Prevention & Outreach

Patient Prevention Outreach Using Technology

Project lead: Professor Sam Harvey (Black Dog Institute)

Who is it for?

About one-third of people with a chronic physical health condition, such as diabetes, heart disease or cancer, also have depression or anxiety. Mental health problems have biological effects that worsen some physical diseases, and they can also sap energy and motivation – making people less able to follow treatment plans. People with mental ill health on top of physical disease are admitted to hospital more often and stay longer, and they also die sooner. Despite this, most mental health issues are recognised too late to make much difference to people’s physical health treatment.

What is it about?

The Black Dog Institute, UNSW and NeuRA have developed online screening tools to help identify people with early symptoms of depression or anxiety, and those at risk of future depression. Many of these tools are already available to the general community via the BDI Online Clinic, which attracts more than 10,000 new users each month.

This two-year project will adapt the BDI Online Clinic for use by patients with chronic physical health problems, and will also integrate online and tablet-based mental health screening resources for hospital patients with physical illnesses, developed at King’s College, London. Alongside the screening tools, the partners in this project will develop care pathways, basic mental health training for physical health teams, self-help material and a linked research program. The first stage is to establish appropriate pilot sites in physical health clinics, and to test the concept for acceptability and feasibility, both for patients and clinicians. If successful, this would eventually lead to an online system offering personalised app and online interventions based on responses to a screening quiz.

Which organisations are involved?

  • Black Dog Institute
  • SESLHD Consultation Liaison Psychiatry Unit
  • UNSW
  • King’s College, London

Measuring and Promoting Wellbeing

Project lead: Dr Justine Gatt (NeuRA)

Who is it for?

Mental health is more than the absence of mental illness; it is also about positive wellbeing. Across the whole community, fewer than a quarter of people report “flourishing”, or optimal wellbeing, while up to 25 per cent have a diagnosable mental illness. This means that at any given time, the majority of people are not mentally unwell but still have room for improvement in their wellbeing.

What is it about?

This project aims to confirm the validity and importance of measuring wellbeing in various mental health settings, and to develop wellbeing programs using different platforms. Dr Justine Gatt has developed one of the first composite wellbeing scales, called COMPAS-W, which uniquely measures both subjective wellbeing (hedonia) and psychological wellbeing (eudaimonia). Most other wellbeing scales measure only one component, for example life satisfaction or quality of life.

This 18-month project will test the practicality and value of measuring mental wellbeing using the COMPAS-W Wellbeing Scale in multiple settings: in patients of the Mental Health Rehabilitation Unit at Prince of Wales Hospital; among hospital staff attending a wellbeing program (which will be developed in collaboration with LHD nursing education staff); and with young clients of a headspace mental health clinic. The outcomes will inform the development of an online app that will provide a personal report on wellbeing using the COMPAS-W Wellbeing measurement tool, plus recommended self-help and online intervention modules that target six wellbeing dimensions. This app will be suitable for the general population and will also be tested in targeted population groups.

Which organisations are involved?

  • NeuRA
  • UNSW
  • SESLHD

Using Technology to Coordinate Care*

Project lead: Conjoint Professor Nicholas Lintzeris (SESLHD)

Who is it for?

People who have co-occurring mental health and substance use disorders often receive separate programs of treatment and support for these issues. Better coordinated, more holistic approaches have the potential to improve people’s health and wellbeing and promote their recovery.

What is it about?

Using a shared clinical information system (CIS), care teams in mental health and drug and alcohol services will develop and implement a Comorbidity Package which will enhance care coordination and collaboration through common training, dashboards, alerts and reminders. The project leaders will bring together clinicians, academics, consumers, service managers and data specialists to iteratively co-design the software, so the resulting package will deliver benefits for all users.

Which organisations are involved?

  • SESLHD
  • UNSW
  • Black Dog Institute
  • NSW Ministry of Health
  • Mid North Coast Local Health District
  • University of Sydney

Reducing Ventilation After Spinal Injury*

Project lead: Dr Euan McCaughey (NeuRA)

Who is it for?

About 350 people experience a spinal cord injury in Australia every year. More than half involve an injury to the neck, known as tetraplegia. As well as all four limbs, tetraplegic paralysis also affects the diaphragm and abdominal muscles involved in breathing; about 40 per cent of people with tetraplegia need mechanical ventilation, increasing the likelihood of illness and death, extending hospital stays and delaying rehabilitation.

What is it about?

Electrical pulses to the abdominal muscles, called Abdominal Functional Electrical Stimulation (Abdominal FES), improve respiratory function in tetraplegia and help wean people from ventilation – but the evidence is not yet complete enough to make this routine practice. A definitive randomised controlled study will assess whether Abdominal FES reduces the duration of mechanical ventilation in people with tetraplegia, with the potential to improve their health and rehabilitation prospects and produce significant health system cost savings. The study will also explore how this treatment can be introduced into worldwide clinical practice.

Which organisations are involved?

  • NeuRA
  • UNSW
  • SESLHD

Treatment for Fear of Falling*

Project lead: Associate Professor Kim Delbaere (NeuRA)

Who is it for?

Many older people are afraid of falling, and while this can be important in protecting them from injury it may also lead to unnecessary limitations in their mobility and activities.

What is it about?

Previous research has shown fear of falling can be reduced through cognitive behavioural therapy (CBT) and balance exercise programs, but these face-to-face treatments are expensive and not commonly available. This study will evaluate whether myCompass online CBT modules developed to treat worry and anxiety can be combined with the StandingTall graded activity program to help people aged 65 and over become more active in a way that is safe and consistent with their lifestyle and abilities. The 8-week program will be delivered through mobile phone technology.

Which organisations are involved?

  • NeuRA
  • UNSW
  • SESLHD
  • Black Dog Institute

Improving Crisis Care for Suicide Risk*

Project lead: Dr Fiona Shand (Black Dog Institute)

Who is it for?

People who are experiencing a suicidal crisis or an episode of severe anxiety can sometimes become further distressed during standard care in busy hospital emergency departments, but alternative support approaches have not yet been developed.

What is it about?

In collaboration with mental health consumers, families and supporters and people bereaved through suicide, this project will develop a new model of crisis care and then test it a large hospital, comparing the outcomes for patients against standard care at another hospital and also assessing the experiences of clinicians.

Which organisations are involved?

  • SESLHD
  • Black Dog Institute

Chronic Pain and Suicidality*

Project lead: Dr Julia Lappin (UNSW)

Who is it for?

People who live with chronic pain are more likely to take their own life, but it is not known what proportion of people who attend hospital experiencing a suicidal crisis are suffering from pain, or how treating the pain might influence their distress.

What is it about?

This project will estimate the prevalence of chronic pain in people who attend emergency departments following a suicide attempt or experiencing a suicidal crisis, and assess how these people can best be supported. If treating their pain results in better health and reduced suicidal distress then this may justify routine pain screening and treatment for people who go to hospital because they are at risk of suicide, and the issue will be studied further in a national clinical trial.

Which organisations are involved?

  • UNSW
  • SESLHD
* This is a Clinical Translational Research Program project