Dr Tonelle Handley

Dr Tonelle Handley

Research Fellow

Centre for Rural and Remote Mental Health

Career Summary

Biography

Dr Tonelle Handley is a Research Fellow at the University of Newcastle's Centre for Rural and Remote Mental Health. She is a psychiatric epidemiologist whose research focus is on quantitative approaches to improving mental health for rural Australians. Her areas of work include improving access to mental health services, improving community attitudes towards mental health, and rural suicide prevention. She has research experience across university and health sectors, and has worked on projects spanning targeted interventions to broad public health approaches. She is particularly interested in the analysis of large data sets, including longitudinal analyses to identify long-term risk factors for mental health problems, suicidal thoughts and behaviours in non-metropolitan areas.

Qualifications

  • Doctor of Philosophy, University of Newcastle
  • Bachelor of Social Science (Psychology), University of Newcastle
  • Postgraduate Diploma in Psychology, University of Newcastle

Keywords

  • Mental health
  • Rural health

Fields of Research

Code Description Percentage
111714 Mental Health 50
111706 Epidemiology 30
111712 Health Promotion 20
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Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Journal article (35 outputs)

Year Citation Altmetrics Link
2020 Kelly B, Handley T, Kissane D, Vamos M, Attia J, 'An indelible mark the response to participation in euthanasia and physician-assisted suicide among doctors: A review of research findings', Palliative and Supportive Care, 18 82-88 (2020) [C1]

Copyright © 2019 Cambridge University Press. Introduction The debate regarding euthanasia and physician-assisted suicide (E/PAS) raises key issues about the role of the doctor, an... [more]

Copyright © 2019 Cambridge University Press. Introduction The debate regarding euthanasia and physician-assisted suicide (E/PAS) raises key issues about the role of the doctor, and the professional, ethical, and clinical dimensions of the doctor-patient relationship. This review aimed to examine the published evidence regarding the response of doctors who have participated in E/PAS.Methods Original research papers were identified reporting either qualitative or qualitative data published in peer-reviewed literature between 1980 and March 2018, with a specific focus on the impact on, or response from, physicians to their participation in E/PAS. PRISMA and CASP guidelines were followed.Results Nine relevant papers met selection criteria. Given the limited published data, a descriptive synthesis of quantitative and qualitative findings was performed. Quantitative surveys were limited in scope but identified a mixed set of responses. Where studies measured psychological impact, 30-50% of doctors described emotional burden or discomfort about participation, while findings also identified a comfort or satisfaction in believing the request of the patient was met. Significant, ongoing adverse personal impact was reported between 15% to 20%. A minority of doctors sought personal support, generally from family or friends, rather than colleagues. The themes identified from the qualitative studies were summarized as: 1) coping with a request; 2) understanding the patient; 3) the doctor's role and agency in the death of a patient; 4) the personal impact on the doctor; and 5) professional guidance and support.Significance of results Participation in E/PAS can have a significant emotional impact on participating clinicians. For some doctors, participation can contrast with perception of professional roles, responsibilities, and personal expectations. Despite the importance of this issue to medical practice, this is a largely neglected area of empirical research. The limited studies to date highlight the need to address the responses and impact on clinicians, and the support for clinicians as they navigate this challenging area.

DOI 10.1017/S1478951519000518
Citations Scopus - 1Web of Science - 3
Co-authors Brian Kelly, John Attia
2020 Austin EK, Rich JL, Kiem AS, Handley T, Perkins D, Kelly BJ, 'The concerns about climate change among rural residents in Australia.', Journal of Rural Studies, 75 98-109 (2020) [C1]
DOI 10.1016/j.jrurstud.2020.01.010
Co-authors Jane Rich, David Perkins, Anthony Kiem, Brian Kelly, Emma Austin
2020 Heinsch M, Sampson D, Huens V, Handley T, Hanstock T, Harris K, Kay-Lambkin F, 'Understanding ambivalence in help-seeking for suicidal people with comorbid depression and alcohol misuse.', PloS one, 15 e0231647 (2020) [C1]
DOI 10.1371/journal.pone.0231647
Co-authors Tanya Hanstock, Frances Kaylambkin, Milena Heinsch
2019 McGill K, Hiles SA, Handley TE, Page A, Lewin TJ, Whyte I, Carter GL, 'Is the reported increase in young female hospital-treated intentional self-harm real or artefactual?', Australian and New Zealand Journal of Psychiatry, 53 663-672 (2019) [C1]

© The Royal Australian and New Zealand College of Psychiatrists 2018. Background: The Australian Institute of Health and Welfare has reported an increased rate of hospital-treated... [more]

© The Royal Australian and New Zealand College of Psychiatrists 2018. Background: The Australian Institute of Health and Welfare has reported an increased rate of hospital-treated intentional self-harm in young females (2000¿2012) in Australia. These reported increases arise from institutional data that are acknowledged to underestimate the true rate, although the degree of underestimation is not known. Objective: To consider whether the reported increase in young females¿ hospital-treated intentional self-harm is real or artefactual and specify the degree of institutional underestimation. Methods: Averages for age- and gender-standardised event rates for hospital-treated intentional self-harm (national: Australian Institute of Health and Welfare; state: New South Wales Ministry of Health) were compared with sentinel hospital event rates for intentional self-poisoning (Hunter Area Toxicology Service, Calvary Mater Newcastle) in young people (15¿24 years) for the period 2000¿2012. A time series analysis of the event rates for the sentinel hospital was conducted. Results: The sentinel hospital event rates for young females of 444 per 100,000 were higher than the state (378 per 100,000) and national (331 per 100,000) rates. There was little difference in young male event rates ¿ sentinel unit: 166; state: 166 and national: 153 per 100,000. The sentinel hospital rates showed no change over time for either gender. Conclusion: There was no indication from the sentinel unit data of any increase in rates of intentional self-poisoning for young females. The sentinel and state rates were higher than the national rates, demonstrating the possible magnitude of underestimation of the national data. The reported increases in national rates of hospital-treated self-harm among young females might be due to artefactual factors, such as changes in clinical practice (greater proportion admitted), improved administrative coding of suicidal behaviours or possibly increased hospital presentations of community self-injury cases, but not intentional self-poisoning. A national system of sentinel units is needed for the accurate and timely monitoring of all hospital-treated self-harm.

DOI 10.1177/0004867418815977
Citations Scopus - 3Web of Science - 2
Co-authors Sarah Hiles, Terry Lewin, Gregory Carter, Katherine Mcgill
2019 Peters I, Handley T, Oakley K, Lutkin S, Perkins D, 'Social determinants of psychological wellness for children and adolescents in rural NSW', BMC PUBLIC HEALTH, 19 (2019) [C1]
DOI 10.1186/s12889-019-7961-0
Co-authors David Perkins
2019 Handley TE, Rich J, Lewin TJ, Kelly BJ, 'The predictors of depression in a longitudinal cohort of community dwelling rural adults in Australia', Social Psychiatry and Psychiatric Epidemiology, 54 171-180 (2019) [C1]

© 2018, Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: Many major studies of depression in Australia are under-representative of rural and remote residents, limit... [more]

© 2018, Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: Many major studies of depression in Australia are under-representative of rural and remote residents, limiting the generalizability of their findings. This study explores the contributions of a range of individual, social, and community factors to the trajectory of depressive symptoms among a cohort of rural and remote residents. Methods: Data from four waves of the Australian Rural Mental Health Study (baseline n = 2639), a 5¿year longitudinal study of rural community residents, were examined within generalized linear mixed models to predict depressive symptoms. Depression was measured using the PHQ-9, with key correlates including social support, employment status, financial wellbeing, neuroticism, and rural community factors. Results: Moderate-to-severe depression was reported by 6.3% of the baseline sample. Being permanently unable to work resulted in over a threefold increase in the odds of depression at the following survey wave. Self-rated financial hardship was associated with a fourfold increase in the odds of future depression, as was a high level of community concerns. Neuroticism and tobacco use also made a significant independent contribution to future depressive symptoms. Interpersonal support was a protective factor, reducing the odds of next-wave depression by 64%. Conclusion: Financial and employment-related difficulties appear to be important risk factors for depression, and targeting individuals experiencing such difficulties may be an effective means of reducing depression among certain sub-groups. Strategies to prevent depression in rural and remote Australia may benefit from a focus on interpersonal and community-level support, as the effects of this support are lasting and contribute to a reduced likelihood of depressive episodes in future years.

DOI 10.1007/s00127-018-1591-1
Citations Scopus - 5Web of Science - 4
Co-authors Terry Lewin, Jane Rich, Brian Kelly
2019 Dalton H, Read DMY, Booth A, Perkins D, Goodwin N, Hendry A, et al., 'Formative Evaluation of the Central Coast Integrated Care Program (CCICP), NSW Australia.', International journal of integrated care, 19 15 (2019) [C1]
DOI 10.5334/ijic.4633
Citations Scopus - 1
Co-authors Hazel Dalton, Nicholas Goodwin, Donna Read, Kate Davies, David Perkins, Angela Booth
2018 Rich J, Handley T, Inder K, Perkins D, 'An experiment in using open-text comments from the Australian Rural Mental Health Study on health service priorities.', Rural and remote health, 18 (2018) [C1]
DOI 10.22605/rrh4208
Citations Scopus - 1Web of Science - 1
Co-authors David Perkins, Jane Rich, Kerry Inder
2018 Butterworth P, Kelly BJ, Handley TE, Inder KJ, Lewin TJ, 'Does living in remote Australia lessen the impact of hardship on psychological distress?', Epidemiology and Psychiatric Sciences, 27 500-509 (2018) [C1]

Copyright © Cambridge University Press 2017. Aims. Rural and remote regions tend to be characterised by poorer socioeconomic conditions than urban areas, yet findings regarding di... [more]

Copyright © Cambridge University Press 2017. Aims. Rural and remote regions tend to be characterised by poorer socioeconomic conditions than urban areas, yet findings regarding differences in mental health between rural and urban areas have been inconsistent. This suggests that other features of these areas may reduce the impact of hardship on mental health. Little research has explored the relationship of financial hardship or deprivation with mental health across geographical areas.Methods. Data were analysed from a large longitudinal Australian study of the mental health of individuals living in regional and remote communities. Financial hardship was measured using items from previous Australian national population research, along with measures of psychological distress (Kessler-10), social networks/support and community characteristics/locality, including rurality/remoteness (inner regional; outer regional; remote/very remote). Multilevel logistic regression modelling was used to examine the relationship between hardship, locality and distress. Supplementary analysis was undertaken using Australian Household, Income and Labour Dynamics in Australia (HILDA) Survey data.Results. 2161 respondents from the Australian Rural Mental Health Study (1879 households) completed a baseline survey with 26% from remote or very remote regions. A significant association was detected between the number of hardship items and psychological distress in regional areas. Living in a remote location was associated with a lower number of hardships, lower risk of any hardship and lower risk of reporting three of the seven individual hardship items. Increasing hardship was associated with no change in distress for those living in remote areas. Respondents from remote areas were more likely to report seeking help from welfare organisations than regional residents. Findings were confirmed with sensitivity tests, including replication with HILDA data, the use of alternative measures of socioeconomic circumstances and the application of different analytic methods.Conclusions. Using a conventional and nationally used measure of financial hardship, people residing in the most remote regions reported fewer hardships than other rural residents. In contrast to other rural residents, and national population data, there was no association between such hardship and mental health among residents in remote areas. The findings suggest the need to reconsider the experience of financial hardship across localities and possible protective factors within remote regions that may mitigate the psychological impact of such hardship.

DOI 10.1017/S2045796017000117
Citations Scopus - 3Web of Science - 1
Co-authors Terry Lewin, Kerry Inder, Brian Kelly
2018 Handley T, Rich J, Davies K, Lewin T, Kelly B, 'The Challenges of Predicting Suicidal Thoughts and Behaviours in a Sample of Rural Australians with Depression.', International journal of environmental research and public health, 15 1-9 (2018) [C1]
DOI 10.3390/ijerph15050928
Citations Scopus - 7Web of Science - 6
Co-authors Terry Lewin, Kate Davies, Brian Kelly, Jane Rich
2018 Wilhelm K, Handley T, Reddy P, 'A case for identifying smoking in presentations to the emergency department with suicidality', Australasian Psychiatry, 26 176-180 (2018) [C1]

© 2018, © The Royal Australian and New Zealand College of Psychiatrists 2018. Objectives: The aim of this study was to identify mental health and lifestyle factors predicting smok... [more]

© 2018, © The Royal Australian and New Zealand College of Psychiatrists 2018. Objectives: The aim of this study was to identify mental health and lifestyle factors predicting smoking among people at high risk of suicidal behaviour. Methods: Participants (n = 363) completed self-report mental health and lifestyle measures at first appointment in a hospital clinic following presentation to the emergency department for deliberate self-harm or suicidal ideation. Results: The rate of daily smoking in this group, 61.4%, is more than four times the rate observed in the general population. Those with a history of previous deliberate self-harm were twice as likely to be smokers. Each one-point increase in poor health behaviours increased the odds of smoking by 22%. Conclusions: Identifying and managing smoking and related lifestyle behaviours are important considerations in routine clinical assessments.

DOI 10.1177/1039856218757638
Citations Scopus - 2Web of Science - 2
2018 Handley TE, Lewin TJ, Perkins D, Kelly B, 'Self-recognition of mental health problems in a rural Australian sample', Australian Journal of Rural Health, 26 173-180 (2018) [C1]

© 2018 National Rural Health Alliance Ltd. Objective: Although mental health literacy has increased in recent years, mental illness is often under-recognised. There has been littl... [more]

© 2018 National Rural Health Alliance Ltd. Objective: Although mental health literacy has increased in recent years, mental illness is often under-recognised. There has been little research conducted on mental illness in rural areas; however, this can be most prominent in rural areas due to factors such as greater stigma and stoicism. The aim of this study is to create a profile of those who are most and least likely to self-identify mental health problems among rural residents with moderate- to-high psychological distress. Design: Secondary analysis of a longitudinal postal survey. Setting: Rural and remote New South Wales, Australia. Participants: Four-hundred-and-seventy-two community residents. Main outcome measure: Participants completed the K10 Psychological Distress Scale, as well as the question ¿In the past 12 months have you experienced any mental health problems?¿ The characteristics of those who reported moderate/high distress scores were explored by comparing those who did and did not experience mental health problems recently. Results: Of the 472 participants, 319 (68%) with moderate/high distress reported a mental health problem. Reporting a mental health problem was higher among those with recent adverse life events or who perceived more stress from life events while lower among those who attributed their symptoms to a physical cause. Conclusions: Among a rural sample with moderate/high distress, one-third did not report a mental health problem. Results suggest a threshold effect, whereby mental health problems are more likely to be acknowledged in the context of additional life events. Ongoing public health campaigns are necessary to ensure that symptoms of mental illness are recognised in the multiple forms that they take.

DOI 10.1111/ajr.12406
Citations Scopus - 6Web of Science - 4
Co-authors David Perkins, Brian Kelly, Terry Lewin
2018 Austin EK, Handley T, Kiem AS, Rich JL, Lewin TJ, Askland HH, et al., 'Drought-related stress among farmers: findings from the Australian Rural Mental Health Study.', The Medical journal of Australia, 209 159-165 (2018) [C1]
DOI 10.5694/mja17.01200
Citations Scopus - 16Web of Science - 13
Co-authors Hedda Askland, Jane Rich, Brian Kelly, Emma Austin, David Perkins, Terry Lewin, Anthony Kiem
2018 Fitzpatrick SJ, Perkins D, Handley T, Brown D, Luland T, Corvan E, 'Coordinating mental and physical health care in rural Australia: An integrated model for primary care settings', International Journal of Integrated Care, 18 1-9 (2018) [C1]
DOI 10.5334/ijic.3943
Citations Scopus - 2Web of Science - 2
Co-authors David Perkins, Scott Fitzpatrick
2017 Considine R, Tynan R, James C, Wiggers J, Lewin T, Inder K, et al., 'The contribution of individual, social and work characteristics to employee mental health in a coal mining industry population', PLoS ONE, 12 1-15 (2017) [C1]
DOI 10.1371/journal.pone.0168445
Citations Scopus - 15Web of Science - 19
Co-authors John Wiggers, Terry Lewin, Kerry Inder, Carole James, Brian Kelly, David Perkins
2017 Inder KJ, Holliday EG, Handley TE, Fragar LJ, Lower T, Booth A, et al., 'Depression and risk of unintentional injury in rural communities a longitudinal analysis of the Australian rural mental health study', International Journal of Environmental Research and Public Health, 14 (2017) [C1]
DOI 10.3390/ijerph14091080
Citations Scopus - 3Web of Science - 2
Co-authors Terry Lewin, Liz Holliday, Brian Kelly, Angela Booth, Kerry Inder
2017 Thornton L, Handley T, Kay-Lambkin F, Baker A, 'Is A Person Thinking About Suicide Likely to Find Help on the Internet? An Evaluation of Google Search Results', Suicide and Life-Threatening Behavior, 47 48-53 (2017) [C1]

© 2016 The American Association of Suicidology It is unclear whether individuals searching the Internet for assistance with thoughts of suicide are likely to encounter predominant... [more]

© 2016 The American Association of Suicidology It is unclear whether individuals searching the Internet for assistance with thoughts of suicide are likely to encounter predominantly helpful or harmful resources. This study investigated websites retrieved by searching Google for information and support for suicidal thoughts. Google searches retrieved a high percentage of irrelevant websites (26%, n¿=¿136). Of the 329 relevant websites retrieved, the majority were suicide preventive (68%); however, a considerable proportion of sites expressed mixed (22%) or neutral (8%) suicide attitudes, and 1% were explicitly pro-suicide. The results highlight a need for suicide prevention organization websites to be made more easily accessible. In the meantime, clinicians should be aware of appropriate websites to recommend to clients.

DOI 10.1111/sltb.12261
Citations Scopus - 15Web of Science - 13
Co-authors Frances Kaylambkin, Amanda Baker
2017 Iseme RA, McEvoy M, Kelly B, Agnew L, Walker FR, Handley T, et al., 'A role for autoantibodies in atherogenesis', CARDIOVASCULAR RESEARCH, 113 1102-1112 (2017) [C1]
DOI 10.1093/cvr/cvx112
Citations Scopus - 24Web of Science - 21
Co-authors Brian Kelly, Christopher Oldmeadow, Mark Mcevoy, John Attia, Rohan Walker
2016 Handley TE, Kay-Lambkin FJ, Baker AL, Lewin TJ, Kelly BJ, Inder KJ, et al., 'Investigation of a Suicide Ideation Risk Profile in People with Co-occurring Depression and Substance Use Disorder', Journal of Nervous and Mental Disease, 204 820-826 (2016) [C1]

© Wolters Kluwer Health, Inc. All rights reserved. Disengagement from services is common before suicide, hence identifying factors at treatment presentation that predict future su... [more]

© Wolters Kluwer Health, Inc. All rights reserved. Disengagement from services is common before suicide, hence identifying factors at treatment presentation that predict future suicidality is important. This article explores risk profiles for suicidal ideation among treatment seekers with depression and substance misuse. Participants completed assessments at baseline and 6 months. Baseline demographics, psychiatric history, and current symptoms were entered into a decision tree to predict suicidal ideation at follow-up. Sixty-three percent of participants at baseline and 43.5% at follow-up reported suicidal ideation. Baseline ideation most salient when psychiatric illness began before adulthood, increasing the rate of follow-up ideation by 16%. Among those without baseline ideation, dysfunctional attitudes were the most important risk factor, increasing rates of suicidal ideation by 35%. These findings provide evidence of factors beyond initial diagnoses that increase the likelihood of suicidal ideation and are worthy of clinical attention. In particular, providing suicide prevention resources to those with high dysfunctional attitudes may be beneficial.

DOI 10.1097/NMD.0000000000000473
Citations Scopus - 4Web of Science - 4
Co-authors John Attia, Amanda Baker, Frances Kaylambkin, Kerry Inder, Brian Kelly, Terry Lewin
2016 Wilhelm K, Handley T, Reddy P, 'Exploring the validity of the Fantastic Lifestyle Checklist in an inner city population of people presenting with suicidal behaviours', Australian and New Zealand Journal of Psychiatry, 50 128-134 (2016) [C1]

© The Royal Australian and New Zealand College of Psychiatrists 2015. Purpose: Although patients demonstrate a range of problematic health-related lifestyle behaviours preceding s... [more]

© The Royal Australian and New Zealand College of Psychiatrists 2015. Purpose: Although patients demonstrate a range of problematic health-related lifestyle behaviours preceding suicidal behaviour, there is little research that routinely measure these behaviours. This paper seeks to establish the utility of health-related lifestyle measure (Fantastic Lifestyle Checklist) in people presenting to a major inner city Emergency Department with a range of suicidal behaviours. Methods: From 2007-2014, data from the 366 patients who had completed the Fantastic Lifestyle Checklist, after referral by the Emergency Department to a service for people with deliberate self-harm or suicidal ideation, were included in the analysis study. A Maximum Likelihood factor analysis was performed to assess the factor structure of the Fantastic Lifestyle Checklist and the resultant factors were explored in relation to measures of health; namely the Depression, Anxiety and Stress Scale and the 12-item Short-Form Health Survey. Results: A three-component factor structure emerged comprising Component 1 'positive life investments', Component 2 'poor emotional regulation' and Component 3 'poor health behaviours'. There was a significant negative correlation between 'positive life investments' and each of the Depression, Anxiety and Stress scales subscales and significant positive associations with 'poor emotional regulation' and Short Form Health Survey-12 mental health scores. Only the Short Form Health Survey-12 physical health subscale was weakly correlated with 'poor health behaviours', in females. Conclusion: Our findings support the construct and concurrent validity of the Fantastic Lifestyle Checklist measure. The three factors obtained for the Fantastic Lifestyle Checklist were coherent and seem useful for research and clinical practice.

DOI 10.1177/0004867415621393
Citations Scopus - 3Web of Science - 3
2016 Handley TE, Ventura AD, Browne JL, Rich J, Attia JR, Reddy P, et al., 'Suicidal ideation reported by adults with Type 1 or Type 2 diabetes: results from Diabetes MILES Australia', Diabetic Medicine, 33 1582-1589 (2016) [C1]

© 2015 Diabetes UK Aims: To examine the prevalence and correlates of suicidal ideation (SI) in a community-based sample of adults with Type 1 or Type 2 diabetes. Methods: Particip... [more]

© 2015 Diabetes UK Aims: To examine the prevalence and correlates of suicidal ideation (SI) in a community-based sample of adults with Type 1 or Type 2 diabetes. Methods: Participants were 3338 adults aged 18¿70 years with Type 1 diabetes (n = 1376) or Type 2 diabetes (non-insulin: n = 1238; insulin: n = 724) from a national survey administered to a random sample registered with the National Diabetes Services Scheme. Depression and SI were assessed using the Patient Health Questionnaire, and diabetes-specific distress with the Problem Areas In Diabetes scale. Separate logistic regression analyses by diabetes type/treatment were used to determine relative contribution to SI. Results: Overall, we observed a SI rate of 14% in our sample. Participants with Type 2 diabetes using insulin reported more frequent depressive symptoms, and were more likely to report recent SI (19%) compared with those with either Type 1 diabetes or Type 2 diabetes not using insulin (14 and 12%, respectively). After controlling for depression, there was little difference in the prevalence of SI between diabetes types/treatments, but higher diabetes-specific distress significantly increased the odds of SI. Conclusions: As SI is a significant risk factor for a suicide attempt, the findings have implications for healthcare professionals, pointing to the importance of adequate screening and action plans for appropriate follow-up of those reporting depression. Our findings are also indicative of the psychological toll of diabetes more generally, and the need to integrate physical and mental healthcare for people with diabetes.

DOI 10.1111/dme.13022
Citations Scopus - 12Web of Science - 14
Co-authors Jane Rich, John Attia
2015 Handley T, Perkins D, Kay-Lambkin F, Lewin T, Kelly B, 'Familiarity with and intentions to use Internet-delivered mental health treatments among older rural adults', Aging and Mental Health, 19 989-996 (2015) [C1]

© 2014 © 2014 Taylor & Francis. Objectives: Older adults are the fastest growing age group in Australia, necessitating an increase in appropriate mental health services in t... [more]

© 2014 © 2014 Taylor & Francis. Objectives: Older adults are the fastest growing age group in Australia, necessitating an increase in appropriate mental health services in the coming years. While Internet-delivered mental health treatments have been established as acceptable and efficacious among younger samples, little research has explored whether they would be similarly useful in older populations.Methods: The participants were part of the Australian Rural Mental Health study, which explores mental health and well-being in residents of non-metropolitan New South Wales. A postal survey was used to assess knowledge of and intentions to use Internet-delivered mental health treatments. Demographics, mental health, and frequency of Internet use were also measured.Results: The survey was completed by 950 adults aged 50-93. The sample was largely unfamiliar with Internet mental health services, with 75% reporting that they had never heard of them and a further 20% not knowing any details of what they involved. Intentions to use these services were also low, at 13.5%; however, this increased with level of familiarity. Respondents with higher psychological distress, higher education, and more frequent Internet use were significantly more likely to consider using Internet treatments.Conclusions: Among older adults, overall awareness of Internet-delivered mental health treatments appears to be limited; however, higher familiarity contributes to higher intentions to use these treatments. Importantly, respondents with higher distress and greater computer literacy were more likely to consider mental health treatments delivered via the Internet. Future research exploring strategies to increase the promotion of these services to older samples may further improve their perceptions and use.

DOI 10.1080/13607863.2014.981744
Citations Scopus - 5Web of Science - 8
Co-authors Frances Kaylambkin, Terry Lewin, Brian Kelly, David Perkins
2015 Handley TE, Kelly BJ, Lewin TJ, Coleman C, Stain HJ, Weaver N, Inder KJ, 'Long-term effects of lifetime trauma exposure in a rural community sample Health behavior, health promotion and society', BMC Public Health, 15 (2015) [C1]

© 2015 Handley et al. Background: This study examines the long-term outcomes of lifetime trauma exposure, including factors that contribute to the development of PTSD, in a sample... [more]

© 2015 Handley et al. Background: This study examines the long-term outcomes of lifetime trauma exposure, including factors that contribute to the development of PTSD, in a sample of rural adults. Methods: In 623 rural community residents, lifetime trauma exposure, PTSD, other psychiatric disorders and lifetime suicidal ideation were assessed using the World Mental Health Composite International Diagnostic Interview. Logistic regressions were used to examine relationships between potentially traumatic events (PTEs) and lifetime PTSD and other diagnoses. Results: 78.2 % of participants reported at least on PTE. Rates were broadly comparable with Australian national data: the most commonly endorsed events were unexpected death of a loved one (43.7 %); witnessing injury or death (26.3 %); and life-threatening accident (19.3 %). While the mean age of the sample was 55 years, the mean age of first trauma exposure was 19 years. The estimated lifetime rate of PTSD was 16.0 %. Events with the strongest association with PTSD were physical assault and unexpected death of a loved one. Current functioning was lowest among those with current PTSD, with this group reporting elevated psychological distress, higher mental health service use, a greater number of comorbidities, and lower perceived social support. Respondents with a past PTE but no PTSD history were generally similar in terms of their current wellbeing to those with no lifetime PTE. Conclusions: PTEs may have diverse psychological and social consequences beyond the development of PTSD. Ensuring that adequate support services are available in rural areas, particularly in the period immediately following a PTE, may reduce the long-term impact of traumatic events.

DOI 10.1186/s12889-015-2490-y
Citations Scopus - 8Web of Science - 9
Co-authors Terry Lewin, Brian Kelly, Natasha Weaver, Kerry Inder
2014 Butterworth P, Handley TE, Lewin TJ, Reddy P, Kelly BJ, 'Psychological distress in rural Australia: regional variation and the role of family functioning and social support', Journal of Public Health (Germany), 22 481-488 (2014)

© 2014, Springer-Verlag Berlin Heidelberg. Aim: Regional variation in the prevalence of mental disorders and particularly variation in the role of risk and protective factors has ... [more]

© 2014, Springer-Verlag Berlin Heidelberg. Aim: Regional variation in the prevalence of mental disorders and particularly variation in the role of risk and protective factors has received limited research attention. This study investigates variation in the prevalence of significant psychological distress across regions, and quantifies the relative impact of family functioning and social support. Subject and method: Multilevel analysis of data from the longitudinal Australian Rural Mental Health Study, comprising a stratified random sample from non-metropolitan New South Wales. Distress was assessed using the Kessler-10. The analysis considered clustering within households and across geographic regions based on Local Government Areas and collapsed to represent residence in inner regional, outer regional, remote and very remote locations. Results: There was limited clustering of psychological distress within areas (0.4¿%). However, the household accounted for almost 45¿% of the variance in psychological distress, and the salience of the household was greater in more remote regions (33.1¿% in inner regional to 60.5¿% in very remote areas). Family functioning and perceived social support were associated with increased risk of psychological distress, but explained only a modest amount of variance in mental health at household level. After controlling for individual and family/social covariates, 34.5¿% of the remaining variance in psychological distress was observed at the household level. Conclusion: The findings suggest that individuals in remote locations are more reliant on their family/confidants for their mental health than those in more populated areas. Future research will consider whether this simply reflects differences in the accessibility of formal health services or broader social and cultural differences.

DOI 10.1007/s10389-014-0640-9
Citations Scopus - 4Web of Science - 1
Co-authors Brian Kelly, Terry Lewin
2014 Handley TE, Kay-Lambkin FJ, Inder KJ, Attia JR, Lewin TJ, Kelly BJ, 'Feasibility of internet-delivered mental health treatments for rural populations', Social Psychiatry and Psychiatric Epidemiology, 49 275-282 (2014) [C1]

Purpose: Rural populations face numerous barriers to mental health care. Although internet-delivered mental health treatments may offer an accessible and cost-effective answer to ... [more]

Purpose: Rural populations face numerous barriers to mental health care. Although internet-delivered mental health treatments may offer an accessible and cost-effective answer to these barriers, there has been little evaluation of the feasibility of this approach among rural communities. Methods: Data were obtained from a random rural community sample through the third wave of the Australian Rural Mental Health Study. Attitudes towards internet-delivered mental health treatments and availability of internet access were explored. Data were analysed to identify sub-groups in whom internet-delivered treatments may be usefully targeted. Results: Twelve hundred and forty-six participants completed the survey (mean age 59 years, 61 % females, 22 % from remote areas). Overall, 75 % had internet access and 20 % would consider using internet-based interventions, with 18 % meeting both of these feasibility criteria. Logistic regression revealed feasibility for internet-delivered mental health treatment was associated with younger age, male gender, being a carer, and a 12-month mental health problem. Participants who had used internet-delivered services in the past were significantly more likely to endorse these treatments as acceptable. Conclusions: There is considerable potential for internet-delivered treatments to increase service accessibility to some sub-groups, particularly among people with mental health problems who are not currently seeking help. Resistance to internet treatments appears to be largely attitudinal, suggesting that enhancing community education and familiarity with such programs may be effective in improving perceptions and ultimately access. © 2013 Springer-Verlag Berlin Heidelberg.

DOI 10.1007/s00127-013-0708-9
Citations Scopus - 12Web of Science - 12
Co-authors Terry Lewin, Brian Kelly, Frances Kaylambkin, John Attia, Kerry Inder
2014 Handley TE, Hiles SA, Inder KJ, Kay-Lambkin FJ, Kelly BJ, Lewin TJ, et al., 'Predictors of Suicidal Ideation in Older People: A Decision Tree Analysis', AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY, 22 1325-1335 (2014) [C1]
DOI 10.1016/j.jagp.2013.05.009
Citations Scopus - 24Web of Science - 21
Co-authors Terry Lewin, John Attia, Roseanne Peel, Frances Kaylambkin, Kerry Inder, Sarah Hiles, Mark Mcevoy, Brian Kelly
2014 Handley TE, Kay-Lambkin FJ, Inder KJ, Lewin TJ, Attia JR, Fuller J, et al., 'Self-reported contacts for mental health problems by rural residents: Predicted service needs, facilitators and barriers', BMC Psychiatry, 14 (2014) [C1]

© 2014 Handley et al.; licensee BioMed Central Ltd. Background: Rural and remote Australians face a range of barriers to mental health care, potentially limiting the extent to whi... [more]

© 2014 Handley et al.; licensee BioMed Central Ltd. Background: Rural and remote Australians face a range of barriers to mental health care, potentially limiting the extent to which current services and support networks may provide assistance. This paper examines self-reported mental health problems and contacts during the last 12¿months, and explores cross-sectional associations between potential facilitators/barriers and professional and non-professional help-seeking, while taking into account expected associations with socio-demographic and health-related factors. Methods: During the 3-year follow-up of the Australian Rural Mental Health Study (ARMHS) a self-report survey was completed by adult rural residents (N = 1,231; 61% female 77% married; 22% remote location; mean age = 59¿years), which examined socio-demographic characteristics, current health status factors, predicted service needs, self-reported professional and non-professional contacts for mental health problems in the last 12¿months, other aspects of help-seeking, and perceived barriers. Results: Professional contacts for mental health problems were reported by 18% of the sample (including 14% reporting General Practitioner contacts), while non-professional contacts were reported by 16% (including 14% reporting discussions with family/friends). Perceived barriers to health care fell under the domains of structural (e.g., costs, distance), attitudinal (e.g., stigma concerns, confidentiality), and time commitments. Participants with 12-month mental health problems who reported their needs as met had the highest levels of service use. Hierarchical logistic regressions revealed a dose-response relationship between the level of predicted need and the likelihood of reporting professional and non-professional contacts, together with associations with socio-demographic characteristics (e.g., gender, relationships, and financial circumstances), suicidal ideation, and attitudinal factors, but not geographical remoteness. Conclusions: Rates of self-reported mental health problems were consistent with baseline findings, including higher rural contact rates with General Practitioners. Structural barriers displayed mixed associations with help-seeking, while attitudinal barriers were consistently associated with lower service contacts. Developing appropriate interventions that address perceptions of mental illness and attitudes towards help-seeking is likely to be vital in optimising treatment access and mental health outcomes in rural areas.

DOI 10.1186/s12888-014-0249-0
Citations Scopus - 15Web of Science - 11
Co-authors Frances Kaylambkin, John Attia, David Perkins, Natasha Weaver, Terry Lewin, Brian Kelly, Kerry Inder
2014 Inder KJ, Handley TE, Johnston A, Weaver N, Coleman C, Lewin TJ, et al., 'Determinants of suicidal ideation and suicide attempts: Parallel cross-sectional analyses examining geographical location', BMC Psychiatry, 14 (2014) [C1]

Background: Suicide death rates in Australia are higher in rural than urban communities however the contributors to this difference remain unclear. Geographical differences in sui... [more]

Background: Suicide death rates in Australia are higher in rural than urban communities however the contributors to this difference remain unclear. Geographical differences in suicidal ideation and attempts were explored using two datasets encompassing urban and rural community residents to examine associations between socioeconomic, demographic and mental health factors. Differing patterns of association between psychiatric disorder and suicidal ideation and attempts as geographical remoteness increased were investigated.Methods: Parallel cross-sectional analyses were undertaken using data from the 2007 National Survey of Mental Health and Wellbeing (2007-NSMHWB, n = 8,463), under-representative of remote and very remote residents, and selected participants from the Australian Rural Mental Health Study (ARMHS, n = 634), over-representative of remote and very remote residents. Uniform measures of suicidal ideation and attempts and mental disorder using the World Mental Health Composite International Diagnostic Interview (WMH-CIDI-3.0) were used in both datasets. Geographic region was classified into major cities, inner regional and other. A series of logistic regressions were undertaken for the outcomes of 12-month and lifetime suicidal ideation and lifetime suicide attempts, adjusting for age, gender and psychological distress. A sub-analysis of the ARMHS sample was undertaken with additional variables not available in the 2007-NSMHWB dataset.Results: Rates and determinants of suicidal ideation and suicide attempts across geographical region were similar. Psychiatric disorder was the main determinant of 12-month and lifetime suicidal ideation and lifetime suicide attempts across all geographical regions. For lifetime suicidal ideation and attempts, marital status, employment status, perceived financial adversity and mental health service use were also important determinants. In the ARMHS sub-analysis, higher optimism and better perceived infrastructure and service accessibility tended to be associated with a lower likelihood of lifetime suicidal ideation, when age, gender, psychological distress, marital status and mental health service use were taken into account.Conclusions: Rates and determinants of suicidal ideation and attempts did not differ according to geographical location. Psychiatric disorder, current distress, employment and financial adversity remain important factors associated with suicidal ideation and attempts across all regions in Australia. Regional characteristics that influence availability of services and lower personal optimism may also be associated with suicidal ideation in rural communities. © 2014 Inder et al.; licensee BioMed Central Ltd.

DOI 10.1186/1471-244X-14-208
Citations Scopus - 21Web of Science - 18
Co-authors Terry Lewin, Kerry Inder, Natasha Weaver, Brian Kelly
2013 Handley TE, Attia JR, Inder KJ, Kay-Lambkin FJ, Barker D, Lewin TJ, Kelly BJ, 'Longitudinal course and predictors of suicidal ideation in a rural community sample.', Australian & New Zealand Journal of Psychiatry, 47 1032-1040 (2013) [C1]
DOI 10.1177/0004867413495318
Citations Scopus - 10Web of Science - 10
Co-authors Frances Kaylambkin, Kerry Inder, Daniel Barker, Terry Lewin, Brian Kelly, John Attia
2013 Handley TE, Kay-Lambkin FJ, Baker AL, Lewin TJ, Kelly BJ, Inder KJ, et al., 'Incidental treatment effects of CBT on suicidal ideation and hopelessness', JOURNAL OF AFFECTIVE DISORDERS, 151 275-283 (2013) [C1]
DOI 10.1016/j.jad.2013.06.005
Citations Scopus - 14Web of Science - 14
Co-authors Amanda Baker, Frances Kaylambkin, Kerry Inder, Terry Lewin, Brian Kelly, John Attia
2012 Handley T, Inder KJ, Kelly BJ, Attia JR, Lewin TJ, Fitzgerald MN, Kay-Lambkin FJ, 'You've got to have friends: The predictive value of social integration and support in suicidal ideation among rural communities', Social Psychiatry and Psychiatric Epidemiology, 47 1281-1290 (2012) [C1]
Citations Scopus - 30Web of Science - 28
Co-authors Brian Kelly, Terry Lewin, John Attia, Kerry Inder, Frances Kaylambkin
2012 Handley T, Inder KJ, Kay-Lambkin FJ, Stain HJ, Fitzgerald M, Lewin TJ, et al., 'Contributors to suicidality in rural communities: Beyond the effects of depression', BMC Psychiatry, 12 105 (2012) [C1]
Citations Scopus - 30Web of Science - 28
Co-authors John Attia, Frances Kaylambkin, Terry Lewin, Brian Kelly, Kerry Inder
2012 Inder KJ, Handley T, Fitzgerald MN, Lewin TJ, Coleman CE, Perkins DA, Kelly BJ, 'Individual and district-level predictors of alcohol use: cross sectional findings from a rural mental health survey in Australia', BMC Public Health, 12 (2012) [C1]
DOI 10.1186/1471-2458-12-586
Citations Scopus - 12Web of Science - 13
Co-authors Kerry Inder, Terry Lewin, Brian Kelly, David Perkins
2011 Handley T, Inder KJ, Kelly BJ, Attia JR, Kay-Lambkin FJ, 'Urban-rural influences on suicidality: Gaps in the existing literature and recommendations for future research', Australian Journal of Rural Health, 19 279-283 (2011) [C1]
DOI 10.1111/j.1440-1584.2011.01235.x
Citations Scopus - 10Web of Science - 10
Co-authors Brian Kelly, John Attia, Frances Kaylambkin, Kerry Inder
2010 Lynagh MC, Gilligan C, Handley T, 'Teaching about, and dealing with, sensitive issues in schools: How confident are pre-service teachers?', Asia-Pacific Journal of Health, Sport and Physical Education, 1 5-11 (2010) [C1]
Citations Scopus - 6
Co-authors Marita Lynagh, Conor Gilligan
Show 32 more journal articles

Conference (8 outputs)

Year Citation Altmetrics Link
2019 Dalton H, Wilson J, Read D, Booth A, Day J, Hayes A, Handley T, 'Early intervention and integration of access to health and social care for vulnerable families in schools on the Central Coast, New South Wales, Australia', Melbourne, Victoria (2019)
Co-authors Hazel Dalton, Donna Read, Alan Hayes, Angela Booth
2018 Austin E, Rich J, Kiem A, Handley T, Perkins D, Kelly B, 'Concerns about climate change: the voice of rural New South Wales', Newcastle, Australia (2018)
Co-authors Brian Kelly, Emma Austin, Anthony Kiem, David Perkins
2018 Dalton H, Perkins D, Goodwin N, Hendry A, Davies K, Read D, Handley T, 'Use of the Project Integrate Framework for situational analysis and benchmarking of progress towards care integration in the Central Coast NSW', INTERNATIONAL JOURNAL OF INTEGRATED CARE (2018)
DOI 10.5334/ijic.s1088
Co-authors Angela Booth, Donna Read, Hazel Dalton, David Perkins, Kate Davies, Nicholas Goodwin
2018 Dalton HE, Perkins D, Goodwin N, Hendry A, Read D, Booth A, et al., 'Using the Project Integrate Framework for assessing progress towards care integration: Results from a formative evaluation of a complex intervention in Central Coast Local Health District, NSW, Australia', Utrecht, Netherlands (2018)
Co-authors Kate Davies, Donna Read, Hazel Dalton, Angela Booth, David Perkins
2017 Livingstone F, Davies K, Handley T, 'How effective are they? An evaluation of community and clinician-targeted rural suicide prevention workshops', Albury, NSW (2017)
Co-authors David Perkins, Kate Davies
2017 Davies K, Handley T, Livingstone F, de Jaeger A, '"Making the journey easier": An evaluation of community- and clinician-targeted rural suicide prevention workshops', "Making the journey easier": An evaluation of community- and clinician-targeted rural suicide prevention workshops, Kingscliff, NSW, Australia (2017) [E1]
Co-authors Kate Davies
2016 Austin EK, Rich JL, Kiem AS, Handley TE, Perkins D, Kelly B, 'Rural peoples' concerns about climate change: findings from the Australian rural mental health study', NCCARF Climate Adaptation 2016 Conference - Change, Challenge, Opportunity, Adelaide, Australia (2016)
Co-authors David Perkins, Jane Rich, Brian Kelly, Anthony Kiem
2010 Handley T, 'Social support and suicidal ideation in a rural sample', Proceedings of the Australasian Society for Psychiatric Research (ASPR) 2010 Conference, Sydney, NSW (2010) [E3]
Show 5 more conferences

Report (7 outputs)

Year Citation Altmetrics Link
2020 Handley T, 'Evaluation of the Uniting Parkwood Palliative End of Life Service', Western NSW Local Health District, 41 (2020)
2018 Kay-Lambkin F, Gilbert J, Pedemont L, Sunderland M, Dalton H, Handley T, et al., 'Prevention and early intervention for people aged 18 and over with, or at risk of, mild to moderate depression and anxiety: An Evidence Check', Beyond Blue, 110 (2018)
Co-authors Brian Kelly, Hazel Dalton, Frances Kaylambkin, David Perkins
2018 Dalton HE, Read D, Handley T, Booth A, Davies K, Goodwin N, Hendry A, 'Central Coast Integrated Care Program: Formative Evaluation Report', Central Coast Local Health District (2018)
Co-authors Angela Booth, Hazel Dalton, Donna Read, Kate Davies
2018 Read D, Dalton H, Booth A, Davies K, Handley T, Goodwin N, et al., 'Central Coast Integrated Care Program: Formative Evaluation, Technical Paper', Central Coast Local Health District (2018)
Co-authors Donna Read, Hazel Dalton, David Perkins, Kate Davies, Angela Booth
2017 Dalton H, Read D, Handley TE, Perkins D, 'Low Intensity Mental Health Services: A Rapid Review', A multi-state collective of Primary Health Networks, 124 (2017)
Co-authors Donna Read, Hazel Dalton, David Perkins
2017 Handley TE, Davies K, Rich J, Booth A, Considine R, 'Mental health of Port Stephens youth: Needs analysis study for Caring for Our Port Stephens Youth', Caring for our Port Stephens Youth, 62 (2017)
Co-authors Kate Davies, Angela Booth
2014 Perkins D, Handley T, Parker S, Gill T, 'Opiate Substitution: A Rapid Review', New South Wales Health Mental Health and Drug and Alcohol Office (2014)
Co-authors David Perkins
Show 4 more reports
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Grants and Funding

Summary

Number of grants 7
Total funding $977,431

Click on a grant title below to expand the full details for that specific grant.


20181 grants / $25,000

Prevention and early intervention for people aged 18 and over with, or at risk of, mild to moderate depression and anxiety$25,000

Funding body: The Sax Institute

Funding body The Sax Institute
Project Team Professor Frances Kay-Lambkin, Professor Sally Chan, Professor Brian Kelly, Professor David Perkins, Doctor Tonelle Handley, Doctor Hazel Dalton, Dr Matt Sunderland
Scheme Project Grant
Role Investigator
Funding Start 2018
Funding Finish 2018
GNo G1801155
Type Of Funding C3112 - Aust Not for profit
Category 3112
UON Y

20172 grants / $233,604

Central Coast LHD Integrated Care Formative Evaluation$133,604

Funding body: Central Coast Local Health District

Funding body Central Coast Local Health District
Project Team Professor David Perkins, Doctor Hazel Dalton, Doctor Kate Davies, Doctor Tonelle Handley, Doctor Donna Read, Mrs Angela Booth
Scheme Research Grant
Role Investigator
Funding Start 2017
Funding Finish 2017
GNo G1700888
Type Of Funding C2210 - Aust StateTerritoryLocal - Own Purpose
Category 2210
UON Y

GP’s with a Special Interest in Mental Health$100,000

Funding body: Murrumbidgee Primary Health Network

Funding body Murrumbidgee Primary Health Network
Project Team Doctor Tonelle Handley, Doctor Hazel Dalton, Professor David Perkins, Louise Upton, Sarah Connor, Jane Connolly, Sean Mutchmor, Doctor Kate Davies
Scheme Research Grant
Role Lead
Funding Start 2017
Funding Finish 2018
GNo G1701306
Type Of Funding C2110 - Aust Commonwealth - Own Purpose
Category 2110
UON Y

20161 grants / $41,330

Needs Analysis Study - Mental Health of Port Stephens Youth$41,330

Funding body: Caring for Our Port Stephens Youth (COPSY)

Funding body Caring for Our Port Stephens Youth (COPSY)
Project Team Doctor Tonelle Handley, Doctor Kate Davies, Doctor Jane Rich
Scheme Research Project
Role Lead
Funding Start 2016
Funding Finish 2016
GNo G1601159
Type Of Funding C3112 - Aust Not for profit
Category 3112
UON Y

20151 grants / $99,270

Supporting young Aboriginal men in their transition to fathering through a user developed website$99,270

Funding body: Young and Well CRC

Funding body Young and Well CRC
Project Team Associate Professor Richard Fletcher, Professor Brian Kelly, Doctor Josephine Gwynn, Doctor Tonelle Handley, Ms Nicole Turner, Doctor Geoffrey Skinner, Ms LISA Shipley, Professor David Perkins
Scheme Research Grant
Role Investigator
Funding Start 2015
Funding Finish 2015
GNo G1401077
Type Of Funding CRC - Cooperative Research Centre
Category 4CRC
UON Y

20141 grants / $225,000

Multi-tiered approach to suicide prevention in young Australians$225,000

Funding body: Australian Rotary Health

Funding body Australian Rotary Health
Project Team

Doctor Tonelle Handley

Scheme Geoffrey Betts Postdoctoral Fellowship
Role Lead
Funding Start 2014
Funding Finish 2017
GNo
Type Of Funding Aust Competitive - Non Commonwealth
Category 1NS
UON N

20131 grants / $353,227

Mental Health in the Coal Mining Industry: Measuring Extent, Impact and Solutions for Workplace Health, Safety and Productivity$353,227

Funding body: ACARP (Australian Coal Industry’s Research Program)

Funding body ACARP (Australian Coal Industry’s Research Program)
Project Team

Professor Brian Kelly, Professor John Wiggers, Conjoint Associate Professor Terry Lewin, Associate Professor Carole James, Doctor Kerry Inder, Mrs Robyn Considine, Doctor Mark Lock, Mr Trevor Hazell, Ms Jaelea Skehan, Mr Ross Tynan, Ms Tonelle Handley

Scheme Project
Role Investigator
Funding Start 2013
Funding Finish 2014
GNo
Type Of Funding Aust Competitive - Non Commonwealth
Category 1NS
UON N
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Research Supervision

Number of supervisions

Completed0
Current1

Current Supervision

Commenced Level of Study Research Title Program Supervisor Type
2018 PhD Quantifying Relationships Between Climate Extremes and Mental Health PhD (Psychiatry), Faculty of Health and Medicine, The University of Newcastle Principal Supervisor
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News

Mental illness going unrecognised in country communities

June 20, 2018

Researchers have found that one third of country people experiencing psychological distress don’t identify as having a mental health problem.

Dr Tonelle Handley

Position

Research Fellow
Centre for Rural and Remote Mental Health
Faculty of Health and Medicine

Contact Details

Email tonelle.handley@newcastle.edu.au
Phone (02) 4033 5622

Office

Room 5010 McAuley Centre, Calvary Mater
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