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This paper presents findings from the evaluation of an Australian trial of self‐managed home aged care. The self‐management model was codesigned by advocacy organisation COTA Australia, consumers and service providers. The primary aim of the evaluation was to examine whether self‐management improved consumers' perceptions of their choice, control, and wellbeing. The secondary aim was to examine whether provider prior experience with self‐managed packages significantly influenced consumers' perceptions of choice, control and wellbeing, thereby confounded trial effects. A pre‐test post‐test quasi‐experimental design and mixed‐methods design were used to collect data over nine months in 2018–2019. The pre‐trial methods and findings have been published. The post‐trial evaluation replicated the pre‐trial data collection method of an online survey (n = 60) and semi‐structured telephone interviews with consumers (n = 9), family carers (n = 13), and consumers and carers jointly (n = 2), totalling 24 interviews. Semi‐structured telephone interviews were also conducted with CEOs and senior managers from each of the seven providers (n = 14). Three providers had prior experience supporting self‐management. Parametric and non‐parametric tests examined the statistical data. Qualitative data were analysed thematically and framed according to self‐determination principles and ecological systems theory. Both datasets demonstrated that consumers reported greater choice and control at post‐trial than pre‐trial. This finding was not affected by providers' prior experience with self‐management; therefore, it was not a confounding factor. Participants reported improved wellbeing in interviews, however this was not reinforced statistically. Key desirable features of self‐management included greater autonomy and control over spending, recruiting support staff and paying lower administration fees. There was no evidence of increased risks or fraud. The research limitations included a small sample size, convenience sampling with providers recruiting interview participants, no control group and differences in trial implementation. The findings support the expansion of self‐management opportunities and more comprehensive evaluations that use mixed methods. [ABSTRACT FROM AUTHOR]

Men's Sheds are named within the Australian and Irish National Male Health Policies as an exemplar of male health and well-being and offer a range of formal and informal mentoring to counter the known consequences of social exclusion. The study aimed to report on whether Men's Sheds undertake mentoring programmes, and if so, who is being mentored; are mentors being trained, and if so by whom; and the perceived effectiveness of the mentoring programme. Furthermore, the study aimed to explore associations between sheds with a mentoring programme and factors that reflect an inclusive and a health-focused environment. All known Men's Sheds were invited to participate in the survey; of those, 324 (42.8%) Men's Sheds in Australia and 59 (48.0%) International sheds participated in the study between April and August 2012. Overall, 39.2% ( n = 127) of Australian sheds and 23.7% ( n = 14) of International sheds undertook formal mentoring. Youth was the most common group being mentored in both Australia (60.6%; n = 77) and Internationally (71.4%; n = 10). Over half of Australian shed co-ordinators rated their mentoring programme as moderately effective (52.8%; n = 67) and over a third as highly effective (36.2%; n = 46), while half of International shed co-ordinators rated theirs as highly effective (50.0%; n = 7). The findings from this paper support the notion that a large number of Men's Sheds offer formal mentoring programmes targeting a range of disadvantaged sub-populations, thus supporting social inclusion. Inter-generational mentoring is the most frequently occurring type of mentoring programme. While training mentors occurs at some sheds, the efficacy of this training and programme outcomes are unknown. A typology of shed types appears to be emerging based on a divergence of sheds with a more utilitarian focus and sheds that appear to embrace a health and well-being focus. [ABSTRACT FROM AUTHOR]

Lifeline Australia operates crisis support services through Lifeline Crisis Supporters. An integral part of their role is to conduct online suicide risk assessments with help‐seekers. However, there is limited literature regarding suicide risk assessment practices for this population. This study aimed to examine how suicide prevention training, vicarious trauma and fears impacted suicide risk assessment behaviours of Lifeline Crisis Supporters. A cross‐sectional survey design was used to recruit a volunteer convenience sample of 125 Lifeline Australia Crisis Supporters (75.2% females; Mage = 54.9) in 2018 to participate in an online survey. Findings revealed that those with more suicide‐specific training had less risk assessment‐related fears, and that fears were not related to attitudes towards suicide prevention. There was no significant relationship between vicarious trauma and amount of training or years of experience in the role. Further, participants with higher levels of vicarious trauma demonstrated significantly more negative attitudes towards suicide prevention. Overall, training appears to be a significant factor in suicide risk assessment practice behaviours of Lifeline Crisis Supporters, highlighting a need for ongoing training and support for them. This research also suggests that whilst fears exist, they do not significantly impair Lifeline Crisis Supporters' ability to undertake suicide risk assessment. [ABSTRACT FROM AUTHOR]

Caregivers for family or friends who are elderly people or have a disability provide critical supports, with a range of positive and negative consequences associated with their role. This research explores the positive and negative aspects of care‐giving, including the experience of abuse within the caring relationship, through an anonymous online survey of the mental health, well‐being and caring experience of Australian family carers (N = 305). The voluntary participants were recruited through local and national carer associations. Over 40% of respondents reported having experienced abuse by the person they cared for, with the most common form of abuse being verbal abuse (35% of the respondents reporting abuse) and physical abuse (14%). The experience of abuse was related to poorer mental health as measured by the DASS‐21 and a lower reported quality of life. Financial stress, lack of support and the negative impacts of care‐giving were also significantly associated with mental health and well‐being outcomes. The current research is among the first to directly assess the experience of abuse within a broad sample of caregivers, identifying this as a significant issue for caregivers. The findings have clear implications for programs and policies that protect the rights, safety and well‐being of caregivers. [ABSTRACT FROM AUTHOR]

Children from food insecure households are more likely to have substandard food and nutritional intakes, and experience developmental delays, behaviour issues and increased use of health services. In Australia, screening for household food insecurity (HFI) within health services is not undertaken routinely, limiting opportunities to optimise nutrition and healthcare. This research aimed to (a) identify the prevalence, potential determinants and outcomes of HFI among paediatric outpatients in two Queensland hospitals; and (b) identify questions suitable for screening households at risk of HFI. A cross‐sectional survey collected data from caregivers of children attending paediatric appointments at two hospitals in Brisbane, Australia (n = 148). Sociodemographic, health and household‐related characteristics were collected, and food security status was assessed using four HFI measures. Chi‐square, independent t‐tests, ANOVA and logistic regression explored associations between HFI and health‐related characteristics. A potential HFI screener was identified based on the most frequently endorsed questions from any HFI measure, and its validity was assessed through calculation of sensitivity and specificity. Prevalence of HFI was 41%, with 16% experiencing very low food security. Households with a child of 'fair/poor' health had 5.59 times greater odds of being food insecure than being food secure, compared to households with a child of 'excellent/good' health (aOR 5.59, 95% CI: 1.3–23.5). HFI was also positively associated with household chaos (p =.006). A combination of two questions was identified as a possible screening tool, with a sensitivity of 96% and a specificity of 90%. This study demonstrated HFI may be highly prevalent in a paediatric outpatient population, which may result in difficulties in being able to follow nutrition prescriptions. A highly sensitive and specific two‐question screening tool was identified and may assist practitioners in paediatric healthcare settings in identifying clients who are at risk of HFI. [ABSTRACT FROM AUTHOR]

Therapists and counsellors who provide trauma‐focussed therapy and support to refugees and asylum seekers are often exposed to distressing and confronting stories of war, violence, torture, loss and grief, and other atrocities. In addition to this, working within an immigration and detention context has been reported to further contribute to experiences of burnout, vicarious trauma, and other adverse consequences of working with traumatised populations. There is a scarcity of research seeking to understand how therapists address these difficulties and maintain well‐being to help them continue in this field of work. This mixed‐methods research aimed to identify and explore factors associated with mental health and well‐being among workers, with a particular focus on the role of clinical supervision. Participants were staff (n = 50) who identified as providing therapeutic support to refugees and asylum seekers either in Australia or in Australian‐run detention facilities. Participants took part in an anonymous online survey which focussed on the psychological impact of their work, professional quality of life, and clinical supervision and incorporated free‐text items. Thematic analysis of free‐text data revealed four themes related to maintaining well‐being at work including relationships and support seeking; physical and contemplative practices; professional growth; and balance and boundaries. Results from the quantitative analyses revealed several variables related to supervision that were important for well‐being. In particular, the findings suggest that rapport and overall alliance with one's clinical supervisor are protective of secondary traumatic stress and depression, respectively. Important aspects of supervision were also explored in greater depth through qualitative and quantitative inquiry, increasing our understanding of the mechanisms underlying the relationship between clinical supervision and mental health and well‐being for this group. [ABSTRACT FROM AUTHOR]

Informal care‐givers play an important role in society, and many of the people who provide this care are lesbian women and gay men. Being a care‐giver is known to be associated with poorer health and well‐being, and lesbian and gay care‐givers report experiences of stigma and discrimination in the care‐giving context. This study involved a survey of 230 lesbian women and 503 gay men aged 60 years and over living in Australia, of which 218 were care‐givers. We compared care‐givers to non‐caregivers on a range of health and well‐being measures, including psychological distress, positive mental health, physical health and social support. While we found no significant differences between these two groups, we further compared care‐givers who were caring for an LGBTI person to those who were caring for a non‐LGBTI person. Among the lesbian women, care‐givers of an LGBTI person reported feeling less supported in their carer role and reported lower levels of social support more generally. They were also lower on positive mental health and physical health indicators. Among the gay men, care‐givers of an LGBTI person also reported feeling less supported in their carer role, but there were no differences in reported levels of social support more generally or health and well‐being compared to those caring for a non‐LGBTI person. Overall, results from this study suggest that older lesbian and gay care‐givers may be facing some challenges related to their well‐being and feeling supported, especially if they are caring for another LGBTI person. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess clients' and service providers' perspectives on changes in mental health after an admission to a residential recovery-focused, sub-acute service, in Australia. Clients were either step-up clients, entering the service directly from the community, or step-down clients who were transitioning from an inpatient unit to home. During the 30-month period of data collection (August 2011 to January 2014) all clients ( N = 102) were invited to participate in the longitudinal study and 41 clients consented to be involved (38% response rate). At admission and exit, participants completed the Behaviour and Symptom Identification Scale (Basis-32) and service providers completed the Life Skills Profile-16 and Health of the Nations Outcome Scales. Follow-up data 3 months after exit were available for 12 clients, including the Basis-32 and a self-report measure of quality of life (Assessment of Quality of Life 8-dimension). Both client groups reported positive improvements between admission and exit in the areas of relation to self and others, psychosis, daily living and presence of depression or anxiety symptoms. Service providers reported gains for clients in the areas of self-care, level of symptoms and presence of social problems. At 3 months, clients generally reported positive quality of life, although there was no significant change in symptoms and functioning. This study demonstrates that after an admission to a sub-acute service, step-up clients experience an improvement in their symptoms and functioning, have avoided a hospital admission and are well enough to return home. Step-down clients also experience further improvements in their symptoms and functioning, indicating that the service has assisted them in their transition to independent living after a hospital admission. Sub-acute residential units provide a continuation of care for inpatients preparing to return home, and people with a mental health problem living in the community who experience an escalation in symptoms and prefer an alternative to hospital. [ABSTRACT FROM AUTHOR]

People, along with their families, feel the impact of chronic illness in many areas of their lives. It has been known that those with chronic illness leave the workforce earlier than their peers, have lower incomes and often need additional support to manage their health and lives. However, limited information is available about whether chronic illness is already present prior to retirement, or has developed subsequently. Similarly, we know little about what personal and household assistance is needed by people with chronic illness. In this study, a random sample of 10 000 members of National Seniors Australia, stratified by age and state of residence, were surveyed by post between August and September 2009 and asked about their chronic illnesses along with their age at diagnosis. In addition, participants were asked about their need for assistance with everyday household tasks and personal care. Responses were received from 4574 respondents, a response rate of 45.7%. Of those responding, 82.2% reported having at least one chronic illness at the time of the survey. The study confirms that ill health leads to earlier retirement from the workforce, and those who are sickest require more assistance with their household tasks and personal care. Each additional chronic illness present at age 50 reduced working life by a year, and each present at age 60 by 0.7 years. Diabetes, arthritis and depression were significantly related to earlier retirement. The impact was greatest for both continued workforce participation and need for assistance for those suffering from depression or anxiety. The relationships between health, workforce participation and need for assistance in daily activities are complex. Further research is required to uncover this complexity; nevertheless, the findings highlight the need to review the adequacy of current social and health policy for this particular population. [ABSTRACT FROM AUTHOR]