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Objectives: This paper reports a pilot study exploring the benefits of offering sensory modulation within a mental health emergency setting for consumers experiencing distress during a psychiatric presentation.Methods: Seventy-four consumers with a mental health presentation reported on their sensory modulation use experiences during their stay in a South Australian tertiary teaching hospital emergency department. An evaluation form was used to document use of items, self-reported distress pre and post sensory modulation use, and other consumer experiences.Results: Consumers used between one and six sensory items for a median duration of 45 min. There was a statistically significant reduction ( t(73) = 15.83, p < .001) in self-reported distress post sensory modulation use, and consumers also reported that use was helpful, distracting, calming and assisted in managing negative emotions and thoughts.Conclusions: The results demonstrate the potential value of sensory-based interventions in reducing behavioural and emotional dysregulation in an emergency setting whilst also promoting consumer self-management strategies. [ABSTRACT FROM AUTHOR]

Objectives: Reducing or eliminating seclusion from mental health care settings has been a national priority for Australia since 2005. This paper describes Australia's national seclusion data collection, and summarises changes in seclusion rates in Australian public mental health services.Methods: Seclusion events per 1000 patient days were calculated from 2009-2010 to 2014-2015 utilising state and territory administrative data sources. Combined national data were used to calculate results for a number of service characteristics, such as target population and location of the service.Results: The rate of seclusion events decreased by 43% over the 6 years. Child and adolescent services reported consistently higher rates of seclusion, but a shorter duration of seclusion episodes, compared with other service types. There is high variation in seclusion rates between individual services (range 0.0-53.0 seclusion events per 1000 bed days in 2014-2015).Conclusions: Seclusion event rates in Australia's specialised public acute mental health hospital services are declining. The use of existing administrative data was instrumental in establishing a national data source to facilitate the monitoring and reporting of progress of seclusion reduction strategies. [ABSTRACT FROM AUTHOR]

There is a need for qualitative studies on motherhood and mental distress. Many mothers have a diagnosis of mental illness, and their motherhood exists in constant tension with their distress. This paper focuses on 10 mothers’ stories about motherhood in relation to being admitted as mental health service users in three different Norwegian community mental health centers. The study has a narrative approach, and through a thematic analysis of personal stories, we emphasize how the 10 women make sense of their experiences of admittance to mental health services in relation to dominant Discourses of good motherhood. Themes identified were: (1) being able to put oneself in the child’s shoes; (2) the emotional impact of being admitted; (3) being open with the children about the admission; and (4) being an emotionally available and present mother. Based on the results of our analysis, we suggest the mothers experienced their distress as a natural reaction to life strains over time, and that they relate to the admissions as interruptions. This underlines the necessity of a more holistic approach, with a support system that focuses on both personal and social aspects of motherhood and mental distress. [ABSTRACT FROM AUTHOR]

This paper presents a case study that illuminates the clinical and practical challenges that accompany the treatment of people with serious mental illness (SMI) and criminal involvement. We discuss the historical conditions that led to the influx of a large number of people with SMI into the criminal justice system. We discuss the case history of Richard P., which illustrates the use of Assertive Community Treatment (ACT) to care for criminally involved people with SMI. We focus on the ACT model that was employed by Thresholds to treat Richard P. It was known as the Thresholds Jail Program. We track his progress in the program and explicate the case management considerations that are most salient in treating offenders with SMI. [ABSTRACT FROM AUTHOR]

Objectives: Australian research has identified that there are significant variations between service providers in terms of clinical management of patients with comparable presenting problems. Internal audits within the facility at Royal Brisbane and Women's Hospital revealed that these variations occurred between wards, treating teams and psychiatric consultants. Given the increasing emphasis on evidence-based practice, it was decided that the literature should be reviewed to determine what the standard of care should be. The paper then examines how clinical pathways for psychosis and for depression were developed and how they eventually evolved into an acute inpatient pathway. It identifies the framework used and examines important aspects relating to the adaptation of these frameworks to mental health issues. The process for the development and implementation of the clinical pathway is discussed. Recommendations for their future use in a mental health setting are also presented.Conclusions: Mental Health care is complex. For this reason, mental health clinical pathways have to remain flexible and innovative. With the present project, it was found that the pathways were not suited for specific diagnoses so that they evolved into a single acute inpatient pathway. [ABSTRACT FROM AUTHOR]

Objectives: This paper reports results from the evaluation of a cultural consultation service (CCS) for mental health practitioners and primary care clinicians. The service was designed to improve the delivery of mental health services in mainstream settings for a culturally diverse urban population including immigrants, refugees, and ethnocultural minority groups. Cultural consultations were based on an expanded version of the DSM-IV cultural formulation and made use of cultural consultants and culture brokers. Methods: We documented the service development process through participant observation. We systematically evaluated the first 100 cases referred to the service to establish the reasons for consultation, the types of cultural formulations and recommendations, and the consultation outcome in terms of the referring clinician's satisfaction and recommendation concordance. Results: Cases seen by the CCS clearly demonstrated the impact of cultural misunderstandings: incomplete assessments, incorrect diagnoses, inadequate or inappropriate treatment, and failed treatment alliances. Clinicians referring patients to the service reported high rates of satisfaction with the consultations, but many indicated a need for long-term follow-up. Conclusion: The cultural consultation model effectively supplements existing services to improve diagnostic assessment and treatment for a culturally diverse urban population. Clinicians need training in working with interpreters and culture brokers. [ABSTRACT FROM AUTHOR]

Objective: The primary aim was to examine differences in functional health outcomes in consumers entering a regional mental health service compared with a city service.Method: A retrospective analysis of consumer outcomes and characteristics was undertaken. Consumer demographics and diagnoses were compared between the two services. Functional outcomes were measured using the 16-item Life Skills Profile (LSP-16). The data analysis plan utilised descriptive statistics. For between-clinic comparisons, relevant inferential statistics was used.Results: Patients attending the regional health service were five times more likely to be in the high impairment category on the LSP-16, independent of demographic factors and diagnosis. Other independent contributions to high impairment were being male, Indigenous and a diagnosis of schizophrenia. Of the four LSP-16 subscales, regional consumers scored relatively higher on withdrawal, compliance and anti-social but not self-care subscales.Conclusions: There was a greater level of functional impairment in consumers attending the regional service. The independent contributions did not explain the higher impairment; therefore, other factors such as socioeconomic disadvantage may explain the difference. Regional clinicians may need to consider recovery-orientated interventions that address a greater burden of functional impairments in regional services. [ABSTRACT FROM AUTHOR]

Using a lens of structuration theory, this study highlights the ways that specific structures within the current community-based model of mental health care might enable and constrain individuals and families living with mental illness. Through a case study of a volunteer mental illness advocacy group, the authors employed a duality analysis on a variety of data collected from the case (i.e., interviews, organizational documents, and community health care data). Findings indicate that while group members encountered structural barriers to their organizational mission, they also used communicative agency creatively and collectively to (re)create structures within the current community-based model of mental health care. Member agency is examined in relation to perceived structural influence. Theoretical and practical applications of the findings are discussed. [ABSTRACT FROM AUTHOR]

Objective: Several studies have shown a relationship between individual attachment and various aspects of treatment utilization in individuals with medical problems as well as mental health disorders. This review systematically evaluates existing literature targeting the relationship between attachment and all aspects of treatment utilization, such as engagement, participation, and completion, in adults with mental health problems.Method: A computerized search of PsycINFO, Medline, Embase, PubMed, and Healthstar and a manual search were employed. Of 5733 titles, 105 abstracts were selected. Of these, 18 studies met full inclusion criteria. The quality of studies was evaluated and scored according to 9 characteristics.Results: Most studies supported an association between attachment and treatment engagement and participation. In general, attachment anxiety was associated with higher engagement and participation in services while attachment avoidance was associated with less. Data regarding attachment dimensions and treatment completion were less conclusive.Conclusions: The review suggests a clear relationship between attachment and stages of treatment engagement and participation in a variety of psychiatric populations and treatments. The 2 attachment dimensions appear to have opposite effects, with possible risks for either treatment over- or underutilization. Clinical implications are discussed. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To describe the impact on mental health and psychosocial wellbeing of the armed conflict that occurred in the Solomon Islands from 1998-2003 and the subsequent political unrest and natural disasters, and the developments in mental health services since 2003.Method: A literature and document review was conducted, supplemented by the written reflections of senior staff in the Solomon Islands Mental Health Service.Results: Conflict and natural disaster have had a significant impact on the mental health and functioning of individuals, families and communities. National health system reform has been accompanied by the reorientation of the mental health services from custodial care to care in the community and greater emphasis on mental health promotion and prevention. The dedication of the small group of Solomon Islands mental health professionals, supported by local health service managers and external donors, has been a major strength. However, they face significant challenges.Conclusions: Continued investment in mental health, including the treatment and prevention of mental and substance use disorders, is essential for mental health and development outcomes. All development stakeholders, including civil society, government, academic and research institutions, and development partners, have a role to play. [ABSTRACT FROM AUTHOR]

Objectives: This article reviews recent trends in the provision of psychiatric services to the emergency departments of tertiary hospitals in Australia, involving the establishment of specialised in-reach or liaison services as well as various forms of short stay unit attached to emergency departments. The Emergency Psychiatry Service at Flinders Medical Centre, South Australia, is described as a case example. Its specialised models of assessment and clinical care are described, highlighting how these are differentiated from more traditional models in inpatient, community and general hospital consultation-liaison psychiatry.Conclusions: Emergency psychiatry, and in particular the application of specialised psychiatric models of in-reach service and short stay units, is an increasingly important and growing field of psychiatry that warrants further exploration in research. The Emergency Psychiatry Service at Flinders Medical Centre has developed a distinct group of assessment and treatment approaches that exemplifies this growing field. [ABSTRACT FROM AUTHOR]

Multicultural advocates within professional psychology routinely call for "culturally competent" counseling interventions. Such advocates frequently cite and celebrate traditional healing practices as an important resource for developing novel integrative forms of psychotherapy that are distinctively tailored for diverse populations. Despite this interest, substantive descriptions of specific forms of traditional healing vis-à-vis psychotherapy have appeared infrequently in the psychology literature. This article explores the prospects for therapeutic integration between American Indian traditional healing and contemporary psychotherapy. Systematic elucidation of historical Gros Ventre healing tradition and Eduardo Duran's (2006) culture-specific psychotherapy for American Indians affords nuanced comparison of distinctive therapeutic paradigms. Such comparison reveals significant convergences as well as divergences between these therapeutic traditions, rendering integration efforts and their evaluation extremely complex. Multicultural professional psychology would benefit from collaborative efforts undertaken with community partners, as interventions developed in this manner are most likely to effectively integrate non-Western healing traditions and modern psychotherapy. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To identify and describe barriers to access to mental health services encountered by ethnoracial seniors.Method: A multiracial, multicultural, and multidisciplinary team including a community workgroup worked in partnership with seniors, families, and service providers in urban Toronto Chinese and Tamil communities to develop a broad, stratified sample of participants and to guide the study. This participatory, action-research project used qualitative methodology based on grounded theory to generate areas of inquiry. Each of 17 focus groups applied the same semistructured format and sequence of inquiry.Results: Key barriers to adequate care include inadequate numbers of trained and acceptable mental health workers, especially psychiatrists; limited awareness of mental disorders among all participants: limited understanding and capacity to negotiate the current system because of systemic barriers and lack of information; disturbance of family support structures; decline in individual self-worth; reliance on ethnospecific social agencies that are not designed or funded for formal mental health care; lack of services that combine ethnoracial, geriatric, and psychiatric care; inadequacy and unacceptability of interpreter services; reluctance of seniors and families to acknowledge mental health problems for fear of rejection and stigma; lack of appropriate professional responses; and inappropriate referral patterns.Conclusions: There is a clear need for more mental health workers from ethnic backgrounds, especially appropriately trained psychiatrists, and for upgrading the mental health service capacity of frontline agencies through training and core funding. Active community education programs are necessary to counter stigma and improve knowledge of mental disorders and available services. Mainstream services require acceptable and appropriate entry points. Mental health services need to be flexible enough to serve changing populations and to include services specific to ethnic groups, such as providing comprehensive care for seniors. [ABSTRACT FROM AUTHOR]

The author comments on an article which raised important issues on how to sustain the growth of specialized early psychosis intervention (EPI) in mental health care. The article focuses on the Prevention & Early Psychosis Intervention (PEPP) Program of London, Ontario, which discovered a significant number of EPI nonusers. The author also cites two challenges that the EPI program faces, including a gap in wellness/recovery-oriented planning and supports.