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Aboriginal psychiatric morbidity, whilst culturally different in presentation to white communities has been suggested to run at a mean prevalence rate of 13.5% of the major disorders found in non-Aboriginal communities. This paper discusses the socio-political and cross cultural issues to do with mental health for Australian Aboriginals from a non-Aboriginal perspective. The paper is particularly concerned with the effects of racism on Aboriginal mental health and how racism effectively limits Aboriginal people from full participation in the pluralist mainstream. Racism has been seen to be a major contributor to mental illness. The scope of this paper addresses the issue of transforming mainstream culture as well as highlighting the need for protection, participation and collaborative involvement in mental health service delivery. [ABSTRACT FROM AUTHOR]

The opportunity for consumers to participate in all stages of mental health service delivery, including the planning of their individual care, is now clearly enshrined in Australian mental health policy. Published research which examines the extent to which this has been realised in practice is limited, and the paucity is even greater for research reflecting the views of the consumers themselves. This paper presents the findings of a qualitative study. In-depth interviews were undertaken with consumers of mental health services from two rural areas in Victoria to explore their views and opinions regarding their ability for genuine participation in the planning and delivery of their mental health care, and in particular on the role of nurses in facilitating this process. Data were analysed with the assistance of NVivo, using a content analysis approach. The main themes identified were: respect, encouragement, collaboration and systemic barriers. The findings suggest that consumer participants identify a number of barriers which limit their ability to participate effectively. The implications for the role of the nurse in facilitating genuine consumer participation are discussed. [ABSTRACT FROM AUTHOR]

International literature and New Zealand health policy is giving increased emphasis to the role of the primary health care sector in responding to mental health issues. These issues include the need for health promotion, improved detection and treatment of mild to moderate mental illness, and provision of mental health care to some of those with severe mental illness who traditionally receive care in secondary services. These developments challenge specialist mental health nurses to develop new roles which extend their practice into primary health care. In some parts of New Zealand this process has been under way for some time in the form of shared care projects. However developments currently are ad hoc. There is room for considerable development of specialist mental health nursing roles, including roles for nurse practitioners in primary mental health care. [ABSTRACT FROM AUTHOR]