Alison L Calear

• PhD
• Research Associate at Australian National University

Rates of self-harm among young women have been increasing in recent years across multiple high-income nations. Given the negative outcomes associated with self-harm, it is essential that young women who engage in self-harm receive the support that best addresses their specific needs. The aim of the current study is to explore support preferences am...

Background There have been few rigorous evaluations of population, multi-strategy, suicide prevention programmes, despite increasing global recognition that such approaches are needed to reduce suicide. Objective To examine the effects of a multi-strategy suicide prevention model on age-standardised rates of hospital presenting self-harm and suici...

Background Psychological prevention programmes delivered in schools may reduce symptoms of depression. However, high-quality, large-scale trials are lacking. Objective The aim was to examine whether a digital cognitive–behavioural programme (‘SPARX’), delivered at scale in schools, would reduce depressive symptoms 12 months later. Methods A clust...

Objective: While loneliness has been robustly linked to many health outcomes, limited research has considered its relationship with posttraumatic stress. The evidence that does exist points to a complex and bidirectional relationship between loneliness and posttraumatic stress disorder (PTSD) in the aftermath of trauma. Method: We conducted a longi...

Background Effective parenting can mediate the negative impact of complex humanitarian emergencies (CHEs) on child mental health, however many caregivers struggle to parent effectively in these settings. Parenting interventions have robust evidence in many settings, however research supporting their use in CHEs is limited. We describe the developme...

The involvement of service–users, clinicians, and other health service end–users is recognised as an essential part of health and medical research. This collaborative approach can significantly contribute to methodological advancements including the development of research instruments and measures that ensure their suitability for research particip...

Background Postpartum anxiety and depression are common in new parents. While effective interventions exist, they are often delivered in person, which can be a barrier for some parents seeking help. One approach to overcoming these barriers is the delivery of evidence-based self-help interventions via websites, smartphone apps, and other digital me...

Background Applied research using co‐creation methods is rarely described or evaluated in detail. Practical evidence of co‐creation processes and collaboration effectiveness is needed to better understand its complex and dynamic nature. Methods Using a case study design and survey method, we assessed processes of co‐implementation and co‐evaluatio...

Objectives: Young people attending university for the first time may be at heightened risk of experiencing mental health problems. However, limited research has examined the mental health experiences of this cohort using longitudinal methods. This study aimed to examine mental health symptoms prior to commencing university, estimate changes in symp...

In this study, we reduced the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-5) to its constituent symptoms and reorganized them based on patterns of covariation in individuals’ ( N = 14,762) self-reported experiences of the symptoms to form an empirically derived hierarchical framework of clinical phenomena. Speci...

Objective Digital interventions can be effective in preventing and treating common mental health conditions among university students. Incorporating student experiences and perspectives in the design and implementation of these programmes may improve uptake and engagement. This qualitative study explored university students’ perspectives of a low-i...

Background Mental health problems are common among university students, yet many students do not seek professional help. Digital mental health interventions can increase students’ access to support and have been shown to be effective in preventing and treating mental health problems. However, little is known about the extent to which students imple...

Background Numerous studies have demonstrated the effectiveness of digital interventions for improving the mental health of university students. However, low rates of engagement with these interventions are an ongoing challenge and can compromise effectiveness. Brief, transdiagnostic, web-based video interventions are capable of targeting key menta...

Background The acquisition of knowledge and use of skills from digital mental health interventions (DMHIs) are considered important for effectiveness. However, our understanding of user experiences implementing skills learned from these interventions is limited, particularly outside of research trials. This qualitative study aimed to investigate ho...

Introduction Rates of help-seeking for mental disorders and suicide are low among children and adolescents. Parents are viewed as gatekeepers for their care, yet they may lack the knowledge and skills to identify needs or facilitate service access. The primary aim is to test the effect of a new gatekeeper resource for parents and caregivers on thei...

Background The process of tailored implementation is ill-defined and under-explored. The ItFits-toolkit was developed and subsequently tested as a self-guided online platform to facilitate implementation of tailored strategies for internet-based cognitive behavioural therapy (iCBT) services. In ImpleMentAll, ItFits-toolkit had a small but positive...

Background Outcome monitoring can support the delivery of quality service that meets the needs of clients, clinicians and services. However, few studies have examined client or staff perspectives on the design and implementation of outcomes monitoring within a service. Implementation of outcomes monitoring requires understanding the preferences and...

Background Mental disorders are common in childhood, but many young people do not receive adequate professional support. Help-seeking interventions may bridge this treatment gap, however, there is limited research on interventions for primary-school children. This study aims to evaluate the effectiveness of an emotion literacy program at increasing...

Witnessing degradation and loss to one’s home environment can cause the negative emotional experience of solastalgia. We review the psychometric properties of the 9-item Solastalgia subscale from the Environmental Distress Scale (Higginbotham et al. (EcoHealth 3:245–254, 2006)). Using data collected from three large, independent, adult samples (N =...

Introduction This study aimed to investigate the mechanisms of the development of suicidal ideation and its moderating and protective factors. Drawing on the Interpersonal‐psychological theory of suicide, we proposed that disruptions to belongingness, in conjunction with tolerance of health risk, may influence the development of suicidal ideation a...

People derive less solace from environments that become degraded or destroyed, which is an experience called solastalgia. In the wake of Australia's 2019–2020 bushfires, many Australians faced a markedly different natural environment: one, for example, charred by fire and void of the animals that once lived there. We examined experiences of solasta...

Background Many young people with mental health problems do not readily seek help or receive treatment and support. One way to address low help-seeking behavior is to improve access to information on mental health services and how to navigate the mental health system via a web-based tool. Seeking input from the end users (young people and parents o...

BACKGROUND Most people with mental health problems do not seek help, with delays of even decades in seeking professional help. Lack of engagement with professional mental health services can lead to poor outcomes and functional impairment. However, few effective interventions have been identified to improve help seeking in adults, and those that ex...

Background Most people with mental health problems do not seek help, with delays of even decades in seeking professional help. Lack of engagement with professional mental health services can lead to poor outcomes and functional impairment. However, few effective interventions have been identified to improve help-seeking in adults, and those that ex...

In this study, we reduced the DSM-5 to its constituent symptoms and reorganized them based on patterns of covariation in individuals’ (n = 14,762) self-reported experiences of the symptoms to form an empirically derived hierarchical framework of clinical phenomena. Specifically, we used the points of agreement among hierarchical principal component...

In this study, we reduced the DSM-5 to its constituent symptoms and reorganized them based on patterns of covariation in individuals’ (n = 14,762) self-reported experiences of the symptoms to form an empirically derived hierarchical framework of clinical phenomena. Specifically, we used the points of agreement among hierarchical principal component...

Background The factors that influence transition from suicidal ideation to a suicide attempt or remission of suicidal thoughts are poorly understood. Despite an abundance of research on risk factors for suicidal ideation, no large-scale longitudinal population-based studies have specifically recruited people with suicidal ideation to examine the me...

BACKGROUND Numerous studies have demonstrated the effectiveness of digital interventions for improving the mental health of university students. However, low rates of engagement with these interventions are an ongoing challenge and can compromise effectiveness. Brief, transdiagnostic, web-based video interventions are capable of targeting key menta...

BACKGROUND Postpartum anxiety and depression are common in new parents. While effective interventions exist, they are often delivered in person, which can be a barrier for some parents seeking help. One approach to overcoming these barriers is the delivery of evidence-based self-help interventions via websites, smartphone apps, and other digital me...

Effective implementation strategies are important for take-up of programs in schools. However, to date, few implementation strategies have been co-designed with teachers and support staff (including principals) in Australia. The aim of this study was to iteratively co-design multiple implementation strategies to enhance the delivery of mental healt...

Purpose Recent literature highlights that no emotion regulation strategy is universally helpful or harmful. The present study aimed to build understanding of for whom and what cognitive reappraisal is helpful, by testing the influential hypothesis that reappraisal is most helpful when there is good individual or situational capacity to apply this s...

Background: Two of the most common modifiable barriers to help-seeking for mental health problems during adolescence are stigma and poor mental health literacy. However, relatively little is known about stigma as it relates to suicide, and knowledge about suicidality in this age group. Aims: To assess levels of suicide literacy and suicide attit...

Suicide is the leading cause of death among Australian young people, yet rates of help-seeking for suicidal ideation and behaviors in this population are concerningly low. In this study, the relationships between parental suicide stigma, parental suicide literacy, and their attitudes and intentions toward seeking professional help for their child i...

Purpose As environmental disasters become more common and severe due to climate change, there is a growing need for strategies to bolster recovery that are proactive, cost-effective, and which mobilise community resources. Aims We propose that building social group connections is a particularly promising strategy for supporting mental health in co...

In 2019–2020, Australia experienced an unprecedented bushfire season that caused widespread environmental destruction across the continent, and especially to its south-east corner. Over two studies, we examine mental health outcomes of individuals impacted by bushfire, drawing on the concept of solastalgia – the sense of distress arising from unwan...

Background Suicide is a global public health problem. Digital interventions are considered a low-threshold treatment option for people with suicidal ideation or behaviors. Internet-based cognitive behavioral therapy (iCBT) targeting suicidal ideation has demonstrated effectiveness in reducing suicidal ideation. However, suicidal ideation often is r...

Aims: We assessed the mental health effects of Australia's 2019-2020 bushfires 12-18 months later, predicting psychological distress and positive psychological outcomes from bushfire exposure and a range of demographic variables, and seeking insights to enhance disaster preparedness and resilience planning for different profiles of people. Method...

Background: Digital cognitive behavioral therapy (CBT) interventions can effectively prevent and treat depression and anxiety, but engagement with these programs is often low. Although extensive research has evaluated program use as a proxy for engagement, the extent to which users acquire knowledge and enact skills from these programs has been la...

Background: Internet interventions for common mental disorders are widely available, effective, and economical, yet community uptake remains low. One consistently cited reason for not engaging in mental health interventions is lack of time. Aims: This research examined whether lack of time as a rationale for not using online interventions reflec...

BACKGROUND Many young people with mental health problems do not readily seek help or receive treatment and support. One way to address low help-seeking behavior is to improve access to information on mental health services and how to navigate the mental health system via a web-based tool. Seeking input from the end users (young people and parents o...

Background: Child anxiety disorders are highly prevalent yet undertreated. As parents are often 'gatekeepers' to children receiving treatment and support, this study aimed to investigate modifiable parental factors affecting professional help-seeking for their children from general practitioners (GPs), psychologists, and paediatricians. Methods:...

Background When COVID-19 spread to Australia in January 2020, many communities were already in a state of emergency from the Black Summer bushfires. Studies of adolescent mental health have typically focused on the effects of COVID-19 in isolation. Few studies have examined the impact of COVID-19 and other co-occurring disasters, such as the Black...

Background The mental health impacts of the COVID-19 pandemic remain a public health concern. High quality synthesis of extensive global literature is needed to quantify this impact and identify factors associated with adverse outcomes. Methods We conducted a rigorous umbrella review with meta-review and present (a) pooled prevalence of probable d...

COVID-19 has disrupted the normative social order, particularly for young adults. Their deteriorating mental health over 2020 has been associated with the economic and social conditions during the COVID-19 lockdowns. We conducted 19 semi-structured interviews with young adults aged 8 and 29 most of whom lived in Victoria, Australia. The interviews...

BACKGROUND Suicide is a global public health problem. Digital interventions are considered a low-threshold treatment option for people with suicidal ideation or behaviors. Internet-based cognitive behavioral therapy (iCBT) targeting suicidal ideation has demonstrated effectiveness in reducing suicidal ideation. However, suicidal ideation often is r...

Background: Suicidality research has typically focused on affective disorders to identify at-risk youth. Investigating the predictive role of individual symptoms, particularly anxiety symptoms, may allow for preventative targeting of additional risk factors for suicidal ideation and attempts. Methods: This analysis used the Sources of Strength A...

Background: Internet-based cognitive behavioral therapy (iCBT) services for common mental health disorders have been found to be effective. There is a need for strategies that improve implementation in routine practice. One-size-fits-all strategies are likely to be ineffective. Tailored implementation is considered as a promising approach. The self...

Background Digital mental health (DMH) programs can be effective in treating and preventing mental health problems. However, community engagement with these programs can be poor. Understanding the barriers and enablers of DMH program use may assist in identifying ways to increase the uptake of these programs, which have the potential to provide bro...

preprint here: https://psyarxiv.com/jxg2t

The risk of suicidal behaviour in Australia varies by age, sex, sexual preference and Indigenous status. Suicide stigma is known to affect suicide rates and help-seeking for suicidal crises. The aim of this study was to investigate the sociodemographic correlates of suicide stigma to assist in prevention efforts. We surveyed community members and i...

A burgeoning array of affective indices are proposed to capture features of affect that contribute to mental health and well-being. However, because indices are often investigated separately, it is unclear what—if any—unique role they have. The present study addresses this question in a high-stress naturalistic context by prospectively testing the...

Background: Social distancing requirements due to the COVID-19 pandemic saw a rapid increase in the delivery of telehealth consultations as an alternative to face-to-face healthcare services. Objective: The objectives of the current study were to assess the use and acceptability of telehealth during the early stages of the pandemic and identify...

Students transitioning from secondary school to university may experience unique issues that impact their mental health. There is limited research, however, on what drives first year students to seek professional help for mental health problems. There is also a current lack of knowledge about the factors that may be associated with engagement with...

Question: Digital interventions based on cognitive-behavioural therapy (iCBT) is associated with reductions in suicidal ideation. However, fine-grained analyses of effects and potential effect-moderating variables are missing. This study aimed to investigate the effectiveness of iCBT on suicidal ideation, effect moderators, effects on suicide atte...

This report provides an overview of mental health and wellbeing following Australia’s 2019-20 bushfires, with data recorded 12-18 months after the bushfire season ended. Findings are based on 3,083 adults' responses in an online survey to standard measures of psychological distress (i.e., symptoms of depression, anxiety, stress and posttraumatic st...

BACKGROUND Digital cognitive behavioral therapy (CBT) interventions can effectively prevent and treat depression and anxiety, but engagement with these programs is often low. Although extensive research has evaluated program use as a proxy for engagement, the extent to which users acquire knowledge and enact skills from these programs has been larg...

Objectives The Future Proofing Study (FPS) was established to examine factors associated with the onset and course of mental health conditions during adolescence. This paper describes the design, methods, and baseline characteristics of the FPS cohort. Methods The FPS is an Australian school‐based prospective cohort study with an embedded cluster‐...

Background Family and kinship networks are a key aspect of culture for Aboriginal and Torres Strait Islander peoples from Australia. They are intrinsically connected to good health and wellbeing, and cultural knowledge exchange. However, despite the known importance of family and kinship networks in Aboriginal and Torres Strait Islander cultures, a...

Introduction Safe spaces are an alternative to emergency departments, which are often unable to provide optimum care for people experiencing emotional distress and/or suicidal crisis. At present, there are several different safe space models being trialled in Australia. However, research examining the effectiveness of safe space models, especially...

Objectives: The Future Proofing Study (FPS) was established to examine factors associated with the onset and course of mental health conditions during adolescence. This paper describes the design, methods, and baseline characteristics of the FPS cohort. Methods: The FPS is an Australian school-based prospective cohort study with an embedded cluster...

BACKGROUND Digital programs are increasingly being implemented in schools for student mental health. Schools are complex environments and contextual factors impact the implementation of these digital programs. OBJECTIVE The purpose of the current study by was to examine the contextual factors that influence implementation of the Future Proofing Pr...

Background Depression is common during adolescence and is associated with adverse educational, employment, and health outcomes in later life. Digital programs are increasingly being implemented in schools to improve and protect adolescent mental health. Although digital depression prevention programs can be effective, there is limited knowledge abo...

BACKGROUND Internet-based Cognitive Behaviour Therapy (iCBT) services for common mental health disorders have been found to be effective. There is a need for effective strategies to improve implementation in routine practice. One-size-fits-all strategies are likely to be ineffective and tailored implementation is considered as a promising approach....

Objective: The present study examined behavioral responses during the coronavirus disease 2019 (COVID-19) pandemic and the role of dispositional risk tolerance in the Australian context. Method: The study involved a six-wave longitudinal investigation with a nationally representative sample of Australians (N = 1,296). Dispositional risk tolerance w...

Background The COVID-19 outbreak has spread to almost every country around the world and caused more than 3 million deaths. The pandemic has triggered enormous disruption in people's daily lives with profound impacts globally. This has also been the case in Australia, despite the country's comparative low mortality and physical morbidity due to the...

Bushfires, and resulting bushfire smoke, were major environmental, social and health crises in Australia in the summer of 2019–20. In Australia’s national capital the smoke pollution index topped global charts, and public health communications were rapidly developed that advised people to stay indoors to avoid smoke exposure. Drawing on interviews...

Background Suicidal ideation is a major risk for a suicide attempt in younger people, such that reducing severity of ideation is an important target for suicide prevention. Smartphone applications present a new opportunity for managing ideation in young adults; however, confirmatory evidence for efficacy from randomized trials is lacking. The objec...

Background The COVID‐19 pandemic has resulted in disruptions across many life domains. The distress associated with the pandemic itself, and with public health efforts to manage the outbreak, could result in increased alcohol use. This study aimed to quantify changes in alcohol use during the early stages of the pandemic and factors associated with...

Background Self-guided web-based programs are effective; however, inadequate implementation of these programs limits their potential to provide effective and low-cost treatment for common mental health problems at scale. There is a lack of research examining optimal methods for the dissemination of web-based programs in the community. Objective Th...

Background Suicide is the leading cause of death among young Australians, therefore identifying factors that increase risk is important. The aims of this study was to investigate the association between personality domains and suicidal ideation, plans and attempts in a community-based sample of adolescents. Methods 1428 students from thirteen seco...

Introduction Implementation of evidence-based programs in school settings can be challenging, undermining the benefits these programs deliver for children. The primary aim of this study is to assess whether an enhanced implementation intervention increases adoption of the PAX Good Behaviour Game in New South Wales (NSW) primary schools in Australia...

The aim of the current study was to explore awareness and perceived helpfulness of mental health peer workers in Australia, and factors associated with knowledge and perceptions. As part of a broader longitudinal study of mental health in the COVID-19 pandemic, a survey of a nationally representative sample of N = 812 Australians was conducted in J...

Background The uptake of professional mental health services among people with suicidal ideation remains low, yet few community-based studies have characterised modifiable individual barriers to service use. Our aims were (1) to identify factors associated with use of professional mental health services among people experiencing suicidal ideation,...

Objective To examine and describe telehealth use and attitudes among mental health professionals in Australia and New Zealand during the initial stages of the COVID-19 pandemic. Methods Participants completed a brief online survey between May and July 2020. Participants were recruited via peak and professional organisations and through psychology-...

We examine how prior mental health predicts hopes and how hopes predict subsequent mental health, testing hypotheses in a longitudinal study with an Australian nation-wide adult sample regarding mental health consequences of the COVID-19 outbreak during its initial stage. Quota sampling was used to select a sample representative of the adult Austra...

Despite growing research on the associations between environmental conditions and mental health, no previous study has collected both quantitative indicators of farm-scale ecology and validated measures of farmer mental health. We assessed whether on-farm factors of engaging in natural resource management (NRM), the environmental state of the farm,...

The 2019–20 bushfires that raged in eastern Australia were an overwhelming natural disaster leading to lives lost or upended, and communities destroyed. For almost a month, Canberra, Australia's capital city in the Australian Capital Territory (ACT), was obscured by smoke from fires which threatened the outer suburbs. While smoke itself is experien...

Objective: Physical and natural environments might strongly influence mental health and well-being. Many studies have examined this relationship in urban environments, with fewer focused on rural settings. The aim of this systematic review was to synthesise quantitative evidence for the relationship between environmental factors (drought, climate...

Introduction The majority of people who die by suicide have never seen a mental health professional or been diagnosed with a mental illness. To date, this majority group has largely been ignored, with most existing research focusing on predictors of suicide such as past suicide attempts. Identifying the characteristics of people who die by suicide...

Background The COVID-19 pandemic has been highly disruptive, with the closure of schools causing sudden shifts for students, educators and parents/caregivers to remote learning from home (home-schooling). Limited research has focused on home-schooling during the COVID-19 pandemic, with most research to date being descriptive in nature. The aim of t...

Introduction: Vast available international evidence has investigated the mental health impacts of the COVID-19 pandemic. This review aims to synthesise evidence, identifying populations and characteristics associated with poor mental health.Methods: A meta-review of pooled prevalence of anxiety and depression, with subgroup analyses for the general...

Background COVID-19 lockdowns have resulted in school closures worldwide, requiring curriculum to be delivered to children remotely (home schooling). Qualitative evidence is needed to provide important context to the positive and negative impacts of home schooling and inform strategies to support caregivers and children as the pandemic continues. T...

Objective: The direct and indirect mental health impacts of the COVID-19 pandemic are considerable. However, it is unclear how suicidal ideation was affected in communities during the acute lockdown phase of the pandemic, and over the longer-term. This study provides longitudinal data on the prevalence of, and risk factors for, suicidal ideation in...