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

Background: The Recovery Assessment Scale: Domains and Stages (RAS-DS) was designed to be both a recovery outcome measure and a tool to enhance service-user control over their recovery journey. While extensively and globally used in mental health services for the former purpose, routine use for the latter purpose is yet to be realised. The aim of this study was to identify barriers, facilitators and additional supports needed for RAS-DS to be used to support service user participation, goal setting and recovery action planning. Methods: An online survey was conducted of mental health workers who had engaged with RAS-DS, including fixed choice and open-ended questions. Data were analysed using descriptive statistics and interpretive content analysis respectively. Results: The 65 respondents reported more frequent use of RAS-DS as an outcome measure than as a collaboration tool and more than half reported difficulties in using it in this way. Factors that they described as influencing the use of RAS-DS as a tool for collaboration and support included: previous experiences with RAS-DS; organisational supports and policies; awareness of the RAS-DS amongst colleagues; RAS-DS related training and support; staff time and capacity; the format of RAS-DS; service user population or context; and respondents' own active efforts. Conclusions: Extending the use of RAS-DS, an already widely used tool, to routinely support recovery-oriented practice has both efficiency and service user empowerment benefits. However further work is needed to enable this including: provision of co-designed, accessible training resources; a user platform including built in guidance; and strategies to promote management understanding and valuing of the enhanced recovery-orientation opportunities inherent in RAS-DS use. [ABSTRACT FROM AUTHOR]

Hope is essential to mental health recovery, yet little is known about how mental health services can foster hope. This paper addresses the question: How can mental health services influence the sense of hope experienced by people who access their services? Sixty-one people who accessed a new mental health service were interviewed about their experiences, including about how the service had influenced their sense of hope. Interviews were analysed using constant comparative analysis. The data revealed that hope increased when people perceived positive changes in themselves and their circumstances: developing new understandings and perspectives; having effective strategies to manage challenges; seeing progress or having plans; and having support. Changes were attributed to three major features of the service: accessibility; staff competence and wisdom; and caring interactions. The findings highlight that, while individual clinicians are important, other interactions with services and the wider service context are also critical for facilitating hope. [ABSTRACT FROM AUTHOR]

The aims of this study were to identify factors that a) predict whether people experience housing related discharge delay (HRDD) from a mental health inpatient unit; and b) predict the length of HRDD for people affected. By identifying the groups most affected by HRDD, clinicians and policy makers can prioritise and address barriers to timely discharge at both an individual and systemic level. A case control study using a detailed medical record review was conducted in one Australian mental health service. Demographic, clinical, contextual and systemic variables were collected for patients with HRDD in one calendar year (n = 55) and a random comparison sample (n = 55). Logistical and multiple regression analyses were conducted to identify variables that predict HRDD and length of HRDD. A model that correctly predicted 92% of HRDD and 78% of non-HRDD cases using five variables was developed. These variables were: diagnosis of schizophrenia or other psychotic disorder, physical comorbidity, having a history of violence or aggressive behaviour, being employed and being involved as a defendant in the justice system. The first three variables increased the likelihood of HRDD, while the second two reduced the likelihood of HRDD. For people who experienced HRDD, the only variable that predicted length of delay was staff reported difficulty finding appropriate support services. This model can be used to rapidly identify patients who might be at risk of HRDD and commence coordinated actions to secure appropriate housing and supports to facilitate timely discharge, thereby addressing a current practice gap. These findings highlight the intersection between health, housing and disability services in the lives of people with serious mental illness, and the need for a whole of government approach to investment and integration to address systemic barriers to suitable housing and supports. [ABSTRACT FROM AUTHOR]

Introduction: Delayed discharge from inpatient mental health units is the continued hospitalisation of consumers after being assessed as ready to be discharged. This is common in adult inpatient mental health services and is usually due to a lack of appropriate housing for discharge. Research indicates a range of possible negative impacts, but no studies have explored consumers' perspectives on this issue. This study explores consumers' perspectives of the experience of housing related delayed discharge (HRDD). Method: Using a grounded theory approach, in‐depth interviews were conducted with 10 consumers. All consumers were experiencing HRDD from inpatient mental health units in one Sydney local health district. The data were analysed using constant comparative analysis. Findings: A lack of choice and control was the central theme that characterised participants' experiences. The combined experience of being delayed in hospital and being homeless led to a lack of choice and control over the basics in life, how consumers spent their time and with whom, and their futures. This lack of autonomy was shaped by the features of the hospital and participants' personal circumstance. The hospital features included rules and routines, physical and social environments, resources, and support from staff. Personal circumstances included individual situations, social networks, and support from community organisations. Participants described a variety of impacts, including reduced mental and physical well‐being, and anticipated difficulty transitioning back into the community. Conclusion: This study is the first of its kind and provides consumer perspectives on the impacts of HRDD on their well‐being and recovery. The inability to participate in meaningful and necessary occupations is an occupational injustice and implies the need for occupational therapists to advocate for both the prevention of HRDD through government investment in affordable and readily available housing and the mitigation of its effects through modified hospital environments and practices. [ABSTRACT FROM AUTHOR]

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

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

International research indicates that delayed discharges from inpatient mental health units are common and most occur because patients lack suitable housing. However, little is known about this issue in an Australian setting. This mixed‐methods study aimed to investigate the extent, cost and contributors to housing‐related delayed discharge (HRDD) from inpatient mental health units in one Local Health District in New South Wales, Australia. A medical records review was conducted to quantify housing‐related delay and housing difficulties noted. Perceptions of discharge staff about the factors contributing to the delays were gathered through in‐depth interviews and analysed using constant comparative analysis. Findings indicated that HRDD for working aged adults accounted for 11.6% of total mental health bed days in 2018, costing the health system $4,054,149. When extrapolated nationally HRDD could cost Australia $269.5 million per year. While individual characteristics and contexts were thought to make some patients more vulnerable, data indicated that the major contributors were lack of housing options, lack of services, difficulty with funding and lack of clear pathways to achieve housing. The findings highlight the urgent need for additional housing for people with mental health issues and a whole of government approach to addressing the substantial issue of housing‐related delayed discharge. [ABSTRACT FROM AUTHOR]

Introduction: Parenting is a valued, common and challenging adult role. Many parents, including some living with disability or difficult social circumstances, experience barriers to fulfilling their parenting roles. Yet, occupational therapy involvement in parenting is rarely documented. Current understandings about 'doing' parenting lack cohesion and are dispersed in occupational therapy literature. This study aims to map and synthesise occupational therapy literature on 'doing' parenting to describe the state of the existing knowledge base, and develop a conceptual framework of parenting occupations as portrayed in occupational therapy literature. Methods: A scoping review was conducted. Medline, EMBASE, CINAHL, PsycINFO, Scopus, and Web of Science were searched on 28 October 2019 and updated on 18 February 2021. Journal articles and book chapters were screened for eligibility. Included texts' publication characteristics, methodological characteristics, and areas of focus were summarised. Interpretive content analysis was conducted. Results: From 5945 unique records, 105 texts were included. These discussed general parenting, parents with disabilities, and parenting in challenging social situations. Most texts focussed on mothers caring for young children in Western cultural contexts. The analysis culminated in the development of a conceptual framework: the Parenting Occupations and Purposes (POP) Framework. This comprises 10 interrelated areas of parenting occupations, which are performed for the purposes of addressing the child's basic, developmental and social needs. Parenting occupations were also found to be influenced by additional, underlying occupations that build parenting capacity ‐ Continuous Parental Development (CPD) occupations. Conclusion: These findings provide an overview of current occupational therapy conceptualisations of parenting. Unlike most of the existing literature on parenting, the POP Framework is parent‐centric rather than child‐centric. More research on parenting occupations is needed, especially with more diverse representation (fathers, ages of children, parental disability and sociocultural background). Further research is required to examine the POP Framework's usefulness in guiding research and practice, particularly among parents with diverse characteristics. [ABSTRACT FROM AUTHOR]

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

Objective: The purpose of this article is to explore the lived experience of having a child removed by child protection services for mothers living with mental illness. Method: This phenomenological study collected data from eight mothers through in-depth interviews. Data were analysed using interpretive phenomenological analysis. Results: The overall phenomenon of living with child removal was found to consist of four overarching essential components: chaotic lives pre-removal; pain and loss; protecting myself; and constrained mothering. Discussion: Mothers need support to manage the suffering associated with child removal in the context of already chaotic lives. Parenting and mental health services are in a position to assist mothers to develop adaptive coping strategies and minimise maladaptive strategies. [ABSTRACT FROM AUTHOR]

Parents are a critical resource in supporting young people who live with mental health problems. Qualitative research has identified that parents use a wide range of strategies to provide support. However, parents report being unsure which strategies are likely to be helpful, so often struggle in this role. Presently, little empirical evidence exists to assist parents to decide which strategies are likely to be most helpful. This study aimed to explore the parent‐perceived helpfulness of parental strategies to support young people living with mental health problems. Data were collected from February to July of 2018, using a cross‐sectional, online, anonymous, self‐report survey of participants who identified as parenting a young person (15–24 years) diagnosed with a mental health problem (n = 70). Overall, the strategies perceived as most helpful were practical assistance and personal interactions aimed at promoting positive thoughts and feelings and obtaining appropriate treatment. Least helpful strategies tended to be control‐type strategies, aimed at behaviour change. Overall, there was good alignment between strategies' helpfulness and frequency of use, however, there were exceptions. These exceptions are likely reflections of the specific context of particular situations as well as parental uncertainty regarding alternative strategies. Generally, perceptions of strategies' helpfulness were unrelated to parent or child characteristics. However, helpfulness of strategies was associated with parents' satisfaction with their relationship with the young person. Parents' collective experience‐based perceptions about the helpfulness of strategies used to support young people experiencing mental health problems can be harnessed to inform mental health practitioners' advice to parents and contribute to better mental health outcomes for young people. [ABSTRACT FROM AUTHOR]

Family inclusion in treatment planning and delivery for people living with mental illness is advocated in government policy but is yet to be widely translated into practice. While external barriers have been identified, including concerns about consumers' best interests, little is known about consumers' own views. This study explores consumers' experiences and perspectives of including family in treatment. Semi-structured interviews were conducted with 13 adult consumers who could identify supportive family members. Data were analysed using constant comparative analysis. The findings indicated that the outcomes reported from family inclusion depended on who, how, how much and when family were included, and the degree of choice consumers had regarding these features For consumers to have real choice around these features, family inclusion needed to be accessible, families needed to be willing, and all parties needed to agree upon a consumer-centred purpose. Findings can aid health professionals to facilitate consumer choice. [ABSTRACT FROM AUTHOR]

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

Introduction: Throughout the transition to motherhood, changes are experienced across a woman's physical, mental, social, and occupational self. Maternal chronic illness adds the complexity of increased healthcare needs and navigating a high‐risk, medicalised pregnancy, birth, and post‐natal period. Literature concerning motherhood transitions in chronic illness generally focusses on the mother's medical health and pregnancy outcomes; little is known about the impacts on women's occupations, balance, and quality of life. Understanding these issues may help support women in a more tailored and holistic way. Objective: This scoping review aims to gather, analyse, and synthesise existing empirical research on occupational engagement and occupational balance as they impact on wellbeing and quality of life in women with a lifetime chronic illness before and during pregnancy and in early motherhood. Method: The review follows the nine‐stage framework described in the Joanna Briggs Institute Manual for Evidence Synthesis (2020). Five databases were searched: Embase, Medline, PsycINFO, CINAHL, Scopus, and OT Seeker. Data were extracted and examined via content analysis, described in narrative synthesis, summarised into a conceptual framework, and tabulated. Findings: A total of 8,655 papers were discovered on initial search. Following title and abstract screening, 220 full‐text studies were assessed for eligibility, and 46 papers were finally included. Analysis generated four major themes: The Disrupted Transition Journey; Adaptation, Compromise and Choice; Outcomes; and Drawing on What's Available. The themes were conceptualised into a framework to explain how women sought to balance motherhood and illness‐related occupations. Adequate access to information, social support, expert care, and financial resources improved both quality of life and healthcare compliance. Conclusion: Findings of this scoping review deepen the understanding of occupational balance during the transition to motherhood in the context of lifetime chronic illness. Healthcare providers and supportive family and friends can use this knowledge to adapt their approach to assisting women with chronic illness on the motherhood journey. These findings may also inform further inquiry into the scope of occupational therapy practice with this population. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to identify aspects of the consumer-provider relationship that consumers saw as important in a care coordination service model. Method: Semi-structured interviews were conducted, between October 2015 and March 2016, with 20 people living with severe and persistent mental illness who used a care coordination service in Sydney, Australia. Data were analysed using constant comparative analysis. Results: Participants described five specific aspects of the consumer-provider relationship that they deemed important within their care coordination service experience: rapport and listening; an individualised approach; collaboration and partnership; reliability; and genuine care and respect. These were not independent, but rather, interdependent elements that collectively described a ‘good’ consumer-provider relationship. Discussion: While previous literature has examined the consumer-provider relationship in high-intensity and therapeutic models of service, this study confirms that similar relationship features are important in low-intensity or brokerage type models. Aspects such as the provider being easy to talk to and reliable appear to be of additional importance in this particular model. Findings suggest that the ability to develop trusting and collaborative relationships within a short timeframe is a critical consideration for recruitment and training of service providers working within care coordination models of service. [ABSTRACT FROM AUTHOR]

Secure and appropriate housing is critical for the well-being of people living with mental illness (consumers). Yet it is often difficult to achieve. Housing assistance is available, but is often difficult for consumers to access and negotiate. While the need for support is well-recognised, little is known about the active part consumers play in finding and keeping appropriate accommodation. This paper addresses the research question: How do consumers who use housing assistance actively manage their housing situations? In-depth interviews were conducted with 18 consumers who had used housing assistance within the past five years. These were analysed using constant comparative analysis, based on a grounded theory approach. Participants engaged in a range of activities to address six major concerns: working toward my home; following the rules to keep what I have; managing and improving my accommodation; working with housing services; living within my current situation; and finding and using supports. All participants described times when their mental health negatively affected their ability to do these activities. The findings highlight the need for housing services and mental health services to collaborate to develop policies and protocols that place reasonable demands on consumers and support their abilities to actively manage their housing situations. [ABSTRACT FROM AUTHOR]

Background/aim International students from culturally and linguistically diverse backgrounds experience personal and academic challenges when studying health sciences in Australia. Given recent discussions about cultural specificity in occupational therapy and its status as an emerging profession in most Asian countries, this study aimed to explore and describe the experiences of international students from Asian backgrounds studying occupational therapy in Australia. Method A phenomenological approach was used to understand the experiences of participants. In-depth interviews were conducted with eight international occupational therapy students from Asian countries studying in Australia. Data were analysed using hermeneutic methods. Results Participants described three interlinked and ongoing experiences: (1) Discovering and engaging with occupational therapy; (2) Fitting into my new role; and (3) Anticipating my role at home. Whilst theoretical aspects of occupational therapy were seen as compatible with participants' home cultures, application was seen as problematic due to the differences in structure and institutional culture of the healthcare systems. Although students made adaptations to fit in as occupational therapy students in Australia, they continued to see themselves as different, and their adaptation also influenced how they saw themselves in relation to their home culture. Conclusion Findings can contribute to creating culturally sensitive education for occupational therapy students from Asian countries. To best serve these students, educators should consider ways to facilitate transitions both out of and back into students' home cultures. [ABSTRACT FROM AUTHOR]

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

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

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

Background/Aims: Assisting clients to achieve wellbeing, even in the presence of ongoing mental illness, should be a primary goal of mental health services. However, little is known about what wellbeing means for young people living with mental illness. The aim of this study is to explore the ways in which young Australians living with mental illness conceptualise their wellbeing. Methods: Five focus groups were conducted with young people (n=20; age range: 16-25 years) living with mental illness. Results were analysed qualitatively using constant comparative analysis. Results: Analysis of the data indicated that participants were describing two different but complementary types of concepts. We conceptualised these two types of concepts as 'building blocks' and 'foundations' of wellbeing, respectively. Five building blocks were identified, which together constituted wellbeing for participants: i) sense of self; ii) relationships; iii) sense of the future; iv) feelings and experiences; v) agency. These building blocks were supported or undermined by seven foundations: i) activities; ii) having things; iii) mental illness; iv) the past; v) coping strategies; vi) environmental supports and barriers; vii) personal characteristics. Conclusions: The findings support the use of a recovery paradigm for young people with mental illness. The framework presented can be used to assist young people to consider different aspects that make up their wellbeing and plan ways to address these by attending to multiple foundational factors. [ABSTRACT FROM AUTHOR]

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

Employment is a crucial avenue through which young people with disability can experience material wellbeing and social participation. While the low employment rates of young people with disability are well established, little is known about the stability of employment status -- that is, the degree to which individuals remain in or move in and out of employment. This article uses longitudinal data from a large Australian national data set to investigate the transitions between full-time, part-time and non-employment for young people with and without disability. Considerable mobility was found between employment states for both young people with and without disability, with young people with disability more likely than their peers without disability to transition to reduced levels of employment and less likely to transition to increased levels of employment. Social background and contextual factors predicted employment for young people with disability; however, disability represented an additional penalty even after taking these factors into account. Findings suggest a need for social policy targeted specifically towards the barriers to maintaining and increasing employment experienced by young people with disability. [ABSTRACT FROM AUTHOR]

Parents of young people with mental illness use a variety of strategies to try to positively influence young people's mental health-related behaviours. Evidence suggests that these parents can influence young people's well-being and mental health trajectories. However little is known about how young people perceive and are affected by the strategies parents use. In-depth qualitative interviews focussing on parental involvement in mental health were conducted with 26 young people with mental illness. The data were analysed using constant comparative analysis. Young people described parents as directly influencing their mental health-related behaviour through facilitative, persuasive and controlling practices. Young people's behavioural and emotional responses to these practices were influenced by when the incident occurred; what they believed about the attitudes and motives behind their parents' actions; whether they agreed in principle with the practices; the degree to which they accepted their parents' authority and anticipated their own increasing autonomy; and whether other support was provided alongside the behavioural practices. Understanding how young people view their parents' influence on their mental health-related behaviour under different circumstances is a vital step towards promoting the best possible parental support for these young people. [ABSTRACT FROM AUTHOR]

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

As noted in the preamble to the 2007 UN Convention on the Rights of Persons with Disabilities, 'persons with disabilities continue to face barriers in their participation as equal members of society and violations of their human rights in all parts of the world'. In this paper we present nationally representative data on the nature and level of disadvantage faced by young Australians with a long-term health condition, impairment or disability in 2001 and 2006. The results suggest that: (1) when compared with their non-disabled peers, young Australians with a long-term health condition, impairment or disability face pervasive social and material hardship and have lower subjective well-being; (2) no progress was made between 2001 and 2006 in equalising the opportunities of young Australians with a long-term health condition, impairment or disability; (3) lower subjective well-being is not inherently associated with disability, but is contingent on the experience of social exclusion and material hardship. [ABSTRACT FROM AUTHOR]

Parents' encounters with health professionals can influence their ability to cope with having a daughter with anorexia nervosa. Using qualitative analysis of in-depth interviews with 24 parents, we examine the question "What support do parents of teenage girls with anorexia want from clinicians?" The analysis shows that parents wanted clinicians to include them in treatment, support and guide them in their daughters' care, and demonstrate positive attitudes toward them. The implications for clinicians are discussed, including being sensitive to parents' vulnerability, ensuring congruence between clinicians' and parents' expectations about treatment, and strengthening formal channels of communication. [ABSTRACT FROM AUTHOR]

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

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

This qualitative study explored the perspectives of adolescent girls diagnosed with anorexia nervosa and parents about the influence of siblings on sufferers' experiences of anorexia. In-depth interviews were conducted with 24 girls and 24 parents and analysed using constant comparative methods. Findings indicated that siblings can have both a positive and negative influence on girls through their presence in the family, responses to the illness, and impact on parents. A number of contributing factors affected the influence of siblings including: the sibling's understanding of anorexia; lifestyles; pre-anorexia relationships; whether parents and girls encouraged or discouraged a sibling's involvement with the anorexia; sibling and family characteristics; and professional interventions. The findings are presented as a conceptual framework that illustrates the relationships between these different dimensions. The findings underline the significance of sibling influence and the clinical value of further research into relationships between siblings and other family members in cases of anorexia nervosa. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

In this article, the authors report on an interview study in which parents described the coping strategies they used to deal with the demands of having a daughter diagnosed with anorexia nervosa. They compare parents' accounts with commonly used categorizations in quantitative studies of parental coping and adjustment. The study indicates that parents attribute multiple, complex, and unique motives to their actions that problematize quantitative constructions of types of coping. Parents often defined their actions differently and reported using coping strategies that were not considered or measured by the most widely used quantitative coping instruments. The analysis indicates that when the focus is on understanding and assisting parental coping in particular circumstances, situated, context-specific analyses are necessary to design measures that accurately reflect parents' coping efforts. [ABSTRACT FROM AUTHOR]

This paper examines parents’ actions in response to anorexia nervosa, and how these are shaped by the ways they construct or understand the eating disorder. The findings indicate that parents try to influence their daughters by searching for help, providing practical support, avoiding confrontation, complying with special requirements, persuading, explaining, and pressuring, using ploys and force, providing emotional support, and mediating interactions. Parents’ actions are influenced by how they construct anorexia, such as whether they see it as an eating issue, an illness, a psychological problem, a choice, or a mystery. Understanding parents’ actions and constructions can help clinicians develop collaborative partnerships with parents. [ABSTRACT FROM AUTHOR]

This essay offers a critical, reflective analysis of some of the sticky moral questions that can entangle feminist researchers as they work to transform a research proposal into an application for ethics committee approval. In the first section, it relates an account of how ethical theory plays out in the real world, drawing on the experience of preparing the ethics applications for an interview study with anorexic teenage girls and struggles with two pillars of research ethics policy. Meanwhile, the second section teases out the implications of the research ethics approval process for the people who participate in research and for those who desire to be ethical and moral researchers.

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

The purpose of this article is to review the research literature on people with psychiatric disabilities and employment outcomes. The bulk of this knowledge has been gathered using methods that rely on statistical techniques based on the notion of probability. Missing from our current knowledge base is bow people with psychiatric disabilities view their own employment experiences. An argument is presented for researchers to incorporate qualitative methods into their work to ensure that personal experiences of work are explored and documented. [ABSTRACT FROM AUTHOR]

Great controversy surrounds the use of electroconvulsive therapy or ECT. However, it continues to be used internationally. While research on short term effects of ECT abound, there is limited knowledge about long term impacts of ECT on individuals, especially from the lived experience perspective. The aim of this qualitative study was to gain an in-depth understanding of longer-term lived experiences of ECT and how people navigate any impacts on their daily lives. Twenty-three people participated in semi-structured interviews. Data collection and analysis involved an iterative process. Data were coded into four categories: (1) My ECT experience included physical mechanics, decision making, clinic experiences, post ECT support and attitudes and support of others); (2) Direct impacts of ECT on me encompassed both cognitive and emotional impacts; (3) Impacts on my life comprised daily activities, relationships, ongoing health care; and My strategies incorporated fixing or working around the problem, reframing, using support networks, protecting myself and taking control. Insights gleaned through lived experiences have important implications for other service users, direct service providers and those striving for system reforms that embrace more recovery orientated and trauma informed practices. [ABSTRACT FROM AUTHOR]

The article presents a study which discusses facilitators and barriers to inter-professional education (IPE) with other health-care students from the perspectives of residents, medical and nursing students. It mentions information on importance of teaching to address inter-professional skills and attitudes for health-care curriculum. It presents information on adverse impact of lack of formal assessment and an emphasis on professional knowledge rather than team work skills over IPE.

Background: Lived experience research is conducted by people who have experience of mental health issues and is therefore better placed than more traditional research to illuminate participants' experiences. Findings that focus on identifying enablers of recovery from a lived experience perspective have the potential to assist people in their recovery process. However, this lived experience research is often difficult to find, access and interpret. We co-produced user-friendly and engaging resources to disseminate findings from six lived experience research studies. This paper seeks to answer the research questions: a) Did exposure to lived experience research increase hopefulness for participants?; and b) How else did interacting with lived experience research resources influence participants' lives? Methods: Thirty-eight participants were introduced to four resources of their choosing by peer workers over a four-week period. The helpfulness of resources was evaluated using mixed methods, including a quasi-experimental analysis of change in hope, an anonymous survey and in-depth interviews. Results: Findings indicated that the resources promoted hope, but that increases in hopefulness may not be seen immediately. Other impacts include that the resources: encouraged helpful activities; provided a positive experience; increased valued knowledge; encouraged people to reflect on their journey and think constructively about mental health issues; helped people to feel less alone; and assisted people to explain their situation to others. Conclusions: The research suggests the potential usefulness of lived experience research resources, presented in user-friendly formats, in the lives of people who experience mental health issues and implies a need to nurture this type of research. [ABSTRACT FROM AUTHOR]

Background: Obesity is a global epidemic affecting all age groups, populations, and income levels across continents, though is known to disproportionately affect socioeconomically disadvantaged populations. The causes of obesity are complex, informed by diet and weight practices, but shaped by social, commercial, and environmental factors and government policy. Consequently, a Whole System Approach (WSA)–which considers the many causes of obesity and shifts the focus away from individuals as points of intervention and puts an emphasis on understanding and improving the system in which people live–is required. This scoping review of reviews aims to: determine how WSAs to diet and healthy weight have been implemented and evaluated nationally and internationally; to determine what models or theories have been used to implement WSAs; describe how WSAs have been evaluated; determine if WSAs are effective; and to identify the contribution of the public and/or service users in the development of WSAs. Method: Systematic searches were carried out using CINAHL, Scopus, PsycINFO (ProQuest), the Cochrane Library, and MEDLINE. Included review papers were those that focused on the application of a whole system approach to diet and/or healthy weight, and/or reported the theory/model used to implement or simulate this approach. Databases were searched from 1995 to March 2022 using a combination of text and Medical Subject Headings (MeSH terms). In addition, reference sections of identified articles were examined for additional relevant articles. Covidence software was used to screen titles and abstracts from the electronic databases and resolve conflicts. Results: A total of 20,308 articles were initially retrieved; after duplicate removal 7,690 unique title and abstracts were reviewed, and 110 articles were selected for full text review. On completion of full text review, 8 review articles were included for data extraction. These included: one umbrella review, four systematic reviews, a rapid review, and two literature reviews (one of which was on strategic reports written for government and public health policy). Evaluations of WSA were mainly process evaluations although health outcomes were assessed in some studies. Several conceptual frameworks or mathematical modelling approaches have been applied to WSAs for diet, healthy weight, and obesity to inform their planning or delivery, and to understand/map the associated systems. Common mathematical approaches include agent based or System Dynamic Modelling. Underlying both conceptual and mathematical models is an understanding how the elements of the complex systems impact each other to affect diet, healthy weight, and obesity. WSA implementations have reported some success in positively impacting health outcomes including reducing Body Mass Index, reducing sugary food intake, and increasing physical activity. Public and user involvement in WSA was not widely reported. Conclusion: The application of WSA to diet and healthy weight shows promise, yet the research is lagging behind their implementation. Further robust evidence for using WSA to address diet and healthy weight are required, including incorporating process and outcome evaluations (perhaps using established approaches such as Systems Dynamic Modelling). Furthermore, the analysis of epidemiological data alongside longitudinal process and outcome evaluation regarding the implementation of a WSA is required. [ABSTRACT FROM AUTHOR]

Background: Mothers who live with mental illness face diverse challenges. Research suggests that partner support or otherwise is likely to have a crucial influence on mothers' abilities to manage these challenges, yet little is known about how this plays out. In this study, we aimed to explore the roles played by male partners in the mothering experiences of women living with mental illness. Methods: We conducted a qualitative secondary analysis using interview data collected from 18 participants in two previous qualitative studies. Both studies focused on the mothering experiences of women who lived with mental illness. In both studies, the importance of male partners was striking. The data were analyzed using constant comparative analysis. Results: The roles of partners in women's experiences of mothering were multiple and dynamic, with each male partner playing a unique combination of roles. These included: facilitator; teammate; unfulfilled potential; distraction; dismantler, and threat to child. Roles were influenced by: mothers' interpretations; partners' behaviors, characteristics and circumstances; the family's living and custody arrangements; mothers' active management strategies; and a range of external controls and supports. Conclusions: Health professionals need to consider the complex roles partners play. This crucial aspect of mothers' social environments can be optimized by directly supporting and enabling partners themselves, and by supporting mothers to actively shape their partners' roles. [ABSTRACT FROM AUTHOR]

The study objective was to identify the types of experiences that consumers identify as igniting and maintaining hope, and those most frequently reported. Data were collected through an anonymous online survey. Two open-ended questions elicited reflective personal accounts regarding hope-promoting experiences. Using an interpretive content analysis design, data were coded inductively using constant comparative analysis. Numbers of participants reporting each type of experience were calculated to identify patterns of hopeful experiences. Findings from 72 participants highlighted a diversity of hope-promoting experiences and sources. Fifteen experiences were identified, forming two broad categories: interactions and experiences involving others, and personal or internal experiences, insights and actions. Findings suggest that consumers play an active role in igniting and maintaining their own hope. Peer workers and health workers can support this by being cognizant of the quality of their interactions with consumers and by facilitating connections with others, particularly families, friends and peers. [ABSTRACT FROM AUTHOR]

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

There is a need for robust outcome measures for use in psychiatric services. Particularly lacking are self-rated recovery measures with evidence of sensitivity to change. This study was established to examine the convergent validity and sensitivity to change over time (responsiveness) of the Recovery Assessment Scale – Domains and Stages (RAS-DS), in comparison to level of unmet need as measured by the Camberwell Assessment of Need – Short Appraisal Scale (CANSAS). Convergent validity was examined through cross-sectional correlations between 540 CANSAS and RAS-DS scores collected on the same day for the same individuals. Sensitivity to change was examined using correlations between change scores in CANSAS and RAS-DS where both were collected on the same day and the two time points were separated by 90 days or more ( n = 498). Results demonstrated moderate, significant cross-sectional correlations between CANSAS scores and RAS-DS total and domain scores and between change scores of both instruments. Results suggest that the RAS-DS is sensitive enough to detect change over time. Only moderate correlation between the RAS-DS and CANSAS suggests that, in the context of recovery-oriented service provision, it is important to measure self-reported recovery in addition to level of unmet needs. [ABSTRACT FROM AUTHOR]

Objective:The aim of this study was to understand the strategies women living with mental illness use to balance the demands of mothering with mental health recovery. Method:Semi-structured interviews were conducted with 10 Australian women who self-identified as managing to balance mothering with mental health recovery. The data were analysed using constant comparative analysis, and other techniques informed from grounded theory. Results:Mothers used four interconnected balancing strategies: prioritising in the present; looking after myself; buffering children; and using supports. Awareness of the crucial interconnectedness of mothering and recovery was the foundation for these balancing strategies. Developing this awareness was essential in order to value, develop and therefore implement these strategies. Supports and resources played a critical role in helping mothers to develop awareness of, as well as use, strategies to balance motherhood and mental health recovery. Discussion:Mental health services can support mothers to develop an understanding of the inextricable connection between their own recovery needs and the needs of their child. Mothers can also be supported to successfully identify and employ their own strategies within each of the four categories developed in this study. [ABSTRACT FROM AUTHOR]

Background: The time following discharge from psychiatric hospitalisation is a high risk period. Rates of hospital readmission are high and there is increased risk for homelessness and suicide. Transitional and post-discharge support programs have demonstrated positive results in terms of enhanced wellbeing, improved connection with community-based services and, in some cases, reductions in hospital re-admission. This paper reports on the outcomes of a peer-delivered post-discharge support program. Methods: The program involved peer workers (individuals with their own lived experience of mental illness and recovery) providing individualised practical and emotional support to individuals for six to eight weeks following discharge from an inpatient psychiatric unit. Outcomes measures included self-reported mental health recovery, personal wellness and self-reported re-admission rates. Process and satisfaction measures were also collected and semi-structured follow-up interviews were completed with consenting participants. Results: The program provided support for a total of 64 individuals, 38 of whom consented to participate in the evaluation. Participants reported improvements in terms of functional and clinical recovery and in the areas of intellectual, social and psychological wellness. Participants self-report of hospital readmissions suggested that there was a reduction in hospital bed days following engagement with the program. Themes from the follow up interviews included: Easing the transition to the "real world"; Practical and individualised support; Someone to talk to; Positive qualities of the worker, Workers' lived experience was a positive thing, and It wasn't long enough. Conclusion: Overall, evaluation data suggest that the program supported positive outcomes for participants in terms of recovery, wellbeing and hospital avoidance. Participant feedback suggested that the use of support workers with their own lived experience of mental illness was a particularly powerful aspect of the program. [ABSTRACT FROM AUTHOR]

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

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

The Recovery Assessment Scale (RAS) is a frequently used measure of recovery from mental illness but has previously been shown to poorly differentiate between more recovered consumers. This research aimed to: (1) identify components of later recovery stages; (2) ascertain the extent to which these are measured in the RAS; and (3) suggest modifications to improve the ability of the RAS to differentiate between more recovered consumers. Clubhouse members who scored high on the RAS participated in focus groups in which they discussed areas of recovery most recently or yet to be achieved. Constant comparative analysis of data indicated that later stages of recovery are characterized by: (a) accepting your illness and gaining control over symptoms (b) self love and optimism, (c) doing things for and experiencing pleasure, (d) contributing through meaningful activity, (e) having a diversity of friendships, (f) being needed and valued by others and (g) coming to terms with family relationships. Results suggest the RAS would be improved by addition of items, particularly in functional and social recovery domains. [ABSTRACT FROM AUTHOR]

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