September PD Blog

Professional development

You can add to the professional development post by commenting below or emailing the library.

Online resources

Webpage

The Cultural Atlas developed by SBS is an online educational resource that provides comprehensive cultural information on the countries that Australia’s biggest migrant populations have originated from. When working with young people and families of different cultural backgrounds to our own, it helps to develop a cultural reference to inform how you approach interactions. Part of practicing from a culturally competent framework is acknowledging the impact of culture. The Cultural Atlas includes a broad range of cultural information, for example common etiquette, religious considerations and greetings.

Read – professional reading

Available from the library database

George, A. M., & Zamboanga, B. L. (2018). Drinking game participation and outcomes in a sample of Australian university students. Drug and Alcohol Review37(5), 599-606.

Heiman, T., & Olenik Shemesh, D. (2018). Predictors of cyber-victimization of higher-education students with and without learning disabilities. Journal of Youth Studies, 1-18.

Hennessy, M. J., Patrick, J. C., & Swinbourne, A. L. (2018). Improving Mental Health Outcomes Assessment with the Mental Health Inventory‐21. Australian Psychologist, 53(4), 313-324.

Krakouer, J., Wise, S., & Connolly, M. (2018). “We Live and Breathe Through Culture”: Conceptualising Cultural Connection for Indigenous Australian Children in Out-of-home Care. Australian Social Work71(3), 1-12.

LaBrie, J. W., Boyle, S., Earle, A., & Almstedt, H. C. (2018). Heavy Episodic Drinking Is Associated With Poorer Bone Health in Adolescent and Young Adult Women. Journal of studies on alcohol and drugs, 79(3), 391-398.

Sharmin, S., Kypri, K., Wadolowski, M., Bruno, R., Khanam, M., Aiken, A., … & Attia, J. (2018). Parent characteristics associated with approval of their children drinking alcohol from ages 13 to 16 years: prospective cohort study. Australian and New Zealand Journal of Public Health42(4), 347-353.

Open Access Articles

Amodeo, A. L., Picariello, S., Valerio, P., & Scandurra, C. (2018). Empowering transgender youths: Promoting resilience through a group training program. Journal of Gay & Lesbian Mental Health, 22(1), 3-19.

Canham, S. L., Mahmood, A., Stalman, M. N., King, D., & O’Rourke, N. (2018). Personal theories of substance use among middle-aged and older adults with bipolar disorder. Aging & Mental Health, 22(6), 813-818.

Doñamayor, N., Strelchuk, D., Baek, K., Banca, P., & Voon, V. (2018). The involuntary nature of binge drinking: goal directedness and awareness of intention. Addiction Biology, 23(1), 515-526.

Tsirigotis, K., & Łuczak, J. (2018). Resilience in women who experience domestic violence. Psychiatric Quarterly, 89(1), 201-211.

Open access online journal

Produced by the Penington institute the Anex Bulletin is a specialty publication for workers in Australia’s needle and syringe programs (NSPs)

Useful resources

Tx! Mag is a free to download magazine about viral hepatitis which is published 3 times a year

Headspace has launched a national mental health campaign for young men called Headcoach.  Headcoach seeks to educate young men that maintaining their mental health is just as important as maintaining their physical health.  Some of Australia’s top athletes share stories, tips and advice from their own experiences to help educate young men about the importance of looking after their mental health and knowing when to ask for help.  These videos may be beneficial to show to young men to identify early warning signs and promote help-seeking for better mental health.

e-Book of the month

Out of this world: suicide examined by Antonia Murphy

This book is intended for anyone with either an interest in suicide or suicidal behaviour. It is not aimed solely at the professional psychotherapist but at a broad range of professionals who encounter suicidal people in their work. It is also intended for those of us who have been touched by suicide personally. The book approaches suicide from the point of view of the suicidal state of mind and is intended to help us understand more about this condition. In its essence suicide is examined as a largely unconscious aggressive act having its roots in a perceived or real experience of thwarted childhood needs. The wounds of the suicidal person are often long held and deep. The suicidal person is pursued by haunting losses and the suicidal act comes from deep disturbance created by this and from the idea of death as an acting out of some form of suicidal fantasy. The quasi delusional and split quality of the act is examined – namely that suicide is both an act for and against the self (from publisher).

Free to download for all HOA staff from the library catalogue on work computers

Attend – informal learning sessions, journal club, seminar series

Insight Queensland

Free training sessions at Biala Community Health Centre in Brisbane, unless otherwise specified including:

7 September, 8:30-16:00. AOD Clinical Assessment at Townsville. Prerequisite online induction module 4.

10 September, 9:00-16:30. Introduction to Withdrawal Management at Ipswich (Goodna)

11 September, 9:00-16:30. Advanced Harm Reduction at the Gold Coast (Southport)

Online induction modules are a prerequisite to some of the courses. To access and download them visit www.insightqld.org

Attend – conferences 

NDARC 2018 Annual Research Symposium: Clinical, Community and Policy Responses to Emerging Problems in Drug and Alcohol Use. October 8, 08:30-18:15 at UNSW, Sydney. Cost $275. For more details and registration click here

2018 NDRI Annual Symposium: Alcohol and Other Drug Research, Policy and Practice, November 22, 08:30-17:00 at Melbourne. Cost from $210. For more details and registration click here

Listen – podcasts, webinars

Podsocs: podcasts for social workers. An initiative of the School of Human Services and Social Work, Griffith University that consists of up-to-the minute research, diverse and sometimes controversial perspectives on social phenomena and focus on knowledge and skills needed in the human services.

Insight webinars. Wednesdays, 10:00-11:00 AEST

September 5: Domestic violence and its relationship with alcohol and drug abuse. Findings from the Queensland Death and Homicide Review board

September 12: Past, present and future in the regulation of prescription opioids

September 19: Testing times. Drug checking in the UK with “The Loop”

September 26: Opioids, scaling up the analgesic ladder wrong by wrong

August PD Blog

Professional development

You can add to the professional development post by commenting below or emailing the library.

Online resources

Webpage

Youth alcohol and other drugs learning hub for workers provides access to free self-directed learning modules

Read – professional reading  

Available from the library database

Atkinson, J. A., Prodan, A., Livingston, M., Knowles, D., O’Donnell, E., Room, R., … & Wiggers, J. (2018). Impacts of licensed premises trading hour policies on alcohol‐related harms. Addiction.

Couto E Cruz, C., Salom, C., Maravilla, J., & Alati, R. (2018). Mental and physical health correlates of discrimination against people who inject drugs: A Systematic Review. Journal of Studies on Alcohol and Drugs, 79(3), 350-360.

Geia, L., Broadfield, K., Grainger, D., Day, A., & Watkin‐Lui, F. (2018). Adolescent and young adult substance use in Australian Indigenous communities: a systematic review of demand control program outcomes. Australian and New Zealand Journal of Public Health, 42(3), 254-261.

Hawke, L. D., Koyama, E., & Henderson, J. (2018). Cannabis use, other substance use, and co-occurring mental health concerns among youth presenting for substance use treatment services: Sex and age differences. Journal of Substance Abuse Treatment, 91, 12-19.

McKetin, R., Lubman, D. I., Baker, A., Dawe, S., Ross, J., Mattick, R. P., & Degenhardt, L. (2018). The relationship between methamphetamine use and heterosexual behaviour: evidence from a prospective longitudinal study. Addiction.

Whiteside, M., MacLean, S., Callinan, S., Marshall, P., Nolan, S., & Tsey, K. (2018). Acceptability of an Aboriginal wellbeing intervention for supporters of people using methamphetamines. Australian Social Work, 1-9.

Open Access Articles

Moss, M. J., Warrick, B. J., Nelson, L. S., McKay, C. A., Dubé, P. A., Gosselin, S., … & Stolbach, A. I. (2018). ACMT and AACT position statement: preventing occupational fentanyl and fentanyl analog exposure to emergency responders. Clinical Toxicology, 56(4), 297-300.

Mustonen, A., Niemelä, S., Nordström, T., Murray, G. K., Mäki, P., Jääskeläinen, E., & Miettunen, J. (2018). Adolescent cannabis use, baseline prodromal symptoms and the risk of psychosis. The British Journal of Psychiatry, 212(4), 227-233.

Thompson, T. P., Taylor, A. H., Wanner, A., Husk, K., Wei, Y., Creanor, S., … & Wallace, G. (2018). Physical activity and the prevention, reduction, and treatment of alcohol and/or substance use across the lifespan (The PHASE review): protocol for a systematic review. Systematic Reviews, 7(1), 9.

Young, J. T., Heffernan, E., Borschmann, R., Ogloff, J. R., Spittal, M. J., Kouyoumdjian, F. G., … & Kinner, S. A. (2018). Dual diagnosis of mental illness and substance use disorder and injury in adults recently released from prison: a prospective cohort study. The Lancet Public Health, 3(5), e237-e248.

Open access online journal

QNADA Focus: The latest edition focusses on LGBTIQ+ issues

Useful resources

Psychology tools – the library has just purchased Professional Team Membership for HOA  to the leading online resource for therapy tools.

Overview of Aboriginal and Torres Strait Islander Health Status Report 2017

NHRMC Comorbidity newletter New Horizons includes an article on developing a culturally appropriate AOD prevention program for Aboriginal and Torres Strait Islander young people.

Positive choices This contains resources including factsheets and videos about AOD use in youth aimed at teachers, youth and parents. There are also resources specific to Aboriginal and Torres Strait Islanders and youth that are Culturally and Linguistically Diverse

CleanM8 provides digital tools to provide support for those suffering from addiction, along with their significant others and clinicians, particularly in regional areas. It has been developed by the University of Newcastle

Lowitja Institute provides access to free e-books and reports pertaining to Aboriginal and Torres Strait Islander health research

 

e-Book of the month

Helping Male Survivors Of Sexual Violation To Recover : An Integrative Approach – Stories From Therapy  by Sarah Van Gogh

Placing the experiences of men at the heart of this book, Sarah Van Gogh outlines an integrative approach to effective therapeutic treatment of male sexual abuse. In a culture where to be male is often to be expected to embody strength, power and being in control, male victims of sexual abuse can be particularly challenging to help. This book outlines seven composite detailed case studies representing men from a wide range of backgrounds and demographics. It lays out how the author’s pioneering model of an integrative approach which includes psychodynamic, humanistic, relational, cognitive/behavioural, body-based and arts-based approaches can offer an effective model for working with this client group. This key text provides a valuable resource for all those working with male survivors of sexual abuse.

(copied from EBSCO site)

Free to download for all HOA staff from the library catalogue on work computers

Attend – informal learning sessions, journal club, seminar series

Insight Queensland

Free training sessions including:

1st August, 09:00-16:30 – AOD Crash Course at St George

2nd August, 08:30-12:30 – Crystal Clear: Responding to Methamphetamine Use at St George

2nd August, 13:00-16:30 – Brief Interventions at St George

9th August, 09:00-16:30 – Advanced Harm Reduction at Toowoomba

10th August, 09:00-16:30 – Introduction to Withdrawal Management at Toowoomba

16th August, 09:00-16:30 – Introduction to Withdrawal Management at the Gold Coast

23rd August, 09:00-16:30 – AOD Crash Course at Ipswich

 

30th August, 09:00-16:30- Advanced Harm Reduction at the Sunshine Coast

Attend – conferences 

The 16th Annual Conference for the Australia & New Zealand Academy for Eating Disorders will be taking place at the Melbourne Convention Centre on the 3rd & 4th of August, 2018. The theme for  this year will be Courageous Conversations: Furthering Understanding, Embracing Change. See the conference website:  http://conference.2018.anzaed.org.au for more info and details on how to register.  Cost $100-660

Write – presentations and papers

Call for papers: Australian Social Work  – Working with involuntary clients. Guidelines available here.

Listen – podcasts, webinars

Insight presentation recordings available now here

LGBTIQ young people share their stories on the podcast “Hear and queer

Assessed learning – short courses, certificates, diplomas, bachelors, post-grad

Lighthouse resourses

6th August: Assessing family dynamics: cost  $245

29th-31st August: Introduction to a strengths approach: cost $660

Workshop Venue: Lighthouse Resources Upstairs Training Room, Kyabra Street RUNCORN, QLD. 4113

Moss, M. J., Warrick, B. J., Nelson, L. S., McKay, C. A., Dubé, P. A., Gosselin, S., … & Stolbach, A. I. (2018). ACMT and AACT position statement: preventing occupational fentanyl and fentanyl analog exposure to emergency responders. Clinical Toxicology, 56(4), 297-300.Moss, M. J., Warrick, B. J., Nelson, L. S., McKay, C. A., Dubé, P. A., Gosselin, S., … & Stolbach, A. I. (2018). ACMT and AACT position statement: preventing occupational fentanyl and fentanyl analog exposure to emergency responders. Clinical Toxicology, 56(4), 297-300.

July PD

Professional development

You can add to the professional development post by commenting below or emailing the library.

Online resources

Webpage

Dovetail provides advice and support to workers, organisations and communities who engage with young people affected by alcohol and drug use.

Read – professional reading

Available from the library database

Bowles, T. V. (2018). Motivation to the Past, present, and future: Time orientation and disorientation before therapy. Australian Psychologist, 53(3), 223-235.

 

Coomber, K., Hayley, A., & Miller, P. G. (2018). Unconvincing and ineffective: Young adult responses to current Australian alcohol product warnings. Australian Journal of Psychology, 70(2), 131-138.
Livingston, M., Callinan, S., Raninen, J., Pennay, A., & Dietze, P. M. (2018). Alcohol consumption trends in Australia: Comparing surveys and sales‐based measures. Drug and Alcohol Review, 37, S9-S14.
Lucabeche, V. X., & Haney, J. L. (2018). The effect of alcohol severity on outpatient treatment completion: The differential outcome by gender and race/ethnicity. Journal of Substance Abuse Treatment, 90, 1-8.
Pidd, K., Roche, A., Cameron, J., Lee, N., Jenner, L., & Duraisingam, V. (2018). Workplace alcohol harm reduction intervention in Australia: Cluster non‐randomised controlled trial. Drug and Alcohol Review.
Tan, W. H., Sheffield, J., Khoo, S. K., Byrne, G., & Pachana, N. A. (2018). Influences on psychological well‐being and ill‐being in older women. Australian Psychologist, 53(3), 203-212.
Urbanoski, K., Kenaszchuk, C., Inglis, D., Rotondi, N. K., & Rush, B. (2018). A system-level study of initiation, engagement, and equity in outpatient substance use treatment. Journal of Substance Abuse Treatment, 90, 19-28.

Open Access Articles

Christie, G. I., Bavin, L. M., & Wills, S. (2018). Can we predict which adolescents will engage in outpatient substance abuse treatment?. Substance Abuse: Research and Treatment, 12, 1178221818762802.
Guajardo, M. G. U., Slewa-Younan, S., Kitchener, B. A., Mannan, H., Mohammad, Y., & Jorm, A. F. (2018). Improving the capacity of community-based workers in Australia to provide initial assistance to Iraqi refugees with mental health problems: an uncontrolled evaluation of a Mental Health Literacy Course. International Journal of Mental Health Systems, 12(1), 2.
Poulton, A., Pan, J., Bruns Jr, L. R., Sinnott, R. O., & Hester, R. (2017). Assessment of alcohol intake: retrospective measures versus a smartphone application. Addictive Behaviors.
Wyndow, P., Walker, R., & Reibel, T. (2018, January). A novel approach to transforming smoking cessation practice for pregnant Aboriginal women and girls living in the Pilbara. In Healthcare (Vol. 6, No. 1, p. 10). Multidisciplinary Digital Publishing Institute.

Open access online journal

Addictive Behaviors

Useful resources

Headspace resource library contains links to resource for young people, families and health professionals

Project Air Strategy contains resources including factsheets and videos focusing on borderline personality disorder

 

e-Book of the month

Kerry, S. (2018). Trans Dilemmas : Living in Australia’s Remote Areas and in Aboriginal Communities. London: Routledge

Trans Dilemmas presents the findings of a three-year research project which examined the lived experiences of trans people in Australia’s Northern Territory. The book argues that whilst trans people, who live in remote areas, experience issues which may not be distinct from those living in urban areas and the inner-city, these issues can be aggravated by geographic and demographic factors. By conducting online surveys and in-depth interviews, Stephen Kerry brings to light the issues for transgender people which are compounded by living in sparsely populated, remote communities. Namely social isolation, maintaining relationships with friends, family and partners, and the difficulties accessing health care. The book also includes significant findings on the experiences and treatment of Australia’s trans Aboriginal people, also known as sistergirls and brotherboys. An analysis of first-person narratives by sistergirls and brotherboys reveals the racism within predominantly white trans communities and transphobia within traditional Aboriginal communities, which they are uniquely faced with. Trans Dilemmas represents an important contribution to contemporary research into the lives of transgender Australians. It gives a voice to those transgender people living in the more isolated communities in Australia, which up until now, have been largely unheard. (copied from EBSCO site)

Free to download for all HOA staff from the library catalogue on work computers

Attend – informal learning sessions, journal club, seminar series

Insight Queensland

Free training sessions at various Queensland locations including:

6th July, 9:00-16:30 at Cairns: AOD relapse prevention and management. Prerequistite- online induction module 6

10th-11th July, 9:00-16:00 at Mackay: Culturally secure AOD practice featuring IRIS

17th July, 9:00-16:30 at Townsville: Introduction to withdrawal management

18th July, 9:00-16:30 at Townsville: Harm reduction 101

26th July, 9:00-16:30 at Sunshine Coast: Introduction to withdrawal management 

30th July, 9:00-16:30 at Roma: AOD crash course- introduction to AOD

31st July, 9:00-16:30 at Roma: Crystal clear- responding to methamphetamine use

Online induction modules are a prerequisite to some of the courses. To access and download them visit www.insightqld.org

National comorbidity guidelines free online training and website

The training program consists of 10 training modules that can be completed in any order. Registrants can choose which modules to engage in based on interest and experience. Those wishing to receive a certificate of completion must complete all modules (in any order) and successfully complete all quizzes.

At the end of each module, registrants will be presented with a quiz. All questions must be answered correctly before the module is completed, but there is no limit to how many times the quiz can be taken. Incorrect answers will refer participants to relevant sections of the Guidelines website.

At the completion of all modules, training participants will receive a certificate of completion

Attend – conferences 

Australian Youth AOD Conference

August 16-17,  Melbourne

Theme: Assertive advocacy

Cost: $260-360. Register here

 

Listen – podcasts, webinars

On Drugs looks through the lenses of history, pop culture and personal experience to understand how drugs have shaped our world. Site includes archive of previous podcasts.

 

Annotated bibliography: Unemployment and mental health

Annotated bibliography

 Bidargaddi, N., Bastiampillai, T., Schrader, G., Adams, R., Piantadosi, C., Strobel, J., & … Allison, S. (2015). Changes in monthly unemployment rates may predict changes in the number of psychiatric presentations to emergency services in South Australia. BMC Emergency Medicine, 15(1), 1-6.  

The aim of this paper was to establish if monthly presentation rates to Mental Health Emergency Departments (MHED) in South Australia Public Hospitals (SAPH) was associated with Australian Bureau of Statistics (ABS) unemployment rates. The data was collected using times series modelling of relationships between monthly MHED SAPH presentations obtained from the Integrated South Australian Activity Collection (ISAAC) and the ABS South Australia unemployment figures between January 2004 and June 2011. The study found that over 32% of MHED presentations in males could be predicted by male unemployment rates from the two months prior. Over 63% of MHED presentations in females could be predicted by male and female unemployment in the previous months. They concluded that small shifts in unemployment rates can increase MHED presentations particularly in women and that ABS unemployment statistics can be a useful tool for predicting future MHED. A limitation of this study is that it establishes an association between MHED presentations and unemployment but not causality, so increased unemployment might not be the cause of the increase in MHED presentations.

 Buffel, V., van de Straat, V., & Bracke, P. (2015). Employment status and mental health care use in times of economic contraction: a repeated cross-sectional study in Europe, using a three-level model. International Journal for Equity in Health, 14(1), 1-19.

 This study aimed to compare the mental health care use of the unemployed with that of the employed and whether the relationship between unemployment status and mental health care use varied across different economic climates. They wanted to establish whether the economic context affected mental health care use due to its impact on mental health or irrespective of mental health. Data from three waves of the Eurobarometer (2002, 2005/6 and 2010) was utilised, which consists of a repeated cross-sectional and cross-national design. The data was analysed using linear and logistic multi-level regression in which mental health and contacting a medical practitioner for mental health issues were considered variables. They found that mean unemployment rate was negatively associated with mental health, although in women this only applied to those employed. There was no association found in women between changes in the macro-economic climate and mental health.  Men’s care use however is associated with changes in the unemployment rate and gross domestic product (GDP) irrespective of mental health. This is true of both employed and unemployed men. They conclude that it is important to consider macro-economic conditions when studying mental health care use, particularly in men. A limitation noted in the study is that the Eurobarometer records employment status at the time of the interview and mental health in the twelve months preceding the interview. Therefore it is not able to distinguish between causation and reverse causation for any association between mental health and employment. 

Crowe, L., Butterworth, P., & Leach, L. (2016). Financial hardship, mastery and social support: Explaining poor mental health amongst the inadequately employed using data from the HILDA survey. SSM – Population Health, 2(1), 407-415.

 Data from the Household Income and Labour Dynamics in Australia (HILDA) Survey were analysed to try and establish if there was a relationship between employment status and mental health, along with the effects of financial hardship, mastery and support. They also wanted to explore how duration of unemployment impacted on mental health. Three waves of data were analysed from the HILDA Survey which encompassed 4965 adult respondents. The relationship between employment status and mental health was assessed using longitudinal population-averaged logistic regression models to explain associations between employment groups (unemployed vs. employed; employed vs. underemployed). The effect on duration of unemployment on mental health was evaluated using regression analysis. Unemployed or underemployed respondents exhibited poorer mental health than their employed counterparts. Mastery, financial hardship and social support ameliorated this association particularly in the underemployed. Transition to unemployment was associated with a decline in mental health among a broad age range of respondents.  The relationship between mental health and unemployment duration was not linear but mental health showed a marked decline in the first nine weeks. The study concluded that mastery, financial hardship and social support are important factors to consider in the understanding of the relationship of poor mental health and un- or underemployment. It also suggests intervention should commence immediately after job loss with deterioration in mental health being most severe in the first weeks before plateauing.  A limitation in this study is the possibility of reverse causation or low mastery and lack of social support causing unemployment.

 Limm, H., Heinmüller, M., Gündel, H., Liel, K., Seeger, K., Salman, R., & Angerer, P. (2015). Effects of a Health Promotion Program Based on a Train-the-Trainer Approach on Quality of Life and Mental Health of Long-Term Unemployed Persons. Biomed Research International, 2015(1),

 The authors of this study state that long-term unemployment is associated with poorer mental health. They therefore conducted this study to evaluate the effectiveness of a health promotion program to improve the mental health and health related quality of life (HRQL) utilising the train-the-trainer approach. A parallel-group study was performed using 287 unemployed participants (179 were in the intervention group and 108 in the control group), who were reassessed after 3 months. The intervention comprised individual sessions based on motivational interviewing and participatory group sessions, with the control group receiving no health promotion. Within 3 months HRQL improved and symptoms of depression and anxiety decreased in the intervention group, but not in the control group. The trainers were all professionals (mainly social workers) who had received three days training to deliver the interventions.  A limitation of this study was that participants were not “blinded” and the positive results may be influenced by this. 

Olesen, S., Butterworth, P., Leach, L., Kelaher, M., & Pirkis, J. (2013). Mental health affects future employment as job loss affects mental health: findings from a longitudinal population study. BMC Psychiatry, 13(1), 144.

 Internationally, participation in the workforce is regarded as an important factor in mental health policies and social inclusion. This study aimed to examine simultaneously the effects on mental health on unemployment and how mental health effects employment prospects and participation. The data was derived from respondents who completed the nine waves of the HILDA Survey in Australia. They were all of working age (20-55 years) at commencement of the study (n=7176). Simultaneous relationships between employment and mental health were tested over time using cross-lagged path analysis, whilst adjusting for sociodemographic differences. They found that poor mental health was both a result of and a predisposing factor for unemployment. Poorer mental health in people who are unemployed can be both attributable to the unemployment and existing mental health issues. In women both these factors had equal rating, whereas in men the impact of unemployment on mental health was weaker than mental health on subsequent unemployment. The data available in the HILDA survey meant that the researchers were limited to using the respondents’ concept of their mental health rather than diagnosed mental illnesses.

 Strandh, M., Winefield, A., Nilsson, K., & Hammarström, A. (2014). Unemployment and mental health scarring during the life course. The European Journal of Public Health, 24(3), 440.

 The long-term relationship between unemployment and mental health over the life course has been little researched. This study examined the relationship between youth unemployment along with periods of adult unemployment and mental health at several life stages (16, 18, 21, 30 and 42 years) who all graduated from compulsory school in a town in Sweden.  Originally there were 1083 participants and of those still living at the 27 year follow-up, 94.3% were still involved. The researchers measured mental health in three ways: nervous symptoms, depressive symptoms and trouble sleeping. These were analysed using a repeated measures linear mixed models approach at ages 16, 21, 30 and 42 years. Unemployment was measured using a period of unemployment of at least six months over three time periods: 18–21, 21–30 and 30–42 years. They found that youth unemployment was significantly associated with poor mental health at ages 21, 30 and 42 years. Later single unemployment periods did not appear to have the same long-term effects, although two or more periods of unemployment did have a significant relationship with poor mental health. A limitation of the study is its small geographical sample base, with consequent limits on sociodemographic variants.