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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.

The article focuses on a study which explores several issues concerning the emergence of problematic internet use (PIU) in childhood and youth. It uses relevant literature-search methodology as well as using the key terms of PIU, internet addiction, and youth mental health. The use of common internet search engines is discussed.

Purpose To descriptively assess medical students' concerns for their mental and emotional state, perceived need to conceal mental problems, perceived level of support at university, knowledge and use of student support services, and experience of stresses of daily life. Study design From March to September 2011, medical students at an Australian university were invited to complete an anonymous online survey. Results 475 responses were received. Students rated study and examinations (48.9%), financial concerns (38.1%), isolation (19.4%) and relationship concerns (19.2%) as very or extremely stressful issues. Knowledge of available support services was high, with 90.8% indicating they were aware of the university's medical centre. Treatment rates were modest (31.7%). Students' concerns about their mental state were generally low, but one in five strongly felt they needed to conceal their emotional problems. Conclusions Despite widespread awareness of appropriate support services, a large proportion of students felt they needed to conceal mental and emotional problems. Overall treatment rates for students who were greatly concerned about their mental and emotional state appeared modest, and, although comparable with those of similarly aged community populations, may reflect undertreatment. It would be appropriate for universities to address stressors identified by students. Strategies for encouraging distressed students to obtain appropriate assessment and treatment should also be explored. Those students who do seek healthcare are most likely to see a primary care physician, suggesting an important screening role for these health professionals. [ABSTRACT FROM AUTHOR]

The article discusses evolution of KYDS Youth Development Service "KYDS," a pioneering youth service in Sydney, Australia, programs offered by it and challenges faced by it. It is informed that the program was started in 2005 to provide mental health services to affected young people and gradually included services like therapy for referred clients, parent educational forums and group programs for mentally ill people.

Background: The prevailing view that the vast majority of those who complete suicide have an underlying psychiatric disorder has been recently challenged by research on the contribution of "predicaments", in the absence of mental illness, to suicide. In this paper, we sought data to support the notion that forced marriage may lead to suicide without the presence of psychiatric disorder. Method: Historical records, newspapers, and the electronic media were searched for examples. Results: Two examples from ancient times and six from the last hundred years were located and described. Conclusion: These cases suggest that forced marriage may lead to suicide and complements earlier findings that loss of fortune, health, liberty, and reputation may lead to suicide in the absence of mental disorder. [ABSTRACT FROM AUTHOR]

Objective: This paper describes aspects of the child and adolescent benchmarking forums that were part of the National Mental Health Benchmarking Project (NMHBP). These forums enabled participating child and adolescent mental health organizations to benchmark themselves against each other, with a view to understanding variability in performance against a range of key performance indicators (KPIs). Method: Six child and adolescent mental health organizations took part in the NMHBP. Representatives from these organizations attended eight benchmarking forums at which they documented their performance against relevant KPIs. They also undertook two special projects designed to help them understand the variation in performance on given KPIs. Results: There was considerable inter-organization variability on many of the KPIs. Even within organizations, there was often substantial variability over time. The variability in indicator data raised many questions for participants. This challenged participants to better understand and describe their local processes, prompted them to collect additional data, and stimulated them to make organizational comparisons. These activities fed into a process of reflection about their performance. Conclusions: Benchmarking has the potential to illuminate intra- and inter-organizational performance in the child and adolescent context. [ABSTRACT FROM AUTHOR]

Objective: This paper provides an overview of the National Mental Health Benchmarking Project (NMHBP) which explored the value of benchmarking within the four main program areas of public sector mental health (general adult, child and adolescent, older persons and forensic). The NMHBP involved a series of forums which enabled participating organizations to benchmark themselves against each other, with a view to understanding variability in performance against a range of key performance indicators (KPIs). Method: Twenty-three mental health organizations took part in the NMHBP. The forums culminated in each mental health organization documenting its performance against relevant KPIs. The processes, impacts and outcomes of the NMHBP were evaluated via a multi-methods evaluation. Results: There was considerable variability across program streams for many of the KPIs, much of which could be explained by contextual factors. Within program streams there was considerable intra-organization variability. Participants found the examination of intra-organization variability on particular indicators to be useful. Conclusions: The NMHBP has shown that benchmarking is possible. Managers and clinical leaders will need to champion benchmarking and highlight its utility in relation to quality improvement and service development if the accountability goals of the Fourth National Mental Health Plan are to be realized. [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]

Objective: This paper reports on a brief survey of clinicians' judgements when making treatment decisions in the context of diagnostic uncertainty. Specifically, attitudes and opinions were sought from practising consultant psychiatrists regarding two key areas of clinical decision-making in first episode psychosis (FEP), namely, when to initiate medication and, how long to continue treatment. Method: Interviews were conducted with consultant psychiatrists using a combination of structured and semi-structured questions that examined and explored pharmacological treatment decisions in FEP. Results: Twenty-three consultant psychiatrists participated in the interviews. The threshold to initiate pharmacological treatment was lower when a risk to self or others is present, when symptoms are primarily positive, when the patient is in distress, or where there is a family history of mental illness. Atypical antipsychotics are routinely used as front-line medication in FEP and the choice of medication is determined largely by their likely side effect profile. However, the greater the perceived efficacy, the greater the anticipated tolerability burden. The ideal duration of treatment is considered to be 1–2 years in instances of full remission, and 5 years where only a partial response has been achieved or where recovery has not been sustained. Conclusions: The ‘first episode’ represents a unique period in the management of psychosis where by definition there is no history of pattern of illness, diagnostic certainty is rare, and the patient usually does not have any prior exposure to medications. Therefore, each management decision needs to be considered following a risk benefit analysis which takes into account the context of the individual. [ABSTRACT FROM AUTHOR]

Objective: This study measured patient satisfaction levels and staff views regarding their expectations and workplace and other opinions after relocation to a new purpose-built mental health facility within the grounds of a general repatriation hospital. Method: Patients were interviewed face-to-face using a standardized satisfaction survey at least 2 months after the move to the new facility. In addition, surveys were sent by mail to all clinical staff rostered to work the same period that the patient interviews were conducted. Results: One hundred patients were interviewed and 123 staff returned the survey (56% response rate). Patients and staff rated the new ward environment and food services most highly and were least satisfied with patient information and medical services. Less satisfaction was expressed about resource issues such as information technology and dedicated staff facilities. Most staff (70-80%) rated services provided to patients to be the same or better than their original expectations. Conclusions: The results indicate that the hospital move did not have any measurable negative impact on overall service provision or patient satisfaction. In fact, expectations were met or improved for several clinically relevant areas after relocating the mental health facility. Another survey is planned in 12 months to assess if patient and staff ratings change. [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]

The article discusses the narrative ethics in psychiatry. Psychiatric narratives serve the roles of both providing a means of moral reflection for psychiatrists in the light of stories and a de facto role of influencing public perceptions of issues such as psychopathology and the treatment of psychiatric disorder. The article discusses psychiatric narratives in the context of the depiction of adolescents in literature. It also explores the dialectic between psychiatric narratives and the narratives in literature.

Without evidence, clinicians may inadvertently be providing treatment that is not necessarily best for some consumers. If consumers, carers, and staff have different views about what type of services are best and which treatments are most effective, it is in all our interests to know more about these differences and find common ground. This article provides an overview of factors that require consideration and action for collaborative research to be successful. Actively involving consumers and carers in mental health research may improve the quality of research and has the potential to enhance clinical outcomes. However, a range of challenges must be overcome, which include insufficient training, extra time requirements, stress and non-representativeness, and the impact on research projects, consumers, and researchers. These factors apply equally to carers and, arguably, staff. With sufficient motivation, commitment, and funds for the requisite time, all of these disadvantages could be overcome or at least minimized. [ABSTRACT FROM AUTHOR]

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Objective: To describe a pilot group programme for parents with a mental illness that was developed and implemented on the NSW Central Coast. Conclusions: The Parenting and Mental Illness Group Program is a 6-week group programme that is followed by four weekly, individual home visits. Data from the Eyberg Child Behaviour Inventory and Parenting Scale suggest the programme produced positive outcomes in children’s behaviour and parenting practices; the programme was also viewed favourably by participants. While encouraging, these findings require replication, using larger numbers and evaluation of the programme in other sites. Supported by an evidence base, programmes such as this will be important to implement if mental health services are to improve outcomes for parents with mental health problems and their children. [ABSTRACT FROM AUTHOR]

Objective: To provide some direction for those interested in obtaining funding with the purpose of highlighting opportunities for beginner researchers in the health-care field. Method: Features of a good grant application are described and an audit of seven mental health professional journals was undertaken, the latter to determine, inter alia, whether the paper reported research findings and whether the authors received formal research funding. Result: The audit revealed that many types of papers that are published do not receive formal research funding and describe, for example, services, training issues, clinical practice and education programmes. Conclusion: Innovative and enterprising efforts are required to secure clinical research funding. Submissions must be detailed, comprehensive and relevant, but the onus is also on the researcher to ensure a feasible study, where funding obligations can be fulfilled and findings readily disseminated. Many research studies are conducted without achieving competitive funding, and getting published – and getting started in writing – does not hinge on conducting formal research or receiving research funding. [ABSTRACT FROM AUTHOR]

There is increasing emphasis on enhancing consumer and carer participation in the planning and provision of mental health services. However, health professionals, consumers, and carers have different perceptions about what constitutes optimal care; identifying, negotiating, and meeting their respective needs can be challenging. The aim of the paper is to highlight the challenges of facilitating carer participation in daily practice and emphasize the broader issues that would benefit from more extensive discussion among health professionals. By examining the strategies used to enhance consumer participation, there is the potential to avoid many of the mistakes of the past and create a flexible and responsive framework to increase carer involvement. The authors anticipate that this discussion will resonate with many clinical staff as well as carers themselves. Identifying barriers to carer participation opens the way to promoting collaboration and enhancing care. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the contribution of the ‘School-Link’ initiative to an Area Mental Health Service. Method: Surveys and focus groups of school and health service personnel were conducted to examine the three foci of the School-Link initiative, namely prevention, early intervention and service access. Results: Improvements witnessed since the commencement of School-Link include an increase in the number of evidence-based mental health promotion programmes in schools, improvements in the communication between health and education departments, improvements in referral patterns and better practices, such as improved feedback, in both health and education sectors. School counsellors feel more supported in their role by health services and better able to manage certain patients. Conclusions: The actual and potential benefits of School-Link for young persons appear considerable. School-Link has provided opportunities for communication, upgrading of skills and collaborative work on mental health issues, in both education and health settings. [ABSTRACT FROM AUTHOR]

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]

Various lifestyle factors contribute to morbidity and mortality. Health promotion programs have the potential to increase awareness about, and possibly modify, some of these factors. In the workplace, these programs can be accessed by large groups of people. A healthy lifestyles programme was piloted for non-clinical staff in Central Sydney Area Mental Health Service, Australia. The aim of the programme was to provide non-clinical staff working in a mental health setting with education and information on a range of health conditions and topics. A needs analysis survey, along with formal and informal liaison and discussion, informed the programme's development and implementation. A total of 28 sessions were held; attendance ranged from 1 to 51 with a mean of 13.57 and a median of 12.5. Feedback regarding the programme has generally been positive. This pilot demonstrates that nurses, with their colleagues from other disciplines, are well positioned to deliver health promotion and education initiatives that may contribute to increasing awareness, and possibly modification, of lifestyle factors. [ABSTRACT FROM AUTHOR]

In this article, author suggests ways for engaging and encouraging boys in mental health care and mentions the advantages of internationally respected 'Headspace' program. Topics discussed include use of the prescribing services of general practitioners for mental health medication in young girls, need of providing care to young people with mental health problems and implementation of psychotherapeutic techniques for promoting mental health recovery among boys.

The article provides the author's view in relation to his retirement as editor of the journal "Australasian Psychiatry." He highlights the journal's objectives in bringing several issues related to the art of psychiatry through article on clinical practice, innovative services, and training and educational programs. He acknowledges several individuals who have helped him in the industry.

Objective: Because major depression in adolescents often goes undiagnosed, it is useful to establish whether clinicians’ rates of making this diagnosis in a specialist adolescent mental health service change when a self-rating depression scale is routinely administered. Method: A retrospective, naturalistic study examining the rate of diagnosis of major depression in a mental health service between 1993 and 1997. The intervention was the administration of the Center for Epidemiological Studies Depression Scale (CES-D) prior to initial assessment from September 1995 onwards. The proportion of clinical diagnoses of DSM-III-R or DSM-IV major depression was the outcome measure. Age, gender, ratings of depression and other confounding variables were used to control for changes in patient population over time. Results: One thousand three hundred and ten adolescents aged 12 to 17 years assessed between 1993 and 1997 were included. After taking into account potential confounders, diagnosis of major depression was 2.8 times (95% confidence interval 1.8, 4.3) as likely when the CES-D was in use. Increase was more marked when adolescents were more disturbed overall. There was no evidence suggesting this was due to changes in diagnostic practices or in the patient population. Conclusion: Availability to clinicians of a self-rating depression scale completed prior to assessment was associated with an increase in the frequency of diagnosis of depression in a specialist mental health service for adolescents. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to describe the content and time allocated to undergraduate medical education curricula in child and adolescent psychiatry. The results show a limited agreement about curricula content for undergraduate child and adolescent psychiatry teaching programs in medical schools. In many countries, the number of child and adolescent psychiatrists with academic appointments is limited, and child and adolescent psychiatry programs are developed and taught by a small number of teaching staff at each medical school. It suggests the need for medical schools to reconsider the relatively low priority given to teaching child and adolescent psychiatry to medical students.