Costs of psychosis in 2010: findings from the second Australian national survey of psychosis

Objectives
To estimate the annual costs of psychosis in Australia from societal and government perspectives and assess whether average costs per person differ by principal service provider at time of census.

Methods
Costs of psychosis encompassing health sector costs, other sector costs, and productivity losses were assessed for 2010 using a prevalence-based, bottom-up approach. Resource use data were obtained from the second Australian National Survey of Psychosis and unit costs were from government and non-government organization (NGO) sources. Costs to society were assessed by principal service provider at census: public specialized mental health services (PSMHS) and NGOs during the census month (current clients), and PSMHS in the 11 months preceding census (recent clients), and any differences were ascertained.

Results
The average annual costs of psychosis to society are estimated at $77,297 per affected individual, comprising $40,941 in lost productivity, $21,714 in health sector costs, and $14,642 in other sector costs. Health sector costs are 3.9-times higher than those for the average Australian. Psychosis costs Australian society $4.91 billion per annum, and the Australian government almost $3.52 billion per annum. There are significant differences between principal service providers for each cost category. Current PSMHS clients had the highest health sector costs overall, and the highest mental health ambulatory, inpatient, and antipsychotic medication costs specifically. NGO clients had the highest other sector costs overall and the highest NGO assistance, supported employment, and supported accommodation costs. Recent PSMHS clients had the lowest productivity losses for reduced participation and the highest costs for absenteeism and presenteeism.

Conclusions
The costs of psychosis are broad ranging and very high. Development and implementation of cost-effective prevention, treatment, and support strategies is critical to maximizing the efficiency of service delivery. A needs-based framework based on principal service provider and recency of contact may facilitate this process.

Colonial feminism and Australian literary culture in Ethel and Lilian Turner's the Parthenon (1889–92)

The Parthenon is a unique example of a colonial Australian magazine published for girl readers by two aspirant writers, Ethel and Lilian Turner. In addition to its domestic content, typical of women's magazines, it also sought to contribute to nascent Australian literary culture. This article locates the Parthenon within the history of colonial women's publishing and literary culture, and situates its content within the context of the Woman Movement of the period. It reads the Parthenon's telling picture of young women's perceptions of colonial literary culture and of the need to balance literary aspirations with domestic responsibilities through the lens of the “expediency feminism” advocated by the Dawn, a women's magazine published by Louisa Lawson from 1888. The article argues that the Parthenon's superficially conservative opinion of women's supreme calling being in the home rather than the newspaper office or university library was in alignment with the arguments made by the Woman Movement to advocate for women's greater participation in the public sphere. The comparison of these contemporaneous monthly publications written and produced by women enables an understanding of the ways in which late nineteenth-century attempts to encourage women's careers and independence were grounded in domesticity.

The impact of community notification on the management of sex offenders in the community : an Australian perspective

Western Australia recently passed legislation that allows information about convicted sex offenders to be disclosed to the general public. After critically appraising the rationale behind community notification, this paper considers its impact on offenders’ reintegration into the community and their subsequent risk of reoffending, its potential deterrent effect and usefulness as a management tool, and implementation issues. This discussion identifies several factors that potentially moderate the effectiveness of community notification schemes and some directions for future research and the development of policy and practices in this area.

Psychiatric disorders and unmet needs in Australian police cells

To determine the prevalence of current psychiatric disorders and unmet needs in a sample of police cell detainees in Victoria. A cross-sectional descriptive study was conducted, including data linkage with the Victoria Police database and the Victorian Psychiatric Case Register. In Melbourne, Australia, 150 detainees were recruited from two busy metropolitan police stations. Outcome measures included estimated rates of psychiatric disorders, using the Structured Clinical Interview for DSM-IV-TR, and individual needs, using the Camberwell Assessment of Need – Forensic Version. One quarter (n = 32, 25.4%) of detainees had a prior admission to a psychiatric hospital, and three quarters met current criteria for a diagnosable mental disorder. The most common disorders were substance dependence (n = 81, 54%) and mood disorders (n = 60, 40%). A third met diagnostic criteria for both a mental illness and a substance use disorder. The odds of being classified with mood (OR = 10.1), anxiety (OR = 2.2), psychotic (OR = 15.4) and substance use disorders (OR = 26.3) were all significantly higher in the current sample as compared with the general population. Detainees with a mental illness identified significantly more needs and significantly more unmet needs (e.g. psychological distress) than those who did not rate as having a current mental illness. There remains a pressing need to evaluate standardized screening tools for mental illnesses in police cells to provide timely access to assessment and treatment services. The need for functional interagency collaborations are highlighted and discussed.

Understanding Australian ethnic minority artists' careers

This article examines the degree to which Australian ethnic minority artists possess or do not possess the career capitals necessary to develop their artistic journey. We listened to stories of career experiences that show how artists learn to negotiate their way by developing their career paths. The study found that ethnic minority artists possess more cultural capital than economic and social capitals, thus limiting their career to attain hierarchy and power in creative institutions. Ethnic minority artists can use strategies to manage career, boosting economic, social capitals and to a lesser extent cultural capital. This article adds to the current literature on the utility of Bourdieu’s forms of capital, contextualising voices of artists to account for their experiences in managing the process of advancement which both facilitates and limits their career-related opportunities.

A review of program evaluations in an Australian independent school: participants’ perspectives

This paper reports on ways in which one Australian independent school seeks to develop and sustain best practice and academic integrity in its programs through a system of ongoing program evaluation, involving a systematic, cyclical appraisal of the school’s suite of six faculties. A number of different evaluation methods have been and continue to be used, each developed to best suit the particular program under evaluation. In order to gain an understanding of the effectiveness of this process, we conducted a study into participants’ perceptions of the strengths and weaknesses of the four program evaluations undertaken between 2009 and 2011. Drawing on documentary analysis of the evaluation reports and analysis of questionnaire data from the study participants, a number of findings were generated. These findings are provided and discussed, together with suggestions about ways in which the conceptualisation and conduct of school program evaluations might be enhanced.

Projected age- and sex-specific prevalence of cardiovascular diseases in Western Australian adults from 2005-2045

For decades, the incidence and mortality of cardiovascular diseases (CVDs) have declined. More recently, we have seen a halting in these declines, especially at younger ages. It is difficult to predict how these changing trends will impact CVD prevalence. We aimed to predict future prevalence of CVDs in Western Australian adults from 2005-2045 based on current incidence and mortality probabilities, population growth and ageing.

Tracks to advocacy: journalism studies, animal rights and Australian media law

This article considers the role of animal rights-based journalism and its connection to teaching media law and ethics to undergraduate students in an Australian university arts faculty. An anecdotal discussion of a reflective practice informing the teaching of an undergraduate course in a journalism major relates questions of ethics and law to broader considerations of the role of advocacy in and around journalism, and media practice. It is argued that animal rights-related stories have a role in training media professionals, and also in inspiring journalists to envision their own work as part of the democratic mechanisms of social and legal reform in Australia.

Is implementation of the 2013 Australian treatment guidelines for posttraumatic stress disorder cost-effective compared to current practice? A cost-utility analysis using QALYs and DALYs

To assess, from a health sector perspective, the incremental cost-effectiveness of three treatment recommendations in the most recent Australian Clinical Practice Guidelines for posttraumatic stress disorder (PTSD). The interventions assessed are trauma-focused cognitive behavioural therapy (TF-CBT) and selective serotonin reuptake inhibitors (SSRIs) for the treatment of PTSD in adults and TF-CBT in children, compared to current practice in Australia.

Experience and expression of anger among Australian prisoners and the relationship between anger and reintegration variables

We examined the experience and expression of anger among a group of Australian prisoners prior to and following prison release, as well as the relationship between anger and several reintegration variables. Participants were 79 adult prisoners (54 male, 25 female) who completed the State-Trait Anger Expression Inventory (STAXI-2) 1 month prior to release and again at 1 to 4 weeks and 3 to 4 months post-release. A postrelease questionnaire was also administered at the two postrelease points focusing on the quality of life conditions experienced following release. Mean state and trait anger scores were significantly higher at pre-release than post-release. As well, higher levels of anger expression and anger control were reported at pre-release compared with post-release. Higher age was related to lower state anger at post-release, whereas several variables were related to trait anger at post-release. Theoretical implications for reintegration theory are discussed, together with practical applications.

Stakeholders' perceptions of the benefit of introducing an Australian intermediary system for vulnerable witnesses

Vulnerable witnesses (e.g. children and adults with communication impairment) face many barriers to testifying and achieving justice when participating in the criminal justice system. To date, reforms have been implemented in Australia to address these, yet the barriers remain. Several other countries have implemented an intermediary scheme, whereby an independent third party assists vulnerable witnesses to understand the questions and processes encountered during interviews and trials, and helps witnesses to be understood. This study provides a qualitative analysis of stakeholders' (N = 25 professionals) perceptions regarding the potential benefits of implementing an intermediary scheme in Australia. While all participants demonstrated an open-minded attitude to new reform in this area, their perspectives did not support the introduction of an intermediary scheme at this time. Stakeholders highlighted the need for improved use and effectiveness of current measures, and expressed concern about adding further complication to the system.