Our Research

Research at MAPrc is extraordinarily diverse. Our projects range from  neuroimaging techniques that are recognised around the world for the breakthrough insights they provide into brain structure and function in health and illness, to innovative new treatments to boost the effectiveness of conventional medications for major mental illnesses. Other research streams are grassroots initiatives looking at ways to make the delivery of community mental health service more efficient and addressing the mental health aspects of problem gambling.

Our approach reflects our commitment to ‘bench to bedside’ research. Results translate directly into everyday benefits for people with mental illnesses, carers and healthcare professionals.

All our activities are guided by our mission: to conduct world-class psychiatric research with respect, equality and understanding.

MAPrc research is divided into a number of streams listed below. For further information, please see the menu links on the right. 

 

AttachmentSize
Annual report 2014 1.26 MB

Healthy Lifestyles and Outcomes

 Research has found that people experiencing mental illness have a significantly shortened lifespan compared to those without mental illness. It is known that people with mental illness are more likely to have serious physical health conditions, like heart disease, obesity and diabetes, and are less likely to receive the medical attention and treatment they require.

The physical health of people experiencing mental illness needs to be given the attention it deserves. Improvements in physical health contribute to better mental health, increased daily functioning and improved quality of life.  

The Healthy Lifestyles and Outcomes stream of research focuses on physical health for people experiencing mental illness.  In particular, our work involves:

Therefore, work in this stream has both a research and a clinical focus.

You can watch an overview of the team's work here.

Healthy Lifestyles and Outcomes team

Team Leader      
Professor Jayashri Kulkarni

Coordinator   
Sacha Filia 

Researchers
Amity Green
 
Collaborating Researchers
Professor Amanda Baker (University of Newcastle)
Professor Robyn Richmond (University of New South Wales)
Professor David Castle (University of Melbourne, St Vincent’s Hospital)
Associate Professor Jill Williams (UMDNJ − Robert Wood Johnson Medical School)
Dr Frances Kay-Lambkin (University of Newcastle)
Dr Melinda Carrington (Baker IDI Heart & Diabetes Institute)
Lucinda Riches (Inner South Community Health Service)
 

 

Healthy Lifestyles and Outcomes: current projects

1. Healthy lifestyle intervention for cardiovascular disease risk reduction among people with psychotic disorders

Aim
To test the effectiveness of a treatment for smoking cessation and reducing risk for cardiovascular disease (CVD) among people experiencing psychosis

Funding
The National Health & Medical Research Council (NHMRC)

Participants

People who meet the following criteria are eligible to participate:
•   Diagnosis of psychosis (such as bipolar affective disorder, schizophrenia, schizoaffective disorder, first-episode psychosis and other psychosis)
•    Smokes at least 15 cigarettes per day
•    Aged over 18 years
•    Can speak English
•    Has no organic brain damage
•    No medical history that would preclude treatment with nicotine
     replacement therapy (NRT), e.g pregnancy, uncontrolled diabetes

Methods
Once people agree to participate, they meet with a member of the research team to have a comprehensive assessment of their mental and physical health (including weight, blood pressure, blood sugar and cholesterol). 

After completing the assessment phase, each person will receive an individual feedback session.  They will then be randomly allocated to receive the Healthy Lifestyle intervention or a minimal intervention (regular phone contact by the research team).  The Healthy Lifestyle intervention consists of cognitive behaviour therapy and motivational interviewing designed to encourage reduction in cigarette usage, and healthier diet/nutrition and physical activity.  Nicotine Replacement Therapy (NRT) will be offered to all participants to assist with attempts to quit cigarettes.  All participants are followed up at 15 weeks, 12 months and 18 months.  

 

 
 2. Varenicline (Champix) for smoking cessation in people experiencing psychosis

Aim
The project aims to examine the safety and efficacy of varenicline for smoking cessation among people experiencing psychosis. 

Participants
A total of 15 participants will be recruited. This project has been funded by an investigator-initiated grant from Pfizer. 

Project status
Recruitment is currently under way and some participants have commenced the study.

Researchers
This study is being conducted at St.Vincent’s Hospital in collaboration with Professor David Castle and Dianne Harris.  Professor Kulkarni is a Chief Investigator.

 

 
3. Becoming a smokefree inpatient psychiatry ward: the staff & client experience.

Aim
This study aims to evaluate staff/client attitudes, expectations and experience regarding the smokefree policy before and after the ban is introduced on the inpatient psychiatry ward.

Participants
Staff and clients of the inpatient psychiatry ward at the Alfred Hospital.

Methods
Information is completed via questionnaires before and after the smoking ban.

Project status
Pre smoking ban questionnaires have been completed by 45 staff members and 46 clients. Post smoking ban questionnaires are being collected at present.  The first round of data collection was completed March 2009 and data analysis has commenced.  

 

 
4. Smokefree Support Group

Aim
This study aims to evaluate the Smokefree Support Group on the inpatient psychiatric ward

Project status
This project is currently under way.

 

 

Psychopharmacology

Medication remains a cornerstone of treatment for most mental illnesses. For this reason, MAPrc is committed to investigating new and improved medications for serious mental illnesses such as schizophrenia, bipolar affective disorder, major depression, anxiety and other disorders.

In keeping with our research philosophy of equality, respect and understanding, the clinical trials that we undertake are limited in number and aim to provide better symptom resolution. We do not undertake studies that contain placebo-only groups and we require that the active medications being trialled are ones that have been shown in preliminary trials to be superior to currently available medications. During trials, we take care to monitor the participants’ subjective assessments of their experience, the effects of the trial medications and other general responses. We also invite carers to give their views and opinions about the treatments being studied.

In recent years, a number of new and improved treatments have become available, and advances in biotechnology are paving the way for new techniques for drug discovery. We believe that the future holds substantial hope for new and better treatment options for people living with devastating mental illnesses.

 
 

Psychopharmacology Research Team

 

Principal Investigator
Prof. Jayashri Kulkarni

Research Manager
Mr Anthony de Castella
 
 

 

 

Therapeutic Brain Stimulation

The Therapeutic Brain Stimulation division focuses on using advanced neuroscience technology to investigate brain function and develop innovative treatments across a range of disorders. 

We use a range of advanced imaging techniques and novel treatments, including:

To find out more about our research and treatment tools see here.

Our research team is studying potential uses of these techniques in disorders such as:

To find out about current clinical research projects and investigative studies and how to be involved see our Treatment Studies and our Investigative Studies

Therapeutic Brain Stimulation division

Director 
Professor Paul Fitzgerald

Deputy Director
A/Prof Kate Hoy, Head Cognitive Therapeutics Program

Senior Research Fellow 
Dr Bernadette Fitzgibbon 

Division Co-ordinator
Dr Karyn Richardson      

Research Fellows / Post Doctoral Reserachers
Dr Richard Thomson 
Dr Neil Bailey              
Dr Robin Cash
Dr Manreena Kaur

Melanie Emonson (CTRP Co-ordinator)
Aron Hill
SungWook Chung

Research Registrars
Dr Leo Chen                   
Dr Odette Edelstein

Research Nurses
David Elliott 
Susan McQueen 
Lenore Wambeek                                                                                                                                                             
Linda Pearce

Research Assistants
Kirsten Gainsford
Laura Knox
Caley Sullivan
Megan Ross
 
Doctoral Students
Oscar Murphy (DPsych)
Hannah Coyle (DPsych)
Sin-Ki Ng (PhD)
Xianwei Che (PhD)
Shuxiang Tian (PhD)
Robert Cooper (PhD)

Honours Students

 

 

Research and Treatment Tools

Transcranial magnetic stimulation (TMS)

Transcranial magnetic stimulation (TMS) is a technology which is an effective treatment for
depression and also showing substantial promise as a therapy for a range of other conditions.

TMS is a non-invasive treatment which works by using a magnetic field to stimulate nerve cells in superficial areas of the brain. A hand-held, plastic-coated coil is placed close to the scalp of the person receiving TMS treatment. An electrical current passes through the coil, creating a magnetic field that stimulates electrical activity in the nerve tissue below the coil.

The effect of the stimulation varies with the frequency and intensity of stimulation and the orientation of the stimulation coil. TMS stimulation has been shown to have effects on mood, motor (control of movement) and cognitive (thinking and planning) functioning.

As well as a therapeutic tool,TMS can be used as a method to investigate brain function.

 

TMS as a treatment method

Studies have been evaluating the use of TMS in the treatment of patients with depression for over 15 years. At MAPrc we have been at the centre of a worldwide research effort focused on evaluating and more recently improving the use of TMS treatment for patients with depression. We have conducted an extensive series of clinical trials that have contributed to robustly demonstrating that TMS is an effective treatment. We have also conducted extensive research evaluating the use of potentially new and improved forms of TMS treatment.

Because it is a non-invasive therapy that is carried out while the person receiving it is awake and alert, TMS has important advantages over older therapies such as electroconvulsive therapy (ECT). These include: low risk of side-effects or serious complications, avoidance of the need for anaesthesia and its associated risks, lower costs and less inconvenience to the patient, avoidance of the stigma that ECT sometimes carries, and the fact that TMS is suitable for use in medically unwell people who may not be able to tolerate certain medications or ECT.

TMS is now becoming a widely used treatment for depression around the world. There are clinical programs providing TMS treatment globally, including the US, and its place in clinical practice is gradually being refined.

In addition to using TMS in depression, studies are now exploring its use in other disorders including bipolar disorder, autism, Asperger's disorder and substance abuse. We have conducted, and continue to conduct innovative studies like these, including in depression, autism, schizophrenia, fibromyalgia and obsessive compulsive disorder. You can find more information about this research on the Psychiatric Neurotechnology: current projects page                          

Contact details
Email: tms-enquiry@monash.edu
Phone: 9076 8538

 

TMS as a probe of brain function 

TMS is widely utilised as a technique in studying normal and abnormal brain activity. When TMS pulses are applied to the muscle area of the brain, a muscle response is produced, for example in the hand, which can be measured and characterised accurately. This allows researchers to study the function of the motor control system. When TMS pulses are applied to other brain regions, they can be used to interfere with or temporarily augment other brain activities allowing study of these brain functions.

Researchers have also combined TMS with brain imaging methods such as EEG and NIRS as a method of studying brain function in non-motor brain regions. When EEG is recorded during a TMS pulse, we can measure the brain's electrical response to the TMS pulse, which reflects the normal functioning of the brain being stimulated. In a similar way, the brain's vascular response to stimulation can be measured with NIRS.

Researchers within MAPrc have extensively used TMS-EEG and TMS-NIRS methods to study brain function and the response to TMS in healthy subjects and in a number of illness states including depression, schizophrenia and addiction.

 

Transcranial direct current stimulation

Transcranial direct current stimulation (tDCS) is a relatively new brain stimulation technique. It uses a very gentle electrical current (1-2 mA) to change the activity level of cells in specific areas of the brain. The low current is not enough to cause brain cell to fires, but it changes the environment around nerve cells in the area of the brain that is stimulated making them more or less likely to fire. 

Like TMS, tDCS is a non-invasive technique which does not require any anaesthetic and has minimal side-effects. It also has potential use as a way of investigating brain function but is mostly being explored in the possible treatment of conditions such as chronic pain, epilepsy, stroke, Parkinson's disease and depression. Currently, it is being investigated as a treatment for depression in people whose symptoms have not been resolved with medication (treatment-resistant depression). 

Over recent years, researchers within MAPrc have conducted a careful series of studies demonstrating that tDCS has the potential to modulate and improve aspects of brain cognition, including learning and memory. These studies are ongoing and hopefully will lead to the development of tDCS methods as treatments for disorders with cognitive dysfunction such as schizophrenia, head injury and Alzheimer's disease.  You can find more information about this research on our current Treatment Studies and Investigative Studies.

 

 

Treatment Studies

The Therapeutic Brain Stimulation team is currently researching new treatments and conducting investigative studies for depression, bipolar, OCD, autism, schizophrenia, head injury and chronic pain. 

To read about our current research in these areas and to find out how to get involved, please see below. You can also view our Investigative Studies

 

Treatment Studies 

1. Accelerated TMS for depression

Aim: To see whether we can speed up the response to TMS. TMS response is usually slow, with a typical treatment course taking between four and six weeks. Over this time, patients are required to attend the hospital or clinic on a daily basis for a treatment that takes approximately 45 minutes. In this study we are investigating whether we can use a higher dose of treatment to get an accelerated treatment response, such that patient's symptoms improve in a much shorter period of time.

Participants: People with treatment-resistant depression  i.e. depression that has not adequately improved with antidepressant medications.

Project status: This project is currently underway.  

Contact details

Email: tms-enquiry@monash.edu

Phone: 9076 8538

 

2. DBS for treatment-resistant depression

Aim: To evaluate deep brain stimulation (DBS) in depression that has proved extremely resistant to standard treatments.

Methods: This study involves neurosurgical implantation of a neurostimulator in consenting patients who have severe depression that has proved extremely resistant to all less invasive antidepressant treatment options. 

Participants: As DBS is considered a treatment of last resort, only individuals who have trialled all less invasive antidepressant treatments and remained severely depressed can be considered for the procedure. This means having trialled multiple medications from all antidepressant drug classes, combinations of antidepressant medications, cognitive behavioural therapy, transcranial magnetic stimulation and extensive electroconvulsive therapy (ECT).

Project status: This project is currently in progress.

Contact details:

Email: maprc-dbs@monash.edu

Phone: 9076 6564

 

3. TBS for the treatment of fibromyalgia

Aim: The purpose of this project is to investigate the use of a form of therapeutic brain stimulation called Theta Burst Stimulation (TBS), as a treatment for the symptoms of fibromyalgia.

Participants: To be involved, participants must be aged between 18 and 75 years and have a diagnosis of fibromyalgia. Participation will involve attending MAPrc for 16 sessions over a four week period. Each treatment takes approximately 30 minutes. 

Project status: Recruitment underway.

Contact details

Ms. Freya Stockman

Email: freya.stockman@monash.edu

Phone: (03) 9076 9896

For further information:

 

 

4. Non-invasive brain stimulation in autism spectrum disorder (ASD)

Aim: We are currently conducting a number of studies that investigate whether transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) can be used to improve social and behavioural aspects of autism spectrum disorder.

Participants: Depending on the study, we are recruiting people aged between 14 and 40 who have a formal diagnosis of autism spectrum disorder.

Project status: Currently underway

Contact Details

A/Prof. Peter Enticott

Email: peter.enticott@deakin.edu.au

Phone: (03) 9244 5504

 

5. Alzheimer’s Study

Aim: To investiage whether Transcranial Magnetic Stimulation (TMS) can improve the cognitive symptoms of Alzheimer's disease. TMS is a painless, safe, and non-invasive means of stimulating nerve cells in the brain.

Participant's: Volunteers between 50 and 95 years of age with a diagnosis of mild to moderate Alzheimer's. Participation will involve attending the Alfred for a 2 week or 4 week period of daily (Monday-Friday) treatments followed by a  few follow up appointments (1-2hrs) up to 6 months post treatment. Each treatment appointment takes approximately 30 minutes. Participants will be provided compensation toward your travel and time costs.

Project Status: Currently underway

Contact Details

Ms Sarah Haines
 
Email: 
Sarah.Haines@monash.edu


Phone: 03 9076 5180

For more information:


- Download this flyer
 

 

Investigative Studies

Investigative studies are key to improving our understanding of the nature of mental health disorders and often require healthy controls in addition to patient populations as volunteers.  

 

 

 

 

 

 

 

 

 

 

 

 

 

Honours projects

Within the Therapeutic Brain Stimulation team at MAPrc, there are a range of potential honours projects available for 2017 and beyond. These will most likely involve the use of brain stimulation techniques such as transcranial magnetic stimulation and transcranial direct current stimulation or neuroscience tools such as EEG or neuroimaging.

These include studies focused on the following areas:

  • Using TMS to study the role of expectancy and anticipation in motor cortical excitability
  • The role of stimulation duration in working memory enhancement using tDCS
  • Using near infra red spectroscopy (NIRS) to investigate brain changes following Transcranial Magnetic Stimulation
  • Cortical Inihibiton, Dorsolateral Pre Frontal Cortex and Working Memory: Using TMS/EEG to establish a neurophsyiological marker of working memory 

 

Cognitive Therapeutics Research Program

The Cognitive Therapeutics Research Program is headed by Associate Professor Kate Hoy. The group's research is focused on the development of novel biological treatments for cognitive impairment in both psychiatric and neurological illnesses. Information about our current research studies are provided below.

Current Treatment Trials:

Investigating the use of brain stimulation to treat the cognitive symptoms of mild to moderate Alzheimer's

We are seeking volunteers between 50 and 95 years of age with a diagonsis of mild to moderate Alzheimer's. We are investigating whether a form of Transcranial Magnetic Stimulation can improve the cognitive symptoms of Alzheimer's. Participation will involve visiting our research centre in Prahran for an initiial interview (2-3 hours), 21 treatments over a 6 week period (each lasting approximately 30 mintues), and two follow up interviews (2-3 hours each).  Participants will be provided compensation toward your travel and time costs.  If you think this sounds interesting and would like to know more please contact Melanie Emonson on 9076 9864 or email tms-enquiry@monash.edu or click here for further details.

Current Investigative Studies:

The relationship between cortical activity and cognitive function after head injury

We are seeking volunteers between the ages of 18 and 55 to help us investigate the relationship between changes in brain activity and symptoms after a concussion. We are using a non-invasive type of brain stimulation to learn more about changes post-concussion and during recovery. Participation will involve visiting our research centre in Prahran for three research sessions.  The first session will occur within 1 month since your concussion and take approximately 3 hours. The following sessions will occur 3 and 6 months post-concussion and will take approximately 2 hours each. Together we will complete an interview, do some thinking tasks, take a recording of your brain waves and give you a short session of non-invasive brain stimulation. If you think this sounds interesting and would like to know more please contact Ms Hannah Coyle on 9076 8649 or hannah.coyle@monash.edu 

Women's Mental Health

Mental illness has many gender-specific aspects that clinical research has not always addressed. For example, in conditions such as schizophrenia, the age of onset and pattern of symptoms commonly seen is different for women and men. Women and men may also respond differently to medications or other treatments. In addition, changes in the level of sex hormones such as estrogen are known to affect symptoms.

The Women’s Mental Health team is working on numerous aspects of women’s mental health, the experiences of women with mental illness and potential options for treatment. To find out more about current projects click here or for schizophrenia treatments for men and women click here. For information about our PTSD clinical trial, please click here.

One particular focus of our research is the role of the neuroendocrine system in mental illnesses, and specifically the use of female hormones to improve the results of treatment. We are conducting ground-breaking research into the use of estrogen to improve symptoms in schizophrenia and the use of selective brain estrogens in postmenopausal women. We are also exploring possible links between the oral contraceptive pill and depression.

Another important project is NRAMP, the National Register of Antipsychotic Medications in Pregnancy. This is the first register of its kind worldwide. NRAMP aims to create a database of information about the effects of antipsychotic medications taken during pregnancy and the postnatal period. More information about NRAMP is available here

 

Women’s Mental Health Research Team

 
Team Leader
Professor Jayashri Kulkarni

Team Research Manager
Emmy Gavrilidis
 
Team Strategic Research Director
Dr Caroline Gurvich
 
Consultant Psychiatrist
Dr Carolyn Breadon
 
Consultant Endocrinologist
Dr Caroline Thew
 
Research Medical Officer
Dr Abdul Rahman Hudaib
  
Psychiatry Registrar 
Dr Sarah Rotstein 

Research Nurse
Heather Gilbert

Post Doctoral Researcher
Dr Natalie Thomas
 
Research Assistants
Gayan De Mel
Caitlin Bleeker
 
 
WMH Clinic Coordinators
Cindy Yu


 
 
 

 

Schizophrenia Treatments for Men and Women

 

We are currently recruiting for the following projects: 
 

VicHealth Smoking Harm Reduction Study

SERM (Selective Estrogen Receptor Modulator) Hormone treatment 

Smoking Cessation

Vaporising smoking-related harms in people with severe and persistent mental illness: A study
of the acceptability of vaporised nicotine products for smoking cessation or long-term
substitution
 
Research Team:  
                                 Prof. Jayashri Kulkarni, MAPrc
                                 Mr Anthony de Castella, MAPrc
                                 Dr Coral Gartner, University of Queensland
                                 Prof.  Ron Borland, Cancer Council Victoria
                                 Prof. Steve Kisely, University of Queensland
                                 A/Prof. Dan Siskind, University of Queensland
                                 Dr Lisa Brophy, University of Melbourne and MIND Australia
                                 Mr Gayan De Mel, MAPrc
 
Aims:
 

1) To investigate if adding a tobacco harm reduction intervention to standard care for smoking cessation is an acceptable and attractive public health strategy for Victorian smokers with Severe and Persistent Mental Illness (SPMI)

 
2) To provide pilot data to assist the design and planning of a fully-powered clinical trial

The study will:

1) Compare cigarette and nicotine product use among a) smokers with SPMI who are offered
Standard Care + Harm Reduction (SC+HR); and b) smokers with SPMI who are offered
Standard Care (SC) alone;
 
2) Explore whether access to novel Vaporised Nicotine Products (VNPs) and HR advice
increases/decreases interest in stopping smoking compared to the SC approach alone;
 
3) Determine which VNP is likely to have the greatest uptake by smokers with SPMI, if given
access to these products; and
 
4) Measure how smokers with SPMI use nicotine products (nicotine patches and VNPs).

 Funding for this study has been provided by VicHealth

 

For further enquiries please contact Gayan De Mel on tel: +61 03 9076 8045 

 


 

SERM

Adjunctive SERM Hormone Treatment for Men and Women with Schizophrenia and Schizoaffective Disorder

Background

Increasing evidence points to the protective role of estrogen in the brain, and for its positive effect on the symptoms of schizophrenia and schizoaffective disorder. However, adverse effects on breast and uterine tissue in females, and feminisation of males, limit the long-term therapeutic use of estrogen in this population.

Raloxifene is a new hormone treatment that belongs to a group of medications called Selective Estrogen Receptor Modulators (SERMs). Raloxifene is thought to have positive estrogenic effects in the brain without affecting peripheral body tissue, thus offering a longer-term treatment approach with potential mental health and cognitive benefits, and few estrogen-related side effects.

Raloxifene for men as well as for women?

Although more commonly associated with women, estrogen is also a naturally occurring hormone in the bodies of men, and is already used clinically to reverse bone loss, enhance cardiovascular function and treat prostate cancer. The advantage of using raloxifene instead of estrogen in men is that the beneficial effects of estrogen can be experienced in the brain without the feminising side effects typically associated with hormone treatments.

Aim

To examine whether adding raloxifene 120mg/day to regular antipsychotic treatment can improve psychotic symptoms, and mood and cognitive functioning, for men and women with schizophrenia or schizoaffective disorder.

Participants

Men and women who are 18+, who have been diagnosed with schizophrenia or schizoaffective disorder, are invited to take part in this study.

Methods

This study is a 12-week randomised controlled trial. Participants will be randomly selected to receive daily either 1) 120mg raloxifene, or 2) inactive placebo. Participants will meet with the study coordinator, Dr Jasmin Grigg, every two weeks to monitor psychotic and mood symptoms, and memory functioning will be assessed twice during the study. The occurrence of any unwanted side effects is also monitored.

Following completion of the trial, participants meet with the chief investigator, Professor Jayashri Kulkarni, to discuss their study outcomes.

Reimbursement

Participants will be reimbursed for their time and travel can be negotiated.

Project status

The study is currently recruiting participants.

Study coordinator
Amelia Arnold

For more information, please contact Amelia Arnoldon (03) 9076 6589 or via email amelia.arnold@monash.edu

Women's Mental Health: current projects

The Women's Mental Health Team coordinates a number of treatment and intervention trials focused on the gender differences in psychiatric care.

 
We are currently recruiting for the following projects:

Tibolone for peri-menopausal depression

Treatment trial for Complex Trauma Disorder: The Alison Project

NRAMP - The National Register of Antipsychotic Medication in Pregnancy

 

Tibolone

 

Treatment Trial for Complex Trauma Disorder

 
 

New treatment trial for PTSD

 A Randomized, Double-blind, Placebo-controlled Phase II Study of BNC210 in Adults with Post-Traumatic Stress Disorder (PTSD)


Aim: To evaluate the safety and efficacy of BNC210 in patients with Post-Traumatic Stress Disorder (PTSD) 

Method:  A total of 192 patients are planned to be enrolled in this randomized, double-blind, placebo-controlled study. The study will compare the effect of three different doses of BNC210 to placebo, on the symptoms of PTSD.  Patients will be treated for 12 weeks and will be assessed using a variety of psychiatric and cognitive assessment tools. 

Project status: This study is currently recruiting in Australia and will open soon in the USA. 

Study team: Professor Jayashri Kulkarni, Professor Paul Fitzgerald, Dr Matthew Kang, Dr Fenny Muliadi, Ms Fiona James

For more information, please contact Fiona James on fiona.james@monash.edu or (03) 9076 2404
 
 
AttachmentSize
BNC210.007_Study Brochure_V1.0_161024.pdf2 MB

Service Related Research

 Service Related Research focuses on the day-to-day problems managed by government funded mental health services. The great majority of this research is currently undertaken in collaboration with the Alfred Hospital Department of Psychiatry.

Such research includes, but is not limited to: observational studies designed to better characterise and describe a particular issue; evaluation studies designed to measure current practice against clinical and/or financial benchmarks; and interventional studies, trialling novel approaches in diagnosis and/or treatment.

 The key focus of Service Related Research at APRC is on the ‘real world’ problems confronted by service managers in public mental health services and by clinicians working at the coal-face.

 

You watch an overview of the team's work here.

 

Service Related Research team

Team Leader
Professor Jayashri Kulkarni
Dr Yitzchak Hollander
Anthony de Castella

Coordinator
Dr Stuart Lee

 

 

 

Service Related Research: current projects

1. Understanding interpersonal hostile-dominance and its role in aggressive behaviour in psychiatry inpatients

This project is being undertaken by MAPrc in collaboration with the Centre for Forensic Behavioural Science, Monash University. The study is being conducted at the Alfred Hospital.

Aggressive behaviour by patients admitted to psychiatric hospitals occurs frequently and causes problems for patients and staff. Considerable research has explored the various factors that appear to contribute to aggression in psychiatric hospitals. Historically, this research has focussed on the clinical characteristics of aggressive patients, although environmental factors and interactional aspects of aggression have recently been emphasised.

There is some evidence to suggest that interpersonal style, which refers to the characteristic ways in which a person manages their relationships with others and is a significant feature of personality, and levels of perceived coercion, may have an effect on the risk of violent and aggressive behaviour during hospitalisation.

The project aims to:

* to explore the relationship over time between interpersonal style, psychiatric symptoms and aggression in hospitalised psychiatric inpatients,

* to delineate the psychological characteristics of patients with a hostile-dominant interpersonal style,

* to examine whether a history of early childhood abuse predicts hostile-dominance.

Participants

A total of 200 adult acute psychiatric patients have been recruited from the inpatient unit at the Alfred Hospital.

Methods

Anyone newly admitted to the acute inpatient psychiatry services at The Alfred over a specific period were eligible for inclusion. Participants who consented to take part in the study were asked to spend approximately 60 minutes with a research assistant to discuss their experience of being admitted to hospital. This step involved completion of the Impact Message Inventory-Circumplex, Positive and Negative Syndrome Scale, Life History of Aggression Questionnaire, State-Trait Anger Expression Inventory and the Childhood Trauma Questionnaire. Participants were also asked to give permission for the research assistant to have access to their Alfred Psychiatry file to check for incidents of aggression and behaviours during their admissions.

Project status

Data collection has completed and publications detailing project findings are currently being prepared.

Researchers

Dr Michael Daffern

Dr Yitzchak Hollander

Tegan Podubinski

Dr Stuart Lee

2. The impact of psychosocial factors on psychological distress, quality of life and survival of patients undergoing haematopoietic stem cell transplantation

This project is being undertaken by MAPrc in collaboration with the Cabrini Monash Psycho-oncology Unit and staff from Alfred Health. The study is being conducted at the Alfred Hospital.

Stem cell transplantation is often the last course of treatment for patients with haematological cancer who have experienced a relapse or previously unsuccessful treatment attempts. It is often experienced as a very difficult treatment with a number of physical side effects, and many patients experiencing this treatment have been found to experience high levels of psychological distress that impacts on quality of life and capacity to follow treatment recommendations. 

While much is known about the physical and medical predictors of treatment success, less is known about the level of distress and when distress is experienced, as well as how social, medical and other coping approaches help or worsen the experience of distress over time. One particular dispositional factor that is being explored in this study is Sense of Coherence which captures the extent to which people view a difficult situation as comprehensible, manageable and meaningful.

The project aims to:

* to examine the level of emotional distress and quality of life of patients immediately before HSCT, 2-3 weeks post-transplant and 3 months post-transplant,

* to determine if clinical risk factors, demographic factors and Sense of Coherence predicts psychosocial distress in patients undergoing HSCT,

* to determine retrospectively whether various demographic factors, clinical indicators, coping styles and psychological distress experienced pre-transplant predicted survival at 12 months post-transplant.

Participants

Two separate studies have been conducted. Study 1 collected data from the hospital files of 122 people who underwent a stem cell transplant at The Alfred hospital between 20052011. Study 2 which began in 2012, directly collected information from 60 people directly who were about to undergo a stem cell transplant at The Alfred hospital as a treatment for a haematological cancer.

Methods

For Study 1, measures completed with patients as part of the pre-transplant preparation were collected assessing aspects of cancer coping response, quality of life, and distress. For Study 2, participants were invited to complete a set of questionnaires at three timepoints: immediately prior to the transplant, 2-3 weeks after the transplant (while usually still in hospital) and at 3 months after the transplant. Included measures assessed distress, sense of coherence, quality of life and severity of trauma symptoms related to the transplant experience. 

Project status

Data collection has completed for both studies and publications are currently being prepared.

Researchers

Dr Stuart Lee

Brindha Pillay

Lynda Katona

Sue De Bono 

Dr Sue Burney

Dr Sharon Avery

3. Piloting the effectiveness of physical health nurses in community based mental health services

This project is being undertaken by MAPrc in collaboration with the Alfred Psychiatry and Inner South Community Health Service.

Previous research has shown that in comparison to people in the general population, people with a severe mental illness die on average 25 years earlier. A particular reason for this is that people with a severe mental illness have higher rates of cardiovascular disease, metabolic disorders, obesity and hypertension, and reduced engagement with health services.

A pilot study has been implemented within a community team of Alfred Psychiatry and Inner South Community Health Service, which was compared to usual care, to appoint a physical health nurse to lead members of their clinical team in monitoring and establishing plans to address identified physical health difficulties for their clients.

The project aims to:

* Measure whether a physical health intervention led by a physical health nurse for case managed community mental health consumers produces greater improvements in physical health indicators compared to treatment as usual.

* Explore how staff encountering the physical health nurse and receiving provided training about physical illness in people with a severe mental illness, experienced these initiatives.

Participants

People who are case managed by Alfred Psychiatry and Inner South Community Health Service and have a Client Physical Health Guide completed with their case manager are eligible to participate in this study.

Methods

Participants who are case managed by a clinician who has access to a physical health nurse will be compared with participants whose case manager does not have access to the physical health nurse. Their scores on the Client Physical Health Guide will be compared between the initial assessment and 6 month follow-up to determine whether there has been a greater improvement in health indicators with the intervention condition. Case managers employed by both services will also be invited to complete a questionnaire to explore their experience of the initiative.

Project status

Baseline completion of Client Physical Health Guides has completed and follow-up assessment will shortly commence. The staff experience questionnaire is also currently being finalised.

Researchers

Dr Stuart Lee

Troy Macris

Susanne Birks

Kent Burgess

Jessica Price

Narelle Heeney

Lee Kelleher

David Pritchard

Neural Diagnostics

 

The Neural Diagnostics team is working on vestibular diagnostics, which involves measuring and recording the activity in the vestibular system, the middle-ear and brain structures that are responsible for balance and sensing the body’s position in space.

By developing vestibular diagnostic techniques, we hope to find new and accurate ways to measure the efficacy of medications and other therapies used in mental illness and nervous system disorders such as Parkinson’s disease, unipolar and bipolar depression, schizophrenia and vertiginous diseases (Meniere’s disease, benign paroxysmal positional vertigo and central vertigo).

 

You can watch an overview of the team's work here.

Neural Diagnostics team

Team Leader
Brian Lithgow
 
 

Neurodiagnostics: current projects

1. Quantitative measurement of schizophrenia using electrovestibulography. (ARC Linkage Grant)

Aim
The purpose of this is to develop vestibular-based diagnostics for schizophrenia and to use these to measure the efficacy of medications and other therapies used in schizophrenia.

Participants
People with and without schizophrenia.

Methods
Electrovestibulography is used to record impulses from the vestibular systems of people with and without various illnesses in order to identify possible differences between groups.

Project status
This project is currently under way. Early results indicate that electrovesibulography can distinguish between participants with schizophrenia and people with other disorders or no diagnosed disorders.

Researchers
Brian Lithgow
Jayashri Kulkarni
Caroline Gurvich
Saman Hagoohie
 


 

2. Quantitative measurement of depression using electrovestibulography.
 
Aim
The aim of this project is to develop vestibular-based diagnostics for depression (unipolar and bipolar) and to use these to measure the efficacy of medications and other therapies used in depression.

Participants
People with and without depression (unipolar and bipolar).

Methods
Electrovestibulography is used to record impulses from the vestibular systems of people with and without various illnesses in order to identify possible differences between groups.

Project status
This project is currently under way. Early results indicate that electrovestibulography can distinguish between participants with depression and people with other disorders or no diagnosed disorders. There also appear to be differences between results from people with unipolar and bipolar depression.

Researchers
Brian Lithgow
Paul Fitzgerald
Caroline Gurvich
Amber Garrett
 


 

3. The diagnosis, biomarker identification and measurement of drug efficacy in mental illness and neurological conditions
(NHMRC Development Grant).

Aim
The project aims to further validate vestibular-based diagnostic techniques for use in Parkinsons disease, schizophrenia, and depression.

Methods
Electrovestibulography is used to record impulses from the vestibular systems of people with and without various illnesses in order to identify possible differences between groups.

Project status
Based on early results, it appears that electrovestibulography can successfully distinguish participants with schizophrenia, Parkinson’s disease or depression from each other and from people without any of these disorders (control group).

Researchers

Brian Lithgow
Jayashri Kulkarni
Paul Fitzgerald
Caroline Gurvich
 


 

4. Quantitative measurement of vertiginous disorders using electrovestibulography.
   
Aim
The aim of this project is to develop vestibular-based diagnostic techniques for vertiginous disorders (central vertigo, BPPV and Meniere’s disease.)

Methods
Electrovestibulography is used to record impulses from the vestibular systems of people with and without vertiginous disorders in order to identify possible differences between groups.

Project status
This project is currently under way. So far it appears that electrovestibulography can successfully distinguish participants with Meniere’s disease from people with schizophrenia, Parkinson’s disease or depression and from people without any of these disorders (control group). The technique is also able to separate Meniere’s disease from BPPV.

Researchers
Brian Lithgow
Daniel Heibert

Proposed/future projects
 We hope to evaluate the use of electrovestibulography as a diagnostic technique in autism, Aspergers disorder and attention-deficit hyperactivity disorder (ADHD).

 

 

Affiliated Research

MAPrc has participated in a number of affiliated research programs. For further information, please see the menu on the right.

Aged Psychiatry

The Research Unit within Caulfield Aged Psychiatry has experienced its busiest year yet. This is most encouraging, having only commenced work in 2009.

Our main research activities for the year have involved ongoing work on two large, industry-funded clinical trials examining the safety and efficacy of potential disease-modifying concepts in Alzheimer’s disease. Both are sponsored by eli Lilly, and are known as the LZAN and LZAO studies resectively.
 
A further industry-sponsored Alzheimer’s trial, sponsored by Velacor Therapeutics, commenced in January 2010, with a study sponsored by Prana Biotechnology also due to start in March 2012. The research unit has now established itself as a sought-after site by industry partners, and we receive numerous expressions of interest from big pharmaceutical companies in relation to conducting further research with us.
 
The monies accrued in our research SPF (some $160,000 at year’s end) are allowing us to initiate investigator-driven work. We are currently partnering with a number of sites around Melbourne to drive an examination of models of care within psychogeriatric nursing homes. Our other interests in nursing home psychiatry are leading us to examine the effectiveness of regular staff support within these facilities, and to examine the quality of life of carers in the periods before and after their loved on moving into high-level residential care.
 
In addition, we are conducting research into the area of senile squalor, partnering with a number of local NGO’s and the Metropolitan Fire Brigade in this endeavour. Our aim is to collect the largest series of neuropsychology reports on such individuals, with the aim of supporting the hypothesis that frontal lobe deficits invariably underlie the syndrome.
 
Recently Janssen Pharmaceuticals have agreed to fund a 50-patient, Melbourne-based study into the effects of the injectable antipsychotic Invega Sustenna on elderly patients with schizophrenia. This is a Caulfield-based initiative and is proposed to involve four other Melbourne-based sites over a two-year period.
 

Aged Psychiatry team

Team Leader
Associate Professor Steve Macfarlane FRANZCP
 
Medical Officer
Dr Christine Kotsios FRANZCP
 
Clinical trials Coordinator 

Maree Mastwyk RN RPN
 
Research Coordinator
Dr Matt Lewis Ph.D
 
Research Nurse
Ms Jenny Bortoli RN
Ms Natalia Pimenova RN  

Aged Psychiatry: current projects

Protocol H8A-MC-LZAN - Effect of Passive Immunisation on the Progression of Alzheimer’s Disease: LY2062430 versus Placebo (Lilly) – concludes June 2012

Protocol H8A-MC-LZAO - Effect of Passive Immunisation on the Progression of Alzheimer’s Disease: LY2062430 versus Placebo. An Open-Label Extension Study (Lilly) – concludes December 2013

A Randomised, Double-Blind, Placebo-Controlled Trial to Evaluate the Safety, Tolerability and the Biological and Cognitive Effects of VEL015 (Sodium Selenate) in Patients with Mild to Moderate Alzheimer’s Disease – a Pilot Study (Velacor Therapeutics) – in progress, recruiting

A randomised, double-blind, placebo-controlled study to assess the safety and tolerability of PBT2, and its effect on amyloid deposition in the brains of patients with prodromal or mild Alzheimer’s disease. (Prana Biotechnology) – commencing March 2012

Neuropsychological Characteristics of Patients Referred With Senile Squalor (self-funded; in progress)

Psychogeriatric nursing homes in Victoria: a comparison of models of care (self-funded; in progress)

Effect on the family carer post-institutionalisation of the patient with dementia (self-funded; awaiting HREC approval)

Effects of regular supervision upon paid professional carers within a nursing home environment (self-funded; awaiting HREC approval)

Effects of an educational programme targeting general practitioners (regarding the management of behaviours of concern) on psychotropic prescribing and adverse outcomes in nursing homes: a pilot study (self-funded; in protocol development)

Efficacy and safety of paliperidone long-acting injection in elderly people with schizophrenia (proposed, involving 5 local sites, external funding secured, in protocol development)

A pilot study to evaluate the use of mobile computing within a community aged psychiatry service (internally funded, in protocol development)

 

Child and Adolescent Mental Health

Alfred Child and Adolescent Mental Health Service (CAMHS) offers mental health care to infants, children and youths and their families or carers.  People who live in the cities of Port Phillip, Stonnington, Glen Eira, Bayside and Ports of Kingston are eligible to use Alfred CAMHS.

We are actively looking to increase the amount and quality of research that we are doing and we have a particular interest in practice-based evidence.

Child and Adolescent Mental Health team

Chief Investigator/Team Leader   
Professor Jayashri Kulkarni

Researchers               
Louise Newman
Paul Denborough
 

Child and Adolescent Mental Health: current projects

1. Intervening in child trauma

Aim   
The purpose of this study is to improve understanding of child trauma and to assess an evidence-based intervention

Participants 
  
Children and youth from Israel and Australia

Project status   
This project is due to commence soon

Researchers   
Professor Jayashri Kulkarni
Louise Newman
Paul Denborough

2. Theory of mind, emotion recognition and temperament: association with social functioning in children and adolescents.

Aim   
The aim of this project is to look at factors that might be linked with the difficulties some young people have in getting along with others

Participants and methods
Young people, completing a variety of questionnaires

Project status   
This project is currently ongoing.

Researchers   
Emma Newton
Paul Denborough

3. Client-directed, outcome-informed practice pilot

Aim
The purpose of this project is to pilot the introduction of an effectiveness measure of the clinical work of the Alfred Child and Adolescent Mental Health Service

Participants
The project involves 8 clinicians and 50 families

Methods
Clinician and carer satisfaction with the CDOI practice is being measured.

Project status
The pilot commenced in June 2009 and is currently under way.

Researchers   
Rachel Barbara-May
Paul Denborough
Stuart Lee

4. Sharing reports with families

Aim
This project aims to improve collaborative practice at the CAMHS and to improve the usefulness of assessment reports.

Participants
The Middle South team

Methods
Information is collected via a telephone survey of clients and a staff satisfaction survey.

Status       
This project is in the planning stages.

Researchers   
Dr Campbell Thorpe
Michelle Knuckey

5. How parents inform children about autism

Aim
The purpose of this project is to find out baseline information about how and at what age parents inform their children about autism spectrum disorder.

Participants   
20 families who came to Alfred CAMHS through the DAP Program.

Methods
Families that agree to participate will be interviewed and baseline data will be collected.

Status       
This study is currently in preparation.

Researchers   
Mary Fleming
Jenny Harrison

6. Satisfaction survey of autism assessment service

Aim
The study sets out to survey past families to measure satisfaction and identify areas for program improvement.

Participants   
55 clients of the service.

Methods       
The 55 clients were sent a 31-item questionnaire to complete.

Status       
Complete in 2009

Researchers
Roger Pelletier

7. Use of interpretation in children under 3 years old

Aim
This study examined what interventions are effective when working psychotherapeutically with 2 years olds.

Methods       
Literature review.

Status       
Completed in 2009

Researchers
Rosalie Birkin

8. Children of mentally ill patients

Aim
The purpose of the project is to examine the engagement and needs of children of clients attending Adult Psychiatry.

Methods
Information is collected via file audit

Status
This study is currently ongoing

Researcher
Sharon Sutherland
 

Consultation Liaison Psychiatry

Consultation-Liaison Psychiatry is the psychiatric sub-specialty that helps people with mental health problems in general medical settings such as general hospitals. We offer assessment and treatment of psychiatric disorders in patients who are medically unwell. The C-L Unit at the Alfred is one of the largest in Australia, with specialised services for oncology, neurology, HIV, burns, trauma, heart-lung transplant, hepatitis, renal medicine, and respiratory medicine, as well as general service for all other patients of Alfred Health.

Our Unit has a strong focus on education and research, and a close affiliation with MAPrc. A range of projects in various medical units have been completed. Many of these projects are in conjunction with other major research units. Areas of particular interest include studies of the psychological consequences of trauma (led by Meaghan O’Donnell from the Australian Centre for Post-traumatic Mental Health), and studies examining the rates and effects of psychiatric disorders in HIV and AIDS.

Consultation Liaison Psychiatry team

Head of Unit and Research Team Leader
Associate Professor Steven Ellen
 

Consultation Liaison Psychiatry: current projects

1. Telephone-Administered Early Psychological Intervention for Depression and Anxiety Following Serious Injury

Investigators
Dr Meaghan O’Donnell
Associate Professor David Forbes
Professor Mark Creamer
Dr Alexander Holmes
Associate Professor Steven Ellen
Professor Richard Bryant

Aim
The aim of this study is to test whether early intervention telephone-administered cognitive behavioural therapy can help prevent and/or treat depression, post-traumatic stress disorder (PTSD) and anxiety in people who have had a traumatic injury.

Participants
Patients admitted to the Trauma Service.

Project status
The project has received funding from BeyondBlue and is currently under way.

 


2.  Engaging Students in Psychiatry
 
Chief Investigator
Dr Dielle Felman

Co-investigators
Dr Rob Selzer
Dr Steve Ellen

Background and aims
This study is designted to investigate the attitudes of Monash University fourth year medical students towards psychiatry before and after their undergraduate MBBS psychiatry rotation.  In particular, it attempts to explore medical student attitudes about

  • Desire to be a psychiatrist
  • The perceived importance/utility of psychiatry
  • The desire to acquire knowledge about psychiatry, and
  •  Regard for psychiatrists

The study investigates the effect that different experiences of subspecialties within the psychiatry rotation (i.e. acute adult inpatient, outpatient, aged, consultation-liaison, child and adolescent psychiatry) have on the above aspects of medical students’ attitudes. 

Participants
All fourth year medical students from Monash University, undertaking their psychiatry rotations at metropolitan hospitals between July 2009 and June 2010 will be invited to participate in the study.  This is approximately 250 students in total.

Methods
This project has been approved by the Monash University MBBS Committee and the Monash University Ethics Department.

The study uses a number of questionnaires:

  • Behaviors and Attitudes to Psychiatry Questionnaire (BAP)
  • Behaviors and Attitudes Questionnaire – with focus on subspecialties (BAP- fs). 
  • Focus on Subspecialty questionnaire (FOS)

The students will be invited to complete the questionnaires before and after their psychiatry rotations, and the results of the questionnaires will be analysed to evaluate the impact of various experiences on students’ attitudes to psychiatry.

 


3. A Transcranial Magnetic Stimulation study of cortical activity in HIV-1 Associated Neurocognitive Disorder.
 
Researchers
Dr Toby Syme
Professor Paul Fitzgerald
Associate Professor Steve Ellen
Dr Mark Jeanes
 

Aim
A significant proportion of people with HIV-1 infection (HIV) experience brain effects (neurocognitive impairments) despite being on adequate antiretroviral therapy (cART). Transcranial Magnetic Stimulation (TMS) has been used in a range of disorders affecting the nervous system to improve understanding of the mechanisms behind various diseases and to aid in diagnosis and monitoring of therapy. However, so far it has been little used in studying HIV associated neurocognitive disorders (HAND).

This project aims to evaluate the usefulness of TMS in improving our understanding of neurological disease in people with HIV, as well as in early diagnosis and monitoring the effectiveness of various treatments.  

 

Medicine of the Mind

The Medicine of the Mind team is responsible for teaching psychiatry, psychology and psychological medicine. Its mission is ‘to deliver a seamless education in psychiatry and related disciplines across the breadth of the undergraduate medical course’.

Specifically, this involves: teaching into the Years 1 and 2 of the MBBS course via the Human Lifespan Development and Health and Human Behaviour subjects as well as a Year 1 elective; directing students’ clinical placement for Psychiatry  during Year 4; and a Year 5 selective subject. Medicine of the Mind also teaches students in the Radiography, Dietetics and Medical Science courses.

Over the past twelve months, Medicine of the Mind has remodelled several aspects of its teaching in the undergraduate medical course in Years 1, 4 and 5, as well as in Year 1 of the Radiography course.

The review and remodelling process aims to achieve several things: to research new and vibrant models for teaching psychiatry; to encourage, recruit and reward vibrant teachers; to use staff and materials more efficiently; and to smooth the process by which students acquire the psychology and psychiatry knowledge they will need to be doctors.

Coordinating all teaching through one office helps eliminate duplication and gaps in teaching, ensures consistency in content and facilitates sharing of resources such as staff, materials, ideas, research, forums and simulations.

Students see the same tutors across the years, which provides them with a consistent reference person and fosters development of personal relationships, mentoring and modelling of professional development. Medicine of the Mind also involves psychiatry registrars in its teaching program to foster peer learning. 

 

Medicine of the Mind team

Director, Undergraduate Medical Education
Prof Rob Selzer

Deputy Director
Dr Revi Nair

Administration
Anne Crawford

Innovations

Medicine of the Mind has introduced a number of innovations and continues to identify opportunities to improve students’ learning experience.

Teaching

1. Clinical placement
In response to students’ feedback, the Year 4 clinical placement has been changed from a split 18-week semester alternating psychiatry and general practice to a continuous 9-week program that emphasises clinically based learning and teaching. Students are embedded in a team and expected to play an active role. All clinical staff and students are provided with clear guidelines about the students’ roles and responsibilities.

2. PEERLS
Instead of traditional case-study-based workshops, PEERLS (Professionalism, Ethics, Evidence-base, Roles, Legal, Systemic) has been developed to help students integrate clinical experiences with theory. PEERLS sessions are patient-based, but held away from the bedside. They are led by a clinician /expert, and involve the tutor sharing his/her knowledge and experience.

3. Resources
So far, Medicine of the Mind has produced a book for students that provides an introductory overview to psychiatry and also a video journal.

Technology

Medicine of the Mind seeks to make maximum use of technology to improve teaching and maximise opportunities for students.

1. Web-based video instructions for PEERLS tutors
These provide an easily accessible guide for PEERLS session tutors.

2. COAT – Computerised OSCE Assessment Tool
This system simplifies and speeds up the process of collecting and posting results of students’ practical OSCE (Observed Structured Clinical Evaluation) exams.

3. TICLE – Texting to Improve the Clinical Learning Experience
By making better use of text messaging, students can be advised of last-minute schedule changes, interesting clinical cases and events. This helps avoid delays, bottlenecks and missed learning opportunities.

4. Exam database
A database of past questions by topic, difficulty, etc facilitates the preparation of examinations.

 

Participatory Action Research

"Essentially Participatory Action Research (PAR) is research which involves all relevant parties in actively examining together current action (which they experience as problematic) in order to change and improve it. They do this by critically reflecting on the historical, political, cultural, economic, geographic and other contexts which make sense of it. … Participatory Action Research (PAR) is not just research which is hoped that will be followed by action. It is action which is researched, changed and re-researched, within the research process by participants. Nor is it simply an exotic variant of consultation. Instead, it aims to be active co-research, by and for those to be helped. Nor can it be used by one group of people to get another group of people to do what is thought best for them - whether that is to implement a central policy or an organisational or service change. Instead it tries to be a genuinely democratic or non-coercive process whereby those to be helped, determine the purposes and outcomes of their own inquiry." - Wadsworth, Y. (1998)

The key elements of Participatory Action Research:

Participatory – People who access the mental health service and people who deliver the Mental Health service are both participants and co-researchers.

Action – Action is not just changes that are made, but also the formation of new knowledge and new understandings by both groups of people that currently hold differing perspectives of mental health service delivery.

Research
– We use research methodologies of triangulation of data, and test and re-test for validity checking. Grounded Theory methodology and principles are also extensively used.

The subject of the research is the service system of mental health service delivery.

 

Participatory Action Research: current projects

 

The Participatory Action Research Stream applies its methodologies, within the Consumer Participation Program of Alfred Psychiatry, to projects that improve the quality of services of Alfred Psychiatry.
 
Each Project contains Quality Improvement cycles that are:
  1. Consumer Driven
  2. Staff / Consumer Collaborative.
  3. Quality Improvement focused.
  4. For all to participate.
  5. Supported and resourced by management.
From 2000 -2010 we have had 46 consumer co-researchers (CPP Workteam members), all renumerated for their work, but not employed, conducting these cycles of improvement. Each received experiential training for specific tasks relevant to the types of cycles they were facilitating.
 
The following table is indicative of a sample of Projects we have conducted.
 
Table 1 – Consumer participation rates for samples of activities and QI cycle utilisation.
 
Activity / Project
Number of cycles
Number of consumer participants / respondents
Ward Feedback Cards
5 for Ward 1                          
6 for Ward 2
250              
300                      
Total   550
Consumer Evaluation of CCU
1
20
Consumer Focus group – Lets talk about the Wards
1
30
Consumer Focus Group – Lets talk about the CAT Team
1
17
Consumer Focus Group – Drugs and Alcohol and Mental Health
1
10
Consumer Issues Group / Projects Reference Groups
24 at Community Clinic site 1
24 at Community Clinic site 2
120
170                       
Total   290
PARC monthly Feedback Group
36
138
PARC annual Feedback forum
3
72
Consumer Evaluation of Mobile Support and Treatment Service (MSTs)
1
60
Consumer Evaluation of Homeless Outreach Psychiatric Service (HOPS)
1
12

Some QI cycles have led to other Projects being conducted that are focused on consumer supports rather than changes and improvements to current service delivery.
 
Table 2 – Consumer participation in Consumer run Supports.
 
Activity / Project
Project Duration
Number of Consumer participants
Staff – Consumer collaboration in Treatment workbook and workshops
12 months
47 workshops conducted
470 consumer participants
Consumer Led Recovery Groups
3 x 12 week groups over 36 months
28 consumer participants

Alfred Psychiatry (Adult) has funded an external independent Evaluation of the Consumer Participation Program that will be completed by March 2012.
 
The Participatory Action Research Stream collaborates with other Research Streams and Projects of MAPrc.

 

 

Participate in a Research Study

MAPrc researchers regularly seek people who have experience with mental illness, as well as those who do not, for participation in research projects and treatment trials. 

See our Treatment Trials page for information about current projects requiring research. We are also always in need of healthy volunteers to act as 'control' participants. For more information see the MAPrc recruitment drive flyer below.

What is involved in participation will depend on what the research project is, but may include:

Any personal information provided and the record of participation are treated as private health information and kept confidential.

All MAPrc studies have been approved, and are governed by, the Alfred Hospital Ethics Committee.

If you would like to forward a general expression of interest in participating in any of our research projects, please contact our centre on:

Phone: +61 (0)3 9076 6564

Fax: +61 (0)3 9076 6588

E-mail: maprc@monash.edu

AttachmentSize
MAPrc recruitment drive flyer.pdf292.06 KB