Psychiatrist, researcher, educator, technologist. <br> Eternally curious. Let's connect ↓ Psychiatrist, researcher, educator, technologist.
Eternally curious. Let's connect ↓
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), including semaglutide and tirzepatide, are highly effective for weight management; however, long-term outcomes depend on sustained behavioral engagement. Digital health tools may enhance these behavioral components, but evidence regarding their real-world benefit alongside pharmacotherapy remains limited.
Sleep and circadian problems are highly prevalent in ex-military personnel and first responders and often impact comorbid mental health disorders. This study tested the feasibility and efficacy of a transdiagnostic intervention—transdiagnostic intervention for sleep and circadian dysfunction (TranS-C)—in improving sleep problems and comorbid mental health symptoms in ex-military personnel and first responders with sleep and circadian disorder(s).
A parallel-group, assessor-blinded, pilot randomized controlled trial design was employed. Forty first responders and ex-military personnel meeting the criteria for sleep disorder were randomized to receive immediate TranS-C or delayed TranS-C (n = 20 per condition) via telehealth. An assessment battery at pretreatment, posttreatment, and 3 months posttreatment was completed. The primary outcome was severity of sleep problems. Secondary outcomes included severity of posttraumatic stress disorder, depression, and anxiety symptoms.
TranS-C treatment was associated with large pre- to posttreatment improvements in sleep problems (d = −0.97, p < .001) and depressive symptoms (d = −0.83, p < .001), as well as medium-to-large improvements in anxiety (d = −0.59, p < .001) and posttraumatic stress disorder (d = −0.69, p < .001) symptoms, with improvements maintained over time. The immediate TranS-C group had significantly greater sleep improvement after 12 weeks than the delayed TranS-C group, which, at this time, had not received treatment. After receiving treatment, symptoms in the delayed TranS-C group improved to similar posttreatment and follow-up levels as the immediate TranS-C group.
In ex-military personnel and first responder populations, TranS-C is an effective treatment that simultaneously addresses sleep and circadian disorders and comorbid mental health symptoms.
Rural, regional, and remote hospitals in Australia face barriers to digital transformation, including limited infrastructure, digital literacy, and workforce capacity. This Commentary outlines a pragmatic strategy to build rural digital readiness through the safe implementation of ambient artificial intelligence (AI) scribes as a low-risk starting point for AI adoption.
AI scribes use generative AI to convert clinical conversations into documentation. They offer potential to reduce administrative burden and workforce strain while preparing rural health services for future AI use. Although the Victorian Department of Health has established minimum standards for AI scribe use, rural hospitals face unique challenges including lower AI literacy, workforce pressure, and limited research infrastructure. Insights from ongoing implementation research highlight the value of simulation methods to examine usability, workflow effects, and ethical considerations before deployment.
Three key enablers support responsible implementation: (1) clinical simulation for research, (2) harmonisation of evaluation metrics, and (3) shared infrastructure for consent, training, and monitoring.
Implementing AI scribes provides a practical pathway for rural hospitals to strengthen capability, reduce administrative burden, and build readiness for more advanced clinical AI, supporting safe and equitable adoption across rural Australia.
People with complex mental health needs in Australia face substantial psychosocial challenges across multiple life domains, including social and vocational functioning, self-efficacy, and general quality of life. These needs often remain unmet in a mental health system that is largely structured to focus on time-limited symptom reduction, which assumes a linear recovery path that may not match lived experience. Multidimensional support that blends clinical care with digital psychosocial programmes carry the potential to strengthen the range of supports to support long-term recovery in people with complex mental health needs. Self-guided programmes include peer-led online forums, often paired with psychoeducation modules to enhance effectiveness. Guided programmes include a range of additional channels including one-to-one coaching, and telehealth groups. Evidence is emerging for the effectiveness of both self-guided and guided online programmes in improving social isolation, self-confidence, wellbeing, employment and education opportunities for people facing a range of severe and enduring mental illnesses: including schizophrenia, bipolar disorder and complex trauma. While engagement in these programmes can vary, satisfaction and acceptability is usually very high, providing practitioners with a wider range of options to help clients move beyond symptom reduction and satisfy a broader spectrum of psychosocial needs.