Teachers as first responders: classroom experiences and mental health training needs of Australian schoolteachers.

BACKGROUND: Schoolteachers are often the first to respond when a student presents with a mental health issue in the classroom. This places a burden on schools that impacts school staff, healthcare workers and teachers. More broadly, it places a responsibility on the education system to address students' mental health. This study examines Australian teachers' classroom experiences and the training areas identified by teachers as necessary to manage these issues. METHOD: Interviews were undertaken with 18 in-service teachers between 2020 and 2021 from Catholic, Independent and Public schools. Data were gathered via multiple interviews and analysed using thematic content analysis. RESULTS: The major mental health issues identified by teachers related to mental disorders, depression, anxiety, and a complex range of negative emotional states. Teachers requested training in child and adolescent mental health, counselling skills, early detection and intervention, and training skills to manage the complex relationship with parents and external health and community personnel. Teachers also reported the need to access mental health resources, support and training, which were differentially accessed along socioeconomic status and postcodes. CONCLUSION: The data show that teachers are often placed as first responders when a student has a mental health issue but feel inadequately trained to manage these issues in the classroom. We identified mental health issues presenting in Australian classrooms and documented critical features of mental-health training asked for by teachers in order to address those issues. Given the increasing demands on teachers to address the mental health of children and adolescents, we argue that an urgent review of mental health training for teachers is needed.

Student drinking cultures in tertiary education residential accommodation: A contextual research study.

Background: In Australia, harmful drinking among students aged 18-24 years in tertiary education residential accommodation (TRA) remains high, placing students at higher risk of harms than non-TRA and university peers. Aim: The aim of this study was to identify the context-specific factors distinctive to TRAs that supported a heavy drinking culture among students. Conducted across three sites in Melbourne, Australia, the purpose of the study was to inform the development of context-specific harm reduction interventions for these sites. Methods: Five focus groups were conducted with 32 students to examine their lived experience of drinking within the distinctive environments of their TRAs. The data were examined using thematic data analysis. Results: Three themes were identified: (1) routine drinking in TRAs; (2) drinking for social inclusion in the TRA; and (3) TRA alcohol governance and students' self-regulation. The data show that factors contributing to these TRA drinking cultures included: liberty to store alcohol and drink on campus; freshers' belief that admission to the TRA was conditional on "partying hard"; students' belief that staff supported the TRA drinking culture; and poor dissemination and operationalisation of TRA alcohol policy. Collectively, these factors fostered an environment that enabled frequent and heavy alcohol consumption among residents. Conclusions: The TRA drinking cultures were supported by social and regulatory factors specific to these institutions and, in particular, by a liberal approach to TRA alcohol governance and poorly disseminated alcohol policy that made widespread heavy drinking possible. Drinking cultures in TRAs can be changed through appropriate interventions that include nuanced policy and effective governance.

Alcohol-related harm minimization practices among university students: Does the type of residence have an impact?

BACKGROUND: The culture of 'risk-related alcohol use' has been identified as an intrinsic part of university life for many students, especially those in residential colleges in English-speaking countries. While the prevailing approach to managing drinking in these countries is harm minimization, little is known about students' uptake of these practices or the relationship of them to students' type of residence. OBJECTIVE: To examine the ways in which type of residence may impact alcohol-related harm minimization practices among university students. DESIGN: A qualitative research design using focus group methodology informed all aspects of the study. METHODS: University students (N = 70) aged 18-24 years and differentiated by their type of residence were recruited from universities in Australia. Nineteen audio-recorded focus groups were conducted. Systematic qualitative analysis was used to identify the main themes. RESULTS: Students reported risk-related alcohol use and alcohol-related harms as either consumers or having witnessed others' consumption through three main themes: (1) The pervasiveness of alcohol use and harms; (2) Perceived safety and physical spaces; and (3) Gender-based alcohol-related harms. Harm minimization practices were talked about in terms of four themes: (1) Policy ineffectiveness; (2) Pre-drinking planning; (3) Friends look after friends; and (4) Help-seeking as a covert activity. CONCLUSIONS: Alcohol use by university students occurs with limited knowledge of harm minimization policies or practices. Students do engage in ad hoc harm minimization practices usually developed during their first year at university through specific 'drinking cultures' that are constituted by various factors including their type of residence. Statement of contribution What is already known on this subject? Previous research has strongly indicated that university students' heavy alcohol consumption is linked with social and environmental factors such as marketing alcohol, low cost, availability, 'wet' environments, and shared accommodation. However, little is known about what, if any, alcohol-related harm minimization practices students employ and if type of residence has an impact on these practices. What does this study add? This study is one of the first to examine alcohol-related harm minimization practices among university students and type of residence demonstrating the impact of social environments on drinking and related practices. Regardless of type of residence, university students were either not aware of university and residential college alcohol policies or found them unclear. Students do engage in ad hoc harm minimization practices usually developed during their first year at university through specific 'drinking cultures' that are constituted by various factors including the type of residence. Two practical recommendations are made in this study to develop alcohol-related harm minimization related to university students.

Raising Rates of Childhood Vaccination: The Trade-off Between Coercion and Trust.

Vaccination is a highly effective public health strategy that provides protection to both individuals and communities from a range of infectious diseases. Governments monitor vaccination rates carefully, as widespread use of a vaccine within a population is required to extend protection to the general population through "herd immunity," which is important for protecting infants who are not yet fully vaccinated and others who are unable to undergo vaccination for medical or other reasons. Australia is unique in employing financial incentives to increase vaccination uptake, mainly in the form of various childcare payments and tax benefits linked to timely, age-appropriate vaccination. Despite relatively high compliance with the childhood vaccination schedule, however, the Australian government has determined that rates should be higher and has recently introduced policy that includes removing certain tax and childcare benefits for non-vaccinators and formally disallowing conscientious objection to vaccination ("No Jab No Pay"). In addition, it has raised the possibility of banning unvaccinated children from childcare centres ("No Jab No Play"). This article examines the impact of coercive approaches to childhood vaccination and raises the question of the ethical justification of health policy initiatives based on coercion. We consider the current evidence regarding childhood vaccination in Australia, the small but real risks associated with vaccination, the ethical requirement for consent for medical procedures, and the potential social harms of targeting non-vaccinators. We conclude that the evidence does not support a move to an increasingly mandatory approach that could only be delivered through paternalistic, coercive clinical practices.

Genetic counselling as care of the self.

Genetic counselling has frequently been described as a disciplinary practice, with the goal of 'risk reduction'. In this article another dimension to genetic counselling is considered through the Foucauldian theorization on the care of the self. Drawing on narrative analysis, I examine how one informant undergoing genetic counselling interprets the technique of imagining alternative futures learned through counselling, and transforms it into an ethical practice of self-care. The findings suggest that what may begin as a medical issue with implications for one's health, becomes a meditation over one's disposition towards life, in a way that is consonant with one's desires and values.