Search

Objective: The Medicare Benefit Schedule (MBS) telehealth items were expanded in March 2020 during the COVID-19 pandemic. We measured the use of MBS telepsychiatry items compared to consultant physician telehealth items within the context of these item changes, to understand differences in telepsychiatry and physician telehealth utilisation. Methods: Monthly counts of face-to-face and telehealth (videoconferencing and telephone) MBS items for psychiatrists and physicians from January 2017 to December 2022 were compiled from Services Australia MBS Item Reports. Usage levels were compared before and after telehealth item expansion. Usage trends for MBS telepsychiatry and physician telehealth items were compared in time-series plots. Results: Telehealth item expansion resulted in a greater rise of telepsychiatry services from 3.8% beforehand to 43.8% of total services subsequently, compared with physician telehealth services (from 0.6% to 20.0%). More physician telehealth services were by telephone compared with telepsychiatry services. Time-series of both telehealth services displayed similar patterns until mid-2022, when physician telehealth services declined as telephone items were restricted. Telepsychiatry services consistently comprised a greater proportion of total services than physician telehealth services. Conclusions: MBS psychiatrist services showed a more substantial and persistent shift to telehealth than physician services, suggesting a greater preference and use of telepsychiatry. [ABSTRACT FROM AUTHOR]

We have evaluated the final-year Psychiatry and Addiction Medicine (PAM) summative Objective Structured Clinical Examination (OSCE) examinations in a four-year graduate medical degree program, for the previous three years as a baseline comparator, and during three years of the COVID-19 pandemic (2020–2022). A de-identified analysis of medical student summative OSCE examination performance, and comparative review for the 3 years before, and for each year of the pandemic. Internal reliability in test scores as measured by R-squared remained the same or increased following the start of the pandemic. There was a significant increase in mean test scores after the start of the pandemic compared to pre-pandemic for combined OSCE scores for all final-year disciplines, as well as for the PAM role-play OSCEs, but not for the PAM mental state examination OSCEs. Changing to online OSCEs during the pandemic was related to an increase in scores for some but not all domains of the tests. This is in line with a nascent body of literature on medical teaching and examination following the start of the pandemic. Further research is needed to optimise teaching and examination in a post-pandemic medical school environment. [ABSTRACT FROM AUTHOR]

Exposure to childhood adversity is a prevalent and pressing issue due to its established links with poor physical and mental health outcomes across the lifespan. High rates of adversity have been found within young people attending mental health services, and the provision of trauma-informed care and trauma-specific therapies are therefore essential within these services. Trauma-focused cognitive behaviour therapy (TF-CBT) is an evidence-based intervention with established efficacy amongst traumatised children and youth. The primary objective of this study was to evaluate the effectiveness of trauma-specific therapy (TF-CBT) when implemented in a Child and Adolescent Mental Health Service (CAMHS). Given that most youth receive care in community settings, it is important to determine whether treatments tested under controlled conditions can apply in the real world of clinical practice. Specifically, this study aimed to quantify the number and type of adversities reported by clients receiving the intervention; investigate whether the intervention is associated with improvements in participants' posttraumatic stress disorder (PTSD) symptoms, general mental health symptoms and functioning; and report contact with CAMHS at 3 months and 2 years post-treatment. Results showed that CAMHS clients were more likely to have experienced multiple traumatic events than single events, with 100% of clients experiencing suicidal thoughts. Treatment was associated with significant improvements in PTSD symptom severity and improvements in general mental health symptoms. Many clients received ongoing mental health support at the 3-month and 2-year follow-ups, reflecting the complex nature of their issues and the need for support to maintain gains achieved during treatment. Highlights: Result from the dissemination and implementation of TF-CBT in a real-world clinical setting. CAMHS clients had experienced multiple traumas, including sexual, emotional and physical abuse. Treatment with trauma-specific interventions was associated with significant improvements in PTSD, general mental health symptoms and greater functioning. A significant number of CAMHS clients required ongoing mental health support in the short and long term. [ABSTRACT FROM AUTHOR]

Objective: To gain an understanding of how women with gestational diabetes perceive their illness, and whether depressive/anxiety symptoms and/or psychological distress influence these illness perceptions. Method: A cross-sectional study was conducted with 159 pregnant women aged 18–44 attending gestational diabetes clinics. Participants completed a questionnaire, which included the Edinburgh Depression Scale (EDS), Kessler 10-item Psychological Distress Scale (K-10), Brief Illness Perception Questionnaire (BIPQ), and psychiatric/general health items. Multiple regression was used to explore the relationship between EDS (total and anxiety subscale) scores and BIPQ scores, as well as between K-10 (total and anxiety subscale) scores and BIPQ scores. Results: Regression analysis revealed a positive association between EDS total/anxiety subscale scores and BIPQ total score, as well as between K-10 total/anxiety subscale scores and BIPQ total score, controlling for potentially confounding variables. There was a strong positive correlation between EDS total score and K-10 total score. The most frequently expressed concern about GDM was an adverse effect on their baby's health. A poor diet was the most frequently reported perceived 'cause' of GDM. Conclusion: Greater severity of depressive and anxiety symptoms, and psychological distress, is associated with more negative illness perceptions of GDM in pregnant women. [ABSTRACT FROM AUTHOR]

Objective: The Australian Commonwealth Government introduced new psychiatrist Medicare-Benefits-Schedule (MBS)-telehealth items in the first wave of the COVID-19 pandemic to assist with previously office-based psychiatric practice. We investigate private psychiatrists' uptake of (1) video- and telephone-telehealth consultations for Quarter-2 (April–June) of 2020 and (2) total telehealth and face-to-face consultations in Quarter-2, 2020 in comparison to Quarter-2, 2019 for Australia. Methods: MBS item service data were extracted for COVID-19-psychiatrist-video- and telephone-telehealth item numbers and compared with a baseline of the Quarter-2, 2019 (April–June 2019) of face-to-face consultations for the whole of Australia. Results: Combined telehealth and face-to-face psychiatry consultations rose during the first wave of the pandemic in Quarter-2, 2020 by 14% compared to Quarter-2, 2019 and telehealth was approximately half of this total. Face-to-face consultations in 2020 comprised only 56% of the comparative Quarter-2, 2019 consultations. Most telehealth provision was by telephone for short consultations of ⩽15–30 min. Video consultations comprised 38% of the total telehealth provision (for new patient assessments and longer consultations). Conclusions: There has been a flexible, rapid response to patient demand by private psychiatrists using the new COVID-19-MBS-telehealth items for Quarter-2, 2020, and in the context of decreased face-to-face consultations, ongoing telehealth is essential. [ABSTRACT FROM AUTHOR]

The sample included 48 patients with a diagnosis of schizophrenia (Scz) recruited from inpatient and community health care settings in the Australian Capital Territory, matched (age, gender, and employment status) with a sample of 48 patients from general practice (GP) settings without a diagnosis of schizophrenia. 19.626.147.830.419.615.28.710.94.36.5 2 = 1.15p = 0.28 ht 1 Scz = schizophrenia; GP = general practice. [Extracted from the article]

Objective: To describe the context, challenges and responses to COVID-19 public health measures for medical education in psychiatry, with an emphasis on sharing strategies for ongoing COVID-19 challenges. Conclusion: The rapidity of COVID-19 public health measures instituted in Australia required swift action for medical education to address lockdowns of student clinical placements. The responses included a transition to interim online learning followed by a return to truncated clinical placements renegotiated to conform to public health measures. Adjustment of formative and summative assessment has been necessary. However, further contingencies may emerge depending upon the overall progress of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]