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Medically Assisted Psychotherapy in a Global Context

 

World from space

Written by Amelia French and Dr Alana Roy

Psychedelics and plant medicines have been used around the world since early humanity for spiritual, ritual, divination and recreational purposes.[1] Indigenous cultures used plants as medicines for millennia and many cultures carry on this tradition today.[2] Despite the growing evidence for use of psychedelics by humans as modern-day medicine for mental health disorders, they were abruptly made illegal to supply and possess by the United Nations convention in 1971 as a result of President Nixon’s War on Drugs.[3] Studies suggest psychedelics could be a breakthrough therapy for mental health issues including depression, anxiety, addiction, Obsessive Compulsive Disorder, and Post Traumatic Stress Disorder through their ability to work on a deep emotional as well as biological level. [4] Currently statistics of Mental Health in Australia is one in four people.[5] Depression is a leading cause of disability worldwide and is a major contributor to the overall global burden of disease.[6] There needs to be innovation and change for the treatment of mental illnesses. MMA are advocating for the therapeutic use of Psilocybin and MDMA to support people with treatment resistant depression and Post traumatic stress disorder, respectively.

Current pharmacotherapy treatments for depression and anxiety work in 20–40% of cases.[7] Psilocybin has been shown to alleviate depression in 67% of patients within one to two doses even where standard treatments have failed.[8] Current pharmacotherapy has even lower efficacy in the treatment of PTSD with success rates of around 20%, MDMA has been shown lead to remission from PTSD in 78% of cases where standard treatments have not worked.[9] Current treatments such as antidepressants must be taken every day for months, often years. With medicine-assisted psychotherapy, patients frequently experience long-lived reductions in symptoms within a few single dose sessions.

Around the globe we are seeing countries take the lead in medically assisted psychotherapy with the legalization or decriminalization of psychedelics with logical, research-based, and tolerant policies on psychoactive substances. There are currently no countries in which psychedelics are regulated and approved medicines. Also, psilocybin is legally available in the Netherlands and both psilocybin and MDMA are decriminalized for personal use in Portugal, Czech Republic and several countries in South America.[10] When we explore the research into countries with decriminalization of MDMA and Psilocybin from across Europe there is statistics to show the positive outcomes for mental health.

“When delivered safely and professionally, psychedelic therapy holds a great deal of promise for treating some very serious mental health conditions.” Dr Robin Carhart-Harris Head of the Centre for Psychedelic Research

Portugal allows the use of psychedelic drugs through the decriminalization of drugs since 2001 and opted for a harm minimization approach to drug use.[11] Portugal have found that removing criminal penalties for personal drug possession did not cause an increase in levels of drug use but rather drug use is dependent on social and cultural factors and trends.[12] Decriminalization allowed space for research into mental health, supporting those with addictions better access to services by reducing the taboo and shame around drug use.[13] The Dutch drug policy is also driven by the idea that each person should make informed decisions on matters of their own health and recognize that drug policy is also a social issue.

The Dutch are world-renowned for their more logical, research-based, and tolerant policies on psychoactive substances. However, this does not mean psychedelics are completely legal in the Netherlands. Just like many other countries, the Dutch government classifies some drugs, including certain psychedelics, as illegal substances however the use of psychedelics is regulated. Drug policy in the Netherlands is guided by the principle that suppressing drug use and having a blanket ban on all drugs does not make mental health illnesses associated with drug use disappear but quite the opposite, makes mental health outcomes worse.[14] This is reflected in literature that mental health issues become far more difficult to minimize and control without appropriate education and prevention of drug abuse disorders is one of the most effective ways to reduce the impact of mental health on individuals and wider society, this is done through education, effective treatments and reducing cultural stigma or shame around mental health. Mental health disorders are exacerbated through lack of recognition to research and suppression through drug policy.[15] Psychedelic assisted therapies can positively impact mental health outcome and has shown to be safe in therapeutic contexts.[16] The Netherlands are embracing medically assisted psychotherapies through clinics, which are leading a movement to transform the way people approach emotional, cognitive, and spiritual well-being, through safe and legal medically assisted psychotherapy backed by research.[17]

Switzerland have allowed the legal therapeutic use of LSD and MDMA for treatment of post-traumatic stress disorder and depression when used alongside non-drug psychotherapy sessions with an experienced practitioner.[18] In Switzerland, limited medical use of non-registered drugs, or compassionate use is available from psychiatrists to prescribe MDMA for therapeutic use in conjunction with talk therapy for the treatment of trauma disorders.[19] Subjects with chronic, treatment-resistant posttraumatic stress disorder experienced clinically meaningful improvements and no evidence of harm after participating in a Swiss study evaluating MDMA-assisted psychotherapy.[20] The field of medicine-assisted psychotherapy needs to be driven by evidence-based studies to inform policies and law. Through evidence-based research we can effectively improve the quality of people’s lives and to promote healthier societies through policy reform of medicine-assisted psychotherapy. Mind Medicine Australia are advocating for clinical changes to bring these new innovative mental health treatments to Australia. Law is socially constructed by the culture and social influence, and it is ever changing with new research and knowledge emerging. Psychedelics have been shown to have significant therapeutic potential which is seen to outweigh ill-informed anti-drug laws.[21]

There is significant evidence to support the safe use of medicine-assisted psychotherapy when used in a clinically controlled space and appropriate screening is conducted.[22] Research suggests that there is no link between the use of psychedelics and the development of mental illnesses.[23] Further to this, there has been no negative health outcomes associated with the use of psychedelic medicines.[24] However, psychedelic use is highly context dependent and we only advocate for clinical use of psychedelics.

Mind Medicine Australia is an Australian registered charity (with DGR-1 status) seeking to broaden the treatment paradigm available to medical practitioners and their patients and improve treatment effectiveness by establishing, safe, accessible and effective Medicine-Assisted Psychotherapy in Australia for major Mental Illnesses.

 

References

[1]. Nicola Bragazzi et al., ‘Ancient Shamanism and Modern Psychotherapy: From Anthropology to Evidence-Based Psychedelic Medicine,’ Cosmos and History: The Journal of Natural and Social Philosophy 4, no. 1 (2018): 142, https://cosmosandhistory.org/index.php/journal/article/view/688; David Smith, ‘The Role of the Journal of Psychedelic Drugs in the Evolution of Psychedelic Medicine,’ Journal of psychoactive drugs 51, no. 2 (December 2019): 98–101, https://doi.org/10.1080/02791072.2019.1589607

[2]. Richard Doblin, Merete Christiansen, Lisa Jerome, and Brad Burge, ‘The Past and Future of Psychedelic Science: An Introduction to This Issue,’ Journal of psychoactive drugs 51, no. 2 (April 2019):93–97, https://doi.org/10.1080/02791072.2019.1606472; Smith, ‘The Role of the Journal of Psychedelic Drugs,’ 98–101; Michael Winkelman, ‘Shamanic guidelines for psychedelic medicine,’ in Psychedelic medicine: New evidence for hallucinogenic substances as treatments, ed. Thomas Roberts (Connecticut: Praeger Publishers, 2007), 143–168, https://www.academia.edu/4165474/Shamanic_Guidelines_for_Psychedelic_Medicines

[3]. Doblin, Christiansen, Jerome, and Burge, ‘The Past and Future of Psychedelic Science,’ 93–97; Smith, ‘The Role of the Journal of Psychedelic Drugs,’ 98–101

[4]. Tanya Calvey and Fleur Howells, ‘An introduction to psychedelic neuroscience,’ Progress in Brain Research 242, no. 1 (2018): 1–23, https://doi.org/10.1016/bs.pbr.2018.09.013

[5]. Australian Bureau of Statistics. National Survey of Mental Health and Wellbeing: Summary of Results. Canberra: ABS, 2008. https://www.abs.gov.au/statistics/health/mental-health/national-survey-mental-health-and-wellbeing-summary-results/latest-release

[6]. World Health Organization. Prevention of Mental Disorders Effective Interventions and Policy Options. France: WHO, 2004. https://www.who.int/mental_health/evidence/en/prevention_of_mental_disorders_sr.pdf?ua=

[7]. Courtney Hutchison and Sara Bressi, ‘Social Work and Psychedelic‑Assisted Therapies: Practice Considerations for Breakthrough Treatments,’ Clinical Social Work Journal (January 2020), https://doi.org/10.1007/s10615-019-00743-x

[8]. Mind Medicine Australia. A new paradigm for mental health. Australia: MMA, 2020. https://mindmedicineaustralia.org/wp-content/uploads/2020/10/Mind-Medicine-Australia-EBook-09102020-small.pdf

[9]. Smith, “The Role of the Journal of Psychedelic Drugs,” 98–101

[10]. Jeff Lebowe, ‘A Global Guide to Where Magic Mushrooms and Psilocybin Are Legal or Decriminalized,’ Mary Jane, May 29, 2020, https://merryjane.com/culture/a-global-guide-to-where-magic-mushrooms-and-psilocybin-are-legal-or-decriminalized

[11]. David Bronner, ‘The Unified Field Theory of Psychedelic Integration and Portugal Style Decriminalization,’ Multidisciplinary Association for Psychedelic Studies 30, no. 1 (2020): 14–19, https://maps.org/news/bulletin/articles/439-bulletin-spring-2020/8126-the-unified-field-theory-of-psyhedelic-integration-and-portugal-style-decriminalization

[12]. Linnae Ponté, ‘Decriminalization and Harm Reduction in Portugal: An Interview with Dr. João Goulão,’ Multidisciplinary Association for Psychedelic Studies 25, no. 1 (2015): 18–21, https://maps.org/news/bulletin/articles/387-bulletin-spring-2015/5671-decriminalization-and-harm-reduction-in-portugal-an-interview-with-dr-jo%C3%A3o-goul%C3%A3o

[13]. Scott Bernstein, Emily Amirkhani, Dan Werb, and Donald MacPherson, ‘The regulation project: Tools for engaging the public in the legal regulation of drugs,’ International Journal of Drug Policy 86, no. 1 (December 2020):102949, https://doi.org/10.1016/j.drugpo.2020.102949

[14]. Bronner, ‘Unified Field Theory’

[15]. Bernstein, Amirkhani, Werb, and MacPherson, ‘The regulation project,’ 102949; WHO, Prevention of Mental Disorders

[16]. Calvey, and Howells, ‘Intro to psychedelic neuroscience,’ 1–23.

[17]. Bernstein, Amirkhani, Werb, and MacPherson, ‘The regulation project,’ 102949

[18]. Peter Gasser, ‘Psychedelic Group Therapy in Switzerland,’ Multidisciplinary Association for Psychedelic Studies 27, no. 1 (2017): 28–29, https://maps.org/news/bulletin/articles/420-bulletin-spring-2017/6622-research-update-psychedelic-group-therapy-in-switzerland

[19]. WHO, Prevention of Mental Disorders

[20]. WHO, Prevention of Mental Disorders

[21]. David Nichols, ‘Psychedelics,’ Pharmacological Reviews 68, no. 2 (April 2006):264–355, https://doi.org/10.1124/pr.115.011478; Tingying Chi and Jessica Gold, A review of emerging therapeutic potential of psychedelic drugs in the treatment of psychiatric illnesses,’ Journal of the Neurological Sciences 411, no. 1 (Jan 2020): 116715, https://doi.org/10.1016/j.jns.2020.116715

[22]. Jacob Aday et al., ‘Long-term effects of psychedelic drugs: A systematic review,’ Neuroscience and Biobehavioral Reviews 113, no. 1 (June 2020): 179–189, https://doi.org/10.1016/j.neubiorev.2020.03.017

[23]. Teri Krebs and Pål-Ørjan Johansen, ‘Psychedelics and Mental Health: A Population Study,’ PLoS ONE 8, no. 8 (August 2013): 1–9, https://doi.org/10.1371/journal.pone.0063972

[24]. Krebs and Johansen, ‘Psychedelics and Mental Health,’ 1–9

Dr Alana Roy

Ph. D Psychology, B. A Social Work (MHSW)

Dr Alana Roy is a psychologist, social worker and therapist and has spent the last 13 years working in mental health, suicide prevention, trauma, sexual abuse, family violence and the disability sector. Alana has worked with borderline personality and dissociative identity disorder in various roles in the community such as: Rape Crisis Centres with victims of ritual abuse, childhood and adult sexual assault, supporting women in the sex industry, survivors of human trafficking and now as a psychedelic integration specialist.

Alana focuses on harm minimisation, community and connection. She is dedicated to psychedelic-assisted psychotherapy and plant medicines. She has engaged with, and provides integration therapeutic support services for communities across Australia. Alana works at several universities as a Research Fellow and supervisor of students on placement. Alana passionately advocates for public policy, community education and legislative changes so that these treatments are regulated and supported by a strong, connected and skilled sector.

Learn more about Alana’s experiences in: Psychedelic Medicines: How My Journey Into The Jungle Changed My Life

Amelia French

Common Views and Attitudes Towards Psychedelic Medicines and Therapies

 


Psychedelics have a rich history, from use amongst indigenous people, guided by ancient knowledge passed on through centuries of traditional practices, to their discovery by modern science leading into a hampering period of criminalisation and finally through to a resurgence of research into uses in modern psychological treatment. A brief insight into the research, past and present, shines a light on the profound potential of psychedelics. Many studies have perfected the formula for safe therapeutic use, right dose and setting with skilled facilitators. This combination, with few treatment sessions, has provided sufferers of treatment resistant major depressive disorder, depression and anxiety associated with diagnosis of terminal illness, severe posttraumatic stress disorder (PTSD) and substance use disorder, with exceptional enduring therapeutic benefits (Bright & Williams, 2018; Carhart-Harris et al., 2018; Daniel & Haberman, 2017).

The state of mental health is at a tipping point, on the verge of further decline with exacerbation from an imminent economic depression and the increased psychological distress experienced due to the COVID-19 situation. A new approach to mental health treatment is an impending necessity, to help curb future burdens associated with increasing levels of mental distress. Psychedelic research has provided promising results, making psychedelic medicine an obvious candidate for the progression into a new paradigm for treating mental illness. Given the significant benefits of psychedelic medicines, relaying this information to the general public effectively is an important step towards the acceptance and integration of psychedelic-assisted therapy.

This exceptional period of rapid change that we currently find ourselves in has exposed a deep divide in understandings, views and opinions amongst individuals, communities, governments and within institutions. The COVID-19 situation, which is both symbolic and symptomatic of this complex time, has on the one hand produced an enormous amount of conflicting information coming from multiple sources, while on the other hand has not produced a single authoritative position, making it hard for most to differentiate fact from opinion and science from politics. These tensions are not unfamiliar to researchers in the area of psychedelic medicines; however, the scale of the current crisis changes the way we see the problem and directs us to new ways of responding. The COVID-19 situation has shown that when deciphering information, there is an obvious disparity between and within, science, medicine, politics and industry.

Information from highly influential sources leading to impulsive decision-making, has the capacity to produce unforeseen undesirable implications. We have seen an example of this recently with the initial predicted COVID-19 death rate — later found to be highly inaccurate — resulting in the instantaneous introduction of new policies worldwide. With the implementation of these policies, we are now witnessing a rise in mental illness, substance abuse and suicide risk (Wesley Mission & Suicide Prevention Australia, 2020). In hindsight the inadequacies and long-term implications of these policies are becoming visible, highlighted by new and upcoming research (Atkeson et al., 2020; Kaplan et al., 2020; Madhi, et al., 2020; Miles et al., 2020).

The complexity and tensions inherent within the COVID-19 situation present a unique opportunity for reflective research in that it surfaces, in a very explicit way, the challenges associated with the delivery and receipt of information. Learning from the COVID-19 situation, more focus can be placed on the fundamentals of the spread of information within the area of psychedelic medicines and how information flows impact on consensus and associated behaviour and attitudes.

The public perception of psychedelic medicines, relates back to the criminalisation of psychedelics in the 1960’s. The residual effects of this classification, including stigmatisation, rejection and fear, is central to the continuous spread of confusing and incorrect information within the public domain (Belouin & Henningfield, 2018; Bright & Williams, 2018; Sessa, 2016). The spread of this information has both created serious limitations for scientific research, and the uptake of the medicines and therapies themselves (Belouin & Henningfield, 2018; Bright & Williams, 2018; Sessa, 2016).

The way in which information is delivered can either be, a shortcoming for the distribution of correct information, or a catapult for the distribution of incorrect information, leading to a myriad of challenges for policymakers and public health. The dissemination of information in the COVID-19 environment has brought into focus the associated challenges, highlighting how advancements in the use of psychedelic assisted therapy may be curtailed. It is an important consideration when making informed decisions regarding the delivery of information, to examine and understand the sources, intended purposes behind, and the interpretation.

Misinformation can be described as information that originates from an absence or lack of supporting empirical or factual evidence. History tells us that the current scheduling of psychedelics follows on from the criminalisation of LSD in 1966 (Belouin & Henningfield, 2018; Sessa, 2016). LSD was completely banned for any use, including research purposes, on the basis that it posed a danger to the public, despite thousands of studies on the therapeutic use of LSD during the 1950’s and 1960’s deeming LSD, when used in controlled settings, to be “overwhelmingly safe and effective” (Sessa, 2016, p. 8). Based on this, the criminalisation and stringent scheduling of psychedelics is not supported by empirical evidence and based on misinformation.

In understanding the roots and propagation of misinformation, it is important to examine the sources. A study by McCright and Dunlap (2017) discusses the origins and spread of political misinformation and outlines that it is; often based on ideological agendas, deeply ingrained and mutually reinforced by the public, and cohesively promoted through collaborative relationships with industries and media outlets. This study highlights the disregard for accuracy in the delivery of highly influential information and also the difficulties in rectification at this level.

Research suggests that information is often selectively chosen, skewed or sensationalised for entertainment purposes (Klin & Lemish, 2008). With the media driven stigma of a ‘dangerous party drug’, ecstasy is an unregulated drug found to often not contain MDMA at all (Rickwood et al., 2005). MDMA, the psychedelic component in what’s been classified as breakthrough treatment for PTSD (Doblin et al., 2019) is often misleadingly referred to as ecstasy. This demonstrates the potential for incorrect terminology to exacebate misconceptions. However, becoming aware of misleading terminology allows for intervention to expose and correct it, helping to conteract misconceptions.

Aside from understanding and acknowledging the origins of information and misinformation, it is equally important, to recognise and understand how it is received and absorbed. Deciphering whether information is correct or incorrect involves not only the way it is delivered but also how it is interpreted, transferred into knowledge and beliefs, and interacts with prior knowledge and beliefs. Amongst the general population there are many misconceptions associated with psychedelics as a result of misinformation, such as, they are dangerous, toxic and addictive physically, psychologically and/or socially (Belouin & Henningfield, 2018; Byock, 2018). These misconceptions have been refuted by the large amount of research that has taken place since psychedelic medicines were discovered by scientists in the 1890’s (Bright & Williams, 2018; Nichols, 2016; Sessa, 2016), but the obvious dilemma is that such research is not readily available to, or accessed by the general public.

Misconceptions and misinformation are difficult to counteract, as they become imbedded in beliefs and attitudes. The “war on drugs” campaign, led by politics and propagated by mass media has left an unfortunate legacy. The campaign established psychedelics position as an enemy and threat to society. In establishing this position, knowledge was tactfully directed, shifting and cementing the general public opinion of psychedelics. In a study reviewing literature on cognitive biases that influence social perceptions, Marks and Miller (1987) found that values and beliefs held by individuals are often influenced by social groups and the selective exposure to biased samples of information that agrees with and maintains a desired or already held position.

It has been proposed that individuals generally only seek new knowledge when it is necessary or vitally important to do so (Thon & Jucks, 2017), and when it comes to acknowledging new information — whether it is evidence based or not — an individual’s prior knowledge and beliefs are often defended and upheld (Pennycook, 2020). Clearly, prior knowledge and beliefs play a significant role in the adoption of new information, exemplifying the difficulties in shifting firmly held beliefs and gaining trust and acceptance.

The “war on drugs” has been described as, a war on “sovereignty over consciousness” (Hancock, 2015, p. 3). In the current media climate we are witnessing an increase in censorship and a polarisation of information, which similarly to the “war on drugs” can be described as a war on sovereignty over knowledge. Ideally there should be accountability for ingenuousness within sources of information, but it is instead, left to the individual to firstly identify misinformation and secondly rationally and logically question it. Awareness leads to change and begins with acknowledgement and acceptance. Acknowledging and accepting the dilemmas within the delivery and uptake of information, will therefore bring about awareness necessary for change.

Misinformation is somewhat complicated and incorporates many variables from all parties including the sources of information and the intended audience, and many aspects that influence the interpretation and accommodation of information. Misinformation has effectively sustained misconceptions and stigmatisation surrounding psychedelics. It is therefore relevant to investigate and understand in order to move forward and create a model for initiating and establishing positive views and attitudes towards psychedelic medicines and therapies. Further research is needed to explore the barriers surrounding misinformation, to aid successful advocation for psychedelic medicines and promote their place in therapeutic, psychological and clinical practice.

By Candice Folkard

 

References

Atkeson, A., Kopecky, K., & Zha, T. (2020). Four stylized facts about COVID-19. NBER Working Paper №27719. https://doi.org/10.3386/w27719

Belouin, S. J., & Henningfield, J. E. (2018). Psychedelics: Where we are now, why we got here, what we must do. Neuropharmacology, 142, 7–19. http://doi.org/1016/j.neuropharm.2018.02.018

Bright, S., & Williams, M. L. (2018). Should Australian psychology consider enhancing psychotherapeutic interventions with psychedelic drugs? A call for research. Australian Psychologist. https://doi.org/10.1111/ap.12345

Byock, I. (2018). Taking psychedelics seriously. Journal of Palliative Medicine, 21(4), 417–421. https://doi.org/10.1089/jpm.2017.0684

Carhart-Harris, R.L., Bolstridge, M., Day, C.M.J. et al. (2018). Psilocybin with psychological support for treatment-resistant depression: six-month follow-up. Psychopharmacology, 235, 399–408. https://doi.org/10.1007/s00213-017-4771-x

Daniel, J., & Haberman, M. (2017). Clinical potential of psilocybin as a treatment for mental health conditions. Mental Health Clinician, 7(1), 24–28. https://doi.org/10.9740/mhc.2017.01.024

Doblin, R. E., Christiansen, M., Jerome, L., & Burge, B. (2019). The past and future of psychedelic science: an introduction to this issue. Journal of Psychoactive Drugs, 51(2), 93–97. https://doi.org/10.1080/02791072.2019.1606472

Hancock, G. (2015). The devine spark, psychedelics, consciousness and the birth of civilization. London: Hay House UK Ltd.

Kaplan, G., Moll, B., & Violante, G. L. (2020). The great lockdown and the big stimulus: tracing the pandemic possibility frontier for the U.S. NBER Working Paper №27794. 1–53. https://doi.org/10.3386/w27794

Klin, A., & Lemish, D. (2008). Mental disorders stigma in the media: review of studies on production, content, and influence. Journal or Health Communication, 13, 434–449. https://doi.org/10.1080/10810730802198813

Madhi, S. A., Gray, G. E., Ismail, N., Izu, A., Mendelson, M., Cassim, N., Venter, F. (2020). COVID-19 lockdowns in low- and middle-income countries: success against COVID-19 at the price of greater costs. South African Medical Journal, 110(8), 724–726. https://doi.org/10.7196/SAMJ.2020.v110i8.15055

Marks, G., & Miller, N. (1987). Ten years of research on the false-consensus effect: an empirical and theoretical review. Psychological Bulletin, 102(1), 72–90.

McCright, A. M., & Dunlap, R. E. (2017). Combatting misinformation requires recognizing its types and the factors that facilitate its spread and resonance. Journal of Applied Research in Memory and Cognition, 6, 389–396.

Miles, D. K., Stedman, M., & Heald, A. H. (2020). “Stay at home, protect the national health service, save lives”: A cost benefit analysis of the lockdown in the United Kingdom. The International Journal of Clinical Practice, 1–14. https://doi.org/10.1111/ijcp.13674

Nichols, D. E. (2016). Psychedelics. Pharmacological Reviews, 68(2), 264–355. https://doi.org/10.1124/pr.115.011478

Pennycook, G. (2020). Belief bias and its significance for modern social science. Psychological Inquiry: An International Journal for the Advancement of Psychological Theory, 31(1), 57–60. https://doi.org/10.1080/1047840X.2020.1722577

Rickwood, D., Crowley, M., Dyer, K., Magor-Blatch, L., Melrose, J., Mentha, H., & Ryder, D. (2005). Perspectives in psychology: substance use. Melbourne: The Australian Psychological Society Ltd.

Sessa, B. (2016). The history of psychedelics in medicine. In M. V. Heyden, H. Jungaberle, & T. Majić, Handbuch Psychoaktive Substanzen (pp. 1–26). Berlin: Springer, Berlin, Heidelberg. https://doi.org/10.10.1007/978-3-642-55214-4_96-1

Thon, F. M., & Jucks, R. (2017). Believing in expertise: how authors’ credentials and language use influences the credibility of online health information. Health Communication, 32(7), 828–836. http://dx.doi.org/10.1080/10410236:2016.1172296

Wesley Mission & Suicide Prevention Australia. (2020, June). Policy and Advocacy. Suicide Prevention Australia: https://www.suicidepreventionaust.org/policy-advocacy

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