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The merits of technology-based mental health service reform have been widely debated among academics, practitioners, and policy makers. The design of new technologies must first be predicated on a detailed appreciation of how the mental health system works before it can be improved or changed through the introduction of new products and services. Further work is required to better understand the nature of face-to-face mental health work and to translate this knowledge to computer scientists and system designers responsible for creating technology-based solutions. Intensive observation of day-to-day work within two rural youth mental health services in South Australia, Australia, was undertaken to understand how technology could be designed and implemented to enhance young people's engagement with services and improve their experience of help seeking. Data were analysed through a lens of complexity theory. Results highlight the variety of professional roles and services that can comprise the mental health system. The level of interconnectedness evident in the system contrasted with high levels of service self-organization and disjointed information flow. A mental health professional's work was guided by two main constructs: risk and engagement. Most clients presented with a profile of disability, disadvantage, and isolation, so complex client presentations and decision-making were core practices. Clients (and frequently, their families) engaged with services in a crisis-dependent manner, characterized by multiple disengagements and re-engagements over time. While significant opportunities exist to integrate technology into existing youth mental health services, technologies for this space must be usable for a broad range of medical, psychological and cognitive disability, social disadvantage, and accommodate repeat cycles of engagement/disengagement over time. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper was to estimate the degree to which smoke-free facilities may facilitate smoking cessation in smokers with mental illness by estimating the proportion of smokers with mental illness who receive inpatient treatment, their smoking rates and average durations of stay. Method: Smoking and hospitalization rates were estimated from the Australian National Survey of Mental Health and Wellbeing. Information on duration of inpatient treatment was calculated from the Western Australian Mental Health Information System. Results: Of Australia's estimated 3 567 000 current adult smokers, 32.4% had a mental illness in the past 12 months, and 66.6% had a lifetime mental illness. However, only 1.4% of smokers were hospitalized for a mental health problem in the past 12 months, and 6.3% had ever been hospitalized for a mental health problem. Of those hospitalized for mental health treatment in the past 12 months, 61.2% were current smokers. In 2007 median duration of inpatient mental health admissions was 1 day, and 57% of admissions had duration of 2 days or less. Conclusions: The majority of smokers with mental illness are not treated in inpatient facilities, and where inpatient admissions occur they are generally of short duration. While smoking cessation is an important goal in treatment of smokers with mental illness, support after discharge from inpatient care is important for longer term cessation. Other strategies will be required to support smoking cessation efforts for the majority of smokers with mental illness not in contact with mental health services. [ABSTRACT FROM AUTHOR]

Aims: To determine if the Partners in Health scale, pertinent to assessing patient chronic condition self‐management, operates equivalently for men and women. Background: There are distinct gender‐based differences in self‐management behaviours and health perceptions. This may introduce non‐invariance in self‐report measures. Testing of measurement invariance is a recommended practice in nursing science to ensure robust metrics. Design: A representative cross‐sectional population survey in South Australian. Method: In 2014, 940 people responded to the South Australian Health Omnibus Survey, a battery of health‐related questions. MI and estimation of heterogeneity was tested using Bayesian confirmatory factor analysis. Results: Findings showed self‐management constructs were interpreted equivalently between men and women. Observed population heterogeneity associated lower education levels with poorer illness and treatment knowledge, smokers with poorer treatment partnerships and mental health problems with lower coping capacity. Conclusion: Approximate measurement invariance was achieved between men and women for Partners in Health scale. Impact: There is a lack of well‐validated generic instruments, including investigation into gender variability, for measuring chronic condition self‐management behaviours. Lower education levels were found to connect with poorer knowledge of health condition and treatment. Mental health problems attenuated ability to cope with the effect of the condition. Findings can facilitate the development of better tailored interventions for self‐management of patients' chronic condition/s. [ABSTRACT FROM AUTHOR]

Objectives:Mental health care for older people is primarily delivered in the community and is largely dependent on informal carers. Mental health policy encourages partnerships between carers and service providers to facilitate service access, coordination and positive experience of care. However, carers often lack information and support from services, with the potential for carer burden, and negative impacts on their own health and capacity to fulfil caring tasks. This paper explores rural carers' experiences of accessing care from a range of services for older people with mental health problems. Method:The Pathways Interview Schedule was used to facilitate 9 in-depth care journey interviews with 11 carers of older people with a mental health problem. Interviews explored their journeys to and through mental health, aged care, primary care and social care services. Framework analysis was used to explore carers' experiences and perceptions of care with a focus on access enablers and barriers. Results:Carers had a significant role in navigating services and operationalising care for their relative. Enablers to accessing care included carer knowledge and workers actively involving carers in planning. Barriers included carer mental health literacy, consumer and carer readiness for services, and worker misinterpretation of confidentiality and privacy laws. Conclusion:Carers should be considered key partners in mental health care planning that crosses service sectors. For this to occur, changes are required at the worker level, including increased communication between mental health workers and carers, and the service level, involving training for staff in interpreting confidentiality and privacy policy. [ABSTRACT FROM PUBLISHER]