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Aims and objectives: The aim of the current study is to explore whether and how the expectations of consumers to be “representative” influences consumers’ ability to contribute to health services partnerships. Background: Health standards call for services to partner with consumers in service development and governance. While existing research criticises the assumption that individual mental health consumers working with mental health services must be representative of consumers more broadly, research has yet to explore whether this requirement exists for consumers of other health services. Requiring individual consumers to be representative of consumers more broadly marginalises and limits consumer involvement. Design: A qualitative, exploratory design was employed. Methods: Consumers (n = 6), clinicians (n = 7) and health managers (n = 5) were interviewed about consumer participation in health services. Data analysis was conducted through the lens of social exchange theory and informed by discursive psychological principles. Results: The current study extends the existing literature within mental health, finding that consumers of other health services are also held responsible for representing broader communities. Data also suggested that a requirement to be representative would marginalise consumers with a passion to bring about change in health systems. Conclusions: The findings suggest that organisations might need a culture change so that individual consumers are not expected to be representative of consumers more broadly and that participation be made more accessible for diverse groups of consumers. Relevance to clinical practice: Given the role that nurses might play as allies to consumers within health services, the findings of this study contribute to knowledge about the expectations placed on consumers and the ways that nurses might advocate for better partnerships. [ABSTRACT FROM AUTHOR]

Aims and Objectives To elicit the perspectives of carers of people with mental illness regarding access to, and experience with, physical healthcare services for mental health consumers. Background People diagnosed with mental illness have increased risks of physical illness and earlier death, problems able to be addressed through better physical health services. Carers of people with mental illness play a significant role in the mental healthcare system yet research examining their views is lacking. Design Qualitative exploratory. Methods In-depth interviews were conducted with 13 mental health carers. They were asked to describe their views and experiences pertaining to the physical health and availability of physical health care for the people they care for. Data were analysed using the framework of Braun and Clarke. Results Analysis of carer responses identified two important themes: responsiveness and access, and a shortage of care coordination. Carers felt alienated from physical healthcare providers and were compelled to fill gaps in available care through persistence in ensuring access to physical healthcare services. Conclusions The findings identify carers as key stakeholders in the physical health care for the people they care for. Their involvement in accessing and coordinating care provides vital perspective on health service capacity, which requires further consideration in the practice and research domains. Relevance to clinical practice Carers of people diagnosed with mental illness are crucial to the effective delivery of mental health services. Their perspectives must be central to their research agenda and contribute to the development of initiatives to improve clinical practice and promote improved physical health care. [ABSTRACT FROM AUTHOR]

Aims and objectives To ascertain the views and experiences of mental health consumers regarding the availability and quality of care and treatment received for their physical health needs. Background People diagnosed with mental illness have higher occurrence of physical health problems. Responsive health care services are crucial for prevention and management of physical health problems, and for reducing disparities in health between people diagnosed with mental illness and those who are not. There is limited research giving voice to consumer perspectives on their experiences with health care providers. Design Exploratory qualitative. Methods Focus group interviews with mental health consumers accessed via a consumer network group in a region of Australia ( n = 31). All interview audio recordings were transcribed professionally. Interviews were thematically analysed. Results The main themes were: symptomising; failure to act and alertness to prejudice. The first two themes were consumer perceptions of the actions and behaviours of health professionals, and the third describes consumer responses to these behaviours and actions. Consumers described increased risks of illness and death because of undiagnosed physical illness despite their physical health advice-seeking as the reason for the health consultation. Conclusion Health care providers' non-recognition of physical health problems presents a clear example of a significant and potentially life threatening health inequity. The service provider responses described by participants suggest that mental health consumers' physical health needs may not be taken seriously. Relevance to clinical practice Clinicians need to take seriously the physical health needs and concerns of people with mental illness. Nurses can play a crucial role in the prevention of diagnostic overshadowing as part of a broader direction of balancing biomedical perspectives with other approaches to health care. [ABSTRACT FROM AUTHOR]

Aims and Objectives. To explore factors impacting on the feasibility of academic and educator roles for consumers of mental health services. The supports required to facilitate these roles from the perspectives of mental health nurse academics and consumer educators/academics will also be explored. Background. Involving consumers in the education of health professionals is becoming more common. Frequently this strategy is viewed as important to influence the attitudes of health professionals towards consumer participation in mental health services. There remains a paucity of research about these roles and the factors which promote and support their feasibility. Design. Qualitative exploratory. Method. In-depth telephone interviews were undertaken with 34 nurse academics and 12 consumer educators or academics. Participants included nurse academics coordinating undergraduate and postgraduate mental health subjects, and consumer academics and educators involved in teaching mental health nursing components. Interviews were 20 - 45 minutes in duration. Data were analysed thematically. Results. Four subthemes were identified under the broad theme of feasibility and support: Reliability, support, vulnerability and seen to be griping. Conclusions. Significant barriers were identified by nurses and consumers to effective consumer involvement, largely reflecting the impact of mental health challenges. Despite this, there was little evidence of structured support being available to enhance the viability of these positions. Relevance to clinical practice. Involving consumers in the education of health professionals through teaching, curriculum development, assessment and evaluation, is likely to enhance consumer participation in mental health services and ultimately improve service delivery. This involvement needs to be genuine to be effective. Consumers are often viewed as unreliable, vulnerable and using education to voice their own negative experiences. These issues and lack of support provided pose major barriers to successful roles, strategies to overcome barriers and maximise the effectiveness of roles require investigation and implementation. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify nurse perceptions on the potential value of general and specific nursing approaches to improving physical health outcomes of people with serious mental illness. Background People diagnosed with serious mental illnesses experience heightened rates of physical illnesses and can be supported better via healthcare system prevention and management. Nurses working in mental health are a critical part of a system-wide approach to improving physical health care, but there is little known on their views on specific approaches within Australia (e.g. screening for risks, stigma reduction). Design A national, cross-sectional and nonrandom survey study delivered online. Methods Members of the Australian College of Mental Health Nurses ( n = 643), representing nurses employed in mental healthcare services across Australia (71·6% from public mental health services). Participants were asked to rate the potential of nine nurse-based strategies for improving physical health (options: 'yes', 'no', 'not sure') and the potential value of 10 nursing and general strategies for improving physical health (rating from 'negative value' to 'significant value'). Results There was a high endorsement of all nine nurse-based strategies for physical health (e.g. lifestyle programmes, screening, linking services), although there was less support for reducing antipsychotics or advocating for fewer side effects. Participants mainly viewed all strategies as of moderate to significant value, with the most promising value attached to colocation of primary and mental care services, lifestyle programmes and improving primary care services (reduce stigma, train GPs). Conclusions Australian nurses working in mental health services view a range of nurse-based strategies for improving physical healthcare services and standards as important. Relevance to clinical practice Nurses collectively need to work with consumers, health agencies and the general public to further define how to organise and implement physical health integration strategies, towards more comprehensive health care of people with serious mental illness. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore nurses' views on the role of nurses in screening and monitoring for physical care of consumers with serious mental illness, at a regional mental health care service. Background People with serious mental illness experience heightened incidence of preventable and treatable physical illnesses such as cardiovascular disease and diabetes. Screening and monitoring are considered universal clinical safeguards. Nurses can potentially facilitate systematic screening, but their views on physical health care practices are rarely investigated. Design Qualitative exploratory study. Method Focus group interviews with 38 nurses of a regional mental health care service district of Australia. To facilitate discussion, participants were presented with a screening system, called the Health Improvement Profile ( HIP), as an exemplar of screening of physical health risks by nurses. Inductive data analysis and theme development were guided by a thematic analysis framework. Results Nurses argued that treatable and preventable physical health problems were common. Four main themes were identified: screening - essential for good practice; the policy-practice gap; 'screening then what?' and, is HIP the answer? Screening and monitoring were considered crucial to proper diagnosis and treatment, however, were not performed systematically or consistently. Nurse readiness for an enhanced role in screening was shaped by: role and responsibility issues, legal liability concerns, funding and staff shortages. Participants were concerned that lack of follow up would limit effectiveness of these interventions. Conclusions Screening was considered an important clinical step in effective diagnosis and treatment; however, identified barriers need to be addressed to ensure screening is part of a systemic approach to improve physical health of consumers with serious mental illness. Relevance to clinical practice Nurses have potential to influence improvement in physical health outcomes for consumers of mental health services. Such potential can only be realised if a systematic approach to physical health care is taken. [ABSTRACT FROM AUTHOR]

Aim. To determine effectiveness of clinical placements in non-mental health facilities in producing improvement in attitudes toward people with a mental illness and toward mental health nursing in nursing students. Background. Clinical placements in mental health settings have favourably impacted students' attitudes and confidence in mental health settings. Placement shortages have created discussion about using non-mental health settings to gain this experience, as mental illness is common in all health settings. To date, no research findings support or refute the efficacy of non-mental health settings in influencing confidence and attitudes. Design. A within-subject design was used. Participants provided self-report data soon after the beginning and at the conclusion of the mental health component. Methods. A questionnaire was administered to a cohort of undergraduate nursing students ( n = 66) to measure attitudes, preparedness for practice and interest in mental health nursing as a career, using a pre- and post-test design. Results. Only 25% of participants completed clinical experience in a mental health facility. Minor improvement in attitudes, confidence and appreciating the nursing role in mental health were identified, but the impact on attitudes was considerably less favourable than when clinical experience was undertaken in a mental health facility. Conclusion. Participants who completed clinical experience in a non-mental health facility did not demonstrate more favourable views about mental health nursing. Relevance to clinical practice. Clinical placements in mental health are essential preparation for undergraduate students to maximise improvement in attitudes to the care of people diagnosed with a mental illness and to mental health nursing. [ABSTRACT FROM AUTHOR]