Health Times March 2018

H

March 2018

Mental Health Feature + Organisational psychologists beneficial in a time of #metoo and workplace bullying + Nurses hold a crucial but undervalued role in the Australian mental health sector + Addressing language and mental health issues in the youth justice system + Treating depression with exercise: what does an accredited exercise physiologist do?

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GET YOUR CPD SORTED FOR 2018!

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HealthTimes - March 2018 | Page 03

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March 2018 We hope you enjoy perusing the range of opportunities included in this Issue.

If you are interested in pursuing any of these opportunities, please contact the advertiser directly via the contact details provided. If you have any queries about our publication or would like to receive our publication, please email us at contact@healthtimes.com.au DISTRIBUTION 46,300

Advertiser list Aspen Medical Australian College of Nursing Bendigo Health CCM Recruitment International CRANAplus Doctor Mikhail

The HealthTimes magazine is the most widely distributed national nursing and allied health publication in Australia.

For all advertising and production enquiries please contact us by telephone on 1300 306 582, email contact@healthtimes.com.au or visit www.healthtimes.com.au Published by Seabreeze Communications Pty Ltd trading as HealthTimes.

ABN 29 071 328 053. Š 2018 Seabreeze Communications Pty Ltd. All right reserved. No part of this publication may be copied or reproduced by any means without the prior written permission of the publisher. Compliance with the Trade Practices Act 1974 of advertisements contained in this publication is the responsibility of those who submit the advertisement for publication.

Next Publication: Education Publication Date:

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Artwork Deadline:

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Time restraints and lack of training place added pressure on midwives and patients

By Nicole Madigan

W

anxiety and can provide a tipping point for hile awareness of the mental health mental illness to occur.” struggles faced by many new mums Ms Barclay says there are a number of is increasing, new research shows that one processes in place to help midwives identify quarter of pregnant women will experience mental health issues in both pregnant some form of mental health challenge. women and new mothers, however multiple The UK study from King’s College limitations and barriers contribute London revealed that of the one in to increased pressure on four women, 11 per cent had maternity staff, reducing depression, 15 per cent their ability to effectively had anxiety, 2 per cent support the women had eating disorders who need it. and 2 per cent D u r i n g had obsessivep r e g n a n c y , c o m p u l s i v e universal screening disorders. generally the Many women Edinburgh Postnatal experienced a Focusing on the clinical skills that are For more information and to Depression Score combination two or book tickets go to: required and essential for the recognition and (EPDS), is offered to more issues. emergency management of the seriously ill Melbourne: all women on booking A u s t r a l i a n infant and young child. http://bit.do/CRITMEL in.

Nursing and Midwifery At this visit issues such Federation (Vic Branch) Brisbane: as intimate partner violence Maternity Services Officer http://bit.do/CRITBRIS in all and health a rangeprofessionals of other psychosocial Julianne Barclay says she isn’t paramedics and allied medical fields. issues, for example, housing, are raised by surprised by the findings.

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Respect - Professionalism - Care - Commitment - Collaboration Registered Nurse Operating Theatre An opportunity has become available for a suitably qualified and experienced Registered Nurse. We are seeking a dynamic and enthusiastic nurse with solid Peri-operative knowledge to join our Operating Theatre Complex. With 2 General surgeons and visiting surgeons from 6 different specialties we cover a surgical variety to consolidate or expand current Peri-operative skill. A great lifestyle awaits the successful applicant with no regular weekend or public holiday work (excluding on-call), providing ample opportunity to experience our amazing district and all it has to offer.

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Division One Registered Nurse (AHPRA).

Post graduate qualification in peri-operative Nursing or broad experience in Operating Suite essential.

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The position includes an attractive salary, as well as salary packaging, and a relocation allowance. Swan Hill District Health is also strongly committed to professional development.

Further information and position description is available from www.shdh.org.au

Closing date to: Wednesday, 28th March 2018

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Own your car?

Borrow up to $20,000 against its value

• It must be a late model vehicle* • It must be registered in your name; if registered in your partner’s name, you can apply jointly • You must repay your loan through Payroll Deduction or Salary Sacrifice (and enjoy potential tax benefits) • You must be government-employed or work in a related industry (education, health care)

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*Age of vehicle determines the amount client is eligible to borrow; Terms and Conditions Apply. ABN 18 132 485 066.

A National Credit Act compliant company. 1: A motor vehicle which is paid off, registered in your name and not encumbered (i.e. not currently used as security on any loan with another financial institution). Australian Credit Licence No. 388143

Page 10| HealthTimes.com.au

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HealthTimes - March 2018 | Page 11

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Rural maternity ward not possible without Federal Governmentfunded program

I

magine not having a maternity service available in your local area, forcing you to travel to the next town to receive adequate maternity care?

This was a very real possibility for Moruya Hospital had they not engaged the Rural Locum Assistance Program (Rural LAP). Moruya Hospital is part of the Eurobodalla Health Service located on the South Coast of New South Wales. Lynette Munro, Acting Unit Manager for the Maternity Ward at Moruya Hospital, said “our maternity unit has been very shortstaffed with several midwives going on long term sick leave and others from our team having already booked leave in advance. So without the Rural LAP coming and saving the day the maternity unit would not have been able to run safely”.

Rural and remote health services often face difficulty in backfilling permanent staff that go on leave. It puts a strain on healthcare providers both financially and physically as they are either forced to pay additional fees and charges for agency locums or their remaining staff have to work the extra hours to cover these shifts.

Leanne Ovington, the Director of Nursing for the Eurobodalla Health Service which encompasses Batemans Bay and Moruya Hospitals, says the greatest benefit of the Australian Government-funded program is that it relieves the financial burden of hiring agency

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locums to cover leave.

“It is more economically viable. We don’t pay all of the extra fees that agencies charge.

We pay a Rural LAP nurse exactly the same as what we would pay one of our own staff. That creates a bit of equity in the workforce”.

The program has helped Moruya Hospital considerably reduce excess leave and use their casual pool of staff to cover unanticipated leave. This gives their permanent staff more freedom to go on mandatory training or annual leave without worrying that it will be cancelled.

Moruya Hospital has also been successful in facilitating multiple leave requests during the same roster period where previously this could not be guaranteed. “The program has allowed us to continue our normal hospital business but in a financially affordable way”. Ms Ovington concluded.

Rural LAP is a component of the Australian Government’s rural workforce capacity agenda managed by healthcare solutions provider, Aspen Medical. The program aims to provide targeted rural and remote support services to general practitioners (obstetricians and anaesthetists), specialists (obstetricians and anaesthetists), nurses, midwives and allied health professionals in rural and remote Australia.

For more information visit: www.rurallap.com.au.

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HealthTimes - March 2018 | Page 13

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About us At Murrumbidgee Local Health District we provide a range of public health services to the Riverina and Murray regions of New South Wales. Our Mental Health, Drug and Alcohol (MDHA) teams provide critical services within acute, sub-acute and community settings. We are known for our innovative models of care designed for the rural and regional population we serve. Some of our locations include Wagga Wagga, Griffith, Young, Deniliquin, Tumut, Temora and more.

About our roles We are always on the lookout for dedicated mental health clinicians from an array of backgrounds and experiences including: • Mental Health Emergency Consultation Service Clinicians and Clinical Leaders • Registered Nurses, Nurse Practitioner and Enrolled Nurses • Allied Health – OT, Social Work, Pharmacy, Psychology • Youth Mental Health Workers • Adult Mental Health Workers • Child and Adolescent Mental Health Workers

What's on offer?

• A range of flexible work options including full time and part time opportunities • Relocation assistance for eligible candidates – come and explore our regional communities!

• Competitive salary and packaging provisions including monthly ADOs • Ongoing professional development opportunities • The chance to work with great multidisciplinary teams

Learn more We’d love to speak with you about our opportunities.

Please call Sam Fraser on 0455 085 810 or email sam.fraser@health.nsw.gov.au You can also follow us on LinkedIn or Facebook to learn more about our services and organisation.

To view our MHDA roles please visit: https://healthnswgov.referrals.selectminds.com/mlhd

HealthTimes - March 2018 | Page 15

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Flight Nurses

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The Royal Flying Doctor Service is an Equal Opportunity Employer

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DID YOU KNOW? Bendigo Health is the lead provider of a new eight bed dual diagnosis residential rehabilitation facility opening early 2018. This facility will be Victoria’s first regional dual diagnosis service aiming to provide treatment to clients with co-existing mental health and substance use issues.

Bendigo Health has a variety of positions available for Registered Nurses and Enrolled Nurses to work in our new eight bed dual diagnosis residential rehabilitation facility. If you are a registered nurse or enrolled nurse with a special interest or previous qualification/experience in dual diagnosis this is an exceptional opportunity for you.

For more information or to apply

www.bendigohealth.org.au/careers HealthTimes - March 2018 | Page 17

Organisational psychologists beneficial in a time of #metoo and workplace bullying

O

ne in 5 people will encounter a mental health illness this year, according to new data published by Mental Health First Aid Australia, making mental disorders the third largest disease burden in the country, just behind cancer and cardiovascular disease.

But it’s not just the individual that’s impacted by mental illness. The broader community, along with the organisations that employ those combating such difficulties, also face significant challenges.

“A recent publication by the Mentally Healthy Workplace Alliance found that the economic cost of mental illness is in the vicinity of $11 Billion dollars each year, through absenteeism, presenteeism, reduced work performance increased turnover rates and compensation claims,” says Psychologist Norm Turkington.

“It is well recognised that as with most health matters prevention and/or early intervention is the key to reducing those costs.”

Which is why an increasing number of organisations and getting qualified psychologists on board, who are able to support organisations in becoming aware of the risks for mental health issues and to develop appropriate intervention strategies.

“A recent study by National Mental HealthCommission concluded that for every dollar spent on effective mental health actions

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returned $2.30 in benefits to the organisation,” says Mr Turkington.

But workplace understanding of the impact of mental illness is relatively new.

“Not so many years ago mental health was in the shadows and especially in organisations who preferred to avoid the matter altogether.

“Organisations recognise that having productive staff requires effort on their part by ensuring the work environment is supportive in many areas and sensitive to individual needs.

“Insurance companies also expect that organisations will develop appropriate intervention strategies to reduce or minimise the cost of mental health claims.”

While most businesses are aware of the need to access professional support whether it be legal, logistics, business planning or market dynamics, the importance of access to mental health professionals is only now beginning to be more fully understood.

“The need for professional support or intervention is needed more than ever because of the awareness of rights today,” says Mr Turkington.

“Most large organisation have an Employee Assistance Program (EAP) in place, however some of the smaller organisations either are not aware or can’t afford it.

“Considering that such a large part of the

as awareness of the potential consequences grows.

“Psychologists are able to add additional dimensions to an investigation into bullying by considering the potential causes, interpersonal dynamics and structural issues leading to the inappropriate behaviour, and of course recommending how those further issues could be addressed.

“It would not be unusual for a psychologist to make findings with regard to the bullying claims and to also make recommendations to ensure the matters do not arise again.

“This additional service would be further enhanced if the psychologist is a registered mediator who would then also have the skills to bring the parties together to establish an enduring resolution to the dispute.”

While large corporations are fortunate enough to have the resources to commit to addressing mental health matters, smaller organisations can struggle due to costs and the lack of access to the necessary professional supports.

“Psychologists are able to support an organisation’s Human Resource department with appropriate strategies, interventions and professional psychological advice relating to staff and staff matters.

“With the current appropriate focus on mental health psychologists are ideally suited to assist guide interventions and education.”

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population is employed in small business this may be a area for further awareness raising or development.”

Psychologists are able to support staff deal with a wide range interpersonal issues through evidence-based interventions.

One of the most difficult and sensitive situations is claims of sexual harassment, however in light of the #metoo movement, it’s an issue of increasing importance to organisations.

“Many people would be familiar with some of the more high profile cases that make the front pages of the papers but sadly so many more remain either silent or are resolved locally,” says Mr Turkington.

“For these claims the presumption of innocence is paramount as reputations can be severely damaged.”

Mr Trukington says the Australian Human Rights Commission found that 1 in 5 Australians have experienced sexual harassment in the workplace since the age of 15, and that overall, 68 per cent of sexual harassment takes place at work.

“Psychologists are acutely aware of the sensitivity for both parties and ideally placed to act in a supporting role for parties in sexual harassment cases.

“Most staff accept that a psychologist is a professional with the necessary rules and rigour about confidentiality.

“Psychologists are able to assist deal with these matters while maintaining the dignity of all concerned.”

Along with sexual harassment cases, workplace bullying is another area of concern,

Addressing language and mental health issues in the youth justice system

S

peech pathologist Rosie Martin was recognised as the 2017 Tasmanian Australian of the Year for her pro-bono work in prisons in the fields of adult literacy, and parenting communication through the circle of trust method. Her work not only improved their ability to communicate and build relationships, changing the trajectory of their lives beyond detention, but also brought hope to their families’ lives.

Poor social communication skills, ability to recognise and respond to the communication of others, and difficulties managing emotions. In a report from the (UK) Royal College of Speech and Language Therapists last year, it was found that 60% of children in contact with youth justice services present with speech, language and communication difficulties – and recent Australian headlines have indicated previously unidentified high levels of incarcerated individuals with intellectual disability and/ or traumatic brain injury, conditions which are regularly paired with communication impairment.

The role of speech pathologists in language and social development has, to date, been underrecognised by institutional bodies, despite the consensus that better communication skills can improve children’s lives. But Mary Woodward from Speech

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Pathology Australia has been touring the country on a mission to change that.

“Young people with language difficulties struggle to acquire literacy, they struggle in school, disengage with education, and they are more likely to engage in crime. It is here that their behaviour is recognised – and their carers have missed the opportunity to identify underlying reasons as to what is causing the problems.”

Woodward has just taken on a new role as National Advisor for Justice and Mental Health, where she has been meeting with state and federal representatives of the justice system, advising on ways to improve communication and literacy programs within correction and rehabilitation centres, in order to address mental health problems in youth.

“I recently travelled to Western Australia to meet with policy advisors, along with the commissioner for corrective services and the commissioner for young people. There was lots of interest in how to address these issues, such as setting up an independent intermediary pilot scheme based on one that operates in England and Wales. “ “A similar pilot is running in Victoria, whereby speech pathologists assist police or court officials as part of the justice system in assessing and managing communication

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context; and having difficulties engaging in conversation.

With proper treatment of communication difficulties through a tailored speech pathologist treatment plan, mental health conditions such as schizophrenia and autism can also be identified and correctly treated.

Woodward says the need for language and communication support in the youth justice system is enormous, with every jurisdiction having different processes, funding structures and laws, but her new role adds more credibility to previous work. She has already seen new speech pathologist roles implemented within Queensland and Victorian youth justice centres, and is aware of others in Tasmania, Victoria and New South Wales.

HealthTimes - March 2018 | Page 21

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difficulties, such as identifying communication breakdowns and supporting the process throughout cross examination, interviews, and the like. The speechies are acting on behalf of the court, not the defendants.�

When it comes to early intervention, there is a lack of funding for community-based paediatric speech pathologists, Woodward says, with free or subsidised treatment ending at five years of age. It is the people who are less likely to be able to access or afford private therapy who need it the most. School counsellors, community health nurses and GPs play a big role in picking up the red flags which can include: An inability to initiate or maintain peer friendships; struggling with literacy; missing the point in a conversations; providing brief or monosyllabic answers; being aggressive to avoid questions; using common words out of

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ECG INTERPRETATION WORKSHOP MELBOURNE- 30 MAY 2018 BRISBANE - 19 SEPTEMBER 2018 For more information and to book tickets go to: Melbourne: http://bit.do/ECGMELB Brisbane: http://bit.do/ECGBRIS

Enquiries: Contact HealthTimes 1300 306 582 Contact@healthtimes.com.au PRESENTED BY

In this clinically based workshop you will have the opportunity to develop skills and confidence to examine ECGs and readily identify abnormalities associated with cardiac or lung disease or associated with toxicological or biochemical disorders.

The workshop is delivered using an interactive, problem based approach that first allows participants to examine a series of ECGs in a small group before joining a large group discussion led by the facilitators that explores the ECG findings in detail.

Suited to Nurses and Medical officers (GP, Registrars, TMOs, SMOs). It is also likely to be of assistance to final year medical / nursing students and to paramedics.

Price - $250 (Early Bird $199) Tickets strictly limited

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Latrobe Regional Hospital Mental Health Service The Latrobe Regional Hospital (LRH) Mental Health Service is the regional provider of mental health services in Gippsland. LRH Mental Health Service operates an integrated specialist mental health program across ten sites and provides inpatient and community mental health care for adults, children and young people, and older persons. LRH Mental Health Service also operates a Community Residential Care Unit,Prevention and Recovery Care Unit and a Parent and Infant Unit.

Eight community mental health centres are located in Traralgon, Sale, Bairnsdale, Orbost, Wonthaggi, Korumburra, Warragul and Yarram. Gippsland provides a fantastic regional lifestyle with easy access to Melbourne.

LRH Mental Health Service isa recovery oriented and trauma informed service and we are seeking dynamic and passionate staff to join our team.

The following positions are available now: Trainee Positions - If you have recently completed a Bachelor of Nursing Degree or an Allied Health qualification (Social Work, Psychology, Occupational Therapy) and are seeking a career in mental health - we have trainee nursing/allied health and mid-year intake graduate nurse positions available across our inpatient AND community AND specialist programs! Please contact us to discuss your new and exciting mental health career.

Team Manager Grade 5 - Wonthaggi/Korumburra Community Mental Health Service

Acute Community Intervention Service Grade 3/4 - Mental Health Clinicians and Consultation Liaison

Mental Health Nurses

Grade 4 - Mental Health and Police Response - Bairnsdale

Grade 3 Enrolled Nurse - Complex Care Position - Adult Community

Associate Nurse Unit Manager Grade 3 - Inpatient Unit - Aged

Registered and Enrolled Nurses Grade 2 - Inpatient Units - Aged, Adult - Full-time/Part-time/Casual

Community Mental Health Clinicians Grade 3/4 - Adult, Aged and Child and Youth Mental Health

Services - Sale, Warragul, Bairnsdale, Latrobe Valley

Senior Project Manager RN 5 - Eating Disorders Clinical Pathway

Grade 4 Dialectical Behaviour Therapy Coordinator - Specialist and Therapeutic Programs

Grade 4 Families where a Parent has a Mental Illness (FaPMI) Coordinator - Specialist and

Therapeutic Programs

Grade 4 - Senior Clinician - Prevention and Recovery Care Service - Bairnsdale

LRH Mental Health Service offers a supportive environment with clinical educators, preceptors, clinical supervision, a nurse practitioner mentoring program and professional development opportunities.

Please visit www.lrh.com.au and go to our employment sections to view current vacancies and register your interest. For enquiries please contact CayteHoppner, Director of Mental Health on (03) 5173 8549 or email choppner@lrh.com.au.

HealthTimes - March 2018 | Page 23

Mental Health Nurses hold a crucial but undervalued place in the Australian mental health sector

M

ental Health Nurses are undervalued in Australia, according to a Southern Cross University professor, who says mental health funding and scope of practice for disciplines should be bound by capability, not professional discipline.

“Mental Health Nurses work across all stepped care health settings but experience significant barriers working outside of state funded mental health services,” says Professor John Hurley.

“The highly medicalised treatment of mental health problems within tertiary care settings reflects parts of the nursing scope of practice with medications and physical health care,” he says.

“Simultaneously, Better Access to Mental Health Care, the largest Medicare based fund for providing mental health services in primary care settings, operates with Mental Health Nurses as the only professional discipline barred from accessing it.”

According to Professor Hurley, if a mental health service with a consumer focus was being constructed from scratch, it would not look like the Australian system does today.

“Funding and scope of practice for disciplines should be capability bound, not bound by professional discipline,” he says.

“The mental health system has been described in multiple national reports and commissions as being fragmented, complex and

Page 24| HealthTimes.com.au

not consumer friendly.”

Professor Hurley says arguably most damaging factor hindering the progression of Mental Health Nurses is the generalist undergraduate training, which does little to prepare qualifying Registered Nurse to work as a Mental Health Nurse.

“Post Graduate education is therefore needed, but there is a paucity of Commonwealth Supported Funding for those Registered Nurse’s to undertake that Post Graduate education.

“The possibilities are unlimited in one sense, as to how much post graduate education the mental health nurse is willing to undertake.

“They will, however, in primary health care be restricted by funding arrangements, and more broadly, by historical expectations of nursing being in service to other disciplines.”

While it other countries, mental health nurses are considered leaders in their fields, Australia doesn’t value the profession in the same way, said Professor Hurley.

“Nurses in Australia are leaders who have a capability set that includes clinical governance, translational research, evidence based practice, complex clinical care provision and coordination.

“However, they are arguably not seen as being leaders by government, other disciplines and the wider public.

by the medical profession, instead of being autonomous practitioners working in partnership with the multidisciplinary team.

“The individual capabilities and consumer based outcomes achieved by CMHNs through the MHNIP radically exceeds the policy based expectations of them.”

State run mental health services should invest in the nursing workforce generally, and the ental health nursing workforce more specifically, says Professor Hurley, in order to capitilise on their unique skill set.

“No one discipline ‘owns’ compassion, trust, empathy and consumer centeredness, however nurses are recognised for being just these things.

“Less recognised is the nurses’ capabilities in formulating and delivering complex clinical interventions and judgments.

“This fusion of technical capability alongside emotional intelligence makes an ideal leadership skill set that can only benefit the country’s health system.”

Unfortunately though, mandatory training regimes are not responding to consumers’ needs, but rather the needs of the health service.

“Mental health nursing is a specialist field of nursing practice, however there is scant mental health content within the undergraduate preparation of nurses, with the curriculum having an historical bias toward predominantly surgical and medical nursing within hospital contexts.

“Underprepared registered nurses are entitled to work within mental health settings despite having little preparation to do so.

“The creation of career pathways for nurses wanting to undertake mental health work stretching from initial entry into their undergraduate training through to post graduate education is hence vital to improve consumers’ experiences of care through having a specialist skilled workforce.”

HealthTimes - March 2018 | Page 25

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“This is in part due to the historical female makeup of the workforce within a country that, even in the 21st century, still has significant gender gaps in both pay and holders of executive level positions.

“Additionally both medical and psychology have historical dominance and political leverage to position themselves onto decision making committees and policy making groups.”

In Australia, the NMBA does not recognise or endorse specialty areas of nursing practice, as the undergraduate training is a comprehensive rather than being specialist focussed.

“The strength and influencing power of the medical profession is such that leadership existing from outside that professional group is often not considered by policy makers.”

Which is why post graduate education is important in order to boost the presence and value of mental health nurses within the sector.

A Credentialed Mental Health Nurse is recognised by the Australian College of Mental Health Nursing as being the only specialist qualification for the profession, having successfully undertaken post graduate education, at least 3 years’ experiences and a record of ongoing professional development.

“Credentialed Mental Health Nurses will be delivering psychological therapies, undertaking psychosocial interventions, medication based interventions, holistic assessments and care coordination.”

Despite this, they remain underpaid and undervalued, says Professor Hurley.

“CMHNs have access to only one stream of medicare based funding (the Mental Health Nurse Incentive Programme), which contrasts poorly with other disciplines, some with less specialist training.

“The remuneration is poor and has not been increased for some 9 years.

“The CMHN, through the funding rules, are seen as only the enactors of care plans devised

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Treating depression with exercise: what does an accredited exercise physiologist do?

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ith depression being hailed the third highest cause of disease burden worldwide, often overlapping with other chronic conditions, the media is full of news about the latest mental health treatments. pressants have been proved to work. So has talk therapy. Exercise is a known lifestyle change that can improve mental health, but often people don’t know where to start and they can be dealing with other problems caused by their depression such as weight gain, social anxiety and withdrawal.

So how does exercise help?

A study conducted by Guszkowska, 2004 found that improvements in mood are proposed to be caused by exercise-induced increase in blood circulation to the brain and by an influence on the hypothalamicpituitary-adrenal (HPA) axis and, thus, on the physiologic reactivity to stress.

Other studies have found that it is the selfefficacy, distraction and social interaction that exercise can bring that is actually beneficial. The brain learns to be too busy concentrating on the exercise that it forgets to generate stress and fear, which lead to anxiety and depression.

Group exercise is often encouraged, but doesn’t work for everyone – which is where an

Page 26 | HealthTimes.com.au

exercise physiologist can be a great help. The presence of a highly specialised professional coach can provide the same motivation as the fear of letting down teammates.

Accredited exercise physiologists who specialise in mental health are able to identify and respond to behaviours arising from mental illness, being aware of the side effects from any medications the patient may be on (such as dizziness or elevated blood pressure).

They understand how their work fits into the multi-disciplinary mental health team of GP, psychologist and chronic health educator to produce a client-centred standard of care.

Techniques include motivational and goalsetting strategies, physical activity and healthy eating education and assistance in reducing the stigma of participating in mental health services; one of many barriers for those resisting exercise.

Exercise to treat mental illness has been shown to decrease symptoms of depression, anxiety, stress and schizophrenia. It improves sleep quality and social engagement; and reduces cravings and withdrawal in substance use disorders and alcohol addiction (ESSA consensus on role of AEP in treatment of mental disorders, 2015).

People who have ongoing mental health conditions such as depression are able to receive Medicare rebates for up to five sessions per year with an Exercise Physiologist under the Chronic Disease Management Plan. Private psychologists/psychiatrists are also able to refer to accredited exercise physiologists, which most health funds recognise under allied health cover.

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HealthTimes - March 2018 | Page 27

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Mothers with mental health issues more likely to have babies with reflux

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nfants admitted to the two NSW residential parenting services Karitane and Tresillian within their first year for gastro-oesophageal reflux (GOR) or gastro-oesophageal reflux disease (GORD) had a strong association of maternal anxiety, according to a study undertaken by Western Sydney University.

While the focus group analysis discussed the reasons for the increase in GOR/GORD diagnosis in recent years, and the overlap between the parental social influences; the medical model of care; and the medical over-diagnosis and tendency to prescribe medications before treating underlying psychological factors, the data did show maternal health pre- and post- birth played a role in the rate of infant oesophageal, respiratory and sleep difficulties.

The study indicated that a maternal mental condition had the strongest correlation with GOR/ GORD, increasing the likelihood of occurrence fivefold within the first twelve months of life.

Other findings included the presentation of GOR/GORD in babies is more common to mothers who are: • Australian-born; • Having their first child; • Giving birth in a private hospital, via caesarean section; • Having a pre-term or early term infant (37 or 38 weeks); • Having a male infant, who spent time in the NICU; and • Suffering from a psychiatric condition (most commonly anxiety) This additional information suggests that the disturbance of the gut microbiome via caesarean section, and antibiotics administered in NICU could also be contributing factors to the infant GOR/ GORD diagnosis.

Page 28 | HealthTimes.com.au

However, maternal health and parenting resources showed the highest correlation in infant reflux symptom responsiveness once GOR/GORD presented.

Research leader Professor Hannah Dahlen from the University’s School of Nursing and Midwifery says, “A cycle of anxiety in the mother and unsettled behaviour in the baby, leads to more anxiety in the mother and therefore a more unsettled baby.”

“This does not mean that there is not a legitimate medical issue with the infant, or that the symptoms of reflux are in some way imagined. But it may mean that the medical issues are exacerbated when the mother is not coping.”

Rather than blaming mothers for ‘fussing’ over their babies, this research provides even more reason to help women with their post-natal mental health. GOR is common in infants, and while distressing, it is a short-term condition. Over-treatment can contribute to delaying diagnosis and treatment for the more serious GORD, which is a chronic condition and can affect a child’s development.

“We focus so much on birth as a medical or increasingly a surgical event, and not enough on how women are coping. This research tells us that ignoring this is to the detriment of women, their babies and families.”

“If health professionals delved a little deeper, they would find that it may be the mothers that actually need help – and sometimes, there may be better ways to deal with the issues without the need for anti-reflux medication.”

For the full article visit HealthTimes.com.au

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HealthTimes.com.au Page 30 | HealthTimes.com.au

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HealthTimes - March 2018 | Page 31

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