Perceived workplace discrimination on the basis of parent status in Australia: who is vulnerable and how does it link to mothers' and fathers' mental health?

OBJECTIVE: This study focused on employees' perceived discrimination due to parenthood; and mental health, occupational stress and turnover intention. METHODS: Survey (2016) of an Australian convenience sample of employed parents: women (n = 2950) and men (n = 1318). RESULTS: Forty-two percent of all mothers reported missing out on promotion (n = 1,234/2950); one third reported negative comments from managers (n = 805/2950, 27%) or colleagues (n = 832/2950, 28%). One in five fathers reported these forms of discrimination. In adjusted analyses perceived discrimination was associated with poorer mental health (ß = 0.23, p < .001); higher occupational stress (ß = 0.30, p < .001); and increased odds of turnover intention (aOR = 1.5, p < .001) for mothers; and poorer mental health (ß = 0.34, p < .001); stress (ß = 0.35, p < .001); and increased odds of turnover intention (aOR = 1.7, p < .001) for fathers. CONCLUSIONS: Experiences of negativity and hostility at work are common, and link to employee health and wellbeing.

Understanding suicidal transitions in Australian adults: protocol for the LifeTrack prospective longitudinal cohort study.

BACKGROUND: The factors that influence transition from suicidal ideation to a suicide attempt or remission of suicidal thoughts are poorly understood. Despite an abundance of research on risk factors for suicidal ideation, no large-scale longitudinal population-based studies have specifically recruited people with suicidal ideation to examine the mechanisms underlying critical transitions to either suicide attempt or recovery from suicidal ideation. Without longitudinal data on the psychological, behavioural, and social determinants of suicide attempt and the remission of suicidal ideation, we are unlikely to see major gains in the prevention of suicide. AIM: The LifeTrack Project is a population-based longitudinal cohort study that aims to identify key modifiable risk and protective factors that predict the transition from suicidal ideation to suicide attempt or remission of suicidal ideation. We will assess theory-informed risk and protective factors using validated and efficient measures to identify distinct trajectories reflecting changes in severity of suicidal ideation and transition to suicide attempt over three years. METHODS: A three-year prospective population-based longitudinal cohort study will be conducted with adults from the general Australian population who initially report suicidal ideation (n = 842). Eligibility criteria include recent suicidal ideation (past 30 days), aged 18 years or older, living in Australia and fluent in English. Those with a suicide attempt in past 30 days or who are unable to participate in a long-term study will be excluded. Participants will be asked to complete online assessments related to psychopathology, cognition, psychological factors, social factors, mental health treatment use, and environmental exposures at baseline and every six months during this three-year period. One week of daily measurement bursts (ecological momentary assessments) at yearly intervals will also capture short-term fluctuations in suicidal ideation, perceived burdensomeness, thwarted belongingness, capability for suicide, and distress. CONCLUSION: This study is intended to identify potential targets for novel and tailored therapies for people experiencing suicidal ideation and improve targeting of suicide prevention programs. Even modest improvements in current treatments may lead to important reductions in suicide attempts and deaths. STUDY REGISTRATION: Australian New Zealand Clinical Trials Registry identifier: ACTRN12623000433606.

Wildfires and COVID-19: syndemic impact on maternal and child health.

The prevailing COVID-19 pandemic and climate change-mediated wildfires can combine to impact maternal-child health, yet this connection remains understudied. To shape policies and design interventions to mitigate the combined effects of future global catastrophes, it is vital to holistically evaluate the impact of syndemics on maternal-child health.

Liminality and insecurity: A qualitative study of young adults' vulnerabilities during the first twelve months of COVID-19 in Australia.

COVID-19 has disrupted the normative social order, particularly for young adults. Their deteriorating mental health over 2020 has been associated with the economic and social conditions during the COVID-19 lockdowns. We conducted 19 semi-structured interviews with young adults aged 8 and 29 most of whom lived in Victoria, Australia. The interviews explored participants' experiences and responses to COVID-19, covering areas such as disrupted everyday practices and future plans, impacts on their physical and mental health, and interactions with community and services. Young adults were concerned about loss of social connectedness, their mental health and the complex interplay of issues such as employment, income, education and housing. They developed routines to protect their physical and mental health while in lockdown and some made the most of new opportunities. However, the pandemic may have had a profound effect by disrupting some young adults' plans for the future, thus contributing to a sense of ontological insecurity.

How the mental health of working parents in Australia changed during COVID-19: A pre- to during pandemic longitudinal comparison.

BACKGROUND: Cross-sectional studies indicate that mental health has deteriorated in Australia during the COVID-19 pandemic, including for parents. However, robust longitudinal studies interrogating change from before to during the pandemic remain rare. The current study analysed data from Australian parents surveyed in 2016 and August 2020. We investigate whether distress was higher in the COVID-19 period compared to pre-pandemic levels, and whether any increases in distress were greatest for parents living in Victoria (who had entered their second prolonged lockdown). METHODS: A community cohort of Australian working parents (n = 5197) was recruited online in 2016. In August 2020, 25.9 % (n = 1348) completed a follow-up survey. Analyses were restricted to those employed at both time-points (n = 1311). Random effects longitudinal models examined the association between time (i.e. pre vs. during-pandemic) and distress (K6 scale). Fixed effects models specifically tested change between time periods in association with change in distress. LIMITATIONS: The initial sample were recruited online with highly educate parents over-represented. Attrition between survey time-points may also limit generalisability. RESULTS: All models consistently showed that the pandemic period was associated with greater distress. Overall, serious mental illness (i.e. K6 score ≥ 18) increased by 5.3 percentage points (from 8.0 to 13.3). This increase was greater (by 4.7 percentage points) for those parents in Victoria. CONCLUSIONS: This study is one of few to longitudinally assess mental health pre- to during the pandemic. Psychological distress and serious mental illness increased for Australian working parents, and this effect was greatest for those experiencing a prolonged lockdown in Victoria.

Preconception factors associated with postnatal mental health and suicidality among first-time fathers: results from an Australian Longitudinal Study of Men's Health.

PURPOSE: Prospective evidence about men at risk of postnatal difficulties is rare-particularly for postpartum suicidal ideation. This study aimed to determine the extent to which first-time fathers reported depressive symptoms and suicidal ideation and behaviours in the first postnatal year, and to identify preconception risk factors for postnatal mental health difficulties. METHODS: Secondary analysis of data from The Ten to Men Study-Australia's population-based prospective study of men's health was conducted. Participants were 205 men who became first-time fathers in the 12 months prior to wave 2 (2015/16). Regression analyses were used to ascertain preconception (mental and physical health, lifestyle) and demographic factors associated with postnatal depressive symptoms. RESULTS: Postnatally, 8.3% of fathers reported moderate to severe depressive symptoms, 5% had suicidal thoughts, 3% had plans, and less than 1% had attempted suicide. Preconception depressive symptoms was the only factor significantly associated with postnatal depressive symptoms. CONCLUSION: The transition into fatherhood is marked with significant psychological distress for some men. These results suggest that mental health screening and support in the preconception period is crucial to supporting the mental health of new fathers.

Poor psychosocial job conditions increase sickness absence: evidence from the PATH Through Life Mid-Aged Cohort.

OBJECTIVES: Evidence is mounting that poor psychosocial job conditions increase sickness absence, but there is a need for further rigorous prospective research to isolate the influence of psychosocial job quality from other measured and unmeasured confounders. This study used four waves of prospective longitudinal data (spanning 12 years) to investigate the extent to which increases in poor psychosocial job quality are associated with greater relative risk of day of sickness absence. DESIGN: Prospective cohort study. SETTING: Data were from the Australian PATH Through Life cohort study. The analyses adopted hybrid-regression estimations that isolated the effect of within-person change in psychosocial job quality on sickness absence over time. PARTICIPANTS: Participants were from a midlife cohort aged 40-44 at baseline (7644 observations from 2221 participants). PRIMARY OUTCOME MEASURE: Days sickness absence in the past 4 weeks. RESULTS: The results show that after adjusting for a wide range of factors as well as unmeasured between-person differences in job quality, each additional psychosocial job adversity was associated with a 12% increase in the number of days of sickness absence (relative risk ratio: 1.12, 95% CI 1.03 to 1.21). Increases in psychosocial job adversity were also related to greater functional impairment (relative risk ratio: 1.17 (1.05 to 1.30)). CONCLUSION: The results of this study strengthen existing research highlighting the importance of addressing poor psychosocial job quality as a risk factor for sickness absence.

Systemic Inflammation Predicts Alzheimer Pathology in Community Samples without Dementia.

Neuroinflammation and oxidative stress (OS) are implicated in the pathophysiology of Alzheimer's disease (AD). However, it is unclear at what stage of the disease process inflammation first becomes manifest. The aim of this study was to investigate the associations between specific plasma markers of inflammation and OS, tau, and Amyloid-ß 38, 40, and 42 levels in cognitively unimpaired middle-age and older individuals. Associations between inflammatory states identified through principal component analysis and AD biomarkers were investigated in middle-age (52-56 years, n = 335, 52% female) and older-age (72-76 years, n = 351, 46% female) participants without dementia. In middle-age, a component reflecting variation in OS was most strongly associated with tau and to a lesser extent amyloid-ß levels. In older-age, a similar component to that observed in middle-age was only associated with tau, while another component reflecting heightened inflammation independent of OS, was associated with all AD biomarkers. In middle and older-age, inflammation and OS states are associated with plasma AD biomarkers.

COVID-19 and mental health in Australia - a scoping review.

BACKGROUND: The COVID-19 outbreak has spread to almost every country around the world and caused more than 3 million deaths. The pandemic has triggered enormous disruption in people's daily lives with profound impacts globally. This has also been the case in Australia, despite the country's comparative low mortality and physical morbidity due to the virus. This scoping review aims to provide a broad summary of the research activity focused on mental health during the first 10 months of the pandemic in Australia. RESULTS: A search of the Australian literature was conducted between August-November 2020 to capture published scientific papers, online reports and pre-prints, as well as gaps in research activities. The search identified 228 unique records in total. Twelve general population and 30 subpopulation group studies were included in the review. CONCLUSIONS: Few studies were able to confidently report changes in mental health driven by the COVID-19 context (at the population or sub-group level) due to a lack of pre-COVID comparative data and non-representative sampling. Never-the-less, in aggregate, the findings show an increase in poor mental health over the early period of 2020. Results suggest that young people, those with pre-existing mental health conditions, and the financially disadvantaged, experienced greater declines in mental health. The need for rapid research appears to have left some groups under-researched (e.g. Culturally and Linguistically Diverse populations and Indigenous peoples were not studied), and some research methods under-employed (e.g. there was a lack of qualitative and mixed-methods studies). There is a need for further reviews as the follow-up results of longitudinal studies emerge and understandings of the impact of the pandemic are refined.

Bushfire Smoke in Our Eyes: Community Perceptions and Responses to an Intense Smoke Event in Canberra, Australia.

The 2019-20 bushfires that raged in eastern Australia were an overwhelming natural disaster leading to lives lost or upended, and communities destroyed. For almost a month, Canberra, Australia's capital city in the Australian Capital Territory (ACT), was obscured by smoke from fires which threatened the outer suburbs. While smoke itself is experientially different from many natural disasters, it nevertheless poses a significant public health threat. As the impact of extended bushfire smoke in an urban setting is relatively unexplored we aimed to capture the individual and community-level experiences of the event and their importance for community and social functioning. We responded rapidly by conducting semi-structured interviews with a range of Canberra residents who, due to their personal or social circumstances, were potentially vulnerable to the effects of the smoke. Three major themes emerging from the narratives depicted disruption to daily life, physical and psychological effects, and shifting social connectedness. This study highlighted the ambiguous yet impactful nature of a bushfire smoke event, and identified four simple key messages that may be critically relevant to policy making in preparation for similar smoke events in the future.

Working out dads (WOD): a study protocol for a randomised controlled trial of a group-based peer support intervention for men experiencing mental health difficulties in early fatherhood.

BACKGROUND: Approximately one in ten men experience mental health difficulties during the early years of fatherhood, and these can have negative impacts on children and families. However, few evidence-based interventions targeting fathers' mental health are available. The aim of the trial is to evaluate the effectiveness and cost-effectiveness of Working Out Dads (WOD) - a facilitated peer support group intervention for fathers of young children, in reducing psychological distress and other mental health symptoms. METHODS: This trial will employ a parallel-arm randomised controlled trial (RCT) to evaluate the effectiveness and cost effectiveness of WOD peer support group intervention compared to usual care (a 30-min mental health and service focused phone consultation with a health professional). A total of 280 fathers of young children (aged 0-4 years) who are experiencing mental health difficulties and/or are at risk of poor mental health will be recruited. Randomisation and analyses will be at the level of the individual participant. The primary outcome is psychological distress symptoms, measured by the Kessler Psychological Distress Scale (K10) from baseline to 24 weeks post randomisation. A range of secondary outcomes will be assessed including suicidal ideation; mental health disorders, specific symptoms of depression, anxiety, and stress; social support, quality of life, health service use, and health care costs. Data will be collected at baseline, 10- and 24 weeks post-randomisation. DISCUSSION: This trial will examine the effectiveness of a novel group-based peer support intervention in reducing the psychological distress and other mental health symptoms of fathers compared to usual care. The economic and process evaluation will guide policy decision making along with informing the future implementation of WOD on a larger scale if effectiveness is demonstrated. TRIAL REGISTRATION: The current trial has been registered with ClinicalTrials.gov (Registration ID - NCT04813042 ). Date of Registration: March 22nd, 2021.

How does working nonstandard hours impact psychological resources important for parental functioning? Evidence from an Australian longitudinal cohort study.

This study investigates the link between nonstandard schedules and three psychological resources salient to working parents' parental functioning (psychological distress, work-family conflict and relationship quality). Data from fathers and mothers are analysed separately, using a nationally representative sample of dual-earner parents (6190 observations from 1915 couples) drawn from the Longitudinal Study of Australian Children (LSAC). The LSAC data was collected between 2008 and 2018 (with data collected every two years). Hybrid analysis models were conducted to identify within-person changes in these psychological resources in association with moving in and out of nonstandard work schedules, as well as between-person differences between parents working standard hours and nonstandard hours. The results indicate that the connections between working nonstandard schedules and the psychological resources were patterned differently across genders. No significant differences in psychological distress were found between those working nonstandard schedules and those working standard schedules for either fathers or mothers. Fathers working nonstandard schedules had higher work-family conflict compared to fathers working standard schedules, while no such effect found for mothers. This effect for fathers was largely explained by other characteristics related to working a nonstandard schedule, rather than the schedule itself. For fathers (but not mothers), working nonstandard schedules was significantly, and potentially causally, associated with lower relationship quality (i.e. within-person effects were found). Additional supplementary analyses found the connections between work schedules and psychological resources varied somewhat across different types of schedules (i.e. evening/night shift, rotating shift and irregular shift). As one of the first nationally representative longitudinal studies to explore changes in work schedules in association with changes in parents' psychosocial resources, the impacts for fathers (particularly relationship quality) are an important line for future enquiry.

Mental health: who is more vulnerable to high work intensity? Evidence from Australian longitudinal data.

AIM: The adverse impacts of exposure to work intensity on mental health have been widely studied. However, there is a lack of research examining who is most vulnerable in terms of position on the mental health distribution. The current study aims to: (a) initially estimate the average impacts of work intensity on workers' mental health in Australia, and then (b) estimate the extent to which this effect varies across the mental health distribution. MATERIALS AND METHODS: The current study uses data from waves 2005--2017 of the Household Income and Labour Dynamics in Australia (HILDA) survey. It first employs Average Treatment Effect (ATE) to provide a baseline/average treatment effect for the whole population, and then applies Quantile Regression fixed effects models for various quantiles on the mental health distribution. DISCUSSION AND CONCLUSION: The baseline estimates show that there are significantly negative effects of work intensity on mental health for the whole population, but importantly the quantile fixed effect estimates show that these adverse effects are substantially stronger for those with the poorest mental health (i.e. at the bottom of the distribution). When ATE alone is estimated, the significant effect is averaged over the mental health distribution, missing important information regarding the heterogeneity of the effect. The findings have important implications for understanding and reducing mental health inequality, particularly inequality driven by workplace stress. First, they align with existing research demonstrating the importance of reducing psychosocial job stressors. Second, given workers with mental health problems were most susceptible to the adverse effects of work intensity, there is a need to offer additional support (and be sensitive of workloads) for this group in particular.

Paternal coping and psychopathology during the perinatal period: A mixed studies systematic review and meta-analysis.

How fathers cope with stress may be critical to their mental health during the perinatal period. Using a sequential explanatory design for systematic review and meta-analysis, we aimed to identify associations and causal relations between higher- and lower-order avoidant and approach coping strategies and paternal psychopathology. We searched five electronic databases and grey literature, and used random-effects models to calculate pooled effects from 11 quantitative studies. Meta-analytic results were integrated with findings from 18 qualitative studies. Fathers' avoidant coping was positively associated with global psychopathology and depression. Approach-oriented coping, particularly problem-solving, was associated with positive affect but not psychopathology. Qualitative findings indicate distressed fathers employ avoidant coping strategies such as suppression, distraction, and social withdrawal. Approach-oriented coping strategies such as problem-solving and cognitive reappraisals appeared to be constructive components of men's coping repertoires supporting adaptation to fatherhood. Different coping strategies and approaches may reflect enactment of constrictive, moderate, or reinterpreted masculine norms. Study designs did not allow conclusions about causal relations between coping and psychopathology. Screening for, and targeting of, high avoidant coping among expectant and new fathers may help detect men at risk of or experiencing mental health difficulties and inform clinical response to psychopathology. Research examining whether different patterns of avoidant and approach coping are associated with psychopathology over time could inform interventions to support men's mental health and adaptation to fatherhood.

Australian parents' work-family conflict: accumulated effects on children's family environment and mental health.

PURPOSE: Many parents struggle to balance their work and family responsibilities. Yet, little research in the field of social psychiatry has explored the emergence of work-family conflict (WFC) as an important social determinant of mental health, particularly for children. The current study used longitudinal Australian population-based data to investigate the impact of parents' accumulated experiences of work-family conflict on children's mental health. Levels of parent psychological distress, marital satisfaction and parenting irritability were examined as potential explanatory factors within the family environment. METHODS: The study used five waves of data from the Australian Longitudinal Study of Australian Children (LSAC), a representative community sample of Australian children and their parents. Analyses were restricted to coupled, employed mothers (1903) and fathers (1584) who reported their WFC levels in all five waves. Structural Equation Modelling (SEM) was used to examine the association between accumulated experiences of work-family conflict across all time-points (AWFC) and children's mental health at wave 5. Family environment factors were assessed as possible explanatory mediators. RESULTS: There was a significant association between AWFC and children's mental health at wave 5. Parent psychological distress, marital satisfaction and parenting irritability were all found to significantly explain this association (accounting for 66% of the total effect). CONCLUSIONS: Children whose parents have ongoing or accumulated difficulties managing their work and family responsibilities are more likely to have poorer mental health. This has important implications for family-friendly work arrangements and demonstrates the need to further understand the intergenerational impacts of parents' jobs on their children's psychological wellbeing.

How are you sleeping? Starting the conversation with fathers about their mental health in the early parenting years.

BACKGROUND: Approximately 1 in 10 fathers of infants experience symptoms of common mental health disorders, prompting calls for paternal postpartum screening. However, numerous obstacles exist to screening implementation. The aim of this study was to provide preliminary evidence for an alternative approach that starts with asking fathers about their sleep. METHODS: Using self-reported father data at 0 to 36 months postpartum (N=1204) from four Australian cohort studies, we assessed associations between responses to various single-item questions about sleep (good to poor), and scores on validated measures of mental health (depression, anxiety and stress). We conducted regressions, unadjusted and adjusted for father age, child age, household income, education, first or later child, and marital status, to test associations between sleep and each indicator of mental health. We then meta-analyzed effects and assessed interactions between sleep and each of the covariates. RESULTS: Consistent associations between fathers' subjective poor sleep and depression, anxiety and stress were replicated across the four cohorts despite heterogeneity in the sleep questions. At the meta-analytic level, effects ranged from weak to moderate (0.25 to 0.37) and were robust to all adjustments. Interactions were only detected between family income and poor sleep, such that the association was stronger for high income fathers. LIMITATIONS: This study does not address the sensitivity or specificity of single-item sleep questions for assessing paternal mental health risk. CONCLUSIONS: A low-cost, non-stigmatizing single question to postpartum fathers about their sleep may present a gateway opportunity to enquiring about mental health.

Cumulative impact of high job demands, low job control and high job insecurity on midlife depression and anxiety: a prospective cohort study of Australian employees.

OBJECTIVE: There is a lack of evidence concerning the prospective effect of cumulative exposure to psychosocial job stressors over time on mental ill-health. This study aimed to assess whether cumulative exposure to poor quality jobs places employees at risk of future common mental disorder. METHODS: Data were from the Personality and Total Health Through Life project (n=1279, age 40-46 at baseline). Data reported on the cumulative exposure to multiple indicators of poor psychosocial job quality over time (ie, a combination of low control, high demands and high insecurity) and future common mental disorder (ie, depressive and/or anxiety symptom scores above a validated threshold) 12 years later. Data were analysed using logistic regression models and controlled for potential confounders across the lifespan. RESULTS: Cumulative exposure to poor-quality work (particularly more secure work) on multiple occasions elevated the risk of subsequent common mental disorder, independent of social, health, verbal intelligence and personality trait confounders (OR=1.30, 95% CI 1.06 to 1.59). CONCLUSIONS: Our findings show that cumulative exposure to poor psychosocial job quality over time independently predicts future common mental disorder-supporting the need for workplace interventions to prevent repeated exposure of poor quality work.

Mental Health Problems and Internet Access: Results From an Australian National Household Survey.

BACKGROUND: Mental health support and interventions are increasingly delivered on the web, and stepped care systems of mental health services are embracing the notion of a digital gateway through which individuals can have access to information, assessment, and services and can be connected with more intensive services if needed. Although concerns have been raised over whether people with mental health problems are disadvantaged in terms of their access to the internet, there is a lack of representative data on this topic. OBJECTIVE: This study aimed to examine the relationship between mental health and internet access, particularly lack of access because of affordability issues. METHODS: Data from wave 14 of the Household, Income, and Labour Dynamics in Australia survey were used (n=15,596) in the analyses. Sample weights available in the survey were used to calculate the proportion of those with or without internet access for those with and without mental health problems and more severe long-term mental health conditions. These proportions were also calculated for those with and without internet access due, specifically, to affordability issues. Multinomial logistic regression analyses assessed the relationship between mental health status and internet access/affordability issues, adjusting for a range of covariates. RESULTS: Access to the internet was poorer for those with mental health problems (87.8%) than those without mental health problems (92.2%), and the difference was greater when a measure of more severe mental health conditions was used (81.3% vs 92.2%). The regression models showed that even after adjusting for a broad range of covariates, people with mental ill health were significantly more likely to have no internet access because of unaffordability than those without mental ill health (mental health problems: relative risk ratio [RRR] 1.68; 95% CI 1.11-2.53 and severe mental health conditions: RRR 1.92; 95% CI 1.16-3.19). CONCLUSIONS: As Australia and other nations increasingly deliver mental health services on the web, issues of equity and affordability need to be considered to ensure that those who most need support and assistance are not further disadvantaged.

Workplace Bullying and Suicidal Ideation: Findings from an Australian Longitudinal Cohort Study of Mid-Aged Workers.

Workplace bullying adversely affects mental health, yet little is known about the outcomes for suicidal ideation. The current study used Australian population-based data to investigate the association between workplace bullying and suicidal ideation. The sample included 1488 employed participants aged 52-58 from wave 4 of the Personality and Total Health (PATH) Through Life Study. Workplace bullying was measured in two ways: (a) a single item asked about experiences of bullying 'currently', 'previously in the current workplace' and 'in a past workplace', and (b) 15 items asked about bullying behaviours experienced in the past 6 months. Suicidal ideation was measured using items from the Psychiatric Symptom Frequency Scale (PSF) and the Patient Health Questionnaire-9 (PHQ-9). Psychosocial job quality, both current and prior, was adjusted for. Current and past experiences of workplace bullying were associated with increased risk of suicidal ideation. Current experiences were no longer associated after adjusting for concurrent indicators of psychosocial job stress, although a tendency for increased ideation remained. Reported prior experience of workplace bullying in a past workplace remained associated with higher odds of suicidal ideation after adjusting for prior psychosocial job stressors and excluding individuals with prior suicidal ideation. Being bullied at work is associated with increased risk of suicidal thoughts, although this occurs within the broader influence of other psychologically stressful employment conditions.