Burden Of Disease: Costing An Effective Package Of Care For Mental Disorders
Funder
National Health and Medical Research Council
Funding Amount
$272,735.00
Summary
The Global Burden of Disease project, a WHO-World Bank-Harvard collaboration, presented an unprecedented picture of global health across the developed and developing world, providing much-needed information for planning health services. Health was measured at the population level, and combined the number of life years lost due to death and disablement to give a total amount of life lost per disorder. One surprise of the project was the importance of mental disorders, accounting for 43% of life y ....The Global Burden of Disease project, a WHO-World Bank-Harvard collaboration, presented an unprecedented picture of global health across the developed and developing world, providing much-needed information for planning health services. Health was measured at the population level, and combined the number of life years lost due to death and disablement to give a total amount of life lost per disorder. One surprise of the project was the importance of mental disorders, accounting for 43% of life years lost due to disability in countries like Australia. Service planning to reduce this burden requires knowledge of cost-effective treatments.This project will trial a method used for combining burden and cost-effectiveness data to design an essential package of services to address the treatment shortfall in mental disorders. This research will assist in our understanding of why burden due to mental disorders persists, and the extent to which current treatment knowledge is able to address this burden within existing budgetary constraints. This will be achieved by: 1) detailing the costs and population outcome of current services in Australia for mental disorders, to determine which disorders are currently adequately treated and which disorders require further intervention, 2) calculating the costs and outcome of best practice interventions from clinical practice guidelines, to understand the extent to which current treatment knowledge can reduce burden due to mental disorders, 3) examining the equity consequences of such a package of ideal interventions, with the understanding that the treatment endpoint is not the same for all disorders. This is a secondary analysis, representing a method for translating existing cost and outcome data for individual treatments into their costs and consequences for health planning at the population level.Read moreRead less
Using Epidemiology To Inform Psychiatric Classification (DSM-V And ICD-11)
Funder
National Health and Medical Research Council
Funding Amount
$631,502.00
Summary
Classification systems are vital for scientific progress. The classifications of mental disorders of the World Health Organization and the American Psychiatric Association are both being revised and this Australian team is a principal contributor to both processes. We have access to three national epidemiological surveys (n-30,000) that will inform fundamental issues by developing models of mental disorder typology and identifying practical improvements in the classification systems.
The Effectiveness Of An Early Intervention And Prevention Strategy For Anxiety And Depressive Disorders.
Funder
National Health and Medical Research Council
Funding Amount
$119,924.00
Summary
Adult anxiety and depressive disorders are common, cause significant distress to sufferers and cost to the community, and generally begin in childhood. Prior research has shown that children who exhibit higher than average levels of anxiety in their late childhood are at risk for developing anxiety and depressive disorders as they grow older. However if at risk children can learn skills to better manage their anxiety, the chance that they will continue to experience significant anxiety problems ....Adult anxiety and depressive disorders are common, cause significant distress to sufferers and cost to the community, and generally begin in childhood. Prior research has shown that children who exhibit higher than average levels of anxiety in their late childhood are at risk for developing anxiety and depressive disorders as they grow older. However if at risk children can learn skills to better manage their anxiety, the chance that they will continue to experience significant anxiety problems is greatly reduced. For example, school-based skills-building programs run by specialist mental health professionals have been shown to reduce the rate of existing anxiety disorder and prevent the onset of new anxiety disorders across middle to late childhood and early adolescence. The proposed study will aim to show that a school-based program, run by school counsellors, can prevent the development of anxiety and depressive disorders in late adolescence. In other words, the aim is to demonstrate whether the benefit of the program can be achieved across the wider school-aged population when conducted wholly within the education sector. This outcome is significant, not only in its potential to reduce distress to a large number of adolescents and their families, but in reducing costs to the community in terms of reduced disability and reduced need for health care and specialist mental health treatment.Read moreRead less
Assessment And Prevention Of The Early Signs Of Anxiety And Depression In Children.
Funder
National Health and Medical Research Council
Funding Amount
$149,363.00
Summary
Anxiety and depression are common mental health problems and children rate them as their most common emotional problems. Recent research has indicated that brief psychotherapy programs are effective in reducing these problems in 8 to 14 year olds, however, the earliest signs of these problems are detectable in the preschool years. Thus there is an urgent need for adequately evaluated community prevention programs to address the promotion of sound mental health in much younger children. The aim o ....Anxiety and depression are common mental health problems and children rate them as their most common emotional problems. Recent research has indicated that brief psychotherapy programs are effective in reducing these problems in 8 to 14 year olds, however, the earliest signs of these problems are detectable in the preschool years. Thus there is an urgent need for adequately evaluated community prevention programs to address the promotion of sound mental health in much younger children. The aim of this study is to conduct a comprehensive controlled trial of a community based programme for the detection and prevention of early signs of internalising disorders (i.e., shyness, fears and anxiety, depression). It is hypothesised that by intervening when children are young with the aim of improving parent-child interaction patterns, children will be steered towards a more competent and resilient approach to life. The study consists of three major components. First, we will evaluate the psychometric properties and predictive validity of the best available measures of teachers', parents' and children's' perceptions of the child's adjustment status. Second, we will follow-up the full cohort of preschool children to test which combination of the measures best predicts internalising disorders after 2 years. Third, we will conduct a controlled trial with a sample of the larger cohort to evaluate the effects of a brief parent and teacher training programme on children's adjustment. The major questions of this project are: a) Can we successfully identify children in a community preschool setting and under the age of 6 who are at risk of developing internalizing disorders? b) What assessment measures are the most reliable and valid predictors of the development of internalising disorders in this age group? c) What are the short-term and medium-term effects of a parent and teacher prevention program on children stratified according to risk for internalising disorders?Read moreRead less
The Comparative Health System Efficiency For Treating Chronic Physical And Mental Disorders
Funder
National Health and Medical Research Council
Funding Amount
$58,500.00
Summary
Mental disorders account for 15% of the burden of disease in Australia, and are the largest cause of disability. Effective treatments are available for all mental disorders, however the majority of sufferers in Australia do not receive these treatments that work. Hence the burden of disease due to mental disorders in Australia persists. Why is this so? Is there something unique about mental disorders that means little can be done with direct treatment? The feasibility and affordability of mental ....Mental disorders account for 15% of the burden of disease in Australia, and are the largest cause of disability. Effective treatments are available for all mental disorders, however the majority of sufferers in Australia do not receive these treatments that work. Hence the burden of disease due to mental disorders in Australia persists. Why is this so? Is there something unique about mental disorders that means little can be done with direct treatment? The feasibility and affordability of mental health treatment can only be truly understood in comparison with other chronic disorders. Such comparisons are particularly significant as mental health remains a stigmatised area of the health sector. Without comparative data it would be easy for critics to argue for decreased funding for people with mental disorders. Project Outcomes: For three chronic physical disorders in Australia (osteoarthritis, rheumatoid arthritis, asthma) this project will define the cost-effectiveness of current care, the cost-effectiveness of optimal care (everyone getting treatments that work), and the amount of disease burden that can be averted with high-quality health care. These findings will be compared to similar calculations we have produced for mental disorders, to determine if it is mental disorders or chronic disorders per se that require much more effort by the health care system in Australia.Read moreRead less
Beyond Motherhood: A 27-year Follow-up Of The Mental Health Of Mid-age Women.
Funder
National Health and Medical Research Council
Funding Amount
$1,755,651.00
Summary
There have been few studies of the causes and consequences of anxiety disorders yet they are disabiling, chronic and impair life prospects particularly for women. Environmental factors hold the greatest promise to understanding their natural history and for mitigating their effects. This proposal is for a 27 year follow up of women participating in the Mater University Study of Pregnancy to understand the development of anxiety disorders and comorbid depression and substance use.
Early Intervention For Anxiety And Phobic Disorders In Young Children With Intellectual Disability
Funder
National Health and Medical Research Council
Funding Amount
$305,674.00
Summary
Children with intellectual disability (ID) are 2-3 times more likely to have behavioural and emotional disturbance, including anxiety and fears, than children of normal intellectual ability. Anxiety problems are a source of distress for the child, impair their ability to learn and are a cause of family burden and community cost. Therefore, effective interventions are urgently required. Research with non-disabled children has demonstrated the effectiveness of teaching parents to manage their chil ....Children with intellectual disability (ID) are 2-3 times more likely to have behavioural and emotional disturbance, including anxiety and fears, than children of normal intellectual ability. Anxiety problems are a source of distress for the child, impair their ability to learn and are a cause of family burden and community cost. Therefore, effective interventions are urgently required. Research with non-disabled children has demonstrated the effectiveness of teaching parents to manage their child's anxiety, however the effectiveness of this approach in children with ID has not yet been established. This project aims to compare the relative effectiveness of two intervention conditions compared to a waiting list group, for highly anxious children aged 4-7 years with ID. One intervention will teach parents to help their child deal with anxiety problems, and develop skills to overcome their own associated emotional upset and family and social problems. The other intervention will provide non-directive counselling and support to help the parents understand the nature and causes of ID, associated anxiety problems in the child, and parent and family stress. The long term outcome of these two interventions will be assessed by following the children and their families for two years. A manual of each treatment is produced. This project aims to provide evidence for a relatively inexpensive, feasible and effective early intervention program for young children with ID at risk for developing anxiety problems that can be easily taught to professionals and is acceptable to parents. Widespread use of this intervention has the potential to reduce the added burden and cost to families and the community of persistent severe anxiety in young people with ID.Read moreRead less
The Prevention Of Anxiety And Related Disorders: Long Term Follow-up Of Temperamentally At-risk Preschoolers.
Funder
National Health and Medical Research Council
Funding Amount
$391,476.00
Summary
Anxiety and related disorders such as depression provide a tremendous cost to the individual sufferer and to Australian society. While previous research has focussed on treatment of these conditions, little work has addressed the possibility of preventing these disorders before they interfere with an individual's life. There is growing evidence that children who are shy, withdrawn and inhibited at a very young age are more likely than other children to develop anxiety disorders in later childhoo ....Anxiety and related disorders such as depression provide a tremendous cost to the individual sufferer and to Australian society. While previous research has focussed on treatment of these conditions, little work has addressed the possibility of preventing these disorders before they interfere with an individual's life. There is growing evidence that children who are shy, withdrawn and inhibited at a very young age are more likely than other children to develop anxiety disorders in later childhood and a variety of related disorders in adulthood. In a previous NHMRC-funded grant, we have developed a brief parent education program to modify this personality style in young children. Early results are very promising and it appears that we have been able to help these withdrawn children to become more outgoing. This next proposal aims to follow these children over the coming years to see whether they are also less likely to develop mental health problems than children whose parents have not received the educational program are. We will be observing the children in a laboratory setting and at school at three, yearly intervals. At each point, we will compare withdrawn children whose parents have gone through the education program with those who haven't.Read moreRead less
Randomised Controlled Trial Of Treatment For Alcohol Use Problems And Social Phobia
Funder
National Health and Medical Research Council
Funding Amount
$630,333.00
Summary
Social Phobia and harmful Alcohol use often go together and suferers experince additional distress, disability, and worse results from treatment. Previous clinical trials tested adding treatments for the separate disorders together which may have confused patients. This project test integrated evidence based CBT treatments for the separate problems compared to treatment for alcohol alone. Reduced drinking, decreased social anxiety and increased quality of life are the expected results
Dopamine Mechanisms Conferring Resilience To Depression: A New Antidepressant Target
Funder
National Health and Medical Research Council
Funding Amount
$560,948.00
Summary
A significant proportion of people who suffer depression fail to obtain effective relief from either drugs or psychotherapy. Accordingly, there is a pressing need to develop new, and more effective, treatments. This project will determine whether certain specific brain pathways that use the transmitter dopamine can be manipulated in their activity so as to increase resilience to depression. This work has potential to provide the foundation for the development a new generation of antidepressants.