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Objective: This study examined differences in the types of mental health research that were conducted in the states and territories of Australia in 2008. Differences in both the disorder focus (e.g. depression, psychosis) and goal or methodology (e.g. epidemiological, biological) of published papers were examined. The structural differences underlying research output were examined by comparing output with funding and research infrastructure.Method: A random sample of 1008 Australian-authored mental health research publications and all 126 competitive mental-health related research grants from 2008 were coded in terms of their state or territory of origin, disorder focus and research goal.Results: Victoria and the Australian Capital Territory had the highest per capita rates of mental health research publications in 2008, while Tasmania and the Northern Territory had less per capita output. Research in New South Wales had greater focus on substance use and anxiety disorders, while Victoria was dominant in research on affective disorders and psychosis. Research in Queensland and Western Australia was broader in scope. Research output was more closely linked with number of successful grants than amount of funding.Conclusions: State and territory support for mental health research may have important implications for research output. [ABSTRACT FROM AUTHOR]

Objective: Clinical reasoning in psychiatry may be considered to be more challenging than in other branches of medicine because of its highly subjective nature. The literature on systematic approaches to the teaching of clinical reasoning in psychiatry is lacking, and we propose an approach that may assist educators and learners. Method: A systematic approach with a theoretical underpinning in logical inferences will be proposed as a teaching and learning tool. Conclusion: This paper complements our previous paper on psychiatric case formulation and expands our model of a theoretical framework for diagnostic reasoning and case formulation in psychiatry. Our approach also serves as a tool to assist in integrating the diverse clinical knowledge base in psychiatry. [ABSTRACT FROM AUTHOR]

Objectives: Despite the high prevalence of mental health problems for young Australians, many do not have ready access to treatment or are reluctant to seek help. Until recently there was a tendency for young Australians to fall between the gap of Child and Adolescent Mental Health Services and Adult Mental Health Services, and this has contributed to low rates of service use for young people. In 2006, the Australian Government sought to redress this gap in service delivery with its establishment of the Australian National Youth Mental Health Foundation, headspace. This paper presents demographic data collected at headspace Gosford over a 5.5-year period.Conclusions: The data presented indicates that headspace Gosford has been successful in improving early access to mental health treatment for young people on the Central Coast, in particular for young people aged 14-18. Headspace Gosford has attracted young people of both sexes, with a higher proportion of females. The majority of young people access headspace for mental health problems, predominantly depression and anxiety; however, a significant proportion report physical health or alcohol and drug-related reasons. The likelihood of these referral reasons is informed by gender and age. [ABSTRACT FROM AUTHOR]

Objective: Cultural diversity and its impact on mental health has become an increasingly important issue in a globalised world where the interactions between cultures continue to grow exponentially. This paper presents critical areas in which culture impacts on mental health, such as how health and illness are perceived, coping styles, treatment-seeking patterns, impacts of history, racism, bias and stereotyping, gender, family, stigma and discrimination.Conclusions: While cultural differences provide a number of challenges to mental health policy and practice they also provide a number of opportunities to work in unique and effective ways towards positive mental health. Ethno-specific approaches to mental health that incorporate traditional and community-based systems can provide new avenues for working with culturally diverse populations. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study was to identify mental-health-relevant literature accessible to policy makers and healthcare workers in the island nations of the Western Pacific.Methods: Material collated to support the inaugural Leadership in Mental Health: Island Nations course held in Cairns in May 2015 was used as the basis of a "rapid review".Results: The rapid review considered 303 documents identified by a search carried out using James Cook University's OneSearch, Google Scholar, and the authors' knowledge. Search terms included mental health and the like, and terms with Pacific and current Pacific island country names. Findings were classified by region/country, year of release/publication, mental health issue addressed, peer-reviewed or grey literature, and type of study. Almost half of the findings had been released in the previous five years. However, only 36% were peer-reviewed publications and only 3.6% of the findings were intervention studies.Conclusions: There is limited easily accessible documentation to confidently direct practice or policies regarding which strategies are likely to be effective in responding to the high rates of mental ill-health experienced in the Pacific island nations, or to plan for increases as a consequence of rapid social and demographic changes that are transforming Pacific island societies. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to inform mental health professionals about Activity-based funding (ABF) and the implications for data collection and clinical practice, in particular for consultation-liaison (CL) psychiatry.Conclusions: Activity-based funding may provide an opportunity for mental health services to be more equitably resourced, but much needs to be done to demonstrate that the funding model works in mental health. It is important to ensure that data collected is meaningful and accurate and reflects the diverse roles of mental health clinicians, including in CL. Inpatient and community services should be integrated in the model, as well as safeguards against potential abuse. Clinicians, in partnership with initiatives such as the Australian Mental Health Outcomes and Classification Network, are best placed to guide the development of an ABF system for mental health which appropriately recognises the complexity and variability between patients in different settings. [ABSTRACT FROM AUTHOR]

Objectives: Conversations between anthropologists and psychiatrists have led to new theoretical trajectories, research agendas and clinical practices as social scientists and medical practitioners forged new understandings about the interaction of culture, personhood and illness. However, the demands of global mental health, coupled with health service provision requirements, mean that mental health interventions set up with the best intentions can fail to take into account the knowledge and expertise that social sciences can contribute to a programme's success. In this paper, I reflect on conversations between an anthropologist and mental health professionals in direct reference to data analysis of an AusAID mental health capacity-building programme undertaken in the Pacific region.Conclusions: Social and cultural perspectives embedded within programmes can provide richer, more contextualised interventions. In drawing on the combined expertise of anthropology and psychiatry, new taken-for-granted reference points embedding cultural approaches form the basis for delivery of global mental health programmes. These perspectives include: Locating mental health programmes within development critiques. Situating the subjects of development within contextualised settings, acknowledging and respecting local knowledge, understandings and practices. A focus on interdisciplinarity as the basis for future practice in global mental health projects. [ABSTRACT FROM AUTHOR]

Aim: This paper uses the public record to explore the relationship between reputation damage and suicide. Method: The public record of the last 20 years was examined for examples of individuals without evidence of mental disorder who suffered actual or threatened reputation damage and suicided shortly thereafter. Results: Fifteen individual cases were identified; 18 additional cases, less comprehensively detailed, were mentioned in reports of The Wood Royal Commission and Operation Auxin. All cases were male. Of the 15 individual cases, the average age was 55 years, with a range of 40 to 76 years. The available details of the 18 additional cases were consistent with these findings. Conclusion: Middle-aged males without clear evidence of mental disorder, who suffer actual or threatened reputation damage, may be at increased risk of suicide. Naming and shaming needs to be conducted with caution. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper was to review the basis of the 'youth model' and new 'headspace' service delivery structures, proposed as a solution to the problem of high rates of psychiatric disorder in the youth period of life. Several issues were examined through asking key questions and answering these from the perspective of two academically oriented child and adolescent psychiatrists. Conclusions: As half of all mental disorders appear during childhood and early adolescence, more research into the origin and emergence of these problems should focus on this early period of life. Prevention research should also focus largely on children and adolescents, with interventions targeted through sequential assessment at pivotal stages. The current problem of access to mental health care for youth in the adult mental health service system could be improved with additional funding and culture change - it is not necessary to create a new service system. Indeed, there are dangers in establishing new services for 12-25-year-olds, as the 12-17-year-old population has different needs from 18-25-year-olds. In particular, the younger group are at risk of 'adultification' by being grouped together with young adults, and this risk needs to be actively managed. Health service planning must pay attention to developmental differences. Several suggestions are proposed for addressing the mental health needs of young adults. [ABSTRACT FROM AUTHOR]

Objective: Consumer involvement in mental health research is considered both a right and a benefit, despite the identified barriers to forming effective collaborative relationships. The purpose of this paper is to examine the literature relating to consumer involvement in mental health research with a view to articulating a model to guide this process. Method: A qualitative review of the relevant literature was undertaken. Literature referring to consumer roles in research was accessed and reviewed with the aim of articulating the benefits of, and barriers to, consumer participation in research. Results: The literature has identified a number of important benefits and some significant barriers to consumer involvement in mental health research. However, a clear model to articulate definitions of involvement is lacking. Four distinct levels of involvement were articulated. Conclusions: The identification of clearly defined models for consumer involvement in mental health research is important in order to facilitate collaboration and avoid tokenism. Research is required in order to determine the applicability of these models within actual research projects. [ABSTRACT FROM AUTHOR]

In this article, the author discusses the aspects of qualitative psychiatric research. He relates the paper by S. Crabb and A. Chur-Hansen on the contribution of qualitative methods to mental health theory. He mentions the reflective interaction between the evolution of knowledge and the environment as the epistemic method in human thought. He contends that qualitative research provides an alternative forms of understanding about the phenomena that are central to mental health field.

Objective: The aim of this paper is to advance and enrich innovative thinking about mental health issues from an Indigenous perspective, through consideration of the gap between Indigenous mental health research and Indigenous mental health practice. [ABSTRACT FROM AUTHOR]

Objectives: To consider the claim that there is a fundamental epistemological conflict between religion and psychiatry over what constitutes rational explanation, and what impediment this might be to rapprochement between the two.Conclusions: An epistemological gap most certainly exists, but there is a growing acceptance of the importance of religion and spirituality to psychiatry. Rapprochement may best be achieved by increasing psychiatric awareness and knowledge of the issues, and by a willingness to embrace intellectual, cultural and religious pluralism. [ABSTRACT FROM AUTHOR]

Objectives: This paper provides an example of a mental health research partnership underpinned by empowerment principles that seeks to foster strength among community organizations to support better outcomes for consumers, families and communities. It aims to raise awareness among researchers and service providers that empowerment approaches to assist communities to address mental health problems are not too difficult to be practical but require long-term commitment and appropriate support. Methods: A collaborative research strategy that has become known as the Priority Driven Research (PDR) Partnership emerged through literature review, consultations, Family Wellbeing Program delivery with community groups and activities in two discrete Indigenous communities. Progress to date on three of the four components of the strategy is described. Results: The following key needs were identified in a pilot study and are now being addressed in a research-based implementation phase: (i) gaining two-way understanding of perspectives on mental health and promoting universal awareness; (ii) supporting the empowerment of carers, families, consumers and at-risk groups through existing community organizations to gain greater understanding and control of their situation; (iii) developing pathways of care at the primary health centre level to enable support of social and emotional wellbeing as well as more integrated mental health care; (iv) accessing data to enable an ongoing process of analysis/sharing/planning and monitoring to inform future activity. Conclusion: One of the key learnings to emerge in this project so far is that empowerment through partnership becomes possible when there is a concerted effort to strengthen grassroots community organizations. These include social health teams and men's and women's groups that can engage local people in an action orientation. [ABSTRACT FROM AUTHOR]

Objective: There is little published research about mental health and climate change in the Pacific, including Solomon Islands. Solomon Islands has one of the highest rates of sea-level rise globally. The aim of this research was to document mental health issues related to sea-level rise for people in East Malaita, Solomon Islands.Method: A cross-sectional study was carried out in six low-lying villages in East Malaita, Solomon Islands. The researcher travelled to villages by dugout canoe. In addition to quantitative, closed-ended questions, open-ended questions with villagers explored individual and community responses to rising sea level.Results: Of 60 people asked, 57 completed the questionnaire. Of these, 90% reported having seen a change in the weather patterns. Nearly all participants reported that sea-level rise is affecting them and their family and is causing fear and worry on a personal and community level. Four themes emerged from the qualitative analysis: experience of physical impacts of climate change; worry about the future; adaptation to climate change; government response needed.Conclusion: Given predictions of ongoing sea-level rise in the Pacific it is essential that more research is conducted to further understand the human impact of climate change for small island states which will inform local, provincial and national-level mental health responses. [ABSTRACT FROM AUTHOR]

Objectives: To pilot an art and mental health project with Samoan and Australian stakeholders. The aim of this project was to provide a voice through the medium of art for people experiencing mental illness, and to improve the public understanding in Samoa of mental illness and trauma.Methods: Over 12 months, a series of innovative workshops were held with Samoan and Australian stakeholders, followed by an art exhibition. These workshops developed strategies to support the promotion and understanding of mental health in Samoa. Key stakeholders from both art making and mental health services were engaged in activities to explore the possibility of collaboration in the Apia community.Results: The project was able to identify the existing resources and community support for the arts and mental health projects, to design a series of activities aimed to promote and maintain health in the community, and to pilot these programs with five key organizations.Conclusions: This project demonstrates the potential for art and mental health projects to contribute to both improving mental health and to lowering the personal and social costs of mental ill health for communities in Samoa. [ABSTRACT FROM AUTHOR]

Objective: We aimed to assess the feasibility of delivering a music therapy program on adolescent psychiatric wards.Method: We undertook a mixed-methods evaluation of a pilot program. Various active and receptive techniques were employed in group music therapy sessions delivered as part of a structured clinical program. Data collected in interviews with participants and staff and feedback questionnaires were thematically and descriptively analysed and triangulated.Results: Data from 62 questionnaires returned by 43 patients who took part in 16 music therapy sessions, and seven staff, evidenced strong support for music therapy. Patients typically reported experiencing sessions as relaxing, comforting, uplifting, and empowering; >90% would participate by choice and use music therapeutically in the future. Staff endorsed music therapy as valuable therapeutically, reporting that patients engaged enthusiastically and identified sessions as improving their own moods and ward milieu.Conclusions: Integration of music therapy in inpatient treatment of adolescents is feasible and acceptable, and is valued by staff and patients as a complement to 'talking therapies'. Participation is enjoyed and associated with outcomes including improvement in mood, expression of feelings and social engagement consistent with recovery. [ABSTRACT FROM AUTHOR]

Objective: Our aim was to determine the views and experiences of carers of people with severe mental illness in regard to Community Treatment Orders (CTOs). Method: Questionnaires were posted using the mailing lists of two well-established carer support organisations in Victoria. The questionnaires included information about the person with a mental illness, the carer and their experience of care (ECI) and knowledge of recovery (RKI). Results: In total, 278 questionnaires were sent and 63 returned, of which 62 provided valid data. Those who responded were predominantly female (90%) and older (mean age 63 years), and were the carer of a person with a severe and recurrent mental illness. Some 60% had experience of caring for a person on a CTO. Most felt the CTO had been of benefit, and in 89% the person relapsed and needed further treatment when the CTO was stopped. Conclusion: Mental health legislation is shifting to bring a greater focus on rights, individual choice and autonomy in line with recovery-oriented care. This study describes the impact of severe mental illness and decisions in relation to CTOs on carers. [ABSTRACT FROM AUTHOR]

Objectives: Community treatment orders (CTOs) have been used in New Zealand since 1992 and are now used in most Commonwealth countries. There is little research on the rate of use of CTOs in New Zealand. This study compares the prevalence of CTO use across New Zealand's 20 health districts and makes comparisons with international prevalence rates.Methods: New Zealand Ministry of Health reports provided data on rates of CTO use in New Zealand between 2005 and 2011. International rates were obtained from published reports and academic literature on CTO use.Results: Rates of CTO use in New Zealand show marked and persistent regional variation over the period of data collection. National average rates increased from 58 per 100,000 in 2005 to 84 per 100,000 in 2011. Rates of use of CTOs are increasing internationally. New Zealand's CTO use is high by international comparisons.Conclusions: New Zealand's high and increasing rate of CTO use by international standards raises questions about the delivery and functioning of mental health services, and about mental health service users' experience of mental health care. The high rate of CTO use needs to be addressed as a human rights issue as well as a clinical issue. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to investigate restraint use in Australian emergency departments (EDs).Method: A retrospective audit of restraint incidents in four EDs (from 1 January 2010 to 31 December 2011).Results: The restraint rate was 0.04% of total ED presentations. Males and females were involved in similar numbers of incidents. Over 90% of restrained patients had a mental illness diagnosis and were compulsorily hospitalised. Mechanical restraint with the use of soft shackles was the main method used. Restraint was enacted to prevent harm to self and/or others. Median incident duration was 2 hours 5 minutes.Conclusions: In order to better integrate the needs of mental health clients, consideration is needed as to what improvements to procedures and the ED environment can be made. EDs should particularly focus on reducing restraint duration and the use of hard shackles. [ABSTRACT FROM AUTHOR]

Objective: To describe the core components of the Early Psychosis Prevention and Intervention Centre service model as the template agreed with the Australian Federal Government for national upscaling. The Early Psychosis Prevention and Intervention Centre model of early intervention has two main goals: to reduce the period of time between the onset of psychosis and the commencement of treatment and to bring about symptomatic recovery and restore the normal developmental trajectory as early as possible.Conclusions: The Early Psychosis Prevention and Intervention Centre comprises three elements of service provision for young people experiencing a first episode of psychosis: (i) early detection; (ii) acute care during and immediately following a crisis; (iii) recovery-focused continuing care, featuring multimodal interventions to enable the young person to maintain or regain their social, academic and/or career trajectory during the critical first 2-5 years following the onset of a psychotic illness. It does this via a combination of 16 core components, which provide a flexible, comprehensive, integrated service that is able to respond quickly, appropriately and consistently to the individual needs of the young person and their family. Innovative service reforms, such as Early Psychosis Prevention and Intervention Centre, that recognise the value of early intervention are crucial to reducing the impact of serious mental illness on young people and their families and, ultimately, on our society. [ABSTRACT FROM AUTHOR]

Objective: To describe the implementation of an Improving Access to Psychological Therapies (IAPT) service at Flinders Medical Centre emergency department (IAPT@Flinders). IAPT, a population-based model of guided self-help for anxiety and depression delivered mainly by phone, was rolled-out nationally in the UK in 2010. There is a growing body of evidence demonstrating its clinical effectiveness and efficiency that can improve treatment adherence, reduce stigma, remove appointment attendance barriers and improve access for hard-to-reach populations.Conclusions: IAPT@Flinders was the test site for the first IAPT in Australia and also the first IAPT service that was integrated with an emergency department (ED). IAPT@Flinders offers rapid access, low-intensity cognitive behavioural therapy, social prescribing and signposting to clients with adjustment disorders, anxiety and/or depressive symptoms. Successful implementation within an Australian crisis setting has demonstrated that many IAPT structures and protocols are applicable to ED settings and the model can be implemented with fidelity. Adaption required consideration of positioning of the service within the Australian mental health framework; staff qualifications; the referral pathways; and exclusion criteria. It is recommended additional test sites and larger scale trials are conducted to provide further evidence of the applicability of large-scale adoption of the UK IAPT model into Australian ED settings. [ABSTRACT FROM AUTHOR]

The article features the E-Mental Health Service for Young People Living With Cancer (YPLWC) service in Australia developed by CanTeen. Topics discussed include the service's purpose, outcome and value, the high incidence of mental illness in young people, statistical data on the number of young people suffering from cancer. Also discussed are cancer-related services offered through the Internet, teleconferencing and telephone counselling.

Objective: To provide an example of one model of research capacity building for mental health from a remote setting in Solomon Islands.Methods: The Atoifi Health Research Group is building health research capacity with a health service on the remote east coast of Malaita, Solomon Islands. The group uses a 'learn-by-doing' approach embedded in health service and community-level health projects. The group is eclectic in nature and deliberately engages a variety of partners to discover culturally informed methods of collecting, analysing and disseminating research findings.Results: Key successes of the Atoifi Health Research Group are: that it was initiated by Solomon Islanders with self-expressed desire to learn about research; the learn-by-doing model; inclusion of community people to inform questions and socio-cultural appropriateness; and commitment to ongoing support by international researchers.Conclusions: Given different social, cultural, economic, geographic, spiritual and service contexts across the Pacific, locally appropriate approaches need to be considered. Such approaches challenge the orthodox approach of centralized investment to replicate specialist driven approaches of funder nations. Increasing expertise at all levels through participatory capacity building models that define and address local problems may be more sustainable and responsive to local mental health contexts. [ABSTRACT FROM AUTHOR]

Objective: This article presents the case of an elderly woman experiencing a depressive phase of Bipolar Affective Disorder 1 (BPAD1), who required electroconvulsive therapy (ECT), prior to which her lithium was ceased, and who developed ultra-ultra-rapid cycling (UURC) and ultra-rapid cycling (URC). This resolved with the recommencement of lithium and continuation of ECT.Method: Case report and review of the relevant literature.Results: The patient's mood stabilized with recommencement of lithium and continuation of ECT.Conclusions: Ceasing lithium prior to ECT may carry a risk of URC or UURC in BPAD1. [ABSTRACT FROM AUTHOR]

Objective: In this study we aimed to examine the characteristics of Mental Health Act (MHA) usage in the Emergency Department (ED) of an urban teaching hospital in Sydney.Methods: All MHA certificates written on individuals in the ED over a 12-week period in 2013 were collected. The medical record of each individual was reviewed by a member of the research team using an audit tool developed for the study. Any uncertainty over individual cases was addressed through research team consensus.Results: A total of 172 MHA certificates were collected; 67 were written by police, 45 by ambulance, 54 by medical officers and three by accredited persons. Three magistrate orders for assessment were also received. Seventy percent of police and 60% of ambulance MHA certificates did not result in admission. Over a third were revoked by ED physicians. Forty-five people (32.4%) who presented voluntarily were subsequently detained.Conclusions: Police and ambulance MHA certification was a poor predictor of admission. Least restrictive measures were predominantly the outcome. Delegating ED physicians with authorised medical officer status assisted in facilitating this process. Formalised education and training on the principles and practicalities of MHA legislation should be ongoing for all professionals involved. [ABSTRACT FROM AUTHOR]