Vocational Interventions to Improve Employment Participation of People with Psychosocial Disability, Autism and/or Intellectual Disability: A Systematic Review

Objective: To systematically review interventions aimed at improving employment participation of people with psychosocial disability, autism, and intellectual disability. Methods: We searched MEDLINE, Embase, PsycINFO, Web of Science, Scopus, CINAHL, ERIC, and ERC for studies published from 2010 to July 2020. Randomized controlled trials (RCTs) of interventions aimed at increasing participation in open/competitive or non-competitive employment were eligible for inclusion. We included studies with adults with psychosocial disability autism and/or intellectual disability. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias II Tool. Data were qualitatively synthesized. Our review was registered with PROSPERO (CRD42020219192). Results: We included 26 RCTs: 23 targeted people with psychosocial disabilities (n = 2465), 3 included people with autism (n = 214), and none included people with intellectual disability. Risk of bias was high in 8 studies, moderate for 18, and low for none. There was evidence for a beneficial effect of Individual Placement and Support compared to control conditions in 10/11 studies. Among young adults with autism, there was some evidence for the benefit of Project SEARCH and ASD supports on open employment. Discussion: Gaps in the availability of high-quality evidence remain, undermining comparability and investment decisions in vocational interventions. Future studies should focus on improving quality and consistent measurement, especially for interventions targeting people with autism and/or intellectual disability.

Correction: ‘National Disability Insurance Scheme and the Lived Experience of Psychosocial Disability for People Presenting to the Emergency Department: Protocol for a Mixed Methods Study’. (Preprint)

UNSTRUCTURED In ‘National Disability Insurance Scheme and the Lived Experience of Psychosocial Disability for People Presenting to the Emergency Department: Protocol for a Mixed Methods Study’ some errors were noted after publication. One author has requested a revision of the text; although the article was signed off the author’s contribution was not contained in the article.

Atypical presentation of rheumatic fever

Sydenham Chorea (St. Vitus dance) occurs in about 10-15% of children with acute rheumatic fever. Herein, we present the case of a 5-year-old male child with hemichorea and arthralgia. The child also presented with mild mitral regurgitation and mild aortic regurgitation. Appropriate management is essential to prevent mortality, morbidity, and psychosocial disability in such cases. We would also like to shed light on the challenges faced in the management of chorea in young children with key emphasis on the anticipation of adverse reactions to commonly used medications.

Examining women’s health through a psychosocial lens

During the COPASAH Global Symposium 2019, a group of therapists and mental health practitioners tried to highlight the issue of women’s mental health with two specific focuses, one being the lived experiences of persons living with mental illness and the secondary burn-out and shame faced by their caretakers. The second session explored the contours of somatisation that is often seen in the human body as a result of the impact of trauma. The participants reflected on the value of lived experiences and also discussed the challenges faced in getting representation for people living with mental illness. The challenges listed by participants were concentrated around the participation and representation of persons living with intellectual disability and psychosocial disability. Somatisation of traumatic experiences needs recognition in a country like India where women’s life-stressors exist right from childhood which keeps them on the threshold of mental illness and/or psychosomatic illnesses. Psychosocial health issues are relegated to a subordinate category of discussion while public health, reproductive health, and health rights feature in mainstream discussions in various seminars, researches and conferences in India. This paper is based on two sessions of the COPASAH Global Symposium 2019 and focuses on the gender and psychosocial dimensions of health from the framework of women being subjected to unpaid care work, through social and reproductive labour and stressors resulting in psycho-social distress. It concludes that, it is important to build a community of practitioners that looks beyond the reproductive health of women.

National Disability Insurance Scheme and the Lived Experience of Psychosocial Disability for People Presenting to the Emergency Department: Protocol for a Mixed Methods Study (Preprint)

BACKGROUND Currently, within Australia, 3.6% of all emergency department (ED) presentations are mental health–related. Information about the context of the person presenting to the ED (beyond immediate needs), including their psychosocial disability (PSD) National Disability Insurance Scheme (NDIS) plan, is reported as incomplete and fragmented. There are missed opportunities for early intervention and care continuity that could potentially inform ED practitioners to revise current practices. OBJECTIVE The aims of this study are: (1) to obtain original data from the lived experience voice of those with the PSD NDIS plan and their experience when presenting to an ED, (2) to gather information from NDIS service providers to reveal communication pathways between the ED and NDIS services, and (3) to gain knowledge from ED clinicians around processes for continuity of care with this population group. METHODS This inductive, mixed methods phenomenological study will involve data collection analyzed sequentially, with each stage informing future stages of the research. Interviews will focus on the lived experience voice exploring potential indicators that have led to an ED presentation, alongside an analysis of associated clinical and administrative documentation and communications. Focus groups with NDIS support workers and support coordinators will provide phenomenological data around the experience from their perspective. National quantitative surveys among those with a PSD NDIS plan and emergency services clinicians will provide insight into current practices within community care and ED presentations. The research project design includes a lived experience advisory group who are assisting with the design of the interview and focus group schedules and national surveys, as well as in shaping the interpretation of qualitative information. All transcripts will be subject to thematic analysis to understand individuals’ meaning-making of these complex and particular phenomena. The research team includes a lived experience researcher and a lived experience carer (PhD candidate). RESULTS This study is funded by MIND Australia as a PhD industry scholarship, which commenced in April 2020. A systematic review as a preresearch activity has been completed and is currently under review. The Human Research Ethics Committee of the University of South Australia has approved this project. An advisory group has been selected, and interview, focus group, and survey schedules are currently being codesigned. Recruitment will commence in November 2021. It is envisaged that data collection will be completed by June 2022. CONCLUSIONS Understanding the lived experience of the precare, during care, and postcare stages of ED presentations from the perspective of those with a PSD NDIS plan will inform the research team around current practices and provide information about improvement for pathways of care for this vulnerable group of people, while also informing health policy. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/33268

Somatic Symptoms and Sleep Disorders: A Literature Review of Their Relationship, Comorbidities and Treatment

This study aimed to investigate the relationship between somatic symptom disorder (SSD) and sleep disorders, following three research questions: (1) How are these disorders correlated? (2) What are the comorbidities reported in these patients? and (3) What are the most effective pharmacological and non-pharmacological treatments for both conditions? PubMed, Scopus, OVID, Medline, and ProQuest databases were searched for relevant articles published between 1957–2020. Search terms included “somatic symptoms disorder”, “sleep disorders”, “insomnia”, “somatoform”, “somatization”, “therapeutic”, “psychotherapy”, and alternative, formerly used terms for SSD. Forty papers were finally included in the study. Prevalence of insomnia in SSD patients ranged between 20.4%–48%, with this being strongly correlated to somatic symptoms and psychosocial disability. The most relevant comorbidities were generalized anxiety disorder, depression, fatigue, negative mood, substance use, orthorexia, alexithymia, anorexia, weight loss, poor eating habits, and acute stress disorder. Patients receiving antidepressant therapy reported significant improvements in insomnia and somatic symptoms. In terms of non-pharmacological interventions, cognitive-behavioral therapy (CBT) showed improvements in sleep outcomes, while the Specialized Treatment for Severe Bodily Distress Syndromes (STreSS) may represent an additional promising option. Future research could include other medical and psychosocial variables to complete the picture of the relationship between sleep disorders and somatic symptoms.

Working in disability employment: An interpretative phenomenological study of experiences of people with a diagnosis of schizophrenia

Aim To understand how employees with schizophrenia in disability employment interpret their work experience. Method Nine people with schizophrenia were interviewed. Data were analysed with the interpretative phenomenological analysis. Results All participants regarded themselves as ‘persons with mental illness’. Some participants developed their mental illness identity by realising that working without accommodations is difficult. Although participants found working in the current company comfortable because the supervisors provided appropriate accommodations, they were dissatisfied with low salary. A proportion of the participants felt dissatisfaction with the menial work, which led to low levels of self-esteem as they viewed non-disability employment of higher value. In addition, the present study noted a difference between self-labelling and labelling by others; although participants regarded themselves as ‘persons with mental illness’, they felt reluctant to be viewed as such by others. Most of the participants wanted to work in non-disability employment in future for financial and personal reasons, such as to increase self-esteem. Conclusion It is imperative that benefits and other issues in disability employment for people with psychosocial disability relating to mental illness are explored more broadly in future research. Further, employers must create healthy workplaces, for all employees regardless of disability can benefit from it.