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This qualitative study explored the experiences of mental health employees working with Indigenous clients living with mental illness. Interviews were conducted with 20 mental health workers to identify strategies they adopt to facilitate community engagement with Indigenous clients. Using a thematic analysis approach, 'Brokering community engagement' was the umbrella theme from which two subthemes related to community engagement for the service and clients emerged (1) enabling connections -community and family; and (2) recovery and reconnecting with community. Participant insights enabled a deeper understanding of the role of community in the recovery process for Indigenous clients and highlight the importance of community engagement as a primary, yet multifaceted strategy used by mental health workers in the communities they serve.

Aims and Objectives: To determine clinical mental health nurses' views and preferences about continuing professional development., Background: Participation in continuing professional development is now expected for nurse and midwifery registration. However, it is unclear how clinically based mental health nurses view continuing professional development and its relevance to career intentions., Design: Qualitative., Method: Semi-structured face-to-face interviews with mental health nurses (n=50) drawn from inpatient mental health units., Results: The most prominent factor identified through this research is that the majority of the fifty participants valued continuing professional development and sought more opportunities to participate. They particularly favoured in-house locally based sessions targeting patient-related clinical skills enhancement. Importantly, this interest in continuing professional development was not confined to new graduates needing to consolidate their skills. Work-based flexibility, the types of courses available and opportunities for study leave were also identified as important factors. Of the 50 nurses interviewed, 40% expressed a desire for continuing professional development vis-à-vis remaining in the service; 30% of nurses responded to the same question with an emphasis on the importance of collegial support amongst peers and management; and 30% of the nurses indicated their primary focus for continuing professional development was to further their tertiary studies., Conclusions: These results are not only timely given the requirements around continuing professional development, but are also important to drive improvements in quality continuing professional development where needs are prioritised, discussed and agreed on., Relevance to Clinical Practice: Findings from this study highlight the value clinical nurses place on having access to work-based and clinically focussed education and development. Relevant on-the-job professional education has the potential to improve job satisfaction and retention of clinical nurses, thus ultimately directly and positively influence patient care., (© 2011 Blackwell Publishing Ltd.)

There is a growing expectation for staff to participate in benchmarking activities. If benchmarking projects are to be successful, managers and clinicians need to be aware of the steps involved. In this article, we identify key aspects of benchmarking and consider how clinicians and managers can respond to and meet contemporary requirements for the development of sound benchmarking relationships. Practicalities and issues that must be considered by benchmarking teams are also outlined. Before commencing a benchmarking project, ground rules and benchmarking agreements must be developed and ratified. An understandable benchmarking framework is required: one that is sufficiently robust for clinicians to engage in benchmarking activities and convince others that benchmarking has taken place. There is a need to build the capacity of clinicians in relation to benchmarking.

For people with autism spectrum disorder (ASD), the risk of mental illness, including suicidality, has a higher prevalence than the general population. This scoping review explored how people with ASD access suicide hotlines/crisis support services; and current approaches to delivering mental health services (MHS) to people with ASD. A search identified 28 studies meeting the selection criteria with analysis revealing four key findings. The support received by the person with ASD influenced how they accessed MHS; people often encounter barriers to accessing MHS; a separation exists between autism and MHS; and no studies on accessing or delivering MHS through crisis hotlines. The presence of such autism-specific crisis hotlines and the dearth of studies suggest a void in the existing research. [ABSTRACT FROM AUTHOR]

Many health-related measurement instruments have been developed to measure psychological constructs and whilst several instruments are usually available for a particular study, finding the right tool for the job is important. Systematic reviews of measurement properties of instruments have long been identified as a valuable strategy to ensure that we select the right tool to assess mental health. There are many important steps and procedures to guide these types of systematic reviews to find the "best fit" and this paper summarizes some of these key processes and steps. The selection of instrument(s) to use should be made considering the most recent comprehensive review of the quality of the outcome measurement instrument based on unbiased assessment of its psychometric properties, responsiveness, and generalizability of results. Researchers planning to conduct a systematic review of health-related measurement instruments should design the review beforehand using standardized frameworks. Conducting systematic reviews of the quality and psychometric properties of health-related measurement instruments is important to ensure we choose the best tool for the research question and target population. [ABSTRACT FROM AUTHOR]

Aim: Two integrated headspace Early Intervention Teams (hEITs) were established in 2017 to bridge gaps between headspace, the national primary care youth mental health programme in Australia, and the state funded secondary and tertiary mental health services. This study aims to describe functioning and outcomes of patients referred to hEIT over a 6‐month period. Methods: A retrospective file audit was conducted for all patients accepted into the service over a 6‐month period in 2018. Measures of distress, functioning and client satisfaction were collected and analysed. Exemplar vignettes were created to construct hypothetical examples and illustrate research findings. Results: At admission, the three most common presentations were depression/anxiety, trauma and stress related, and psychotic disorders. During their time in the service, young people displayed a statistically significant improvement in functioning, reduction in self‐harm in those 18 years and under, and a trend to reduction in distress scores. hEIT delivered a broad range of services covering social, occupational, educational, medical and mental health care, and the service was experienced positively by the patient cohort. Conclusions: hEIT appears to meet the needs of young people requiring greater care than primary care services can deliver. The integrated, wrap‐around care coordination facilitates treatments across social, educational and health domains. Further exploration of young people who disengage from care, improved outcome data reporting and economic evaluation are indicated. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to review animal hoarding cases referred to the Royal Society for the Prevention of Cruelty to Animals (RSPCA) in New South Wales (NSW) to examine mental health factors that influence the development of animal hoarding and to consider strategies for dealing with such cases. Methods: Data were gathered by RSPCA inspectors regarding consecutive cases referred to the agency over 2 years. Result: Details were provided about animals and 50 identified hoarders (11 male, 39 female; mean age 57 years) on 48 properties. The mean number of animals per case was 53 (range 6–300). Fifteen participants (30%) were known to have had involvement with mental health or social services. Mental health factors appeared to contribute to animal hoarding in well over 50% of cases. Severe and moderate squalor were observed in 52% and 21% of dwellings assessed respectively, many with accumulated rubbish. Conclusions: Animal hoarding is largely attributable to psychological and psychiatric problems. It is recommended that clinical services work alongside animal welfare inspectorates, assessing (and, where appropriate, treating) such problems. What is known about the topic?: Animal hoarding is believed to be partly attributable to the hoarders having psychiatric or psychological problems, but relevant mental health assessment of hoarders is not usually arranged. Recidivism after removal of animals is nearly 100%. What does this paper add?: The study confirms that animal hoarders commonly have mental health issues. However, RSPCA inspectors are not expected to screen for such issues or refer cases to mental health clinicians. What are the implications for practitioners?: There is good reason to develop clinical services to help animal hoarders deal with their psychological or psychiatric problems. [ABSTRACT FROM AUTHOR]

PURPOSE To explore the experiences of mental health workers and perceptions of their role and the scope of their work. DESIGN AND METHODS Qualitative design. Twenty interviews were conducted with mental health workers. Interviews were analyzed using thematic analysis. FINDINGS Three overarching themes were identified. In this paper the overarching theme of 'dimensions of my role' is discussed. Subthemes were (a) information and education, (b) person-centered care, and (c) networking and partnerships. PRACTICE IMPLICATIONS Professional development, networking, and partnerships underpin the provision of coordinated services and ultimately person-centered care. Enhancing staff capacity building may also enable sustainability of appropriate quality services. [ABSTRACT FROM AUTHOR]

Mental health is a major concern in Indigenous communities, as Indigenous people experience poorer health outcomes generally, and poorer social and emotional well-being throughout their lives, compared to non-Indigenous populations. Interviews were conducted with 20 mental health workers from a housing assistance programme for Indigenous clients with mental illness. Service and infrastructure needs identified to support clients were classified under the following overarching theme 'supports along the road to recovery'. Subthemes were: (i) It is OK to seek help; (ii) linking in to the local community; (iii) trusting the workers; and (iv) help with goal setting and having activities that support their achievement. This paper highlights the importance of targeted housing and accommodation support programmes for Indigenous people to prevent homelessness, and the essential services and infrastructure required to support Indigenous clients' mental health needs. These insights may inform service review, workforce development, and further research. [ABSTRACT FROM AUTHOR]

Objective: To describe the lived experiences of people subject to community treatment orders (CTOs) and their carers.Method: We recruited 11 participants (five mental health consumers and six carers) through consumer and carer networks in NSW, Australia, to take part in interviews about their experiences. We analysed the interview data set using established qualitative methodologies.Results: The lived experiences were characterised by 'access' concerns, 'isolation', 'loss and trauma', 'resistance and resignation' and 'vulnerability and distress'. The extent and impact of these experiences related to the severity of mental illness, the support available for people with mental illnesses and their carers, the social compromises associated with living with mental illness, and the challenges of managing the relationships necessitated by these processes.Conclusions: The lived experience of CTOs is complex: it is one of distress and profound ambivalence. The distress is an intrinsic aspect of the experience of severe mental illness, but it also emerges from communication gaps, difficulty obtaining optimal care and accessing mental health services. The ambivalence arises from an acknowledgement that while CTOs are coercive and constrain autonomy, they may also be beneficial. These findings can inform improvements to the implementation of CTOs and the consequent experiences. [ABSTRACT FROM AUTHOR]

Aggregation is a defensive strategy employed by many prey species in response to predatory threat. Our group has characterized defensive aggregation (huddling) in Rattus norvegicus in response to a ball of cat fur. In this situation some rats huddle less, and approach the threatening cue more than others (active vs. passive responders). The present study explored whether active responding is a stable phenotype associated with behaviors outside direct predatory encounters. The neural substrates of active and passive responding under predatory threat were explored using c-Fos immunohistochemistry. Finally, we examined whether the presence of conspecifics during predatory threat biases behavior towards active responding. Active and passive responding styles were found to be stable in individual rats across consecutive group exposures to cat fur, and were predicted by anxiety-like behavior in an open-field emergence test. Active responders displayed less conditioned fear in an environment associated with predatory threat, and had higher post-exposure intake of a weak sucrose solution (a test of “anhedonia”). Active responding was associated with: greater cat fur-induced activation of the accessory olfactory bulb, reflecting greater olfactory stimulation in rats actively approaching the fur; lowered activation of somatosensory cortex, reflecting reduced huddling with conspecifics; and reduced activation in the lateral septum. Social exposure to cat fur promoted active responding relative to individual exposure, and lowered c-Fos expression in the dorsomedial periaqueductal grey, medial caudate putamen and lateral habenula. We conclude that individual differences in anti-predator behavior appear stable traits with active responders having a more resilient phenotype. Social exposure to predatory threat has an acute buffering effect, subtly changing the neural and behavioral response towards threat and encouraging active responding. An association between active responding and lower c-Fos expression in the lateral septum is consistent with previous studies that highlight this region as an important neurobiological substrate of defensive aggregation. [ABSTRACT FROM AUTHOR]

An overview of approaches used in contemporary mental health research to consider when coordinating research agendas is presented. Connections between the research-practice gap and evidence-based practice are explored. Collaboration, as a key concept and practice, is investigated particularly in relation to community and consumer participation in mental health research. Non-commensurate belief systems, inadequate infrastructure, and institutional tendencies maintain the status quo and constitute significant impediments to widespread planned and integrated research programs. Communication and trust building between researchers and practitioners is central to developing effective collaborations that can deliver more effective health care. [ABSTRACT FROM AUTHOR]

In this article, we identify key aspects for enhancing real-world research in mental health care clinical settings and broadly discuss some practicalities and issues that must be considered beforehand. Practice which is evidence-based uses interventions or treatment methods that are supported by research findings for their quality and efficacy. Modern mental health settings endorse evidence-based practice and welcome the development of innovative, evidence-based approaches to care. Often, however, research findings are inaccessible, inconclusive, inconsistent, contradictory and overwhelming in sheer volume. Further, where there is no evidence, the absence of evidence is frequently mistaken for evidence of absence of the effectiveness of services. Discursive paper. The main themes expressed in the literature were collated by the authors into themes, and their relevance to the development of real-world clinical mental health research is summarised with the aid of a vignette. Ideally, research should be part of mainstream activities and as such constitute core business. Staff in mental health services should be encouraged to be research productive, and prospective clinical researchers should consider linking their studies to higher research degree programmes so that they can access resources, support and expertise to sustain motivation and morale. For research findings to make the leap to evidence-based practice, the research needs to include real-world consumers and families typical of clinical practice supported by clinically relevant outcomes. Clinical and research leaders should create opportunities for academic and clinical nurses to collaborate in research, and researchers should ensure that clinically relevant outcomes are presented in ways that are meaningful and accessible to clinicians. [ABSTRACT FROM AUTHOR]

Increasingly, consumers and carers are involving themselves in many aspects and levels of mental health services. However, one area in which active involvement has been less prominent is research. This paper describes an educational initiative that sought to increase consumers' and carers' understanding of the way research is conducted and its role in evidence-based practice. Information regarding participants' attitudes towards research, knowledge about research practice and participation was also examined. The findings provide evidence that workshop attendance increases knowledge and encourages participation in future research projects, particularly when participants have confidence in the researcher. [ABSTRACT FROM AUTHOR]

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Objective : The objectives of this study were to: (i) obtain baseline data on the extent of carer involvement across a representative sample of hospital and community patients within an integrated area health service; and (ii) examine perspectives on discharge planning and community care among patients and their carers to identify information and resources they consider important. Method : Over a 4-month period, inpatients before discharge and patients accessing community mental health services participated in face-to-face interviews. Information was collected about carer involvement and, with the patient's consent, the identified carer was sent a similar survey to determine demographics and information needs. This resulted in a representative sample of patients and carers accessing inpatient and community settings across a metropolitan mental health service. Support needs and carer burden were also assessed but are not reported here. Results : A total of 407 interviews were completed, 207 in inpatient settings and 200 in the community. An inpatient response rate of 70% and a community response rate of 75% was achieved. Across both settings, 67% of patients identified a carer and a carer response rate of 28% was then obtained. We found carers and patients have different priorities regarding the information they want and information is often not provided to carers. Furthermore, patients were more confident in their ability to manage their mental health in the community than carers. Conclusions : This study yielded important baseline data about the number of patients who have a carer. We were also able to determine that routine clinical information provided to patients and carers is inadequate from their perspective. It is anticipated that this initiative will assist ongoing service planning and improve partnerships with patients and their carers. Australian and New Zealand Journal of Psychiatry 2005; 39:507–513 [ABSTRACT FROM AUTHOR]

The author reflects on the impact of different methodologies in the mental health research which includes research output like publications, knowledge transfer like citations and clinical implementation. He states that the effects of social and economic research in any research assessment exercise (RAE) as various institutions follow national and international standings. Prior to research, a better evidence-based health practice by clinicians and consumers is also suggested.

Objective: Consultation-liaison psychiatry (CLP) services vary in terms of structure, function and responsiveness. It is not known whether evaluation measurements can be meaningfully compared across different CLP services to assess value and efficiency. The aim was to develop and test a common tool for measuring process and outcome measures in CLP.Methods: A data collection tool was developed using the literature and consultation with CLP clinicians. The tool was used to prospectively gather referral data, response times, health utilisation data and functional outcomes for individuals referred over seven months to three different CLP teams, servicing inner city, district and regional areas.Results: The structure, staffing, liaison attachments and scope of practice varied between the services. The regional CLP service attended seven hospitals and had the highest referral rate and largest inpatient population pool. The three services received referrals for similar reasons and made similar diagnoses. Multimodal management was the norm, and CLP facilitated follow-up arrangements upon discharge. Only the district CLP service saw all emergency referrals within an hour. Age and need for an interpreter did not affect response times.Conclusion: Despite local differences in geography, CLP roles, hospital and community mental health service pathways and patient populations, the CLP data collection tool was applicable across sites. Staff resourcing and referral demand are key determinants of CLP response times. [ABSTRACT FROM AUTHOR]