A step towards mental health first aid-savvy teens

A training programme of mental health first aid for adolescents shows promise as a training tool in increasing likelihood of adolescents supporting each other during mental stress, according to a paper published in the Australian and New Zealand Journal of Psychiatry this week.

The teen mental health first aid programme was tested against a physical first aid programme with adolescents allocated randomly to one programme or the other. teen Mental Health First Aid (tMHFA) is a classroom-based training programme for students aged 15–18 years to designed to improve supportive behaviours towards peers, increase mental health literacy and reduce stigma, the authors said.

Both interventions involved almost 2000 students of government-funded schools, and consisted of three 75-minute classroom sessions, presented by trained external instructors. All students were provided with a specific programme booklet and completion certificate, the authors explained.

The authors reported significant improvements to attitudes and intention to give mental health first aid to peers, as well as significant increase in mental health literacy and reduction of stigmatising attitudes.

They pointed out that the programme still required further research to evaluate whether teen Mental Health First Aid training translated into actual supportive behaviours.

Reference: Laura M Hart, Amy J Morgan, Alyssia Rossetto, Claire M Kelly, Andrew Mackinnon and Anthony F Jorm. Helping adolescents to better support their peers with a mental health problem: A cluster-randomised crossover trial of teen Mental Health First Aid. Australian and New Zealand Journal of Psychiatry; 52 (7) July 2018. Research Article.

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Are we heading for a tobacco-free world?

The nation’s lungs can breathe easier since Australia won a trade dispute against the tobacco industry this week over plain packaging for cigarettes. Backed by the World Health Organisation, international action on tobacco control will have legal muscle, according to an editorial in the Lancet this week.

This follows reports from China last month that trains are to be smoke-free and that in Japan new laws were passed to make smoking in bars and restaurants illegal, paving the way for a tobacco-free 2020 Olympics. Although these wins are a major step forward in global anti-smoking efforts the editorial stated that despite the fall in prevalence since 1990, the actual number of smokers continues to increase worldwide owing to population growth.

While the latest global legal successes are good progress, the editorial pointed out that it will be necessary to intensely monitor the tobacco industry to sustain the progress made so far.

Editorial, Lancet; 392 (10141):1, July 2018

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Novel treatment for major depressive disorder available

Transcranial magnetic stimulation (TMS), a trialled and tested treatment for major depressive disorder could soon become affordable to the average Australian. An article in the Medical Journal of Australia this week has called for a medicare item number for TMS. This will make it an accessible treatment to those who need it. Currently, private out-patients fork out a prohibitive $6000 for a course of 20–30 TMS treatments delivered over 4–6 weeks. TMS may also become available as a treatment for major depressive disorder to in-patients as part of a private psychiatric clinic admission.

TMS is less invasive than electro convulsive therapy (ECT) and does not require an anaesthetic team and recovery room to conduct the treatment. Like ECT, which is effective in many patients, TMS is recommended for patients with treatment-resistant depression but does not cause memory impairments that some ECT patients experience.

The article says that over the past two decades TMS has been subject to robust testing; 59 sham controlled trials, 30 systematic reviews and meta-analyses as well as naturalistic studies with effective results.

Depression affects at least one in five people during their lifetime. Three-quarters of depressive illnesses start before the age of 24 and half before the age of 18.

An item number for TMS would help all people who need it to access this important therapeutic advance.

Med J Aust 2018; 208 (11): 468. || doi: 10.5694/mja17.00849

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