Professor David Kavanagh
University of Queensland
Evaluation of Mental Health Service Provision, 2007 and 2009
David Kavanagh was educated at Sydney and Stanford universities. He has held senior academic posts at the Universities of Sydney and Queensland, and currently holds a Research Chair in the Institute of Health & Biomedical Innovation and School of Psychology & Counselling at Queensland University of Technology in Brisbane.
His primary research interests are the nature and treatment of addictive and mental disorders, particularly where they occur together. A theme has been the development of brief and accessible treatments, including treatments obtained via correspondence or the internet. He has an extensive grant record, including three recent grants from Australian Rotary Health, on correspondence-based treatments to avert relapses of depression or to assist people with both alcohol and depression problems, and on dissemination of treatments for comorbid mental health and substance use problems.
As at February 2009, Professor Kavanagh had around 150 publications, including over 100 in refereed journals and 4 books, and some 1500 citations to his work. In 1992, he was awarded the Ian Mathew Campbell Prize by the Australian Psychological Society for contributions to clinical psychology research and practice, and in 1993 he was conferred a Fellowship by the Society. He has served on several national advisory committees or boards on research or clinical psychology practice.
SUMMARY OF PROJECT:
Evaluation of Strategies to Promote the Dissemination of Programs for People with Serious Mental Disorders and Comorbid Substance Use Disorders
Over 40 percent of Australians with serious mental disorders (SMD) also have a lifetime history of substance use disorder (SUD). This is a four times higher ratio than in the general population. People with SMD incur greater costs to health services and the community because of substance use. SMD and SUD are inextricably linked: the worsening of either disorder exacerbates the other. These people need only small amounts of cannabis, alcohol and/or other substances to produce problems, so most people with SMD/SUD comorbidity who are seen by mental health services do not have significant substance dependence.
Research suggests an integrated approach to both disorders with treatments being delivered by a single provider. In the case of SMD, this is the mental health service. However, many mental health staff lack confidence and skills working with people with SUD. Some see alcohol and other drug problems as not being part of their role.
The Queensland State Government recently appointed 13 specialist dual diagnosis coordinators covering every major service centre. They not only provide training and consultation; they act as ‘local champions’ who foster the routine integration of SUD work in mental health service provision.
A team of researchers led by Professor David Kavanagh from the Queensland University of Technology has received an Australian Rotary Health grant to:
• evaluate the impact of the recent appointment of dual diagnosis coordinators to all major service centres and
• improve the dissemination of information and expertise between staff and the coordinators.
This project is expected to be completed by mid June 2009
PROGRESS REPORT:
Detection of Relapse Risk and Improvement of Health Risk Behaviours in People with Depression: Randomised Controlled Trial of Correspondence-Based Intervention
People with a history of repeated episodes of depression are not only at high risk of further episodes; they also have higher risks of serious physical illness than the general community. Their physical risks are mainly due to the higher prevalence of smoking, alcohol use, inactivity, poorer diet and poor oral care.
This project evaluates whether treatment via attractive and simply worded letters in the post will encourage people with repeated episodes of depression to adopt a more protective and recovery-oriented lifestyle. During the first 6 months outcomes of sustained recovery from depression or improved health maintenance will be compared. In the next 6 months participants will then receive the other intervention. While components of the programs are derived from existing evidence-based treatments, their combination and mode of delivery is novel. The study supports people with recurrent depression, and is likely to provide practical, accessible and cost-effective treatment, regardless of a person's location or income.
2009 Progress Data
To date progress has included:
Total enquiries: 458
Wanted information only 42
Refused screening 15
Ineligible 111
Withdrew prior to commencing treatment 117
Active participants 13
Withdrew after commencing treatment 88
Completed treatment 72
Allocated to condition = 173. This includes all participants who were allocated to a treatment condition (including those who withdrew after commencing treatment).
While 50% of participants have withdrawn from treatment, this is considered reasonable given the nature of the treatment program. Data from all 173 participants will be used in outcome analyses. Preliminary data analysis suggests that participants have had a reduction in depressive symptoms and are giving very positive feedback. The project has established its viability and has highlighted the need for this form of correspondence-based service delivery, particularly for those people with limited access to mental health treatment.