Eating disorders (EDs) are among the deadliest of the mental disorders, however detection and early intervention rates remain extremely low. Early intervention significantly improves ED prognosis, however large numbers of people with the illness are not being identified or managed in primary care. The findings of two studies will be presented – the original psychometric validation of a co-designed digital screening tool and the extension of that validation for face-to-face use by primary care physicians. The original study used a mixed cross-sectional and repeated measures longitudinal survey design with 1346 participants aged 14-74 (73.8% female, 22.6% male). The InsideOut Institute Screener (IOI-S) was strongly correlated with existing standardised measures the EDE-Q (rs = .88) and SCOFF (rs = .75), providing support for the concurrent and convergent validity of the scale. The IOI-S demonstrated high internal consistency ( = .908) and excellent two-week test-retest reliability (.968, 95% CI 0.959-0.975; p = <0.1). It accurately distinguished likely EDs (sensitivity = 82.8%, specificity = 89.7% [AUC = .944]) and two stepped levels of risk. The extended study recruited 83 individuals aged 14-81 in general practice & headspace youth mental health centres in NSW and the Northern Territory. Test re-test reliability between digital self-report and clinician delivery was measured by two-way mixed effects model Intraclass Correlation Coefficient (ICC). The screener performed equally well when delivered face-to-face, with a significantly positive ICC between successive iterations of 0.980. The IOI-S is an adaptive 6-item screening tool designed to “start a conversation” and determine risk using gentle language conceived by individuals with lived experience. In conjunction with increased practitioner education and improved treatment referral pathways, broad implementation and use of the screener in primary care settings can support early identification and intervention for those with EDs.

1. Prevalence of eating disorders in primary care and the importance of identifying early
2. Key features of the InsideOut Screener, how it was co-designed and developed
3. Psychometric validity of the InsideOut Institute Screener and how to effectively use it in clinical practice

Medical students have been known to face a wide array of mental health issues at disproportionately high rates. Of pertinence, medical students have been shown to have high rates of suicide. However, little is known about the risks for death by suicide for this group. We therefore conducted a systematic review regarding the risk factors and causes of death by suicide among medical students. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted searches in six different databases. Studies with stratified data on at least one suicide death by a medical student were eligible for inclusion. Searches produced a total of 1748 articles, and of those, 13 articles were eligible for inclusion. There was a pooled total of 362 suicide deaths of medical students across five different countries. 73.4% of deaths occurred among male students, and the majority of all deaths occurred for students who were single and in their early twenties. Students in their later years of medical school were more likely to die by suicide, as were those with a history of psychiatric issues such as depression. Frequently discussed reasons for suicide were academic stress/poor academic performance, and familial/relationship issues. The most commonly reported cause of death by suicide was hanging (65.2%), followed by jumping from a height/building (11.6%), and poison/overdose (11.6%). Our findings indicate that rates of completed suicide are particularly high amongst medical students of certain, specific demographics. Notably, there were few large-scale studies analyzing risks and causes for medical student suicide. Hence, there is a need for more transparency of data and reporting regarding suicide among medical students. In conclusion, it is imperative that medical schools continually aim to identify students who at high risk of suicide, and offer appropriate wellness services and programs.

1. What the key risk factors for suicide among medical students
2. What are the most common causes of suicide among medical students
3. How can medical schools better support students to lower rates of suicide

Even before the Pandemic the burden of chronic mental health conditions was rising in Australia and mental health care systems were becoming increasingly overwhelmed. Psychological problems have now become most common reason for presentation to a General Practitioner (GP). GPs are the largest craft group of doctors in Australia and are often the “heath worker of last resort”, left to contain and monitor patients with treatment resistant illness, complex PTSD and chronic suicidality who are unable to afford or access community psychological or psychiatric care . These patients are often deemed not acute enough for mental health unit admission or publicly funded services. These complex “heart sink patients” often exacerbate GP’s burn out and now the pressures of the Pandemic has escalated all of these dynamics.

This presentation outlines a new and innovative model of care, a GP/Psychiatry community Consultation/Liaison shared care clinic. Where joint consulting strategies train GPs in and disseminate innovative models of psychotherapy focused on self care and self regulation and monitoring novel treatments such as oral ketamine that are normally managed exclusively by Psychiatrists. The clinic has so far treated over 800 patients with severe or treatment resistant, complex mental health problems and has published research showing a reduction in mental health hospital admissions of 60% and reduced days admitted by 70%.

This model would be translatable to most primary care settings, which is often the first and sometimes only point where many of these patients access their care and it integrates well with patients’current treatments. The psychotherapy approaches also assists GPs to self regulate their intensity in consults and manage the cognitive and emotional load of caring for these complex patients. Therefore reducing GP burn out and preserving our capacity to provide care in the face of such unprecedented demand.

1. Dissemination of skills to manage complex mental health in the community is necessary due to the increasing prevalence and overload of systems
2. This model works well for patients improving their access and frequency of review with Psychiatrist supervision
3. This model works well for GPs in reducing their burn out by managing the intensity of patient consultations and having regular peer and Psychiatrist support.

The use of antidepressants is increasing globally, and Australia has one of the highest rates of prescribing in the world – with 86.6% of prescriptions being made in general practice. Despite the clear benefits of antidepressants for many people, ongoing use of this medication is not always properly monitored or ceased when a person’s mental health improves. There is also little support for patients to reduce (deprescribe) their medication when the time is right for them.

The WiserAD randomised controlled trial (RCT) is attempting to address this issue through developing an online tool to support participants and their GPs (general practitioners) through the deprescribing journey.

Drawing on GP and patient perspectives and using an iterative, user-centred design process, a pragmatic and patient approved model of support for antidepressant deprescribing that aligns with Australian deprescribing guidelines is currently being trialed in Victorian general practices. This will help to determine if it serves as an effective tool for successful antidepressant cessation at 6 months.

It is anticipated that the use of an evidence-based, deprescribing support tool will lead to the successful cessation of antidepressant medication in patients who are no longer clinically depressed, resulting in an enhanced quality of life and cost saving over the longer term.

1. The current barriers to deprescribing in Australian primary healthcare
2. The development of a support too to enable successful deprescribing
3. The anticipated impact of successful deprescribing for patients and society

Child development begins at birth and progresses until the age of 9. Enabling children to reach their full developmental potential is a human right and an essential requirement for the development of autonomy. For this reason, monitoring growth and development as an action provided throughout the basic health services network is one of the priority axes of the National Policy for Comprehensive Assistance to Children (PNAISC). Thus, the primary care professional has the first contact with child development disorders, either by observation during monitoring or by family demand. Within the favela context, some risk factors for this condition are very common, such as discrimination, marginalisation, and exposure to violence. Moreover, with the COVID-19 pandemic, the demand from families and schools for case evaluation has increased. The suspicion and diagnosis of a disturbance in a child's development have repercussions on families, often leading to changes in the routine and dynamics of family relationships. They may trigger a paranormative family crisis, causing intense anxiety and stress. Because of this, throughout 2022, a family health strategy team in Rio de Janeiro, whose target area includes a favela, mapped children with reports and signs of developmental disorders. Before doing so, they had to resort to scientific literature in search of references on methods of multidisciplinary approach and follow-up, considering the particularities of the population and the territory. Children and their families were welcomed, underwent medical and nursing care, and individual therapeutic plans (STP) were drawn up. This paper reports this experience, seeking to discuss and reflect on the challenges and potentialities encountered and the care strategies adopted.

1) Knowledge about the organisation of the Brazilian universal public health system
2) Knowledge about limitations and potentialities of the organisation of the family health strategy in the approach of the patient that presents infant development disorder
3) Knowledge about an experience of family and community approach to children's mental health

Residents caring for palliative care patients are considered vulnerable themselves. The impact of caring for this group of patients can bring about emotional reactions like guilt, sadness, hopelessness, loss, internal conflict, feelings of failure, and questioning competence. Being in residency training while expressing these emotions may not be possible because it may raise concerns about privacy breaches, fear of stigma, and worry on the negative impact on training and career.

Gaps identified in the course of a hospice and palliative care rotation are the risk of burnout and compassion fatigue among residents, no avenue or forums to process emotionally significant experiences (e.g., death and dying, family and caregiver issues, challenging cases), no way to assess if they are already experiencing burnout and maladaptive coping, and no strategies to address possible negative emotional reactions.

To address such issues and gaps and promote wellbeing among Family Medicine residents rotating at a hospice and palliative care unit, an advocacy project was proposed based on good practices observed in developed countries focusing on 2 processes: screening for burnout and debriefing. It was proposed that the Maslach Burnout Inventory Abbreviated (MBI-9) be used for screening then Patient Death Debriefing Sessions (PDDS) and Grief Rounds be used as needed and towards the end of the rotation to help residents process their experience.

The goals of the proposed interventions (MBI-9, PDDS, and Grief rounds) are to identify residents at risk or suffering from burnout in the course of the palliative medicine rotation, provide avenues for healthy discussion regarding emotional reactions, and provide needed emotional support.

After discussions with key stakeholders, this advocacy project to promote wellbeing and adaptive coping among Family Medicine residents was implemented since May 2022 and is continually being practiced at a tertiary government hospital in a developing country.

At the conclusion of my presentation attendees will take away:
1. The emotional impact of caring for hospice and palliative care patients among Family Medicine residents.
2. Good practices being done in developed countries to address burnout and compassion fatigue among residents rotating in hospice and palliative medicine.
3. The possible outcome and benefit of a screening tool for burnout, debriefing, and grief rounds among Family Medicine residents caring for hospice and palliative care patients.

Objectives: To investigate the effects of the Mindfulness-Based Health Promotion (MBHP) training program on the quality of life and well-being of older adults assisted in Primary Care compared to an active control group. Methods: A randomized controlled trial nested in a cohort study was conducted. The participants were allocated into two groups: the MBHP intervention, and an active control group (computer-based cognitive stimulation classes). Quality of Life and well-being measures such as psychological health, quality of sleep and religiosity were assessed. Both groups were paired in length and intensity and occurred over four months. Qualitative and quantitative data were collected at baseline and at post-intervention. Results: Statistically significant changes in quality of life were noticed only for the active control group but the mindfulness group. The mindfulness group showed positive improvements on stress, anxiety, intrinsic religiosity, and quality of sleep when compared to the control group. Qualitative data suggested improvements on the subjective perception of social support, self-awareness, self-care and on quality of sleep for the participants submitted to the mindfulness program. Conclusion: the MBHP training program did not improve the quality of life in older adults when compared to a cognitive stimulation intervention. On the other hand, well-being outcomes were improved when compared to that active control group. Future studies on this topic should investigate what type of older adults’ profile may benefit more from mindfulness regular practice, refining the prescription of mindfulness for this population.

1) A growing number of articles on the subject of mindfulness-based interventions (MBIs) have been published in rapid succession seeking to identify the role of mindfulness-based interventions in addressing aging processes and older adults.

2) Most articles to date have used small sample sizes, compared interventions with waiting lists or inactive controls, and lacked follow-up and real-life (pragmatic).

3) In this randomized controlled study we verified among older adults assisted in Primary Care, if a MBI program is superior to a computer-based cognitive stimulation program on quality of life (primary outcome) and other psychological quantitative outcomes, added to qualitative data in order to address perceptions of the participants about the program and raise new hypothesis. Interestingly, we found that at post-treatment that changes in quality of life were not noticed for the MBI group (the computer-based program was superior). On the other hand, some improvements could be observed on stress, anxiety, and quality of sleep among MBI participants. Number Needed to Treat showed favorable outcomes for stress, quality of sleep and intrinsic religiosity for the MBI group. Qualitative data suggest improvement on social support, self-awareness, self-care and on quality of sleep for the participants submitted to the mindfulness program.