Search

Objective: The Australian federal government is considering a 'digital front door' to mental healthcare. The Brain and Mind Centre at the University of Sydney has published a discussion paper advocating that the government should adopt a comprehensive model of digital triage and monitoring (DTM) based on a government-funded initiative Project Synergy ($30 million). We critically examine the final report on Project Synergy, which is now available under a Freedom of Information request. Conclusion: The DTM model is disruptive. Non-government organisations would replace general practitioners as care coordinators. Patients, private psychiatrists, and psychologists would be subjected to additional layers of administration, assessment, and digital compliance, which may decrease efficiency, and lengthen the duration of untreated illness. Only one patient was deemed eligible for DTM, however, during the 8-month regional trial of Project Synergy (recruitment rate = 1/500,000 across the region). Instead of an unproven DTM model, the proposed 'digital front door' to Australian mental healthcare should emphasise technology-enabled shared care (general practitioners and mental health professionals) for the treatment of moderate-to-severe illness. [ABSTRACT FROM AUTHOR]

Objective: This paper provides an update on recent developments at the largest state-funded gender clinic for adults in Australia. It focuses on the current staffing profile, the role of the mental health professional and the evolution of the clinic as a provider of specialist care supporting primary care providers who offer an informed consent model of care in accessing gender-affirming treatments.Conclusions: While significant improvements have been made at the clinic to provide comprehensive care in a framework that is viewed more favourably by clients, gaps in clinical service provision persist and are in need of urgent attention. [ABSTRACT FROM AUTHOR]

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]

Objective: This paper aimed to investigate narratives regarding the experience of Maori cultural identity of Maori psychiatrists and registrars who have worked with tamariki (children), taiohi (adolescents) and whanau (families). Method: This was a Kaupapa Maori (Maori-centred) qualitative study where a total of five Maori psychiatrists and registrars were interviewed using a semi-structured questionnaire informed by Tikanga Maori (Maori custom and protocol). Results: This paper presents one significant theme, that of “doing the work differently”. Within this theme, the perceived 'mismatch' between psychiatric training, seeming to value opacity in clinical sessions, compared to Tikanga Maori aspects of the doctor's identity which values whakawhanaungatanga (connectivity and relationships) was consistently described. Conclusions: This paper has implications for registrar training needs, workforce development, service development and cultural competency. [ABSTRACT FROM AUTHOR]

Objective: The use of formal supervision contracts has been strongly advocated across non-medical mental health professions. However, the use of such agreements is not a feature of the RANZCP Competency-Based Fellowship Program. This paper critically examines the evidence to support the use of formal supervision contracts.Method: A systematic review of empirical studies relating to the outcomes of supervision contracts was completed. Included records were subject to quality appraisal.Results: Two studies met the inclusion criteria; both were assessed to be of poor quality. One study found improved supervision effectiveness associated with the use of supervision contracts, and the other found no significant differences associated with formal contracting.Conclusion: Despite strong advocacy, limited empirical evidence was found to support the value of formal supervision contracts across mental health professions. PROSPERO registration - PROSPERO 2018 CRD42018104142. [ABSTRACT FROM AUTHOR]

Objective: The Australian Commonwealth Government introduced new psychiatrist Medicare-Benefits-Schedule (MBS)-telehealth items in the first wave of the COVID-19 pandemic to assist with previously office-based psychiatric practice. We investigate private psychiatrists' uptake of (1) video- and telephone-telehealth consultations for Quarter-2 (April–June) of 2020 and (2) total telehealth and face-to-face consultations in Quarter-2, 2020 in comparison to Quarter-2, 2019 for Australia. Methods: MBS item service data were extracted for COVID-19-psychiatrist-video- and telephone-telehealth item numbers and compared with a baseline of the Quarter-2, 2019 (April–June 2019) of face-to-face consultations for the whole of Australia. Results: Combined telehealth and face-to-face psychiatry consultations rose during the first wave of the pandemic in Quarter-2, 2020 by 14% compared to Quarter-2, 2019 and telehealth was approximately half of this total. Face-to-face consultations in 2020 comprised only 56% of the comparative Quarter-2, 2019 consultations. Most telehealth provision was by telephone for short consultations of ⩽15–30 min. Video consultations comprised 38% of the total telehealth provision (for new patient assessments and longer consultations). Conclusions: There has been a flexible, rapid response to patient demand by private psychiatrists using the new COVID-19-MBS-telehealth items for Quarter-2, 2020, and in the context of decreased face-to-face consultations, ongoing telehealth is essential. [ABSTRACT FROM AUTHOR]

Objective: To describe key practical knowledge and skill components required for clinicians involved with the assessment of military personnel and veterans.Conclusions: Assessment of military and veterans' mental health issues involves a tailored history-taking process that includes specific aspects of service, transition and reporting requirements. Recommendations for the detailed assessment of military personnel and veterans are provided. Comorbid conditions, chronic pain and the needs of both women and older veterans are also discussed. [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 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]

The article focuses on the implementation of the new assessment procedures for the fellowship examination at the Australian Medical College. The most recent review of the curriculum for psychiatrists in training led to substantial changes to the training programs, which came into force at the beginning of the year. The Committee for Examinations has also reviewed the assessment procedures. The written exam is now vastly different from the written paper. An Observed Clinical Interview (OCI) replaces the clinical exam. Two examiners now observe the trainee conducting a comprehensive psychiatric assessment of a patient.

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: This paper will define and describe impairment in medical practitioners due to mental illness, with special reference to the specialty of psychiatry, and then review the prevalence and identification of impaired practitioners. Methods: The quantitative and qualitative evidence regarding the incidence and impact of medical practitioner impairment due to mental illness (and, to some extent, substance use), with special reference to impaired psychiatrists, is reviewed. Results: Medical practitioner impairment due to mental illness has a severe impact on their lives and their families due to both the effects of the disorder and the experience of communal, professional and self stigma. Conclusions: The consequences of impairment among medical practitioners and specialist psychiatrists as well as the under-reporting of impaired practitioners is a significant problem. [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 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 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 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: Difficulties recruiting and retaining adequate numbers of mental health nurses have been extensively documented in the Australian literature. The continued increase in the average age of practicing mental health nurses has intensified concerns that a workforce crisis is rapidly approaching. Despite the urgency of this situation, there has been no comprehensive, co-ordinated collection of labour force data. The aim of this paper is to synthesise and present labour force data gathered from various official sources to more clearly identify and articulate the nature and extent of the problem. Method: Relevant labour force data was obtained from reports produced by the Australian Institute of Health and Welfare and the Victorian Department of Human Services. Information was collated, synthesised and, in some cases, re-analysed to provide a clearer picture of the current national and Victorian mental health nursing labour force, as well as requirement and supply projections. Results: Findings are consistent with conclusions in the available literature but suggest that the magnitude of the problem is likely to be greater than previously anticipated. Conclusions: The systematic and coordinated collection of mental health nursing labour force data is crucial in order that appropriate interventions can be implemented and evaluated. [ABSTRACT FROM AUTHOR]

Discusses the proposed Maintenance of Professional Standards (MOPS) program for 2001 of the Royal Australian and New Zealand College of Psychiatrists. Removal of categories in educational meetings; Change in program activities for clinical and non-clinical practice; Focus on quality improvement and incorporation of peer review; Contribution of peer review groups; Papers relevant to quality improvement in psychiatry.

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: Mental health clinicians can experience problems communicating distressing diagnostic information to patients and their families, especially about severe mental illnesses such as schizophrenia. Evidence suggests that interpersonal communication skills can be effectively taught, as has been demonstrated in the specialty of oncology. However, very little literature exists with respect to interpersonal communication skills training for psychiatry. This paper provides an overview of the communication skills training literature. Conclusions: The report reveals significant gaps exist and highlights the need for advanced communication skills training for mental health clinicians, particularly about communicating a diagnosis and/or prognosis of schizophrenia. A new communication skills training framework for psychiatry is described, based on that used in oncology as a model. This model promotes applied skills and processes that are easily adapted for use in psychiatry, providing an effective platform for the development of similar training programs for psychiatric clinical practice. [ABSTRACT FROM AUTHOR]

These include the report of the National Suicide Prevention Adviser, the Medicare Benefits Schedule Review Taskforce and National Mental Health Workforce Strategy as well as royal commissions into Aged Care Quality and Safety, and into Disability. Graph It is my hope that by the time you read this, both Australia and New Zealand will be taking big steps towards a more normal future in our fight against COVID-19, with vaccines starting to play a critical role in protecting the health and wellbeing of our communities. In New Zealand, the College has made submissions in response to the Ministry of Health's COVID-19 Psychosocial and Mental Wellbeing Recovery Plan, the Medical Council of New Zealand's statement on telehealth and Te Pou's Integrated care in primary health discussion paper. [Extracted from the article]

Objective: This paper considers the potential utility in clinical practice of writing a letter to patients. Conclusion: Letters written by psychiatrists to patients may be helpful in some clinical situations. [ABSTRACT FROM AUTHOR]

Given trauma's rippling effects, psychiatrists must skilfully address trauma within vulnerable communities. By implementing trauma-informed practice at individual, community and societal levels psychiatrists invite the world to peer through the looking glass towards a future of more holistic care of the Human Kaleidoscope. [Extracted from the article]

Objectives: We argue that mental health-related concepts have become degraded within professional circles and in the wider community. We identify three trends: concept creep, the rise of broad umbrella concepts (e.g. distress and trauma), and the conflation of mental health with well-being, which marginalises serious mental illness. We speculate on the causes of these trends, including cultural shifts towards greater sensitivity to harm and the rise of wellness industries. Contributing factors within psychiatry include overdiagnosis, dimensional models and transdiagnostic perspectives. Conclusions: These trends may lead to inflated demands on services from those at the milder end of the psychopathological spectrum. We set out seven measures that mental health professionals can take to resist trends towards broad concepts of mental illness and limit some of their adverse consequences. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to provide a clinical update on moral injury from the perspective of a public sector community psychiatrist, and to outline approaches to addressing the issues raised.Conclusions: Although not considered a mental illness, moral injury is an important condition for psychiatrists to have an awareness of, as it is associated with psychological distress and/or impairments in emotional, social or behavioural functioning. Potentially morally injurious events (PMIEs) for community psychiatrists may include staff shortages and deficient resources rendering it difficult to provide an acceptable standard of professional care; time constraints negatively impacting teaching, supervising and mentoring medical students; cost-prohibition regarding preferred medication choices; lack of gender and cultural diversity of available psychiatrists; and work environments not conducive to psychiatrists speaking out about their concerns. The COVID-19 pandemic has exposed and exacerbated PMIEs for some community psychiatrists. Whether or not a PMIE transitions to a moral injury may be influenced by the individual's resilience and the quality of emotional, psychological and administrative support they receive before, during and after the potentially precipitating event. Preventative strategies to mitigate susceptibility to a moral injury may be implemented at both a systems level and individual level, and include collective healthcare advocacy action. [ABSTRACT FROM AUTHOR]

MetS was assessed using the International Diabetes Federation (IDF) criteria.[3] Management strategies employed to address metabolic concerns were broadly categorised as providing lifestyle advice (e.g. diet and exercise), adjusting the dose of the current antipsychotic, switching to a different antipsychotic, adding a medical therapy (e.g. metformin, statin, ACE-inhibitor) or "other" (e.g. referral to another service). Keywords: metabolic syndrome; antipsychotics; screening; psychiatrists EN metabolic syndrome antipsychotics screening psychiatrists 84 89 6 03/09/22 20220201 NES 220201 The high rates of physical health problems - notably cardiovascular risk factors - in people with schizophrenia and related disorders has been highlighted in the Royal Australian and New Zealand College of Psychiatrists (RANZCP) clinical practice guidelines for the management of schizophrenia and related disorders.[1],[2] People with psychotic disorders have high rates of metabolic syndrome (MetS), and this in turn is associated with a doubling of the risk of developing cardiovascular disease within 5-10 years and up to five times greater risk of developing type 2 diabetes.[3],[4] MetS is also associated with an approximately two-fold increase in cardiovascular mortality[4] and a 1.5-fold increase in all-cause mortality.[5] People with psychotic disorders have high levels of co-morbidity and their life expectancy is significantly reduced compared to the general population.[6],[7] Cardiovascular disease contributes significantly to the poor health and early deaths of people with psychotic disorders.[7] There is general acknowledgement that certain antipsychotics carry a higher risk of metabolic problems than others. Discussion This clinical audit showed high rates of MetS in patients being treated with antipsychotic medications. [Extracted from the article]

Objective: To examine psychological distress and professional burnout in a cohort of Australian mental healthcare workers during the COVID-19 pandemic Methods: This study examined a multi-disciplinary cohort of mental healthcare workers in a large metropolitan service in Australia. Demographic information as well as information on employment and individual's personal experience of the COVID-19 pandemic was collected and correlated with cross-sectional assessments of anxiety, depression and professional burnout using validated clinical questionnaires Results: Mental healthcare workers reported high levels of anxiety, depression, and professional burnout. Participants reported some reduction in anxiety since the early phases of the pandemic, but the reduction was more modest in mental healthcare workers identifying as being "vulnerable" employees. Conclusion: Despite the low numbers of COVID-19 cases, mental healthcare workers in Australia report significant levels of psychological distress and professional burnout during the pandemic. [ABSTRACT FROM AUTHOR]

Objective: The aims of this study were to explore the knowledge, attitudes, confidence and practices of Australian psychiatrists and psychiatry registrars with regard to smoking cessation with their patients and to promote clinical practice reflection and re-framing. Methods: A mixed-methods questionnaire was developed. Interviews were conducted via telephone or face-to-face utilising participatory action research principles. Qualitative data were de-identified and analysed following a reflexive thematic approach. Results: The questionnaire was completed with 15 participants. The majority worked in the public health sector and agreed that smoking cessation could be used as a clinical tool across mental health services. However, nearly all of the participants reported being unfamiliar with the latest literature. Only one-third of participants reported having had received formal training in smoking cessation. Overwhelmingly, more training was reported as necessary and welcomed by participants. Conclusion: Our study has identified gaps in psychiatrists' and psychiatry registrars' knowledge and confidence regarding the promotion, initiation and oversight of smoking cessation strategies for patients. It's important that psychiatrists lead the way in re-framing and engaging with this issue, and consider smoking cessation as a tool that can improve mental health outcomes. A review of existing Australian policies, guidelines and training is recommended. [ABSTRACT FROM AUTHOR]

Objectives: This paper aims to identify and respond to workplace stress and related issues in a rural community mental health team. Method: Action research (AR) underpinned this study and facilitated change in practice through four distinctive completed AR cycles with data analysis proceeding alongside data collection. Theories were articulated and explored and resulted in the development of a new model of praxis. Conclusions: A new model of praxis was developed which should contribute to both positive patient outcomes and improved staff occupational safety and wellness. Based on this, three clinical nursing tools were developed and implemented into practice. [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 assess rates of metabolic monitoring in patients prescribed antipsychotic medications in the psychiatric inpatient setting and the impact education can have regarding monitoring compliance.Method: Two identical audits were undertaken at a NSW mental health inpatient service before and after a campaign designed to educate mental health workers about the importance of metabolic monitoring. Results from both audits were compared for statistically significant improvements in monitoring rates.Results: Rates of monitoring plasma lipids increased from 21.7% to 78.8% (p < 0.01) and rates for plasma glucose increased from 20.8% to 73.7% (p < 0.01). There were no statistically significant changes in rates of monitoring body mass index (83.0% and 77.1%, respectively), waist circumference (36.8% and 43.2%, respectively) and blood pressure (99.1% and 100%, respectively).Conclusion: This study has shown that rates of metabolic monitoring in the inpatient setting can be improved with a relatively low-cost education intervention. While absolute rates remain low, outcomes suggest that it may be worthwhile trialling further modes of education and repeating this education in cycles. [ABSTRACT FROM AUTHOR]

Objective: General practitioners (GPs) are key health professionals for referrals to mental health specialists. Youth mental health issues are particularly challenging, requiring a competent assessment and understanding of appropriate referral pathways. We surveyed local GPs about their understanding of youth mental health problems and needs to competently look after young patients. Methods: GPs working in the Hunter region were contacted via email, fax and post over a 6-month period in 2019. Results: Seventy-five GPs participated. They reported 577 of 1698 (34%) of young people seen 2 weeks prior to being surveyed presented with a mental health problem. Predominantly, referrals were to private practice psychologists and Headspace. Almost a third (31%) reported having limited understanding of 'at-risk mental state' and are 'not always comfortable' when facing a young person with a mental health problem. Nearly all (95%) expressed interest in attending specialised training. GPs identified treatment costs, scarce access to psychiatrists and limited patient engagement as the main obstacles to help young people. Conclusions: Effective treatment of a mental health problem relies on early identification. GPs are seeing young people on a regular basis but don't feel well equipped for this task and are keen to up-skill, which needs to be addressed by targeted training. [ABSTRACT FROM AUTHOR]

Objectives: To provide a clinical update on the mechanisms of, and potential population mental health risks of, excessive media exposure and misinformation regarding the COVID-19 pandemic. To outline guidance for government, health services, psychiatrists and health professionals in managing mental health effects of COVID-19 media exposure. Conclusions: Social and traditional media businesses attract interest by reporting threats and negativity, and heavy media exposure during disasters is associated with increased depressive and post-traumatic symptoms. There are three main recommendations for mitigation of the adverse population mental health effects of excessive media exposure and misinformation. Clear, authoritative communication from governments, health authorities and health professionals is essential, combined with correction of misinformation and addressing mistrust. Specific warnings by governments, health authorities and clinicians of the potential adverse mental health consequences of excessive COVID-19 media consumption are needed. Limitation of exposure to media and disinformation regarding COVID-19 is crucial – the less, the better. Healthcare professionals can advise patients to check information once daily, and be guided by reliable public health authorities, as part of interventions for managing the mental health impact of COVID-19. [ABSTRACT FROM AUTHOR]

Objective: To consider how a mental health professional might respond to a newly diagnosed depressed patient who inquires into its potential genetic origins and whether they might pass depression on to their children. Methods: Data are provided on risk and pursuit of genetic pathways. Results: As most studies have focussed on DSM-defined major depression – and which is not an entity – no definitive data are available, while there are some few studies indicating a greater genetic risk in those with melancholic than those with non-melancholic depression. Conclusion: We will not know the genetic contribution to clinical depression unless its key sub-types are evaluated as separate conditions. Findings may assist a clinician's response to an inquiring patient. [ABSTRACT FROM AUTHOR]

Objective: To describe the characteristics and clinical capacity of Australian and New Zealand psychiatrists working in intellectual and developmental disability mental health (IDDMH).Method: Consultant psychiatrists (n=71) with an interest or expertise in IDDMH completed an online survey about their roles, experience and time spent in intellectual developmental disability (IDD)-related activities.Results: Psychiatrists had worked in IDDMH for a median of 11.34 years and half (53.5%) reported expertise in the area. One-fifth of psychiatrists reported IDDMH as their main area of practice. The majority of respondents (85.1%) reported that they were working clinically with people with IDD. Respondents practicing clinically worked a median of 8 hours in clinical and 3 hours in non-clinical IDD-related work per week.Conclusions: Surveyed psychiatrists had considerable experience in IDDMH. However, their work in IDDMH represented a relatively small proportion of their overall work hours, and a minority of respondents were responsible for a large proportion of clinical work. Exploring ways to broaden capacity is crucial to ensuring the mental health needs of people with IDD are met. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to examine the training experiences of and determine capacity to train future Australian and New Zealand psychiatrists working in intellectual and developmental disability mental health.Methods: Australian and New Zealand psychiatrists with expertise or interest in intellectual and developmental disability mental health completed an online survey detailing their training pathway, support for subspecialty training and capacity to provide rotations in this area.Results: Psychiatrists (n=71) indicated the most common reasons they started practicing in intellectual and developmental disability mental health, and these included seeing people with intellectual or developmental disability in a service in which they worked, or personal experience with intellectual or developmental disability. Compared to those trained overseas, psychiatrists trained in Australia or New Zealand had lower ratings of the sufficiency of education received in intellectual and developmental disability mental health. Of the total respondents, 80% supported the development of subspecialty training. Augmentation of intellectual and developmental disability mental health content in the intermediate stage of training was also strongly supported. Participants identified 80 potential six-month training rotations in this area.Conclusions: Psychiatrists working in intellectual and developmental disability mental health strongly support enhancements to intellectual or developmental disability training, including the development of subspecialty training, and can identify potential training capacity if such subspecialty training was developed. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to indicate how online cognitive behavioural therapy (CBT) training for rural and remote health professionals can enhance access to evidence-based treatments in rural communities and address psychotherapy training shortfalls for rural practitioners treating Australians with high prevalence psychological disorders. Conclusions: Issues of cost, distance and disruption to services have meant that, until now, it has been very difficult to provide really effective training in evidence-based therapies (in the main, CBT) for Australian rural and remote health professionals. The recent development of online CBT training provides new opportunities. Online training, supplemented by regular supervision, can fulfil many of the functions of face-to-face training at significantly reduced cost. While face-to-face residential workshops will still be necessary to embed new skills, we estimate that online training can reduce the face-to-face time required by at least 50%. [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]

Objectives: The study aimed to evaluate the attitudes of patients and staff in relation to the potential benefits and risks of allowing psychiatric inpatients controlled access to personal electronic devices (PEDs), and to document a snapshot audit of practice within the mental health inpatient units of New South Wales, Australia.Methods: Psychiatric inpatients and staff at Royal North Shore Hospital's Mental Health inpatient units were surveyed, and an audit of the policies of the psychiatric inpatients of New South Wales was undertaken.Results: Access to PEDs is denied in 85% of New South Wales psychiatric inpatient units. While patients and staff appear to concur on the risks of access to PEDs and the need for risk assessment and rules, compared to patients, staff appear to underestimate the importance of PEDs to maintaining social connection and recovery.Conclusions: This study may assist in the formulation of local policy and procedure to allow a more recovery-oriented approach to the question of whether patients should have access to their PEDs while in hospital. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to demonstrate the benefits of collaboration between Australia and Kiribati, a Pacific island nation, to enhance Kiribati's mental health system.Method: The collaboration involved a training program for a Kiribati senior mental health leader in Melbourne, Australia, and service planning including prioritisation of key areas for development.Results: As well as receiving general training in community-based mental health, the Kiribati mental health leader gained skills in modification of the inpatient environment, with plans for implementation in Kiribati within the current limited resources. Future planning will focus on shifting from an emphasis on acute psychiatric treatment and custodial care to a recovery-oriented approach.Conclusion: The international exchange was a positive experience for both the Kiribati participants and their Australian colleagues. Knowledge transfer was achieved in a short time, and service development appropriate and realistic for the Kiribati environment was planned. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to disseminate advice imparted to early career psychiatrists by a panel of senior colleagues at a Royal Australian and New Zealand College of Psychiatrists symposium, reflecting on things they wished they had known at the earlier stage in their careers.Methods: Key themes were extracted from notes taken at the symposium, where opinions were expressed by three senior psychiatrists.Results: There are components in building a sustainable career as a psychiatrist, which include considering one's work environment and relationships with colleagues; self-care, mentorship and reflective practice; and seeking opportunities to teach and research for career progression.Conclusions: The mentorship and advice from senior colleagues can be highly influential. In order to sustain a career that has reward, meaning and longevity, psychiatrists would do well to pay attention to aspects of self-care, stay connected to their loved ones, seek an optimal work-life balance and take an interest in their long term career plans. [ABSTRACT FROM AUTHOR]

Henry et al.[1] propose a model that can be adopted to assist trainees and their supervisors in managing this profoundly distressing event. Russel Davies Sydney, NSW References 1 Henry J. The development of patient suicide post-vention guidelines for psychiatry trainees and supervisors. The basic tenets of the model can be extrapolated from trainees to consultants and those in other substantive non-training positions. [Extracted from the article]

The article discusses the background and objectives of the Mental Health Professionals' Association (MHPA), which was convened in early 2006 by the Royal Australian and New Zealand College of Psychiatrists. It was made up of interdisciplinary health professionals in mental health care to advocate for and advise on effective mental health reform. Furthermore, the paper introduces the objectives of the association's Mental Health Interdisciplinary Network (MHIN) project.

The article presents the message of the president of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) on the importance of actively working to develop international relationships and understanding. A key step towards this goal will be the World Psychiatric Association international congress on November 28 to December 2, 2007 in Melbourne, Victoria.

Presents accounts of the social aspects of suicide. Views regarding the prevention of suicide cases by mental health professionals; Problem with overstating the existence of mental illness in suicide; Details of lay press reports of suicide cases in various countries.