Aim: Groups facilitated by peer workers have been shown to be effective in improving recovery‐related outcomes in adult populations. However, limited research has explored the involvement of peer workers in groups in youth mental health services. This qualitative study aimed to explore young people's experiences of participating in groups co‐facilitated by youth peer workers and clinicians.Methods: Semi‐structured interviews were conducted with 13 young people aged 15–25 years who had attended groups conducted in‐person and online at a tertiary youth mental health service. Young people were receiving individual support through the service for a range of mental health concerns. Groups were conducted by two clinicians and a youth peer worker who had used the same service and had undergone training in Intentional Peer Support®. An inductive approach using open, process, in vivo and pattern coding was used to identify key themes. Concept mapping was used to explore the relationships between them.Results: Nine overarching themes were identified that highlighted the unique and complementary contributions of youth peer worker and clinician roles. The sharing of lived experience by youth peer workers facilitated young people's engagement in group discussions, hope for the future, and sense of belonging, whereas clinical input created a sense of safety, structure and purpose.Conclusions: These findings support the value of a co‐facilitation model in improving the engagement and recovery outcomes for young people experiencing mental health challenges.
Personal experience with mental health (MH) challenges has been characterized as a concealable stigma. Identity management literature suggests actively concealing a stigma may negatively impact wellbeing. Reviews of workplace identity management literature have linked safety in revealing a stigma to individual performance, well-being, engagement and teamwork. However, no research to date has articulated the factors that make sharing MH challenges possible. This study employed a comparative case study design to explore the sharing of MH challenges in two Australian MH services. We conducted qualitative analyses of interviews with staff in direct service delivery and supervisory roles, to determine factors supporting safety to share. Workplace factors supporting safety to share MH challenges included: planned and unplanned “check-ins;” mutual sharing and support from colleagues and supervisors; opportunities for individual and team reflection; responses to and management of personal leave and requests for accommodation; and messaging and action from senior organizational leaders supporting the value of workforce diversity. Research involving staff with experience of MH challenges provides valuable insights into how we can better support MH staff across the workforce.
Objective: Awareness of one's individual risk of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) is a necessary precursor to engagement with prevention strategies and sexual health care. Web-based sexual health applications may improve engagement in sexual health prevention and care by providing individualised and evidence-based sexual health information. The STARTOnline ( Supporting Timely and Appropriate Review and Treatment Online) study sought the views of sexual health service users on three web-based sexual health applications to better understand their usefulness, acceptability and accessibility. This paper reports the views and experiences of users of one of the applications called MySTIRisk. MySTIRisk estimates the risk of three common STIs and HIV using data from attendees of a metropolitan sexual health service. Methods: This study used a bespoke qualitative design, informed by a developmental evaluation approach. Melbourne Sexual Health Centre clinic attendees’ views were sought using semi-structured interviews conducted between October 2023 and January 2024 via videoconferencing, telephone and on site at the clinic. Data was analysed using qualitative data analysis methods. Results: A diverse group of 14 participants described an ideal pathway to better sexual health outcomes that might be facilitated by use of the MySTIRisk application, particularly for individuals with limited sexual health knowledge, or affected by stigma and geographical barriers. This pathway was described as: 1) being concerned about my sexual health; 2) checking my STI risk easily and privately; 3) understanding and trusting the result; and 4) deciding how to look after my health. Factors that might influence this pathway were also described, including areas for improvement in accessibility and acceptability. Conclusion: These findings support the role of web-based sexual health applications in facilitating access to sexual health education and behavioural change and underscore the importance of codesign approaches in improving their uptake and impact.
Over the past three decades, “lived experience” designated roles in mental health services in Australia have increased. However, the lived experience of staff in roles not designated in this way is often hidden or unacknowledged. This qualitative study included 33 participants employed in a range of roles at two Victorian mental health services, including 10 social workers. Interviews explored staff perspectives regarding the sharing of lived experience by staff with colleagues and supervisors. Concept analysis identified conflicting ways of thinking about lived experience, which influenced when and how staff shared and how they responded to sharing by other staff. These findings suggest the need to explicitly address the purpose and value of sharing lived experience in the mental health workplace, to better support staff and service users. Recommendations for social workers and their colleagues, working at all levels of the mental health system, are provided.
Background: Early identification of sexually transmissible infections (STIs) is central to their control by facilitating timely access to healthcare. A web-based sexual health application using artificial intelligence (AI) to identify the risk of a genital or anal lesion being an STI, from a photographic image, is in development. However, the usefulness, accessibility, and acceptability of this technology to potential users are unknown. Method: This research adopted a developmental evaluation approach to explore potential users’ views of the usefulness of this AI application, as well as factors impacting its acceptability and accessibility. Three focus groups were conducted with attendees of a sexual health clinic. Focus group discussions were recorded, transcribed, and analysed using action coding to identify key concepts. Results: A diverse group of 12 participants provided feedback on the proposed application. Feedback on the application's usefulness highlighted its potential value in supporting access to individualised sexual health information; informing decisions about healthcare seeking; and preventing transmission to others. Factors mediating the accessibility and acceptability of AI-powered applications included potential users’ awareness of the application; concerns about data security; the accessibility of the application to diverse user groups; trust in the technology; and transparency about the application's limitations. Conclusion: AI applications for the identification of visible changes in the ano-genital region have the potential to support access to sexual health information, healthcare seeking and the prevention of onward transmission of STIs. Codesign approaches will increase the likelihood of more widespread uptake and public health impact of AI-powered sexual health applications.
The rising prevalence of bacterial sexually transmitted infections (STIs) is cause for concern in the context of antimicrobial resistance and the potential health outcomes of untreated infections. The Community Awareness and Surveillance of Transmission (CAST) study sought sexual health service users' views on reducing the prevalence of STIs. Semi-structured interviews were conducted with sexual health clinic attendees who had received a diagnosis of chlamydia, gonorrhea or syphilis in the previous six months. Participant comments relating to antibiotic post-exposure prophylaxis (APEP) and vaccination were inductively coded, then compared using comparative qualitative data analysis methods described by Miles and Huberman. Twenty-one participants with differing genders, ages, nationalities and sexual orientations, were interviewed. Participants across informant groups expressed concerns about APEP for STI prevention because of potential antimicrobial resistance and personal health impacts. Vaccination against bacterial STIs was more acceptable. Common factors mentioned in relation to both interventions included perception of individual STI risk over time, safety, effectiveness and accessibility. The views of sexual health service users support efforts to find alternatives to more frequent use of antibiotics, such as vaccinations against bacterial STIs, to reduce STI incidence and support antimicrobial stewardship.