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Objective: This opinion paper discusses certain recommendations of the House of Representatives Select Committee on Mental Health and Suicide Prevention pertaining to psychology, GP and psychiatric professions. Conclusions: The Committee's recommendations may compromise patient care by undermining the ability of private sector medical specialists in providing direct clinical treatment and their role in the coordination of multidisciplinary teams. Expanding private psychological therapies without GP and private psychiatry support might increase the reliance on public hospital emergency departments and public sector mental health services for severe disorders and suicidal crises. Psychiatrists and GPs need to engage in more effective policy advocacy with the Australian Government, in order to maintain their roles in leading private sector collaborative multidisciplinary care. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to identify promising elements of best practice relevant to mainstream mental health service (MHS) delivery of early psychosis intervention (EPI) to Indigenous communities. In a companion paper, a comprehensive literature review identified a promising service model with potential for delivering EPI: an Indigenous sub-team embedded within a mainstream health service. Method: This paper describes a consultation process with Indigenous Mental Health Workers (IMHWs) in south eastern Queensland. A case study of the Sunshine Coast Cultural Healing Program (CHP-SC) was carried out during the consultation process. Results: IMHWs agreed that the Australian clinical guidelines for early psychosis were relevant to improving outcomes for Indigenous patients. IMHWs unanimously identified the CHP-SC as a best practice mainstream MHS for delivering EPI. The CHP-SC, which represented an Indigenous sub-team model, was found to be associated with substantially improved engagement of Indigenous young people. Conclusions: We provisionally conclude that specialist EPI could be delivered by specialist Indigenous sub-teams (rather than specialist EPI teams) embedded in mainstream MHSs that incorporate culturally safe practice and are fully integrated with Indigenous primary care services, and recommend that the model be formally evaluated. [ABSTRACT FROM AUTHOR]

Objectives: Mental health professionals are particularly susceptible to occupational stress; however, there are limited formal programmes to address the problem. This paper discusses the preliminary results of a brief mindfulness-based stress reduction (MBSR) programme for practising professionals in a public hospital mental health unit.Method: A mixed-group of nine mental health professionals participated in eight weeks of daily 15-minute MBSR training interspersed with three 30-minute education sessions developed by the authors (AD and AT). Levels of psychological distress and mindfulness skill were measured before and immediately after participation.Results: Following the brief MBSR programme, quantitative and qualitative participant feedback revealed a perceived reduction in psychological distress.Conclusions: A brief MBSR programme can be incorporated into the full-time workloads of practicing mental health professionals, potentially addressing a significant unmet workplace need. [ABSTRACT FROM AUTHOR]

Objective: Mental illness is a major contributor to disease burden in China. Guangdong province has a population of over 104 million. This province's health information system is inadequate, especially the mental health workforce and service response. This paper describes a field survey to assess the existing mental health workforce and service capacity in Guangdong.Method: A total of 125 major service providers in Guangdong were identified with the capacity to treat serious mental illness at all levels of the health system. These services were approached to complete a standardised survey based on the WHO Assessment Instrument for Mental Health Systems.Results: The survey identified 8498 mental health workers with 72.5% working in psychiatric hospitals. Service providers reported a treatment rate of 68.8% of a total of 430,000 people registered for treatment of severe mental illness, and only 28.4% of over a million people estimated to be experiencing severe mental illness. An inadequate mental health workforce was cited as a common barrier to treatment access.Conclusion: Guangdong province has a significant treatment gap for severe mental illness and a shortage in the mental health workforce. The distribution of the mental health workforce and facilities is imbalanced towards hospital care rather than community care. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to describe the characteristics and outcomes of participants with an Australian physician health program, the Victorian Doctors Health Program (VDHP), for case management of substance use disorder (SUD) and/or significant mental illness. Method: As part of quality assurance, processes data, including demographic information, care plan components and outcomes, were analysed. Results: Between 2001 and 2008, 115 participants undertook case management plans with the VDHP. The majority (n == 71, 62%) had some involvement with the Medical Practitioners Board of Victoria (MPBV). Case management included facilitating referrals to addiction specialists, psychiatrists, counsellors and peer-based support. Ninety (78%) participants reported SUD, the remainder having mental illness (n == 25, 22%). Alcohol was the main drug reported by the SUD group (n == 44, 49%). Most of the SUD participants undertook biochemical monitoring. On commencement with the VDHP, 39 (34%) participants were on leave due to illness. The majority of participants case managed for 5 years were in medical work (n == 31, 84%). Conclusions: Case management by an independent physician health program may protect the health of the doctor and the community, and could be considered in other jurisdictions. [ABSTRACT FROM AUTHOR]

Objective: There is an emerging consensus that the assessment and management of adverse outcomes in mental health, such as violence and self harm, is best achieved by approaches which incorporate validated tools using “structured professional judgement”. Although several useful tools have emerged from the literature, there is no clear consensus on the best way to integrate these with clinical practice. This paper describes a framework, the Forensicare Risk Assessment and Management Exercise (F.R.A.M.E.), employed by a statewide community forensic mental health service, which incorporates two structured professional judgement tools, and explicitly integrates these into case management and psychiatric treatment. The potential benefits of the framework are discussed in the context of contemporary trends in risk assessment and management. Conclusions: The F.R.A.M.E. appears to assist with the task of integrating risk assessment with clinical management. Formal evaluative research is indicated before it can be recommended for use by other services. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to summarize information about the dissemination and implementation of the Royal Australian and New Zealand College of Psychiatrists' clinical practice guidelines (CPGs) since their completion in 2003, and assess the effectiveness of these activities. Method: The dissemination and implementation activities undertaken from 2003 to the present are described. Data regarding the dissemination of the clinician and consumer-carer versions of the CPGs are presented. The results of a series of implementation pilots are summarized. Results: Available data suggest the CPGs have been widely disseminated through both the clinician and consumer-carer communities in Australia and New Zealand, and that the consumer-carer versions in particular continue to be in high demand. Evaluation of CPG implementation pilots, using tools that assist in bringing summary evidence into clinical practice, have suggested that such tools are acceptable, are a useful aid to implementing evidence-based practice, and have a positive impact on practice. Common barriers to implementing the evidence are highlighted. Conclusions: Summary consumer-carer versions of CPGs seem to be acceptable and useful to both consumer-carers and non-government mental health providers. Locally led implementation of CPGs using tools that summarize evidence and support its use in everyday practice has a positive impact, but also highlights system-level barriers to implementing evidence-based practice. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to outline the impact of Community Treatment Orders over a 20-year period on service delivery and clinical practice in Victoria. Conclusions: Community Treatment Orders, as utilized in Victoria, have undermined optimal service delivery and supported paternalistic, reductionistic clinical practice. The psychiatric profession has failed to advocate adequately for better mental health resourcing and human rights protection of those subject to Community Treatment Orders. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to examine the role of consumers as service providers and to describe the successful employment of peer support workers in a public mental health service. Conclusions: The Peer Support Worker program in Adelaide, South Australia is consistent with evidence obtained from previous research in demonstrating the successful training and employment of consumers as peer workers in a public mental health service. [ABSTRACT FROM AUTHOR]

Objective: The aim of this present paper is to highlight some of the issues faced by therapists and sign language interpreters when working with deaf patients. Conclusions: Key issues include linguistic, interpreting and role challenges, and potential threats to the therapeutic alliance. Recommendations are made in relation to preparation strategies and training for sign language interpreters and therapists. [ABSTRACT FROM AUTHOR]

Objective: To provide psychiatrists with a guide to using the Internet.Conclusions: The key to using the Internet is to have the skills to keep the signal-to-noise ratio high. This requires knowledge and practice. The paper contains tips on searching and information about surfing skills, noticeboards, portals and email lists, and lists a range of very useful websites. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to provide further outcome data on a novel consumer-clinician co-taught borderline personality disorder training program. Method: Participants (n=216) who attended consumer-clinician co-taught borderline personality disorder training had their ratings of the training compared to ratings of participants who attended the previous clinician-only borderline personality disorder training. Results: Mean training ratings of the consumer-clinician co-taught borderline personality disorder trainings were 37 percentile points higher (77th vs 40th percentile) than the ratings of the previous clinician-only borderline personality disorder training, which already had evidence of effectiveness. Conclusion: Data confirm preliminary findings that adding a consumer-presenter to training adds considerable value. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to illustrate through poetry that self-directed recovery from mental illness is possible, and that through vigilance and a supportive network of family and mental health workers, life beyond recovery can be full and rewarding for any consumer. Conclusions: Through positive choice, a consumer can break the cycle of admission and realize self-empowerment, which can lead to a full and complete life. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to report the experiences of the author during her Advanced Training Fellowship year in Indigenous mental health and consultation-liaison psychiatry through the Royal Australian and New Zealand College of Psychiatry. The description will include a discussion of how such a Fellowship may complement the key learning objectives of advanced training in psychiatry. Conclusions: A Fellowship in Indigenous mental health can offer a variety of experiences for the psychiatry trainee, including clinical work, research and teaching. The planning and collaboration with Aboriginal health organizations, key clinicians and Ethics committees provides a unique opportunity to learn invaluable communication and consultancy skills. [ABSTRACT FROM AUTHOR]