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Objectives: Demand for places in postgraduate psychiatry training programmes has increased over recent years. All systems have capacity limits, and concerns have been raised regarding the sustainability of the current intake. This paper presents a modelling exercise to exploring the presence and strategies to resolve bottleneck in the Queensland training programme. Methods: Mathematical modelling based on the RANZCP training regulations and the characteristics of the accredited training programme. Results: A training bottleneck was identified which has been impacted by increased training intake, demand for Advanced Training certificates, and location factors. Conclusions: This investigation raises important questions regarding the future management of postgraduate training in psychiatry in Queensland that may be applicable more widely across Australia and New Zealand. In particular, it highlights the large impact that can result from even small incremental increases in trainees across varying levels of the postgraduate programme and the importance of limiting trainee intake in a manner proportional to the availability of mandatory terms. [ABSTRACT FROM AUTHOR]

Objectives:: The study describes the implementation and adaptation of a brief intervention model as routine clinical practice in an acute care service.Methods:: An action research process informed the evaluation and design of the intervention.Results:: The model's theoretical framework enhanced clinical practice and benefited consumers, though it was too rigid to be implemented in an acute care setting, so was adapted to suit this environment.Conclusions:: This paper highlights the value in realigning practice with fundamental engagement principles to improve practice outcomes. [ABSTRACT FROM AUTHOR]

Objective The aim of the current paper is to analyse time trends of non-fatal suicidal behaviour (NFSB) and its repetition at the Gold Coast in 2005-2015. Methods Data on presentations for NFSB were obtained from the Emergency Department (ED) Information System. Potential cases were identified through keyword searches, which were further scrutinised and coded. Annual person-based age-standardised rates for NFSB were calculated. Chi-square test, Poisson regression and Cox proportional hazards regression were used.Results: There was a significant increase in the age-standardised rates of NFSB for males (incidence Rate Ratio = 1.05; 95% confidence interval (CI): 1.04-1.07) and females (iRR = 1.06; 95% CI: 1.04-1.07). Age-specific rates showed significant increases for all age groups, except 25-34 and 55+ for females. Different types of poisoning were the predominant method of NFSB (poisoning only - 61.7% of episodes), followed by cutting (23%). Within the first year after the index episode, 13.4% of subjects repeated NFSB. Multivariate Cox regression model showed that sex, age and method predicted repetition.Conclusion: The increasing trends of NFSB and relatively high repetition rates emphasise the need for preventative actions. Monitoring of NFSB at the ED level should be further extended in Australia. [ABSTRACT FROM AUTHOR]

Objective: To describe the processes undertaken to maximise cultural competence in a complex research project and illustrate how this enhanced the quality of the research and impact of the research outcomes.Methods: An epidemiological survey of the mental health of Indigenous people in custody in Queensland was conducted using culturally informed research processes.Results: The research process that enhanced cultural competence is described. The research outcomes were positive in terms of participant and community experiences, participation rates, publications and other research outputs, capacity building and translation of research findings.Conclusions: This paper describes in practical terms how to conduct culturally informed research and how this approach enhanced the scientific rigour of a complex Indigenous health research project. Indigenous health research should be conducted using a culturally competent method. [ABSTRACT FROM AUTHOR]

Objective: This paper describes my experience as a psychiatric registrar working with indigenous communities in a remote setting in Far North Queensland. Conclusions: Working in a remote environment provided an insight into how to engage culturally diverse Indigenous communities and an invaluable training experience. [ABSTRACT FROM AUTHOR]

Objective: This paper describes the development of a collaborative group of mental health clinicians who have come together to improve practice in adult acute mental health settings for the inpatient management of schizophrenia. Method: Sixteen acute adult mental health inpatient services across Queensland worked together to develop clinical indicators related to the inpatient treatment of schizophrenia. Data collection was conducted by using information available on existing databases and through statewide chart audits using scannable form technology. Through a secure intranet site, and statewide forums, clinicians were able to access information on clinical indicators enabling them to compare their site data to peer and state data. Results: Available data from 15 of the 16 sites provided information on clinical indicators including average length of stay, 28-day readmission rates, antipsychotic prescribing, medication dose and the use of multiple antipsychotic medications at discharge. Conclusions: The formation of the Mental Health Clinical Collaborative has brought together clinicians across the State to develop clinical indicators and openly discuss ideas to inform and improve clinical practice. This process has been effective in improving the quality of routinely collected information across the State and in engaging clinicians in using health information to drive clinical practice. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to describe the Eating Disorders Outreach Service (EDOS), which supports clinicians in the treatment and management of eating disorder patients across Queensland. EDOS’s mandate is to facilitate intake to the specialist inpatient and outpatient services at the Royal Brisbane and Women’s Hospital (RBWH) and to provide eating disorders education and consultation liaison to clinicians statewide. Method: EDOS provides services in four key areas: intake facilitation, service development, education and training, and consultation liaison. Each area is described in detail. Results: EDOS has grown since its inception to currently comprise a full-time team manager and a number of specialist clinician positions in psychiatry, nursing, dietetics, social work and psychology. The Service has become an integral part of the RBWH Adult Eating Disorders Service, providing statewide assessment and treatment recommendations, consultation liaison services and specialist intervention programs. Conclusions: EDOS has been successful in facilitating patient access to local general medical and psychiatric facilities. EDOS also plays a significant leadership role in the development of effective statewide networking forums for clinicians and key stakeholders, in inservice delivery and in the provision of evidence-based educational opportunities, each of which has contributed to improved access to services for eating disorder patients. [ABSTRACT FROM AUTHOR]

Objectives: To describe the development of the first Australian psychiatric emergency centre co-located with the Emergency Department at the Royal Brisbane and Women's Hospital. This paper covers the current operational model, significant partnerships and benefits of this service, which assesses and treats over 7200 presentations per year. Conclusions: The co-location of the Psychiatric Emergency Centre and Emergency Department has created a unique model of service delivery and effective working relationships between the two services. The model improves clinical care providing multiple benefits for patients and the Emergency Department by means of direct access to specialized mental health staff, early mental health responsibility for patients and reduced access block. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to analyse the reasons for a major increase in expenditure on inpatient pharmaceutical costs over a two year period and to describe strategies developed to prevent further increases. Conclusions: By educating our medical staff on the costs of the most commonly prescribed medications and favouring cost effective medications such as risperidone over olanzapine we have been able to contain our inpatient drug costs and achieve a 14% reduction this financial year. [ABSTRACT FROM AUTHOR]

Objective: This paper describes the background to, implementation of and evaluation challenges associated with an innovative, arts-based, wellbeing and mental health recovery project in a remote Indigenous setting. Results: Creative Recovery is a community-based arts initiative for Indigenous people with mental health problems. It has been rolled out as a pilot project in a remote Cape York community and is aimed at promoting wellbeing and recovery. The theoretical basis for the initiative is modelled on ideas of the role that social capital plays in improving mental health. This involves both the beneficial impact community participation and the social cohesion it creates can have, not only on an individual's mental health, but also on the social and emotional wellbeing of the communities they are part of. Such initiatives have already been adopted as an integral part of mental health promotion in countries such as the UK, and in other Australian states such as Victoria and Western Australia. The following paper will locate Creative Recovery in the current field of mental health promotion theory and Indigenous social and emotional wellbeing, and will discuss some of the evidence for and challenges inherent in adopting such initiatives. [ABSTRACT FROM AUTHOR]

Objectives: This paper describes the challenges in implementing an innovative arts-based mental health project in a remote Indigenous community. Method: The author (the Art Centre Manager) presents a personal narrative of the development of the Aurukun Creative Livelihoods project. Results: A partnership between an existing arts and mental health project (Creative Recovery) and the Wik and Kugu Arts and Craft Centre is described. This collaboration aims to enhance the emotional and social wellbeing of vulnerable Aboriginal people in a remote Indigenous community in Cape York - Aurukun. [ABSTRACT FROM AUTHOR]

Introduction: The Australian Government has provided $20 million to establish the Population Health Research Network (PHRN), with representation from all States and Territories to facilitate population health research through data linkage. Health LinQ is part of the Queensland node involving four Queensland universities, Queensland Health and the Australian e-Health Research Centre. Method: This paper reviews the potential for using administrative databases to study the mental health experience of Indigenous Queenslanders. Researchers can define cohorts for study within the administrative data or link them to their own data. Robust protocols preserve confidentiality so that researchers only receive anonymized data. Indigenous status can be defined either through place of residence or through the recording of Indigenous status in datasets such as the Queensland Hospital Admitted Patient Data Collection. Results: Available data include hospital morbidity, mental health data and mortality. Indigenous status is correctly identified in about 89% of cases with variation by definition used. Conclusions: Administrative data provide researchers and decision makers with accessible, cost-effective information without the intrusion and cost of additional data collection. These techniques are especially useful in studying regional, rural and remote populations where access may be difficult. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to overview the history, structure and activities of the Queensland Mental Health Review Tribunal in relation to Indigenous patients. Results: The Mental Health Review Tribunal is an independent statutory body established under the Mental Health Act 2000 (MHA2000) to safeguard the rights of patients receiving involuntary treatment under the Queensland MHA2000. In the period from when the Tribunal commenced in 2002 to end of June 2008, people of Aboriginal and Torres Strait Islander background represent 2.3% of all patient registrations with the Tribunal. The Tribunal has established a range of strategies to encourage Aboriginal and Torres Strait Islander patients to attend and participate in their hearing. This includes widening the Tribunal's body of knowledge, strategies to inform patients about the Tribunal, culturally sensitive hearing practices, and widening the circle of participation in the hearing. Conclusions The future direction for the Tribunal in this strategy will be influenced by more formal evaluation of the outcomes and by further development of a model for the provision of cultural advice. [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]

This project focuses upon the use of jam2jam, a generative computer system, to increase access to improvization experiences for children and to facilitate new kinds of relationships with artists. The network jamming system uses visual and audio cultural materials to enable communities to be expressive with artistic materials that they value as a community. As the system is part of a network, performances can be shared between communities at great distances and recordings of performances can be uploaded to a digital social network () and shared both locally and with the wider community. This paper examines a preliminary project where artwork made by Indigenous mental health clients in Far North Queensland was digitized and given to a group of 8–12-year-old urban Indigenous children to ‘improvize’ with and make music/video clips using the jam2jam instrument. It seeks to generate a discussion and identify applications within creative arts-led community health settings to facilitate new kinds of relationships with self, peers, local community, culture and artists through collaborative improvization. [ABSTRACT FROM AUTHOR]

Art therapy encompasses both preventative and curative activities and aims to improve ways of engaging those who might be reticent in seeking more traditional forms of psychological support offered through ‘talking therapies’. The Longreach base of the Royal Flying Doctor Service in Queensland provides mental health support to people living in rural and remote locations in central western Queensland and has been complemented since 2006 by the addition of a full-time art therapist. This paper provides an overview of art therapy and a description of this innovative approach to addressing mental health needs in a rural and remote setting. [ABSTRACT FROM AUTHOR]