Helen Herrman - Academia.edu (original) (raw)

Papers by Helen Herrman

Journal of Affective Disorders, 2013

Background: Depression screening in primary care yields high numbers. Knowledge of how depressive... more Background: Depression screening in primary care yields high numbers. Knowledge of how depressive symptoms change over time is limited, making decisions about type, intensity, frequency and length of treatment and follow-up difficult. This study is aimed to identify depressive symptom trajectories and associated socio-demographic, co-morbidity, health service use and treatment factors to inform clinical care. Methods: 789 people scoring 16 or more on the CES-D recruited from 30 randomly selected Australian family practices. Depressive symptoms are measured using PHQ-9 at 3, 6, 9 and 12 months. Results: Growth mixture modelling identified a five-class trajectory model as the best fitting (lowest Bayesian Information Criterion): three groups were static (mild (n ¼ 532), moderate (n ¼138) and severe (n ¼ 69)) and two were dynamic (decreasing severity (n ¼ 32) and increasing severity (n ¼18)). The mild symptom trajectory was the most common (n ¼ 532). The severe symptom trajectory group (n ¼69) differed significantly from the mild symptom trajectory group on most variables. The severe and moderate groups were characterised by high levels of disadvantage, abuse, morbidity and disability. Decreasing and increasing severity trajectory classes were similar on most variables. Limitations: Adult only cohort, self-report measures. Conclusions: Most symptom trajectories remained static, suggesting that depression, as it presents in primary care, is not always an episodic disorder. The findings indicate future directions for building prognostic models to distinguish those who are likely to have a mild course from those who are likely to follow more severe trajectories. Determining appropriate clinical responses based upon a likely depression course requires further research.

Trends in Urology & Men's Health, 2015

... Dedicated to Suman and Rajesk and their families ... homeless MAX MARSHALL Old and homeless i... more ... Dedicated to Suman and Rajesk and their families ... homeless MAX MARSHALL Old and homeless in London and New York City: a cross-national comparison CARL I. Cor-IEN AND MAUREEN CRANE Primary health care of the single homeless DAvID EL—KABIR AND SIIvIoN ...

Mental Health of Refugees and Asylum Seekers, 2010

... POST-MIGRATION FACTORS AFFECTING MENTAL HEALTH 45 An inquiry into immigrationdetention and it... more ... POST-MIGRATION FACTORS AFFECTING MENTAL HEALTH 45 An inquiry into immigrationdetention and its alternatives ... work and healthcare for community based… (applicants for asylum or other immigration visas)… is known to have harmful long term effects on all those ...

The Australian and New Zealand journal of psychiatry, Jan 23, 2015

e-Mental health services have been shown to be effective and cost-effective for the treatment of ... more e-Mental health services have been shown to be effective and cost-effective for the treatment of depression. However, to have optimal impact in reducing the burden of depression, strategies for wider reach and uptake are needed. A review was conducted to assess the evidence supporting use of e-mental health programmes for treating depression. From the review, models of dissemination and gaps in translation were identified, with a specific focus on characterising barriers and facilitators to uptake within the Australian healthcare context. Finally, recommendations for promoting the translation of e-mental health services in Australia were developed. There are a number of effective and cost-effective e-health applications available for treating depression in community and clinical settings. Four primary models of dissemination were identified: unguided, health service-supported, private ownership and clinically guided. Barriers to translation include clinician reluctance, consumer awa...

Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2011

While everyone-including front-line clinicians-should strive to prevent the maltreatment and othe... more While everyone-including front-line clinicians-should strive to prevent the maltreatment and other severe stresses experienced by many children and adults in everyday life, psychiatrists and other health professionals also need to consider how best to support, throughout the lifespan, those people affected by severe adversity. The first step in achieving this is a clear understanding of the definitions and concepts in the rapidly growing study of resilience. Our paper reviews the definitions of resilience and the range of factors understood as contributing to it, and considers some of the implications for clinical care and public health. This narrative review took a major Canadian report published in 2006 as its starting point. The databases, MEDLINE and PsycINFO, were searched for new relevant citations from 2006 up to July 2010 to identify key papers considering the definitions of resilience and related concepts. Definitions have evolved over time but fundamentally resilience is u...

World psychiatry : official journal of the World Psychiatric Association (WPA), 2011

This paper summarizes the history of the development of Chinese mental health system; the current... more This paper summarizes the history of the development of Chinese mental health system; the current situation in the mental health field that China has to face in its effort to reform the system, including mental health burden, workforce and resources, as well as structural issues; the process of national mental health service reform, including how it was included into the national public health program, how it began as a training program and then became a treatment and intervention program, its unique training and capacity building model, and its outcomes and impacts; the barriers and challenges of the reform process; future suggestions for policy; and Chinese experiences as response to the international advocacy for the development of mental health.

European Neuropsychopharmacology, 2000

Australian Journal of Public Health, 1991

This article describes three recently established community-based crisis services for people with... more This article describes three recently established community-based crisis services for people with acute psychiatric illness. Data were obtained from local information systems developed in the early phase of service operation. Patterns of service were found to vary among the teams in terms of the frequency of contact with the client, the period of contact with the client and the overall numbers of contacts. Such diversification of services reflects, at least in part, the differences in the service networks within which the new services were set. Such diversification of services is inevitable and creative, and the evaluation of these services must consider not only the short-term impact of crisis services, but also the impact of the network of care services on longer term outcomes for the client. (Aust J Public Health 1991; 15: 122-9) rograms that offer an alternative to hospitalisation for people with serious mental illness Correspondence to Dr

Trained clinicians interviewed 346 people who were representative of those aged 15 to 60 years st... more Trained clinicians interviewed 346 people who were representative of those aged 15 to 60 years staying in crisis accommodation centres for the homeless and cheap single-room accommodations in inner Melbourne. The interviewers used a standardised diagnostic instrument, the structured clinical interview for DSM III-R. (Diagnostic and statistical manual of mental disorders - revised), to diagnose a range of severe mental disorders, including psychotic, affective, and substance-related disorders. Almost half the people interviewed received diagnoses of current disorders and over 70% received diagnoses of lifetime disorders. The prevalences of lifetime and current disorders in all categories were as high in young as in older men. Only small numbers of women were seen. The relatively high prevalence of disorder in younger men may be related to selective factors in the survey, to a cohort effect, or to recovery or death of older men with a history of mental disorder. From a practical point of view the important issue is the effect of varying systems of mental health care, and of welfare and housing policies, on the course and outcome of the various disorders, and on the likelihood of individuals living impoverished and disaffiliated lives.

Journal of Affective Disorders, 2013

Background: Depression screening in primary care yields high numbers. Knowledge of how depressive... more Background: Depression screening in primary care yields high numbers. Knowledge of how depressive symptoms change over time is limited, making decisions about type, intensity, frequency and length of treatment and follow-up difficult. This study is aimed to identify depressive symptom trajectories and associated socio-demographic, co-morbidity, health service use and treatment factors to inform clinical care. Methods: 789 people scoring 16 or more on the CES-D recruited from 30 randomly selected Australian family practices. Depressive symptoms are measured using PHQ-9 at 3, 6, 9 and 12 months. Results: Growth mixture modelling identified a five-class trajectory model as the best fitting (lowest Bayesian Information Criterion): three groups were static (mild (n ¼ 532), moderate (n ¼138) and severe (n ¼ 69)) and two were dynamic (decreasing severity (n ¼ 32) and increasing severity (n ¼18)). The mild symptom trajectory was the most common (n ¼ 532). The severe symptom trajectory group (n ¼69) differed significantly from the mild symptom trajectory group on most variables. The severe and moderate groups were characterised by high levels of disadvantage, abuse, morbidity and disability. Decreasing and increasing severity trajectory classes were similar on most variables. Limitations: Adult only cohort, self-report measures. Conclusions: Most symptom trajectories remained static, suggesting that depression, as it presents in primary care, is not always an episodic disorder. The findings indicate future directions for building prognostic models to distinguish those who are likely to have a mild course from those who are likely to follow more severe trajectories. Determining appropriate clinical responses based upon a likely depression course requires further research.

Trends in Urology & Men's Health, 2015

... Dedicated to Suman and Rajesk and their families ... homeless MAX MARSHALL Old and homeless i... more ... Dedicated to Suman and Rajesk and their families ... homeless MAX MARSHALL Old and homeless in London and New York City: a cross-national comparison CARL I. Cor-IEN AND MAUREEN CRANE Primary health care of the single homeless DAvID EL—KABIR AND SIIvIoN ...

Mental Health of Refugees and Asylum Seekers, 2010

... POST-MIGRATION FACTORS AFFECTING MENTAL HEALTH 45 An inquiry into immigrationdetention and it... more ... POST-MIGRATION FACTORS AFFECTING MENTAL HEALTH 45 An inquiry into immigrationdetention and its alternatives ... work and healthcare for community based… (applicants for asylum or other immigration visas)… is known to have harmful long term effects on all those ...

The Australian and New Zealand journal of psychiatry, Jan 23, 2015

e-Mental health services have been shown to be effective and cost-effective for the treatment of ... more e-Mental health services have been shown to be effective and cost-effective for the treatment of depression. However, to have optimal impact in reducing the burden of depression, strategies for wider reach and uptake are needed. A review was conducted to assess the evidence supporting use of e-mental health programmes for treating depression. From the review, models of dissemination and gaps in translation were identified, with a specific focus on characterising barriers and facilitators to uptake within the Australian healthcare context. Finally, recommendations for promoting the translation of e-mental health services in Australia were developed. There are a number of effective and cost-effective e-health applications available for treating depression in community and clinical settings. Four primary models of dissemination were identified: unguided, health service-supported, private ownership and clinically guided. Barriers to translation include clinician reluctance, consumer awa...

Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2011

While everyone-including front-line clinicians-should strive to prevent the maltreatment and othe... more While everyone-including front-line clinicians-should strive to prevent the maltreatment and other severe stresses experienced by many children and adults in everyday life, psychiatrists and other health professionals also need to consider how best to support, throughout the lifespan, those people affected by severe adversity. The first step in achieving this is a clear understanding of the definitions and concepts in the rapidly growing study of resilience. Our paper reviews the definitions of resilience and the range of factors understood as contributing to it, and considers some of the implications for clinical care and public health. This narrative review took a major Canadian report published in 2006 as its starting point. The databases, MEDLINE and PsycINFO, were searched for new relevant citations from 2006 up to July 2010 to identify key papers considering the definitions of resilience and related concepts. Definitions have evolved over time but fundamentally resilience is u...

World psychiatry : official journal of the World Psychiatric Association (WPA), 2011

This paper summarizes the history of the development of Chinese mental health system; the current... more This paper summarizes the history of the development of Chinese mental health system; the current situation in the mental health field that China has to face in its effort to reform the system, including mental health burden, workforce and resources, as well as structural issues; the process of national mental health service reform, including how it was included into the national public health program, how it began as a training program and then became a treatment and intervention program, its unique training and capacity building model, and its outcomes and impacts; the barriers and challenges of the reform process; future suggestions for policy; and Chinese experiences as response to the international advocacy for the development of mental health.

European Neuropsychopharmacology, 2000

Australian Journal of Public Health, 1991

This article describes three recently established community-based crisis services for people with... more This article describes three recently established community-based crisis services for people with acute psychiatric illness. Data were obtained from local information systems developed in the early phase of service operation. Patterns of service were found to vary among the teams in terms of the frequency of contact with the client, the period of contact with the client and the overall numbers of contacts. Such diversification of services reflects, at least in part, the differences in the service networks within which the new services were set. Such diversification of services is inevitable and creative, and the evaluation of these services must consider not only the short-term impact of crisis services, but also the impact of the network of care services on longer term outcomes for the client. (Aust J Public Health 1991; 15: 122-9) rograms that offer an alternative to hospitalisation for people with serious mental illness Correspondence to Dr

Trained clinicians interviewed 346 people who were representative of those aged 15 to 60 years st... more Trained clinicians interviewed 346 people who were representative of those aged 15 to 60 years staying in crisis accommodation centres for the homeless and cheap single-room accommodations in inner Melbourne. The interviewers used a standardised diagnostic instrument, the structured clinical interview for DSM III-R. (Diagnostic and statistical manual of mental disorders - revised), to diagnose a range of severe mental disorders, including psychotic, affective, and substance-related disorders. Almost half the people interviewed received diagnoses of current disorders and over 70% received diagnoses of lifetime disorders. The prevalences of lifetime and current disorders in all categories were as high in young as in older men. Only small numbers of women were seen. The relatively high prevalence of disorder in younger men may be related to selective factors in the survey, to a cohort effect, or to recovery or death of older men with a history of mental disorder. From a practical point of view the important issue is the effect of varying systems of mental health care, and of welfare and housing policies, on the course and outcome of the various disorders, and on the likelihood of individuals living impoverished and disaffiliated lives.

Layperson accounts of depression are gaining increasing prominence in the health research literat... more Layperson accounts of depression are gaining increasing prominence in the health research literature. This paper considers the accounts of lay people from a cross-cultural perspective. By exploring lay concepts of distress from Anglo-Australian, Ethiopian and Somali communities in Australia, we describe commonalities and divergences in understandings of depression. A total of 62 Anglo-Australians were interviewed, and 30 Somali and Ethiopians participated in focus groups and individual interviews. Anglo-Australian accounts frequently portray depression as an individual experience framed within narratives of personal misfortune, and which is socially isolating. In the accounts of distress from the Somali and Ethiopian refugees living in Australia, family and broader socio-political events and circumstances featured more frequently, and ‘depression’ was often framed as an affliction that was collectively derived and experienced.

Successful community engagement is often a crucial component of effective qualitative research. I... more Successful community engagement is often a crucial component of effective qualitative research. In this article we reflect on our experience of engaging with ethnic minority communities in a qualitative study of help seeking for depression. Community engagement emerges as a complex process that provides important insights into the way mental illness is constructed in various cultural contexts and from diverse perspectives. Contested notions of ethnicity, culture, community, and depression were the domains in which personal and public politics were played out. We worked with bilingual research assistants who provided an entrée to the community. Despite this, disparate community subgroups and influential individuals vied for input into and control of the research agenda. We conclude that negotiating the politics of these processes requires great reflexivity and is itself a powerful seam of data, adding richness to findings about the experience of mental distress in a community seeking to locate itself within mainstream society.