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Crystal methamphetamine ('ice') use is a large and growing worldwide problem, yet few research studies have explored the impact of crystal methamphetamine use on affected friends and family members. We explored the experiences and narratives of family members and friends of people who use methamphetamine to inform the development of a Family and Friend Support Program. This paper reports on a subset of findings from a mixed method study, which sought to better understand the experiences of family members and friends of people who use methamphetamine. Participants were recruited via Facebook advertising and asked to complete a survey outlining their experiences. At the end of the survey, participants were invited to be interviewed by a clinical psychologist on the research team, to discuss their experiences in greater depth; seventeen people agreed to be interviewed. This paper is based on a qualitative thematic analysis of these interviews using Braun and Clarke's 6-stage approach to identify key areas of concern for friends and family members of people who use methamphetamine. Through thematic analysis, five key themes were developed, namely: (1) loss, (2) stigma, (3) support (or lack thereof), (4) ways of coping, and (5) the value in sharing personal experiences. The results of this study revealed the profound sadness, frustration and loss friends and family members experienced when caring for a loved one who uses methamphetamine. This loss was further complicated by societal stigma surrounding the use of methamphetamine, which often extended to friends and family members themselves. Since experiences of grief and loss were interwoven across the three themes, concepts of ambiguous loss, disenfranchised grief, and narrative constructivist approaches to understanding loss, were applied to the discussion of results. This study provides a more complete picture of family and caregiver experiences when caring for a loved one using methamphetamine, which may further help inform the design of intervention programs. Implications for future research and practice with this population are considered.

Background Mental health and alcohol and other drug use problems consistently dominate the top causes of disease burden in Australians. eHealth stands to be a key tool in addressing these issues but is not routinely well-integrated into service provision models. This study will evaluate the uptake of the digital ecosystem and website, eCliPSE [electronic Clinical Pathways to Service Excellence], developed to improve the symptoms of mental health and alcohol and other drug use problems in people experiencing comorbidity. It will compare two different implementation strategies designed to engage consumers and health services with the eCliPSE website. Methods A cluster randomised controlled trial involving participants from 30 Australian public mental health and alcohol and other drug use services and 8 private psychology services will be conducted across the 15 local health districts in NSW. Each district will be randomised to receive one of two interventions: a Direct-to-Consumer [DtC] Marketing Strategy, or the DtC strategy in addition to an Integrated Translation and Engagement Model [ITEM] of implementation developed by the research team. The effectiveness of each strategy in encouraging uptake of eCliPSE (number of registrations) will be evaluated and compared. Data will be collected using a combination of the eCliPSE website and social media analytics, quantitative surveys, ethnographic observation, document review and qualitative interviews. An economic evaluation will also estimate the cost-effectiveness of DtC + ITEM and budget impact of the strategies, if implemented across Australia. Discussion It is expected that the DtC marketing strategy will result in significant uptake of eCliPSE, that districts receiving DtC + ITEM will demonstrate significantly greater uptake of eCliPSE than those receiving DtC only, and that the combined strategy will be cost-effective compared to DtC alone. Findings from this study will inform future integration and upscaling of digital health tools into traditional service settings for mental health and alcohol and other drug use across Australia. Trial registration This trial is registered with the Australian New Zealand Clinical Trials Registry as: The eCliPSE Project: A 3-level cluster randomised controlled trial implementing evidence-based eHealth interventions for comorbid mental health and alcohol/other drug use problems into health and community settings. Registration number: ACTRN12622000333718. Registration date: 23rd of February 2022.

Help-seeking prior to a suicide attempt is poorly understood. Participants were recruited from a previous research trial who reported a history of suicidal behaviours upon follow-up. Qualitative interviews were conducted with six adults to understand their lived experience of a suicide attempt and the issues affecting help-seeking prior to that attempt. Participants described being aware of personal and professional supports available; however, were ambivalent about accessing them for multiple reasons. This paper employs an ecological systems framework to better understand the complex and multi-layered interpersonal, societal and cultural challenges to help-seeking that people with suicidal ideation can experience.

Community participation and leadership as a shared responsibility of emergency and disaster preparedness is receiving increasing attention. This paper offers an approach informed by complexity and community development theories to support, map and gauge community-led disaster preparedness. A review of existing research, theoretical debates and primary research with communities suggests community preparedness is supported by action across 7 domains: information, networks, communication, resources, decision-making, self-organising and inclusion. These dimensions are best understood as part of a complex system; that is, dimensions interconnect and adapt in non-linear and dynamic ways. The aim of this paper is to offer theoretical foundations for work that strengthens community preparedness.

Background/objectives: The way in which topics like suicide, mental health concerns and alcohol and other drug use are communicated matters. It has the potential to have either a positive or negative impact on people and communities, particularly those with a lived experience of these concerns. This article draws on the findings of a qualitative study designed to explore the experiences and perceptions of stakeholders on the imagery and language used to depict suicide, mental health concerns or alcohol and other drug use. Methods: The focus group method was used as a form of participatory action research to gain an in-depth understanding of the experiences and views of those who use or are impacted by language and imagery about suicide, mental ill-health and AOD use, including those with lived experiences of these topics. Results: A series of 10 focus groups were created in February and March 2022 with media and other professional communicators; people identifying as having a lived experience of suicide, mental ill-health or alcohol and other drug use; mental health and suicide prevention sector professionals; and people from priority populations (n = 49). From these focus groups, principles were developed as well as exemplars of helpful and less helpful depictions. Rather than prescriptive or static rules, the participants indicated that safe representations require an ongoing engagement with the principle of “do no harm”. Conclusions: A positive conclusion arose—that words and images have the potential to promote help-seeking, challenge stigma or stereotypes and create change.

Community participation and leadership as a shared responsibility of emergency and disaster preparedness is receiving increasing attention. This paper offers an approach informed by complexity and community development theories to support, map and gauge community-led disaster preparedness. A review of existing research, theoretical debates and primary research with communities suggests community preparedness is supported by action across 7 domains: information, networks, communication, resources, decision-making, self-organising and inclusion. These dimensions are best understood as part of a complex system; that is, dimensions interconnect and adapt in non-linear and dynamic ways. The aim of this paper is to offer theoretical foundations for work that strengthens community preparedness.

The Creating Meaningful Connections project is a longitudinal study that resulted from a partnership between social work academics at the University of Newcastle and educators at a regional secondary school in NSW, Australia. It seeks to better understand the relationship between school connectedness and youth mental health. In stage 1, focus groups were conducted with 99 students 9 months after their transition to secondary school. The shift to secondary school created a range of social and academic challenges for young people. It often resulted in limited-or no-contact with friends from primary school, requiring the negotiation of new friendships. While this process was relatively trouble-free for many students, others described it as risky and challenging. Positive peer relationships appeared to increase happiness, feelings of safety, offer support during difficult periods and facilitate secondary school adjustment. This paper offers a unique perspective by capturing student voice and commentary about the nature and importance of peer relationships during transition. It also highlights the potential for social work and education to work collaboratively to enhance peer relationships, mental health and school connectedness during transition. [Author abstract]

Despite the known psychosocial challenges associated with supporting a loved one using alcohol and other drugs (AOD), there is a scarcity of mental health and well-being interventions for affected friends and family members (AFFMs). Stigma has also been shown to discourage help-seeking among AFFMs. Web-based interventions may facilitate help-seeking by ensuring privacy and anonymity. This pilot study examines the usability, acceptability, and feasibility of the Family and Friend Support Program (FFSP), a world-first, evidence-based web-based resilience and well-being program designed with, and for, people caring for someone using AOD. This study also examined AFFM's experiences of caring for a loved one using AOD and their help-seeking behaviors and barriers. In 2021 (November-December), participants across Australia completed a baseline web-based cross-sectional survey that assessed the impact of caring for a loved one using AOD (adapted Short Questionnaire for Family Members-Affected by Addiction), and distress levels (Kessler Psychological Distress Scale [K-10]). Following baseline, participants were invited to interact with the FFSP over 10 weeks. Postprogram and follow-up surveys (10 and 14 wk postbaseline, respectively) and semistructured interviews assessed the usability and acceptability of the program, as well as help-seeking experiences and barriers. Baseline surveys were completed by 131 AFFMs, with 37% (n=49) completing the postprogram survey and 24% (n=32) completing the follow-up survey. A total of 5 participants took part in individual semistructured interviews at postprogram. On average, K-10 scores fell in the moderate to severe range at baseline (mean 28.4, SD 8.6). At postprogram, the majority of participants (n=27, 55.1%) reported that they did not seek help to cope with or manage their role supporting their loved one and the most common endorsed barrier was cost (n=11, 28.6%). Overall, participants found the FFSP easy to use and provided them with relevant, helpful, and validating information. The majority (n=35, 71.5%) of participants said they would be likely to recommend the FFSP to a person supporting a loved one using AOD. Qualitative responses highlighted the need for free, accessible support for AFFMs such as the FFSP. Limitations included low program engagement and high attrition. Overall, the FFSP appears to be a promising mental health intervention for AFFMs. This study builds on existing research finding high levels of distress among AFFMs, while highlighting the ongoing barriers to help-seeking. Limitations and future directions for refinements and future efficacy evaluation of the FFSP are discussed including ways to address attrition and increase engagement.

BackgroundCrystal methamphetamine ('ice') use is a large and growing worldwide problem, yet few research studies have explored the impact of crystal methamphetamine use on affected friends and family members. We explored the experiences and narratives of family members and friends of people who use methamphetamine to inform the development of a Family and Friend Support Program.MethodsThis paper reports on a subset of findings from a mixed method study, which sought to better understand the experiences of family members and friends of people who use methamphetamine. Participants were recruited via Facebook advertising and asked to complete a survey outlining their experiences. At the end of the survey, participants were invited to be interviewed by a clinical psychologist on the research team, to discuss their experiences in greater depth; seventeen people agreed to be interviewed. This paper is based on a qualitative thematic analysis of these interviews using Braun and Clarke's 6-stage approach to identify key areas of concern for friends and family members of people who use methamphetamine.ResultsThrough thematic analysis, five key themes were developed, namely: (1) loss, (2) stigma, (3) support (or lack thereof), (4) ways of coping, and (5) the value in sharing personal experiences. The results of this study revealed the profound sadness, frustration and loss friends and family members experienced when caring for a loved one who uses methamphetamine. This loss was further complicated by societal stigma surrounding the use of methamphetamine, which often extended to friends and family members themselves. Since experiences of grief and loss were interwoven across the three themes, concepts of ambiguous loss, disenfranchised grief, and narrative constructivist approaches to understanding loss, were applied to the discussion of results.ConclusionThis study provides a more complete picture of family and caregiver experiences when caring for a loved one using methamphetamine, which may further help inform the design of intervention programs. Implications for future research and practice with this population are considered.