Background:
Community Reinforcement and Family Training (CRAFT) is an evidence based program designed to support concerned significant others (CSOs) of individuals experiencing substance-use problems, while also encouraging treatment engagement for the person using substances. Although CRAFT is widely implemented in the United States and parts of Europe, access to CSO focused support remains limited in rural Australia, where service availability, distance, and workforce shortages create significant barriers to care. Online delivery offers a potential solution to these challenges.
Aim:
This study evaluated the effectiveness of an online, practitioner led CRAFT program for CSOs supporting individuals with substance-use problems in rural Australian communities.
Methods:
A randomised controlled trial with a two arm, parallel group design was conducted. Participants (N = 126) were randomly allocated to either a six session online CRAFT intervention (n = 64) or a waitlist control group (n = 62). Psychological wellbeing was assessed at baseline and post intervention using the Depression Anxiety Stress Scales 21 (DASS 21), Satisfaction with Life Scale (SWLS), Flourishing Scale (FS), and Brief COPE. Primary outcomes focused on mental health and wellbeing, with secondary outcomes examining coping strategies.
Results:
Compared with the waitlist group, participants receiving online CRAFT demonstrated significant improvements in psychological outcomes. Depression scores decreased (adjusted mean difference = −2.71, 95% CI −5.36 to −0.06), life satisfaction increased (mean difference = 1.98, 95% CI 0.45 to 3.50), and use of problem focused coping strategies improved (mean difference = 2.92, 95% CI 1.33 to 4.51).
Conclusion:
Findings indicate that online delivery of CRAFT is an effective and accessible intervention for improving mental health and coping among CSOs in rural Australia. These results support the integration of practitioner led online CRAFT into rural substance-use and mental health service systems to reduce access barriers and better support families affected by substance use.

Community events exploring themes of mental illness and suicide have become more common in rural and regional communities, providing opportunities to normalise and validate experiences of mental ill-health, promote wellbeing, and reduce stigma. Film screenings, high profile and local lived experience speakers, panel discussions and expert presenters have all been found to engage, educate and empower communities. However, safe storytelling requires thoughtful consideration and planning to reduce the potential for harm to both attendees and speakers.

The Rural Adversity Mental Health Program (RAMHP) is a leader in rural mental health and understands the need for safe, respectful spaces where meaningful conversation about mental ill-health and sharing of lived experience can be held. Across the Program there have been consistent themes and examples witnessed of well-meaning events leading to negative outcomes due to insufficient safeguards and supports in place for attendees and presenters alike. To build capacity in rural communities and support the organisers of these events, RAMHP developed and distributed guidelines for the facilitation of safe community events, providing consistency and clarity around tangible ways to encourage best practice.

These community guidelines provide support in framing and planning events to be safe and respectful to communities, recognising the duty of care event organisers have to their audience. They address key themes including choosing the right event format based on the intended audience’s experience of adversity, trauma, service access and community connection; encouraging thorough and considered planning and messaging; providing clear referral pathways and service access options; identifying strategies to manage distress or triggering responses; and ensuing follow up and debriefing processes.

It is hoped that by creating safe and supportive spaces which are responsive to community needs, we can empower communities to deliver a valuable and memorable experience for all.

The Rural Adversity Mental Health Program (RAMHP) exists across regional, rural and remote NSW, with 18 Coordinators being place based and embedded within their community.

Annually, coordinators are supported by the Grand Pacific Health management team to deliver a statewide collective action project or event. In 2025-26 this project was “Halls with Heart”.

In a time when social connection is as important as ever, community halls provide people with a space to connect, create and celebrate. Halls also act as meeting points during times of crisis; providing shelter, safety and access to resources. Halls are the beating heart of a community and if their walls could talk what incredible stories they would share.

“Halls with Heart” saw 19 community events take place with over 700 attendees and engagements. Events included community dinners, morning teas, movie nights, local shows, meditation and butchering workshops to name a few. Events provided mental health promotion messaging as a way to gently guide community from awareness around the importance of mental health to action, including: recognising signs, knowing how to start a conversation and how to offer support when needed.

These events also created opportunities to reminisce and share stories of yesteryears, to access support and promote connection in places where the geographical distance between people, is often vast.

The impact this project has had on bringing people together and breaking down isolation and stigma is best captured through this feedback of a participant in Broken Hill. “At the heart of our main street stands the town hall, a large, unassuming building with iron exterior walls and beautiful timber floors. It may not be the most striking at first glance, but it holds something far more important: heart, soul, and a lifetime of memories. A place where there is a chair for everyone”.

Rural and farming communities experience elevated psychological distress alongside persistent barriers to accessing mental health care, including workforce shortages, stigma, travel distance, cost, and limited availability of tailored services. Digital mental health interventions offer potential to improve access and flexibility; however, it is important to consider rural contexts, literacy, connectivity, and cultural relevance when implementing programs in a rural setting.
MemFlex is a simple digital memory-based program that refocuses individuals towards positive memories from their past through structured memory-based exercises. This approach has been proven effective in other settings and this collaborative project aims to determine the feasibility of delivering MemFlex as a digital mental health support option for members of rural and farming communities facilitated by peers from the rural and farming community. It draws on both the learnings from previous delivery of MemFlex intervention in other settings by A/Prof Caitlin Hitchcock and colleagues, and learnings from previous peer delivery models (Back on Track) and community consultation work by the National Centre for Farmer Health.
This presentation will discuss lessons learned from the early stages of the project assessing the suitability of MemFlex for rural settings, considerations when recruiting facilitators from the farming community to guide participants through the intervention, and the acceptability of the intervention to reduce psychological distress in rural Australians.

Rural and remote communities offer distinctive conditions that enable deliberate connection between community and health service suicide prevention efforts. Lower structural complexity, strong community networks, and the intimacy of place enable deliberate connection between these settings to support capacity-building in both directions, creating a place-based and locally responsive approach.

This presentation introduces The Bridge, an emerging proof of concept that developed through practice in Mount Isa, North West Queensland. It describes what becomes possible when a clinician with specialist knowledge operates voluntarily across both community and health service suicide prevention settings. The Bridge describes a specific kind of connection, one that brokers knowledge and insight between community and health service contexts. Clinical knowledge, the evidence base and practical know-how move into community settings, while community knowledge, local insight and lived experience flow back into the health service, informing service development and workforce priorities.

While recent calls for regionally specific approaches to suicide prevention have pointed to the importance of local action, suicide prevention rooted in specific communities may require more than regional planning alone can deliver. The Bridge suggests that genuine connection between community and health service settings, built from the ground up in a specific place, offers something not typically achieved through regional planning.

Drawing on relevant literature, this presentation explores the conceptual territory surrounding The Bridge, examining why this kind of connection matters, what enables it, and what health services may need to consider to sustain it in rural and remote contexts.

The Bridge is an emerging proof of concept that developed through practice in Mount Isa, North West Queensland, describing what becomes possible when a mental health clinician with specialist knowledge operates voluntarily across both community and health service suicide prevention settings.

Mount Isa is a remote regional centre where the Mount Isa Suicide Prevention Network (MISPN) operates as a community-led initiative, independent of the local health service. A Clinical Nurse Consultant in Suicide Prevention and Aftercare within the North West Hospital and Health Service chairs the network in a voluntary capacity, with this cross-sector participation supported by the health service during work hours. This arrangement creates a deliberate point of connection across community and health service settings. This is The Bridge.

The Bridge operates as a two-way exchange. Clinical knowledge, the suicide prevention evidence base and practical know-how are applied in community settings, informing help-seeking and demystifying pathways to support. Community knowledge, local insight and lived experience flow back into the health service, informing workforce development priorities, service planning and care pathways.

Outcomes include identifying Stay Strong training as a community need. This crossed into the health service context, resulting in local delivery to community service providers and exploration of integration into MHAOD care pathways and assessment tools. The Black Dog Institute LifeSpan framework was used to map MISPN's role within the local suicide prevention landscape, helping to clarify its strategic role.

The Bridge suggests that voluntary cross-sector engagement, enabled by organisational support, can support more connected, locally relevant and evidence-informed suicide prevention in remote communities.

Background: People living in rural and regional Australia experience significant inequities in access to eating disorder care due to workforce shortages, limited specialist services, and fragmented care pathways. These challenges contribute to delayed identification and intervention and poorer outcomes. Scalable, locally delivered models of care are needed, yet there is limited evidence regarding their feasibility in real-world regional settings.

Aims: To evaluate the feasibility and preliminary outcomes of a provisional psychologist-delivered, brief, evidence-based eating disorder assessment and treatment program in a regional Australian community

Method: Adults participants with mild to moderate eating disorder symptoms were recruited through local community and health networks and randomised to one of two structured programs (Cognitive Behaviour Therapy Ten and Guided Self Help) incorporating assessment and intervention in 10 sessions were delivered by provisionally registered psychologists completing their first Master of Psychology placement, under supervision. Services were provided in person at a regional university and via telehealth. Feasibility indicators included recruitment, retention, and service delivery, alongside pre–post clinical outcomes.

Results: Conducted between August 2023 and March 2025, the study met recruitment and retention targets, indicating strong demand, feasibility, and acceptability. Preliminary findings suggest improvements in eating disorder symptoms and psychosocial functioning over 10-sessions for both treatment groups. A key implementation challenge was timely access to general practitioners for medical assessment and monitoring. The model also supported training and supervision of 16 provisional psychologists in empirically supported eating disorder interventions, contributing to workforce capability development in evidence-based eating disorder care.

Conclusions: A supervised student-delivered model is a feasible approach to providing evidence-based eating disorder care in regional settings, with promising early outcomes. This model simultaneously addresses immediate service gaps and builds longer-term workforce capacity, offering a scalable pathway to strengthen rural mental health systems.

Introduction:
Australian farmers face an array of challenges impacting mental health, such as extreme climatic events, market uncertainties, technological dependence, regulatory demands, and social isolation. Regenerative agriculture (RA) has been suggested as a way for farmers to improve wellbeing by integrating natural systems, continuous evaluation, and adaptation, while benefiting from the socio-cultural aspects of farmer relations
Individually, regenerative agriculture and mental health have been studied widely, but less so when coupled as one concept. This literature review aimed to improve our understanding of the association between regenerative agriculture and farmers' mental health and wellbeing. This will inform future intervention and prevention strategies to support farm management adaptations.
Methodology:
A rapid systematic review process identified 44 key articles of interest from an initial 13,795 articles from 9 databases, and 209 records from 3 publicly available sources.
Results:
The final 44 items included in the review demonstrated that regenerative agricultural practices have gained recognition for environmental benefits and that the impact on farmers’ mental health has started to be explored.
The intersections of people, profit and planet were selected as the triple bottom line framework to demonstrate where tensions exist.
Findings show underlying tensions in the transition process from conventional farming practices to RA. This includes notable phases of triggering, accepting alternatives, adopting, and adapting.
Conclusion:
Although evidence is still scarce and limited in its scope, tailored mental health intervention and prevention strategies should consider farmers’ vulnerability during these RA transition phases. Importantly, farmers require different supports at different phases of the system.

Children in rural and regional communities often have fewer opportunities to access specialist supports, identity-affirming environments, and peer connections that strengthen mental health and wellbeing. For neurodivergent children, these challenges can be further compounded by misunderstanding, stigma, school disengagement, and limited access to services that support self-understanding and respectful self-advocacy.

This interactive workshop explores practical and emerging approaches to identity development and self-advocacy for neurodivergent children across school, health, disability, and community settings. Participants will engage directly with activities, discussion prompts, and co-design concepts being developed through a national project led by Social Science Translated with support from the National Disability Insurance Agency Peer Support and Capacity Building program.

Grounded in lived experience, strengths-based practice, and participatory co-design, the workshop will share how children, families, educators, clinicians, and neurodivergent mentors are collaboratively shaping flexible learning modules that can be adapted across diverse identities, communities, and service contexts. Participants will also explore a real-world example of a self-discovery camp delivered within specialist education, highlighting how preparatory activities, immersive group experiences, and structured follow-up can support belonging, confidence, self-awareness, and peer connection.

Designed as a collaborative and hands-on session, the workshop invites delegates to contribute ideas, reflections, and feedback while exploring how identity-informed, culturally responsive, and community-based approaches can strengthen mental health outcomes and inclusion for neurodivergent children across metropolitan, regional, and remote Australia.

Individuals experiencing Borderline Personality Disorder (BPD) related symptoms often have high and repeated Emergency Department (ED) presentations, a pattern intensified in regional settings by limited access to timely, community‑based care for the missing middle. Between 2023 and 2024, approximately 1,500 self‑harm and suicidal ideation presentations occurred across EDs in Northern New South Wales (NNSW), highlighting the need for accessible step‑down and early intervention responses outside tertiary care. In response, the Lismore Medicare Mental Health Centre implemented the Gold Card Clinic (GCC), a brief, structured step‑down intervention for adults experiencing acute distress and suicidality who do not meet criteria for inpatient admission.
The GCC is a manualised four‑session intervention informed by Project Air principles and operates through cross‑sector collaboration between a non‑government organisation and the NNSW Local Health District. This model prioritises rapid access, continuity of care, and service navigation following ED presentation.
To date, 90 clients have been referred from the Acute Care Service (ACS) and Mental Health Emergency Care (MHEC) teams. Timely access was achieved, with 87.7% (n=79) booked for their first GCC appointment within 7 days of referral, and 55.5% (n=50) booked within 3 days, demonstrating the feasibility of rapid engagement in a regional setting.
Of those who exited the service, 50% (n=42) completed all four brief intervention sessions, showing significant reductions in suicidality and BPD symptom severity, measured using the Suicidal Ideation Attributes Scale (SIDAS) and the Borderline Symptom List‑23 (BSL‑23). Analysis of pre‑ and post‑GCC ED presentations demonstrated a clear reduction in subsequent ED presentations following GCC engagement.
The Gold Card Clinic illustrates how timely stepped‑care interventions can improve access, reduce ED reliance, and strengthen continuity of care for the missing middle within rural mental health systems.

Men in rural and remote Queensland experience disproportionately poor mental health outcomes, including higher suicide rates, yet are significantly less likely to engage with formal mental health services. This reflects the combined impact of structural barriers such as workforce shortages, limited service accessibility, and geographic isolation, alongside socio-cultural norms that discourage help-seeking and reinforce self-reliance.

Aligned with the conference theme “What Works, Where It Matters,” this paper explores how integrated, place-based approaches can strengthen early intervention for rural men. Drawing on research evidence, practice insights, and lived experience perspectives, it highlights key policy directions from the Queensland Mental Health Commission, including ‘Every life: The Queensland Suicide Prevention Plan 2019-2029’, which emphasises community-led responses, and targeted strategies for priority populations.

The paper examines innovative approaches that improve engagement, including peer-supported initiatives, outreach and mobile service delivery, and informal community settings that reduce stigma and increase accessibility. It also considers culturally responsive models, particularly First Nations-led frameworks of social and emotional wellbeing, which emphasise connection to community, culture, and Country.

Strengthening rural men’s mental health requires integrated, community-led systems that are co-designed, culturally responsive, and grounded in local contexts, with a sustained focus on early intervention, prevention, and workforce sustainability.

Background and Aim: Drought is a slow-onset disaster that places sustained emotional strain on individuals, families and communities. Stress, fatigue and cumulative mental health impacts are common, yet are often under-recognised in drought planning. Working alongside the North-East Catchment Management Authority within the Ovens Murray region of north-east Victoria, this project aims to co-design a contextually appropriate psychological preparedness resource for drought.

Approach: Underpinned by human-centred design methodology, the project has prioritised immersion in farming communities to understand not just what people say and do, but why. Engagement has been built through trusted local partnerships, farm-gate conversations, community events and informal interactions in spaces where people feel comfortable. A local, well-connected project officer was purposefully engaged, with the goal of building trust and networks and strengthening existing relationships. Community members have contributed their knowledge, describing their own experiences in their own language and iteratively shaping the direction of the work. Researchers have continuously engaged in a reflexive practice, ensuring that community voices, rather than researcher perspectives, drive the work.

Progress: This approach has generated rich contextual insights. Farming identity, emotional attachment to place, and the ‘slow-burn’ nature of drought all shape how people respond under pressure, often reactively rather than proactively. Further, communities use their own language to describe drought experience and engage more readily with practical, peer-led conversation than clinical framing. Through collaborative sense-making, a problem statement was created: people need support to get into the right headspace to make good decisions before conditions reach crisis point. Three “solutions” have been identified and will be presented. The project is now entering a co-creation phase, using community workshops to test and refine these ideas.

Significance: This work demonstrates that meaningful psychological preparedness must be community-led, relationally grounded, and expressed in community language.

Background: Tasmania’s highly dispersed geography presents ongoing challenges for equitable access to mental health care, particularly for adults experiencing moderate to severe psychosocial needs who are ineligible for the National Disability Insurance Scheme. These challenges are compounded by socioeconomic disadvantage, housing instability, and limited availability of specialist services in rural communities. The Horizons program was developed by BaptistCare to address this service gap. Mental health and peer practitioners provide flexible, recovery oriented psychosocial outreach support and service navigation tailored to client's priorities, circumstances, and rural context. This poster describes a pre-post evaluation examining goal progress across key psychosocial domains.
Method: The Horizons Goal Outcomes Tool was used to capture client progress toward self-identified goals across 14 psychosocial domains, including mental health strategies, relationships, physical wellbeing, housing, independence, and day to day living skills. A total of 212 clients were included in the analysis. Clients rated perceived progress toward their goals on a 10-point Likert scale at baseline and each review. The distribution of goals across domains and changes in average domain scores over time were analysed.
Results: The most common goals related to mental health strategies and self management, followed by relationships and social connection, physical wellbeing, and day to day living skills. Significant improvements were observed across all domains from baseline to final review. The largest average increases were observed in financial goals, social skills, independence, housing, and physical wellbeing.
Conclusion: These findings highlight the value of goal-based outcome measurement for capturing meaningful change in recovery-oriented psychosocial programs, particularly in supporting the missing middle in rural communities. The Outcomes Tool offers a nuanced person centred understanding of impact beyond traditional clinical measures. Horizons demonstrates how integrated, navigation-focused, and peer-informed models can strengthen rural mental health systems and help prevent people with complex needs from falling through service gaps.

Background
Rural and remote communities in Tasmania experience ongoing barriers to accessing consistent and coordinated mental health support, particularly for individuals with severe and persistent mental ill health. The Foundations program, delivered by the Mindset Tasmania in partnership with the department of health, is designed to address this gap through statewide, recovery-oriented psychosocial outreach model. The program supports individuals who are engaged with Mental Health Services (MHS) Case Management, providing critical bridge between clinical services and community-based recovery supports. This partnership enables integrated care, ensuring that clinical treatment and psychosocial support are aligned and responsive to individual needs.

Program Approach
Foundations is an intensive, person-centered outreach program that works one on one with participants to build life skills, enhance independence and support recovery goals. Referrals are made exclusively by through MHS Case Management and Mental Health Practitioners (MHP) collaborate closely with Case Manager to coordinate care, monitor progress and respond to changing needs. Outreach delivery enables practitioners to engage with people in their homes and communities, which is particularly important in rural regions where services access is limited. The model emphasises strengths-based practice, family/community engagement and flexible, tailored support.

Observed Outcomes
Participants demonstrate improvements across key psychosocial domains, including independent living skills, social connection, housing stability and overall wellbeing. The inclusion of MHS Case Management strengthens continuity of care and reduces service fragmentation, contributing to more sustainable recovery outcomes. The outreach model ensures that individuals in rural and remote locations can access consistent and meaningful support, reducing isolation and improving engagement with clinical and community services.

Conclusion
Strong collaboration with Mental Health Services Case Management enables a coordinated approach that bridges clinical and community care systems. By supporting individuals in rural communities to build skills, increase independence and remain connected, Foundations contributes to improved long term recovery outcomes.

Cerebral atrophy refers to a reduction in total brain volume resulting from the loss of neurons and synaptic connections, leading to impairments in cognitive and executive functioning. This study aims to understand the experiences and neuropathy of two underprivileged women with premorbid cognitive functioning who developed progressive neurological impairment and decline in cognitive ability resulting in structural cerebral atrophy in the absence of any neurodegenerative or cerebral vascular etiologies. In the presence of evident neurological imaging findings, neuropsychological profiles, collateral histories, and using contemporary neuroscience stress literature, this study formulates a more comprehensive diagnostic framework that demonstrates the presence of severe and sustained long-term relational trauma as a legitimate neurological risk factor rather than an adjacent psychosocial consideration. The primary converging point of both studies is prolonged exposure to severe psychosocial trauma and the objective confirmation of cerebral atrophy in women who are the most marginalized individuals in Pakistan when it comes to the identification of neurological diseases. The neuroimaging highlighted cerebral atrophy in both cases, but their neurological expression differed in distinct patterns of motor speech impairment, seizure activity, and dysexecutive-amnestic syndromes. These findings question traditional neurological diagnostic procedures by demonstrating that chronic psychosocial trauma constitutes a significant pathological risk factor and therefore integration of psychological assessment must become part of routine diagnostic assessment. This study reinforces the role of emotional and financial abuse as a significant stressor in the development of brain pathology. Ethical neurological practices must facilitate the trauma-informed diagnostic processes for the well-being of the patients. The study recommends trauma-informed neurological practice in marginalized sectors and emphasizes the need for interdisciplinary approaches to improve pathological understanding.

Eating disorders are complex and severe psychiatric conditions increasing in prevalence and impact physical, psychological and social functioning.

There is a lack of research investigating rurality and eating disorders and thus little is known about service models, experiences, and client outcomes. Metropolitan data cannot be generalised to regional, rural and remote communities in part due to differences in health care services, and differences in risk factors for eating disorders, such as socioeconomic status and childhood obesity. There is a need to investigate what is known about eating disorders in regional, rural and remote communities due to the lack of access to services and severe mental illness consequences in these locations.

This scoping review aims to collect, evaluate and synthesise the existing literature on eating disorders/disordered eating in regional, rural and remote communities.

The review research questions seek to understand prevalence and characteristics, identify risk and protective factors, proposed mechanisms, relevant theories, and the effects of eating disorders and disordered eating within these populations. Additionally, they aim to assess methods for evaluating eating disorders and disordered eating, prevention strategies, treatment options and models, psychosocial support services, guidelines and recommendations for clients, carers, clinicians, and service providers living and working in regional, rural and remote communities. Finally, they aim to identify service gaps, barriers and facilitators to recovery.

The search strategy was developed using two key concepts; "eating disorders/disordered eating" and "rural". Searching uncovered 6682 records, 4655 after duplicates were removed. Title, abstract and keyword screening removed 3635 records, and the 978 remaining are currently in full text review.

Results of the review questions will synthesise the current literature, understand any unique strengths and challenges that come with prevention, diagnosis, treatment and recovery in rural locations, identify knowledge gaps, and explore ways for services to develop/tailor their services.