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Objective: Tasmania is one of the 12 Australian sites chosen to participate in the National Suicide Prevention Trial. The Centre for Rural Health, University of Tasmania, was contracted to conduct a local-level, process evaluation of this initiative using a Participatory Action Research approach, with the objective of this article to summarise progress and key learnings from the local evaluation to date. Design: Empowerment and Utilisation-Focus Evaluation theoretical approaches informed the conduct of process evaluation activities, within an overarching participatory action research approach. Setting: Three participating regions in Tasmania were included as follows: Launceston, the North-West and Break O'Day. Participants: Working group members, service providers and other relevant stakeholders. Interventions: Mixed-methods surveys, field observations and content analysis were conducted. Results: Survey results indicated that most working group members understood the concept of a "systems-based" approach to suicide prevention. Most participants believed that working group structures/functions engaged community members with lived experience, while around half believed that these structures/functions facilitated relationships with local services and that working group action plans adequately addressed issues of capacity building and sustainability. Preliminary field data suggested that awareness raising, engagement and face-to-face capacity-building activities focused on the wider community were preferred to activities targeting specific populations. Conclusion: These preliminary findings suggest ambivalence among key stakeholders concerning the application of a systems-based approach to suicide prevention in regional areas of Tasmania. Consistent with a participatory action research approach, the findings will inform the evolution of trial site activity for the remainder of the trial and, in due course, the implementation of future such initiatives. [ABSTRACT FROM AUTHOR]

Aims: Refugees and asylum seekers are at high risk of mental health problems such as post‐traumatic stress disorder (PTSD) and depression. Elucidating the occurrence and correlates of these problems in specific resettled refugee populations may be helpful in informing tailored prevention and health promotion programs. We sought to elucidate the occurrence and correlates of depressive symptoms among Afghan refugees resettled in Launceston, a regional town of Australia. Methods: We conducted a cross‐sectional survey of 66 resettled Afghan refugees residing in Launceston in April 2019. We used the Hopkins symptoms checklist (HSCL‐25) and the post migration living difficulties scale (PMLD) to measure depression symptoms and post‐migration variables, respectively. Demographic characteristics and levels of physical activity were also assessed. Multivariate analysis was used to examine factors associated with depressive symptoms. Results: High levels of depressive symptoms were reported by 21.2% of participants (95% CI: 12.1%‐33.0%) and were more common among female participants (41.2%, 95% CI: 18.4%‐67.1%) than male participants (14.3%, 95% CI: 5.9%‐27.2%). Isolation (loneliness, being or feeling alone) (OR = 19.5, 95% CI: 1.9‐203.5) and physical inactivity (OR = 9.2, 95% CI: 1.8‐45.8) were the only variables independently associated with depressive symptoms. Conclusions: Depressive symptoms were common among Afghan refugees living in Launceston, particularly women, and were associated with isolation and physical inactivity. Hence these factors might usefully be targeted in local health promotion and prevention programs. [ABSTRACT FROM AUTHOR]

Objective: To examine the resettlement experiences of former refugees living in regional Australia, focusing on mental health and mental health and support services, including barriers to access. Design: A phenomenological approach utilising a combination of six qualitative, semi‐structured, face‐to‐face focus groups (n = 24) and seven individual interviews. Data were analysed thematically using NVivo 10 software. Setting: Launceston, Tasmania. Participants: Adult and youth former refugees from Afghanistan, Bhutan, Burma, Sierra Leone, Sudan and Iran, and essential service providers, residing in Launceston. Main outcome measures: Participants were asked about experiences of resettlement and mental health. Results: Participants reported that their mental health had improved since resettlement; however, major stressors impacted mental health and resettlement included employment and housing access and mastering the English language. Past experiences continued to impact current functioning, with trauma commonly experienced intergenerationally through parenting and attachment and ongoing trauma and feelings of guilt and responsibility experienced with families left behind. Participants noted barriers to accessing services: (a) Language difficulties including lack of interpreters; and (b) lack of culturally sensitive and trauma‐informed practices. Discrimination was experienced through the inconsistent provision of interpreters and lack of due consideration of cultural and religious differences. The use of children as interpreters enhanced a number of risk including miscommunication of medical information, exposure to age‐inappropriate information and the resulting increased risk of trauma for the child. Conclusion: Culturally sensitive, trauma‐informed and discrimination‐free practices should be employed across services, where Western‐views surrounding this medical model are not imposed, cultural differences are respected, and timely access to interpreters was provided. [ABSTRACT FROM AUTHOR]