Development of key messages for adolescents on providing basic mental health first aid to peers: a Delphi consensus study.

AIM: Most young people fail to receive professional treatment for mental disorders; however, they do indicate a preference for sharing problems with peers. This article describes key messages about knowledge and actions to form the basis of a basic mental health first aid (MHFA) course for adolescents to increase recognition of and help seeking for mental health problems by teaching the best knowledge and helping actions a young person can undertake to support a peer with a mental health problem. METHODS: The Delphi method was used to achieve consensus among Australian and Canadian youth mental health experts regarding the importance of statements that describe helping actions a young person can take, and information they should have, to support a friend with a mental health problem. There were two expert panels, one consisting of 36 youth mental health consumer advocates and the other of 97 Youth MHFA instructors. Panellists rated each statement according to how appropriate it would be as a basic mental health first aid message for both a junior adolescent (12-15 years) and a senior adolescent (16-18 years). RESULTS: Out of 98 statements, 78 were endorsed as key basic MHFA messages for junior adolescents and 81 were endorsed for senior adolescents. CONCLUSION: The study has identified key messages for adolescents on how they can help a peer. These messages will form the basis of the curriculum for an MHFA course for adolescents, which will aim to facilitate early recognition of and help seeking for mental health problems in adolescents.

Providing culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent: development of expert consensus guidelines

BACKGROUND: It is estimated that the prevalence of mental illness is higher in Aboriginal and Torres Strait Islander adolescents compared to non-Aboriginal adolescents. Despite this, only a small proportion of Aboriginal youth have contact with mental health services, possibly due to factors such as remoteness, language barriers, affordability and cultural sensitivity issues. This research aimed to develop culturally appropriate guidelines for anyone who is providing first aid to an Australian Aboriginal or Torres Strait Islander adolescent who is experiencing a mental health crisis or developing a mental illness.

METHODS: A panel of Australian Aboriginal people who are experts in Aboriginal youth mental health, participated in a Delphi study investigating how members of the public can be culturally appropriate when helping an Aboriginal or Torres Strait Islander adolescent with mental health problems. The panel varied in size across the three sequential rounds, from 37-41 participants. Panellists were presented with statements about cultural considerations and communication strategies via online questionnaires and were encouraged to suggest additional content. All statements endorsed as either Essential or Important by ≥ 90% of panel members were written into a guideline document. To assess the panel members' satisfaction with the research method, participants were invited to provide their feedback after the final survey.

RESULTS: From a total of 304 statements shown to the panel of experts, 194 statements were endorsed. The methodology was found to be useful and appropriate by the panellists.

CONCLUSION: Aboriginal and Torres Strait Islander Youth mental health experts were able to reach consensus about what the appropriate communication strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander adolescent. These outcomes will help ensure that the community provides the best possible support to Aboriginal adolescents who are developing mental illnesses or are in a mental health crisis.

Primary mental health care reform in Australia : the vision and the reality

Reports on primary mental health care reform in Australia 1991-2001 and the involvement of general practioners as the key providers. Investigates the degree to which the vision of policy makers and key stakeholders for a more integrated and effective system had been achieved. Findings suggested there is a considerable mismatch between the policy vision and the implementation reality and that the current system falls short of providing the support and systemic changes necessary for GPs to provide effective mental health care.

‘Knowledge aid’ as instrument of regulation: World Bank’s non-lending higher education support for Ethiopia

In the context of low-income countries, the role of donors in public policymaking is of great importance. Donors use a combination of lending and non-lending instruments as pathways of influence to shape policy directions in aid-recipient countries. This paper reports some findings from a doctoral study on the role of the World Bank in the recent higher education (HE) policy reform process in Ethiopia. It focuses on the nature and impact of non-lending assistance by the Bank to the Ethiopian HE subsystem. Based on an interpretive policy analysis of sector reviews and advisory activities of the Bank, and selected national HE policy documents, the following findings are highlighted. First, as a ‘knowledge institution’, the World Bank produces, systematises and disseminates knowledge through policy advice, policy reports, analytical sector reviews, and thematic conferences and workshops. Second, knowledge aid from the Bank not only has a profound discursive effect on shaping Ethiopian HE policy reform priorities in accordance with its neoliberal educational agenda but also undermines the knowledge production capacity of the nation. The paper also argues that, for an effective education policy support, the Bank needs to shift its modality of engagement from knowledge aid to research capacity building. 

Mapping postgraduate nurse education in Australia 2001-2002

Workforce planning at a national level within nursing and midwifery has been largely fragmented and uncoordinated with health-care organisations, state health authorities, peak nursing organisations and the tertiary sector often engaging in independent decision making and planning. In order to gain an increased understanding of the complexity of contemporary nurse education and to quantify the number of graduates of nursing education courses into categories that are meaningful for workforce planning, the federal Department of Education, Science and Training commissioned a national study in 2002. The aim of this study was to map and quantify current and projected numbers of Australian domestic nursing postgraduate students within their respective specialisation according to each State/Territory. All Australian universities offering postgraduate courses in nursing were electronically surveyed (n=30). Two non-university providers of postgraduate nursing education were also asked to participate, but only one responded. Data were gathered on the number of domestic postgraduate nursing students enrolled in 2002, the number of course completions in 2001 and projected completions for 2002. Of the 13 broad band specialty categories developed for the study, the specialties of Midwifery and High Dependency were dominant in both student enrolments and course completions, including projected completions. The range of specialties that were offered varied by State/Territory, as did the number and percentage of students enrolled, completing and projected to complete each specialty program. Generic courses (without listed specialisations) continue to complicate the process of attempting to tease out and quantify accurately the number of enrolled and completing postgraduate students according to area of specialty practice.

Battlers fail to gain a solid foothold at universities

New analysis suggests universities do not have as many disadvantaged students as they thought, according to equity expert Trevor Gale.

On a new measure of socioeconomic status, involving a smaller geographic unit of analysis, these students made up 15.2 per cent of total domestic numbers last year, statistics released by the federal Department of Education, Employment and Workplace Relations have revealed. The familiar postcode analysis, a cruder measure, had the proportion as 16.2 per cent.

First aid recommendations for psychosis: using the Delphi method to gain consensus between mental health consumers, carers, and clinicians.

BACKGROUND: Members of the general public often lack the knowledge and skills to intervene effectively to help someone who may be developing a psychotic illness before appropriate professional help is received. METHODS: We used the Delphi method to determine recommendations on first aid for psychosis. An international panel of 157 mental health consumers, carers, and clinicians completed a 146-item questionnaire about how a member of the public could help someone who may be experiencing psychosis. The panel members rated each questionnaire item according to whether they believed the statement should be included in the first aid recommendations. The results were analyzed by comparing consensus rates across the 3 groups. Three rounds of ratings were required to consolidate consensus levels. RESULTS: Eighty-nine items were endorsed by >or=80% of panel members from all 3 groups as essential or important for psychosis first aid. These items were grouped under the following 9 headings: how to know if someone is experiencing psychosis; how to approach someone who may be experiencing psychosis; how to be supportive; how to deal with delusions and hallucinations; how to deal with communication difficulties; whether to encourage the person to seek professional help; what to do if the person does not want help; what to do in a crisis situation when the person has become acutely unwell; what to do if the person becomes aggressive. CONCLUSIONS: These recommendations will improve the provision of first aid to individuals who are developing a psychotic disorder by informing the content of training courses.

Lifting the cloak of conceptual confusion: Exploring the meaning of the human right to higher education

The right to education, and specifically higher education, is clearly set out in international law. Higher education is, however, in a state of change as a result of pressures from the increased demand for higher education, globalisation and the impact of new technology (Barber, Donnelly and Rizvi 2013, 1–2). This article asserts that before significant changes to higher education are made, we should reflect on the content of the human rights obligations contained in the international documentation. It seeks to outline the content and scope of the right to higher education in an effort to assist this consideration.

Numeracy across the curriculum: recognising and responding to the demands and numeracy opportunities inherent in secondary teaching

The 1998 Report of the National Standards and Guidelines for Initial Teacher Education Project, 'Preparing a Profession' illustrates the emphasis being placed in Australia on the development of numeracy skills amongst not only primary but also secondary school pupils. This report demands that graduates of all initial teacher training courses should not only be numerate themselves, but should also understand the contribution of numeracy to education and daily life, and be able to identify and respond to pupils' numeracy learning needs. This report and its implementation in Victoria through the 'Guidelines for the Evaluation of Teacher Education Courses' led to the introduction in 1999 of a compulsory unit 'Numeracy across the curriculum' for all Deakin University students in the final year of their secondary teacher training course. This paper discusses the nature of the current emphasis on numeracy. It also describes the rationale, development and delivery of the first year of the 'Numeracy across the curriculum' unit, provides a brief evaluation from the perspective of staff and students, and discusses what impact such teacher education programs might have on secondary schools' approaches to numeracy.

Mortality, malnutrition and the humanitarian response to the food crises in Lesotho

Background: At the height of the food crisis in southern Africa, the Government of Lesotho declared a state of famine and emergency in April 2002 and launched a Famine Relief Appeal for over $137 million. World Vision, in partnership with the World Food Program, became involved in December 2002 providing food aid to affected communities.
Objective: to document mortality rates, causes of death, malnutrition prevalence, and the proportion of lost pregnancies after almost three years of humanitarian response to the food crisis in Lesotho and to propose a way forward.
Design: A two-stage, 30 cluster household survey was undertaken in three districts from the 16th to the 26th of May 2005, with a sample size of 3610 people.
Results: The crude mortality rate (CMR) of 0.8/10,000/day (95%CI: 0.7-0.9). The reported CMR was significantly lower than the CMR emergency threshold (<1/10,000/day). Using 2000 as a pre-drought baseline, 38528 excess deaths occurred between 2000 and 2005. The under-five mortality rate (U5MR) of 3.2 deaths/10,000/day (95%CI: 2.8-3.6/10,000/day) was 4 times the reported CMR and 1.4 times higher the U5MR emergency threshold for sub-Saharan Africa (2.3/10,000/day). CMR was lower among food aid beneficiaries (0.68; 95%CI: 0.57-0.79) than non-beneficiaries (1.42; 95%CI: 1.13-1.70). This was also true for U5MR (2.94; 95%CI: 2.39-3.50 versus 6.44; 95%CI: 5.21-7.68). The prevalence of wasting increased from 5.4% to 12% while that of stunting declined from 45.4% to 36.2% between 2000 and 2005, but the nutritional status did not vary by beneficiary status.
Conclusion: Despite the alarming U5MR, findings suggest that the food aid program ensured survival mainly among adults. The situation could have been catastrophic in the absence of humanitarian assistance.

Education for social justice in an uncertain world

There is a broad body of literature that examines the notion of ‘uncertainty’ in education and, indeed, the themes of this 13th international conference on learning acknowledge that the world is in flux. Barnett (2004), in particular, promotes a renewed approach to education — one that he believes transcends the traditional scope of higher education. Barnett notes that higher education has focused traditionally on knowledge, but, in an uncertain world, this is no longer enough. He encourages teachers in higher education to consider reconstructing curriculum and pedagogy so that a focus on knowing and acting is retained but is complemented by a pedagogy that is designed to enhance students' being in the world. This paper focuses on the potential synergies or difficulties that arise from an analysis of the ‘education for uncertainty’ literature and the goals of education for social justice. Does education for being provide greater possibilities for the enhancement of social justice?

Teacher renewal: collaboration and collegiality

This paper draws in part on findings gathered for the evaluation of the Victorian Department of Education and Training (DE&T) response to the federal Department of Education, Science and Training (DEST) funded Quality Teacher Progam (QTP). The paper reports on findings from one strategy, the Local Area Project and focuses on aspects of that project that relate to teacher renewal and enhancement of professionalism. The findings suggest that the professional development opportunities offered by participation in Local Area Projects have, through collaboration and collegiality, enhanced teacher professionalism and provided an environment for teacher renewal.