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Purpose – This paper adds to growing research of psychiatric intensive care units (PICU) by recounting descriptions of psychiatric intensive care settings and discusses the perceptions held by nurses of the organisational interfaces, arrangements and provisions of care in these settings. Design/methodology/approach – Data gathered from focus groups held with nurses from two PICUs was used to establish terminology, defining attributes, related concepts, antecedents, values, processes and concepts related to current practices. A literature search was conducted to permit a review of the conceptual arrangements and contemporary understanding of intensive care for people experiencing acute psychiatric illness based on the perspectives held by the nurses from the focus groups. Findings – Dissonance between service needs and the needs and management of individual patients overshadow strategies to implement comprehensive recovery-oriented approaches. Three factors are reported in this paper that influence standards and procedural practice in PICU; organisational structures; physical structures; and subtype nomenclature. Practical implications – Acute inpatient care is an important part of a comprehensive approach to mental health services. Commonly intensive acute care is delivered in specialised wards or units co-located with acute mental health inpatient units mostly known as PICU. Evidence of the most effective treatment and approaches in intensive care settings that support comprehensive recovery for improved outcomes is nascent. Originality/value – Current descriptions from nurses substantiate wide variations in the provisions, design and classifications of psychiatric intensive care. Idiosyncratic and localised conceptions of psychiatric intensive care are not adequately entailing effective treatment and methods in support of recovery principles for improved and comprehensive outcomes. The authors suggest that more concrete descriptions, guidelines, training and policies for provision of intensive psychiatric health care encompassing the perspective of nursing professionals, would reinforce conceptual construction and thus optimum treatments within a comprehensive, recovery-oriented approach to mental health services. [ABSTRACT FROM AUTHOR]

Purpose – Mental health reform needs to engage leaders across jurisdictions and governments/communities. This paper aims to describe the history leading to the establishment of the Australian National Mental Commission (the Commission) in 2012 and to identify opportunities/challenges in cross jurisdictional/sectoral reform of mental health services. Design/methodology/approach – This case study is based on the observations of the author who has held lead state and national roles prior to leading the Commission. It sets the establishment of the Commission in the broader context of changing community attitudes, strong consumer/carer advocacy, increased financial support for mental health and establishment of state commissions. Findings – Cross sectoral/jurisdictional reform needs leadership from government heads and central agencies. Risks relate to the need to effectively articulate state and national commissions and challenges accompanying multilateral stakeholders with high and often conflicting expectations, and tensions with other high priority issues that also require alignment between Federal and State leaders and agencies. Research limitations/implications – There may be potential bias based on the perspective of the narrator, and the benefits of direct experience in multiple jurisdictions. Practical implications – The paper identifies critical success factors in the establishment/operation of the first national Commission and the establishment of relationships with state commissions, relevant to other cross jurisdictional bodies. Originality/value – The paper provides an insight into the factors leading to the establishment of the first national Commission and its articulation with state commissions and the early operational challenges facing cross jurisdictional reforms in changing political climates. [ABSTRACT FROM AUTHOR]

Purpose -- This paper seeks to provide a view on the relevance of spirituality to leadership at various levels and areas of the practice of psychiatry. Design/methodology/approach -- The paper provides a background and discussion on the relevance of spirituality to leadership at various levels and areas of the practice of psychiatry, with particular reference to Australia. Findings -- The author argues that spirituality is relevant to leadership in educating medical undergraduates, training professional psychiatrists, conducting clinical research, delivering mental health services and removing public stigma of mental health problems. Originality/value -- The author provides the unique perspective of a medical specialist practising in different areas and levels of psychiatry on spirituality and leadership. [ABSTRACT FROM AUTHOR]

Purpose -- A schema for more clearly understanding the emotional and psychological abuse and neglect of people with intellectual disability was developed to support a narrative study with people with intellectual disability, families and other supporters about the lived experience of this maltreatment in disability accommodation services in Australia. This paper aims to describe the underpinning review of emotional and psychological abuse and neglect and the evolving new framework. Design/methodology/approach -- A review of existing understandings of this form of abuse in research and policy was conducted, and a framework developed and tested for "trustworthiness" with participants in the research. Findings -- A framework of emotional and psychological abuse and neglect is presented. It centres on the misuse of power and control, details behaviours and interactions which can occur when it is inflicted, and is tested against the experiences of people who have experienced this sort of abuse and neglect. Research limitations/implications -- This is an evolving framework, applied through one study only. Further application and research is needed to test the robustness of the framework. Originality/value -- A more complex construction of emotional and psychological abuse and neglect may inform the development of service policy and support education for people with disability, families, and workers. [ABSTRACT FROM AUTHOR]