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Dear Sir, The Victorian Royal Commission into Mental Health and Well-being highlighted the prevalence of co-occurring experiences of mental illness and addiction. The Dual Diagnosis team consists of a dual diagnosis clinician and an addiction psychiatrist who work closely with alcohol and drug (AOD) clinicians; local general practitioners (GPs); and other allied health services, including mental health, correctional, child protection, employment, family and housing services. The supported primary consultation model, whereby the client is accompanied/supported by their GP and relevant clinicians during the psychiatrist assessment, has been a powerful component of the program. [Extracted from the article]

Objectives: The present paper aims to: (i) describe how the Mental Health Commission in New Zealand works and has contributed to the substantial enhancement of mental health resources and services; (ii) determine whether mental health reform policies will ever be implemented properly without an independent monitor with official influence at the highest levels of government; and (iii) demonstrate how variants on this model work in other Western countries and how it can be adapted to the Federated system in Australia.Conclusions: It is recommended that the Australian National Mental Health Plan 2003-2008 should be complemented by a long-standing national mental health commission (or similarly constituted body), which is also able to report independently from and to the government, with direct access to the Prime Minister, Premiers and Australian Health Ministers. Its aims would be to monitor service effectiveness and identify gaps in service provision, training and performance of the work force, management and government. It would be informed by consumer, carer and provider experience, and by reviews of evidence-based research regarding health needs and cost-effective services. It should accurately cost such service gaps, and advise government on a strategy for implementing them. It could also promote and advise formally on enhancing community awareness, decreasing stigma and discrimination and improving workforce recruitment and retention. [ABSTRACT FROM AUTHOR]

Objective: We reflect upon the processes of mental health administration in Australia with reference to George Orwell's novel, 1984.Conclusions: Mental healthcare in Australia is distorted by politicisation, spin and a refusal to acknowledge the reality of the current situation. These challenges for mental healthcare demonstrate some similarities with the Ministries of Truth and Plenty, which conversely performed as their opposites in Orwell's novel. Psychiatrists and their professional bodies should play a greater role in advocacy for clinician-led, evidence-based services in partnership with our communities. [ABSTRACT FROM AUTHOR]

Objective: We aim to spark renewed discussion of the need for a more effective corporate governance structure for mental health services in Australia. While acknowledging clinical governance faces challenges, we focus here on corporate governance as the overarching level of administration, which profoundly influences delivery of mental healthcare in Australia.Conclusion: Australia's mental health services are ineffectively governed. Improved corporate governance, including psychiatric expertise, is fundamental to create a comprehensive, effective mental healthcare system in Australia. [ABSTRACT FROM AUTHOR]

Objectives: The Mental Health Act 2007 (NSW) ( MHA) was recently reformed in light of the recovery movement and the United Nations Convention on the Rights of Persons with Disabilities. We analyse the changes and describe the impact that these reforms should have upon clinical practice.Conclusions: The principles of care and treatment added to the MHA place a strong onus on clinicians to monitor patients' decision-making capacity, institute a supported decision-making model and obtain consent to any treatment proposed. Patients competently refusing treatment should only be subject to involuntary treatment in extraordinary circumstances. Even when patients incompetently refuse treatment, clinicians must make every effort reasonably practicable to tailor management plans to take account of any views and preferences expressed by them or made known via friends, family or advance statements. [ABSTRACT FROM AUTHOR]

The article explores the role of risk assessment in clinical practice as well as in clinical decision-making in the public mental health services in Australia. It mentions a little evidence supporting the existing form of risk assessment applied in the Australian public mental health services. An overview regarding the development and use of actuarial risk assessment instruments is provided.