Illness In Australia Research Articles

Using telehealth for people at the end of life with chronic illness in Australia.

Traditional models of palliative care have been tested by the challenges of caring for increasing numbers of people at the end stages of a chronic non-malignant illness. The COVID-19 pandemic and consequent reliance on telehealth services, has enabled the development of creative models of care. To improve home-based palliative care for people with chronic illness using telehealth, and this was demonstrated using quality-of-life measures. A total of 35 non-cancer referrals to a community palliative care service were recommended for the pilot project, with one specialist palliative care nurse as their contact. All were offered a telehealth service with a specially designed app to self-monitor their symptoms, a session on advance care directives, and self-rated quality-of-life measures using the RAND 36-Item Health Survey (Version 1.0), consisting of 36 items that cover nine domains. Statistical analysis was performed using SPSS software. Over the 21 months of the pilot study, 13 people chose to participate in the pilot. For participants, telehealth meant more control over their symptoms, fewer emergency presentations and appointment travel time was alleviated. Quality-of-life surveys highlighted physical impairments, which did not change over time. This pilot programme demonstrated an innovative approach to addressing the demands of people dying of chronic illness, with further work required to explore the place of telehealth consultations in the overall healthcare system.

The Influence of Health Literacy and Self-Management on Emergency Healthcare Access for Rural Asthmatics: A Patient's Perspective.

Asthma is a leading cause of respiratory illness in Australia and has a significant prevalence in rural areas. Literature suggests living in rural areas can act as a barrier to receiving emergency healthcare for asthma exacerbations resulting in the need for further resources and advocacy in educating rural asthmatics about managing their condition and knowing when to access further help. This study aims to explore decision-making in accessing emergency healthcare for people with moderate to severe asthma exacerbations in rural New South Wales (NSW). A qualitative interpretative design involving semi-structured interviews with 12 participants was conducted between May and July 2021. Interviews were recorded and transcribed verbatim. Participants were asthmatics who had accessed emergency healthcare for a moderate to severe asthma exacerbation in NSW over the last five years. Data was thematically analysed and grouped into four overarching themes. Due to the depth and range of data this paper will be reporting on two of those themes. Past experiences as education and the impact of self-management strategies were both shown to be prominent influences that affected decisions on choosing to access emergency healthcare during a moderate to severe asthma exacerbation. Participants shared how their decision-making was shaped by health literacy gained from their past experiences of asthma exacerbations and dealing with emergency healthcare. In addition, self-management strategies were utilised to minimise the need to access emergency healthcare. This was achieved through telehealth appointments, lifestyle changes and non-pharmacological strategies. This study shows that an increase in health promotion activities throughout rural areas can help to reassure people about uncertainties that may be associated with their past experiences and improve health literacy. Additionally, providing tools to allow confident self-management of asthma effectively using evidence-based techniques to prevent it progressing to a moderate or severe exacerbation would also be of benefit.

What are the evidence bases for developing models of rehabilitation for older people with mental illness in Australia?

This paper updates clinicians and service leaders on evidence bases relevant to rehabilitation for older Australians with mental illness. Narrative review of literature and relevant public domain data supported by reflections on NSW service development. There is a paucity of high-quality evidence regarding mental health rehabilitation in older people. Available evidence supports integrating lessons from physical healthcare with adaptations of 'adult' mental health rehabilitation. Adaptation is required to respond to the specific needs, strengths and service use of older people with mental illness. Challenges for older people include ageism, increased physical and cognitive comorbidities, lower access to mental health services and earlier residential aged care entry. Strengths of older people include an ongoing desire for recovery, ongoing developmental change and often closer connections with carers and GPs. Evidence is consistent with evaluation of relevant NSW service models and initiatives including the Pathways to Community Living Initiative. Integration of recovery-oriented practice and wellness models may provide a framework for future innovative inpatient and community-based models. There is sufficient evidence to guide development of models of rehabilitation with older people, but innovation and evaluation are essential if older people are to have equal opportunities in their recovery journeys.

FluTracking: Weekly online community-based surveillance of influenza-like illness in Australia, 2019 Annual Report

FluTracking provided evidence for an early, long, but moderate influenza season in the Australian community compared to prior years. Influenza-like illness (ILI) activity in 2019 peaked earlier (week ending 16 June) than any season on record in FluTracking data. ILI attack rates were above average early in the 2019 season (peak of 2.2%), and the duration of peak activity was longer than most prior years. However, ILI attack rates were lower than the five-year average in the latter half of the season. FluTracking participants reported higher vaccination coverage in 2019 (73.3%) compared with 2018 (65.7%), with the most notable increase in children aged less than five years (69.3% in 2019, compared to 55.6% in 2018). The total 2019 count of laboratory notifications (312,945) was higher than prior years (2007 onwards), and the peak weekly count of 18,429 notifications in 2019 was also higher than all prior years, except 2017. FluTracking makes a comparison to another surveillance system each year. The peak weekly percentage of calls to HealthDirect that were influenza-related was higher in 2019 (12.8%) than for 2014-2018 (range of 8.2-11.4% for peak week of activity each year). FluTracking participants reported a 2.5 times increase in influenza testing from 2018 to 2019 and a 1.5 times increase from 2017. Although 2019 was of higher activity and severity than 2018, Flutracking data indicates that 2019 was a lower activity and severity season than 2017, and notifications and influenza-related calls were heightened by increased community concern and testing.

“It’s important to manage our stress”: Mental health advice in the Australian print news media during the COVID-19 pandemic

The COVID-19 pandemic has heightened existing concerns about mental health and illness in Australia. The news media is an important source of health information, but there has been little research into how advice about mental health is communicated to the public via the news media. In this study, we examined how advice about building and maintaining mental health was discursively constructed in the news media during the COVID-19 pandemic. A discourse analytic approach informed by critical discursive psychology was employed to analyse 436 articles published in daily newspapers in Australia between 1 January and 31 December 2020, which contained references to mental health and the COVID-19 pandemic. Three main interpretative repertoires were identified – negative emotions are a risk to mental health and must be managed; risky emotions should be managed by being controlled (based around a ‘border control’ metaphor); and risky emotions should be managed by being released (based around a ‘pressure cooker’ metaphor). This study demonstrates that, amid the COVID-19 pandemic, advice constructed negative emotions as risky and problematic; and normalized the habitual management of emotions by individuals through strategies of control and release. Potential implications of such discourses for goals of improving population mental health are discussed.

Digital mental health and employment - Lessons from the Australian experience

Background and objectivesThis paper reviews Australia's take-up of digital mental health interventions, including some specific reference to their application in relation to employment. Use of these interventions in Australia was already significant. Under COVID-19 they have exploded. The Australian experience offers useful lessons for European and other countries, and these are summarised. MethodsThis paper presents a narrative review of key texts, resources, policies and reports, from government and other sources. It also presents data reflecting the take-up of digital mental health services and the employment of people with a mental illness in Australia. ResultsWe present data showing the explosion in uptake of digital mental health services. There is very limited evidence about the impact of these services in improving employment outcomes for people with a mental illness in Australia. The Government has moved to make them a permanent feature of mental health care, in addition to traditional face-to-face care. ConclusionKey lessons emerge from the Australian experience, including the need for target clarity; the importance of blending digital services into broader frameworks of mental health care; the need for quality and safety standards to be developed and applied to digital services; and the need for better evaluation of the outcomes of digital interventions in the workplace.The digital mental health genie is out of the bottle. New capacity for evaluation of the outcomes of digital mental health services is vital to ensure value and quality of such investments.

FluTracking: Weekly online community based surveillance of influenza-like illness in Australia, 2018 Annual Report.

FluTracking experienced major growth in 2018, with participation numbers increasing 34.1% from 2017. The addition of 16,881 new participants brought the total number of participants for 2018 to 45,532. A majority of participants continued to complete their survey within 24 hours of the email being sent (mean 74.3% responses received in 24 hours). The rate of influenza-like illness (ILI) in 2018 was the lowest since FluTracking commenced in 2007 and was consistently low across all ages. The peak weekly ILI rate was consistent with previous years, occurring during the week ending 19 August. This preceded the peak in laboratory-confirmed influenza notifications by three weeks. During the peak week of FluTracking, 2.1% of unvaccinated, and 1.9% of vaccinated participants reported fever and cough. By the final survey of 2018, 65.6% of participants had received the annual influenza vaccine, compared with 60.2% in 2017. Vaccination rates in participants under five years of age doubled from 23.7% in 2017, to 55.6% in 2018. During the peak four weeks of reported ILI, a lower percentage of participants sought medical care in 2018 compared to 2017 (36.7% and 42.3% respectively), and fewer participants reported a positive laboratory test for influenza (0.8% and 4.8%). Overall the severity of the 2018 season was one of the lowest FluTracking has recorded. Rates of both influenza laboratory notifications and general practitioner (GP) ILI consultations were lower in 2018 than most prior years. We found a reduction in the percentage of FluTracking participants with ILI who were tested for influenza (3.2% compared with 5.0% in 2017), and who visited a medical practitioner (36.7% compared with 42.3% in 2017). The drop in laboratory-confirmed cases and Australian Sentinel Practices Research Network (ASPREN) reported GP consultations concurs with our survey results that 2018 was a milder influenza season than many previous.

Individual and national financial impacts of informal caring for people with mental illness in Australia, projected to 2030.

Mental illness has a significant impact not only on patients, but also on their carers' capacity to work. To estimate the costs associated with lost labour force participation due to the provision of informal care for people with mental illness in Australia, such as income loss for carers and lost tax revenue and increased welfare payments for government, from 2015 to 2030. The output data of a microsimulation model Care&WorkMOD were analysed to project the financial costs of informal care for people with mental illness, from 2015 to 2030. Care&WorkMOD is a population-representative microsimulation model of the Australian population aged between 15 and 64 years, built using the Australian Bureau of Statistics Surveys of Disability, Ageing and Carers data and the data from other population-representative microsimulation models. The total annual national loss of income for all carers due to caring for someone with mental illness was projected to rise from AU$451 million (£219.6 million) in 2015 to AU$645 million (£314 million) in 2030 in real terms. For the government, the total annual lost tax revenue was projected to rise from AU$121 million (£58.9 million) in 2015 to AU$170 million (£82.8 million) in 2030 and welfare payments to increase from AU$170 million (£82.8 million) to AU$220 million (£107 million) in 2030. The costs associated with lost labour force participation due to the provision of informal care for people with mental illness are projected to increase for both carers and government, with a widening income gap between informal carers and employed non-carers, putting carers at risk of increased inequality.

Integrating General Practice Into the Australian COVID-19 Response: A Description of the General Practitioner Respiratory Clinic Program in Australia

Integrating primary care with the health response is key to managing pandemics and other health emergencies. In recognition of this, the Australian Government established a network of respiratory clinics led by general practitioners in response to the coronavirus disease 2019 (COVID-19) pandemic as part of broader measures aimed at supporting primary care. General practitioner (GP) respiratory clinics provide holistic face-to-face assessment and treatment to those with respiratory symptoms in an environment with strict protocols for infection prevention and control. This ensures that these patients are able to access high quality primary care while protecting the general practice workforce and other patients. The GP respiratory clinic model was developed and operationalized 10 days after the policy was announced, with the first 2 respiratory clinics opening on March 21, 2020. Subsequently a total of 150 respiratory clinics were opened and served over 800,000 patients within more than 99% of Australia's postcodes. These clinics used a standardized data collection tool that has provided the largest and most complete primary care surveillance database of respiratory illness in Australia. The success of the GP respiratory clinic model was made possible due to strong partnerships with Primary Health Networks and individual general practices that rapidly shifted operations to embrace this new approach. This article describes the development and early implementation of this model.

Operational response: Policing persons with mental illness in Australia

Across the globe, policing persons with mental illness (PWMI) in crisis involves significant police work. Police must respond effectively to individuals whose behaviour and language are often erratic, and who may be intoxicated or experiencing psychosis. In Australia, police are often criticised for inappropriately handling mental health crises in the community and for differentially policing PWMI in crisis. To better understand Australian police response to PWMI in crisis, this study conducted interviews with 25 operational police officers working in one of the largest Australian state police organisations. The findings indicate that police response to PWMI in crisis is underpinned by trial-and-error practices, because officers are insufficiently trained to manage PWMI in crisis, and police are resistant to accept tasks considered ‘welfare work’. Officers are also relieved when response to PWMI in crisis includes mental health practitioners. We argue that whilst the availability of interagency schemes in Australia is generally restricted to metropolitan areas, effective policing response to PWMI in crisis should include a collaborative response between police and mental health practitioners.

Vibrio parahaemolyticus: an Australian perspective

A recent outbreak of gastroenteritis caused by Vibrio parahaemolyticus following consumption of South Australian oysters has brought to the forefront an increasing hazard for the Australian oyster industry and consumers. Vibrio pathogens have been sparsely implicated in illnesses in Australia; however, rising sea temperatures and varied weather conditions delivered by climate change could be driving the increased prevalence of these pathogens in our oyster growing regions. This is a brief overview of Vibrio parahaemolyticus, the risk it presents to our industry and consumers, and an insight into the limitations involved with detection and identification of the pathogen in foods.

Added Value of Genomic Surveillance of Virulence Factors in Shiga Toxin-Producing Escherichia coli in New South Wales, Australia.

The disease caused by Shiga toxin-producing Escherichia coli (STEC) remains a significant public health challenge globally, but the incidence of human STEC infections in Australia remains relatively low. This study examined the virulence characteristics and diversity of STEC isolates in the state of New South Wales between December 2017 and May 2020. Utilisation of both whole and core genome multi-locus sequence typing (MLST) allowed for the inference of genomic diversity and detection of isolates that were likely to be epidemiologically linked. The most common STEC serotype and stx subtype detected in this study were O157:H7 and stx1a, respectively. A genomic scan of other virulence factors present in STEC suggested interplay between iron uptake system and virulence factors that mediate either iron release or countermeasures against host defence that could result in a reduction of stx1a expression. This reduced expression of the dominant stx genotype could contribute to the reduced incidence of STEC-related illness in Australia. Genomic surveillance of STEC becomes an important part of public health response and ongoing interrogation of virulence factors in STEC offers additional insights for the public health risk assessment.

First record of the stump-tailed lizard tick, Amblyomma albolimbatum (Ixodida, Ixodidae) parasitising a human.

Ticks are haematophagous arthropods that parasitise a wide range of vertebrate hosts. In Australia, there are currently 74 tick species described; 22 tick species have been reported parasitising humans. The stump-tailed lizard tick, Amblyomma albolimbatum, feeds on reptiles, most commonly lizards and snakes; however, we report the first case of A. albolimbatum parasitising a human. The nymphal tick was removed while conducting fieldwork on western tiger snakes (Notechis scutatus occidentalis) in an urban city environment near Perth, Western Australia. The tick was identified using morphological descriptions, which was further supported by the abundance of all parasitic stages of A. albolimbatum on the tiger snakes sampled. The number of tick species recorded from humans in Australia is now revised to 23 species. With the increasing incidence of tick-borne illnesses in Australia, this study highlights the need to report cases of new or atypical hosts, particularly humans, and especially when the ticks have been associated with zoonotic pathogens.

Youth Mental Health Peer Support Work: A Qualitative Study Exploring the Impacts and Challenges of Operating in a Peer Support Role

Youth aged 16–24 years have the highest prevalence of mental illness in Australia, accounting for 26% of all mental illness. Youth mental health peer support work is a promising avenue of support for this population. However, limited research has examined impacts on those who provide youth mental health peer support work. We aimed to identify the benefits and challenges of working in a youth mental health peer support role. Semi-structured qualitative interviews with seven purposefully sampled peer workers from a national youth mental health organisation in Australia were conducted. The interviews were thematically analysed. Six key themes were identified: (1) personal growth, (2) interpersonal factors, (3) organisational factors, (4) boundaries, (5) role acknowledgement, and (6) challenging situations. Key supportive factors included financial reimbursement, training, support, and role-related flexibility. Identified challenges included lack of role acknowledgement, role-related stress, and boundaries. Operating within a youth mental health peer support role is perceived to have positive impacts on personal growth and interpersonal factors, enhanced through financial reimbursement, supervision, and role-related flexibility. Perspectives on the most effective form of role boundaries were diverse however their importance in addressing challenges was emphasised.

1539Australia’s worsening mental health – what’s next?

Abstract Background The population prevalence of mental illness over time, and by sociodemographic subgroups, are important benchmark data. Examining reliable population level data can highlight groups with greater mental-illness related symptom burden and inform policy and strategy. Methods Secondary analysis of Australian National Health Surveys (n = 78,204) from 2001-02 to 2017-18. Trends in the prevalence of very high scores on the Kessler-10 (K10), a measure of psychological distress capturing symptoms of affective and anxiety disorders, were examined by time, age, gender, and socioeconomic status. Data were standardised to the 2001 Australian census population on the strata of sex and age. Results In 2017-18, the rate of probable mental illness was estimated at 5.1%, a 1.5% increase (representing an additional 367,000 Australians) since 2007. In 2017-18, the subgroups with the highest rates were women aged 18-24 (8.01%, 95% CI = 5.9%-10.2%), and the poorest fifth of Australians (8.02%, 95% CI = 7.0%-9.0%). Women aged 55-64 demonstrated the greatest increase in rates (2001: 3.5%, 95% CI = 2.5%-4.6%; 2017: 7.2%, 95% CI = 5.9%-8.5%; z = 4.10, p ≤ 0.001). Conclusions Despite efforts to improve population mental health, rates of probable mental illness in Australia have increased since 2007. Findings will be discussed in conjunction to extant social and health policies, and potential gaps in the delivery of gold-standard mental health care. Key messages The rate of probable mental illness in Australia seem to be increasing, especially in women aged 55-64, and those from low-SES backgrounds.

806Advances in the use of primary care databases for monitoring health outcomes in Australia

Abstract Focus and outcomes for participants Modern technologies offer innovative ways of monitoring health outcomes. Electronic medical records (EMRs) stored in primary care databases provide comprehensive data on infectious and chronic conditions such as diagnosis, medications prescribed, vaccinations, laboratory results, and clinical assessments. Moreover, they allow the possibility of creating a retrospective cohort that can be tracked over time. This rich source of data can be used to generate results that support health policymakers to improve access, reduce health costs, and increase the quality of care. The symposium will discuss the use and future of routinely-collected EMR databases in monitoring health outcomes, using as an example studies based on the MedicineInsight program, a large general practice Australian database including more than 3.5 million patients. This symposium welcomes epidemiologists, researchers and health policymakers who are interested in primary care settings, big data analysis, and artificial intelligence. Rationale for the symposium, including for its inclusion in the Congress EMRs are becoming an important tool for monitoring health outcomes in different high-income countries and settings. However, most countries lack a national primary care database collating EMRs for research purposes. Monitoring of population health conditions is usually performed through surveys, surveillance systems, or census that tend to be expensive or performed over longer time intervals. In contrast, EMR databases are a useful and low-cost method to monitor health outcomes and have shown consistent results compared to other data sources. Although these databases only include individuals attending primary health settings, they tend to resemble the sociodemographic distribution from census data, as in countries such as Australia up to 90% of the population visit these services annually. Results from primary care-based EMRs can be used to inform practices and improve health policies. Analysis from EMRs can be used to identify, for example, those with undiagnosed medical conditions or patients who have not received recommended screenings or immunisations, therefore assessing the impact of government programmes. At a practice-level, healthcare staff can have better access to comprehensive patient histories, improving monitoring of people with certain conditions, such as chronic cardiac, respiratory, metabolic, neurological, or immunological diseases. This information provides feedback to primary care providers about the quality of their care and might help them develop targeted strategies for the most-needed areas or groups. Another benefit of EMRs is the possibility of using statistical modelling and machine learning to improve prediction of health outcomes and medical management, supporting general practitioners with decision making on the best management approach. In Australia, the MedicineInsight program is a large general practice database that since 2011 has been routinely collecting information from over 650 general practices varying in size, billing methods, and type of services offered, and from all Australian states and regions. In the last few years, diverse researchers have used MedicineInsight to investigate infectious and chronic diseases, immunization coverage, prescribed medications, medical management, and temporal trends in primary care. Despite being initially created for monitoring how medicines and medical tests are used, MedicineInsight has overcome some of the legal, ethical, social and resource-related barriers associated with the use of EMRs for research purposes through the involvement of a data governance committee responsible for the ethical, privacy and security aspects of any research using this data, and through applying data quality criteria to their data extraction. This symposium will discuss advances in the use of primary care databases for monitoring health outcomes using as an example the research activities performed based on the Australian MedicineInsight program. These discussions will also cover challenges in the use of this database and possible methodological innovations, such as statistical modelling or machine learning, that could be used to improve monitoring of the epidemiology and management of health conditions. Presentation program The use of large general practice databases for monitoring health outcomes in Australia: infectious and chronic conditions (Professor Nigel Stocks) How routinely collected electronic health records from MedicineInsight can help inform policy, research and health systems to improve health outcomes (Ms Rachel Hayhurst) Influenza-like illness in Australia: how can we improve surveillance systems in Australia using electronic medical records? (Dr Carla Bernardo) Long term use of opioids in Australian general practice (Dr David Gonzalez) Using routinely collected electronic health records to evaluate Quality Use of Medicines for women’s reproductive health (Dr Luke Grzeskowiak) The use of electronic medical records and machine learning to identify hypertensive patients and factors associated with controlled hypertension (Ms Jackie Roseleur) Names of presenters Professor Nigel Stocks, The University of Adelaide Ms Rachel Hayhurst, NPS MedicineWise Dr Carla Bernardo, The University of Adelaide Dr David Gonzalez-Chica, The University of Adelaide Dr Luke Grzeskowiak, The University of Adelaide Ms Jackie Roseleur, The University of Adelaide

The Productivity Commission inquiry into mental health.

The report of the Productivity Commission Inquiry into mental health was released in November 2020, estimating the economic cost of mental illness in Australia at over $200 billion a year. The report makes wide-ranging recommendations for improving the mental health of the population, reforming the mental health treatment system, and in the way mental health is managed in other sectors of society.

Barriers to influenza vaccination of children hospitalised for acute respiratory illness: A cross-sectional survey.

To identify barriers to influenza vaccination of children hospitalised for acute respiratory illness in Australia. A total of 595 parents of children hospitalised with acute respiratory illness across five tertiary hospitals in 2019 participated in an online survey. Multivariate logistic regression identified factors most strongly associated with influenza vaccination barriers. Odds of influenza vaccination were lower with lack of health-care provider (HCP) recommendation (adjusted odds ratio (aOR) 0.18; 95% confidence interval (CI): 0.08-0.38); if parents had difficulties (aOR 0.19; 95% CI: 0.08-0.47) or were 'neutral' (aOR 0.23; 95% CI: 0.06-0.82) in remembering to make an appointment; and if parents had difficulties (aOR 0.21; 95% CI: 0.07-0.62) or were 'neutral' (aOR 0.24; 95% CI: 0.07-0.79) regarding getting an appointment for vaccination. Odds were also lower if parents did not believe (aOR 0.27; 95% CI: 0.08-0.90) or were 'neutral' (aOR 0.15; 95% CI: 0.04-0.49) regarding whether the people most important to them would have their child/ren vaccinated against influenza. Children had lower odds of vaccination if parents did not support (aOR 0.09; 95% CI: 0.01-0.82) or were ambivalent (aOR 0.09; 95% CI: 0.01-0.56) in their support for influenza vaccination. Finally, lack of history of influenza vaccination of child (aOR 0.38; 95% CI: 0.18-0.81) and respondent (aOR 0.25; 95% CI: 0.11-0.56) were associated with lack of receipt of influenza vaccine before admission for acute respiratory infection. Assisting parents in remembering and accessing influenza vaccination and encouraging health-care providers to recommend vaccination may increase uptake.

Wellbeing and experiences of Chinese and Vietnamese carers of people with mental illness in Australia.

Many studies show that carers of people with mental illness experience a negative impact on their wellbeing. Given the growing number of people relocating to Australia every year, there are limited studies examining the experience of carers of people with mental illness from culturally and linguistically diverse communities in Australia. Using cultural safety as a conceptual framework, this exploratory study recruited 14 carers of Chinese and Vietnamese heritage who were attending culturally and linguistically oriented support groups in Sydney, Australia. Standardised, validated scales were administered to measure carers' wellbeing and knowledge of recovery. Structured interviews were conducted to understand carers' perceived needs. Descriptive statistical and qualitative thematic analysis were used. Findings show that carers experienced social isolation and psychological distress, had multiple diverse needs and had a reasonably good understanding of recovery. Six themes were identified: i) obtaining information in own language; ii) attaining emotional support from support groups; iii) needing respite services to cope with caregiving responsibilities; iv) involvement in planning of treatment and care; v) migration process influencing caregiving, and; vi) cultural and transcultural factors influencing caregiving experience. Findings indicate that some carers might be experiencing some level of culturally unsafe practices in mainstream mental health services. Implications for support groups and mental health services are discussed.

Terminology Preferences in Mental Health

People with a mental illness may be exposed to stigma which, when internalised, negatively influences self-esteem, personal goal attainment and quality of life. Avoiding the use of stigmatising language and using terminology that does not exclude the positive characteristics of the individual may play an important role in challenging stigma. This study involved a mixed method approach to identify the terminology preferences of people with a mental illness in Australia. N = 173 participants were recruited via convenience sampling. The humanistic terms ‘individual’ and ‘person with lived experience’ were identified as the preferred terms. Qualitatively there was a wide variation in how the terms made the respondents think or feel, with only one of the terms – ‘survivor,’ having solely negative themes. When contrasting the two most commonly used clinical terms, ‘client’ was significantly preferred to ‘patient’. The term ‘consumer’ was one of the least preferred terms. This suggests that the use of this term, which is in regular use in Australia, should be reconsidered.