Au nsw-amhat-dap cand-mhpc-1208
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Au nsw-amhat-dap cand-mhpc-1208 Au nsw-amhat-dap cand-mhpc-1208 Presentation Transcript

  • ACKNOWLEDGEMENTS“… ―We heard about a lot of problems during thisInquiry. But we also heard tremendous stories ofpersonal pride, strength in the face of adversity, andcultural resilience. …‖NSW Legislative Council, Standing Committee on Social issues, Overcoming IndigenousDisadvantage in NSW. Final Report, 27 November 2008.“… The indices of distress experienced byAboriginal communities today reflect their history.The survival of Aboriginal people within thishistorical context reflects their strengths and theenduring power of their culture.‖ NSW Aboriginal Mental Health and Wellbeing Policy, 2006-10
  • ACKNOWLEDGEMENTS YUWAALARAY YAWAALAYAAY MURRUWARI GAMILARAAY BUNDJALUNG YAGIR GUMBAYNGGIRRWANGKUMARA ANEWAN YARLI DUNGHUTTI/ THUNGHUTTI NGIYAMPAA BIRPAI PAAKANTYI KATTANG WONNARUA AWABAKAL WIRADJURI DARKINYUNG DHARUG EORA MUTHI MUTHI DADI DADI WADI WADI DHARAWALWAMBA WAMBA YORTA YORTA GUNDUNGURRA DHUDHURGA NGUNNAWAL DHAWASource: DAA (2007) - Language Map of NSW NGARRUGU DHURGA
  • ACKNOWLEDGEMENTS – 1982-2007Source: Mr Les Maleza thanking the 144 States who voted to endorse the United Nations Declaration onthe Rights of Indigenous peoples, on behalf of the Global Indigenous Caucus. UN General Assembly, 13thSeptember 2007 (UN photo)
  • UN Declaration on the Rights of Indigenous Peoples Article 24(2)Indigenous individuals have an equal right to the enjoyment of the highestattainable standard of physical and mental health. States shall take thenecessary steps with a view to achieving progressively the full realizationof this right. Article 23Indigenous peoples have the right to determine and develop priorities andstrategies for exercising their right to development. In particular,indigenous peoples have the right to be actively involved in developingand determining health, housing and other economic and socialprogrammes affecting them and, as far as possible, to administer suchprogrammes through their own institutions.
  • ACKNOWLEDGEMENTS, 1971-2008Source: NACCHO
  • The NSW Aboriginal Mental Health The NSW ABORIG Assessment Tools (AMHAT) Project Topic: Assessing Comorbidities Source: NSW Aboriginal Mental Health and Wellbeing Policy 2006-2010 Gavin Stewart(Former) Coordinator, Aboriginal Mental Health Assessment Tools (AMHAT) Project NSW DAPC Meeting 3rd December 2008 and MHPC Meeting, 5th December 2008
  • AMHAT.NSWBrief Project/Service DescriptionThe Aboriginal Health and Medical Research Council [AH&MRC] willconduct a project to oversee the development of a mental healthassessment package relevant to the needs of the Aboriginal population ofNSW. Employment of a project coordinator and the conduct of state andnational consultations are the main components of the project.The project is to be supported by the Mental Health and Drug and AlcoholOffice [MHDAO] and by the establishment of an Aboriginal mental healthassessment reference group.
  • AMHAT.NSWTo inquire into and make recommendations to the Aboriginal MentalHealth Assessment Reference Group, the MHDAO and the AH&MRCon all aspects of mental health assessment and outcomemeasurement for Aboriginal people, with especial reference to waysof addressing the cultural issues affecting application of:• NSW MH-OAT assessment protocols and modules (Triage,Assessment, Review, Care Planning, Discharge, and related modules).• National clinician-rated assessment measures, particularly theHealth of the Nation Outcome Scales (HoNOS, HoNOSCA, HoNOS65+)and the Life Skills profile (LSP).• Self-reported measures for adults (Kessler 10+) and young people11-17 (SDQ: Strengths and Difficulties Questionnaire); and the parent-reported SDQ measures for children 4-10 and young people 11-17.
  • AMHAT.NSWTo consider issues of training of both NSW Health and ACCHS staff;processes for adaptation, selection, and/or development of measures;alignment of service and population survey measures; production ofresource materials; interpretation and reporting; and other aspects of theMH-OAT process in NSW in relation to the particular needs of Aboriginalpeople.To ensure consistency with National developments in Aboriginal mentalhealth data and with developments in other states.To make interim recommendations to the Aboriginal Mental HealthAssessment Steering Group [and] the MHDAO as and when opportunitiesarise out of other MHDAO or AHMRC projects.To develop a final report to the Aboriginal Mental Health AssessmentSteering Group [and the] MHDAO on completion of the project.
  • AMHAT.AU OATSIH Health programs Improving the Capacity of Workers in Indigenous CommunitiesUnder this measure, health practitioners including Aboriginal Health Workers,counsellors and clinic staff will be trained to identify and address mental illnessand associated substance use issues in Aboriginal and Torres Strait Islandercommunities, recognise the early signs of mental illness and make referrals fortreatment where appropriate…..OATSIH is implementing a number of projects to support the roll-out of thisIndigenous-specific measure:•a training program to recognise and address mental illness;•provision of Mental Health First Aid training to increase mental health literacy;•new mental health worker positions;•a mental health Toolkit;•a culturally appropriate mental health assessment tool;•a mental health textbook; and•five additional Puggy Hunter Memorial Scholarships per year to supportAboriginal and Torres Strait Islander students to undertake study within a mentalhealth discipline.http://www.health.gov.au/internet/main/publishing.nsf/Content/health-oatsih-programs-coag
  • Comorbidities and the Burdens of Diseases
  • Number of potentially avoidable deaths amongst Aboriginal people under 75, and the GAP between this and the number if they were prevented as well as for non-Aboriginal people, NSW, 1998-2004. (Source: NSW Health, Chief Health Officers Report, 2006) 400 350 GAP: The potentially avoidableNumber of Deaths deaths that were NOT avoided 300 in Aboriginal people, but COULD have been if the non- 250 165 213 Aboriginal rate applied 195 144 174 178 177 200 EQUITY: Number of avoidable 150 deaths amongst Aboriginal people if the Non-Aboriginal 100 rate applied 150 140 131 124 123 119 117 50 0 1998 1999 2000 2001 2002 2003 2004 Year
  • A model for thinking about ComorbidityMcVeigh KH, Mostashari F, Wunsch-Hitzig RA, Kuppin SA, King CG, Plapinger JD, Sederer LI. There Is No HealthWithout Mental Health. NYC Vital Signs 2003: 2(3);1–4.
  • A model for thinking about Closing GAPs in 25 years 25
  • Another model for thinking about ComorbidityPrince M, Patel V, Saxena S, Maj N, Maselko J, Phillips MR, Rahman A. Global mental Health: 1 No health withoutmental health. The Lancet 2007; 370:859-877.
  • A model for thinking about Closing GAPs in 25 years 25
  • It is evident that social and emotional wellbeing problems are widespread among Aboriginal people, and that multiple coexisting physical acute and chronic health problems are the norm, which has further implications for safe medication use and management. Mental health disorders are often associated with problem use of alcohol and otherSource: Inge Kowanko I, de Crespigny C, drugs, which also adverselyMurray C. Better medication management forAboriginal people with mental health disorders affects safe medication use.and their carers - Final report 2003
  • Aboriginal Primary Health Care An Evidence-based Approach Third Edition Sophia Couzos, Richard Murray Aboriginal Primary Health Care, 3rd edition is Australias definitive guide to best-practice management of the major health problems facing Aboriginal peoples and Torres Strait Islanders. This authentic and authoritative text assists health practitioners, policy-makers and communities to influence health determinants, advocate for and overcome inertia to change, and strengthen health care provision within a human rights context. Proceeds from book sales support the continuedSource: operations of Aboriginal Community Controlledhttp://www.oup.com.au/titles/higher_ed/health Health Services._sciences/9780195551389
  • ABoD (2007)Vos T, Barker B, Stanley L, Lopez AD 2007. The burden of disease and injury in Aboriginal and Torres StraitIslander peoples 2003. Brisbane: School of Population Health, The University of Queensland.
  • MH and D&A as illnesses ―Other‖ includes ~4% for diagnosed D&A, but main contribution is as risk factorsVos T, Barker B, Stanley L, Lopez AD 2007. The burden of disease and injury in Aboriginal and Torres StraitIslander peoples 2003. Brisbane: School of Population Health, The University of Queensland.
  • D&A as a Risk FactorVos T, Barker B, Stanley L, Lopez AD 2007. The burden of disease and injury in Aboriginal and Torres StraitIslander peoples 2003. Brisbane: School of Population Health, The University of Queensland.
  • MH, D&A and other Illneses 10.0% 5.7% ? 3.6% 2.2% ? ? ? 1.5% 1.4% 1.2% 1.0%Vos T, Barker B, Stanley L, Lopez AD 2007. The burden of disease and injury in Aboriginal and Torres StraitIslander peoples 2003. Brisbane: School of Population Health, The University of Queensland.
  • Rate ratios, MH and D&AVos T, Barker B, Stanley L, Lopez AD 2007. The burden of disease and injury in Aboriginal and Torres StraitIslander peoples 2003. Brisbane: School of Population Health, The University of Queensland.
  • Closing Gaps(2005-2008)
  • ACKNOWLEDGEMENTS, 2005-07 2006 – Second meeting – 14th July - Indigenous Issues Generational CommitmentCOAG agreed that a long-term, generational commitment isneeded to overcome Indigenous disadvantage. COAG agreed theimportance of significantly closing the gap in outcomes betweenIndigenous people and other Australians in key areas for action asidentified in the Overcoming Indigenous Disadvantage: KeyIndicators Report (OID) released by COAG in 2003.
  • AH&MRC Aboriginal Health College Site– January 2008
  • The Apology - February 2008
  • The Statement of Intent – March 2008
  • The Renewed NSW Partnership – April 2008 The Aboriginal Health and Medical Research Council of NSW (AH&MRC) and the NSW Government, through its health portfolio, are equal members of the NSW Aboriginal Health Partnership (Partnership) established in 1995. The Partnership adheres to the principles espoused in the National Aboriginal Health Strategy 1989 and continued in the National Strategic Framework for Aboriginal and Torres Strait Islander Health - a Framework for Action by Governments. In particular, the parties commit themselves to the practical application of the principles of Aboriginal peoples self-determination, a partnership approach and the importance of inter-sectoral collaboration. The Partnership is also informed by the Overarching Agreement on Aboriginal Affairs between the Commonwealth of Australia and the State of New South Wales; the NSW State Plan, the NSW State Health Plan and the NSW Aboriginal Affairs Plan Two Ways Together. The Partnership acknowledges the principles in the UN Declaration on the Rights of Indigenous Peoples and the national targets for closing the gap in life expectancy, child mortality and other aspects of health inequity.
  • AMHAT(1996-2000)NSW, N=641
  • NSWHS 1997-98, CHO report 2000
  • AMHAT & MHOAT (2000+)
  • MH-OAT, 2000+Source: NSW Audit Office, May 2005.
  • MH-OAT, 2008+ Revised Modules (ASSESSMENT) Base Modules These modules are to be used for all settings and age groups •Triage •Assessment •Care Plan •Review •Transfer / Discharge Summary Additional Modules These modules are to be used as appropriate to the clinical situation •Physical Examination •Physical Appearance •Risk Assessment •Substance Use Assessment •Family Focused Assessment (COPMI) •Functional Assessment (Older People) •Screening for Domestic Violence •Cognitive Assessment (RUDAS) •Cognitive Assessment (3MS/MMS) •Consumer Wellness Plan
  • MH-OAT 2008+, Substance Use Module
  • MH-OAT, 2000+ (REPORTED ASSESSMENTS)Routine Mental Health Outcome Measures ModulesChild and Adolescent•PC1A – Initial Parent Report Measures for Children Aged 4-10•PC2 – Follow Up Parent Report Measures for Children Aged 4-10•PY1A – Initial Parent Report Measures for Youth Aged 11-17•PY2 – Follow Up Parent Report Measures for Youth Aged 11-17•SM2 – Clinician Completed Measures for Children and Adolescents•YR1A – Initial Youth Self Report Measures Aged 11-17•YR2 – Follow Up Youth Self Report Measures Aged 11-17Adult and Aged Care•SM1 - Standardardised Measures for Adults and Older People with LSP16•SM1A - Standardised Measures for Adults and Older People with LSP20•SM1B - Standardardised Measures for Adults and Older People with LSP39•SR1 - Self Report Measures for Adults and Older People K10 + LM•SR2 - Self Report Measures for Adults and Older People K10 + L3D
  • MH-OAT 2000+, Assessment  HoNOS Ratings the clinician‘s scoring of behaviours that are socially and culturally unacceptable should not be influenced by how common such behaviours are in the community. (Queensland Project)
  • www.mhnocc.org Australian MH Outcomes and Classification Network
  • MH-OAT 2000+, HoNOSCA Ratings Not in scope (Queensland Project)
  • MH-OAT, 2000+ (SDQ)
  • MH-OAT, 2000+ (K10+)
  • AMHAT project development (2001-03)
  • Indigenous Health Survey (National)OVERVIEWThe Indigenous Health Survey (IHS) is part of a series ofsurveys run in conjunction with the National Health Survey (atriennial collection), to collect information about the healthstatus of Indigenous Australians, their use of health servicesand facilities, and health related aspects of their lifestyle. Source: http://www.abs.gov.au/Ausstats/abs@.nsf/0/1a8650f3af9f5c70ca256bd00028807f?OpenDocument
  • Indigenous Health Survey (National)PURPOSEThe aim of the survey is to obtain national benchmarkinformation on a range of health issues to enable comparisonsbetween the health characteristics of Indigenous and non-Indigenous Australians and to allow trends in the health ofIndigenous Australians to be monitored over time. Source: http://www.abs.gov.au/Ausstats/abs@.nsf/0/1a8650f3af9f5c70ca256bd00028807f?OpenDocument
  • SWAN & RAPHAEL (1995):“The following goals are proposed. It is suggested thatthese should be: …3. Baseline data on Aboriginal mental healthencompassing indicators of mental health and levelsand nature of mental health problems and mentaldisorders experienced by Aboriginal people and the riskand protective factors contributing to these.Proposed Target: To be in place within 2–3 years.”Source: Swan P, Raphael B. Ways Forward: National Aboriginal and Torres Strait Islander Mental Health Policy NationalConsultancy Report. Canberra: Commonwealth of Australia, 1995.
  • NATSIHS 2004-05 Design of the SEWB Module NATSIHS NHS 2004-5 and other surveysNSPD Kessler 5 (K5) Kessler 5 extracted from Kessler 10TDD NSPD-related "Total Disability" days NSWHS 1997-2005,SMHWB2007HSU NSPD-related "Health Service Contacts NSWHS 1997-2005,SMHWB2007PCA Physical Cause of NSPD NSWHS 1997-2005,SMHWB2007WB Happy person NHS 1995 SF-36WB Calm Peaceful NHS 1995 SF-36WB Full of Life NHS 1995 SF-36WB Lots of Energy NHS 1995 SF-36ANGER 5 Qs (US) AI-SUPERPFP
  • AMHAT(2004-6)
  • NATSIHS 2004-05 N=10,439 (2%)
  • AN OVERVIEW OF THE SEWB DATA IN NATSIHS 2004-05 (SEWB module review workshop, 24 Nov 2006)http://www.aihw.gov.au/indigenous/seww06/index.cfm
  • EXECUTIVE SUMMARY Aboriginal people experienced High or Very High Psychological Distress at twice the rate of their fellow citizens in 2004-05. Percentage with High or Very High NSPD (K5)Age 18-24 25-34 35-44 45-54 55+ ALL AgesNATSIHS 26% 27% 29% 29% 23% 27%NHS 16% 12% 13% 14% 12% 13%Ratio 1.6 2.2 2.2 2.1 2.1 2.0 This is the same as in New York City8 months after the attack on the World Trade Centre.
  • K5 (remote)
  • K5 Graphic Scale (ABS)
  • “Total Disability” Days
  • Health Service Use
  • Physical Health Cause
  • Individual Items show the same ~2x ratio NATSIHS 2004-05 About how often … did you feel so sad that nothing could cheer you up? Amount of Time Felt like this in last 4 weeksSo sad that nothing None/ Some Most / All can cheer you up A LittleNATSIHS 2004-5 80% 13% 7%NSWHS 2002 91% 6% 3%Ratio 0.9 2.1 2.5
  • OID Key Indicator from 2007 CLOSE THE GAP!
  • The same relative rate (1.7x appears with the SDQ in the WAACHS) CLOSE CLOSE THE GAP! THE GAP!
  • History: Intergenerational Effects of Forced Separation, Part 1 2x Rates of problems in carers who were removed
  • History: Intergenerational Effects of Forced Separation, Part 22.0 x rate of problems in children of carers who were removed Ref 15%
  • NATSIHS – The Wellbeing Q‟s
  • The good and bad news NATSIHS 2004-05About how often … were you a happy person? Amount of Time Felt like this in last 4 weeks Happy None/ Some Most / All Person A LittleNATSIHS 2004-5 9% 19% 72%NHS 1995 4% 26% 70%Ratio 2.2 0.7 1.0
  • The Good News
  • AMHAT(2007-08)
  • What Tools Are Needed? ? …the question should not be “what is the role of a particular tool …”, but rather what is the job to be done and then what are the tools that would be required.Source : Proceedings of the UN Environmental Program workshop to develop a global persistent organicpollutants (POPs) monitoring programme to support the effectiveness evaluation of the StockholmConvention, Geneva, Switzerland, 24-27 March 2003
  • SEWB0 NACCHO/ RACGPScreen for MedicareAdult Health Checks
  • AMHAT - SEWB0 – NACCHO/RACGP Primary Care ScreenWhooley MA, Depression and Cardiovascular Disease: Healing the Broken-Hearted. JAMA. 2006;295:2874-2881
  • AMHAT - SEWB0 – NACCHO/RACGP Primary Care Screen 19 USPSTF. Screening for depression, 2002. Available at: http://www.ahrq.gov/clinic/uspstf/uspsdepr.htm. [Accessed 28 June 2004].
  • AMHAT - SEWB0 and EPDS – UK NCCMH / NIHCE (2005)The Edinburgh Postnatal Depression Scale (EPDS) has been recommended by the mainstream national perinataldepression program across five Australian States. However, the October 2006 Clinical Guidelines of the UK NationalCollaborating Centre for Mental Health and the National Institute for Health & Clinical Excellence, after reviewing allthe published evidence, do not recommend the EPDS for postnatal screening, and instead recommend the [Arroll]variation of the ―two questions‖ developed by Whooley based on the results of a study by Howell et al in 2006[Howell E A, Mora P, Leventhal H. Correlates of early postpartum depressive symptoms. Maternal and Child HealthJournal 2006, 10, 149–157.12c]. Specifically:5.4.5.1 At a woman‟s first contact with primary care, at her booking visit and postnatally (usually at 4 to 6 weeks and3 to 4 months), healthcare professionals (including midwives, obstetricians, health visitors and GPs) should ask twoquestions to identify possible depression:• During the past month have you often been bothered by feeling down, depressed or hopeless?• During the past month, have you often been bothered by having little interest or pleasure in doing things?A third question should be considered if the woman answers „yes‟ to either of the initial questions:• Is this something you feel you need or want help with?5.4.5.2 Healthcare professionals may consider the use of self-report measures such as the EPDS, HADS or PHQ-9 aspart of subsequent assessment or for the routine monitoring of outcomes.5.4.6.1 A validation study should be undertaken of the ‗Whooley questions‘ … in women in the first postnatal year,examining the questions‘ effectiveness when used by midwives and health visitors compared with a psychiatricinterview."National Collaborating Centre for Mental Health. Antenatal and postnatal mental health Clinical management andservice guidance. Final draft, October 2006. URL: http://guidance.nice.org.uk/CG45/guidance/pdf/English ]
  • AMHAT - SEWB0 – Comments (Whooley, 1997)Whooley MA, Avins AL, Miranda J, Browner WS. Case-Finding Instruments for Depression: Two Questions Are as Good as Many.Journal of General Internal Medicine 1997;12(7): 439–445. The Primary Care Evaluation of Mental Disorders Procedure (PRIME- MD) includes a 27-item screening questionnaire and follow-up clinician interview designed to facilitate the diagnosis of common mental disorders in primary care. The questionnaire includes two questions about depressed mood and anhedonia:(1) “During the past month, have you often been bothered by feeling down, depressed, or hopeless?” and(2) (2) “During the past month, have you often been bothered by little interest or pleasure in doing things?”
  • AMHAT - SEWB0 – Comments (Whooley, 1997)
  • AMHAT - SEWB0 – Comments (Whooley, 2006)Whooley MA, Depression and Cardiovascular Disease: Healing the Broken-Hearted. JAMA. 2006;295:2874-2881
  • AMHAT - SEWB0 – NACCHO/RACGP Primary Care Screen
  • AMHAT - SEWB0 – Comment (Arroll, 2005) The third question leads to SEWB0 = GPArroll, B., Goodyear-Smith, F., Kerse, N., et al. (2005) Effect of the addition of a „help‟ question to two screeningquestions on specificity for diagnosis of depression in general practice: diagnostic validity study. British MedicalJournal, 331, 884.
  • SEWB1NATSIHS K5+
  • AMHAT – SEWB1 – (NATSIHS K5) Non-Specific Psychological Distress
  • AMHAT – SEWB1 – Distress Impact and Comorbidity (NATSIHS K5+)
  • AMHAT – SEWB1 – Comment (Roth, 1998) Identifying distress in older men with prostate carcinoma is largely dependent on its reaching a level of significance that is evident to the oncologist. The degree of distress (e.g., 32.6% with anxiety and 15.2% depressed) noted in our clinic study was considerable. However, although distress was noted in 31.2% of the entire group, only 8 of 17 men who were evaluated received a psychiatric diagnosis. These facts highlight a common issue found in patients with chronic illness, namely that they have troublesome and distressing symptoms, but they fail to meet criteria for a psychiatric disorder. Known as subsyndromal symptoms, this is a critically important area for study in medical patients. Our data confirm this.Roth AJ, Kornblith AB, Batel-Copel L, Peabody E, Scher HI, M.D. Holland JC. Rapid Screening for PsychologicDistress in Men with Prostate Carcinoma: A Pilot Study. Cancer 1998; 82:1904–8
  • AMHAT – SEWB1 – Comments (Bultz, 2006; NBCC, 2007, NCCN, 2008). Historically, those who work to treat and cure illness have converged on five key indicators: temperature, respiration, heart rate, blood pressure and more recently, pain … to gauge whether a patient’s physiological systems are functioning sufficiently well to support survival and provide a platform for achieving wellness. In cancer care an area that is often, due the complexity and ubiquity of the disease, a leader in progressive approaches to managing disease - there is a growing recognition of the role a well- functioning mind and spirit play in the path to health. In parallel, there is recognition that interventions to support this vitality need to be empirically supported. Therein lies the need for the sixth vital sign to highlight the importance of distress as a marker of well-being and its reduction as a target outcome measure. Bultz BD, Carlson LE. Editorial: Emotional Distress: TheNational Breast Cancer Centre 2007. Cancer — how Sixth Vital Sign - Future Directions In Cancer Care.are you travelling? National Breast Cancer Centre, Psycho-Oncology 15: 93–95 (2006Camperdown, NSW, 2007.
  • SEWB2NATSIHS Life EventsNon-specific PTSDControl over life areas
  • “… indices of distress …‖ Hi/VHiAboriginal people, Aged 18+ Frequency Distress NATSISS NATSIHSStressor, self or family of friends, last 12 months 2002 2004-5Serious illness or disability 31% 35%Serious accident 12% 34%Death of family member or close friend 46% 32%Divorce or separation 14% 38%Not able to get a job 27% 37%Lost job, made redundant, sacked 8% 36% 39% AlcoholAlcohol or Drug related problems 25% 40% DrugsWitness to violence 16% 36%Abuse or violent crime 11% 42%Trouble with the police 18% 38%Gambling problem 15% 39%Member of family sent to jail/currently in jail 20% 35%Overcrowding at home 20% 38%Treated badly because Aboriginal/Torres Strait Islander 18% 38%
  • AMHAT – SEWB2 – NATSIHS Life Events Kowal E, Gunthorpe W, Bailie RS Measuring emotional and social wellbeing in Aboriginal and Torres Strait Islander populations: an analysis of a Negative Life Events Scale International Journal for Equity in Health 2007, 6:18. http://www.equityhealthj.com/content/6/ 1/18
  • AMHAT – SEWB2 – Non-Specific PTSD SCREEN
  • AMHAT – SEWB2 – Control
  • SEWB0/1NT AIMHi Project SCARF & HfL
  • D&A measures
  • AMHAT - NACCHO/RACGP (2005) and AUDIT 28 Fiellin DA, Reid MC, OConnor PG. Screening for alcohol problems in primary care: a systematic review. Arch Intern Med 2000;10:160(13):1977–89. 30 Brady M, Sibthorpe B, Bailie R, Ball S, Sumner-Dodd P. The feasibility and acceptability of introducing brief intervention for alcohol misuse in an urban Aboriginal medical service. Drug Alcohol Rev 2002;21(4):375–80.
  • AMHAT - SEWB0 – NACCHO/RACGP (2005) and OTHER DRUGS
  • IRIS© Queensland Health
  • Other Instruments – IRIS ( © Queensland Health) – CommentsSchlesinger CM. Ober C. McCarthy MM. Watson JD. Seinen A. The developmentand validation of the Indigenous Risk Impact Screen (IRIS): a 13-item screeninginstrument for alcohol and drug and mental health risk. Drug & Alcohol Review2007; 26(2):109-17.A total of 175 Aboriginal and Torres Strait Islander people from urban, rural, regionaland remote locations in Queensland took part in the study. Measures included theIndigenous Risk Impact Screen (IRIS), the Severity of Dependence Scale (SDS), theAlcohol Use Disorders Identification Test (AUDIT) and the Leeds DependenceQuestionnaire (LDQ). Additional Mental Health measures included the DepressionAnxiety and Stress Scale (DASS-21) and the Self-Report Questionnaire (SRQ).Principle axis factoring analysis of the IRIS revealed two factors corresponding with (i)alcohol and drug and (ii) mental health. The IRIS alcohol and drug and mental healthsubscales demonstrated good convergent validity with other well-establishedscreening instruments and both subscales showed high internal consistency. A receiveroperating characteristics (ROC) curve analysis was used to generate cut-offs for the twosubscales and t-tests validated the utility of these cut-offs for determining risky levels ofdrinking. The study validated statistically the utility of the IRIS as a screen for alcohol anddrug and mental health risk. The instrument is therefore recommended as a briefscreening instrument for Aboriginal and Torres Strait Islander people.Correspondence to: Carla Schlesinger, Centre for Drug and Alcohol Studies, Alcohol and Drug Service, ThePrince Charles Hospital Health Service District, Brisbane Queensland 4000. Email:Carla_Schlesinger@health.qld.gov.au
  • Other Instruments – IRIS ( © Queensland Health) – D&A Screen
  • Other Instruments – IRIS ( © Queensland Health) – MH Screen
  • Other Instruments – IRIS ( © Queensland Health) – Comments
  • Other Instruments – IRIS ( © Queensland Health) – Comments
  • Other Instruments – IRIS ( © Queensland Health) – Comments• No Time Frame• MH screen seen as most useful for screening in non-healthsettings, with outcome being referral (C. Obers, pers. Comm.)• MH “validation” is correlation with longer self-reportinstruments (DASS, SRQ) whose performance is similar to K5+• Similar questions to K5+• Authors did not respond to query about feasibility of retainingD&A screen and replacing MH screen with SEWB0 or SEWB1• Queensland Health uses MHI38 in mainstream MH care – notcompatible with IRIS MH. Not recommended to MHDAO for usein NSW, since K5+ is available, and is compatible with K10+.
  • OTHERS(Really fast)
  • Other Instruments – AIMHI ( Dr Tricia Nagel, NT Health)
  • Other Instruments – AIMHI ( Dr Tricia Nagel, NT Health)
  • Other Instruments – AIMHI ( Dr Tricia Nagel, NT Health)
  • Other Instruments – KICA© – CogLoGiudice D, Smith K, Thomas J, Lautenschlager NT, Almeida OP, Atkinson D, Flicker L. Kimberley IndigenousCognitive Assessment tool (KICA): Development of a cognitive assessment tool for older IndigenousAustralians. International Psychogeriatrics 18:2, 269-280, 2006.Smith K, LoGiudice D, Dwyer A, Thomas J, Flicker L, Lautenschlager NT, Almeida OP, Atkinson D. ‗Nganaminyarti? What is this?‘ Development of cognitive questions for the Kimberley Indigenous CognitiveAssessment. Australasian Journal on Ageing, Vol 26 No 3 September 2007, 115–119Smith K, Flicker L, Lautenschlager NT, Almeida OP, Atkinson D, Dwyer A, LoGiudice D. High prevalence ofdementia and cognitive impairment in Indigenous Australians. Neurology 2008 ;71:1470–1473
  • Other Instruments – KICA© – EWB
  • Other Instruments – KICA© – D&A
  • Other Instruments – NATSIHS - Smoking
  • Other Instruments – NATSIHS - Alcohol
  • Other Instruments – NATSIHS – Alcohol (continued)
  • Other Instruments – A-ATOM – NDARC (K10) N ~200 65% Hi or VHiSimpson M, Lawrinson P, Copeland J, Gates P. The Australian Alcohol Treatment Outcome Measure (AATOM-C):Psychometric Properties NDARC Technical Report No. 288
  • Other Instruments – A-ATOM – NDARC (K10) Vs MHNOCC data 60% Hi or VHi
  • Other Instruments – A-ATOM – NDARC (K10)Simpson M, Lawrinson P, Copeland J, Gates P. The Australian Alcohol Treatment Outcome Measure (AATOM-C):Psychometric Properties NDARC Technical Report No. 288
  • Other Instruments – TOP (UK D&A Services, Clinician+Client)Marsden J, Farrell M, Bradbury C, Dale-Perera A, Eastwood B, Roxburgh M, Taylor S. Development of the treatmentoutcomes profile. Addiction 2008, 103(9), 1450–1460.
  • Other Instruments – TOP (UK D&A Services, Clinician+Client)Marsden J, Farrell M, Bradbury C, Dale-Perera A, Eastwood B, Roxburgh M, Taylor S. Development of the treatmentoutcomes profile. Addiction 2008, 103(9), 1450–1460.
  • Other Instruments – TOP (UK D&A Services, Clinician+Client) r=-0.63 (GHQ12) r=-0.55 (PHQ-15) r=0.74 (WHO-BREF Marsden J, Farrell M, Bradbury C, Dale-Perera A, Eastwood B, Roxburgh M, Taylor S. Development of the treatment outcomes profile. Addiction 2008, 103(9), 1450–1460.
  • Other Instruments – SRQ20 ( Psycheck)Harding TW. de Arango MV. Baltazar J. Climent CE. Ibrahim HH. Ladrido-Ignacio L. Murthy RS. Wig NN. Mentaldisorders in primary health care: a study of their frequency and diagnosis in four developing countries. PsychologicalMedicine. 10(2):231-41, 1980 May.
  • Other Instruments –ASSAD Distress and Substance UseNew South Wales School Students Health Behaviours Survey: 2005 Report. [This was previously the NSW supplementto the Australian Schools Students Alcohol & Drugs (ASSAD) survey].URL:http://www.health.nsw.gov.au/PublicHealth/surveys/hss/05/toc/11_beh_psychological_distress.asp
  • Other Instruments –ASSAD Distress and Substance Use Adjusted Odds Ratios for Association of High Psychological Distress with Substance use, ASSAD surveys, NSW school students aged 12-17, 1996, 1999 and 2002 AOR for High Psychological Distress 5 4 3 2 1 0 9 9 9 9 96 02 96 02 96 02 96 02 99 99 99 99 19 20 19 20 19 20 19 20 -1 -1 -1 -1 k k cit k ee ee ee illi w tw W ed st s st la us la La ce a er an ed n Ev ta iju ok bs ar Sm Su M e d iff SnForero R, Chey T, Bauman A, Silove D. High psychological distress (HPD) and substance use among Australianadolescents: A trend and comorbidity analysis from the NSW Australian School Students‘ Alcohol and Drugs (ASSAD)surveys, 1996, 1999 and 2002. (Unpublished ms. supplied by Roberto Forero, January 2006).
  • Other Instruments –NDSHS K10 Distress and Substance Use Crude Odds Ratios and approximate 95% Confidence Limits for High or Very High Non-Specific Psychological Distress (K10) by self- reported substance use, NDHS, Australia, 2004. 11.0 10.0 9.0 8.0 7.0 6.0 5.0 4.0 3.0 2.0 1.0 0.0 ot ot ot ot t k ot ot Lo isk n Lo isk Vs n No is No o N N N N N N ce s N R Vs w R h yV wR Vs Vs Vs Vs Vs Vs Vs w Re r V Lo th th th th th th th nt on on er oke on on on on on R Vs R s tM tM tM tM tm tM tM O Sm k n H isk is ai as as as as as as as st ly -L -L -L -L -L -L -L th Ab ai ig -D es s n it s ne y nt l- bi ic oi as in ai Ill la ho er na o st am oc cc ha H y Ec co an An ba C et In Al C ph To am h/ et MAnalysis of published table 20.3 and relative standard errors in Appendix 4 of (2004) National Drug Strategy HouseholdSurvey. URL: http://www.aihw.gov.au/publications/index.cfm/title/10190
  • A model for thinking about Closing GAPs in 25 years 25