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ABSTRACT Countries around the world are experiencing both a growing need for mental health services and major gaps in the delivery of mental healthcare. The World Health Organisation's 2022 report on mental health emphasised co‐designed and systems‐level innovations responsive to the voice of those with lived experience. However, evidence for implementing such methodologies is sparse. Group model building (GMB), a participatory systems‐based approach, has been used in various fields, but its application is limited within mental healthcare settings. It is recognised as a valuable tool for engaging stakeholders, including those with lived experience, in understanding and redesigning health systems and services. The participatory approach aligns with the mental health sector's shift towards co‐design and person‐centred care. This study assessed the acceptability of GMB as a method for co‐design within mental healthcare, aiming to explore its potential for meaningful collaborative improvement and systems‐level insights. Participants from a regional Mental Health and Drug and Alcohol Service (MHDAS) engaged in GMB workshops and focus groups. Eighteen individuals, including lived experience workers and healthcare professionals, provided feedback that informed adjustments to the workshops' design, language, timing and facilitation techniques, enhancing GMB's relevance for mental health co‐design. The findings demonstrate the value and acceptability of the adapted GMB process in acute mental healthcare, marking a significant step towards evidence‐based, person‐centred service improvement. This study highlights the potential effectiveness of participatory methods in identifying and addressing systemic challenges, paving the way for future mental health reforms. Future work will focus on implementing and evaluating co‐designed interventions, aiming for more inclusive and effective mental healthcare and advancing innovation and reform in the field. [ABSTRACT FROM AUTHOR]

For much of the pelagic sedimentary record, time control is limited to the resolution of precession cycles (ca 20 kyr): the Milankovitch parameter that forms the most detailed metronome for the Cenozoic and Mesozoic Eras. The influence of precession is often detected in lithological alternations, where the duration represented by individual lithologies is not well constrained. Here the novel technique of extraterrestrial helium abundance (3HeET) is used to investigate the sedimentation dynamics and palaeoceanography within individual precessional cycles. High‐resolution 3HeET timescales were produced for four precession cycles from the rhythmically bedded Scaglia Bianca Formation, a sequence of Upper Cretaceous (Cenomanian) deep‐marine pelagic limestones from central Italy that are well characterized by cyclostratigraphy. Using 3HeET concentrations as a proxy for sedimentation rate allows instantaneous sedimentation rates and organic‐carbon mass accumulation rates to be calculated for each bed within a precession cycle. Eccentricity is known to modulate the amplitude of precession forcing, and precession cycles deposited under eccentricity maxima and minima were selected for comparison. Lithological changes through these chert–(black shale)–limestone cycles are explained using the concept of ‘palaeoenvironmental thresholds’; these timescale calculations indicate that when the amplitude of precessional insolation forcing was greatest (at eccentricity maxima) the palaeoenvironmental system spent longer in the more nutrient‐rich environment under which siliceous and organic‐rich sediments were deposited, reflecting increased time spent above a ‘threshold’ insolation level. Estimates of primary productivity are relatively elevated for organic‐rich beds. An increase in the flux of terrestrial helium (4Heterr) during the deposition of cherts may have been coincident with an increase in terrestrially derived nutrients. The presented results indicate great potential for the use of 3HeET to understand past oceanographic, climatic and sedimentological processes at high temporal resolution. [ABSTRACT FROM AUTHOR]

Elimination of restrictive practices (physical/mechanical restraint and seclusion) from adult acute mental health care services has been demanded internationally for many decades. This study aimed to: (1) Identify priority issues in the elimination of and use of alternative approaches to restrictive practices (seclusion and physical/mechanical restraint) in rural/regional acute adult mental healthcare services, as told by mental healthcare service users and practitioners, (2) identify the community-based, system-level feedback loops that enhance or reduce the use of restrictive practices and viable alternatives and, (3) identify potential action areas to improve system structures to increase regional mental healthcare services' ability to eliminate restrictive practices and use alternative approaches. Group model building (GMB) workshops were held with a small group (n = 9) of mental healthcare practitioners and service users with lived experience of restrictive practice use. This participatory approach enables exploration and visual mapping of local structures causing behaviour patterns of practitioner and service user concern over time - in this case, the barriers, and enablers to alternative approaches to restrictive practices in adult acute mental healthcare services within the Geelong-Barwon region. This is the first study that specifically applies GMB in the discussion of the elimination of restrictive practices in mental health in the non-metropolitan regional/rural context. Participants identified four key priorities in relation to eliminating restrictive practices: (1) self-advocacy, (2) continuity of care, (3) early intervention, and (4) safety for all. The study findings were distilled into a novel preliminary set of mental healthcare practitioner and service user action ideas., (© 2024 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.)