Development of a referral pathway framework for foetal alcohol spectrum disorder in the Pilbara.

INTRODUCTION: This article describes the process of mapping referral pathways to develop a localised resource to enhance the journey to diagnosis, treatment and support for foetal alcohol spectrum disorder (FASD) in a regional community setting. METHODS: Over a 6-month period, a research officer engaged service providers in Port and South Hedland, Western Australia, using participatory action research methods. An iterative process included a service environment scan, interviews with service leaders and refinement of progressive drafts of the pathway through the Hedland FASD Network. A community reference group advised on cultural issues. RESULTS: Referral pathways for interagency sectors (health, education, justice) were developed. Three pathway schematics and a companion four-page referral protocol were endorsed. The pathways were disseminated to all service providers and consensus was reached to trial the pathways within existing service systems. CONCLUSION: The process of referral pathway development provided a service mapping and gapping exercise to facilitate service integration. Evaluation of the resource will be conducted using the RE-AIM framework. The referral pathways template has been adapted and trialled by health and other professionals in several sites across Australia. The model developed for FASD can be applied to other neurodevelopmental disorders.

Sexual health and sexual trauma in women with severe mental illness: An exploratory survey of Western Australian community mental health services.

Australian women attending community mental health services were surveyed to determine the relationship between sexual trauma, sexual activity, and sexual health seeking behaviors. Self-reported history of "forced sex" was 58.4% (n = 122 out of 220). Latent class analysis revealed a three-class model: "sexually active and health seeking," "low sexual activity and health seeking" and "low sexual activity and not health seeking." An association with general practitioner engagement and sexual health seeking behaviors was found. Rates of self-reported sexual trauma reinforce the need for screening and trauma informed care. Groupings may reflect different aspects of recovery associated with sexual health behaviors.

Intact speed of processing in a community-based sample of adults with high schizotypy: A marker of reduced psychosis risk?

Speed of processing is impaired in schizophrenia but intact in schizotypal college students. In view of this disparity, we investigated whether deficient processing speed was associated with schizotypy in adults from the general community. Data were drawn from the Western Australian Family Study of Schizophrenia, including 216 (non-clinical) adults from the general community, and a reference group with schizophrenia spectrum disorder (N=224). Schizotypal traits were assessed with the Schizotypal Personality Questionnaire, whilst processing speed was assessed with a digit-symbol coding task. Community controls had significantly higher digit symbol coding scores than patients with psychosis. However, both correlational and hierarchical regression analysis indicated a lack of association between Cognitive-perceptual, Interpersonal or Disorganized schizotypy traits and digit symbol coding performance. Relative to Australian norms there was also no evidence of a non-linear decline in coding in high schizotypes in young, mature or senior age groups. The results show that speed of information processing is unimpaired in high schizotypes from the general community. The possibility that intact processing speed in at-risk groups confers protection to psychosis onset is discussed. Assessing the trajectory of processing speed throughout development may provide a useful clinical screening tool to distinguish those at heightened risk of developing psychosis.