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Biomedical subjects

Tracey A Davenport

Publications and source records attributed to Tracey A Davenport.

16 recordsLinked to original sources
PubMed2006

Positive relationships between public awareness activity and recognition of the impacts of depression in Australia.

OBJECTIVE: This report records the level of exposure to depression-related information across the Australian community and explores associations with recognition of depression and relevant sociodemographic factors. METHOD: A cross-sectional telephone survey was conducted with a representative community sample. Participants consisted of 3200 respondents (400 respondents across each Australian State/Territory). RESULTS: Sixty-five point four per cent (n=2089/3193) of respondents indicated that they or someone close to them had experienced depression, of whom 18.7% (n=391/2089) reported a personal experience of this illness. Various measures of recent exposure to depression-related information were high with 69.0% (n=2207/3200) reporting that they had seen, read or heard something in the media in the last 12 months. Recognition of beyondblue: the national depression initiative was also surprisingly high (61.9%, 1982/3200). Those with greater understanding that depression is common and debilitating were more likely to recall recent media stories, spontaneously recall relevant organizations such as beyondblue, to have had direct or family experiences, to be younger and to have achieved higher levels of education. Depression, however, is rarely mentioned (1.3%, 47/3720) as a major general health as distinct from a mental health problem. CONCLUSION: The active promotion of depression-related material to the community appears to have contributed to recognition of the commonality and impacts of this illness. Although depression is commonly recognized as a mental health problem, it is not yet considered a major general health problem. Further, like many public health campaigns, those initially reached appear more likely to be female, younger, better educated and residing in metropolitan areas.

Adolescent↗
PubMed2006

Mental health expenditure in Australia: time for affirmative action.

In Australia, there is a clear relationship (r=-0.56) between the ratio of health expenditure to burden and the ratio of mortality to disability across illness groups. Those illnesses with high mortality relative to disability (e.g. cancer and cardiovascular) are associated with lower health expenditure, relative to the burden they impose. Conversely, illnesses with low mortality but high disability (e.g. musculoskeletal disorders) demonstrate higher expenditure. The notable exception is mental health, which has low mortality, high disability and very low health expenditure. Indeed, the relationship between the mortality/disability and health expenditure/burden ratios is stronger (r=-0.72) when mental health is excluded. As this disparity cannot be explained by a lack of cost-effective treatments for mental disorders, we propose a process of affirmative action for mental health. Urgent investments in cost-effective modes of care are required and these should prioritise increased access among those subpopulations disadvantaged by other social, economic or geographic factors.

Australia↗
PubMed2005

Australian mental health reform: time for real outcomes.

After 12 years of national mental health reform, major service gaps and poor experiences of care are common. The mental health community reports little progress in implementing its key priorities, such as expanded early-intervention programs, comanagement of people with mental health problems and related alcohol or substance misuse, and widening of the spectrum of acute care settings. We propose new national targets for reducing the social and economic costs of poor mental health; these include increased access to effective care, reduced suicide rates and improved rates of return to full social and economic participation. We detail specific service reforms designed to maximise the chance of achieving these targets, and prioritise youth health and integrated primary care programs. New independent and national reporting systems on the progress of mental health reform are urgently required.

Adolescent↗
PubMed2005

Can we track the impact of Australian mental health research?

OBJECTIVE: Arguments are being made to increase research and development funding for mental health research in Australia. Consequently, the methods used to measure the results of increased investment require review. This study aimed to describe the status of Australian mental health research and to propose potential methods for tracking changes in research output. Specifically, we describe the research output of nations, Australian states, Australian and New Zealand institutions and Australian and New Zealand researchers using citation rates. METHOD: Information on research output was sourced from two international databases (Institute for scientific information [ISI] Essential Science Indicators and ISI Web of Science) and the ISI list of Highly Cited Researchers. RESULTS: In an international setting, Australia does not perform as well as other comparable countries such as New Zealand or Canada in terms of research output. Within Australia, the scientific performance of institutions apparently relates to the strength of some individual researchers or consolidated research groups. Highly cited papers are evident in the fields of syndrome definition, epidemiology and epidemiological methods, cognitive science and prognostic or longitudinal studies. CONCLUSIONS: Australian researchers need to consider the success of New Zealand and Canadian researchers, particularly given the relatively low investment in health and medical research in New Zealand. Although citation analyses are fraught with difficulties, they can be effectively complemented by other measures of responsiveness to clinical or population needs and community expectations and should be conducted regularly and independently to monitor the status of Australian mental health research.

Australia↗
PubMed2004

General practitioners' response to depression and anxiety in the Australian community: a preliminary analysis.

OBJECTIVES: To examine the uptake by general practitioners (GPs) of the five key components of the Better Outcomes in Mental Health Care (BOiMHC) initiative: education and training for GPs; the three-step mental health process; focussed psychological strategies; access to allied health services; and access to psychiatrist support. SETTING: All Australian states and territories during the first 15 months of the initiative (1 July 2002 - 30 September 2003). DESIGN: Retrospective survey of de-identified registration data held by the General Practice Mental Health Standards Collaboration (training uptake), de-identified Health Insurance Commission (HIC) billing data (provision of the three-step mental health process, focussed psychological strategies and case conferences with psychiatrists), and reports from "access to allied health services" projects to the Australian Department of Health and Ageing (project participation). MAIN OUTCOME MEASURES: Number and percentage of Australian GPs certified as eligible to participate in the initiative; provision of the three-step mental health process and focussed psychological strategies by GPs; participation in allied health pilot projects; and access to psychiatrist support. RESULTS: Within 15 months of the BOiMHC initiative commencing, 3046 GPs (about 15% of Australian GPs) had been certified as eligible to participate, including 387 who had registered to provide focussed psychological strategies. GPs had completed 11 377 three-step mental health processes and 6472 sessions of focussed psychological strategies. Sixty-nine "access to allied health services" projects had been funded, with the original 15 pilot projects enabling 346 GPs to refer 1910 consumers to 134 individual allied health professionals and 10 agencies. In contrast, the "access to psychiatrist support" component was less successful, with the HIC billed for 62 case conferences at which a psychiatrist and a GP were present. CONCLUSION: The level of uptake of the main components of the BOiMHC initiative has expanded the national capacity to respond to the needs of people with common mental disorders, such as depression and anxiety.

Anxiety Disorders↗
PubMed2004

Experience with treatment services for people with bipolar disorder.

OBJECTIVE: To describe the experiences of people with bipolar disorder with primary care and specialist mental health services. DESIGN AND SETTING: Focus groups and indepth interviews were conducted in seven Australian capital cities between July 2002 and April 2003. Thematic analyses were conducted using the QSR NUD*IST software package for qualitative data. PARTICIPANTS: Forty-nine people with bipolar disorder participated in the focus groups and four participated in the interviews. RESULTS: Thematic analyses highlighted eight key themes. Most notably, respondents identified a lack of awareness and understanding about bipolar disorder within the Australian community, which contributed to apparent delays in seeking medical assessment. The burden of illness was exacerbated by difficulties experienced with obtaining an accurate diagnosis and optimal treatment. The healthcare system responses were described as inadequate and included inappropriate crisis management, difficulties accessing hospital care, inappropriate exclusion of carers and families from management decisions, and frequent discontinuities of medical and psychological care. CONCLUSIONS: People with extensive experience of bipolar disorder report barriers to optimal care because of lack of community understanding and healthcare system shortcomings. These barriers exacerbate the social, interpersonal and economic costs of this illness.

Adolescent↗
PubMed2004

How much more can we lose?": carer and family perspectives on living with a person with depression.

OBJECTIVE: To explore the experiences of carers and families of people with depression. DESIGN AND SETTING: Structured focus groups conducted in six Australian capital cities between February 2002 and July 2002. Thematic analyses were conducted using the QSR NUD*IST software package for qualitative data. PARTICIPANTS: Thirty-seven carers or family members. RESULTS: Thematic analyses highlighted five key themes. Most notably, the carer's role is made more difficult by the lack of community awareness about depression, and, in some instances, an unwillingness of other family and friends to provide ongoing support. Carers experience a resulting sense of isolation, often exacerbated by adverse experiences with healthcare providers. Carers and family members are frequently excluded when key decisions are made, and report that emergency services are relatively unresponsive to their concerns. By contrast, community support organisations usually provided a sense of inclusion and common purpose. CONCLUSIONS: The experiences of carers and families of people with depression highlight the urgent need for more extensive community education about the illness and more productive collaboration within the healthcare system.

Adult↗
PubMed2003

Providing psychological treatments in general practice: how will it work?

Provision of "Focussed Psychological Strategies" by general practitioners is one component of the recent Better Outcomes in Mental Health Care (BOiMHC) initiative. The BOiMHC initiative requires GPs to undertake minimum training requirements before they may provide services under the new Medicare Benefits Schedule item number. We argue that GPs need further training and ongoing clinical interaction with mental health specialists (beyond the minimum training requirements) for refinement of psychological skills. Research focusing on GP training and how GPs interact with specialist services in the provision of psychological treatments is urgently required.

Australia↗
PubMed2002

Screening for depression in general practice and related medical settings.

OBJECTIVE: To determine if screening in general practice and related medical settings improves management and clinical outcomes in people with depression. DATA SOURCES: The Medline (1966-2002), EMBASE (1980-2002) and PsycINFO (1966-2002) databases were searched. These were supplemented by searching the Cochrane databases (to 2002); performing additional specific searches on Medline, EMBASE and PsycINFO; scrutinising reference lists of selected articles; and querying experts. STUDY SELECTION: Inclusion criteria were: review of prospective studies with a primary focus of depression screening in general practice settings; review of studies of healthy populations or people with known depression; publication in a peer-reviewed journal; and written in English. Eleven reviews that satisfied these criteria were assessed for quality using the Oxman and Guyatt Index. Four reviews met the criterion of a score of five or more. DATA EXTRACTION: One author tabulated relevant material (including number and type of studies, outcomes/endpoints, measures of association/statistical results, and findings) from the four key reviews. A second author independently checked the accuracy of this extracted material. DATA SYNTHESIS: Brief self-report instruments have acceptable psychometric properties and are practical for use in general practice settings. Screening increases the recognition and diagnosis of depression and, when integrated with a commitment to provide coordinated and prompt follow-up of diagnosis and treatment, clinical outcomes are improved. CONCLUSIONS: Although controversial, the evidence is now in favour of the appropriate use of screening tools in primary care.

Depressive Disorder↗
PubMed2002

Measuring outcomes in patients with depression or anxiety: an essential part of clinical practice.

A wide range of instruments is available for ongoing assessment of clinical status and outcome in patients with depressive or anxiety disorders. However, few doctors use these instruments in managing their patients. As depression and anxiety are relapsing or chronic conditions and are often comorbid with other medical conditions, standard outcome measures should be incorporated into the management plans for all such patients.

Anxiety Disorders↗
PubMed2002

Monitoring awareness of and attitudes to depression in Australia.

OBJECTIVES: To determine the degree of recognition and understanding of depression and its treatments in Australia in 2001, and detail factors and personal experiences that influence awareness of and attitudes to depression. DESIGN AND SETTING: Cross-sectional survey of a representative community sample (900 randomly selected respondents), via telephone interview, conducted 5-7 October 2001. MAIN OUTCOME MEASURES: Reports of community awareness, knowledge and attitudes to depression and its treatments in Australia. RESULTS: The Australian community does not view mental health as a major general health issue. When asked specifically, depression was recognised as the most common mental health problem. Recognition of depression was greater among women and younger people. Most people (58%; 508/879) reported that they or a family member had experienced depression. People younger than 55 years and people with personal or family experiences of depression viewed depression as more disabling than other chronic medical conditions. Half the respondents differentiated depression from normal sadness. Awareness of common risk versus protective factors was limited. Most people endorsed a preference for self-help and non-pharmacological treatments, but community views of antidepressant drugs were less negative than expected. General practitioners were identified as the preferred point of first contact among healthcare professionals. CONCLUSIONS: Although mental health is still not highlighted as a major health issue, Australians do recognise depression as the major mental health problem. Women and younger people have more substantial knowledge about key aspects of depression and its treatments.

Adolescent↗
PubMed2002

Exploring the perspectives of people whose lives have been affected by depression.

OBJECTIVES: To describe the experiences of people whose lives have been affected by depression. DESIGN, SETTING AND PARTICIPANTS: Thematic review of data collected from 21 community meetings (1529 people, providing 911 evaluation forms) and nine focus groups (69 individuals) held nationally, and written feedback and website-based interactions with beyondblue: the national depression initiative between April and December 2001. MAIN OUTCOME MEASURES: Barriers to social participation experienced by people whose lives have been affected by depression, and their interactions with the healthcare system. RESULTS: The key theme was the experience of stigma, which was evident in healthcare settings and in barriers to social participation, particularly regarding employment. Inadequacies of primary care and specialist treatment systems were highlighted. Particular emphasis was placed on limited access to high-quality primary care and non-pharmacological care. The stigmatising attitudes of many healthcare providers were notable. Within society, lack of access to knowledge and self-care or mutual support services was evident. Lack of support both from and for people in caring roles was also emphasised. CONCLUSIONS: People with depression are subject to many of the same attitudes, inadequate healthcare and social barriers reported by people with psychotic disorders. Consumers and carers prioritise certain notions of illness, recovery and quality of healthcare, and expect healthcare providers to respond to these concerns.

Attitude to Health↗