Stream Description

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Anxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders. The peak of this disability occurs in those 15-24 years old and corresponds with the typical period of onset of these problems. Critically, anxiety, depression and substance use disorders share common risk factors.

To reduce the occurrence and cost of such disorders, preventative interventions need to begin early, before the problems begin to cause disability, and vocational, educational and social harm.  To date, the focus of our research has been on developing and evaluating universal internet-based programs to prevent substance use and related harms in adolescents. Our most recent trial involves combining these universal programs with selective personality-targeted interventions with an aim of maximising outcomes for both high and low risk youth.


Ongoing Projects

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Evaluation of the CAYLUS youth worker brokerage program

Prof Anthony Shakeshaft, Dr Fiona Shand
Funding Body: Central Australian Youth Link Up Service (CAYLUS)

Established in 2002, the Central Australian Youth Link Up Service (CAYLUS) supports community initiatives aimed at reducing the supply of, demand for, and harms associated with, substance misuse among young people across Central Australia (spanning approximately 900 square kilometres). Youth substance misuse remains a pressing concern in Central Australia. In particular, the work of CAYLUS focuses on the misuse of volatile substances (e.g., petrol sniffing, paint, aerosols), which includes liaising with retailers of high-risk products to assist with their management. CAYLUS also assists remote communities in the development, funding and implementation of youth programs.


To inform the continued improvement of its programs and ensure that its activities are responsive to community needs, CAYLUS is seeking to establish a rolling monitoring and evaluation process for the activities it runs through the CAYLUS Youth Worker Brokerage Program. The Centre of Research in Mental Health and Substance Use (CREMS) aims to generate new research to increase the knowledge base regarding the nature, prevention and treatment of mental health and substance use disorders. In addition, a fundamental objective of the CREMS is to build research capacity in this area, and assist community agencies develop and conduct their own research. In keeping with this objective, researchers from the CREMS will assist CAYLUS establish a rolling monitoring and evaluation process for the activities it runs through the Youth Worker Brokerage Program, specifically examining the impact of its programs and activities on local level community crime and petrol sniffing. By improving the capacity of the CAYLUS staff to evaluate and monitor their service, the standard of youth programs may be informed and improved, and the enduring disability associated with substance misuse may be reduced.


Stage 1 of the evaluation was completed in February 2016. The Executive Report is available for download here.


Stage 2 of the evaluation of the CAYLUS Youth Worker Brokerage program commenced in June 2016, and will be ongoing until 2019. In stage 2, CREMS will continue to provide assistance to CAYLUS in  maintain a rolling monitoring and evaluation process for the activities it runs through the CAYLUS Youth Worker Brokerage. The project will examine the ongoing impact and perceived impact of programs and activities supported by this brokerage on local level community crime (particularly crime involving young people) and petrol sniffing.”

Project Contacts: Dr Christina Marel
Cracks in the ice

An online toolkit to provide evidence-based information about crystal methamphetamine ('Ice') for the Australian community

Prof Steve Allsop and Dr Nyanda McBride (National Drug Research Institute)
Funding Body: Australian Government Department of Health

Phase 1: Development

The aim of this project is to develop and disseminate an online toolkit to improve access to evidence-based information about crystal methamphetamine (“ice”), raise awareness about the potential harms and mental health problems associated with the use of ice, and provide information about how to access services and support for the Australian community.

Scoping and content development for the Cracks in the Ice online toolkit was conducted in 2015, and initial end-user consultation was conducted in January 2016 to understand information needs about ice among the Australian community. A beta-version of the Cracks in the Ice toolkit was focus tested among end-users (including consumers, families and friends of people who use ice, health professionals, teachers and community groups) in August 2016. The Cracks in the Ice Community Toolkit was launched on 3rd April 2017 by the Minister for Health, Hon Greg Hunt, and is available online Subscribe now for updates about Cracks in the Ice or follow us on Facebook and Twitter.


Phase 2: Ongoing maintenance and development of Cracks in the Ice

The aim of this phase of the project is to to support the ongoing maintenance, development and promotion of the online toolkit. New resources will be added to further develop and enhance the content and functionality of the Cracks in the Ice toolkit including a Community Forum Toolkit and a smartphone application (‘app’). To enable end users to evaluate the usefulness of the online toolkit, a ‘Think Aloud’ evaluation will also be undertaken and new toolkit content will be developed on response to user questions and feedback

Project Contacts: Ms Louise Birrell
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The Brain Games

Funding Body: Australian Rotary Health

Emerging research suggests that deficits in executive functioning are a core feature of mental disorders across the full spectrum of psychopathology. Cognitive training exercises that focus on improving executive functioning have been shown to reduce symptoms related to schizophrenia, major depression and ADHD, as well as eliciting changes in alcohol consumption. However, it is not yet clear whether such training is also effective in preventing the onset of psychological symptoms and substance use in adolescents at risk for developing a broad range of psychopathology. In a sample of adolescents (n=220), the current study will examine whether cognitive training is effective in reducing a range of psychopathology in youth at high risk for developing a mental illness, as determined by a standardised measure of personality. It is expected that a targeted cognitive training program will prevent the onset of a range of mental illnesses and substance misuse in high risk youth.

Project Contacts: Dr Louise Mewton
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Pathways to prevention: The effectiveness of universal and selective prevention in altering developmental pathways to alcohol and cannabis related harms in young adults

Prof Patricia Conrod
Funding Body: National Health and Medical Research Council

Young adulthood marks a period of increased alcohol and cannabis use, and heightened risk of associated harms including injury, violent behaviour, and onset of alcohol or drug use disorders. To reduce this substantial burden, effective prevention is essential and needs to be initiated before patterns of use are established. School-based prevention programs have proven an effective way to reduce the onset and escalation of alcohol and drug use. However, little is known about the durability of these effects during the transition to adulthood, a period characterised by unique risks and challenges.

This project brings together an international team who have developed two complementary prevention approaches: the universal “Climate” program and the selective “Preventure” program. Both have proven effective in reducing alcohol and cannabis harms in the short-term. The project builds on our NHMRC-funded trial, the Climate and Preventure (CAP) study, which was the world-first RCT of a comprehensive strategy combining universal and selective prevention. This trial cohort (n = 2,190) is now on the verge of the important transition into early adulthood, and provides a unique opportunity to address crucial questions about the sustainability of prevention effects.
This study will advance the evidence base in three significant ways: i) it will provide the world-first evaluation of the long-term (7-year) effectiveness of universal and selective prevention; ii) it will answer critical questions about the potential benefits of these approaches in reducing alcohol and drug-related
violence during the high-risk early adulthood period; and iii) it will provide crucial information about the mechanisms of change underlying these prevention.


Project Contacts: A/Prof Nicola Newton
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Making InRoADs: Trial of an innovative early intervention to Interrupt the cycle of Anxiety and Drinking in young Australians

Funding Body: Australian Rotary Health, Society of Mental Health Research (SMHR) Early Career Researcher Fellowship to Lexine Stapinski

Anxiety and alcohol use disorders are among the most prevalent and debilitating of mental health disorders, and commonly co-occur. There is limited evidence about the temporal sequence, although the available data suggests anxiety typically predates alcohol use disorders, and the use of alcohol to cope with anxiety is commonly reported. Increasingly, anxiety and alcohol comorbidity is understood as a clinically important mutually-reinforcing relationship, yet current prevention and treatment approaches are limited by single disorder models.

 The transition into early adulthood is a unique developmental period, characterized by numerous personal and social role changes. Young adulthood also marks a period of increased vulnerability for onset of both anxiety and alcohol use disorders. The unique challenges of this early adulthood period combined with the emergence of anxiety and alcohol use disorder symptoms require a developmentally-targeted early intervention to empower young adults, enhance anxiety coping skills, and prevent the escalation of drinking. This project involves a randomised controlled trial of a new, therapist-supported online early intervention for anxious young people at risk of alcohol use disorders. 

Project Contacts: Dr Lexine Stapinski

Development of culturally-appropriate resources to prevent alcohol and drug-related harms among young Aboriginal and Torres Strait Islander people

A/Prof James Ward
Funding Body: Australian Government Department of Health

In partnership with Gilimbaa, an Indigenous Creative Agency, this project involves development of culturally appropriate school-based resources to prevent drug-related harms among young Aboriginal and Torres Strait Islander people. Development will be in consultation and collaboration with schools, teachers and young Indigenous Australians. An Expert Advisory Group has been established to guide the project. Scoping of existing resources and research literature will inform development of a central access portal, and a culturally-appropriate curriculum program based on the Climate Schools storyboard format. The online portal will facilitate dissemination of information and evidence-based approaches to prevent drug-related harms among young Aboriginal and Torres Strait Islander people.

Project Contacts: Ms Mieke Snijder

Development of an integrated online intervention for Students and Parents to prevent alcohol and cannabis harms among adolescents / Climate Schools Plus

Funding Body: Australian Government Department of Health

Building on the successful Climate Schools: Student Programme, Climate Schools Plus will incorporate a parenting component aiming to enable parents to prevent alcohol and cannabis harms among their adolescent children. The parenting component is based on a successful program developed by Dr Ina Koning at Utrecht University, The Netherlands.

In phase 1 of the project an Expert Advisory Group will be established to guide the design and development of the Climate Schools Plus Student and Parent Programme and focus testing and end-user consultation will be undertaken. Phase 2 will involve an implementation and effectiveness trial of the Programme. Climate Schools Plus will be the first online integrated student and parent program to prevent alcohol and cannabis harms among adolescents.

Project Contacts: Dr Cath Chapman
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Pathways to prevention: The effectiveness of universal and selective prevention in altering the developmental pathways to alcohol related harms in young adults

Professor Patricia Conrod, Assistant Professor Natalie Castellanous-Ryan
Funding Body: NHMRC

The Climate andPreventure (CAP) study was initiated in 2011 by Nicola Newton, Maree Teesson, Tim Slade and Patricia Conrod as a school-based prevention initiative targeting alcohol and drug use. The CAP study was the first ever randomised control trial of a comprehensive prevention approach combining both universal (Climate; delivered to all students) and selective (Preventure; delivered to high-risk students) intervention techniques. Twenty-six schools and 2,190 year 8 participants were recruited to the CAP trial in 2012, and randomised to one of four conditions: (1) Control (health education as usual), (2) Climate (universal prevention for all), (3) Preventure (selective prevention delivered only to 43% of students with high-risk personality profiles), or (4) Climate and Preventure (both universal and selective approaches). All students were followed up for 3 years post baseline. Results at 3 years have shown the effectiveness of universal and selective approaches in preventing harmful alcohol use among low- and high-risk adolescents. The CAP long-term follow up is an opportunistic extension of the landmark CAP study, whereby follow up of this cohort will extend beyond the completion of secondary school and into the critical transition period of early adulthood.

The investigators will extend longitudinal follow-up for a further 3 years, inviting the participants to take part in an online survey assessing demographic information, drinking and drug use habits, and behavioural and personality inventories. This $465,967 NHMRC funded long-term follow up project will be the first in the world to examine whether combining universal and selective drug prevention strategies enhances durability of effects in the longer-term, over a 7-year period from adolescence to early adulthood. The findings will inform policy nationally and internationally, as economic modelling suggests substantial societal benefit can be gained from even modest reductions in drug and alcohol use.

Project Contacts: A/Prof Nicola Newton
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CAP study – Combining effective universal and targeted approaches to drug prevention

Prof Patricia Conrod
Funding Body: National Health and Medical Research Council

More than one quarter of Australian teenagers put themselves at risk of short-term alcohol-related harm at least once a month and 17% use an illicit drug at least once a year. As such, the need for prevention is clear. Although an array of school-based prevention programs exist, the majority show minimal effects in reducing drug use and related harms, and some have even report iatrogenic effects. Given that school–based drug prevention is the primary means by which drug education is delivered, it is essential to focus on increasing program efficacy. Ideally, preventive interventions should aim to delay onset in both adolescents with low-risk profiles who may be influenced to take up substances due to peer influence and social conformity, and adolescents with high-risk profiles whose underlying vulnerability to psychopathology can lead to substance misuse. Yet, there appear to be no models of well implemented programs that do this. The current proposal addresses this gap by developing and evaluating a comprehensive approach to preventing substance use and related harms in adolescents by combining effective ‘universal’ and ‘targeted’ school-based prevention programs. The proposed model, known as the CAP (Climate and Preventure) intervention, builds on our unique success in this area through developing the effective universal Climate, and targeted Preventure programs.

Project Contacts: A/Prof Nicola Newton

Completed Projects

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Feasibility of the Climate Schools program in the United Kingdom

Prof Patricia Conrod
Funding Body: University of New South Wales

The aim of this study was to examine the feasibility and acceptability of the universal internet-based Climate Schools program in the United Kingdom.Climate Schools is an evidence-based prevention course, aimed at reducing alcohol and cannabis use and consists of two sets of six lessons delivered approximately six months apart.  322 students were recruited from Year 9 classes at two secondary schools in London and were assessed at baseline and immediately following the full intervention on their levels of alcohol and cannabis use, as well as related knowledge, harms, and attitudes.Results from this feasibility trial were promising and evaluations from teachers and students were extremely positive. Internet-based drug prevention is therefore feasible and acceptable for use in the United Kingdom. A full evaluation trial of the Climate Schools program is now needed.

Project Contacts: A/Prof Nicola Newton


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