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• Good documentation practice is the foundation for promoting medication safety in young population. • Study identified poor documentation practice through paper and electronic means of medical records. • Newly introduced electronic medical records did not improve the rates of metabolic monitoring nor the quality of documented monitoring. • Youth are at significant risk for antipsychotic induced metabolic syndrome the repercussion of which may impact years of productivity. • Potentially electronic health records could provide health workers with real-time information access, and develop accurate, relevant and structured information thereby adhering to clinical evidence. Since the development of digital records, claims have been made that they improve audits. Clinical audits play important role in evaluation of evidence-practice gaps. Antipsychotic medications are one of the commonly prescribed group of drugs in severe adverse mental conditions. Youth and young people are highly prone to develop drug induced metabolic syndrome. Present study evaluated the extent of data documentation on evidence for metabolic monitoring of antipsychotics and compared paper based to electronic records with good documentation standards. First phase of this study involved a retrospective clinical audit of paper-based documentation on the extent of documentation of weight (primary outcome); lipid and blood glucose (secondary outcomes) of youth prescribed atypical antipsychotics. This was undertaken in three public mental health clinics and a public/private developmental service in Australia based on paper-based documentation. The second phase included auditing electronic data capture from one community clinic. Evidence of documentation was compared with practice standards and published clinical audits (adherence rate benchmark: 40–60%). A total of 310 cases were assessed of which 51 and 37 cases met the eligibility criteria for paper-based and electronic based audit respectively as a component of clinical audit. Evidence of paper documentation of weight was 43% among participants and was comparable with other published clinical audits (p = 0.07) with poor monitoring rates for other blood tests. Findings revealed poor rate of documentation at 35.1% (13 cases), 5.4% (2 cases) and 8.1% (3 cases) for weight, lipid assessments and glucose monitoring, respectively based on electronic records. Present study demonstrate lack of good documentation practices on metabolic monitoring of youth prescribed antipsychotics. It appears transitioning from paper to electronic records did not impact the rate of increase in documentation of metabolic monitoring. This study recommends inclusion of e-monitoring icon with built in metabolic monitoring chart as a component of youth prescribed antipsychotic case records. Good documentation practice is a first step in determination of causality of antipsychotics induced metabolic syndrome. Appropriate strategies to a user-friendly electronic reminder system will be crucial to address on the mechanistic of documentation. [ABSTRACT FROM AUTHOR]

Background: Minimally adequate treatment (MAT) is intended to represent treatment minimally sufficient for common mental health problems. For children, MAT has been defined over a twelve-month period as either eight or more mental health visits, or four to seven visits plus relevant medication. MAT is used to identify those missing out on adequate care, but it is unknown whether MAT improves children's outcomes.Methods: This paper examines whether MAT is associated with improved outcomes for children. It uses survey data from the nationally representative Longitudinal Study of Australian children on 596 children with mental health problems based on the Strengths and Difficulties Questionnaire at ages 8-15 years, linked to health service administrative data from 2012 to 2016. Statistical analysis examines the association of MAT with later quality of life (Pediatric Quality of Life Inventory), using a lagged dependent variable model to account for time-varying unobserved confounding.Results: Compared to children with lower levels of treatment, those who received MAT between baseline and follow up had no statistically significant improvement in either quality of life or mental health symptoms.Limitations: The observational data provide insight into real-world practice but require statistical methods to account for selection into treatment.Conclusions: While clinical trials show mental health treatments can be efficacious, this study shows no evidence that children receiving MAT in routine practice have better outcomes. These findings demonstrate the need for better understanding of the nature and impact of children's mental health care as it is delivered and received in routine practice. [ABSTRACT FROM AUTHOR]

Objectives Young people's participation in decision making that affects them is increasingly recognised and valued as a right. Youth participation in mental health settings is fundamental to service design and delivery, and is beneficial for the young people as well as the organisation. Headspace recognises the many benefits of youth participation with its national and local youth participation initiatives. In 2013, headspace Gosford in Australia established its current youth participation model, called the Youth Alliance (YA), consisting of 12 young people. These young people contribute ideas and opinions around service design and delivery, and participate in a range of activities. Method This paper presents the findings of a focus group conducted with the YA immediately following recruitment. All 12 young people participated in a two hour focus group which sought to identify the key reasons these young people joined the YA, and what they hope to achieve in their capacity of YA consultants. Results The two main reasons participants joined the YA are to help ‘overcome barriers to help seeking and ensure young people get the support they need’ and ‘to build confidence, social skills and make new friends’. The barriers to help seeking identified by the participants are consistent with those outlined in the literature. Conclusion Youth participation in youth mental health settings is beneficial to young people as well as organisations and the community, and it is crucial that strategies are put in place to increase youth participation. The ways in which these young people perceive their participation as beneficial to themselves as well as the organisation and the community is the focus of this paper. [ABSTRACT FROM AUTHOR]

The involvement of families, carers and significant others (i.e. social support networks) has a positive corollary for a person experiencing mental health problems. Accordingly, in Australia involvement of social support networks within mental health services is endorsed in national health policy and service guidelines. Despite the endorsement, this is yet to be fully realised in all areas that provide mental health services, including emergency departments. Social support networks are integral in the provision of mental health consumers' care. Supporting the involvement of social support networks in the emergency department can provide healthcare services with opportunities for enhanced and cost-effective care, contributing to improved outcomes for consumers. An overview of some of the barriers and facilitators of social support network involvement is provided. The intention of this paper is to encourage reflection and dialogue on this important area of mental health service provision and support the evolution of a new paradigm of research into social support network involvement in the emergency department. [ABSTRACT FROM AUTHOR]

Many countries embarked on reforms of mental health law in the wake of the Convention on the Rights of Persons with Disabilities. These reforms have had varying levels of success. This paper considers the experience of consumers in the Victorian mental health system, drawing on an evaluation that asked consumers and clinicians about their knowledge and experience of rights under the Victorian Mental Health Act, 2014. The data show that consumers were not informed of their rights, were not involved in decisions about treatment, were not able to access safeguards, and could not exercise their rights. The explanations for this include limited staff time, unclear delegations of responsibility, a lack of knowledge, training, and support for rights, and a preference for 'best interests' approaches. The paper identifies tangible reforms that would maintain rights for consumers, including competent refusal of treatment, legislative and regulatory reforms, and training and resourcing. Consumers in this study found that the rights-based framework in the Mental Health Act, 2014 had such an insignificant effect on clinical mental health practice in Victoria that their rights appeared to be illusory. [ABSTRACT FROM AUTHOR]