Disparities in Technology and Broadband Internet Access Across Rurality: Implications for Health and Education.

Amidst the COVID-19 pandemic, interest in using telehealth to increase access to health and mental health care has grown, and school transitions to remote learning have heightened awareness of broadband inequities. The purpose of this study was to examine access and barriers to technology and broadband Internet service ("broadband") among rural and urban youth. Washington State public school districts were surveyed about youth's access to technology (ie, a device adequate for online learning) and broadband availability in spring 2020. Availability of and barriers to broadband (ie, geography, affordability, and smartphone-only connectivity) were assessed across rurality. Among responding districts, 64.2% (n = 172) were rural and 35.8% (n = 96) were urban. Rural districts reported significantly fewer students with access to an Internet-enabled device adequate for online learning (80.0% vs 90.1%, P < .01). Access to reliable broadband varied significantly across geography (P < .01). Compared with their urban peers, rural youth face more challenges in accessing the technology and connectivity needed for remote learning and telehealth. Given that inadequate broadband infrastructure is a critical barrier to the provision of telehealth services and remote learning in rural areas, efforts to improve policies and advance technology must consider geographical disparities to ensure health and education equity.

Phase-based approaches for treating complex trauma: a critical evaluation and case for implementation in the Australian context

Phase-based approaches are a recommended treatment option for individuals with complex trauma histories;however, this is based on a limited body of empirical evidence. Phase-based approaches often involve two stages of treatment, with one focusing on safety and stabilisation and phase two on trauma memory processing. Historically, the Australian Better Access Scheme offered a government rebate for up to 10 group and 10 individual psychological sessions annually. In response to the coronavirus pandemic, the number of rebated individual sessions has been increased to 20 through June 2022. Combining individual and group session rebates, phase-based approaches that include both treatment modalities represent a feasible and accessible treatment option for complex trauma. Delivering phase one in a group milieu and providing individual treatment during phase two may be cost effective and optimise outcomes by leveraging the benefits of group and individual treatment for complex trauma. This article aims to provide an overview of the psychological impact of complex trauma, to highlight barriers to seeking mental healthcare, and to critically evaluate phase-based approaches for treating complex trauma. We highlight gaps in the research, followed by a discussion regarding the benefits and limitations of using this approach in the Australian mental health care system. <bold>Key points</bold> <bold>What is already known about this topic:</bold> (1) Individuals with complex trauma face barriers when seeking psychological treatment in Australia, including the affordability of specialised mental health care. (2) The number of Medicare-rebated sessions provided by the Better Access Scheme to treat mental health problems is at times inadequate, and clients bear the burden of cost for extra treatment. (3) Despite garnering support from trauma experts, phase-based treatments for trauma related disorders have promising but limited empirical support. (1) Individuals with complex trauma face barriers when seeking psychological treatment in Australia, including the affordability of specialised mental health care.(2) The number of Medicare-rebated sessions provided by the Better Access Scheme to treat mental health problems is at times inadequate, and clients bear the burden of cost for extra treatment.(3) Despite garnering support from trauma experts, phase-based treatments for trauma related disorders have promising but limited empirical support. <bold>What this topic adds:</bold> (1) Updating prior reviews, a rapid review of the literature identified 15 peer-reviewed papers that examined the delivery of a phase-based treatment for individuals with histories of complex trauma, demonstrating the ongoing implementation of this treatment approach. (2) A phase-based treatment approach for complex trauma is a feasible, accessible and cost-effective option under the current Better Access Scheme, which offers rebates for up to 10 individual sessions (increased to 20 in response to the COVID-19 pandemic through June 2022) and 10 group sessions annually. (3) A phase-based approach that combines group and individual therapy may enable clients to benefit from both group and individual interventions and facilitate continuity of care. (1) Updating prior reviews, a rapid review of the literature identified 15 peer-reviewed papers that examined the delivery of a phase-based treatment for individuals with histories of complex trauma, demonstrating the ongoing implementation of this treatment approach.(2) A phase-based treatment approach for complex trauma is a feasible, accessible and cost-effective option under the current Better Access Scheme, which offers rebates for up to 10 individual sessions (increased to 20 in response to the COVID-19 pandemic through June 2022) and 10 group sessions annually.(3) A phase-based approach that combines group and individual therapy may enable clients to benefit from both group and individual interventions and facilitate continuity of care. [ABSTRACT FROM AUTHOR] Copyright of Australian Psychologist is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

COVID-19 and emergency care for adults experiencing homelessness.

Homeless individuals face many barriers to accessing healthcare, and EDs are often their primary entry point to the healthcare system. The COVID-19 pandemic has the potential to exacerbate existing social inequities and health disparities, including barriers to accessing social services and healthcare. Addressing the complex social and chronic health issues associated with homelessness can be challenging within the acute care environment. This perspective reflects upon the delivery of emergency healthcare to patients experiencing homelessness, and highlights strategies for optimising health outcomes during and beyond the pandemic.