People experiencing homelessness have multiple complex health conditions yet are typically diseng... more People experiencing homelessness have multiple complex health conditions yet are typically disengaged from primary health care services and place a significant burden on the acute health system. Barriers preventing people who are homeless from accessing primary care can be both personal and practical and include competing needs and priorities, illness and poor health, physical access to health services, difficulty in contacting services, medication security, and the affordability of health care. Differences in social status and perceptions of being judged can lead to relationship barriers to accessing primary care. Key solutions include prioritising access to stable housing, continuity of health care, specialised homeless general practice, hospital inreach, discharge planning and coordinated care, general practice outreach, and medical recovery centres.
This article discusses the development, implementation and impact of a social development program... more This article discusses the development, implementation and impact of a social development program developed by the Holyoake Institute in Western Australia for use in schools. The program DRUMBEAT uses hand drumming to engage young people in social learning that assists them in integrating more fully into mainstream school and community life. DRUMBEAT was developed in response to a range of issues that disadvantaged Indigenous youth experienced within the educational system and acted to reinforce entrenched social exclusion. Operational for five years, DRUMBEAT is currently being delivered in over 350 schools across Australia. Since its inception the program has undergone several evaluations. The most recent of these, and the subject of this report, was conducted by researchers at The University of Western Australia and relates to participants in the program during the 2008 school year. This study demonstrated that participants in the program improved their level of self-confidence, ...
There is growing interest across a range of disciplines in the relationship between pets and heal... more There is growing interest across a range of disciplines in the relationship between pets and health, with a range of therapeutic, physiological, psychological and psychosocial benefits now documented. While much of the literature has focused on the individual benefits of pet ownership, this study considered the potential health benefits that might accrue to the broader community, as encapsulated in the construct of social capital. A random survey of 339 adult residents from Perth, Western Australia were selected from three suburbs and interviewed by telephone. Pet ownership was found to be positively associated with some forms of social contact and interaction, and with perceptions of neighbourhood friendliness. After adjustment for demographic variables, pet owners scored higher on social capital and civic engagement scales. The results suggest that pet ownership provides potential opportunities for interactions between neighbours and that further research in this area is warranted. Social capital is another potential mechanism by which pets exert an influence on human health.
The Australian Educational and Developmental Psychologist, 2015
While there is increasing recognition of the need to go beyond measures of mental ill health, the... more While there is increasing recognition of the need to go beyond measures of mental ill health, there is a relative dearth of validated tools for assessing mental well-being among adolescents. The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) is a promising tool for use in this context, and this study evaluated its use in an Australian context. The WEMWBS was completed by 829 Western Australian adolescents, aged from 13 to 16 years old, drawn from Grades 8, 9 and 10 in seven separate high schools. Using confirmatory factor analytic techniques, the utility of the full 14-item scale was not supported, but good fit for a previously validated seven-item short version (SWEMWBS) was supported. Strong measurement invariance was demonstrated across age, and weak measurement invariance was demonstrated across gender. The scale has good internal reliability. There were no differences in SWEMWBS scores across Grades 8 to 10. Overall, the SWEMWBS represents a useful tool for educational, dev...
Abstract Purpose . To examine the role of pet play and dog walking in children&am... more Abstract Purpose . To examine the role of pet play and dog walking in children's and adolescents' leisure time, and the relationship between these activities and physical activity. Design . The study design was observational. Setting . The study setting was metropolitan Perth and nonmetropolitan regions in Western Australia. Subjects . The study included 1097 primary school (mean age, 10.1 years; SD, 1.6 years) and 657 secondary school (mean age, 14.0 years; SD, 1.3 years) students. Measures . Validated measures of total physical activity, dog walking, and pet play activity (prevalence and time) were calculated. Analysis . Generalized linear models tested for differences between proportions, while adjusting for socioeconomic status, age, and school-level clustering. Results . Approximately one third of primary school and one quarter of secondary school students reported that they walked the dog at least once in the last week. Pet play was the most common play activity for primary and secondary school girls, and the second and third most popular play activity for secondary and primary school boys, respectively. Secondary school students who walked the dog or played with pets spent an average of 1 hour per week on each activity, and they were significantly more likely (p < .005) to meet national physical activity recommendations than secondary school students not reporting these activities. Conclusion . Given the significant proportion of young people who frequently engage in dog walking and pet play, and the high level of pet ownership in many Western countries, promotion of these activities to support young people's health is warranted.
ObjectiveIt is likely that there are substantial subconscious effects of organizations’ efforts t... more ObjectiveIt is likely that there are substantial subconscious effects of organizations’ efforts to associate their products with sport via sponsorships, but most research methods are unable to capture these effects. The present study employed a novel projective technique to explore children's implicit associations between popular sports and a range of sports sponsors.DesignChildren participated in an activity using magnets bearing the logos of numerous sports and sponsors. They were invited to arrange the magnets on a whiteboard without being advised that the activity related to sponsorship.SettingPerth, Western Australia.SubjectsChildren (n 164) aged 5–12 years.ResultsThree-quarters (76 %) of the children aligned at least one correct sponsor magnet with the relevant sport. Just over half the children (54 %) correctly matched the most popular sport (an Australian Football League team) with its relevant sponsor (a fast-food chain).ConclusionsGiven the unstructured nature of the p...
The aim of this study was to explore the ways that mothers&am... more The aim of this study was to explore the ways that mothers' groups and playgroups support families with children aged 0-5 years and foster community connectedness in newer residential communities in Perth, Western Australia. The transition to parenthood is a time of increased support need. Changing community demography has resulted in a loss of traditional support structures and an increased need for local community initiatives to support families with young children. A qualitative descriptive design was used for this initial phase of a mixed methods sequential exploratory study. Data were collected between December 2011-August 2012. Interviews and focus groups conducted with 39 mothers provided insights from 16 mothers' groups and 13 playgroups. In addition, interviews were undertaken with three child health nurses and four local government early childhood staff. For the participants in this study, mothers' groups and playgroups provided opportunities to learn about parenting, to build a supportive network, to forge friendships and a connectedness to the local community. The families who relocated often experienced isolation until new groups and social networks were found. In general, where participation in mothers' groups and playgroups facilitated relationships with others from the local community, connectedness to that community was reported by participants to be enhanced. Mothers' groups and playgroups provide important community development opportunities and appear to help reduce potential isolation for mothers with young children. The findings are of interest to nurses and other health professionals working with families with young children.
The Discovering Relationship Using Music, Beliefs, Emotions, Attitudes & Thoughts (DRUMBEAT) prog... more The Discovering Relationship Using Music, Beliefs, Emotions, Attitudes & Thoughts (DRUMBEAT) program used drumming as a way of engaging at risk youth in a form of musical expression, while simultaneously incorporating themes and discussions relating to healthy relationships with others. The program targeted young people who are alienated from the school system. An evaluation was undertaken with a sample of 60 program participants in Western Australia's Wheatbelt region. The evaluation used both quantitative and qualitative methods, including informal discussions with staff and participants, observation, participant and teacher questionnaires, and school attendance and behavioural incident records. Pre- and postintervention data were collected on self-esteem, school attendance, antisocial behaviour, and levels of cooperation and collaboration. Students participating in DRUMBEAT increased their scores over a range of social indicators that act to increase connection with the schoo...
Measuring the effectiveness of health sponsorship at recreational venues Michael Rosenberg,Christ... more Measuring the effectiveness of health sponsorship at recreational venues Michael Rosenberg,Christina Mills, Renee Ferguson, Sarah French and Lisa Wood Contact: Michael Rosenberg, Health Promotion Evaluation Unit, Edith Cowan University m.rosenberg@ecu.edu.au ...
People experiencing homelessness have multiple complex health conditions yet are typically diseng... more People experiencing homelessness have multiple complex health conditions yet are typically disengaged from primary health care services and place a significant burden on the acute health system. Barriers preventing people who are homeless from accessing primary care can be both personal and practical and include competing needs and priorities, illness and poor health, physical access to health services, difficulty in contacting services, medication security, and the affordability of health care. Differences in social status and perceptions of being judged can lead to relationship barriers to accessing primary care. Key solutions include prioritising access to stable housing, continuity of health care, specialised homeless general practice, hospital inreach, discharge planning and coordinated care, general practice outreach, and medical recovery centres.
This article discusses the development, implementation and impact of a social development program... more This article discusses the development, implementation and impact of a social development program developed by the Holyoake Institute in Western Australia for use in schools. The program DRUMBEAT uses hand drumming to engage young people in social learning that assists them in integrating more fully into mainstream school and community life. DRUMBEAT was developed in response to a range of issues that disadvantaged Indigenous youth experienced within the educational system and acted to reinforce entrenched social exclusion. Operational for five years, DRUMBEAT is currently being delivered in over 350 schools across Australia. Since its inception the program has undergone several evaluations. The most recent of these, and the subject of this report, was conducted by researchers at The University of Western Australia and relates to participants in the program during the 2008 school year. This study demonstrated that participants in the program improved their level of self-confidence, ...
There is growing interest across a range of disciplines in the relationship between pets and heal... more There is growing interest across a range of disciplines in the relationship between pets and health, with a range of therapeutic, physiological, psychological and psychosocial benefits now documented. While much of the literature has focused on the individual benefits of pet ownership, this study considered the potential health benefits that might accrue to the broader community, as encapsulated in the construct of social capital. A random survey of 339 adult residents from Perth, Western Australia were selected from three suburbs and interviewed by telephone. Pet ownership was found to be positively associated with some forms of social contact and interaction, and with perceptions of neighbourhood friendliness. After adjustment for demographic variables, pet owners scored higher on social capital and civic engagement scales. The results suggest that pet ownership provides potential opportunities for interactions between neighbours and that further research in this area is warranted. Social capital is another potential mechanism by which pets exert an influence on human health.
The Australian Educational and Developmental Psychologist, 2015
While there is increasing recognition of the need to go beyond measures of mental ill health, the... more While there is increasing recognition of the need to go beyond measures of mental ill health, there is a relative dearth of validated tools for assessing mental well-being among adolescents. The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) is a promising tool for use in this context, and this study evaluated its use in an Australian context. The WEMWBS was completed by 829 Western Australian adolescents, aged from 13 to 16 years old, drawn from Grades 8, 9 and 10 in seven separate high schools. Using confirmatory factor analytic techniques, the utility of the full 14-item scale was not supported, but good fit for a previously validated seven-item short version (SWEMWBS) was supported. Strong measurement invariance was demonstrated across age, and weak measurement invariance was demonstrated across gender. The scale has good internal reliability. There were no differences in SWEMWBS scores across Grades 8 to 10. Overall, the SWEMWBS represents a useful tool for educational, dev...
Abstract Purpose . To examine the role of pet play and dog walking in children&am... more Abstract Purpose . To examine the role of pet play and dog walking in children's and adolescents' leisure time, and the relationship between these activities and physical activity. Design . The study design was observational. Setting . The study setting was metropolitan Perth and nonmetropolitan regions in Western Australia. Subjects . The study included 1097 primary school (mean age, 10.1 years; SD, 1.6 years) and 657 secondary school (mean age, 14.0 years; SD, 1.3 years) students. Measures . Validated measures of total physical activity, dog walking, and pet play activity (prevalence and time) were calculated. Analysis . Generalized linear models tested for differences between proportions, while adjusting for socioeconomic status, age, and school-level clustering. Results . Approximately one third of primary school and one quarter of secondary school students reported that they walked the dog at least once in the last week. Pet play was the most common play activity for primary and secondary school girls, and the second and third most popular play activity for secondary and primary school boys, respectively. Secondary school students who walked the dog or played with pets spent an average of 1 hour per week on each activity, and they were significantly more likely (p < .005) to meet national physical activity recommendations than secondary school students not reporting these activities. Conclusion . Given the significant proportion of young people who frequently engage in dog walking and pet play, and the high level of pet ownership in many Western countries, promotion of these activities to support young people's health is warranted.
ObjectiveIt is likely that there are substantial subconscious effects of organizations’ efforts t... more ObjectiveIt is likely that there are substantial subconscious effects of organizations’ efforts to associate their products with sport via sponsorships, but most research methods are unable to capture these effects. The present study employed a novel projective technique to explore children's implicit associations between popular sports and a range of sports sponsors.DesignChildren participated in an activity using magnets bearing the logos of numerous sports and sponsors. They were invited to arrange the magnets on a whiteboard without being advised that the activity related to sponsorship.SettingPerth, Western Australia.SubjectsChildren (n 164) aged 5–12 years.ResultsThree-quarters (76 %) of the children aligned at least one correct sponsor magnet with the relevant sport. Just over half the children (54 %) correctly matched the most popular sport (an Australian Football League team) with its relevant sponsor (a fast-food chain).ConclusionsGiven the unstructured nature of the p...
The aim of this study was to explore the ways that mothers&am... more The aim of this study was to explore the ways that mothers' groups and playgroups support families with children aged 0-5 years and foster community connectedness in newer residential communities in Perth, Western Australia. The transition to parenthood is a time of increased support need. Changing community demography has resulted in a loss of traditional support structures and an increased need for local community initiatives to support families with young children. A qualitative descriptive design was used for this initial phase of a mixed methods sequential exploratory study. Data were collected between December 2011-August 2012. Interviews and focus groups conducted with 39 mothers provided insights from 16 mothers' groups and 13 playgroups. In addition, interviews were undertaken with three child health nurses and four local government early childhood staff. For the participants in this study, mothers' groups and playgroups provided opportunities to learn about parenting, to build a supportive network, to forge friendships and a connectedness to the local community. The families who relocated often experienced isolation until new groups and social networks were found. In general, where participation in mothers' groups and playgroups facilitated relationships with others from the local community, connectedness to that community was reported by participants to be enhanced. Mothers' groups and playgroups provide important community development opportunities and appear to help reduce potential isolation for mothers with young children. The findings are of interest to nurses and other health professionals working with families with young children.
The Discovering Relationship Using Music, Beliefs, Emotions, Attitudes & Thoughts (DRUMBEAT) prog... more The Discovering Relationship Using Music, Beliefs, Emotions, Attitudes & Thoughts (DRUMBEAT) program used drumming as a way of engaging at risk youth in a form of musical expression, while simultaneously incorporating themes and discussions relating to healthy relationships with others. The program targeted young people who are alienated from the school system. An evaluation was undertaken with a sample of 60 program participants in Western Australia's Wheatbelt region. The evaluation used both quantitative and qualitative methods, including informal discussions with staff and participants, observation, participant and teacher questionnaires, and school attendance and behavioural incident records. Pre- and postintervention data were collected on self-esteem, school attendance, antisocial behaviour, and levels of cooperation and collaboration. Students participating in DRUMBEAT increased their scores over a range of social indicators that act to increase connection with the schoo...
Measuring the effectiveness of health sponsorship at recreational venues Michael Rosenberg,Christ... more Measuring the effectiveness of health sponsorship at recreational venues Michael Rosenberg,Christina Mills, Renee Ferguson, Sarah French and Lisa Wood Contact: Michael Rosenberg, Health Promotion Evaluation Unit, Edith Cowan University m.rosenberg@ecu.edu.au ...
Integrated Altas of Mental Health , Alcohol and other Drugs and Homelessness in SE Melbourne Australia, 2017
In the 2016 Social Progress Index, Australia ranked 4th overall, a view that supports the well-wo... more In the 2016 Social Progress Index, Australia ranked 4th overall, a view that supports the well-worn descriptor of Australia as ‘the lucky country’. However, digging a little deeper, the report draws attention to relative weaknesses that include the provision of shelter, the availability of affordable housing and the foundations of wellbeing, which includes health and wellness.
Australians that live with serious mental illness, those struggling with drug and alcohol issues and those who are homeless, or at risk of homelessness continue to struggle with a disconnected, complex and fragmented health and social service system.
The 2014 National Review of Mental Health Programmes and Services by the National Mental Health Commission drew attention to the need for local planning of care for people with a lived experience of mental illness in Australia and the relevance of a bottom-up approach to understanding “services available locally [in] the development of national policy”. It also called for responsiveness to the diverse local needs of different communities across Australia (NHMC, 2014).
The creation of this Integrated Atlas of Mental Health, Alcohol and Other Drugs (AOD) and Homelessness for South Eastern Melbourne (‘The Atlas’) aligns with these recommendations.
This Atlas, commissioned by the South Eastern Melbourne Primary Health Network (SEMPHN) is the first in the world to present a critical analysis of the pattern of mental health, AOD and homelessness services together.
The Atlas uses a standard classification system, the "Description and Evaluation of Services and Directories in Europe for Long-Term Care" model (DESDE-LTC), to map the services. By utilising this internationally recognised and evidence-based tool as its supporting methodology, it is possible to derive benchmarks and comparisons with other regions both within Australia and internationally. This will provide a sound basis for long-term service planning and development and significantly advance efforts towards integrated care and achieving improved outcomes for all service users.
The ‘integrated care model’ frames the Integrated Atlas. This model has challenged the way health- related care should be assessed and planned. Through focusing on possibilities for integration it enables us to identify new routes for linked-up, consumer-centred approaches to care. Greater integration relies on a global picture of all the services available, regardless of which sector is funding them (i.e. Health, Social Welfare and Family, Employment, Criminal Justice).
Integrated Atlases allow policy planners and decision makers to understand the landscape in which they work (including areas of gap or over-supply), make bridges between the different sectors and to better plan and allocate services. This is particularly important as services become more ‘person-centred’ (placing the person and their needs at the centre of their care), with an increasing emphasis on ‘choice and control’ and public investment focuses on service integration and care coordination programs such as Partners in Recovery (PIR) or the National Disability Insurance Scheme (NDIS).
Data collection for this Atlas took place in 2016. In total, 38 providers had service delivery teams that satisfied the criteria for inclusion in the Atlas. Health services make up 36% of these and non-government organisations (NGOs) 65%.
A total of 373 service delivery ‘teams’ were identified providing 414 Main Types of Care (MTC) across 47 different classifications as defined by the DESDE-LTC model. Of the 414 MTC, 204 (49.2%) are mental health service delivery teams, 79 (19%) are AOD and the remaining 131 (31.6%) are delivering homelessness services.
Data indicates that health sector teams are generally larger than NGO teams, with an average of 12.68 full time equivalent staff (FTE) versus 7.33 FTE, respectively. Teams working within the mental health sector are generally larger (10.85 average FTE) than homelessness services teams (3.99 average FTE) and AOD teams (the smallest at 2.96). The majority of services are for the adult (and general) population, being 312(76.8%). Child and adolescent teams account for 73 (18.0%) of the MTCs and older adults, 20 (4.9%).
Overall, there are some consistencies in the patterns of care for mental health, homelessness and AOD service systems. Services are outpatient focused with a strong community based service response. There is very low availability of day programs across all three service types. This is a time of significant change within the social care sector across Australia. Disruption is evident across all service systems, driven by a range of shifts, pressures and systems changes including: • The introduction of the NDIS and the entry of new providers • The tightening of budgets at State and Federal level • The introduction and empowerment of PHNs • The ageing population • Participant choice and empowerment, and • Technological advancements and digital disruption, with its associated impacts: Ground up, crowd-sourced, crowd-designed programs and services; Entry of start-up ‘disrupters’; Shifts in the way information is consumed and utilised and help and support is accessed; and the sharing economy.
With change comes opportunity. It will be inevitable and indeed welcome to see new entrants and influencers come into play. This is perhaps our greatest opportunity for lasting and impactful systems change, especially for the mental health sector.
For SEMPHN, the creation of this Atlas provides greater awareness and understanding of the local infrastructure and the opportunity to best target its resources to meet population needs on a regional basis. This will allow it to work in partnership with service providers in its region to apply targeted, cost efficient interventions, to try new approaches and to innovate across the continuum of mental ill-health, AOD and homelessness to best support the health and wellbeing of its community.
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Australians that live with serious mental illness, those struggling with drug and alcohol issues and those who are homeless, or at risk of homelessness continue to struggle with a disconnected, complex and fragmented health and social service system.
The 2014 National Review of Mental Health Programmes and Services by the National Mental Health Commission drew attention to the need for local planning of care for people with a lived experience of mental illness in Australia and the relevance of a bottom-up approach to understanding “services available locally [in] the development of national policy”. It also called for responsiveness to the diverse local needs of different communities across Australia (NHMC, 2014).
The creation of this Integrated Atlas of Mental Health, Alcohol and Other Drugs (AOD) and Homelessness for South Eastern Melbourne (‘The Atlas’) aligns with these recommendations.
This Atlas, commissioned by the South Eastern Melbourne Primary Health Network (SEMPHN) is the first in the world to present a critical analysis of the pattern of mental health, AOD and homelessness services together.
The Atlas uses a standard classification system, the "Description and Evaluation of Services and Directories in Europe for Long-Term Care" model (DESDE-LTC), to map the services. By utilising this internationally recognised and evidence-based tool as its supporting methodology, it is possible to derive benchmarks and comparisons with other regions both within Australia and internationally. This will provide a sound basis for long-term service planning and development and significantly advance efforts towards integrated care and achieving improved outcomes for all service users.
The ‘integrated care model’ frames the Integrated Atlas. This model has challenged the way health- related care should be assessed and planned. Through focusing on possibilities for integration it enables us to identify new routes for linked-up, consumer-centred approaches to care. Greater integration relies on a global picture of all the services available, regardless of which sector is funding them (i.e. Health, Social Welfare and Family, Employment, Criminal Justice).
Integrated Atlases allow policy planners and decision makers to understand the landscape in which they work (including areas of gap or over-supply), make bridges between the different sectors and to better plan and allocate services. This is particularly important as services become more ‘person-centred’ (placing the person and their needs at the centre of their care), with an increasing emphasis on ‘choice and control’ and public investment focuses on service integration and care coordination programs such as Partners in Recovery (PIR) or the National Disability Insurance Scheme (NDIS).
Data collection for this Atlas took place in 2016. In total, 38 providers had service delivery teams that satisfied the criteria for inclusion in the Atlas. Health services make up 36% of these and non-government organisations (NGOs) 65%.
A total of 373 service delivery ‘teams’ were identified providing 414 Main Types of Care (MTC) across 47 different classifications as defined by the DESDE-LTC model. Of the 414 MTC, 204 (49.2%) are mental health service delivery teams, 79 (19%) are AOD and the remaining 131 (31.6%) are delivering homelessness services.
Data indicates that health sector teams are generally larger than NGO teams, with an average of 12.68 full time equivalent staff (FTE) versus 7.33 FTE, respectively. Teams working within the mental health sector are generally larger (10.85 average FTE) than homelessness services teams (3.99 average FTE) and AOD teams (the smallest at 2.96). The majority of services are for the adult (and general) population, being 312(76.8%). Child and adolescent teams account for 73 (18.0%) of the MTCs and older adults, 20 (4.9%).
Overall, there are some consistencies in the patterns of care for mental health, homelessness and AOD service systems. Services are outpatient focused with a strong community based service response. There is very low availability of day programs across all three service types.
This is a time of significant change within the social care sector across Australia. Disruption is evident across all service systems, driven by a range of shifts, pressures and systems changes including:
• The introduction of the NDIS and the entry of new providers
• The tightening of budgets at State and Federal level
• The introduction and empowerment of PHNs
• The ageing population
• Participant choice and empowerment, and
• Technological advancements and digital disruption, with its associated impacts: Ground up, crowd-sourced, crowd-designed programs and services; Entry of start-up ‘disrupters’; Shifts in the way information is consumed and utilised and help and support is accessed; and the sharing economy.
With change comes opportunity. It will be inevitable and indeed welcome to see new entrants and influencers come into play. This is perhaps our greatest opportunity for lasting and impactful systems change, especially for the mental health sector.
For SEMPHN, the creation of this Atlas provides greater awareness and understanding of the local infrastructure and the opportunity to best target its resources to meet population needs on a regional basis. This will allow it to work in partnership with service providers in its region to apply targeted, cost efficient interventions, to try new approaches and to innovate across the continuum of mental ill-health, AOD and homelessness to best support the health and wellbeing of its community.