Dr Rahul Khanna

Abstract

Aims

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.

Context

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.

Approach

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.

Conclusion

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.

Abstract

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.

Key points

What is already known about this topic:

1. Around 800,000 Australians experience severe and enduring mental illness, with impairments across multiple psychosocial domains.
2. Recovery-oriented community care options to supplement clinical care are often overlooked within a mental health system focused on time-limited symptom reduction.
3. Digitally-delivered and telehealth psychosocial programmes are increasingly being recognised as having value in supporting broader, long-term mental health recovery.

What this paper adds

1. Self-guided programmes combining peer-led forums and psychoeducation modules have found significant short-term improvements in wellbeing, and longer-term observed changes in self-confidence and insight.
2. Guided programmes that add one-to-one coaching, telehealth groups, and goal-setting have found significant improvements in quality of life, educational and employment outcomes, and reduced emergency department visits.
3. Integrating clinical practice and digital psychosocial programmes can improve social connectedness and problem-solving for higher-risk groups, including those with comorbid suicide risk.

It was priviledge to share some clinical insights alongside such critical lived experience wisdom of those who have survived and thrived with bipolar disorder.

Watch the video and join the conversation at SANE Forums

Understanding Bipolar [SANE Forums] https://saneforums.org/t5/Events-and-updates/Recording-Mental-Health-Recovery-Webinar-Understanding-Bipolar/td-p/1831156

Video

Abstract

Background

Posttraumatic stress disorder (PTSD) is a common and potentially debilitating psychiatric disorder. Current and emerging evidence-based treatments for PTSD have significant limitations. Silexan is an orally administered lavender oil preparation whose main constituents are the monoterpenoids linalool and linalyl acetate. It has a novel pharmacodynamic profile that includes inhibition of voltage-gated calcium channels and promotion of neuroplasticity. Silexan is effective in the treatment of Generalized Anxiety Disorder, subthreshold anxiety disorders and mild-to-moderate Major Depressive Disorder. It has an excellent safety and tolerability profile. Promising pilot data suggest that Silexan may be effective for PTSD. The Silexan in the Treatment Of Posttraumatic stress disorder (STOP) trial aims to investigate the effectiveness of adjunctive Silexan in PTSD.

Methods

The STOP trial is a 12-week, parallel-arm, randomised, placebo-controlled, double-blind trial. Adults living in Australia who meet diagnostic criteria for PTSD according to the Mini-International Neuropsychiatric Interview-7 and have a score of ≥ 33 on the PTSD Checklist for DSM-5 will be eligible to participate. Participants will have the option of taking part in the trial remotely via videoconferencing software. They will receive either Silexan 160 mg or an inactive placebo daily for 12 weeks in addition to their usual prescribed medications. The primary outcome measure will be the change in total symptom severity score on the Clinician-Administered PTSD Scale for DSM-5 from baseline to week 12. Secondary outcome measures will include self-report measures of anxiety symptoms, depressive symptoms, somatic symptoms, sleep quality, subjective wellbeing, quality-of-life and problematic alcohol use. Additional secondary outcome measures will include objective measures of sleep, physical activity and physiology derived from data collected by actigraphy watches. The target sample size will be 278 participants.

Discussion

If Silexan is found to be effective for PTSD, it is likely to be an attractive treatment option for many patients given its favourable safety and tolerability profile. Silexan is already licensed for use in 14 countries, enabling a rapid translation into clinical care.

Trial registration

The STOP trial is registered on the National Institutes of Health clinicaltrials.gov website (ID: NCT06412757, URL: https://clinicaltrials.gov/study/NCT06412757, date of registration: 9 May 2024).