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Over the last decade, there has been a steady increase in the number of Indigenous graduate research students in Australia, yet research and pedagogy has not kept pace with changes underway in the sector. From an extensive search of literature published between 2000 and 2017, 15 papers (representing 10 research projects conducted by seven teams or authors) were identified that addressed Indigenous graduate research student experience. Overall, the literature tends to focus on identifying barriers to completion, noting in particular the impact of financial difficulties, social isolation and racism. A research degree is a key site for the assertion and legitimation of Indigenous knowledges, and it is here that Indigenous students are navigating tensions between legitimated disciplinary practices of the centre and the peripheral status of Indigenous knowledges. We, therefore, adopt Herbert's 'centre-periphery' model to interpret the research, arguing that this framework explains the focus on barriers, the neglect of pedagogy centred on academic excellence and student strengths, and research relationships between students and Indigenous communities. Our review identifies the need for a systematic research agenda specifically focused on Indigenous student success at the graduate research level, and looking internationally in order to assess the performance and strategies of Australian higher education providers in comparison to international institutions meeting the aims of First Nations research communities. This approach, we suggest, should move beyond an analysis of the nature of enablers and barriers to focus on Indigenous Higher Degree by Research success.

Accessible Summary: What is known on the subject: ●Expert by Experience participation in mental health services is embedded in mental health policy in many countries. The negative attitudes of nurses and other health professionals to consumer participation poses a significant obstacle to this policy goal.●Involving mental health Experts by Experience in the education of nursing students demonstrates positive attitudinal change. What the paper adds to existing knowledge: ●The paper presents perspectives from Experts by Experience about the unique knowledge and expertise they derive from their lived experience of mental distress and mental health service use. As a result, they can make a unique and essential contribution to mental health nursing education. They utilize this knowledge to create an interactive learning environment and encourage critical thinking.●The international focus of this research enriches understandings about how Experts by Experience might be perceived in a broader range of countries. What are the implications for practice: ●Mental health policy articulates the importance of service user involvement in all aspects of mental health service delivery. This goal will not be fully achieved without nurses having positive attitudes towards experts by experience as colleagues.●Positive attitudes are more likely to develop when nurses understand and value the contribution experts by experience bring by virtue of their unique knowledge and expertise. This paper provides some important insights to achieving this end. Introduction: Embedding lived experience in mental health nursing education is increasing, with research findings suggesting the impact is positive. To date, research has primarily targeted the perspectives of nursing students and academics from the health professions. Aim: To enhance understanding of the unique knowledge and expertise experts by experience contribute to mental health nursing education. Methods: Qualitative exploratory research methods were employed. In‐depth individual interviews were conducted with experts by experience who delivered a coproduced learning module to nursing students in Europe and Australia. Results: Participants described their unique and essential contribution to mental health nursing education under four main themes: critical thinking, beyond textbooks; interactive and open communication; understanding personal recovery; and mental health is health. Conclusions: These findings present an understanding of the unique knowledge and expertise Experts by Experience contribute to mental health education not previously addressed in the literature. Appreciating and respecting this, unique contribute is necessary as Expert by Experience contributions continue to develop. Implications for Practice: Mental health services purport to value service user involvement. Identifying and respecting and valuing the unique contribution they bring to services is essential. Without this understanding, tokenistic involvement may become a major barrier. [ABSTRACT FROM AUTHOR]

Mental health nursing skills and knowledge are vital for the provision of high-quality healthcare across all settings. Negative attitudes of nurses, towards both mental illness and mental health nursing as a profession, limit recognition of the value of these skills and knowledge. Experts by Experience have a significant role in enhancing mental health nursing education. The impact of this involvement on attitudes to mental health nursing has not been well researched. To explore the impact of Expert by Experience-led teaching on students' perceptions of mental health nursing. Qualitative exploratory study involving focus groups with nursing students from five European countries and Australia. Following Expert by Experience-led teaching, participants described more positive views towards mental health nursing skills and knowledge in three main ways: learning that mental health is everywhere, becoming better practitioners, and better appreciation of mental health nursing. Experts by experience contribute to promoting positive attitudinal change in nursing students towards mental health nursing skills and knowledge. Attitudinal change is essential for the provision of high-quality mental health care in specialist mental health services and throughout the healthcare sector. [ABSTRACT FROM AUTHOR]

A range of barriers that impede collaborations between consumer researchers and other researchers have been identified, despite clear acknowledgement of the benefits of this approach in the literature. Recent research has questioned whether the costs of collaborative research outweigh the benefits. The overarching aim of the current study is to better understand non-consumer researchers' attitudes to, and issues concerning, engagement with consumer researchers. Non-consumer researchers from mental health disciplines were invited to participate in the cross-sectional Consumers as Researchers in Mental Health survey, and to respond to open-ended questions about their experiences of collaborative research with consumer researchers. The findings demonstrate a range of benefits associated with collaborations with consumer researchers – including increased relevance and credibility of research, and greater translation of research findings into changes in health policy, service, research and education. Collaborations were found to be varied and not limited by research design, decision-making styles, or research topic. Understanding these benefits within the context of identified barriers can make an important contribution to the proliferation of mental health consumer researcher roles. [ABSTRACT FROM AUTHOR]

Purpose: To explore the views and opinions of nonconsumer researchers to the concept of an Expert Consumer Researcher Group. Design and Methods: Qualitative exploratory involving individual interviews with nonconsumer mental health researchers experienced in working collaboratively with consumer researchers. Data were analyzed thematically. Findings: Participants viewed the concept positively, albeit with caution. Perceived advantages included: greater visibility and enhanced access; collegiality; sharing and creating expertise; broader acceptance; making it mandatory; and structure and location. Participants were concerned about potential tokenism and implementation barriers. Practice Implications: Consumer involvement enhances the quality and relevance of research, potentially impacting clinical practice. [ABSTRACT FROM AUTHOR]

Consumer collaboration in mental health research has demonstrated significant benefits and reflects both contemporary research practice and policy goals for the expected genuine involvement of consumers in all aspects of mental health service delivery. Notable barriers have been identified as impeding consumer researcher positions that must be better understood and ultimately addressed. The aim of this research was to better understand these barriers from the perspectives of non‐consumer researchers who have worked collegially with consumer researchers. We developed a self‐report survey, Consumers as Researchers in Mental Health (CaRiMH) and administered it to non‐consumer mental health researchers in Australia and New Zealand. Findings suggest a lack of organizational structures to support both consumer research and capacity building of consumer researchers. Most consumer researchers were employed casually with no set hours. Although consumer researchers were typically remunerated, inadequate funding and inflexibility of employment were highlighted as major barriers. There was variation in opinion about token involvement of consumer researchers and some uncertainty about whether these roles, where they existed, were actively resisted. Despite the acknowledged barriers, participants were positive about collaborations with consumer researchers. Overall, findings suggest consumer research is unlikely to proliferate without greater attention to organizational structures. A systematic and strategic approach to advancing mental health consumer research is required, including extra‐organizational policy factors. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Contemporary mental health policy stipulates consumer participation in all aspects of mental health services including service evaluation and other forms of mental health research.Research is identified as underpinning quality mental health services, and therefore, consumers researchers could enhance the mental health sector by contributing to the quality, credibility and relevance of mental health research. What this paper adds to existing knowledge?: Non‐consumer researchers generally supported the concept of a consumer expert reference group for researchers at the individual and institutional level.A consumer expert reference group should reflect diversity and offer expertise relevant to the topic of research and may represent one way to normalize partnerships with consumer researchers and realize the benefits they can bring to research. What are the implications for practice?: Quality mental health services are underpinned by robust research evidence. It is crucial that consumers are active participants in research activity.The availability of a consumer expert reference group could facilitate collaborations between consumer and non‐consumer researchers and contribute to a stronger consumer focus embedded in mental health research. Introduction: Contemporary mental health policy identifies consumers as active participants in all aspects of mental health services from design to evaluation. Consumer researchers should be actively involved in mental health research and contribute to quality service delivery. Aim: To gain a snapshot of mental health researcher views on strategies for increasing research by or with consumers in mental health through the establishment of an Expert Consumer Researcher Group (ECRG). Methods: Cross‐sectional survey of 41 non‐consumer mental health researchers from Australia or New Zealand. Results: The introduction of an ECRG was considered an effective strategy for linking consumer and non‐consumer researchers and providing specialist advice on research design and methodology. The most suitable location for this group was identified as within consumer advocacy agencies (71%), universities (66%) or research funding bodies (66%). Participants rated their likelihood of seeking advice from the ECRG as high. Discussion: Research participants supported the value of an ECRG. They emphasized the importance of ensuring the group reflected a diversity of views and offered specialized expertise related to the specific topic. The ECRG could benefit both individual researchers and larger research organizations. Implications for practice: An ECRG could facilitate collaborations with consumer researchers and in turn enhance the quality of mental health research. [ABSTRACT FROM AUTHOR]

Purpose: Evaluate the validity of the Opening Minds Scale (OMS) for nursing students via Rasch models and confirmatory factor analysis (CFA). Design and methods: Undergraduate nursing student responses to OMS (n = 423). Validity was evaluated via CFA and Rasch analysis. Findings: CFA results were strongest for a three‐factor 13‐item version of OMS. Rasch modeling supported sound properties for two of three scales. Internal reliabilities ranged between 0.6 and 0.7. Practice implications: OMS has potential as a valid measure for stigma research and antistigma program evaluation. Rasch analysis suggest it is inappropriate to use a total OMS score for nursing student populations. [ABSTRACT FROM AUTHOR]

The substantial physical health disadvantage experienced by people diagnosed with mental illness is now identified in a growing body of research evidence. The recent promulgation of improved physical health care as a goal of contemporary Australian Mental Health Policy should provide impetus for initiatives and strategies to address this inequity. To date increased knowledge of the problem has not resulted in obvious and sustained changes. The aim of this article is to introduce the role of the Physical Health Nurse Consultant as a potential strategy. The potential contribution and value of this role is considered by reviewing the evidence from the perspective of multiple stakeholders and considering the suitability of nursing to meet the complex needs involved in improving physical health. The requirement for a multi-faceted and comprehensive evaluation is also articulated. A robust, prospective and long-term evaluation plan includes physical health measures, changes in health behaviours, cost-benefit analysis and consumer acceptability to ensure the intervention is effective in the long term. This thorough approach is essential to provide the level of evidence required to facilitate changes at the practice and policy levels. The specialist nursing role presented in this article, subject to the comprehensive evaluation proposed, could become an integral component of a comprehensive approach to addressing physical health inequities in people with mental illness. [ABSTRACT FROM AUTHOR]

Non‐consumer researchers collaborating with consumer researchers can benefit from greater relevance of research and improved congruence between research processes and health policy. As with all research collaborations, such partnerships are both constrained and facilitated by research ecosystems. However, it seems that collaborations with consumer researchers are impacted in particular ways by the research ecosystem. Drawing on ecological systems theory, this study aims to improve understandings of how ecological structures impact collaborations between non‐consumer and consumer researchers. Interviews were conducted with 11 non‐consumer researchers from a range of mental health disciplines about their experiences collaborating with consumer researchers. One theme developed through analysis of the data set related to the research ecosystem. Data from this theme were extracted and discursively analysed using the principles of discursive psychology. Findings emphasize distinct factors that influence collaborations at each level of the ecosystem, encompassing both local research culture and broader research systems. Findings suggest that external pressures (such as deadlines for funding applications, or bureaucratic processes) from the broader ecosystemic levels need to be challenged at the local collaboration level. Non‐consumer researchers might support collaborations through, for instance, working to create enhanced flexibility in research timelines, or making time for relationship building, thus fostering more meaningful collaborations. [ABSTRACT FROM AUTHOR]

Purpose: Academic positions for consumers of mental health services remain rare despite positive evaluation. This paper considers the benefits and challenges of a consumer academician position, from perspectives of stakeholders involved in the implementation. Design and Methods: Qualitative, exploratory involving in‐depth interviews with academicians. Thematic analysis identified the main benefits and challenges. Findings: Benefits identified included lived experience perspective and facilitates interaction and reflection; demonstrating recovery and promoting person centered care. Challenges identified included process, too close to home, and too little too late. Practice Implications: Enhanced understanding of consumer academician positions could increase effectiveness and maximize educational opportunity. [ABSTRACT FROM AUTHOR]

Interprofessional care and consumer-oriented services are embodied in modern healthcare policy and practice. The views, needs, and values of consumers are essential to ensuring translation of policy to practice. This is particularly pertinent for people diagnosed with mental illness who experience a higher risk of physical health problems and premature death. A qualitative, exploratory research project was conducted, involving focus groups with members of a mental health consumer group in the Australian Capital Territory. Participants were asked about their experiences and opinions in relation to physical health and care and treatment provided. Focus group transcripts were thematically analysed. Three themes arose via analysis: (1) Meeting diverse physical healthcare needs, where mental health consumers connect with many types of healthcare providers, conventional and non-conventional, (2) centre of the interprofessional team for holistic care, where there is preference for a consumer-centred group effort in addressing health issues as the model of care, and (3) more gateways, less gatekeeping, where points of access were affected by cost, place and gatekeepers could be enabling. People with mental illness seek enhanced collaboration between a broader range of health professionals, with potential to contribute to their overall health and well-being. [ABSTRACT FROM AUTHOR]

Background: Collaboration between researchers who have lived experience of mental illness and services (consumer researchers) and mental health researchers without (other mental health researchers) is an emergent development in research. Inclusion of consumer perspectives is crucial to ensuring the ethics, relevancy and validity of mental health research; yet widespread and embedded consumer collaboration of this nature is known to be impeded by attitudinal and organisational factors. Limited research describes consumer researchers' experiences of barriers. Other mental health researchers are key players in the co-production process yet there is also a paucity of research reporting their views on barriers to collaborating with consumers. Aims: To explore other researchers' views and experiences on partnering with consumer mental health researchers in Australia and New Zealand. Methods: Exploratory qualitative design. Eleven semi-structured interviews were conducted with mental health researchers. Interviews were recorded, transcribed and thematically analysed. Results: Four themes concerning barriers to collaborating with consumers (hierarchies, status quo, not understanding, paternalism), and one theme on addressing the barriers (constantly chipping away) were identified. Conclusions: It is suggested that multifaceted strategies for advancing collaboration with consumers are most effective. It is imperative to attend to several barriers simultaneously to redress the inherent power disparity. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to review and synthesise research on the Mental Health Nurse Incentive Program (MHNIP) to ascertain the benefits and limitations of this initiative for people with mental illness, general practitioners, mental health nurses and the wider community. Methods: An electronic and manual search was made of the research literature for MHNIP in May 2017. Features of studies, including cohorts and findings, were tabulated and cross-study patterns in program processes and outcomes were closely compared. Results: Seventeen reports of primary research data have been released. Triangulation of data from different cohorts, regions and design show that the program has been successful on the primary objectives of increased access to primary mental health care, and has received positive feedback from all major stakeholders. Although the program has been broadly beneficial to consumer health, there are inequities in access for people with mental illness. Conclusions: The MHNIP greatly benefits the health of people with mental illness. Larger and more representative sampling of consumers is needed, as well as intensive case studies to provide a more comprehensive and effective understanding of the benefits and limitations of the program as it evolves with the establishment of primary health networks. What is known about the topic?: The MHNIP is designed to increase access to mental health care in primary care settings such as general practice clinics. Studies have reported favourable views about the program. However, research is limited and further investigation is required to demonstrate the strengths and limitations of the program. What does this paper add?: All studies reviewed reported that the MHNIP had positive implications for people with severe and persistent mental illness. Qualitative research has been most prevalent for mental health nurse views and research on Health of the Nation Outcome Scale scores for recipients of the program. There is more research on system dimensions than on person-centred care. Mental health consumers, carers and families have been neglected in the establishment, engagement and evaluation of the MHNIP. What are the implications for practitioners?: A more systematic, national-level research program into the MHNIP is required that is centred more on the experiences of people with mental illness. [ABSTRACT FROM AUTHOR]

Abstract: Nurses in mental health settings avoid talking to consumers about sexual health concerns. It is unclear whether this avoidance prevents the provision of sexual healthcare. The present study gathered information about how mental health nurses respond to sexual health issues within their routine practice, what issues they address, and their view on their role in promoting sexual health for consumers. A cross‐sectional study using an electronic survey questionnaire, originally generated from a previous study in the united kingdom, was employed. The study occurred in four National Health Service Trusts in England and a national call for participants in Australia. Participants were nurse clinicians (n = 303) who self‐selected by completing surveys available via email and newsletters containing links to the survey. The results demonstrated that mental health nurses do not routinely include sexual health in their practice and are poorly prepared in knowing what to do with a sexual health issue, and what services to assist consumers to use. In conclusion, it has been well established in the literature that mental health consumers experience high sexual health needs that potentially impact on health and recovery. Mental health nurses are ideally placed to promote sexual health and refer consumers to sexual health and family planning services. Training to improve the confidence and responsiveness of mental health nurses to sexual health is an urgent need. [ABSTRACT FROM AUTHOR]

The stigma associated with a diagnosis of mental illness is well known yet has not reduced significantly in recent years. Health professionals, including nurses, have been found to share similar negative attitudes towards people with labelled with mental illness as the general public. The low uptake of mental health nursing as a career option reflects these stigmatised views and is generally regarded as one of the least popular areas of in which to establish a nursing career. The aim of the current project was to examine nursing students' attitudes towards the concept of mental illness and mental health nursing across four European countries (Ireland, Finland, Norway and the Netherlands), and Australia, using the Opening Minds Scale and the Mental Health Nurse Education survey. The surveys were distributed to students prior to the commencement of the mental health theory component. Attitudes towards mental health nursing were generally favourable. Differences in opinion were evident in attitudes towards mental illness as a construct; with students from Australia and Ireland tending to have more positive attitudes than students from Finland, Norway and the Netherlands. The future quality of mental health services is dependent on attracting sufficient nurses with the desire, knowledge and attitudes to work in mental health settings. Understanding attitudes towards mental illness and mental health nursing is essential to achieving this aim. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known of the subject: Consumer participation in mental health services is an expectation articulated through mental health policy.Consumers as researchers could contribute significantly to mental health services. Barriers to participation are significant and limit consumer involvement. What the paper adds to existing knowledge: Enhanced understandings of collaborative relationships between consumer and nonconsumer researchers.Researchers from the health disciplines find value in consumer involvement in mental health research.These researchers can support and facilitate consumer research by being allies to consumer researchers. What are the implications for practice: Understanding the role of allies is necessary to strengthen their capacity to support consumer researchers.Involving consumers in mental health research is likely to lead to improved practice. Introduction: Australia and New Zealand mental health policy requires consumer participation in all aspects of mental health services. Systemic participation informs and improves the quality of mental health services. Collaboration with consumer researchers should be similarly required. Enhanced understandings of collaborations are needed. Aim: To enhance understanding of the perspectives and experiences of nonconsumer researchers in working collaboratively with consumers as researchers. Method: This qualitative exploratory study involved interviews with nonconsumer mental health researchers who have worked collaboratively with consumers in research. Interviews were conducted with participants from Australia and New Zealand. Results: "Allyship" emerged as a major theme. This describes nonconsumer researchers playing an actively supportive role to facilitate opportunities for the development and growth of consumer research roles and activities. Seven subthemes were identified: establishing and supporting roles, corralling resources, guiding navigation of university systems, advocacy at multiple levels, aspiring to coproduction and consumer‐led research, extending connections and partnerships, and desire to do better. Discussion: Allyship may have an important role to play in the broader consumer research agenda and requires further consideration. Implications for practice: Embedding meaningful consumer participation within mental health services requires active consumer involvement in research. Allies can play an important facilitative role. [ABSTRACT FROM AUTHOR]

Abstract: Coproduction of research between consumers of mental health services and nonconsumer mental health researchers is increasing. There is some research available describing consumer perspectives of this experience. However, there is a notable lack of research on other (nonconsumer) researcher experiences of and views about consumer involvement in coproduced research. A qualitative exploratory study was undertaken to examine perspectives of mental health researchers about consumer involvement in research. In‐depth individual interviews were undertaken with 11 nonconsumer mental health researchers in Australia and New Zealand. Interview transcripts were analysed to identify major themes. There were three interacting themes: the salience of experiential difference, expanded learning, and enhanced research. The dynamic between different perspectives and learning had the effect of enhancing research across the spectrum of study phases and in ensuring research was of value to different groups. The findings emphasize the important contribution consumer researchers can make to mental health research by bringing their unique perspective and enhancing an environment of mutual learning. Findings also point to the need for foregrounding the numerous benefits of joint research between consumer and other researchers to enhance and improve clinical practice and the development of policy. [ABSTRACT FROM AUTHOR]

A crucial development resulting from consumer involvement in mental health services has been engagement as active participants in mental health research, often conducted in collaboration with mental health researchers representing the health disciplines (referred to in this paper as 'other' researchers). Despite progress in mental health consumer research, unequal power relations continue to pose a major barrier. Although power issues are discussed in the literature, there is little research from the perspective of other mental health researchers who have collaborated with consumers on research projects. This qualitative study explored other mental health researchers' perspectives on the role of power in collaborative research with consumers. Semi-structured interviews were completed with 11 other mental health researchers. Thematic analysis of the transcript version of interview recordings was conducted. The findings were grounded in 'the table' as a literal and metaphorical site of power relations. The umbrella theme was prominence and presence (of consumers) at the table, followed by subthemes on barriers (tokenism, undermined potential) and surmounting them through reworking power (critical mass and openness to power dynamics). Overall it was found that while there continue to be significant power-related barriers to further building of robust collaborative research with consumers in mental health, there are several avenues that should be considered, much more assertively, to disrupt and transcend them. [ABSTRACT FROM AUTHOR]

Background People diagnosed with mental illness have shorter lives and poorer physical health, compared to the general population. These health inequities are usually viewed at an individual and clinical level, yet there is little research on the views of mental health consumers on clinical factors in broader contexts. Objective To elicit the views of consumers of mental health services regarding their physical health and experiences of accessing physical health-care services. Design Qualitative exploratory design involving focus groups. Setting and participants The research was conducted in the Australian Capital Territory. Participants were consumers of mental health services. Main outcome measures The Commission on Social Determinants of Health Framework was drawn on to lead deductive analysis of focus group interview transcripts. Results Issues impacting consumers included poverty, the neglect of public services and being treated as second-class citizens because of diagnosis of mental illness and/or experiencing a psychosocial disability. These factors were connected with significant barriers in accessing physical health care, including the quality and relevance of health provider communication, especially when the broader contexts of mental health consumer's lives are not well understood. Discussion and conclusions These findings suggest the Commission on Social Determinants of Health Framework could be utilized in research and policy, and may provide an effective platform for exploring better health communication with mental health consumers regarding this neglected health inequity. [ABSTRACT FROM AUTHOR]

Purpose: Exploration of the views and experiences of nurse academics and consumer academics and educators regarding the scope of consumer participation in mental health nursing education. Design and Methods: A qualitative, exploratory inquiry into the description and views of mental health nurse academics and consumer educators about these roles Findings: A significant variation in roles from guest speaker to substantive academic positions was evident, with most involvement brief and specifically teaching focused. Consumer participation in education was generally valued but noted to be limited in breadth and scope. Some concern was raised about the relevance of consumer academic roles, with a clear conceptualization of the consumer academic role necessary to facilitate their contribution to the education of health professionals. Practice Implications: Mental health consumer involvement in the education of nurses has been shown to impact positively on the attitudes of health professionals to people with mental illness. Advocacy for increased, meaningful input from consumers into nursing education is therefore necessary to improve practice. [ABSTRACT FROM AUTHOR]

Background: People with severe mental illness have poorer physical health, experience disparities in physical health care, and lead significantly shorter lives, compared to the general population. Routine metabolic monitoring is proposed as a method of identifying risk factors for metabolic abnormalities. Efforts to date suggest routine metabolic monitoring is both incomplete and ad-hoc, however. This present study reports on the recent implementation of a routine metabolic monitoring form at a mental health service in regional Australia. Methods: A retrospective file audit was undertaken on 721 consumers with electronic health records at the mental health service. Descriptive statistics were used to report the frequency of use of the metabolic monitoring form and the range of metabolic parameters that had been recorded. Results: Consumers had an average age of 41.4 years (SD = 14.6), over half were male (58.4%), and the most common psychiatric diagnosis was schizophrenia (42.3%). The metabolic monitoring forms of 36% of consumers contained data. Measurements were most commonly recorded for weight (87.4% of forms), height (85.4%), blood pressure (83.5%), and body mass index (73.6%). Data were less frequently recorded for lipids (cholesterol, 56.3%; low density lipoprotein, 48.7%; high density lipoprotein, 51.7%; triglycerides, 55.2%), liver function (alanine aminotransferase, 66.3%; aspartate aminotransferase, 65.5%; gamma-glutamyl transpeptidase, 64.8%), renal function (urea, 66.3%; creatinine, 65.9%), fasting blood glucose (60.2%), and waist circumference (54.4%). Conclusions: The metabolic monitoring forms in consumer electronic health records are not utilised in a manner that maximises their potential. The extent of the missing data suggests that the metabolic health of most consumers may not have been adequately monitored. Addressing the possible reasons for the low completion rate has the potential to improve the provision of physical health care for people with mental illness. [ABSTRACT FROM AUTHOR]

Aims and Objectives. To explore factors impacting on the feasibility of academic and educator roles for consumers of mental health services. The supports required to facilitate these roles from the perspectives of mental health nurse academics and consumer educators/academics will also be explored. Background. Involving consumers in the education of health professionals is becoming more common. Frequently this strategy is viewed as important to influence the attitudes of health professionals towards consumer participation in mental health services. There remains a paucity of research about these roles and the factors which promote and support their feasibility. Design. Qualitative exploratory. Method. In-depth telephone interviews were undertaken with 34 nurse academics and 12 consumer educators or academics. Participants included nurse academics coordinating undergraduate and postgraduate mental health subjects, and consumer academics and educators involved in teaching mental health nursing components. Interviews were 20 - 45 minutes in duration. Data were analysed thematically. Results. Four subthemes were identified under the broad theme of feasibility and support: Reliability, support, vulnerability and seen to be griping. Conclusions. Significant barriers were identified by nurses and consumers to effective consumer involvement, largely reflecting the impact of mental health challenges. Despite this, there was little evidence of structured support being available to enhance the viability of these positions. Relevance to clinical practice. Involving consumers in the education of health professionals through teaching, curriculum development, assessment and evaluation, is likely to enhance consumer participation in mental health services and ultimately improve service delivery. This involvement needs to be genuine to be effective. Consumers are often viewed as unreliable, vulnerable and using education to voice their own negative experiences. These issues and lack of support provided pose major barriers to successful roles, strategies to overcome barriers and maximise the effectiveness of roles require investigation and implementation. [ABSTRACT FROM AUTHOR]

The physical health of people with serious mental illness ( SMI) has become a focal area of research. The aim of the present study was to ascertain the attention and distribution of research from within Australia on physical illness and SMI co-occurrence, and to identify gaps. A scoping review of peer-reviewed research literature from Australia, published between January 2000 and March 2014, was undertaken through an electronic literature search and coding of papers to chart trends. Four trends are highlighted: (i) an almost threefold increase in publications per year from 2000-2006 to 2007-2013; (ii) a steady release of literature reviews, especially from 2010; (iii) health-related behaviours, smoking, integrated-care programmes, and antipsychotic side-effects as the most common topics presented; and (iv) paucity of randomized, controlled trials on integrated-care models. Despite a marked increase in research attention to poorer physical health, there remains a large gap between research and the scale of the problem previously identified. More papers were descriptive or reviews, rather than evaluations of interventions. To foster more research, 12 research gaps are outlined. Addressing these gaps will facilitate the reduction of inequalities in physical health for people with SMI. Mental health nurses are well placed to lead multidisciplinary, consumer-informed research in this area. [ABSTRACT FROM AUTHOR]

Purpose A cardiometabolic specialist nursing role could potentially improve physical health of people with serious mental illness. Design and Methods A national survey of Australian nurses working in mental health settings investigated predictors of support for the role. Findings Predictors included belief in physical healthcare neglect, interest in training; higher perceived value of improving physical health care. Practice Implications The findings suggest that nurses see the cardiometabolic health nurse role as a promising initiative for closing gaps in cardiometabolic health care and skilling other nurses in mental health. However, as the majority of variance in cardiometabolic health nurse support was unexplained, more research is urgently needed on factors that explain differences in cardiometabolic health nurse endorsement. [ABSTRACT FROM AUTHOR]

Consumers of mental health services have an important role to play in the higher education of nursing students, by facilitating understanding of the experience of mental illness and instilling a culture of consumer participation. Yet the level of consumer participation in mental health nursing programmes in Australia is not known. The aim of the present study was to scope the level and nature of involvement of consumers in mental health nursing higher education in Australia. A cross-sectional study was undertaken involving an internet survey of nurse academics who coordinate mental health nursing programmes in universities across Australia, representing 32 universities. Seventy-eight percent of preregistration and 75% of post-registration programmes report involving consumers. Programmes most commonly had one consumer (25%) and up to five. Face-to-face teaching, curriculum development, and membership-to-programme committees were the most regular types of involvement. The content was generally codeveloped by consumers and nurse academics (67.5%). The frequency of consumer involvement in the education of nursing students in Australia is surprisingly high. However, involvement is noticeably variable across types of activity (e.g. curriculum development, assessment), and tends to be minimal and ad hoc. Future research is required into the drivers of increased consumer involvement. [ABSTRACT FROM AUTHOR]

People with serious mental illness (SMI) have increased risk of cardiovascular disease and premature death, yet research on nurse-provided health promotion in mental health services remains under-developed. This paper informs efforts to improve the nursing role in physical health of consumers with SMI by establishing what nurse perceptions and background influence their care. Members of the Australian College of Mental Health Nursing were invited to participate in an online survey on their views on physical health care in mental health services. Survey questions included: (a) nurse-consumer collaboration in preventative care and (b) sub-sections of the Robson and Haddad Physical Health Attitude Scale to measure nurse perceived barriers to encouraging lifestyle change of consumers with SMI and frequency of nurse physical healthcare practices. Structural equation modelling was applied to investigate antecedents to physical health care, as well as relationships between antecedents. A national sample of 643 nurses reported regular engagement in health promotion (e.g. advice on diet). There was statistical support for a model depicting perceived consumer-nurse collaboration as a dual-determinant of nurse perceived barriers and self-reported health promotion to consumers with SMI. Perceived barriers to consumer lifestyle change did not predict health promotion. The effects of nurse-consumer collaboration were significant, but small. Perceived consumer-nurse collaboration in preventative care may positively influence the amount of health promotion by nurses in mental health. Perceived barriers to consumer adherence with a healthy lifestyle did not have an impact on nurse-delivered health promotion. [ABSTRACT FROM AUTHOR]

People with serious mental illness experience higher rates of oral and dental health problems than the wider population. Little is known about how dental health is viewed or addressed by nurses working with mental health consumers. This paper presents the views of nurses regarding the nature and severity of dental health problems of consumers with serious mental illness, and how often they provide advice on dental health. Mental health sector nurses (n = 643) completed an online survey, including questions on dental and oral health issues of people with serious mental illness. The majority of nurses considered the oral and dental conditions of people with serious mental illness to be worse than the wider community. When compared with a range of significant physical health issues (e.g. cardiovascular disease), many nurses emphasised that dental and oral problems are one of the most salient health issues facing people with serious mental illness, their level of access to dental care services is severely inadequate and they suffer significantly worse dental health outcomes as a result. This study highlights the need for reforms to increase access to dental and oral health care for mental health consumers. [ABSTRACT FROM AUTHOR]

People with serious mental illness experience premature death due to higher rates of cardiometabolic conditions (e.g. cardiovascular disease, diabetes) than the general population. Mental health services often do not provide sufficient cardiometabolic clinical care to address these risks. The cardiometabolic health nurse (CHN) role has been suggested as a strategy for ensuring integrated care is provided and sustained. The views of nurses in mental health would be essential in informing the viability and development for this initiative. This paper presents the findings of open-ended comments from a cross-sectional online survey of nurses working in mental health in Australia ( n  =  643) eliciting views about the possible introduction of the cardiometabolic nurse. Thematic analysis was undertaken, of 133 open comments on this topic. The findings suggest that nurses see the specialist role as suitable and valuable for mental health services. Some nurses voiced concern about specialisation leading to fragmentation (e.g. in responsibilities for physical health, division of mental and physical health care, and less emphasis on equipping all nurses with comprehensive care skills), especially for settings where generalist nursing was seen as already available. The findings suggest this role is viewed favourably by nurses, provided that it is consistent with holistic and comprehensive care. Empirical research is needed to see whether this role increases holism (as valued by consumers and nurses) and cardiometabolic outcomes. [ABSTRACT FROM AUTHOR]

Australian mental health policy clearly articulates recovery focus as the underpinning of mental health services. Barriers to achieving a recovery focus are identified in the literature, with negative attitudes of health professionals receiving particular attention. The involvement of people with lived experience of significant mental health challenges and mental health service use is essential to enhancing more positive attitudes. Lived-experience involvement in the education of nurses is evident; however, it is generally limited and implemented on an ad hoc basis. Overall, there is a paucity of literature on this topic. A qualitative exploratory study was undertaken to elicit the views and perceptions of nurse academics and lived-experience educators about the inclusion of lived experience in mental health nursing education. One major theme to emerge from the research was issues of fear and power, which included three subthemes: facing fear, demystifying mental illness, and issues of power. Lived-experience involvement has an important role to play in the education of nurses in addressing fear and demystifying the experience of mental illness. The power that lived-experience educators exercised in their roles varied considerably, and for many, was limited. Therefore, the effectiveness of lived-experience involvement requires a more equitable distribution of power. [ABSTRACT FROM AUTHOR]

To combat the increasingly poor physical health of people with serious mental illness, the position of a cardiometabolic health nurse has been proposed. We recently conducted a 26-week trial in a regional mental health service. This paper describes the background and rationale for the position, presents the outcomes on health behaviours and health behaviour knowledge and attitudes, and offers recommendations for the future direction of the role. We show that a cardiometabolic health nurse can improve the physical health behaviours in people with mental illness, however much needs to be done to further develop and implement the role. [ABSTRACT FROM AUTHOR]

Mental health policy emphasises the importance of consumer participation in mental health services. To align education with policy and orient future healthcare services to active consumer involvement, the potential of academics with a lived experience of mental illness to impact on student attitudes towards consumer participation needs to be examined. A cohort comparative study was undertaken comparing attitudinal change between undergraduate nursing students undertaking two different mental health courses, one nurse-led ( n  =  61) and one lived experience-led. Attitudes were measured through the Mental Health Consumer Participation Questionnaire. Within-cohort change was assessed via dependent sample t-tests, and degree of change was observed in each cohort, by comparing effect sizes. For the nurse-led course, attitudes on consumer involvement t (60)  =  -1.79, p < 0.005 (95% CI: -2.84, -0.74) and consumer as staff t (60)  =  -4.12, p < 0.005 (95% CI: -3.34, -1.16), positively changed with effect size r of 0.40 and 0.47, respectively. For the lived experience-led course, attitudes on consumer capacity t (109)  =  -3.63, p < 0.005 (95% CI: -0.48, -1.41) and consumer as staff, t (109)  =  -5.63, p < 0.005 (95% CI: -0.97, -0.46), positively changed, effect size r of 0.33 and 0.47, respectively. Mental health nursing education has a positive and selective influence on attitudes to consumer participation. Lived experience-led education was more beneficial in changing attitudes to consumer capacity and both types of education had similar positive effects on attitudes to consumers as staff. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify nurse perceptions on the potential value of general and specific nursing approaches to improving physical health outcomes of people with serious mental illness. Background People diagnosed with serious mental illnesses experience heightened rates of physical illnesses and can be supported better via healthcare system prevention and management. Nurses working in mental health are a critical part of a system-wide approach to improving physical health care, but there is little known on their views on specific approaches within Australia (e.g. screening for risks, stigma reduction). Design A national, cross-sectional and nonrandom survey study delivered online. Methods Members of the Australian College of Mental Health Nurses ( n = 643), representing nurses employed in mental healthcare services across Australia (71·6% from public mental health services). Participants were asked to rate the potential of nine nurse-based strategies for improving physical health (options: 'yes', 'no', 'not sure') and the potential value of 10 nursing and general strategies for improving physical health (rating from 'negative value' to 'significant value'). Results There was a high endorsement of all nine nurse-based strategies for physical health (e.g. lifestyle programmes, screening, linking services), although there was less support for reducing antipsychotics or advocating for fewer side effects. Participants mainly viewed all strategies as of moderate to significant value, with the most promising value attached to colocation of primary and mental care services, lifestyle programmes and improving primary care services (reduce stigma, train GPs). Conclusions Australian nurses working in mental health services view a range of nurse-based strategies for improving physical healthcare services and standards as important. Relevance to clinical practice Nurses collectively need to work with consumers, health agencies and the general public to further define how to organise and implement physical health integration strategies, towards more comprehensive health care of people with serious mental illness. [ABSTRACT FROM AUTHOR]

Purpose To identify how frequently nurses in mental health services communicate about physical health of consumers with other healthcare professionals, and whether such collaboration is associated with physical care actions with consumers. Design and Methods An online national Australian survey of nurses in mental health services. Findings Nurses discuss physical health frequently with general practitioners, psychiatrists, and case managers, and less frequently with occupational therapists, social workers, and nurse practitioners. Interprofessional attention was positively associated with direct physical health care such as clinical screening and health education. Practice Implications Interprofessional communication may support nurses in direct physical healthcare actions with consumers. Increasing collaborations with nurse practitioners, social workers, and occupational therapists need to be explored as part of clinical teamwork development. [ABSTRACT FROM AUTHOR]

Increasing the rate of recruitment of nursing students into mental health nursing (MHN) is vital to long-term sustainability of health care system support for people diagnosed with mental illness. However MHN is not a popular career path; this raises questions about what attitudes and beliefs may divert or attract students to this specialisation. The current research involved a survey of undergraduate nursing students at a regional university in Australia to clarify the nature of relationships between attitudes (e.g., the value of mental health nursing, stereotypes of people with mental illness) and how they may be antecedents to considering MHN as a career path. Through a structural equation model, it was ascertained that anxiety surrounding mental illness leads to less interest in MHN as a future career and suggests that anxiety is (a) partly due to negative stereotypes, and (b) countered by preparedness for a MHN role. Beliefs on how MHN can make a valuable contribution to people's well-being did not affect interest in pursuing MHN. These findings reconfirm the need to reduce anxiety about mental illness by educational approaches that effectively prepare students for MHN, combined with challenging negative stereotypes. [ABSTRACT FROM AUTHOR]

People with serious mental illness have increased rates of physical ill-health and reduced contact with primary care services. In Australia, the Mental Health Nurse Incentive Program ( MHNIP) was developed to facilitate access to mental health services. However, as a primary care service, the contribution to physical health care is worthy of consideration. Thirty-eight nurses who were part of the MHNIP participated in a national survey of nurses working in mental health about physical health care. The survey invited nurses to report their views on the physical health of consumers and the regularity of physical health care they provide. Physical health-care provision in collaboration with general practitioners ( GPs) and other health-care professionals was reported as common. The findings suggest that the MHNIP provides integrated care, where nurses and GPs work in collaboration, allowing enough time to discuss physical health or share physical health activities. Consumers of this service appeared to have good access to physical and mental health services, and nurses had access to primary care professionals to discuss consumers' physical health and develop their clinical skills in the physical domain. The MHNIP has an important role in addressing physical health concerns, in addition to the mental health issues of people accessing this service. [ABSTRACT FROM AUTHOR]

People with serious mental illness ( SMI) die prematurely from common physical illnesses such as cardiovascular disease and diabetes. These cardiometabolic risks are preventable and manageable yet these aspects of health care have been neglected in mental health services. A potential nurse-based strategy to decisively improve cardiometabolic health of people with SMI is to introduce a cardiometabolic health nurse ( CHN) into mental health services. The current study aimed to establish the views of nurses working in mental health care on the potential benefits and limits of CHN to improve physical health-care standards in Australia. All members of the Australian College of Mental Health Nurses were invited to participate in an online survey and 643 participated. Nurses generally agreed that a CHN role would provide a range of improvements to physical health care, such as increased detection, assessment on, and follow up of cardiometabolic risks, and decreased workload for other nurses. While participants were generally supportive of such a role, they felt it would not be suitable in all health-care settings in Australia. [ABSTRACT FROM AUTHOR]

To investigate self-reported health behaviors among Australian adults with mental illness, 1,935 Australian adults completed an online survey including the Kessler Psychological Distress Scale and instruments assessing health behaviors in October 2011. Participants with moderate or higher psychological distress reported significantly lower weekly physical activity levels ( p= .024), daily fruit ( p= .001) and vegetable ( p< .001) intakes, and greater regularity of consuming six or more drinks on one occasion ( p= .002) and of smoking within 30 minutes of waking ( p= .001), Participants with very high psychological distress had significantly increased odds ratios for insufficient weekly physical activity (2.38, 95% CI 1.42–4.00), insufficient daily fruit and vegetable intake (1.72, 95% CI 1.03–2.88), and smoking (2.27, 95% CI 1.12–4.60). Australian adults with current mental illness demonstrate significantly poorer health behaviors than those without mental illness. [ABSTRACT FROM PUBLISHER]

PURPOSE: The study aims to ascertain nurses' views on their preparedness to provide physical health care, and their identified training needs. DESIGN AND METHODS: The study used a qualitative exploratory design. Thirty-eight nurses working in a regional mental health setting participated in focus groups. FINDINGS: Three main themes were identified: (a) the need for physical healthcare training, (b) modes of training, (c) access to training, and (d) organizational commitment. PRACTICE IMPLICATIONS: The philosophy and design of training must reflect workplace context, and take into account individual learning styles. Organizational support is crucial. [ABSTRACT FROM AUTHOR]

Relative to the general population, people with serious mental illness (SMI) experience elevated risks of physical disease and illness and live shorter lives. A human rights perspective argues that people with serious mental illness have a right to equal access to physical health care. Nurses in mental health services can contribute to improving the availability and accessibility of physical health care. This study, involving focus group interviews with nurses in a large regional and rural mental health care district of Queensland, Australia, revealed significant problems in access to physical health care for service users. The current article reports on our exploratory analysis of nurses' views and perceptions to identify (1) orientation of nurses to human rights, and (2) access of consumers with SMI to general practitioner services. It was rare for nurses to raise the topic of human rights, and when raised, it was not as a strategy for improving access to physical health care services that they felt consumers with SMI greatly needed. Two main themes were identified as causes of poor access: clinical barriers to physical care and attitudinal barriers to physical care. In light of these results, the authors explore a human rights perspective on access and how this provides an inclusive lobbying umbrella under which nurses and other groups can pursue access to physical health services that are adequate, accessible, and non-discriminatory. The article then discusses the implications for these findings for the value of human rights as a perspective and means of increasing physical health of people with SMI. [ABSTRACT FROM AUTHOR]

Physical activity is important to the physical and mental health of people with serious mental illness (SMI). This study investigated views of public mental health nurses on physical activity promotion for consumers with SMI, through a national electronic survey in Australia. Consumers with SMI were viewed to be less physically active than the general community. Two-thirds of nurses wanted training on exercise support of consumers. Motivation of consumers was indicated to be a major barrier. There was great variability in discussion frequency between nurses and exercise physiologists. An analysis of open comments revealed two themes: (1) access -- opportunities for health education, participation in physical activity programmes and nurses' connections to exercise physiologists; and (2) commitment -- nurses promoting physical activity and building competencies. Findings indicate that initiatives to increase physical activity promotion for people with SMI are likely to be supported by nurses in the mental health sector of Australia. [ABSTRACT FROM AUTHOR]

People with serious mental illness are at high-risk for physical illnesses and premature death, and nurses can contribute to ensuring mental health services address these risks. There is very little research examining the role of nurses in mental health who provide physical health care. To identify the levels of participation in physical health care of people with serious mental illness (SMI), a national Internet-based survey of nurses working in mental health in Australia was conducted ( n = 643). The survey included an adapted version of the Robson and Haddad Physical Health Attitude Scale. Data were analysed through comparison of frequencies, correlations, principal components analysis, and Mann-Whitney tests. Nurses reported regular physical health care in 12 of the 17 tasks presented to them. The three most common self-reported physical health care activities were inquiring about consumers' contact with GPs, doing physical assessments, and providing information on drug use and lifestyle. Although some practices were less common (e.g., contraceptive advice) nurses who provided one type of care tended to do other types as well. In addition, credentialing in mental health nursing was associated with slightly more regular engagement in all practice domains except screening and assessments. Nurses in mental health in Australia may be engaged in improving physical health of consumers with SMI more than is assumed. [ABSTRACT FROM AUTHOR]

Consumer participation in all aspects of mental health service delivery, including the education of mental health professionals, is now a policy expectation in Australia. Whether education programs introducing nurses to mental health nursing lead to more favourable attitudes towards consumer participation is yet to be examined in pre-registration nursing programs in Australia. The current evaluation examined changes in scores for the Consumer Participation Survey for undergraduate nursing students ( n = 68) in an Australian University. Data were analysed, using repeated measures t-test, to compare the pre- and post-test scores. There was a significant improvement in views on consumers participating as staff members. There were no statistically significant changes in attitudes towards consumer capacity and consumer involvement in care processes. Consumer participation in mental health care is now clearly articulated in Australian Government policy. For this to be successfully implemented a more comprehensive understanding of the ability of education to influence attitudes is required. [ABSTRACT FROM AUTHOR]

Census data indicates a steady increase in the number of Vietnamese people migrating to Australia. Despite this there is a paucity of research examining alcohol usage within this community. A review of the literature was undertaken to examine the prevalence of alcohol use, related harms, and health service use. Vietnamese Australians were found to consume alcohol at a rate lower than that of Australians in general. However, the relevant research may not be generalizable, alcohol usage and associated harms may be under-reported, and prevalence rates contradicted the breadth and frequency of harms reported. These issues are discussed. [ABSTRACT FROM AUTHOR]

Mental health nursing is widely recognized as a stressful occupation; however, little is known about the relationship between work-related stress and health-related quality of life of mental health nurses (MHN). This study aimed to identify MHN health-related quality of life (HR-QoL) and work-related stressors; associations between stressors and HR-QoL; and predictors of HR-QoL. An online cross-sectional survey collected demographic data, work-related stressors and HR-QoL (SF-12v2) of n = 498 Australian MHN. Prominent consumer/carer-related stressors were verbal (90%) and physical aggression (85%). Collegial stressors included staff conflict (71%) and bullying (55%), and colleague-perpetrated verbal (34%) and physical aggression (7%). Key organizational stressors included high workloads (74%), lack of organizational support (60%) and lack of adequate resources to perform nursing role (58%). The mean physical health score was 52.62 (SD = 8.30), and mental health score was 43.59 (SD = 11.34), with mental health substantially lower than national norms (mean difference = 10.11). There were statistically significant negative correlations between the number of work-related stressors and HR-QoL. Younger (21-30 years) and less experienced (<1-4 years) MHN had substantially lower mental health. Higher mental health was predicted with < 15 stressors, >4 years' experience and working in the community. The poorer mental health of MHN has concerning implications for the well-being, retention and practice of the largest group in the mental health workforce. There is a critical need for organizations to enact effective policy and initiatives to reduce workplace aggression, improve staff psychological and physical safety, and strengthen well-being and resilience. New graduates are a priority group for urgent intervention., (© 2020 Australian College of Mental Health Nurses Inc.)

Purpose: To examine nursing students' perceptions of Experts by Experience impact on theoretical and practical learning., Design and Methods: Qualitative exploratory study involving focus groups with undergraduate nursing students from five European countries and Australia. Data were analyzed thematically., Findings: Participants described positive impacts as: bridging the theory and practice gap through first-hand experience, including sub-themes: bringing theory to life; can't be taught any other way, and innovative teaching methods fueling curiosity., Relevance to Clinical Practice: Integrating theory and practice is key for quality mental health nursing practice. Experts by experience can potentially contribute to reducing this enduring gap., (© 2020 Wiley Periodicals, Inc.)

Background: Consumer participation in mental health service delivery is now a policy expectation. Negative attitudes of health professionals towards collaboration with consumers have been identified as a major barrier to policy implementation. Consumers contributing to the education of nurses and other health positions have been identified as an effective strategy, particularly when consumers occupy academic positions. Attitudes of nurse and consumer academics to the consumer academic role remain under-researched. Aims: To explore the implementation of a consumer academic position from the perspectives of the broader academic team. Methods: Qualitative exploratory research was undertaken to give voice to different perspectives of the implementation of a consumer academic position. In-depth interviews were conducted with nurse academics, the consumer academic and the research team. Results: Thematic data analysis revealed five main themes: seeking a united perspective; who can provide a consumer perspective? How accurate is consumer perspective? One consumer, one opinion, one way, one delivery; bias and poor portrayal of nurses. Conclusions: Marked divergence in views and opinions was evident in terms of support for the role and its perceived value. Further investigation of factors facilitating successful implementation is required and strategies identified to facilitate mutual understandings and goal setting.