2020 E-Mental Health International Conference Abstracts

Thursday, 5 November

Keynote Speech I

E-mental health approaches to suicide prevention in clinical and non-clinical populations: benefits, harms, and ethical considerations

Professor Greg Carter

Consultation Liaison Psychiatry, Calvary Mater Newcastle Hospital;

Faculty of Health and Medicine, University of Newcastle, Australia

The presentation will selectively review established and novel e-mental health interventions to reduce suicide in clinical and non-clinical populations with reference to systematic reviews and recently developed interventions to be tested. A number of recent systematic reviews have demonstrated the efficacy of specific aftercare interventions in reducing attempts and suicide.  Most of these interventions are not widely available in clinical services even in face-to-face formats, although an e-mental health approach would be suitable for delivering several of them at scale. The likely benefits, harms and the associated ethical considerations will be presented. For non-clinical populations: as many as 60% of those who die by suicide are not in care, however many are on the internet, and state this as their preferential route to seek help. The recently Announced Under the Radar project addresses this non-clinical population and will be detailed.

Plenary Session I

Moving from Face-to-Face to online over a weekend; the challenges and opportunity of COVID-19

Professor Liz Burd

Pro Vice-Chancellor (COVID-19 Response Leader), Learning and Teaching, Academic Division, University of Newcastle, Australia

Leading an institution through COVID-19: experience from a non-health professional.

The University of Newcastle was one of the few institutions in Australia that remained open during the entire period of the COVID pandemic. This session will review some of the approaches we adopted to the management of staff and student through the pandemic to keep open when others were closed. This session will detail the leadership, decision-making and communication strategies we adopted to retain staff and student confidence and manage their wellbeing through change and uncertainty. In particular, this talk will focus of our data and research driven strategies and how we employed technology to assist in each of these areas.

Using e-technology to support student’s mental health during COVID-19

Dr Emma Kerr

Clinical Psychologist and Online Counsellor, University of Newcastle, Australia

This presentation will share how e-technology was utilised at the University of Newcastle Counselling and Psychological Service to support student’s wellbeing during the COVID19 pandemic. It will explore student’s acceptance, the strengths and limitations of using e-technology in counselling and a way forward.

The role of social media in youth suicide prevention: the development of the #chatsafe project

Associate Professor Jo Robinson

Centre For Youth Mental Health (CYMH), University of Melbourne, Australia

Young people actively use social media to talk about suicide and suicide-related behaviour, which presents both risks and benefits. In response, we developed a comprehensive set of evidence-informed guidelines to foster safe communication about suicide on social media.

We employed the Delphi expert consensus method to develop the guidelines. This involved a systematic literature search to identify key ‘action items’ which were then rated for inclusion in the guidelines by panels of young people and professionals. Two questionnaire rounds were conducted and items that achieved consensus by both panels were included in the guidelines. The #chatsafe guidelines are freely available online: https://www.orygen.org.au/chatsafe/

We then conducted a series of co-design workshops, with around 300 young people from across Australia to co-design a national social media campaign to help bring the guidelines to life. The campaign reached around 3 million young Australians and its impact is currently being evaluated. Since then we have also adapted the guidelines for 12 additional regions around the world and have developed a suite of additional resources for communities and educators, to help them support young people to talk safely online about suicide.

This presentation will cover the rationale for, and creation of, the #chatsafe guidelines. This presentation will also present on some current applications of the #chatsafe guidelines as well future directions for the #chatsafe project.

Can guidelines and a social media campaign improve online safety among young people?

Dr Louise La Sala

Suicide Prevention Team, Orygen, Australia

The #chatsafe guidelines are the world’s first evidence-informed tools and tips designed to help young people have safe conversations on social media about suicide. To date, the guidelines have been downloaded over 50,000 times and are now available in 12 different regions worldwide.

In late 2019 #chatsafe launched a 12-week nation-wide social media campaign. This was to harness the power of social media and make the information within the guidelines accessible to young people. Over 500 people were recruited into a study to help evaluate the #chatsafe campaign content and explore whether engagement with the content resulted in safer conversations online. A final sample of 189 participants completed three questionnaires (before the campaign, immediately after the campaign, and 4-weeks post campaign) measuring patterns of social media usage, willingness and capacity to intervene against suicide online, and perceived self-efficacy, confidence and safety when communicating about suicide online. Each week during the campaign, participants were sent a piece of content to their nominated social media account and were asked to respond to three short questions measuring acceptability and iatrogenic effects.

In this presentation I will discuss the acceptability, safety and feasibility of sharing a suicide prevention campaign entirely through social media. I will also present on the data collected during the evaluation which suggests that the #chatsafe campaign increased participant willingness to intervene against suicide online, and also increased participants perceived safety and confidence when communicating online about suicide.

Plenary Session II

A study protocol to implement school-based eHealth interventions to promote healthy lifestyles and enhance social wellbeing among junior high school students

Professor Regina Lee

School of Nursing and Midwifery, University of Newcastle, Australia

Using e-technology to promote people’s health and wellbeing

Professor Mitch Duncan

School of Medicine & Public Health; Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Australia

Using technology within mental health services

Dr. Agatha Conrad

Hunter New England Local Health District, NSW, Australia

Plenary Session III 

Digital mental health: A panacea in a pandemic?

Professor Rhonda Wilson

School of Nursing and Midwifery, University of Newcastle, Australia

This presentation will discuss the adoption and suitability of digital environments and tools for the administration of clinical mental health care across a range of mental health conditions and acuity. COVID-19 has accelerated the need for digital mental health clinical care provision, with social distancing one of the critical factors in reducing transmission rates generally. Mental health services have had to pivot quickly to facilitate appropriate provision of care. A range of mental health treatments had already become routine care for some jurisdictions, for example, there is a wide evidence base to indicate the effectiveness of internet-based cognitive behavioural therapy. However, COVID-19 has required that additional contactless services are available to the public. This has been a significant challenge for rapid implementation, and some lessons are emerging from the adaption of new digital mental health practice. This presentation will provide an analysis of the lessons learnt, and suggest ways that an integration of digital mental health, infection prevention and control and disaster health principles might be used to prepare for the anticipated magnitude of mental health distress and illness that is likely to emerge as a consequence of the socio-economic impacts of COVID-19.

A (brief) history of psychology and e-mental health

Dr Sally Hunt

School of Psychology, University of Newcastle, Australia

This presentation will explore the history of e-Mental Health over the past three decades and discuss the hurdles and facilitators to implementing novel treatment approaches in mental health settings. The evolution of an online intervention for co-occurring substance misuse and depression will be used to illustrate the change in clinician attitudes, access and usage of e-Mental Health tools and point the way to the current challenges in implementing these and other interventions.

eHealth resources for supporting family carers of people living with dementia in Hong Kong

Associate Professor Helen Chan

The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong

Dementia is a broad category of neurodegenerative syndromes, generally characterized by the progressive decline of cognitive function. People living with dementia generally exhibit various distressed symptoms, including agitation, aggression, wandering, and verbal outbursts. However, their family carers usually fail to manage these symptoms and report high levels of frustration, anxiety and social isolation. This presentation introduces a knowledge transfer project adopting the medical-social collaboration model to prepare family carers for the challenging caregiving tasks. An educational website and a series of demonstration videos and podcast for mindfulness practice were developed for meeting their information needs. We conducted a prospective cohort study to evaluate the feasibility and preliminary effects of the intervention. Findings showed that negative emotion and perceived role strain were significantly reduced at follow up. The family carers also reported significant improvement in depressive symptoms and perceived gain in the caregiving roles at the follow-up assessment. This project provides empirical evidence on the beneficial effects of online resources in promoting mental wellbeing among family carers involved in dementia care. Moreover, the website has been adopted by the government as one of the resources for Dementia Friendly Community Campaign.

Plenary Session IV – Early Career Researchers Showcase

Building confidence and capacity in mental health for family day care educators through online learning: Outcomes of a randomised control trial

Bronte Lyford and Ashleigh Old

Everymind, Australia and University of Newcastle

Positive mental health in early childhood is critical for children’s well-being and development and has important implications for their future. Family daycare (FDC) educators play a significant role in supporting children’s social and emotional wellbeing, with over 180,000 children attending family daycare in Australia each year.

Minds Together is an eight-week online education program developed with the aim of increasing the capacity and confidence of educators to support the mental health and wellbeing of children. Informed by Australian family day care educators and early childhood education experts, Minds Together outlines the knowledge, skills and practices family day care educators need to support children’s wellbeing and provide early intervention when needed. The program also encourages educators to reflect on their own mental health and wellbeing.

A national randomised control trial was conducted in 2020 to test the effectiveness of the Minds Together program. 258 educators were recruited and randomised to program (n=130) and waitlist (n=128) conditions. Educators were invited to complete up to three online surveys, and seven participated in in-depth interviews.

This presentation discusses the results of the trial, specifically, educator’s experience of completing the online program, as well as educator self-efficacy, confidence, and mental health and wellbeing (DASS-21, and WEMWBS). We also report on the impact of COVID-19 on educators' practice, levels of worry, and participation in the Minds Together program. The implications of these findings for FDC educator online professional development and sector sustainability are considered.

An innovative role for digital signage in mental health: implementation science

Richard Clancy

Hunter New England Mental Health, Australia

Background: Clinicians in mental health settings are encouraged to adopt numerous guidelines relating to the service delivery with mixed success. Implementation science explores mechanisms that influence uptake. We describe a novel, collaborative approach to improve guideline uptake using digital signage in clinical settings.

Methods: A two-phase evaluation of digital signage as an adjunctive tool in implementation has commenced.

Phase 1: the co-design of a digital signage campaign in collaboration with consumer, carer, clinician, academic and media design experts aimed at encouraging consumers to adopt a more active role in collaborative recovery planning. Clinicians and consumers have completed baseline questionnaires to establish current practice. These will be repeated following delivery of the digital signage campaign.

Phase 2: employing a similar pre-post design, this physical health digital signage campaign will be based on qualitative feedback from phase 1.  A large cross-sectional survey of mental health clinicians’ perceptions of physical health care in mental health has been completed.

Results: An outline of the digital signage intervention will be provided. Results from baseline surveys will be outlined, including clinicians’ perceptions of the legitimacy of online and telephone-based resources.

Discussion: This intervention is the first to evaluate the utility of digital signage to support consumers to be catalysts for changing clinicians’ practice in collaborative physical health care and recovery.

This project encountered a number of issues relating to the implementation of digital signage in public health settings. Information technology departments in large public health settings are increasingly specialised which complicates the navigation of departments - which though interdependent operate independently. Issues relating to ‘agency’ will be also discussed in large organisations with prescribed lines of delegation which limit the capacity of individuals from outside standardised delegated authority to effect change.

Online support for family, friends and loved ones of people with depressive or anxiety symptoms

Elloyse Saw

Everymind, Australia

In any one year, there are approximately one million Australian adults living with depression, and two million with anxiety. The number of people experiencing symptoms of these disorders is even higher. With many people with mental ill-health not engaged with professional services, the role of providing support to these individuals sits with family, friends and loved ones. The extant literature refers to these support people as ‘carers’.

However, evidence shows that carers have poorer health than non-carers, highlighting that carers also need support. While support for carers is increasing, interventions for carers of people with depressive and anxiety symptoms are rare. Programs that do exist tend to operate face-to-face, despite the many documented limitations of this format, such as time, geography, flexibility and stigma related to attendance in person.

Minds Together for carers is an online support program developed by Everymind for people providing care to a loved one with depressive and anxiety symptoms. The program helps carers to develop the skills and knowledge to respond to their loved one as well as maintain their own health and wellbeing. The online format also addresses some of the accessibility issues associated with existing face-to-face programs.

In 2020, Everymind conducted a pilot randomised controlled trial to explore the feasibility and acceptability of the Minds Together for carers online program. 108 participants were recruited and randomised to program (n=54) and waitlist (n=54) conditions. Participants also completed two surveys and 10 carers participated in one-on-one interviews.

For this presentation, I will discuss the rationale behind the pilot study, including its role in informing the design and processes of a proposed randomised controlled trial. I will also describe the methods and results of the study relating to the feasibility and acceptability of the program and themes taken from the one-on-one interviews.

Investigating the impact of an autonomous vehicle rollout on vulnerable road users' attitude and engagement

Angus McKerral

School of Psychology, University of Newcastle, Australia

Access to independent discretionary transport is a key predictor of health and wellbeing within the broader community, and especially so for vulnerable road users. Cessation of driving is linked to declining health in aged populations, while psychosocial impairments such as driving anxiety and intellectual disability serve as barriers to personal mobility and independence. Telehealth and other virtual solutions may alleviate the need for face-to-face access for a particular service, however the additional mental-health risks of increased confinement to the home are not as readily countered.

The introduction of autonomous vehicles (AVs) have largely won public approval on the promise of a less-demanding driving experience that would allow existing drivers to direct their attention to activities other than driving. This use-case overlooks the substantial benefit that appropriately designed AVs can offer to vulnerable road users who are currently restricted from independent engagement with the broader community due to limited driving capacity.

A key determinant of AV use is an individual’s capacity to resume control of the vehicle in critical scenarios, and safely navigate the environment. Although conventional task requirements are still at play, these instances are expected to be rare in a naturalistic driving setting and require less effort and experience than is required to maintain control of the vehicle for extended period in a manual driving scenario. Our research has examined attitudes, acceptance and takeover capacity in a baseline condition and proposes to extend these measures to clinical populations. Demonstrating the intention and capacity for clinical populations to use AVs and perform comparably in critical takeover scenarios to currently licensed drivers would provide support for the expansion of restricted licensing to individuals previously unable to independently participate in the driving environment.

Friday, 6 November

Keynote Speech II

Telehealth, Rural Adversity and the Orange Declaration

Professor David Perkins

Centre for Rural and Remote Mental Health (CRRMH), University of Newcastle

Telemental Health is often mooted as the answer to poor rural mental health services and poorer mental health outcomes for rural residents. While the range of Telemental health products and technologies has increased considerably over recent years, due in part to government funding responses to disasters and staff shortages, the rural mental health system is still characterised by fragmentation, inequitable access and services that are difficult to navigate.

This presentation will start by examining the claims made for Telemental Health illustrated by a recent systematic review. It will then rehearse some of the continuing rural mental health challenges and propose a benchmark based on the recent Australian Productivity Commission Report.  It will address issues raised by two recent research papers published by the Centre for Rural and Remote Mental Health and its collaborators which address mental health ecosystems from the perspectives of rural adversity and its implications for mental health systems and services.

In closing, it will suggest that we need to locate Telemental Health solutions within an approach that recognises the diversity of rural places, maximises the use of a wide range of data, and locates care within a broad bio-psycho-social and environmental framework.  The conceptual framework we adopt will in large part determine the mental health outcomes for rural people in Australia and many similar international contexts.

Plenary Session V – Supported by CRRMH

Mapping the hidden voices in rural and remote mental health

Professor Jane Farmer

Social Innovation Research Institute, Swinburne University of Technology, Australia

Revealing hidden rural mental health service experiences using GIS and multiple  NGOs’ operational datasets

Insights about mental health experiences in rural places can be difficult to obtain as rural service data can be hard to obtain and affected by ecological fallacy (averaged out across large areas). In this study, we test using routinely collected datasets of NGOs to assess technical feasibility and potential for insights.

We use an innovative “data collaborative” methodology to relate multiple non-governmental organisations’ (NGO) datasets in a Geographic Information System (GIS) to provide partial, but inter-related, understandings of mental health service experiences in rural places. Bringing ‘hidden’ qualitative experience data into conversation with quantitative service need and crisis incident data via a GIS, has potential to reveal new place-based insights that could inform rural mental health service delivery challenges.

As well as providing rich information about experiences of stigma and inaccessible services, data reveal specific challenges from relationship breakdowns and being new to an area.

Drawing on need/demand, ‘crisis’ incidents and experience data we show how it can be feasible and have value to use emergent data science techniques to analyse and visualise where and how needs are (not) being met, providing access to new evidence and helping to build collaborations between NGOs and their data in addressing rural mental health.

Mapping social fragmentation in rural and remote Australia – implications for mental health

Dr Nasser Bagheri

Australian National University, Australia

Currently there is an identified gap in the impact of the Australian Neighbourhood Social Fragmentation Index (ANSFI) and suicide rate pattern across rural and urban Australian communities. In order to bridge the identified gaps and tackle the important challenge of suicide and fragmented communities in rural areas in Australia, we investigated and mapped the association of social fragmentation and suicide rate in rural and urban areas.

We used publicly available suicide data from Australian Bureau Statistics. Further, for social fragmentation data we used two components of the SF index; family and mobility components.  The social fragmentation index was developed by Bagheri et al. 2019 at statistical area level 1 (SA1) for whole Australia. We applied ordinarily least square regression (OLS) to test the impact of social fragmentation on suicide rate. Further, we used a Geographically Weighted Regression (GWR) analysis to test the local relationship between social fragmentation and suicide rate across rural communities.

Both components of the social fragmentation had positive association with suicide rate across communities (SA3). It means that those communities which are highly socially fragmented have higher level of suicide level. Additionally, the relationship between social fragmentation and suicide is stronger in rural areas, particularly in remote and very remote areas. GWR provide better results to investigate the relationship between social fragmentation and suicide rate across local communities in rural regions of Australia.

Our analyses showed that the association between social fragmentation and suicide is not stationary across rural communities and it varies spatially across communities. This spatially varying relationship between SFI and suicide generates new knowledge on local variation of the suicide and social fragmentation index. This allows for better policy planning and design of tailored interventions to improve social cohesion, and as a result reduces suicide rate across rural communities in Australia.

Tele-mental health consultations

Professor Luis Salvador-Carulla

Australian National University, Australia

Keynote Speech III – Supported by Everymind

Use of e-technology in Mental Health Promotion, Prevention and Early Intervention – Opportunities and Challenges

Professor Sally Chan

University of Newcastle, Australia

Plenary Session VI 

Cortical haemodynamic response measured by functional near infrared spectroscopy during a verbal fluency task in patients with major depression and borderline personality disorder

Associate Professor Roger Ho

Department of Psychological Medicine, National University of Singapore, Singapore

Background: Functional near infrared spectroscopy (fNIRS) provides a direct and quantitative assessment of cortical haemodynamic function during a cognitive task. This functional neuroimaging modality may be used to elucidate the pathophysiology of psychiatric disorders and identify neurophysiological differences between co-occurring psychiatric disorders. However, fNIRS research on borderline personality disorder (BPD) has been limited. Hence, this study aimed to compare cerebral haemodynamic function in healthy controls (HC), patients with major depressive disorder (MDD) and patients with BPD.

Methods: fNIRS signals during a verbal fluency task designed for clinical assessment was recorded for all participants. Demographics, clinical history and symptom severity were also noted.

Findings: Compared to HCs (n = 31), both patient groups (MDD, n = 31; BPD, n = 31) displayed diminished haemodynamic response in the frontal, temporal and parietal cortices. Moreover, haemodynamic response in the right frontal cortex is markedly lower in patients with MDD compared to patients with BPD.

Interpretation: Normal cortical function in patients with BPD is disrupted, but not as extensively as in patients with MDD. These results provide further neurophysiological evidence for the distinction of patients with MDD from patients with BPD.

The nurse-led smartphone-based self-management programme for type 2 diabetes patients with poor glycaemic control: Preliminary results from a randomized controlled trial

Associate Professor Wenru Wang

National University of Singapore, Singapore

Background: Over the past decades, Asia has emerged as the ‘diabetes epicentre’ in the world due to rapid economic development, urbanization and nutrition transition. There is an urgent need to develop more effective and cost-effective care management strategies in response to this rising diabetes epidemic.

Aim: This study aims to develop and compare a nurse-led smartphone-based self-management program with an existing nurse-led diabetes service on health-related outcomes among type 2 diabetes patients with poor glycemic control in Singapore.

Methods: We proposed a randomized controlled trial with pre- and repeated post-tests control group design. A total of 128 type 2 diabetes patients with poor glycemic control will be recruited from the diabetes clinic of a public acute hospital in Singapore through convenience sampling. Study participants will be either randomly allocated to the experimental group or control group. Outcome measures used will include the 10-item General Self-Efficacy Scale, 11-item Revised Summary of Diabetes Self-care Activities, and 19-item Diabetes-Dependent Quality of Life. Data will be collected at three time points: baseline, 3 months and 6 months from the baseline, respectively.

Preliminary results: The nurse-led smartphone-based self-management program was developed with integration of the Care4Diabetes application and the web-portal system. The pilot results indicated that the effects of this smartphone-based program on patient’s health-related outcomes were comparable to those of the currently available nurse-led diabetes service.

Conclusion: The smartphone-based self-management intervention was deemed effective, yet full-scale randomised controlled trials are still ongoing, and the results of these may provide strong evidence of the effectiveness of such an approach in improving patient care. The uniqueness of this study lies in the integrated system used, which offers a clinical platform for diabetes nurses to provide personalised coaching and care to patients remotely, while monitoring patients’ progress closely.

Personalizing an App for Individuals with addictive disorders

Dr Melvyn Zhang

Institute of Mental Health, Singapore

Substance & alcohol use disorders are highly prevalent globally and locally. In treating these disorders, psychological approaches are paramount in the maintenance of abstinence. Recent advances in experimental psychology have led to a better understanding of the unconscious, automatic biases, that of attention biases that result in individuals relapsing. Despite these advances, there remain several research gaps, like the lack of evidence regarding these biases in highly prevalent substance disorders; the effectiveness of technology in delivering such interventions; whether gamification could improve motivation to train; and lastly, whether bias modification would be effective amongst Asian participants. Given these, the aim of my research was to develop and evaluate a mobile attention bias intervention for individuals with addictive disorders. The feasibility and acceptability study helped ascertained that mobile intervention was practical. The codesign study bettered the existing intervention, and the pilot study helped guide the plan for the definitive trial.

A mobile application of breast cancer e-Support program for Chinese women with breast cancer undergoing chemotherapy: results of a multicentre randomised controlled trial

Associate Professor Jiemin Zhu

School of Medicine, Xiamen University, China

Aim: To examine the effectiveness of a mobile application of Breast Cancer e-Support program in enhancing self-efficacy, social support, symptom management, quality of life and psychological well-being for women with breast cancer undergoing chemotherapy.

Background: Women with breast cancer undergoing chemotherapy suffered from many symptoms and reported receiving inadequate support from health care professionals. Innovative and easily accessible interventions are lacking.

Design: A single-blinded, multi-centre, randomised controlled trial was conducted.

Methods: Based on Bandura’s self-efficacy theory and the social exchange theory, Breast Cancer e-Support has four modules: 1) a Learning forum; 2) a Discussion forum; 3) an Ask-the-Expert forum; and 4) a Personal Stories forum. Data were collected from September 2016 to February 2017 in two university-affiliated hospitals in China from 114 women with breast cancer who were commencing chemotherapy. Women were randomly assigned to either the control group that received routine care or the intervention group that received routine care plus access to Breast Cancer e-Support for 3 months covering four cycles of chemotherapy. Self-efficacy, social support, symptom distress, quality of life, and anxiety and depression were measured at baseline, 3 months and 6 months. Intention-to-treat analysis was adopted with last observation carried forward. Multivariate Analysis of Variance was performed to analyse the data.

Results: The intervention group had significantly higher scores of self-efficacy and quality of life, lower scores of symptom interference immediately after the intervention compared with the control group. However, no significant difference between the two groups was found at 6 months.

Conclusion: The Breast Cancer e-Support program was effective in improving health outcomes for women with breast cancer during chemotherapy. The results provided evidence to support the implementation of an innovative and easily accessible intervention that enhances health outcomes. Future studies are required to explore the longer-term effect of web-based support programs and their cost-effectiveness.

Plenary Session VII –

Supported by the Priority Research Centre in Physical Activity & Nutrition, University of Newcastle, Australia

Eat better to feel better; Using eHealth to help people optimise their nutrition-related health and well-being

Professor Clare Collins 

School of Health Sciences, Priority Research Centre in Physical Activity & Nutrition, Faculty of Health and Medicine, University of Newcastle, Australia

Diet is the largest contributor to global burden of disease and the third highest contributor in Australia. However there is a lack of translation of research evidence on nutrition and health into practice. Recently there has been renewed interest in the link between dietary pattern and mental health. This provides an opportunity to tailor nutrition interventions to promote mental health, well-being and chronic disease risk simultaneously. However, we need novel ways to address nutrition in population groups most at risk of poor eating habits. Our research focus has been in the use of eHealth tool and technologies to target and tailor nutrition support while providing motivation and support to improve dietary patterns. Examples from my research group will be presented. eHealth technologies provide an opportunity to develop innovative, cost-effective nutrition programs with broad reach that help people eat better, feel better and lower their chronic disease risk.

Addictive overeating and mental health, development of an online telehealth program

Associate Professor Tracy Burrow

Priority Research Centre in Physical Activity & Nutrition, Faculty of Health and Medicine, University of Newcastle, Australia

Food addiction is a controversial area of research and practice. Epidemiological research shows that the term food addiction or addictive eating are terms that many individuals in the community identify with and support. Reviews suggest that it is an issue that affects around 20% of the population however this varies by population group with the condition more common in those individuals with overweight and obesity, or experience mental health conditions, in particular anxiety or depression. However interestingly it is not synonymous to these groups in that it also occurs in those who are healthy weight. Food addiction is commonly defined as a compulsive consumption of foods, for example processed foods that may be high in sugars, fats and salt. The symptoms of food addiction can be assessed by standardised tools some of which align with the Diagnostic Statistic Manual (DSM) for other addictions. Symptoms include craving, withdrawal, and repeated attempts to cut down on the consumption of particular foods with no success and giving up social activities.

My teams research has focused on identifying possible problematic foods (and not sole substances) to better assist in the development of possible treatments. While there is individual variation, our research shows that the most addictive-like foods are those containing both sugars and fats, and also those individuals endorsing symptoms of food addiction tend to have an overall poorer diet quality and/ or dietary patterns.

Large population-based studies show that there is a strong belief in food addiction those who consider themselves to be food addicted are looking for answers and support. We have recently conducted a review of web-based treatments for food addiction identified that the majority of programs are not evidence based, rarely involve credentialed health professionals, and have not been evaluated for their outcomes. My team are currently trialling the first intervention of its kind based on personality traits to assist in treatment management of addictive eating in addition we are exploring possible biomarkers that may be associated with the condition.  These biomarkers include the use of techniques of brain imaging through MRI scans, hormones, peptides, in addition to less invasive measures such as eye tracking and heart rate variability.

No Money No Time: an e-health tool with applicability to populations at risk of mental illness

Dr Lee Ashton

Priority Research Centre in Physical Activity & Nutrition, Faculty of Health and Medicine, University of Newcastle, Australia

The importance of chronic disease prevention in mental health, including major depressive disorder is of increasing global need due to the substantial health, social and economic burden. There is evidence of a bidirectional association between obesity and depression, with depression increasing risk of obesity by 58%, and obesity increasing the risk of depression by 55%. Young Australian adults (18-25yrs) are an ‘at-risk’ group. They have the highest proportion of individuals suffering from high/very high psychological distress compared to other adult age group and they have some of the worst dietary habits which leads to rapid weight gain during this period. Therefore, we have developed a nutrition website tailored to young adults called No Money No Time: https://nomoneynotime.com.au/to motivate and support young adults to eat healthy. This presentation will discuss the applicability of this tool for populations at risk of mental illness.

In one year, No Money No Time has demonstrated high engagement with 44,580 website visitors from 85 countries (90% from Australia), a total of 291,052 page views and an average session duration of 3.5 min. Further, over 20,000 individuals have signed-up to a free account on the site. There is potential to identify individuals at risk of mental illness and direct to the right support. A co-design approach will enable adaptation of the site to feature enhance support for mental health. We are seeking opportunities to help create personally tailored prevention approaches to improving overall diet quality and reducing risk of poor mental health among young adults.

Examining the mental health and well-being of Australia university students: What is the role of health behaviours?

Dr Melinda Hutchesson

Priority Research Centre in Physical Activity & Nutrition, Faculty of Health and Medicine, University of Newcastle, Australia