Background: School-based prevention programs have proven effective in reducing alcohol and other drug (AOD) related harms; however, consultations with Aboriginal and Torres Strait Islander communities have identified a lack of evidence-based, culturally inclusive, substance-use prevention programs for Aboriginal and Torres Strait Islander youth. To address this, we co-developed Strong & Deadly Futures with an Indigenous creative design agency and 4 schools. Following a successful pilot, we are testing the program’s effectiveness in preventing alcohol and drug uptake in a large randomised controlled trial (RCT). The trial is preceded by a consultation and adaptation phase in partnership with Aboriginal Community Controlled Health Organisations (ACCHOs).

Population: Year 7/8 students from 24 secondary schools across Australia.

Method: ACCHOs in participating locations will consult with Aboriginal and Torres Strait Islander adults and young people to obtain feedback on the program. Local input is expected to result in 4-6 regional adaptations of the program. Following the consultations, schools will trial Strong & Deadly Futures in a cluster RCT in 2022.

Results: Community consultations are underway. A challenge of this research will be integrating perspectives of diverse communities while maintaining program cohesion.

Conclusion: Strong & Deadly Futures supports implementation by combining core, standardised components with flexible activities to allow local tailoring of program content. If effective, Strong & Deadly Futures will provide a model for combining participatory research with rigorous evaluation.

Screening for Postnatal Depression: How Maternal and Child Health Nurses Can Support Infant Mental Health (Virtual Poster Presenter)

Postnatal depression and/or anxiety (PNDA) is a prevalent public health issue (Shrivastava et al., 2015) which, if left undetected and untreated can lead to significant adverse outcomes for mothers and their infants (Slomian et al., 2019).

Infants’ significant reliance on their caregiver to meet their basic needs and provide nurturance (behaviours that strengthen infants' psychological development), and the fact that, in most families, mothers act as the infant's primary caregiver, makes the identification of PNDA and provision of appropriate supports for mothers, a public health priority.

Mothers with PNDA are less likely to demonstrate responsiveness and nurturance, and more likely to avoid or provide inconsistent care to their infant. Children of mothers with PNDA are also 1.4 times more likely to be hospitalised, have 1.9 times greater risk of death before their first birthday (Jacques et al., 2019), and more likely to be underweight (Farías-Antúnez et al 2018).

Universal screening, using a validated screening tool, increases rates of detection and service utilisation among mothers requiring mental health support (Reilly et al., 2020) and results in as much as 9% risk reduction in depression prevalence (O’Connor et al., 2016). Conversely, when PNDA is not routinely asked about, and/or a standardised tool is not used for detection, over 50% of cases are missed (Anding et al., 2015).

MCH nurses have an important opportunity to identify and support mothers experiencing PNDA and thereby promote infant mental health by facilitating prevention and early intervention. My PhD research has identified opportunities for greater consistency in the identification of all mothers experiencing PNDA and provides an evidence base for future policy, training and practice strategies.

There is a gap in mental health services for children aged 8-to-12, particularly for early intervention and prevention. Research suggests improving mental health literacy, reducing stigma and strengthening coping skills, reduces the likelihood of severe mental health problems through adolescence and into adulthood. Wesley Kids have designed a psychoed classroom program aimed at addressing these gaps for primary school children.

The Program:
The program involves 4 x 45-minute sessions delivered over the calendar year. The sessions, “Fears and Worries”, “Emotional Resilience”, “Healthy Relationships” and “My Superpowers”, build knowledge and skills, extending these each session, with provisions for revision of previous topics, and knowledge checks. The sessions are designed to be culturally inclusive.

The Participants:
We focused on low socioeconomic areas, where children have limited opportunities and supports including, Eagleby, Beaudesert, Woodridge and Cleveland. The sessions were designed for grades 2 to 6 and the communication and examples tailored to each classroom.

Findings:
The program was evaluated by students and teachers. In classrooms, students are quizzed to measure knowledge pre and post session, and each class (N = 102 classes) was able to explain key concepts. Teachers reported significant improvements in the students’ knowledge and coping skills, and this was higher when teachers were able to integrate the key messages within the classroom on a regular basis (e.g., gratitude wall, mindfulness Mondays).

Implications:
The psychoed sessions have been successful in improving mental health literacy for young children, however, the reach of this program is limited by workforce capacity. There is a demonstrable need for this service, with more schools requesting the program for 2022. The 2022 program will be co-designed with teachers and include strategies for ongoing integration of mental health content with existing teaching practices on a frequent basis.

Covid-19 restrictions have forced many mental health practitioners to rapidly adopt telehealth as their primary delivery mechanism. Coviu has rapidly scaled from 450 calls per day pre-restrictions to a peak of 25,000 calls supporting over 60,000 clinicians Australia-wide with their telehealth needs. Over one third of Coviu users are mental health practitioners who we have been working closely with to co-design new features for the platform.

With 25% of all psychology sessions taking place with children and adolescents (Matthews et al. 2010), it is important to evaluate the benefits of telehealth and address its challenges when working with young people.

We have collected data from 33 discovery interviews and focus groups, user surveys, feedback channels and webinars to understand the benefits and challenges of using telehealth with children, young people and their families.

Mental health practitioners of Coviu platform have highlighted a number of benefits in using telehealth including: seeing children in the home environment, facilitating multidisciplinary meetings, enabling non-school attenders to access school-based counselling, reducing the amount of time taken out of school to attend therapy, providing easy access to parents of young people receiving care and enabling families to find a culturally appropriate professional.


We identified three major challenges that users are experiencing with telehealth in this population;

1. Children can become distracted by the buttons on the screen.
2. The lack of ability to administer common cognitive assessments.
3. Keeping children engaged during therapy.

To address these challenges Coviu has:

1. Implemented a “View only” option to prevent children from interacting with the interface.

2. Partnered with Pearson Clinical to integrate 30 psychological assessments including, WISC-V, WAIS-IV and WIAT-III.

2. Scoped games such as social detective games, creative games, and skill-specific games to maintain engagement and build rapport. These will be integrated into the platform in 2022.

Not just another consultation: Research co-production in practice

Australia has a long history of policy on the involvement of people with experience of mental health issues in service delivery, policy and research. Various National Mental Health Strategy documents and health research statements emphasise the critical role that lived experience plays in our system, and its place in decision-making. However, putting things into practice has been a little less encouraging, especially in the research space. This is in part due to limited guidance on how to do involvement effectively, and especially what all the different levels of involvement actually mean. Confusion about what people expect when terms like co-design and co-production are used has led some people to simply re-badge their consultation processes as co-design. This results in disappointment, dissatisfaction and in some cases anger from people involved, and is becoming a significant problem across research, services and policy alike. People with mental health issues are reluctant to engage for fear their input will not truly be heard, and have limited influence. For groups such as children and young people, who often already carry these fears, having a clear understanding of good practice in co-design and co-production is critical. Good co-production is responsive to the needs of the individual project and people involved. This presentation will explore the broad values and principles that underpin co-produced research in practice, to encourage delegates to challenge their preconceptions and explore approaches for their own work.

Role of CBT with Adjunctive Motivational Interviewing in Adolescents with Conversion Disorder: A Systematic Review
(Virtual Poster Presenter)

Objective:
The purpose of this study was to systematically review the literature relating to intervention in conversion disorder adolescent patients. Specifically, comparing Cognitive Behaviour Therapy, with motivational interviewing as an adjunctive therapy.
As no studies were found for conversion disorders pertaining to the adolescent age range group, the inclusion criteria were expanded to also include papers in the adolescent age range group with internalising and externalising disorders receiving motivational interviewing as adjunctive therapy as well as any papers exploring the role of motivational interviewing in adult patients with conversion disorders.
Methods:
Five online databases were searched and PRISMA guidelines were followed. Temporal limits were not applied to the searches.
Results:
There were 423 relevant search results in total. After the detection of articles that were duplicates, a chronic illness or were substance abuse focussed, these studies were excluded. Eight papers were chosen for discussion in this review.
Conclusion:
These studies were consistently conclusive in finding MI as an adjunctive therapy in adolescents with ADHD and internalising disorders to be beneficial with good attrition rates (<5%) and adherence to treatment over a 3 month follow up period. Additionally, several QOLI subscales showed a significant effect between baseline and 3 months (all P < 0.05). This also translated to transition to adult care in ADHD, as MI with its directive, client centred counselling style may help foster a sense of responsibility and adherence to treatment in patients with poor insight and decision-making skills.
Lastly, with conversion disorders, one sentinel study looking at non-epileptic seizures in the adult population, concluded that MI an adjunctive therapy was noted to be beneficial in increasing treatment adherence 31.0% vs 65.4% (P = 0.015).
With the addition of the expanded inclusion criteria, it is evident that MI is beneficial as an adjunctive therapy to standard care.

Australian young people spend around 11,000 hours of their life at school. Often our young people’s most consistent support networks are in education settings. School attendance and engagement are considered protective factors for adolescents, which can enhance their resilience and wellbeing. As a Guidance Officer and Teacher at the Queensland Adolescent Extended Treatment Centre, Jacaranda Place, we spend our days supporting young people and their families to access their education, whilst actively advocating for the inclusion of young people in schools; and the prioritisation of education within mental health services.

In a fast-paced twenty-minute presentation, Bonnie and Anna will share how they build the capacity of schools and health teams to support young people’s journey through mental health services, and back into schools; whilst placing young people and families at the centre of the process. Participants will explore how young people’s engagement with school and education is an integral part of their recovery from mental health challenges.

Success stories will exemplify strategies and opportunities for adolescent mental health professionals to engage with schools, and for education professionals to engage with adolescent mental health services. Examples of practice will demonstrate how enhanced collaboration between services can better support young people’s recovery from mental health challenges. Participants will develop a deeper understanding of the role education plays for young people’s recovery, enabling them to better respond to opportunities to enhance the collaboration between mental health services and schools.

The Queensland Children’s Hospital School provides continuity of education for all students receiving treatment for mental health challenges. Their campuses include, Jacaranda Place, Adolescent Extended Treatment Centre and Day Program which offers recovery orientated treatment of complex mental health challenges; and the Eating Disorder Day Program, which provides young people with recovery-based treatment for eating disorders. Both services are located in the Chermside area.

Please see Naheen Brennan

The Impact of Fostering Skills and Understanding in Carers of People with Borderline Personality Disorder

Borderline Personality Disorder (BPD) is a distressing mental illness that is overrepresented in adolescents and youth, which was previously thought difficult to treat. The disorder is characterised by difficulties with managing and regulating emotions, impulsivity, self-harming behaviours and suicidal acts, difficulties in relationships, instability in mood, and identity disturbance. Families and carers of those with BPD can also experience high levels of distress and burden. The Families and Carers Training and Support (FACTS) program is an innovative intervention informed by Mentalization Based Treatment principles. The FACTS program is a five session, skills and education program for family members and carers of someone with BPD. The program focuses on providing family members and carers with the knowledge and skills to interact more effectively with their family member with BPD. The intervention was implemented as a delayed treatment randomised control trial at the Alfred Child and Youth Mental Health Service. To evaluate the effectiveness of this program, interviews were conducted with young people whose family members participated in the program. Transcripts of the interviews were thematically analysed to assess whether the young people noticed any changes from their family members participating in the program. Overall, the young people felt there had been positive changes during and the after their family members had participated in the program. Young people felt the communication with their family members improved, they felt more understood, and that the tension in the household decreased. Additionally, a number of the young people felt they would have liked to be more involved in the process and to take part in the program alongside their family members. The findings indicate that interventions focusing on building understanding in carers of those BPD can be important in ameliorating the challenging impact of BPD on young people.