave 8 data which were collected in 2018. The primary outcome of this study revealed the avoidance of healthcare among those who perceived the need for care. Bivariate analyses and multiple logistic regression models were employed to identify the factors associated with the avoidance of healthcare during the COVID-19 and pre-COVID-19 periods. Results: In the sample of 1110 young people, 39.6% avoided healthcare during the first year of the COVID-19 pandemic even though they perceived that they had a health problem that required healthcare. This healthcare avoidance was similar to the healthcare avoidance in the pre-COVID-19 pandemic period (41.4%). The factors most strongly associated with healthcare avoidance during the COVID-19 pandemic were female gender, an ongoing medical condition, and moderately high psychological distress. In comparison, prior to the pandemic, the factor associated with healthcare avoidance was only psychological distress. The most common reason for not seeking healthcare was thinking that the problem would spontaneously resolve itself (55.9% during COVID-19 vs. 35.7% pre-COVID-19 pandemic). Conclusions: A large proportion of youths avoided healthcare when they felt they needed to seek care, both during and before the COVID-19 pandemic