Gene Hodgins

Resilience and well-being of small inland communities: community assets as key determinants.

Abstract Introduction: The current climatic conditions and ongoing changes in the farming sector constitute stressful circumstances that impact on the well-being of many Australian rural communities. In these circumstances, small towns and communities are at particular risk due to their relative isolation from services and resources. However, rural communities are noted for being resilient, or able to successfully adapt to stressful circumstances, with well-being both a determinant and outcome of this resilience. This study operationalised a model of resilience, risk and well-being that examined community assets important for resilience of small, inland rural communities. Methods: 102 participants from eight outer regional or remote towns and communities in the northern Riverina region of New South Wales (Australia) completed survey items developed from the community resilience model and the Personal Wellbeing Index (PWI). Results: Social assets including parents and citizens associations (P&C), sporting clubs and groups, and service agency assets including schools were rated as the assets of most benefit to the community and the PWI results were similar to Australian norms, suggesting these communities were resilient. Conclusions: Identifying schools, sporting and other clubs as prominent social assets highlights the role these rural agencies play to maintain and sustain relationships and connectedness of community members. When developing interventions or support services, program and policy makers should recognise these social assets for their contribution to the resilience and well-being of rural environments. The model of community resilience provides a framework that is useful for future policy development, planning, interventions and research.

Trial of interpersonal counselling after major physical trauma.

Objective: The purpose of the present study was to determine if interpersonal counselling (IPC) was effective in reducing psychological morbidity after major physical trauma. Methods: One hundred and seventeen subjects were recruited from two major trauma centres and randomized to treatment as usual or IPC in the first 3 months following trauma. Measures of depressive, anxiety and post-traumatic symptoms were taken at baseline, 3 months and 6 months. The Structured Clinical Interview for DSM IV diagnoses was conducted at baseline and at 6 months to assess for psychiatric disorder. Results: Fifty-eight patients completed the study. Only half the patients randomized to IPC completed the therapy. At 6 months the level of depressive, anxiety and post-traumatic symptoms and the prevalence of psychiatric disorder did not differ significantly between the intervention and treatment-as-usual groups. Subjects with a past history of major depression who received IPC had significantly higher levels of depressive symptoms at 6 months. Conclusion: IPC was not effective as a universal intervention to reduce psychiatric morbidity after major physical trauma and may increase morbidity in vulnerable individuals. Patient dropout is likely to be a major problem in universal multi-session preventative interventions.

An integrated approach to general practice mental health training: the importance of context.

Objective: The high prevalence of mental disorders and the barriers to detection and treatment of these in general practice are well recognized. As such, the government has placed great emphasis on training general practitioners (GPs) in primary care mental health and on the provision of support for GPs in the delivery of such services. The current paper aims to evaluate a local, rural training program in mental health for GPs. We hypothesized that local ‘context-driven’ training would lead to increased knowledge and reported change in practice by GPs with mental health patients. Method: Locally developed and delivered ‘Level 1’ training was offered to GPs through the Better Outcomes in Mental Health Care initiative. The training was provided with 6-hour workshops covering mental health assessment and management planning. The training was evaluated through pre- and 6-week post-questionnaires assessing attitudes and practice with respect to treatment of patients with mental health problems. Results: Forty-nine GPs from the Loddon Campaspe Southern Mallee region of Victoria participated in the training. Following the 6-hour workshop, there was an increase in reported use of psychoeducation for patients with depression, use of cognitive behavioural therapy for patients with anxiety, and ease in obtaining advice to assist with the management of psychosis. Conclusions: GP mental health education should take into consideration the local context, cover systems issues as well as skills development, and aim to develop personal relationships between mental health clinicians and GPs to enhance outcomes.

Journalists and substance use: A systematic literature review

BACKGROUNDnJournalists exposure to potentially traumatic events (PTEs), high levels of job stress, and anecdotal reports within the industry seem to suggest that journalists are at greater risk than the general population to experience substance use disorders. The present systematic literature review (SLR) aims to provide a concise, comprehensive, and systematic review of the quantitative literature relating to journalists experience of substance use.nnnMETHODSnThe systematic review method adopted within the present study was based on that prescribed by Fink in the 2010 book, Conducting systematic literature reviews: From the internet to paper, 3rd ed., which contains three main elements: sampling the literature, screening the literature, and extracting data.nnnRESULTSnAlcohol consumption is the most widely studied substance in journalist samples and is discussed in relation to quantity, level of risk, and potential alcoholism. The review also considers journalists use of substances, including cigarettes, cannabis, and other illicit substances. In particular, comparisons are made between journalistic roles and gender.nnnCONCLUSIONSnThe research is piecemeal in nature, in that more recent research does not build upon the research that has come before it. Much of what has been reported does not reflect the progress that has taken place in recent years within the alcohol consumption and substance use field in terms of theory, assessment, scale development, practice, and interventions with those who use or are addicted to various substances. This SLR raises a number of methodological and theoretical issues to be explored and addressed in future research.