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The Australian disability workforce has grown, and there is compelling evidence that peer work has a number of valuable impacts. Despite these apparent opportunities, there continue to be high levels of unemployment among people with disability and failure to draw on the assets of people with disability in Australian workplaces. To understand these ostensible missed opportunities, this study examined the ways in which lived experience was described as an asset in disability workforce recruitment. Advertisements for positions in New South Wales, Australia, that referred to lived experience or peer work and disability were collected over a 3‐month period. Through a process of content analysis, we found that there were more employment opportunities for people with lived experience of mental illness than for other types of disability. Community engagement was a key function, and peer workers were described as complementary to professionals. Recruitment processes for lived experience jobs were not necessarily accessible. We recommend systemic reforms to facilitate recognition of lived experience as a valuable criterion for disability sector employment and to harness the benefits of a disability peer workforce. [ABSTRACT FROM AUTHOR]

• Young people do not seek help specifically for debt, despite its impact on them. • Youth workers are a first point of contact, but not equipped to deal with debt issues. • Adequately resourcing and training youth workers can help young people address debt. Debt is a growing, but poorly understood issue for young people in Australia and internationally. To understand how young people seek help with debt, we conducted interviews and focus-groups with 16 youth workers and two financial counselors. We found that youth workers are often the first point of connection for young people experiencing debt. Young people were unlikely to seek help specifically for financial issues but disclosed these issues to trusted youth workers when addressing other concerns. However, youth workers do not have any formal training in this area. We argue that although youth workers are well positioned to support young people in relation to financial issues due to their skills in working with complexity, they are under-resourced for this role. Without adequate resourcing, providing support to young people experiencing debt and financial stress is likely to remain a growing area of concern for an already over-burdened and under-resourced sector. [ABSTRACT FROM AUTHOR]

Aims: Suicide prevention remains a priority in rural and remote Australia, where suicide rates continue to be higher than those in urban communities. This commentary describes the Good SPACE suicide prevention program, and the lessons learned from delivering this program over a 14‐year period. Context: The Good SPACE program has been operating in rural New South Wales since 2007. The program focuses on educating rural community members to recognise the signs of suicide vulnerability, and how to take appropriate action if they encounter someone considering suicide. Approach: Communities are selected to receive Good SPACE training in consultation with key stakeholder organisations, or by request from communities. Across the life of the program, key challenges in its administration have included short‐term funding arrangements and staff turnover. Strengths have included the ability to adapt content to meet the needs of rural communities (eg from an initial focus on helping farmers during periods of drought, to a broader focus on all rural residents and a wider range of adversities). As the program moves forward, emphasis will be placed on harder‐to‐reach populations, including males and those with lower mental health literacy. Conclusion: The Good SPACE program has ongoing funding to adapt its content and continue administration through the Rural Adversity Mental Health Program (https://www.ramhp.com.au/). The lessons learned throughout the life of the program might be of use to other organisations aiming to provide community‐based education programs in rural and remote communities. [ABSTRACT FROM AUTHOR]

Objective: This evaluation considered the potential of We‐Yarn, a suicide prevention gatekeeper training workshop, to contribute to Aboriginal suicide prevention in rural New South Wales. Design: A mixed methods approach included surveys, in‐depth interviews and workshop observations. Setting: Aboriginal suicide prevention training in rural New South Wales, Australia. Participants: Attendees at We‐Yarn training. Intervention: We‐Yarn provided culturally safe suicide prevention skills training for Aboriginal people and for those who work with Aboriginal communities and persons in rural New South Wales. Training workshops were delivered across multiple locations for 6 hours in one day. Workshops were facilitated by two facilitators with lived and professional experience; one Aboriginal and one non‐Aboriginal facilitator. We‐Yarn content was developed by staff from the Centre for Rural and Remote Mental Health, and in consultation with Aboriginal Elders and representatives of Aboriginal Medical Services to ensure relevance and cultural appropriateness. Main outcome measures: Pre and post‐workshop surveys captured capacity and participants' confidence in identifying and responding to a person at risk of suicide. Interviews explored participants' experiences of workshops, implementation of learning, and attitudes regarding social and emotional wellbeing and suicide. Observations detailed the workshop environment, participants' engagement, and participants' responses to facilitators and content. Results: We‐Yarn was considered culturally appropriate. Participants responded to facilitators' lived experiences. Participants reported significant improvements in understanding the links between cultural strengths, social and emotional wellbeing and suicide prevention. However, health professionals with existing knowledge wanted a stronger focus on clinical training. Conclusion: We‐Yarn promoted discussion of suicide prevention within a holistic health framework, building on participants' pre‐existing knowledge about social and emotional wellbeing. Importantly, skilful facilitators with lived experience were vital to the success of the workshops. Consideration should be given to attracting people with low suicide prevention knowledge to the workshops, developing tailored workshops for health professionals and ensuring prolonged engagement with communities. Multifaceted and long term responses in addition to this type of training are important. [ABSTRACT FROM AUTHOR]

• Family inclusion in child protection is a critical but unrealised aim in Australia. • Parents who have had children removed from their care feel powerless and voiceless. • Parents seek collaboration and meaningful roles in their children's lives. • Parents' advocacy and passion can be reconceptualised as an asset for inclusion. The inclusion of families throughout the child protection process can improve lifelong outcomes for children who have been removed from their parents' care. However, child protection authorities have struggled to prioritize principles of family inclusion within systems that position families as risky. While parents' experiences of powerlessness within child protection systems have been well documented, little is known about parents' perspectives on family inclusion specifically. We engaged six parents who had experienced removal of children from their care in interviews and focus groups as part of a larger study that examined practitioners', carers', lawyers' and parents' views on family inclusion in Australia. In this article we report on parents' experiences and recommendations for improving family inclusion. Through the analytical framework of Foucauldian concepts of power, knowledge and acts of resistance we highlight the complexities of parents' lives and intersections in their experiences of systemic and social exclusion. In identifying the importance of collaboration, decision making and parental identity these findings suggest that the advocacy of parents for inclusion in the lives of their children is an underutilized asset in child protection systems. [ABSTRACT FROM AUTHOR]

Summary This article considers the place of service-user knowledge and expertise within an evidence-based practice perspective. It makes a strong argument that client involvement is a core principle of Sackett et al.'s foundational approach in evidence-based medicine. In so doing, it draws on research on service-users' perceptions and experiences of evidence-based practice. Findings For service users, evidence-based practice lacks relevance and trustworthiness unless it explicitly factors in the expertise of service users themselves. Evidence-based practice is seen to have merit as a tool for enhancing accountability, but service users see a role for themselves at individual and representative levels in the process of evidence-based practice. They place a high value on the expertise derived from lived experience, and recognise that fluctuations in capacity and changes in circumstances of many service users require a flexible approach to their participation in decision making. A pragmatic approach to the conceptualisation of evidence is recommended, which not only maintains scientific rigour inherent in evidence-based practice but also more strongly emphasises the process of analysing evidence appropriate to a particular individual's preferences and circumstances. Applications For human service practitioners, this study emphasises the need to develop professional skills in assessing the capacities, circumstances and preferences of clients and analysing and applying evidence for practice in ways that conform to a client-centred approach. It also indicates a need for researchers and practitioners to recognise and value service-user expertise. [ABSTRACT FROM AUTHOR]

This paper draws on findings from an Australian study of mental health service users' perspectives on service user participation to examine the challenges for translating recovery policy into practice. It considers the ways in which national mental health policies and developing welfare reforms reflect and/or contradict the highly personal mode of recovery important to service users; though they seemingly signal potential wins for service user empowerment, they are accompanied by losses for those who do not fit neatly into clinical categorisations. The service users (n = 11) and service providers (n = 6) interviewed for this exploratory qualitative study revealed that recovery was a lifelong process of fluctuating capacity and described a system poorly equipped and often unwilling to move beyond tokenistic modes of participation. The analysis of service user perspectives against the backdrop of policy reform reveals the ongoing tensions between personal and clinical definitions of recovery. [ABSTRACT FROM AUTHOR]

This paper examines the challenges and opportunities for integrating peer support in mental health. After reviewing the contemporary literature, it considers how the findings of a recent qualitative case study, which examined the perspectives of mental health service users (n =  11) on service-user participation and evidence-based practice, might inform the introduction of a peer support program into a mental health service provided by a large Australian non-government organisation. While there is little empirical evidence demonstrating the effectiveness of peer support, the study revealed that service users valued the expertise of their peers and offered guidance for translating evidence into service models. [ABSTRACT FROM AUTHOR]

Models of service-user participation have derived from citizenship or consumerist agendas, neither of which has achieved the structural reforms important for the most marginalised social work clients. This article proposes Fraser's model of 'parity of participation' as an appropriately multifaceted frame for capturing the social justice aspirations of service-user participation. A qualitative case study compared the experiences and expectations of people who had used Australian mental health services with a sample who had used Australian homelessness services to examine their expectations of participation at individual and representative levels. The findings reinforce concerns from Fraser's research about the tendency for identity-based consumerist notions of participation to reify group identity. This leads to tokenistic service-user involvement strategies that have little impact on participation at a structural level. Fraser's parity of participation is shown to have untested potential to reshape service-user participation to meet the social justice aspirations of social work clients. Key Practitioner Message: ● Innovative, service-user driven strategies for collaboration will be those which challenge existing power structures; ● Service users want their contributions to decision making to generate identifiable change in the system of social services; ● The success of service-user participation strategies might be the extent to which political, economic and cultural opportunities are enhanced. [ABSTRACT FROM AUTHOR]

As leaders of the Unknown Fields Division at the Architectural Association (AA) School of Architecture in London, Liam Young and Kate Davies take their students on trips to the end of the earth. Cataloguing extreme territories, they investigate the role of design in developing new cultural relationships. Fictional speculation is used as an instrument for understanding emerging environmental and technological futures, in a process of experiencing, chronicling and, ultimately, reimagining the urban and the remote, and charting global flows and trajectories. Here they describe a speculative supply chain that begins below the surface of the Western Desert in outback Australia, and continues to the Arctic 'Northwest Passage' and on to London. [ABSTRACT FROM AUTHOR]

Background: The Central Coast Integrated Care Program CCICP is one of three integrated care demonstrator projects within NSW Australia funded for three years to challenge existing service fragmentation within and between health and social care sectors. The district-wide complex intervention focused on vulnerable youth, vulnerable older persons and people with chronic and complex conditions. As part of the formative evaluation of the CCICP, the Project Integrate Framework was used to map integrated care progress. This Framework provides an evidence-based understanding of the key dimensions and items of integrated care associated with successful implementation. Methods: Based upon the Project Integrate dimensions, an online survey of key stakeholders was undertaken. The survey results underpinned a workshop to assist CCICP team reflection and assessment of progress. This exercise enabled future program priorities and strategies to be set. Key stakeholder interviews were mapped to the Project Integrate dimensions for additional perspective. Results: The research results indicated where progress had been achieved, where learnings had been embedded in service delivery and aided the determination of priorities for action. Learnings about the suitability of Project Integrate dimensions and their use in online, interview and workshop formats will enable its use in other Australian and international settings. Discussion: The Project Integrate Framework aims to provide a conceptual basis for reflecting on the design and implementation of integrated care programs/projects. Our research found the survey tool alone was inadequate to assess integrated care progress, with many answers reflecting uncertainty Neither Disagree nor Agree. The data was reviewed in a workshop with the CCICP team to contextualise the uncertainty, particularly given the formative assessment stage. This greatly enhanced the understanding of progress in care integration on the Central Coast. This finding is congruent with the recommendation for the use of the Framework outlined in the original research. The Project Integrate Framework was identified by the CCICP team as a key communication tool, enabling a consistent terminology for integrated care. However, certain terminologies were not always understandable or meaningful to everyone. Group discussions were important to generate collective understanding of the meaning and importance of the dimensions. As with international case examples, progress towards system integration was regarded as poor, with substantial structural barriers beyond the control of the CCICP team. The intervention appears to be tracking more favourably in the dimensions of person-centred care, clinical and professional integration which was linked to sustained efforts to build relationships and enable a shared understanding of what the CCICP was seeking to achieve normative integration. Conclusion: Use of the Project Integrate framework supported by appreciative dialogue has enabled the CCICP team to reflect on progress and spread of integrated care within the Central Coast Local Health District and on what should be their next steps for spreading and building sustainability. The research findings are being used to refine the Project Integrate Framework as a means to support on-line assessments of integrated care to enable programs to have meaningful group discussions on design and implementation, and as a means to facilitate comparative research. [ABSTRACT FROM AUTHOR]

Suicide is a leading cause of death, particularly in rural and remote areas. Although depression is strongly related to both suicidal ideation and attempt, it lacks specificity as a predictor, and little is known about characteristics that increase suicide risk among people with depression. A telephone version of the World Mental Health Composite International Diagnostic Interview explored lifetime depression, suicidal ideation, suicide attempt, and related factors among a community-dwelling sample of rural and remote Australians, selected for an interview based on a screener for psychological distress (100% of those with high distress, 75% of those with moderate distress, and 16% of those with low distress). Of 1051 participants interviewed, 364 reported lifetime symptoms of depression; of these, 48% reported lifetime suicidal ideation and 16% reported a lifetime suicide attempt. While depression severity was a significant correlate of suicidality for both males and females, suicide attempt was significantly more common among females with a younger age of depression onset, and a higher number of psychiatric comorbidities. No additional factors were significant for males. Among rural and remote residents with lifetime symptoms of depression, the identification of suicide risk may be enhanced by considering individual and contextual factors beyond depression severity. Further research focusing on risk factors for males would be beneficial.