Parents of adolescents facing suicidality play a crucial protective role, but often feel overwhelmed. The Partners in Parenting Plus – Suicide Prevention (PiP-SP+) programme is a co-designed, coach-supported, online parenting programme aimed to empower parents within their carer role to manage their adolescent’s suicide risk.

To evaluate PiP-SP+’s acceptability, feasibility, validity and short-term effects.

Fifteen parents of adolescents aged 12–18 years, concerned about their adolescent’s suicidality, participated in an open-label, non-randomised uncontrolled trial. Parents (n = 11) completed semi-structured interviews, exploring the programme’s acceptability, feasibility and validity. Thirteen parents completed quantitative assessments of parental self-efficacy to respond to adolescent suicidality and non-suicidal self-injury, protective parenting behaviours, carer burden, parental distress, mental health support quality, family functioning, and adolescent anxiety and depressive symptoms at baseline and 120 days post baseline. Finally, nine adolescents of the participating parents self-reported anxiety symptoms, depressive symptoms and perceptions of parental support at baseline and 120 days post baseline.

PiP-SP+ was an acceptable, feasible and valid intervention for parents. Significant baseline-to-post-intervention improvements were observed in parents’ self-efficacy to respond to adolescent suicidality and non-suicidal self-injury, protective parenting behaviours, carer burden, parental distress and mental health support quality. No significant differences were reported in family functioning. Adolescents perceived increased parental support; both parents and adolescents reported reductions in adolescent anxiety symptoms. Although parents reported a significant decrease in adolescent depressive symptoms, adolescents did not.

Findings support the value of undertaking an appropriately powered, randomised controlled trial to confirm these pilot findings.

There is a need for developmentally tailored intervention approaches that empower parents to respond to adolescent school refusal in the context of internalising disorders. Partners in Parenting Plus-Education (PiP-Ed+) is a manualised coach-assisted online parenting programme that has been co-designed with parents, youth and education-sector experts to fill this gap. It addresses multiple parenting factors associated with adolescent school refusal and internalising disorders.

This study aimed to evaluate the acceptability, feasibility and preliminary indications of efficacy of PiP-Ed+.

An open-label, uncontrolled trial was conducted using a mixed-methods design. Participants were 14 Australian parents of adolescents (12–18 years) who had refused school in the context of internalising disorders.

PiP-Ed+ was viewed as highly acceptable and feasible. Coaching sessions in particular were perceived as valuable and appropriate to the parents’ level of need, although longer-term support was suggested to sustain progress. Between baseline and post-intervention, there were significant increases in parents’ self-efficacy to respond to adolescent school refusal and internalising problems, and concordance with evidence-based parenting strategies to reduce adolescent anxiety and depression. Days of school refused and carer burden did not change.

Findings support the value of proceeding to evaluate the efficacy of PiP-Ed+ in a randomised-controlled trial. Results are interpreted in the context of study limitations.

Suicidal ideation and behaviours are common among adolescents, posing significant challenges. Parents have a protective role in mitigating this risk, yet they often feel ill-equipped to support their adolescents, and their specific support needs are not well understood.

To explore the lived experiences of parents with suicidal adolescents and identify their support needs in the context of a therapist-assisted online parenting programme.

Semi-structured interviews were conducted with three stakeholder groups based in Australia: nine parents with lived experience caring for a suicidal adolescent, five young people who experienced suicidality during adolescence and five clinical/research experts in youth mental health/suicide prevention. Inductive thematic analysis was used to analyse and interpret findings.

Three key themes highlight the experience of parenting a suicidal adolescent: the traumatising emotional experience, uncertainty and parent empowerment. Six themes described parents’ support needs: validation and support, practical and tailored strategies, rebuilding the parent–adolescent relationship, parental self-care, flexible and accessible modes of delivery, and understanding non-suicidal self-injury.

Findings highlight key themes of parenting a suicidal adolescent and parental support needs. An online parenting programme could offer parents flexible access to evidence-based parenting strategies. Yet, a purely digital approach may not address the complexities of the parent-adolescent dynamic and provide adequate tailoring. As such, a hybrid approach incorporating therapist support can provide parents with both the compassionate support and practical guidance they seek.

School refusal is a heterogenous problem which typically emerges in adolescence and co-occurs with internalising disorders. A substantial proportion of adolescents do not respond to existing treatment modalities; thus, novel, effective intervention options are needed. Partners in Parenting Plus (PiP+) is a coach-assisted, web-based intervention designed to empower parents to respond to adolescent internalising disorders.

To conduct a process evaluation of PiP+ and identify programme adaptations required to meet the needs of parents of adolescents who refuse school.

Semi-structured interviews were conducted with 14 Australian mothers who had: (a) received the PiP+ programme (not tailored for school refusal) during a prior research trial; and (b) reported that their adolescent was refusing school during their participation in PiP+. Inductive thematic analysis was used to analyse interview transcripts.

Participants were 41–53 years old (M = 47.8) and parenting adolescent children aged 14–17 years (M = 14.9). Three themes illustrated how PiP+ features met or could better meet the needs of parents of adolescents who were refusing school: (a) feeling heard, supported and respected; (b) relevance to me and my context; and (c) seeing positive changes. Participants had favourable views of PiP+, especially coached components. Participants requested programme enhancements to better meet the needs of parents of neurodiverse adolescents and discussed the impact of cumulative help-seeking ‘failures’ on self-efficacy and locus of control.

PiP+ was highly acceptable to the majority of parents navigating the issue of school refusal. This has implications for the enhancement of coach-assisted parenting interventions and the context-specific adaptation of PiP+ for school refusal.

There is increasing focus on effective preventative interventions applicable at the population scale such as through technology and web-based approaches. We aimed to reduce cognitive decline with ageing using an online package of interventions delivered intensively for 12 months followed by monthly boosters for 24 months.

Invitations were sent to people aged 55-77 years from the 45 and Up study, a population-based cohort study of one in ten people aged 45 years and older in New South Wales, Australia (n=267,000). Participants were required to be eligible for at least two of four modules addressing physical inactivity and associated health risks (Physical Activity), adherence to a Mediterranean-type diet and health risks associated with poor nutrition (Nutrition), cognitive activity (Brain Training) and mental well-being (Peace of Mind). Participants received modules based on their risks, with 1:1 randomized allocation to active personalised coaching modules (intervention) or static information-based modules (control). The primary outcome was change in an online combined multi-domain cognitive score measured using COGSTATE and Cambridge Brain Sciences tests using intention to treat analysis. Secondary outcomes included specific cognitive domain and ANU-ADRI risk scores.

From 96,418 invitations, 14,064 (14%) consented; 11,026 (11%) were eligible; and 6,104 (6%) completed all 10 baseline assessments. Over three years there was a significantly greater improvement in the global composite cognition z-score in the intervention group, ES = 0.106 (p<0.001). Significant benefits were also found in complex attention, executive function and learning and memory (all p<0.001), as well as on a validated dementia risk instrument (p=0.007).

An online platform that tailored physical activity, nutrition, brain training, depression and anxiety interventions to an individual’s risk factor profile over three years significantly delayed cognitive decline in older adults. This platform is scalable and if rolled out at a population level may help reduce the prevalence of dementia globally.

Cross-national comparisons of the prevalence of mental disorders have relied on lay-administered interviews scored using complex diagnostic algorithms. However, this approach has led to some paradoxical findings, with more vulnerable countries showing lower prevalence, and its appropriateness for cross-national comparisons has been questioned. This study used an alternative method involving simple questions from social surveys to assess the prevalence of specific depression and anxiety symptoms, and investigated their association with national indicators of human development, quality of government, mental health resources, and mental health governance.

The study used data on the prevalence of three symptoms indicating depression or anxiety: sadness, worry, and unhappiness. These data were taken from the Gallup World Poll (142 countries) and the World Values Survey (77 countries). National characteristics examined covered indicators of human development (income, life span, education, gender equality), quality of government (human freedom, perceptions of corruption), mental health resources (per capita numbers of psychiatrists, mental health nurses, psychologists, and social workers), and mental health governance (whether there is a national mental health plan and a mental health law).

All the human development and quality of government indicators, and some of the mental health resource indicators, were strongly associated with a lower prevalence of symptoms.

Populations of nations with higher human development, quality of government, and mental health resources have better mental health when measured by the prevalence of specific symptoms.

Expert-consensus guidelines have been developed for how members of the public should assist a person with a mental health problem or in a mental health crisis.

This review aimed to examine the range of guidelines that have been developed and how these have been implemented in practice.

A narrative review was carried out based on a systematic search for literature on the development or implementation of the guidelines.

The Delphi method has been used to develop a wide range of guidelines for English-speaking countries, Asian countries and a number of other cultural groups. The primary implementation has been through informing the content of training courses.

Further work is needed on guidelines for low- and middle-income countries.

A.F.J. is an unpaid member of the Board of Mental Health First Aid International (trading as Mental Health First Aid Australia), which is a not-for-profit organisation.

A 1995 Australian national survey of mental health literacy showed poor recognition of disorders and beliefs about treatment that differed from those of health professionals. A similar survey carried out in 2003/4 showed some improvements over 8 years.

To investigate whether recognition of mental disorders and beliefs about treatment have changed over a 16-year period.

A national survey of 6019 adults was carried out in 2011 using the same questions as the 1995 and 2003/4 surveys.

Results showed improved recognition of depression and more positive ratings for a range of interventions, including help from mental health professionals and antidepressants.

Although beliefs about effective medications and interventions have moved closer to those of health professionals since the previous surveys, there is still potential for mental health literacy gains in the areas of recognition and treatment beliefs for mental disorders. This is particularly the case for schizophrenia.

Subthreshold depression is common, impairs functioning and increases the risk of major depression. Improving self-help coping strategies could help subthreshold depression and prevent major depression.

To test the effectiveness of an automated email-based campaign promoting self-help behaviours.

A randomised controlled trial was conducted through the website: www.moodmemos.com. Participants received automated emails twice weekly for 6 weeks containing advice about self-help strategies. Emails containing general information about depression served as a control. The principal outcome was depression symptom level on the nine-item Patient Health Questionnaire (PHQ-9) (trial registration: ACTRN12609000925246).

The study recruited 1326 adults with subthreshold depression. There was a small significant difference in depression symptoms at post-intervention, favouring the active group (d = 0.17, 95% CI 0.01–0.34). There was a lower, although non-significant, risk of major depression in the active group (number needed to treat (NNT) 25, 95% CI 11 to ∞ to NNT(harm) 57).

Emails promoting self-help strategies were beneficial. Internet delivery of self-help messages affords a low-cost, easily disseminated and highly automated approach for indicated prevention of depression.

Few randomised controlled trials (RCTs) have examined potential preventive agents in high-risk community populations.

To determine whether a mental health literacy intervention, the promotion of physical activity, or folic acid plus vitamin B12 reduce depression symptoms in community-dwelling older adults with elevated psychological distress.

An RCT with a completely crossed 2 × 2 × 2 factorial design: (400 mcg/d folic acid + 100 mcg/d vitamin B12 v. placebo)×(physical activity v. nutrition promotion control) × (mental health literacy v. pain information control). The initial target sample size was 2000; however, only 909 adults (60–74 years) met the study criteria. Interventions were delivered by mail with telephone calls. The main outcome was depressive symptoms on the Patient Health Questionnaire (PHQ–9) at 6 weeks, 6, 12 and 24 months. The Clinicaltrials.gov registration number is NCT00214682.

The drop-out rate was low (13.5%) from randomisation to 24-month assessment. Neither folic acid + B12 (F(3,856) = 0.83, P = 0.476) nor physical activity (F(3,856) = 1.65, P = 0.177) reduced depressive symptoms at any time point. At 6 weeks, depressive symptoms were lower for the mental health literacy intervention compared with its control condition (t(895) = 2.04, P = 0.042).

Mental health literacy had a transient effect on depressive symptoms. Other than this, none of the interventions significantly reduced symptoms relative to their comparator at 6 weeks or subsequently. Neither folic acid plus B12 nor physical activity were effective in reducing depressive symptoms.