Outdoor education and bush adventure therapy: A social-ecological approach to health and wellbeing.

Together, outdoor education and bush adventure therapy can be seen to constitute a population-wide health intervention strategy. Whether in educational or therapeutic settings, the intentional use of contact with nature, small groups, and adventure provides a unique approach in the promotion of health and wellbeing for the general population, and for individuals with identified health vulnerabilities. This paper explicitly emphasises human and social health, however, an integral assumption is that a healthy and sustainable environment is dependent on healthy human relationships with nature. We invite outdoor educators and bush adventure therapy practitioners to examine the proposition that healthy interactions with nature can create a unique stream of socio-ecological interventions. A spectrum of outdoor adventure programs is provided, allowing outdoor educators and bush adventure therapy practitioners to locate their work according to program context and aims, and participant aims and needs.

Children's mental health and wellbeing and hands-on contact with nature

Research on the health and wellbeing benefits of contact with animals and plants indicates the natural environment may have significant positive psychological and physiological effects on human health and wellbeing. In terms of children, studies have demonstrated that children function better cognitively and emotionally in 'green' environments and have more creative play. In Australia as well as internationally, many schools appear to be incorporating nature-based activities into their curricula, mostly via sustainability education. Although these programs appear to be successful, few have been evaluated, particularly in terms of the potential benefits to health and wellbeing. This paper reports on a pilot survey investigating the mental health benefits of contact with nature for primary school children in Melbourne, Australia. A survey of principals and teachers was conducted in urban primary schools within a 20km radius of Melbourne. As well as gathering data on the types and extent of environmental and other nature-based activities in the sample schools, items addressing the perceptions of principals and teachers of the potential effects of these activities on children's mental health and wellbeing were also included. Despite a lower than expected response rate, some interesting findings emerged. Although preliminary, results indicate that participants' perceptions of the benefits to mental health and wellbeing from participation in hands-on nature based activities at their school are positive and encompass many aspects of mental health.

Attaching unit costs to Australia`s national survey of mental health and wellbeing

Background: In mental health, policy-makers and planners are increasingly being asked to set priorities. This means that health economists, health services researchers and clinical investigators are being called upon to work together to define and measure costs. Typically, these researchers take available service utilisation data and convert them to costs, using a range of assumptions. There are inefficiencies, as individual groups of researchers frequently repeat essentially similar exercises in achieving this end. There are clearly areas where shared or common investment in the development of statistical software syntax, analytical frameworks and other resources could maximise the use of data.

Aims of the Study: This paper reports on an Australian project in which we calculated unit costs for mental health admissions and community encounters. In reporting on these calculations, our purpose is to make the data and the resources associated with them publicly available to researchers interested in conducting economic analyses, and allow them to copy, distribute and modify them, providing that all copies and modifications are available under the same terms and conditions (i.e., in accordance with the `Copyleft' principle). Within this context, the objectives of the paper are to: (i) introduce the `Copyleft' principle; (ii) provide an overview of the methodology we employed to derive the unit costs; (iii) present the unit costs themselves; and (iv) examine the total and mean costs for a range of single and comorbid conditions, as an example of the kind of question that the unit cost data can be used to address.

Method: We took relevant data from the Australian National Survey of Mental Health and Wellbeing (NSMHWB), and developed a set of unit costs for inpatient and community encounters. We then examined total and mean costs for a range of single and comorbid conditions.

Results: We present the unit costs for mental health admissions and mental health community contacts. Our example, which explored the association between comorbidity and total and mean costs, suggested that comorbidly occurring conditions cost more than conditions which occur on their own.

Discussion: Our unit costs, and the materials associated with them, have been published in a freely available form governed by a provision termed `Copyleft'. They provide a valuable resource for researchers wanting to explore economic questions in mental health.

Implications for Health Policies: Our unit costs provide an important resource to inform economic debate in mental health in Australia, particularly in the area of priority-setting. In the past, such debate has largely been based on opinion. Our unit costs provide the underpinning to strengthen the evidence-base of this debate.

Implications for Further Research: We would encourage other Australian researchers to make use of our unit costs in order to foster comparability across studies. We would also encourage Australian and international researchers to adopt the `Copyleft' principle in equivalent circumstances. Furthermore, we suggest that the provision of `Copyleft'-contingent funding to support the development of enabling resources for researchers should be considered in the planning of future large-scale collaborative survey work, both in Australia and overseas.

Can health promoting schools contribute to the better health and wellbeing of young people? The Hong Kong experience.

Background: The Health Promoting School (HPS) is a WHO sponsored framework, compiled to enable education and health sectors to be more effective in school based initiatives.

Aims: This study attempted to test the hypothesis that students from schools that had comprehensively embraced the HPS concept as indicated by the Healthy School Award, were better, in terms of health risk behaviour, self reported health status, and academic results, than students from schools that did not reach the standard of the award.

Methods and Results: The results presented came from nine schools (four primary and five secondary) applying for accreditation of the Healthy Schools Award after adopting the HPS framework for two years. Regular consultancy support and training were available to all schools. Students had completed before and after surveys to assess their health behaviours, self reported health status, and academic standing before the two year intervention, and at its end. Data from the before and after surveys of the students attending schools that reached certain level of HPS standard as indicated by the award, were compared with students whose schools did not receive the award, and the results showed differences. Some differences were found to be more significant among the primary school students than secondary schools students. This illustrated early intervention for lifestyle changes to be more effective. Students’ satisfaction with life also improved if their schools adopted the concept of HPS comprehensively.

Conclusions: The results suggest that comprehensive implementation of HPS would contribute to differences in certain behaviours and self reported health and academic status.

Mental health and wellbeing of Australian adolescents: pathways to vulnerability and resilience

The Australian Temperament Project (ATP) provides a unique lens through which to view he pathways to vulnerability and resilience that Australian children take from infancy to adolescence, and beyond. Commencing in 1983, the ATP is now completing its 24th year and 14th wave of data collection. The present paper provides an overview of the data on adolescent antisocial behaviour, substance use, internalising problems and aspects of positive development and wellbeing. Several pathways to vulnerability or resilience are described that vary in their age of onset. Constellations of common risk factors suggest that there may be overlapping priming factors for later mental health problems. A different mix of factors relates to pathways to wellbeing. This unique Australian study provides invaluable insights into stability and change in the pathways to mental health that children take across life.

The Resilient Families program: promoting health and wellbeing in adolescents and their parents during the transition to secondary school.

Resilient Families is a school-based prevention program designed to help students and parents develop knowledge, skills and support networks to promote health and wellbeing during the early years of secondary school. the program is designed to build within-family connectedness (parent--adolescent communication, conflict resolution) as well as improve social support between different families, and between families and schools. It is expected to promote social, emotional and academic competence and to prevent health and social problems in youth.

A review of epidemiological studies on children`s health and wellbeing

New epidemiological studies on children's health and wellbeing are essential to guide policy development. To ensure that these studies are based on the current conceptualisation of health, they should have a theoretical rationale for the selection of their domains. The scales used to measure each domain must be psychometrically sound, and also reflect the current conceptualisation of the domain. When selecting scales for each domain, child questionnaires must be considered, in addition to adult proxy measures. Through following these recommendations, researchers can ensure that their studies have theoretical and practical relevance. (non-author abstract)

Wellbeing of Australians : carer health and wellbeing

This Report concerns the subjective wellbeing of carers in Australia. It is the product of a partnership between Carers Australia, Australian Unity, and Deakin University. All three partners were involved in all stages of the project as planning the logistics, designing the questionnaire and composing the report. Data analysis was undertaken by Deakin University while the logistics of questionnaire mailout was managed by Australian Unity and Carers Australia. The actual mailing took place from each of the state/territory Carers Associations, who used their own databases to print and affix the addresses of their members to the envelopes. Three major outcome measures have been used. The first is the Personal Wellbeing Index, which is our standard measure of wellbeing. The Index score is the average level of satisfaction across seven aspects of personal life – health, personal relationships, safety, standard of living, achieving in life, community connectedness, and future security. The other two outcome measures are sub-scales taken from the Depression, Anxiety, and Stress Scale (Lovibond and Lovibond, 1995). This is a very well regarded scale and the sub-scales of Depression and Stress have been used for this study. A total of 10,939 questionnaires were distributed and 4,107 were returned in time for processing. This constitutes a 37.6% response rate.

Workplace change & the care of the self : health and wellbeing as a professional duty of care?

This paper examines the ways in which transformations in the organisation and practice of teacher’s work have witnessed large numbers of teachers being seen, and seeing themselves, as stressed. These understandings of teacher stress have provoked a number of strategies designed to encourage individuals to take care of themselves – and to take care of themselves in ways that will make schools more effective.