Our future: a Lancet commission on adolescent health and wellbeing.

Unprecedented global forces are shaping the health and wellbeing of the largest generation of 10 to 24 year olds in human history. Population mobility, global communications, economic development, and the sustainability of ecosystems are setting the future course for this generation and, in turn, humankind. At the same time, we have come to new understandings of adolescence as a critical phase in life for achieving human potential. Adolescence is characterised by dynamic brain development in which the interaction with the social environment shapes the capabilities an individual takes forward into adult life.3 During adolescence, an individual acquires the physical, cognitive, emotional, social, and economic resources that are the foundation for later life health and wellbeing. These same resources define trajectories into the next generation. Investments in adolescent health and wellbeing bring benefits today, for decades to come, and for the next generation. Better childhood health and nutrition, extensions to education, delays in family formation, and new technologies offer the possibility of this being the healthiest generation of adolescents ever. But these are also the ages when new and different health problems related to the onset of sexual activity, emotional control, and behaviour typically emerge. Global trends include those promoting unhealthy lifestyles and commodities, the crisis of youth unemployment, less family stability, environmental degradation, armed conflict, and mass migration, all of which pose major threats to adolescent health and wellbeing. Adolescents and young adults have until recently been overlooked in global health and social policy, one reason why they have had fewer health gains with economic development than other age groups. The UN Secretary-General's Global Strategy for Women's, Children's and Adolescents' Health initiated, in September, 2015, presents an outstanding opportunity for investment in adolescent health and wellbeing. However, because of limits to resources and technical capacities at both the national and the global level, effective response has many challenges. The question of where to make the most effective investments is now pressing for the international development community. This Commission outlines the opportunities and challenges for investment at both country and global levels (panel 1)

Megadose vitamin C in treatment of the common cold: a randomised controlled trial

Letter to the editor commenting on the conflicting evidence that increased intake of vitamin C enhances the natural protective mechanisms of the body and decreases both the incidence and severity of the common cold

Disclosure of Mental Health Problems or Suicidality at Work: A Systematic Review

Many adults experience mental health problems or suicidality. Mental health and suicidality are associated with stigma and discrimination. Little is known about disclosure of mental health or suicidality problems in workplaces and the role of stigma and discrimination in affecting disclosure. To address this gap, we conducted a systematic review following the PRISMA guidelines. Searches for peer-reviewed articles in MedLINE, CINAHL, Embase and PsycINFO identified 26 studies, including sixteen qualitative, seven quantitative and three mixed-methods studies. No studies were excluded based on quality assessment. All studies reported on mental health disclosure; none reported on disclosure of suicidal thoughts or behaviours. The narrative synthesis identified four overarching themes relating to disclosure of mental health problems in workplaces. Themes included beliefs about stigma and discrimination, workplace factors (including supports and accommodation), identity factors (including professional and personal identity, gender and intersectionality) and factors relating to the disclosure process (including timing and recipients), with all influencing disclosure decision making. Significantly, this review found that there is a gap in the existing literature relating to suicidality disclosure in workplaces, with none of the included studies investigating disclosure of suicidal thoughts and behaviours

Males' mental health disadvantage: An estimation of gender-specific changes in service utilisation for mental and substance use disorders in Australia

Background: Concerns about low levels of service utilisation for mental and substance use disorders in Australia - especially among males - have prompted targeted help-seeking and stigma-reduction initiatives. Resulting changes in service utilisation according to gender are unknown. We modelled the percentage of Australian males with a mental or substance use disorder who used services each year between 2006-2007 and 2011-2012, and the types of services they used, relative to females

Quality of assistance provided by members of the Australian public to a person at risk of suicide: associations with training experiences and sociodemographic factors in a national survey

Abstract Background Members of the public can potentially take action to assist someone in their social network who is distressed and at risk of suicide. The present study used data from a community survey to examine training experiences and sociodemographic factors associated with the quality of assistance provided in such situations. Methods A national telephone survey using random digit dialing was carried out with Australian adults on attitudes and intentions toward helping someone in severe distress or at risk of suicide, as well as actions taken. Participants were asked open-ended questions about their intentions to assist a hypothetical person in a vignette and about any actions they took to assist a family member or friend in distress over the previous 12 months. Each participant randomly received 1 of 6 vignettes which varied by gender and degree of suicidality portrayed. 3002 participants provided data on intentions and 932 on actions taken. Quality of Intentions and Quality of Actions were scored on 12-point scales. Results Quality of Intentions and Quality of Actions correlated 0.28. Quality of Intentions was associated with more overt suicidality in the vignette, age 31–59 years, female gender, university education, speaking English at home, being non-Indigenous and all forms of suicide training (professional, Mental Health First Aid and other). Quality of Actions was associated with female gender, university education and other suicide training. Conclusions Training on suicide prevention is associated with better quality of intentions and actions to help a person at risk of suicide. There are sub-groups in the population who are in greater need of such training because they have poorer quality of intentions to help and are less likely to have received training. These include males, less educated people and people from non-English speaking backgrounds

Systems levers for commissioning primary mental healthcare: A rapid review

Primary Health Networks (PHNs) are a new institution for health systems management in the Australian healthcare system. PHNs will play a key role in mental health reform through planning and commissioning primary mental health services at a regional level, specifically adopting a stepped care approach. Selected PHNs are also trialling a healthcare homes approach. Little is known about the systems levers that could be applied by PHNs to achieve these aims. A rapid review of academic and grey literature published between 2006 and 2016 was undertaken to describe the use of systems levers in commissioning primary care services. Fifty-six documents met the inclusion criteria, including twelve specific to primary mental healthcare. Twenty-six levers were identified. Referral management, contracts and tendering processes, and health information systems were identified as useful levers for implementing stepped care approaches. Location, enrolment, capitation and health information systems were identified as useful in implementing a healthcare homes approach. Other levers were relevant to overall health system functioning. Further work is needed to develop a robust evidence-base for systems levers. PHNs can facilitate this by documenting and evaluating the levers that they deploy, and making their findings available to researchers and other commissioning bodies

Additional file 1: of Associations of training to assist a suicidal person with subsequent quality of support: results from a national survey of the Australian public

Full interview schedule. (DOCX 51 kb