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Objectives: As mental health services move towards implementing 'Trauma-informed care', there is a need to consider the challenges posed within services and systems. This paper raises some of the challenges associated with integrating TIC into the current public mental health system.. Conclusion: The lack of clarity about expectations of trauma-informed approaches causes difficulties for its integration into services, but the wider political context of mental health services is also of relevance. Transparent and ongoing debate is required about approaches to mental health care, to ensure the system meets the needs of those who require it, while questioning what other purposes it may be serving at social and political levels. [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]

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]

Objective: Historically, people living with mental illness have had limited chance to participate in mental health services other than as patients. This has led to serious negative consequences for their health and wellbeing. Recent public policy has aimed at redressing this situation. This paper sets out to investigate the 'state of play' regarding consumer participation in mental health services. Conclusions: Consumer participation is not a common topic in the recent literature, despite the significant public policy push to promote it. Although the vision of public policy is for consumers to be at the centre of decision making, the changes are understandably slow in coming. The implications for the practice of psychiatry, and therefore mental health services, of the demands for meaningful participation are profound. They challenge some of the social covenants under which mental health services have historically been delivered. Traditionally, people living with a mental illness have not had their rights respected. In recent times, the College has developed policies that aim to ensure that the rights of people living with a mental disorder are respected. These policies also acknowledge that effective health care requires collaboration with consumers. [ABSTRACT FROM AUTHOR]

Objectives: The present paper aims to: (i) describe how the Mental Health Commission in New Zealand works and has contributed to the substantial enhancement of mental health resources and services; (ii) determine whether mental health reform policies will ever be implemented properly without an independent monitor with official influence at the highest levels of government; and (iii) demonstrate how variants on this model work in other Western countries and how it can be adapted to the Federated system in Australia.Conclusions: It is recommended that the Australian National Mental Health Plan 2003-2008 should be complemented by a long-standing national mental health commission (or similarly constituted body), which is also able to report independently from and to the government, with direct access to the Prime Minister, Premiers and Australian Health Ministers. Its aims would be to monitor service effectiveness and identify gaps in service provision, training and performance of the work force, management and government. It would be informed by consumer, carer and provider experience, and by reviews of evidence-based research regarding health needs and cost-effective services. It should accurately cost such service gaps, and advise government on a strategy for implementing them. It could also promote and advise formally on enhancing community awareness, decreasing stigma and discrimination and improving workforce recruitment and retention. [ABSTRACT FROM AUTHOR]

Background: Socioeconomic trends herald what many describe as the Asian Century, whereby Asian economic, political and cultural influence is in global ascendency. Broadening relevant ties between Australia and Asia is evident and logical and may include strengthening alliances in mental health systems. Aim: We argue the importance of strengthening Asian mental health systems and some of the roles Australian mental health workers could have in promoting strengthening the Asian mental health system. Methods: This paper is a narrative review which sources data from reputable search databases. Results: A well-articulated Australian strategy to support strengthening the mental health system in Asia is lacking. While there are active initiatives operating in this space, these remain fragmented and underdeveloped. Coordinated, collaborative and culturally respectful efforts to enhance health education, research, policy, leadership and development assistance are key opportunities. Conclusion: Psychiatrists and other mental health professionals have a unique opportunity to contribute to improved mental health outcomes in Asia. [ABSTRACT FROM AUTHOR]

Objective: To report on economic studies of Australian mental health issues. Conclusion: Although the international literature on the economics of mental health issues is increasing, and although many Australian studies exist on one comorbid condition of mental illness, namely substance abuse, there are very few empirical studies by economists of Australia’s mental health issues. [ABSTRACT FROM AUTHOR]

COVID-19 may threaten the already poor mental health outcomes of Australian gay and bisexual men and cut ties to important social/sexual networks and community. Qualitative research into the experiences of gay and bisexual men during COVID-19 regulations is currently sparse. We report on 489 responses to a qualitative free-text question asking Australian gay and bisexual men about the impacts of COVID-19 during April 2020. Issues pertinent to gay and bisexual men include lost ties to gay and bisexual social/sexual communities, spaces, and activities, which can reduce a sense of belonging to important sexual identity spaces, as well as significant mental well-being vulnerabilities. Reminiscing the collective response to HIV/AIDS, findings reinforce the value of gay and bisexual community organizations, spaces, and networks as supports for gay and bisexual men and emphasize the need for delivering mental health services. [ABSTRACT FROM AUTHOR]

Objectives: As mental health services increasingly position themselves as providing 'trauma-informed care', there is a need for ongoing critical reflection on the challenges that this movement highlights for mental health services, including those related to the concept of trauma itself. Conclusions: To become trauma-informed requires opportunities to reflect on what trauma means and consideration of the challenges the concept poses to diagnostically driven systems. Alongside uptake, further debate is required. [ABSTRACT FROM AUTHOR]

Objective:: The objective of this study was to present an assessment of Australia's mental health system performance, within its social context, by comparison with other countries.Method:: A review of existing literature and databases from both Australia and overseas was undertaken. Systems permitting international comparison of mental health and its social context are few. The review is limited in scope.Results:: Although Australia was one of the first nations to develop and adopt a national mental health policy (in 1992), the data that are available suggest that we are not World leaders across the identified domains.Conclusions:: While international benchmarking can play an important role in fostering quality improvement, there are only limited mental health or social system performance data sources to utilise. It would be desirable for a more systematic international process to be established to review existing approaches and design a new multilateral strategy. It would be important that this new strategy reflected the full experience of mental health and its broader social context. [ABSTRACT FROM AUTHOR]

There are disproportionately higher and inconsistently distributed rates of recorded suicides in rural areas. Patterns of rural suicide are well documented, but they remain poorly understood. Geographic variations in physical and mental health can be understood through the combination of compositional, contextual, and collective factors pertaining to particular places. The aim of this study was to explore the role of “place” contributing to suicide rates in rural communities. Seventeen mental health professionals participated in semi-structured in-depth interviews. Principles of grounded theory were used to guide the analysis. Compositional themes were demographics and perceived mental health issues; contextual themes were physical environment, employment, housing, and mental health services; and collective themes were town identity, community values, social cohesion, perceptions of safety, and attitudes to mental illness. It is proposed that connectedness may be the underlying mechanism by which compositional, contextual, and collective factors influence mental health and well-being in rural communities. [ABSTRACT FROM AUTHOR]

The article features the E-Mental Health Service for Young People Living With Cancer (YPLWC) service in Australia developed by CanTeen. Topics discussed include the service's purpose, outcome and value, the high incidence of mental illness in young people, statistical data on the number of young people suffering from cancer. Also discussed are cancer-related services offered through the Internet, teleconferencing and telephone counselling.

The article focuses on a study which explores the growth of a regionally-based mental health personnel offering services to remote Indigenous communities in north Queensland. It presents several factors that support the development and sustained capacity of integrated mental health groups. An overview of the concept of remote area mental health service is provided.

Objective: To describe the progress and achievements of the psychiatric services developed by the Medical Specialist Outreach Assistance Programme in South Australia over the last 2 years. There is a particular focus on services provided to the remote areas of the far northern region of South Australia.Conclusion: During this period there has been an expansion of visiting psychiatric services to South Australia's rural and remote communities. In particular, child and Indigenous services have improved considerably. These have been important developments and it is hoped that funding and services will continue after the June 2004 conclusion of the Medical Specialist Outreach Assistance Programme. [ABSTRACT FROM AUTHOR]