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This study aimed to explore, from peer workers' perspectives, the supports and strategies they use to optimise their wellbeing and effectiveness in their roles. A qualitative descriptive study was conducted using semi-structured interviews with nine peer workers from a community managed organisation in New South Wales, Australia in 2022. Data were analysed using qualitative content analysis. Peer workers described four types of personal strategies: looking after myself; increasing my peer-related skills; recognising and using my skills; and advocating for and promoting peer work. They described five types of organisational support that helped them to use these strategies and influenced their wellbeing and performance: professional development opportunities; a mental health friendly environment; place of peer work in the organisation; team dynamics and support; and logistical support. This research can help stakeholders recognise the strategies and supports that are beneficial to peer workers and facilitate understanding and support between mental health staff. While a small, contextualised study, it could provide strategies for peer workers new to the industry and for organisations seeking to ensure the sustainability of their peer workforce and the quality of services supplied to consumers. [ABSTRACT FROM AUTHOR]

Unfortunately, it remains a common theme that when students reach the end of secondary school, they have focused most of their efforts on academic achievement but not on preparations for future employment (Hewett, Douglas, & Keil, 2014; McDonnall, 2010). Important employability skills for students with visual impairments are detailed within the career education area of the expanded core curriculum (Wolffe, 2014); however, these are apparently not prioritized until transition looms. This commentary suggests different time constructs are important when preparing for transition. "Starting early" (timing) with a student with visual impairment is essential to increase available time.

In this article, the authors trace the emergence of an institutional discourse of ethical research and interrogate its effects in constituting what ethical research is taken to be and how ethical researchers are configured. They illuminate the dissonance between this regime of truth and research practice and the implications for the injunction to respect others, illustrating their case with instances from their interview study with anorexic teenage girls. The authors propose that conceptualising the regulation of research ethics as an institutional discourse opens up the possibility for asserting counterdiscourses that place relational ethics at the center of moral decision making in research. (Contains 4 notes.)

In this paper we posit a radical retheorization of anorexia as a form of deviance. We examine how the disciplinary practices and moral technologies typical of contemporary secondary schooling signify and enter into the articulation of three "virtue discourses" (discipline, achievement and healthism), and tease out how these "virtue discourses" play into the formation of the "anorexic" subject. Informed by Foucauldian theory, our analysis draws on our life history interview study with teenage girls diagnosed with anorexia nervosa and their parents. We argue that anorexia can be understood not as a form of deviance but as a "paradox of virtue" involving zealous compliance with and taking up of socially and culturally sanctioned "virtue discourses" that are immanent in schooling and wider society. (Contains 2 notes.)

The developmental status of 37 Australian preschool children (ages 5-78 months) born to mothers with intellectual disability was assessed. In all developmental domains, a substantial proportion of the children (between 35 and 57%) showed a delay of at least 3 months. Delays in physical and communication development were most prevalent. (Contains references.) (CR)

Introduction: Dating is an occupation through which people form intimate relationships with others. Despite the importance of intimate relationships for wellbeing, there is limited information available in occupational therapy literature about the activities involved in dating and little guidance for practitioners who wish to support clients from diverse backgrounds who experience difficulties with dating. To address this gap, this study sought to explore dating among young adults (18–35 years) and compare dating activities between two contexts: Australia and Hong Kong. Methods: Data were collected using an e‐survey designed for this study and refined using cognitive interviewing (n = 12). It included questions about dating initiation and activities. Study design and reporting was guided by the Checklist for Reporting Results of Internet E‐Surveys. Data were analysed using descriptive statistics and between group comparisons. Reponses to open ended questions were subjected to interpretative content analysis and quantified. Results: In total, 2208 young adults aged 18–35 who had at least one dating experience and resided in either Australia or Hong Kong completed the survey. Participants met their dates most commonly through school, friends, dating apps, and work. The most frequent ways to ask a person on a date were by suggesting 'hanging out' or going out for food, drink or to the movies. Most participants reported that organising a date required extended negotiation between the parties. Differences were found between participants from Hong Kong and Australia. Conclusions: This is the first study of contemporary dating from an occupational perspective and provides an understanding of dating activities in two different cultural contexts. [ABSTRACT FROM AUTHOR]

This paper explores attitudes toward dating people with disability amongst young people in Australia and Hong Kong. Data relating to disability were extracted from an e-survey that investigated young people's (n = 2208) experiences of and attitudes toward dating. Quantitative data were analysed using descriptive statistics while open ended responses were subjected to interpretive content analysis. When asked about preferred characteristics for potential dates, young people identified factors that were unlikely to be negatively influenced by disability, such as loyalty, honesty, dedication, humour, and kindness. Yet when asked whether disability would influence their dating choices, most said that it would and expressed an unwillingness to date people with disability. Young adults in Hong Kong expressed less openness to dating people with disability than those in Australia. Physical disability and mental health issues were seen as less of a barrier to dating than intellectual or developmental disability. Despite recent gains in public attitudes toward people with disability, improvements are needed in terms of young people in the general population viewing people with disability as suitable partners and thus, allowing them to enjoy equal rights to relationships and sexuality. Culture is an important determinant, indicating a potential for change. [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]

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]

Introduction: Occupational therapists are an integral part of Australian mental health services. Recent changes in the mental health sector mean that increasing numbers of occupational therapists now work in generic, non‐profession‐specific roles in non‐government organisations. Previous research has identified a range of challenges faced by occupational therapists in generic roles, including reduced satisfaction and loss of professional identity. An exploration of potentially positive aspects and strategies that assist occupational therapists to succeed and flourish within generic roles is lacking. The aim of this study was to explore what assists occupational therapists to thrive within generic roles in Australia's non‐government mental health sector. Methods: Semi‐structured, in‐depth interviews were conducted with 12 occupational therapists working in generic mental health roles across three non‐government organisations spanning three Australian states. Data were analysed thematically using constant comparative analysis. Results: Thriving was supported in three domains. First, occupational therapists facilitated their own thriving by keeping their occupational therapy lens, and managing ambiguity. Second, workplaces were supportive when their values aligned with occupational therapy core values, they recognised and valued the occupational therapy contribution, and their roles allowed opportunities for therapists to use their profession‐specific skills. Third, the broader occupational therapy profession assisted thriving through preparation, validation and ongoing inclusion. Conclusion: Despite some challenges, occupational therapists can and do thrive in generic non‐government mental health roles. The preliminary framework of thriving provides valuable insights for those developing university curricula, those providing continuing professional development opportunities and for individual occupational therapists entering this expanding area of practice. Findings also provide insights into how individuals, academic curricula and the profession can respond and adapt to systemic transformations occurring in mental health service delivery. [ABSTRACT FROM AUTHOR]

The authors convey their concerns on transition preparations for students with visual impairments in Australia. Topics mentioned include percentage of Australians with visual impairments of working age who are employed, career identity development and time perspectives, and suggestions to stimulate reflection during practice.

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]

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/Aim. Internationally, mental health policy requires clinicians to shift from a medical to a recovery-oriented approach. However, there is a significant lag in the translation of policy into practice. Occupational therapists have been identified as ideally situated to be recovery-oriented yet limited research exploring how they do this exists. This study aimed to explore Australian occupational therapists' experiences of developing and sustaining recovery-orientation in mental health practice. Methods. Semistructured, in-depth interviews were conducted with twelve occupational therapists working across differentmental health service types. Participants identified themselves as being recovery-oriented. Data were analysed using constant comparative analysis. Results. Occupational therapists described recovery-oriented practice as an active, ongoing, and intentional process of seeking out knowledge, finding fit between understandings of recovery-oriented practice and their professional identity, holding hope, and developing confidence through clinical reasoning. Human and systemic aspects of therapists' workplace environment influenced this process. Conclusions. Being a recovery-oriented occupational therapist requires more than merely accepting a specific framework. It requires commitment and ongoingwork to develop and sustain recovery-orientation. Occupational therapists are called to extend current leadership activity beyond their workplace and to advocate for broader systemic change. [ABSTRACT FROM AUTHOR]

Background/aim International students from culturally and linguistically diverse backgrounds experience personal and academic challenges when studying health sciences in Australia. Given recent discussions about cultural specificity in occupational therapy and its status as an emerging profession in most Asian countries, this study aimed to explore and describe the experiences of international students from Asian backgrounds studying occupational therapy in Australia. Method A phenomenological approach was used to understand the experiences of participants. In-depth interviews were conducted with eight international occupational therapy students from Asian countries studying in Australia. Data were analysed using hermeneutic methods. Results Participants described three interlinked and ongoing experiences: (1) Discovering and engaging with occupational therapy; (2) Fitting into my new role; and (3) Anticipating my role at home. Whilst theoretical aspects of occupational therapy were seen as compatible with participants' home cultures, application was seen as problematic due to the differences in structure and institutional culture of the healthcare systems. Although students made adaptations to fit in as occupational therapy students in Australia, they continued to see themselves as different, and their adaptation also influenced how they saw themselves in relation to their home culture. Conclusion Findings can contribute to creating culturally sensitive education for occupational therapy students from Asian countries. To best serve these students, educators should consider ways to facilitate transitions both out of and back into students' home cultures. [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: Providing children and adults with opportunities to engage in manageable risk taking may be a stepping stone toward closing the gap in life conditions currently experienced by young people with disabilities. We aim to demonstrate the effectiveness of a simple, innovative program for 1) changing the way parents and teachers view manageable risk-taking for children with disabilities and 2) increasing the level of responsibility that children take for their own actions, as seen on the school playground.Methods/design: We will employ a cluster repeated measures trial with six Sydney-area primary-school-based programs for children with disabilities. The intervention comprises two arms. 1) Risk-reframing--teachers and parents will participate together in small group intervention sessions focusing on the benefits of manageable risk-taking; 2) Introduction of play materials--materials without a defined purpose and facilitative of social cooperation will be introduced to the school playground for children to use at all break times. A control period will be undertaken first for two school terms, followed by two terms of the intervention period. Outcome measures will include playground observations, The Coping Inventory, qualitative field notes, and The Tolerance of Risk in Play Scale.Discussion: New national programs, such as Australia's National Disability Insurance Scheme, will place increasing demands on young people with disabilities to assume responsibility for difficult decisions regarding procuring services. Innovative approaches, commencing early in life, are required to prepare young people and their carers for this level of responsibility. This research offers innovative intervention strategies for promoting autonomy in children with disabilities and their carers.Trial Registration: Australian and New Zealand Clinical Trials Registration Number ACTRN12614000549628 (registered 22/5/2014). [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]

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]

The objective of this study was to evaluate the efficacy of a home-based intervention targeted to parents with intellectual disability to promote child health and home safety in the preschool years. A total of 63 parents were recruited for the study with 45 parents (40 mothers and 5 fathers) from 40 families completing the project. The research design permitted comparison between the intervention and three alternative conditions with all parents receiving the intervention in an alternating sequence over the life of the project. The intervention consisted of 10 weekly lessons carried out in the parent’s home focusing on child health and home safety. The program was adapted to suit the Australian context from the UCLA Parent–Child Health and Wellness Project (Tymchuk, Groen, & Dolyniuk, 2000). Outcome measures assessed parental health and safety behaviours. Standard measures included parental health, intelligence and literacy. The intervention improved parents’ ability to recognize home dangers, to identify precautions to deal with these dangers and resulted in a significant increase in the number of safety precautions parents implemented in their homes with all gains being maintained at 3 months post-intervention. Parents’ health behaviours including improved understanding of health and symptoms of illness, knowledge of and skills needed to manage life-threatening emergencies, knowledge about visiting the doctor, knowing when to call, what information to provide and what questions to ask, and how to use medicines safely significantly increased. Again, all gains were maintained 3 months post-intervention. The intervention was effective regardless of parental health, literacy skills, and IQ. This form of home-based intervention promotes a healthy and safe environment which is a prerequisite to continuing parental custody. [Copyright &y& Elsevier]

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., (© 2022. The Author(s).)

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.)

Objective: To determine the extent to which the lower well-being of young Australians with disabilities could be accounted for by increased rates of exposure to adversity and reduced access to personal, economic, social and community resources., Methods: Secondary analysis of data extracted from Waves 1 (2001) to 8 (2008) of the annual longitudinal survey of Household Income and Labour Dynamics in Australia., Results: Self-reported disability was associated with significantly lower scores on all indicators of psychological well-being. However, people self-reporting disability were more likely to be exposed to adversity and less likely to have access to a range of personal, economic, material, social and community resources. When these between-group differences in social context were controlled for, the between-group differences in psychological well-being were largely eliminated., Conclusion: Our results suggest that, among younger adults in Australia, the association between disability and lower psychological well-being largely reflects their increased risk of exposure to adversity and reduced access to resources, rather than the presence of health conditions or impairments per se., Implications: Public health interventions aimed at improving the well-being of young adults with a disability need to address the predominantly social determinants of well-being in this group., (© 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.)

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.)

Background: Young people with disabilities have poorer mental health than their non-disabled peers. However, people with disabilities are more likely than others to experience financial hardship and low social support, both of which have been linked with poor mental health outcomes. This article explores the extent to which the relatively poor mental health of young people with disabilities is related to the social conditions in which they live., Methods: Secondary analysis was performed on Wave 6 (2006) of the survey of Household Income and Labour Dynamics in Australia (HILDA). This nationally representative sample included 3,392 young Australians, aged 15-29, of whom 475 reported having a long-term health condition, impairment or disability., Results: Young people with disabilities reported poorer mental health than their non-disabled peers. However, this relationship was moderated by both social adversity and social support, with minimal differences in mental health observed between the groups under conditions of high social support and low financial hardship., Discussion: The results suggest that disability represents a potential adversity that may be exacerbated or ameliorated by the effects of wealth/financial hardship and social support., Conclusion: It may be possible to improve the mental health of disabled people by addressing their social exclusion.