Jane Rich

Quality, rigour and usefulness of free-text comments collected by a large population based longitudinal study - ALSWH.

While it is common practice for health surveys to include an open-ended question asking for additional comments, the responses to these questions are often not analysed or used by researchers as data. The current project employed an automated semantic program to assess the useability and thematic content of the responses to an open-ended free response item included in the Australian Longitudinal Study on Women’s Health (ALSWH) surveys. The study examined the comments of three cohorts of women, born between 1973–78, 1946–51, and 1921–26, from Survey 1 (in 1996) and Survey 5 (in 2007–2009). Findings revealed important differences in the health status of responders compared to non-responders. Across all three cohorts, and at both time points, women who commented tended to have poorer physical health (except for women aged 82–87) and social functioning, experienced more life events, were less likely to be partnered, and (except for women aged 18–23 years) more likely to have higher levels of education, than women who did not comment. Results for mental health were mixed. The analysis revealed differences between cohorts as well as changes over time. The most common themes to emerge for the 1973–78 cohort were health, time, pregnant and work, for the 1946–51 cohort, the most common themes were health, life, time and work, while for the 1921–26 cohort, the most common themes were husband, health and family. The concepts and frequency of concepts changed from the first to the fifth survey. For women in the 1973–78 cohort, pregnant emerged as a prevalent theme, while eating disappeared. Among women in the 1946–51 cohort, cancer, operation and medication emerged as prevalent themes, while for women in the 1921–26 cohort, the concept children disappeared, while family emerged. This analysis suggests that free-text comments are a valuable data source, suitable for content, thematic and narrative analysis, particularly when collected over time.

Prevalence and correlates of depression among Australian women: a systematic literature review, January 1999- January 2010

BackgroundLittle is known about the prevalence and correlates of depression among Australian women. This systematic review of depression among women in Australia, the largest identified to date, highlights the prevalence and correlates of depression across the life span.ResultsThe report adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement (PRISMA). Six health related databases were selected: Medline, PsychInfo, SCOPUS, Cinhal, Informit and Cochrane Systematic Reviews. 1,888 initial articles were found, and 111 articles were considered relevant for review. Prevalence rates of depression among women ranged from 2.6% to 43.9%. Higher rates were reported for younger women, or specific population groups. Most significant correlates included, age, adverse life events, tobacco use, sole motherhood, and previous mental health problems.ConclusionsLimitations include the scope of the investigation’s aims and inclusion criteria, and the failure to identify gender specific data in most studies. Publication bias was likely, given that only papers reported (or translated) in English were included. Despite the breadth of information available, there were noticeable gaps in the literature. Some studies reported on affective disorders, but did not specifically report on depression; it is concluded that each mental illness warrants separate investigation. It was also common for studies to report a total prevalence rate without separating gender. This report recommends that it is vital to separate male and female data. The report concludes that more research is needed among mid-age women, Indigenous women, non-heterosexual women and Culturally and Linguistically Diverse (CALD) women.

Suicidal ideation reported by adults with Type 1 or Type 2 diabetes: results from Diabetes MILES-Australia

To examine the prevalence and correlates of suicidal ideation (SI) in a community‐based sample of adults with Type 1 or Type 2 diabetes.

'Patience, hormone replacement therapy and rain!' Women, ageing and drought in Australia: narratives from the mid-age cohort of the Australian Longitudinal Study on Women's Health.

OBJECTIVE This paper explores womens experiences of drought in Australia. Despite the significance of drought for rural life in Australia, there is little research seeking to understand its psychological consequences. There is also a need to recognise gendered experiences of drought and for research that addresses its long-term effects as people age in prolonged drought-affected areas. DESIGN The study explores longitudinal qualitative data collected by the Australian Longitudinal Study on Womens Health. Free-text comments (n = 217), collected via mailed survey at five time points (1996, 1998, 2001, 2004, 2007) from the same 77 women, were subjected to a narrative analysis. PARTICIPANTS Participants from the Australian Longitudinal Study on Womens Health who were aged 45-50 when the study began in 1996. RESULTS Findings indicate that drought has an impact on women as they age, particularly in reference to menopause, access to support systems and retirement. CONCLUSION This study concludes that the experience of drought cannot be disentangled from the realities of gender and ageing.

Empirical evidence suggests adverse climate events have not affected Australian women's health and well-being

Objective: To compare the health and well‐being of women by exposure to adverse climate events. An Exceptional Circumstance declaration (EC) was used as a proxy for adverse climate events. The Australian government may provide financial support to people living in EC areas, i.e. areas experiencing a one in 20–25 year event (drought, flood or fire) that results in a severe, extended downturn in farm or farm‐related income.

The Challenges of Predicting Suicidal Thoughts and Behaviours in a Sample of Rural Australians with Depression

Suicide is a leading cause of death, particularly in rural and remote areas. Although depression is strongly related to both suicidal ideation and attempt, it lacks specificity as a predictor, and little is known about characteristics that increase suicide risk among people with depression. A telephone version of the World Mental Health Composite International Diagnostic Interview explored lifetime depression, suicidal ideation, suicide attempt, and related factors among a community-dwelling sample of rural and remote Australians, selected for an interview based on a screener for psychological distress (100% of those with high distress, 75% of those with moderate distress, and 16% of those with low distress). Of 1051 participants interviewed, 364 reported lifetime symptoms of depression; of these, 48% reported lifetime suicidal ideation and 16% reported a lifetime suicide attempt. While depression severity was a significant correlate of suicidality for both males and females, suicide attempt was significantly more common among females with a younger age of depression onset, and a higher number of psychiatric comorbidities. No additional factors were significant for males. Among rural and remote residents with lifetime symptoms of depression, the identification of suicide risk may be enhanced by considering individual and contextual factors beyond depression severity. Further research focusing on risk factors for males would be beneficial.

Drought-related stress among farmers: findings from the Australian Rural Mental Health Study

Objectives: To investigate general and drought‐related stress experienced by farmers at both the personal and community levels, and whether socio‐demographic and community factors influence this stress.

Supporting rural Australian communities after disaster: the Warrumbungle Bushfire Support Coordination Service

Aim: Natural disasters inflict significant trauma upon the individuals and communities in which they occur. In order to gain an understanding of the role of community-based disaster recovery support services in the post-disaster environment, we assessed the acceptability and perceived effectiveness of the Warrumbungle Bushfire Support Coordination Service (BSCS) implemented in response to the January 2013 bushfires in the Warrumbungle Shire, New South Wales, Australia. Method: A mixed-methods approach was taken to explore the perspectives of former BSCS users and key stakeholders involved with the service. A survey was distributed to former services users (in both paper and online modalities) and included closed and open-ended questions. Semi-structured interviews were conducted with key stakeholders (face to face or via telephone). Results: A total of 14 former BSCS users and six key stakeholders participated in the research. Almost half of the former service users had accessed the BSCS for more than six months. Regardless of the duration of their use of the service, most reported that the decision to use the service stemmed from the need for ‘help’. The majority of former service users were satisfied with the support provided by the BSCS and would recommend the service to others. Although most indicated that the BSCS informed them about where to get support, just over half were confident that they could access appropriate recovery services without the BSCS. Key themes arising from the former service use surveys were connectedness and support, whilst key themes in the interviews with key stakeholders were connectedness and the operation of the service. Both former service users and key stakeholders reported that the BSCS played an important role in facilitating community connectedness in the post-disaster period. Key stakeholders also identified challenges for the BSCS, including finding an appropriate agency and location to oversee the service and made suggestions about sustainability. Conclusion: On the whole, the BSCS was perceived by former service users and key stakeholders as acceptable and effective. To develop a better understanding of the role of community-based disaster recovery support services, there is a need for more timely, rigorous and representative evaluation of disaster support services like the BSCS. Recommendations are made for the planning and development of future disaster support services. Key words: bushfires, natural disaster, Australia, disaster recovery support service, rural and remote, communities

Older rural women living with drought

ABSTRACT Women’s experiences of drought are often made invisible particularly in terms of their long-term effects. Drought differs from other “natural disasters” in that droughts are, by definition, experienced over an extended time. This means those experiencing drought do so as they age, with elderly cohorts particularly vulnerable. As such, there is a need to better understand the longitudinal needs and experiences of women living with drought. This study investigates the experiences of drought for 15 Australian women aged over 70, over a period of 12 years. Longitudinal qualitative free-text comments written by the oldest cohort of women in the Australian Longitudinal Study on Women’s Health were subject to a thematic analysis. Findings indicate that experiences of drought have a relationship to women’s ability to age in ways they may have hoped. Themes of Work and Physical activity, Connection to place, and, Service access were prominent in women’s comments. These results demonstrate that place is an important aspect in the experience of ageing, that work and physical activity often intensify during drought for elderly people who might otherwise be expecting to retire, and that drought presents particular challenges for older women in terms of access to services. This study highlights the complex interactions of living and ageing in drought for Australian women.

Understanding The Mental Health Of Rural Young Adults: Risk And Protective Factors

Objective: Psychological distress is a serious concern for all young people, with an estimated one in four young Australians living with a mental disorder. In rural communities young adults may face greater challenges in addressing mental health concerns than their urban counterparts with factors such as social stigma, limited availability of services, problems recognising symptoms, and confidentiality concerns being significant barriers. Addressing the determinants of young peoples mental health is crucial if they are to fulfil their potential and contribute fully in their communities. This presentation will describe risk and protective factors for psychological distress among young rural adults. Methods: Data from the Australian Rural Mental Health Study were analysed, with young adults aged 18-35 completing four surveys about mental health and wellbeing over a period of five years. Predictors of psychological distress for young rural adults were determined using generalised linear mixed models. Results: For respondents aged 18-35 years, the strongest predictor of psychological distress across the five years of data collection was unemployment, with findings suggesting that this was independent from its economic value. Unemployment increased the odds of distress 12-fold even after controlling for key correlates including financial position, gender, and relationship status. Key protective factors included social support, sense of community and level of social involvement, while increased alcohol use was a risk factor for distress. Conclusion: Opportunities for rural young people to connect formally and informally with their community are crucial to mental health. Supporting improved mental health is not exclusively the domain of specialised clinical and community-based mental health services (although these services are important), but also that of the diverse sporting, social, cultural, educational, religious, and vocational groups that operate within rural communities. This highlights the importance of holistic and integrated approaches to promoting mental health.