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Background: The Recovery Assessment Scale: Domains and Stages (RAS-DS) was designed to be both a recovery outcome measure and a tool to enhance service-user control over their recovery journey. While extensively and globally used in mental health services for the former purpose, routine use for the latter purpose is yet to be realised. The aim of this study was to identify barriers, facilitators and additional supports needed for RAS-DS to be used to support service user participation, goal setting and recovery action planning., Methods: An online survey was conducted of mental health workers who had engaged with RAS-DS, including fixed choice and open-ended questions. Data were analysed using descriptive statistics and interpretive content analysis respectively., Results: The 65 respondents reported more frequent use of RAS-DS as an outcome measure than as a collaboration tool and more than half reported difficulties in using it in this way. Factors that they described as influencing the use of RAS-DS as a tool for collaboration and support included: previous experiences with RAS-DS; organisational supports and policies; awareness of the RAS-DS amongst colleagues; RAS-DS related training and support; staff time and capacity; the format of RAS-DS; service user population or context; and respondents' own active efforts., Conclusions: Extending the use of RAS-DS, an already widely used tool, to routinely support recovery-oriented practice has both efficiency and service user empowerment benefits. However further work is needed to enable this including: provision of co-designed, accessible training resources; a user platform including built in guidance; and strategies to promote management understanding and valuing of the enhanced recovery-orientation opportunities inherent in RAS-DS use., (© 2023. The Author(s).)

Lived experience research is potentially useful for assisting the recovery journeys of people experiencing mental health challenges, when presented in user-friendly formats. Consumer peer workers are ideally placed to introduce such resources to the people they work with. This study sought to explore the perspectives of expert consumer peer workers on the potential use of lived experience research resources in peer work practice. In particular: (1) what research topics would be most useful; and (2) what considerations are important for developing user-friendly and useful resources using findings from this research. A hybrid Delphi study was conducted. Eighteen expert peer workers participated in online group interviews, which included a semi-structured discussion and modified nominal group technique. These were followed by two rounds of surveys, which focused on prioritising the identified topics. Participants identified 47 topics suitable for lived experience research resources, 42 of which reached consensus as useful for consumers. A priority list of topics for use in peer work was identified through examination and grouping of peer worker rankings of the usefulness of resources for their work with consumers. The highest priority topics were as follows: developing and maintaining social networks; how peer workers can support consumers in their recovery journey; having choice with medications and participating in the decision-making process; and knowing your rights and responsibilities. Participants noted, however, that the usefulness of each topic ultimately depended on individual consumer's needs. They highlighted that a variety of formats and presentation were required to reach diverse consumer groups.

Parents are a critical resource in supporting young people who live with mental health problems. Qualitative research has identified that parents use a wide range of strategies to provide support. However, parents report being unsure which strategies are likely to be helpful, so often struggle in this role. Presently, little empirical evidence exists to assist parents to decide which strategies are likely to be most helpful. This study aimed to explore the parent-perceived helpfulness of parental strategies to support young people living with mental health problems. Data were collected from February to July of 2018, using a cross-sectional, online, anonymous, self-report survey of participants who identified as parenting a young person (15-24 years) diagnosed with a mental health problem (n = 70). Overall, the strategies perceived as most helpful were practical assistance and personal interactions aimed at promoting positive thoughts and feelings and obtaining appropriate treatment. Least helpful strategies tended to be control-type strategies, aimed at behaviour change. Overall, there was good alignment between strategies' helpfulness and frequency of use, however, there were exceptions. These exceptions are likely reflections of the specific context of particular situations as well as parental uncertainty regarding alternative strategies. Generally, perceptions of strategies' helpfulness were unrelated to parent or child characteristics. However, helpfulness of strategies was associated with parents' satisfaction with their relationship with the young person. Parents' collective experience-based perceptions about the helpfulness of strategies used to support young people experiencing mental health problems can be harnessed to inform mental health practitioners' advice to parents and contribute to better mental health outcomes for young people., (© 2020 John Wiley & Sons Ltd.)

Background: Young people with disabilities are at greater risk of having mental health problems than are their nondisabled peers. Most research about the relationship between disability and mental health has been cross-sectional and unable to identify mental health status prior to onset of disability or possible mental health pathways following disability. There is a lack of information, therefore, about what happens to young people's mental health when they become disabled., Objective: This study aimed to identify the mental health trajectories for young Australian adults after onset of self-reported disability, taking into account their predisability mental health status., Methods: Longitudinal data from waves 1 to 7 (2001 to 2007) of the survey of Household, Income and Labour Dynamics in Australia (HILDA) were analyzed using a growth mixture modeling approach., Results: Three distinct mental health trajectories were identified for the 136 young people reporting onset of ongoing disability. The majority (64.7%) of respondents experienced positive mental health before and following onset of disability. However, a significant minority (35.3%) experienced either (a) low mental health both prior to and following onset of disability (19.1%) or (b) mental health deterioration following onset of disability (16.2%)., Conclusion: Targeting appropriate interventions to the young people with disabilities in these 2 groups could have a significant impact on enduring mental health status., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Introduction: Routine use of self-rated measures of mental health recovery can support recovery-oriented practice. However, to be widely adopted, outcome measures must be feasible. This study examined the feasibility of Recovery Assessment Scale - Domains and Stages (RAS-DS) from the perspectives of mental health workers. Method: Mental health workers who had previously sought permission to use RAS-DS (n=58) completed an online survey that explored three aspects of feasibility: practicality, acceptability and applicability. Results: The highest-rated feasibility items related to applicability, or usefulness in practice, with over 90% of participants reporting that RAS-DS helps "promote discussion" and covers areas that are "meaningful to consumers". Acceptability items indicated that the purpose of RAS-DS is clear but length was an issue for some participants. At a practical level, RAS-DS was seen as easy to access but training was seen by many as necessary to ensure optimal use. Conclusion: Results suggest potential usefulness of RAS-DS as a routine outcome measure and identify aspects that can be addressed to further enhance feasibility including provision of training materials and opportunities, wide-reaching promotion of its use as a collaborative tool, and further investigation of issues around instrument length. [ABSTRACT FROM AUTHOR]

The aims of this study were to identify factors that a) predict whether people experience housing related discharge delay (HRDD) from a mental health inpatient unit; and b) predict the length of HRDD for people affected. By identifying the groups most affected by HRDD, clinicians and policy makers can prioritise and address barriers to timely discharge at both an individual and systemic level. A case control study using a detailed medical record review was conducted in one Australian mental health service. Demographic, clinical, contextual and systemic variables were collected for patients with HRDD in one calendar year (n = 55) and a random comparison sample (n = 55). Logistical and multiple regression analyses were conducted to identify variables that predict HRDD and length of HRDD. A model that correctly predicted 92% of HRDD and 78% of non-HRDD cases using five variables was developed. These variables were: diagnosis of schizophrenia or other psychotic disorder, physical comorbidity, having a history of violence or aggressive behaviour, being employed and being involved as a defendant in the justice system. The first three variables increased the likelihood of HRDD, while the second two reduced the likelihood of HRDD. For people who experienced HRDD, the only variable that predicted length of delay was staff reported difficulty finding appropriate support services. This model can be used to rapidly identify patients who might be at risk of HRDD and commence coordinated actions to secure appropriate housing and supports to facilitate timely discharge, thereby addressing a current practice gap. These findings highlight the intersection between health, housing and disability services in the lives of people with serious mental illness, and the need for a whole of government approach to investment and integration to address systemic barriers to suitable housing and supports. [ABSTRACT FROM AUTHOR]

International research indicates that delayed discharges from inpatient mental health units are common and most occur because patients lack suitable housing. However, little is known about this issue in an Australian setting. This mixed‐methods study aimed to investigate the extent, cost and contributors to housing‐related delayed discharge (HRDD) from inpatient mental health units in one Local Health District in New South Wales, Australia. A medical records review was conducted to quantify housing‐related delay and housing difficulties noted. Perceptions of discharge staff about the factors contributing to the delays were gathered through in‐depth interviews and analysed using constant comparative analysis. Findings indicated that HRDD for working aged adults accounted for 11.6% of total mental health bed days in 2018, costing the health system $4,054,149. When extrapolated nationally HRDD could cost Australia $269.5 million per year. While individual characteristics and contexts were thought to make some patients more vulnerable, data indicated that the major contributors were lack of housing options, lack of services, difficulty with funding and lack of clear pathways to achieve housing. The findings highlight the urgent need for additional housing for people with mental health issues and a whole of government approach to addressing the substantial issue of housing‐related delayed discharge. [ABSTRACT FROM AUTHOR]

Introduction: Consumer-led and collaborative research is consistent with occupational therapy principles of inclusion and client-centredness, and is increasingly valued in mental health. Our research team of three occupational therapists and three consumers was funded to conduct a consumer-led mental health service evaluation. Because of a lack of previous research to guide our practice, we engaged in a collaborative autoethnography to gather information about the process of consumer-led research. We discovered that the systematic reflective processes of collaborative autoethnography played a critical part in shaping the very experiences being investigated. This article describes the impact of using this systematic collaborative reflection on the process of consumer-led research. Method: Data from weekly journal entries and quarterly focus groups were analysed using constant comparative analysis. Codes relating to experiences and impacts of the collaborative autoethnography were extracted for presentation in this article. Findings: Our collaborative autoethnography activities provided unique opportunities that developed our shared understanding of consumer-led research in mental health, facilitated a respectful and open group culture and, ultimately, resulted in a more consumer-led research project. Conclusion: Occupational therapists striving to include and empower service users in research and evaluation could benefit from adopting systematic collaborative, reflective techniques. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to identify aspects of the consumer-provider relationship that consumers saw as important in a care coordination service model. Method: Semi-structured interviews were conducted, between October 2015 and March 2016, with 20 people living with severe and persistent mental illness who used a care coordination service in Sydney, Australia. Data were analysed using constant comparative analysis. Results: Participants described five specific aspects of the consumer-provider relationship that they deemed important within their care coordination service experience: rapport and listening; an individualised approach; collaboration and partnership; reliability; and genuine care and respect. These were not independent, but rather, interdependent elements that collectively described a ‘good’ consumer-provider relationship. Discussion: While previous literature has examined the consumer-provider relationship in high-intensity and therapeutic models of service, this study confirms that similar relationship features are important in low-intensity or brokerage type models. Aspects such as the provider being easy to talk to and reliable appear to be of additional importance in this particular model. Findings suggest that the ability to develop trusting and collaborative relationships within a short timeframe is a critical consideration for recruitment and training of service providers working within care coordination models of service. [ABSTRACT FROM AUTHOR]

Secure and appropriate housing is critical for the well-being of people living with mental illness (consumers). Yet it is often difficult to achieve. Housing assistance is available, but is often difficult for consumers to access and negotiate. While the need for support is well-recognised, little is known about the active part consumers play in finding and keeping appropriate accommodation. This paper addresses the research question: How do consumers who use housing assistance actively manage their housing situations? In-depth interviews were conducted with 18 consumers who had used housing assistance within the past five years. These were analysed using constant comparative analysis, based on a grounded theory approach. Participants engaged in a range of activities to address six major concerns: working toward my home; following the rules to keep what I have; managing and improving my accommodation; working with housing services; living within my current situation; and finding and using supports. All participants described times when their mental health negatively affected their ability to do these activities. The findings highlight the need for housing services and mental health services to collaborate to develop policies and protocols that place reasonable demands on consumers and support their abilities to actively manage their housing situations. [ABSTRACT FROM AUTHOR]

Objective:The aim of this study was to understand the strategies women living with mental illness use to balance the demands of mothering with mental health recovery. Method:Semi-structured interviews were conducted with 10 Australian women who self-identified as managing to balance mothering with mental health recovery. The data were analysed using constant comparative analysis, and other techniques informed from grounded theory. Results:Mothers used four interconnected balancing strategies: prioritising in the present; looking after myself; buffering children; and using supports. Awareness of the crucial interconnectedness of mothering and recovery was the foundation for these balancing strategies. Developing this awareness was essential in order to value, develop and therefore implement these strategies. Supports and resources played a critical role in helping mothers to develop awareness of, as well as use, strategies to balance motherhood and mental health recovery. Discussion:Mental health services can support mothers to develop an understanding of the inextricable connection between their own recovery needs and the needs of their child. Mothers can also be supported to successfully identify and employ their own strategies within each of the four categories developed in this study. [ABSTRACT FROM AUTHOR]

Objectives: A key aim of palliative care is to improve the quality-of-life of people with a life-threatening illness. Occupational therapists are well positioned to contribute to this aim due to their broad range of interventions, client-centeredness and focus on occupation. However, there is a limited understanding of how occupational therapy contributes to the end-of-life experience, which is crucial to providing optimal care. The aim of this study is to investigate the lived experience of occupational therapy in palliative care for people with a life-threatening illness.Method: A hermeneutic interpretive phenomenological approach was adopted. Semi-structured interviews were conducted with eight participants recruited from inpatient and outpatient sectors of a specialist palliative care hospital in Sydney, Australia.Results: The two themes developed from participant responses were: (1) occupational therapy provides comfort and safety and (2) trusting the occupational therapist to know what is needed.Significance Of Results: This study gives insight into the ways in which people with a life-threatening illness experience occupational therapy in palliative care. In addition, it provides a starting point to guide practice that is attentive to the needs of people with a life-threatening illness at end-of-life, thus enhancing client-centered care. [ABSTRACT FROM AUTHOR]

Background/Aims: Assisting clients to achieve wellbeing, even in the presence of ongoing mental illness, should be a primary goal of mental health services. However, little is known about what wellbeing means for young people living with mental illness. The aim of this study is to explore the ways in which young Australians living with mental illness conceptualise their wellbeing. Methods: Five focus groups were conducted with young people (n=20; age range: 16-25 years) living with mental illness. Results were analysed qualitatively using constant comparative analysis. Results: Analysis of the data indicated that participants were describing two different but complementary types of concepts. We conceptualised these two types of concepts as 'building blocks' and 'foundations' of wellbeing, respectively. Five building blocks were identified, which together constituted wellbeing for participants: i) sense of self; ii) relationships; iii) sense of the future; iv) feelings and experiences; v) agency. These building blocks were supported or undermined by seven foundations: i) activities; ii) having things; iii) mental illness; iv) the past; v) coping strategies; vi) environmental supports and barriers; vii) personal characteristics. Conclusions: The findings support the use of a recovery paradigm for young people with mental illness. The framework presented can be used to assist young people to consider different aspects that make up their wellbeing and plan ways to address these by attending to multiple foundational factors. [ABSTRACT FROM AUTHOR]

Parents of young people with mental illness use a variety of strategies to try to positively influence young people's mental health-related behaviours. Evidence suggests that these parents can influence young people's well-being and mental health trajectories. However little is known about how young people perceive and are affected by the strategies parents use. In-depth qualitative interviews focussing on parental involvement in mental health were conducted with 26 young people with mental illness. The data were analysed using constant comparative analysis. Young people described parents as directly influencing their mental health-related behaviour through facilitative, persuasive and controlling practices. Young people's behavioural and emotional responses to these practices were influenced by when the incident occurred; what they believed about the attitudes and motives behind their parents' actions; whether they agreed in principle with the practices; the degree to which they accepted their parents' authority and anticipated their own increasing autonomy; and whether other support was provided alongside the behavioural practices. Understanding how young people view their parents' influence on their mental health-related behaviour under different circumstances is a vital step towards promoting the best possible parental support for these young people. [ABSTRACT FROM AUTHOR]

Background: Lived experience research is conducted by people who have experience of mental health issues and is therefore better placed than more traditional research to illuminate participants' experiences. Findings that focus on identifying enablers of recovery from a lived experience perspective have the potential to assist people in their recovery process. However, this lived experience research is often difficult to find, access and interpret. We co-produced user-friendly and engaging resources to disseminate findings from six lived experience research studies. This paper seeks to answer the research questions: a) Did exposure to lived experience research increase hopefulness for participants?; and b) How else did interacting with lived experience research resources influence participants' lives? Methods: Thirty-eight participants were introduced to four resources of their choosing by peer workers over a four-week period. The helpfulness of resources was evaluated using mixed methods, including a quasi-experimental analysis of change in hope, an anonymous survey and in-depth interviews. Results: Findings indicated that the resources promoted hope, but that increases in hopefulness may not be seen immediately. Other impacts include that the resources: encouraged helpful activities; provided a positive experience; increased valued knowledge; encouraged people to reflect on their journey and think constructively about mental health issues; helped people to feel less alone; and assisted people to explain their situation to others. Conclusions: The research suggests the potential usefulness of lived experience research resources, presented in user-friendly formats, in the lives of people who experience mental health issues and implies a need to nurture this type of research. [ABSTRACT FROM AUTHOR]