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This paper uses secondary analysis to understand how COVID-19 shaped people's experiences with psychosocial support services in Australia. Data are drawn from questionnaires (n = 66) and semi-structured interviews (n = 62), conducted for a national service evaluation, with 121 people living with enduring mental health conditions and using psychosocial support services. Data relating to COVID-19 were inductively coded and analysed using constant comparative analysis. Most people's experiences included tele-support. While some people described minimal disruption to their support, many reported reduced engagement. People's wellbeing and engagement were influenced by: their location, living situation and pre-COVID lifestyles; physical health conditions; access to, comfort with, and support worker facilitation of technology; pre-COVID relationships with support workers; and communication from the organisation. The findings can help services prepare for future pandemics, adjust their services for a 'COVID-normal' world, and consider how learnings from COVID-19 could be incorporated into a flexible suite of service delivery options. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Abstract: Many women who experience mental illness are mothers. Evidence suggests that the role of mother is of great importance and value to these women, yet they are more likely than other women to have their children removed from their care. Little is known about the experiences of these mothers after their children are removed. This paper presents a phenomenological analysis of in‐depth interviews with 8 women to answer the following question: How do mothers living with severe mental illness experience mothering after removal of their children by child protection services? The analysis showed that mothering continued to be a major life role for these women, but the way they enacted this role was transformed. Their mothering was now constrained and prescribed by external agents, likened to Greek gods, which imposed both boundaries to what they could do and an obligation to prove themselves worthy. Like Greek gods, these external agents were seen as all powerful, unpredictable, and flawed. The study highlights the need for child protection services and support services to recognize and support noncustodial mothering activities. [ABSTRACT FROM AUTHOR]

Background: Recovery oriented service provisions means focusing on outcomes that are important to consumers themselves rather than to clinicians or services. Partners in Recovery (PIR) is an Australia-wide initiative designed to provide service coordination and brokerage for individuals with severe and persistent mental illness. One PIR service engaged a consumer-led research team to evaluate the service from the perspective of consumers. This consumer-led study was established to explore PIR consumer's perceptions of outcomes they achieved through their involvement with PIR. Methods: Data were collected through semi-structured interviews exploring participant's views about and experiences with PIR. Data analysis occurred simultaneously with data collection using constant comparative analysis. Results: Twenty consumers participated. They reported experiencing valued outcomes in six domains: feeling supported; feeling more hopeful and positive about the future; improved mental clarity, focus and order in life; getting out of the house and engaging in positive activity; having a better social life; and improved physical health. Conclusions: Exploring outcomes achieved by PIR consumers, from their own perspective provides a nuanced understanding of the contribution these programs can have in supporting individual's recovery. Findings from this study highlight the kinds of outcomes consumers achieve when engaged with service coordination and brokerage services. Findings also suggest that outcome measures used in these types of services should focus on recovery outcomes as well as met and unmet needs. [ABSTRACT FROM AUTHOR]

Background/Aims: Parents can be an important source of support for young people living with mental illness. Young people have the potential to shape this support to best suit their needs, however little is known about this issue. This paper explores, from the perspectives of young people, how they manage parental support and involvement. Methods: Interviews were conducted with 26 young people (15-24 years old) who were living with mental illness and in frequent contact with at least one parent. These were analysed using constant comparative analysis. Findings: Young people reported shaping parental involvement using a combination of facilitation, compliance and resistance. Their actions were determined by a complex alignment of their wish for parent involvement, perceived potential to influence their parents, and ability to communicate their needs. Conclusions: By understanding these dynamics, therapists working with young people and their parents can help address barriers to achieving optimal parent support for young people experiencing mental illness. [ABSTRACT FROM AUTHOR]

Fathers are critical in the lives of young people, including those living with mental illness. Fathers' support may be different to that of mothers and is likely to influence the well-being of other family members. However, fathers' support is often seen as 'secondary' and little is known about the nature, diversity and impact of their involvement. This paper explores the parts played by fathers in supporting a young person (15-21 years old) living with mental illness. A modified grounded theory approach was used to perform a secondary analysis of data from in-depth interviews with 32 participants from 14 families: 13 young people, 13 mothers; and 6 fathers. Participants' descriptions of fathers' involvement varied along five dimensions, being the extent to which fathers: directly supported the young person; supported the mother; aligned with the mother; took responsibility for supporting the young person; and needed input from the mother. From comparison of data relating to each dimension across families, four distinct models of perceived father involvement are proposed. These are represented by transport metaphors: co-pilots; captain/first-mate; gondolier; and separate drivers. Father involvement was seen as having an impact on both young people directly and mothers' abilities to support young people. The findings are preliminary given the exploratory nature of the study, but nevertheless highlight the need for helping professionals and researchers to attend to father involvement to facilitate optimum parent support for young people living with mental illness. [ABSTRACT FROM AUTHOR]

A parent's response to a young person's mental illness can influence their recovery and wellbeing. Many parents devote considerable time and energy to supporting a young person experiencing mental illness and engage in numerous different practices to do so. Yet little is known about why parents use particular practices. This article explores this question through qualitative analysis of parent perspectives. Interviews with 32 parents of young people living with mental illness were analysed using constant comparative analysis. Findings suggest that parents' choice of and ability to carry out particular practices are shaped by: their knowledge and beliefs; their personal resources and constraints; and their social and service networks. Further, parents took active measures to optimize these influences. By understanding the complexity of their own potential influence on both knowing what to do and being able to do it, health professionals can better enable parents to support young adults experiencing mental illness. [ABSTRACT FROM AUTHOR]

Introduction: Engagement in meaningful occupations is of central importance in mental health recovery. The purpose of this study was to gain a richer understanding of the relationships between occupations, sources of meaning and recovery for people living with mental illness. Method: People living with mental illness (n = 78) attending an Australian Clubhouse completed the recovery assessment scale and socially valued role classification scale. Qualitative and quantitative data were analysed using mixed methods. Findings: The most meaningful occupations were those most likely to provide opportunities for social connection and being valued by others. The frequency with which these socially derived sources of meaning were identified far outweighed other sources: positive sense of self; skills/personal development; time use/routine; financial gain and fun/pleasure. Neither the occupations identified as most meaningful nor the source of meaning differed depending on level of recovery. Conclusion: Irrespective of stage of recovery, socially derived aspects of meaning are most frequently prioritized by people living with mental illness. In facilitating engagement in personally meaningful occupations, occupational therapists need to understand that, for many, meaningfulness centres around inter-dependence: being with others, belonging, giving or contributing and being valued by others. [ABSTRACT FROM AUTHOR]

Objective: A self-report instrument of mental health recovery is needed both to facilitate collaborative, recoveryoriented practice and measure recovery-focused outcomes. The Recovery Assessment Scale - Domains and Stages (RAS-DS) has been developed to simultaneously fulfill these goals. The aim of this study was to test the feasibility and measurement properties of the RAS-DS. Method: Feasibility was examined by 58 consumer-staff pairs volunteering from 3 non-government organisations. Consumers completed the RAS-DS, discussed it with staff, and then both completed Usefulness Questionnaires. The psychometric properties were examined using Rasch analysis with the data from these consumer participants and from additional participants recruited from two Partners in Recovery programs (N=324). Results: Over 70% of consumers reported taking 15 minutes or less to complete the RAS-DS and rated the instrument as easy or very easy to use. Qualitative data from both consumers and staff indicated that, for most, the RAS-DS was an easy to use, meaningful resource that facilitated shared understandings and collaborative goal setting. However, for a very small number of consumers, the instrument was too confronting and hard to use. Rasch analysis demonstrated evidence for excellent internal reliability and validity. Raw scores were highly correlated with Rasch-generated overall scores and thus no transformation is required, easing use for clinicians. Preliminary evidence for sensitivity to change was demonstrated. Conclusions: The results provide evidence of the feasibility and psychometric strengths of the RAS-DS. Although further research is required, the RAS-DS shows promise as a potential addition to the national suite of routine outcome measures. [ABSTRACT FROM AUTHOR]

Background/aims Parenting is a critical and complex occupational role, requiring different occupations and abilities depending on the developmental stage and specific characteristics of each child. When a young adult child develops a mental illness, assisting and supporting them to overcome or adapt to the mental illness becomes a crucial aspect of this occupational role to which many parents devote a great deal of time and energy. The way parents respond to mental illness can have an important impact on young people. However, to date, research on these parents has focussed almost exclusively on their characteristics and personal coping rather than what they do to try to assist and support young people. The aims of this study were to identify the occupations parents currently engage in to promote mental health and wellbeing for a young person with a mental illness and to explore the perceived helpfulness of these occupations. Method Interviews with 26 young people (15-24 years old) and 32 parents were analysed using constant comparative analysis. Results Participants reported 78 conceptually distinct mental illness related occupations aimed at promoting: appropriate treatment; positive activities and actions; positive thoughts and feelings; and an ordinary life. Importantly, few participants could evaluate with confidence the helpfulness of individual mental illness related occupations. Conclusion This research demonstrates the breadth of the mental illness related occupations parents employ and provides a framework for understanding their complexities. It highlights the need to establish an evidence base for various mental illness related occupations so that parents can have more knowledge and thus confidence in these critical occupations. [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]

Recovery from serious mental illness refers to the attainment of a meaningful, productive, and satisfying life, regardless of the presence or absence of reoccurring symptoms. A lack of psychometrically sound instruments has thwarted attempts to measure recovery. With the goal of addressing this need, we administered the Recovery Assessment Scale (RAS) to 92 people with serious mental illness attending a Clubhouse program. Clubhouses are community-based psychosocial rehabilitation programs for people living with mental illness. Rasch analysis enabled close examination of the RAS's internal validity and reliability. Through iterative analyses, we made enhancements to the instrument where possible. The preponderance of evidence suggests that the modified RAS forms a unidimensional construct; however, the instrument remains far from a gold standard. Occupational therapy is well suited to take leadership in further development of this instrument. [ABSTRACT FROM AUTHOR]

In this article, the author presents the perspectives of people with mental illness about the benefits and drawbacks of employment, what factors influence these, and how they affect consumers' decisions and actions. Forty-one consumers of mental health services participated in 76 in-depth interviews and two focus groups. The author coded data inductively and analyzed them using grounded theory method. The results demonstrate that the benefits and drawbacks of employment are experienced in six domains. Individuals' perceptions of benefits and drawbacks are influenced by individual and contextual factors, are dynamic over time, and are instrumental in determining their employment-related actions. The findings suggest several areas for future exploration with a view to improving policy and practice in employment for people with mental illness. [ABSTRACT FROM AUTHOR]

This paper is based on a qualitative study of employment for people with mental illness. Forty-one consumers of mental health services were interviewed to obtain their perspectives on employment. One of the major issues they discussed was the ways in which mental illness affected their employment experiences. These effects were complex and interrelated and varied between individuals depending on their unique characteristics and circumstances. Participants described effects relating to the need to maintain mental health, difficulties with work performance, and work confidence and work goals. Understanding consumers' perspectives on how mental illness affects employment is necessary for practitioners and researchers seeking to explain or improve consumers' employment outcomes. [ABSTRACT FROM AUTHOR]