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This article uses data from a doctoral thesis concerning service users' views on what works for them in relation to their mental health wellness following a suicidal ideation/attempt in Aotearoa New Zealand. In particular, it focuses on the experiences of service users regarding mental health crisis team responses and what they wanted from their crisis teams specifically. Participants indicated that what they wanted was to feel heard, respected and not judged, consistent with the core conditions of therapeutic alliance within such professions as social work, counselling and psychology. Social work has a valuable role to play in emphasising and advocating for social, contextual and non-medical responses within crisis teams and service delivery. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Police and ambulance staff are increasingly asked to help people experiencing mental health crises, but they often feel under‐prepared.The single frontline service approach is time‐intensive and risks a coercive pathway to care.The emergency department is the default location for transfers by police or ambulance involving a person involved in a mental health crisis, despite being viewed as suboptimal. What the paper adds to existing knowledge: Police and ambulance staff struggled keeping up with the mental health demand, reporting inadequate mental health training, little enjoyment and negative experiences when trying to access help from other services.Most mental health staff had adequate mental health training and enjoyed their work, but many experienced difficulties getting help from other services.Police and ambulance staff found it hard to work with mental health services. What are the implications for practice: The combination of limited training, poor interagency referral processes, and difficulties accessing support from mental health services means that when police and ambulance services attend mental health crises alone, distress may be heightened and prolonged. Enhanced mental health training for first responders and more streamlined referral processes may improve process and outcomes.Mental health nurses have key skills that could be utilized in assisting police and ambulance staff who attend 911 emergency mental health calls.New models such as co‐response teams, whereby police, mental health clinicians and ambulance staff respond conjointly should be trialled and evaluated. Introduction: First responders are increasingly called to assist people experiencing mental health crises but little research exists canvassing multi‐agency perspectives of such work. Aim/Question: To understand the views of police officers, ambulance and mental health staff attending mental health or suicide‐related crises in Aotearoa New Zealand and to discover how they experience current models of cross‐agency collaboration. Methods: A descriptive cross‐sectional survey involving mixed methods. Quantitative data were analysed using descriptive statistics and free text by content analysis. Results: Participants included 57 police officers, 29 paramedics and 33 mental health professionals. Mental health staff felt adequately trained, but only 36% described good processes for accessing inter‐agency support. Police and ambulance staff felt undertrained and unprepared. Accessing mental health expertise was considered difficult by 89% of police and 62% of ambulance staff. Discussion: Frontline services struggle managing mental health‐related 911 emergencies. Current models are not working well. Miscommunication, dissatisfaction and distrust exist between police, ambulance and mental health services. Conclusion: The single‐agency frontline response may be detrimental to service users in crisis and under‐utilizes the skills of mental health staff. New ways of inter‐agency cooperation are required, such as co‐located police, ambulance and mental health nurses responding in partnership. [ABSTRACT FROM AUTHOR]

For people with autism spectrum disorder (ASD), the risk of mental illness, including suicidality, has a higher prevalence than the general population. This scoping review explored how people with ASD access suicide hotlines/crisis support services; and current approaches to delivering mental health services (MHS) to people with ASD. A search identified 28 studies meeting the selection criteria with analysis revealing four key findings. The support received by the person with ASD influenced how they accessed MHS; people often encounter barriers to accessing MHS; a separation exists between autism and MHS; and no studies on accessing or delivering MHS through crisis hotlines. The presence of such autism-specific crisis hotlines and the dearth of studies suggest a void in the existing research. [ABSTRACT FROM AUTHOR]

Between 2009 and 2016, New Zealand Police experienced a disproportionate increase in lower-priority mental health-related calls. This exploratory study uses content analysis to identify characteristics of these calls, including reasons for calling police, advice and actions undertaken by communications centres staff, and actions undertaken by frontline officers. Four important findings emerge. First, there has been a significant increase in the proportion of mental health-related calls that did not involve reporting of an offence or emergency (increased from 48% in 2010 to 57% in 2016). Second, there was a significant increase in calls that were initiated by the person who appeared to be experiencing mental illness and distress during the time of the call (increased from 53% to 62%). Third, the way communication centres staff and frontline officers responded to mental health-related calls also changed over time. There was an increased tendency of communications centre staff advising the callers to call back if the situation escalates or if they require further assistance (which increased from 14% to 24%). Fourth, among the events attended by a police unit, there was an increase in the proportion of events where a frontline officer contacted a mental health agency (which increased from 6% of attended events to 10%). Moreover, transportation to a police station decreased (21.7% to 11%) while there were increases in the transportation of a person's home (2.7% to 6%). Transportation to a mental health facility averaged at 24.9% over the period. [ABSTRACT FROM AUTHOR]

Crisis intervention services for people experiencing psychological distress and suicidal ideation are frequently described by the people accessing them as failing to meet their needs. This paper reports a prominent finding from a realist evaluation of Taranaki Retreat—a charitable, non‐clinical organisation in New Zealand, which offers free respite for people experiencing acute distress. Using qualitative methods, the study aimed to move beyond vague notions regarding the helpfulness of respite, to a deeper understanding of the contextual factors and mechanisms which generate outcomes for such an intervention. Participant observation, focus groups with staff, semi‐structured interviews with service users, and analysis of service users' case notes were conducted over a six‐month period in 2018. The most prominent finding from the study related to 'genuine care'—care which is interpreted by the recipient as being motivated by a genuine desire to help. We present this finding as to the central mechanism in a wider programme theory developed through the realist evaluation study. We also present five key features of the care participants were offered at Taranaki Retreat which contributed to their common interpretation regarding the motivations behind this care. Upon considering the centrality of this mechanism we conclude that, in designing crisis interventions, greater consideration should be given to how the intervention can demonstrate genuine care. Having highlighted the ways in which the structure of charitable organisations appears conducive for interpretations of genuine care, we further conclude that the provision of comprehensive crisis intervention by charitable organisations should be further explored and supported. [ABSTRACT FROM AUTHOR]

Aims: To explore the experiences of strategic leads for nurse education as they sought to respond to the COVID‐19 pandemic. Design: We utilised a qualitative interpretative approach to explore education leaders' experiences of leading during the early months of the pandemic. Methods: Nineteen leaders with significant strategic responsibility for nurse education in Australia, Canada, New Zealand, Singapore and the United Kingdom were identified via purposive sampling and agreed to participate. Interviews were held between May and July 2020. Results: Four overarching themes arose from the analysis: (1) Crisis driven adaptability & flexibility; (2) Responsive, complex and changing communication; (3) Making decisions for student and staff safety; (4) Looking to the future; stronger partnerships. Conclusion: Internationally, while nursing education leaders faced different problems, they shared a common goal amidst the crisis to remain student‐centred. They demonstrated they were able to face major challenges, respond to large scale logistical problems and make decisions under significant and ongoing pressure. Impact: In responding to the pandemic, nurse leaders shared knowledge and offered mutual support. This bodes well for future collaboration. The move to online learning accelerated an existing trend and it seems likely that this will continue. Given the pressures they experienced over an extended period, the sector may wish to consider how it prepares and supports existing and future leaders. [ABSTRACT FROM AUTHOR]

Aotearoa New Zealand's public health crisis communication approach amidst the COVID-19 pandemic effectively mobilized the nation into swift lockdown, significantly reducing community transmission. This communication approach has been applauded around the world. How did communities situated amongst the "margins of the margins" in Aotearoa New Zealand navigate through the existing structural barriers to health during the pandemic? In this study, we use a culture-centered analysis to foreground the structural context of disenfranchisement amidst the COVID-19 lockdown. Drawing on in-depth interviews with participants in a larger ethnographic project on poverty and health across three communities in Aotearoa New Zealand, we attend to the ways in which health is negotiated amidst the COVID-19 outbreak and lockdown response at the "margins of the margins." The narratives point out that health communication interventions to prevent COVID-19 in the context of Aotearoa New Zealand furthered the marginalization of communities at the margins, and community voices were largely erased from the enactment of interventions. With the extant structures failing to recognize these aspects of everyday struggles of health at the margins, the health and access challenges were further magnified during COVID-19. Our attention to communication situated in relationship to structures builds a register for health communication scholarship in the context of COVID-19 that is committed to disrupting the behaviorally based hegemonic health communication literature and transforming the unequal terrains of health experiences. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to introduce The Royal Australian & New Zealand College of Psychiatrists (RANZCP) Military and Veterans' Mental Health Network (The Network) and profile its inaugural members.Methods: We implemented an online survey of demographic, professional and practice characteristics of network members; self-rated knowledge of military and veterans' mental health; reasons for joining The Network; and suggestions as to how The Network could best support members' needs. Quantitative survey responses were analysed descriptively. Qualitative responses were analysed thematically.Results: Thirty-two out of 60 network members returned the survey. The membership was predominately male and 50 years of age or older. One-half had completed their fellowship or specialty 20 or more years ago. A high level of self-rated knowledge with respect to the assessment and management of current and ex-serving military personnel was reported. Knowledge of the assessment and management of current and ex-serving emergency services personnel was lower.Conclusion: There are RANZCP members with an active interest, expertise and knowledge in the field of military, veterans' and emergency services personnel mental health; this affirms the significant role the RANZCP can play in this area. There is a need to expand, diversify and ensure sustainability of the workforce. [ABSTRACT FROM AUTHOR]

Aim: To understand the experiences of young people with anorexia admitted to hospital for brief stays and to inform the design of contemporary inpatient treatment to better suit their needs in the context of a significant shift in practice from longer hospital admissions to shorter stays.Methods: A qualitative study was undertaken with young people within a few months of discharge from a specialist inpatient eating disorder service, Auckland, New Zealand. Audiotaped, semi-structured interviews were conducted with participants within a few months of their discharge from hospital and transcribed for coding.Results: Nine young people, all female, of mixed ethnicity (seven New Zealand European and two Asian) and aged between 15 and 17 years participated in the study. Five main themes were identified from the data, namely: (i) benefits of admission; (ii) sources of stress; (iii) control and power; (iv) having a voice and being heard; and (v) comparison of oneself with others.Conclusions: Although many of the benefits and challenges associated with brief treatment were similar to those during longer inpatient care, the impact of certain issues was more strongly experienced by participants and highlighted the need for greater attention to be paid to making young people feel better supported and included during predominantly medically focused admissions. [ABSTRACT FROM AUTHOR]

In the week following the Darfield magnitude 7.1 earthquake on September 4th 2010, researchers from the Resilient Organisations research group convened in Christchurch to set out a plan for learning as much as possible about the effects of the earthquake on organisations across their shaken region. This began a six-year process of data collection, analysis, and learning about the way organisations are affected by, adapt to, and recover from major disruptions. Between November 2010 and September 2016, our research team interviewed and surveyed over 1000 organisations across the Canterbury region through a series of earthquakes and disruptions, building a broad and rich dataset of insights that can now help other organisations facing disruptions in the future. In this article, we identify the top ten lessons for managing through crisis, being agile and adaptive in the face of change, and finding opportunities in disruption based on the experiences of real organisations. The lessons learned in the Canterbury event can inform resilience enhancement for the many organisations facing complex hazard risks, including those in New Zealand's capital, Wellington. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine the results of New Zealand initiatives to reduce seclusion rates and report the attitudes of mental health nurses to seclusion, factors involved in seclusion use, and alternatives to seclusion.Design/methodology/approach A questionnaire was circulated to mental health inpatient staff. Data from the Ministry of Health for seclusion numbers and rates for Ma¯ori and non-Ma¯ori were also collected.Findings The major barriers to reducing the use of seclusion related to staffing issues, a lack of management and medical support, and physical characteristics of the facility. Data from the Office of the Director of Mental Health annual reports from 2007-2014 clearly show a reduction in the total seclusion events, the number of patients secluded, and the percentage of total patients secluded. However, the percentage of Ma¯ori secluded compared to the total number of patients secluded showed little change from 2007 to 2013.Originality/value Further analysis of the nurse’s responses showed that four of the six least-used strategies incorporated Ma¯ori cultural approaches. The authors surmise that an inability to provide culturally sensitive care, either through staffing or education factors, may be implicated in the lack of change in the seclusion rates for Ma¯ori. This may also be pertinent to seclusion rates for indigenous peoples in other countries. [ABSTRACT FROM AUTHOR]

In crisis situations, the authority of the nurse is legitimised by legal powers and professional knowledge. Crisis stakeholders include those who directly use services and their families, and a wide range of health, social service and justice agencies. Alternative strategies such as therapeutic risk taking from the perspective of socially inclusive recovery policy coexist in a sometimes uneasy relationship with mental health legislation. A critical discourse analysis was undertaken to examine mental health policies and guidelines, and we interviewed service users, families, nurses and the police about experiences of accessing services. For those who attempt to access services early in crisis, as is suggested to lead to a better outcome, provision of services and rights appear to be reversed by an attempt to exclude them through practices that screen them out, rather than prioritising a choice in access. [ABSTRACT FROM AUTHOR]

The phones hardly ring at Youthline New Zealand anymore; youth still have problems and seek help, but it mostly happens silently. This article reports on experiences of texting at a 24-hour crisis helpline for young people. To date, there has been no formal evidence base for this practice; however, for new practice, there never is. In prompting discussion, this article attends to the tight constraints that texting imposes, returning to the necessary and sufficient conditions of any effective therapeutic relationship particularly in regard to working with young people. New possibilities are demonstrated with emotional support being demonstrated even in the tightly constrained space of a text-based medium. [ABSTRACT FROM PUBLISHER]

Background Safe and effective healthcare is frustrated by failures in communication. Repeating back important information (read-back) is thought to enhance the effectiveness of communication across many industries. However, formal communication protocols are uncommon in healthcare teams. Aims We aimed to quantify the effect of read-back on the transfer of information between members of a healthcare team during a simulated clinical crisis. We hypothesised that reading back information provided by other team members would result in better knowledge of that information by the receiver than verbal response without read-back or no verbal response. Method Postanaesthesia care unit nurses and anaesthetic assistants were given clinically relevant items of information at the start of 88 simulations. A clinical crisis prompted calling an anaesthetist, with no prior knowledge of the patient. Using video recordings of the simulations, we noted each time a piece of information was mentioned to the anaesthetist. Their response was coded as read-back, verbal response without read-back or no verbal response. Results If the anaesthetists read back the item of information, or otherwise verbally responded, they were, respectively, 8.27 (p<0.001) or 3.16 (p=0.03) times more likely to know the information compared with no verbal response. Conclusions Our results suggest that training healthcare teams to use read-back techniques could increase information transfer between team members with the potential for improved patient safety. More work is needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Youth with serious mental health disorders present with a complexity of challenges for the mental health system, schools, youth justice, care and protection, and their communities. Research shows their needs are best achieved by providing coordinated intensive, multidisciplinary, and individualised services. This article outlines the prevalence and characteristics of youth with serious mental health disorders. It also discusses community-based interventions used in New Zealand and their limitations. It introduces Wraparound, an intensive individualised coordination and care planning process as a promising practice for youth with serious mental health disorders and their families. Key principles and phases underpinning the Wraparound process are presented along with a case vignette to exemplify the process. Its theory of change, the challenges experienced in practice, and a brief overview of the evidence-base are also discussed. [ABSTRACT FROM AUTHOR]

This research identifies important themes in critical incident stress management from a social work perspective. Fifteen social workers responded to an advertisement in the national professional newsletter asking about social workers' recent experiences of critical incident stress debriefing (CISD) as an intervention. Their preferred models of critical incident stress management (CISM) were then discussed. Thirteen participants were interviewed, ten of whom had the dual experience as a debriefer and as a social worker who had been debriefed following a “critical event.” Those who had dual experience of facilitating debriefings and being debriefed, commented from both sets of experience. There was overwhelming support for Mitchell's model of CISM. The social workers interviewed thought Mitchell's seven staged model of CISD as an intervention needed to be offered within an integrated CISM policy that could be adapted to the specific field of social work in which the participant was working. Strengths-based principles were considered important to build into a CISM policy with debriefing being an option rather than a compulsory organizational support. The role of individual ongoing clinical supervision was seen as an essential part of an integrated CISM policy complementing the provision of CISD through an ongoing relationship. [ABSTRACT FROM PUBLISHER]

Peer support is a fast growing type of service provision within the mental health sector. This study draws on interviews with peer supporters and peer support managers to explore the ways that risks of violence, suicide and self-harm are managed within peer support settings in Aotearoa New Zealand. Drawing on Nikolas Rose and other theorists, who define risk thinking as an attempt to 'discipline uncertainty', we argue that the philosophy of peer support is in tension with a 'risk consciousness' because it sees crisis as a learning opportunity. We contend that peer supporters are pulled towards the 'risk consciousness', which pervades the mental health sector, and that they address this by managing risk in various ways. Finally, we show that peer supporters challenge this risk consciousness by working with risk through a philosophy of engagement and relationship. As peer support becomes more integrated into the wider health system, the challenge will be to continue the development of risk practices which work within a strong peer support philosophy. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the author discusses various topics within the issue including family therapy, family violence, and violent adolescents.

The article discusses the crisis pregnancy service offered by general practitioners in New Zealand. Topics covered include the choice of some women to terminate pregnancy if they feel socially or economically disadvantaged as well as the important role played by primary health care providers in helping these women. Also mentioned is the high rate of induced abortion in the country.