Journal articles on the topic 'Community mental health services – Australia'
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Rosen, Alan, Roger Gurr, and Paul Fanning. "The future of community-centred health services in Australia: lessons from the mental health sector." Australian Health Review 34, no. 1 (2010): 106. http://dx.doi.org/10.1071/ah09741.
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•It is apparent that hospital-dominated health care produces limited health outcomes and is an unsustainable health care system strategy. •Community-centred health care has been demonstrated to be a more cost-efficient and cost-effective alternative to hospital-centred care, particularly for prevention and care of persistent, long-term or recurrent conditions. Nevertheless, hospital-centred services continue to dominate health care services in Australia, and some state governments have presided over a retreat from, or even dismantling of, community health services. •The reasons for these trends are explored. •The future of community health services in Australia is uncertain, and in some states under serious threat. We consider lessons from the partial dismantling of Australian community mental health services, despite a growing body of Australian and international studies finding in their favour. •Community-centred health services should be reconceptualised and resourced as the centre of gravity of local, effective and affordable health care services for Australia. A growing international expert consensus suggests that such community-centred health services should be placed in the centre of their communities, closely linked or collocated where possible with primary health care, and functionally integrated with their respective hospital-based services. What is known about the topic?Community-centred health care has been widely demonstrated to be a more cost-efficient and cost-effective alternative to hospital-centred care, particularly for prevention and care of persistent, long-term or recurrent conditions, e.g. in mental health service systems. A growing international expert consensus suggests that such community-centred health services should be placed in the centre of their communities, closely linked or collocated where possible with primary health care, and functionally integrated with their respective hospital-based services. What does this paper add?Despite this global consensus, hospital-centred services continue to dominate health care services in Australia, and some state governments have presided over a retreat from, or even dismantling of, community health services. The reasons for these trends and possible solutions are explored. What are the implications for practitioners?Unless this trend is reversed, the loss of convenient public access to community health services at shopping and transport hubs and the consequent compromising of intensive home-based clinical care, will lead to a deterioration of preventative interventions and the health care of long-term conditions, contrary to international studies and reviews.
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Davidson, Fiona, Bobbie Clugston, Michelle Perrin, Megan Williams, Edward Heffernan, and Stuart A. Kinner. "Mapping the prison mental health service workforce in Australia." Australasian Psychiatry 28, no. 4 (December 23, 2019): 442–47. http://dx.doi.org/10.1177/1039856219891525.
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Objective: The rapidly growing number of people in prison in Australia, combined with the high prevalence of mental disorder in this population, results in high demand for mental health services in prison settings. Despite their critical role as part of a national mental health response, prison mental health services (PMHS) in Australia have been poorly characterised. In this paper, we describe findings of the first national survey of PMHS in Australia. Methods: We distributed a survey to key representatives of PMHS in all Australian states and territories in 2016. Results: Our method constitutes a replicable process for quantifying and comparing PMHS in Australia. We describe the structure, governance and staffing models in seven jurisdictions. When compared against international recommendations, only one Australian jurisdiction (the ACT) is funded to provide services at a level equivalent to mental health services provided in the community. Conclusion: Prison mental health services in Australia are delivered by a complex mix of government, private sector and non-government services. Services appear to be severely under-resourced when compared with the available benchmarks.
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Ellis, Andrew. "Forensic psychiatry and mental health in Australia: an overview." CNS Spectrums 25, no. 2 (October 7, 2019): 119–21. http://dx.doi.org/10.1017/s1092852919001299.
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This article reviews the development of forensic psychiatry and mental health services in Australia for the international reader. It covers the legacy of a series of colonial systems that have contributed to a modern health service that interacts with justice systems. The development of relevant legislation, hospitals, prison services, community, and courts services is reviewed. The training and academic development of professionals is covered. Gaps in service delivery and future directions are considered.
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Byrne, Louise, Michael Wilson, Karena J. Burke, Cadeyrn J. Gaskin, and Brenda Happell. "Mental health service delivery: a profile of mental health non-government organisations in south-east Queensland, Australia." Australian Health Review 38, no. 2 (2014): 202. http://dx.doi.org/10.1071/ah13208.
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Objective Non-government organisations make a substantial contribution to the provision of mental health services; despite this, there has been little research and evaluation targeted at understanding the role played by these services within the community mental health sector. The aim of the present study was to examine the depth and breadth of services offered by these organisations in south-east Queensland, Australia, across five key aspects of reach and delivery. Methods Representatives from 52 purposively targeted non-government organisations providing mental health services to individuals with significant mental health challenges were interviewed regarding their approach to mental health service provision. Results The findings indicated a diverse pattern of service frameworks across the sector. The results also suggested a positive approach to the inclusion of consumer participation within the organisations, with most services reporting, at the very least, some form of consumer advocacy within their processes and as part of their services. Conclusions This paper offers an important first look at the nature of non-government service provision within the mental health sector and highlights the importance of these organisations within the community sector. What is known about the topic? Non-government organisations make a substantial contribution to the multisectorial provision of services to mental health consumers in community settings. Non-government organisations in Australia are well established, with 79.9% of them being in operation for over 10 years. There is an increasing expectation that consumers influence the development, delivery and evaluation of mental health services, especially in the community sector. What does this paper add? This paper provides a profile of non-government organisations in one state in Australia with respect to the services they provide, the consumers they target, the practice frameworks they use, the use of peer workers and consumer participation, the success they have had with obtaining funding and the extent to which they collaborate with other services. What are the implications for practitioners? This paper provides readers with an understanding of the non-government organisations and the services they provide to people with mental health conditions. In addition, the findings provide an opportunity to learn from the experience of non-government organisations in implementing consumer participation initiatives.
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Creammer, Mark, and Bruce Singh. "An Integrated Approach to Veteran and Military Mental Health: An Overview of the Australian Centre for Posttraumatic Mental Health." Australasian Psychiatry 11, no. 2 (June 2003): 225–27. http://dx.doi.org/10.1046/j.1039-8562.2003.00514.x.
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Objective: To provide an overview of the development of mental health services for veterans and currently serving military personnel in Australia, with reference to the role of the Australian Centre for Posttraumatic Mental Health (ACPMH). Conclusions: Recent years have seen significant changes in attitudes to the mental health sequelae of military service. The ACPMH, working in collaboration with the Department of Veterans’ Affairs (DVA) and the Australian Defence Force (ADF), as well as with clinicians, researchers, and consumers around Australia, acts as a focus for an integrated approach to veteran and military mental health. The active involvement of both the ADF and DVA in the challenge of mental health provides new opportunities to address psychiatric morbidity at every stage, from recruitment, through deployments and discharge, to veteran status. The ACPMH is in a unique position to facilitate an integrated approach to prevention, intervention, policy development, training, research, and evaluation in order to ensure that Australia remains at the forefront of world's best practice in veteran and military psychiatry. The Centre is also uniquely placed to offer those same services in the field of traumatic stress to the broader community.
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Whiteford, Harvey, Bronwyn Macleod, and Elizabeth Leitch. "The National Mental Health Policy: Implications for Public Psychiatric Services in Australia." Australian & New Zealand Journal of Psychiatry 27, no. 2 (June 1993): 186–91. http://dx.doi.org/10.1080/00048679309075767.
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The Health Ministers of all Australian States, Territories and the Commonwealth endorsed National Mental Health Policy in April 1992 [1]. This Policy is intended to set clear direction for the future development of mental health services within Australia. The Policy recognises the high prevalence of mental health problems and mental disorders in the Australian community and the impact of these on consumers, carers, families and society as whole. It also clearly accepts the need to address the problems confronting the promotion of mental health and the provision of mental health services.
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Edward, Karen-leigh, Rhonda Nelson Hearity, and Boyce Felstead. "Service integration for the dually diagnosed." Australian Journal of Primary Health 18, no. 1 (2012): 17. http://dx.doi.org/10.1071/py11031.
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The needs of dually diagnosed clients in mental health services have been and remain a focus for service development and improvement in Australia. The Council of Australian Governments committed to a five-year National Action Plan on Mental Health with a $1.8 billion injection into mental health services. In Australia there have been great advances in the service initiatives and service deliverables to those clients who experience a dual diagnosis. These advances include that dual diagnosis is systematically identified and responded to in a timely, evidence-based manner as a core business in mental health and alcohol and other drug services. These advances are brought to life by specialist mental health and alcohol and other drug services that establish effective partnerships and agreed mechanisms to support integrated care and collaborative practice. Here, four case studies are offered as a means of illustrating the ways in which projects undertaken in local community health services have approached dual diagnosis treatment for clients. These case studies reflect how cooperation and cross-referral between services, as well as effective management of dual diagnosis clients by suitably qualified staff can produce benefits to clients who use the service.
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Sandford, Donald, and Rob Elzinga. "The consumers of community mental health services within South Australia." Clinical Psychologist 3, no. 2 (January 1, 1998): 41–44. http://dx.doi.org/10.1080/13284209908521043.
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Lloyd, Chris, and Pam Samra. "Healthy Lifestyles: A Community Programme for Chronically Mentally Ill People." British Journal of Occupational Therapy 59, no. 1 (January 1996): 27–32. http://dx.doi.org/10.1177/030802269605900110.
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This article outlines a Healthy Lifestyles Programme (HLP) for chronically mentally ill people in the South Coast Regional Health Authority in Australia, in the area of integrated mental health services. This programme has provided practical community-based experiences for chronically mentally ill people, focusing on functional deficits in daily living skills. Major reforms in service delivery in mental health have resulted in a move to community-based care. The 1994 Queensland Mental Health Plan set out specific objectives and strategies for the implementation of mental health service reform. One of the immediate priorities for Queensland is the establishing of mainstream integrated services to promote continuity of care across service components. The HLP reflects this priority in providing a community-based service in an integrated mental health setting, using the principles of community-based integration, family support, collaboration, rehabilitation and case management, as outlined in the community care model.
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Dwyer, Judith, and Sandra Leggat. "Australian Health Review call for papers." Australian Health Review 29, no. 4 (2005): 377. http://dx.doi.org/10.1071/ah050377.
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The editors of Australian Health Review are seeking articles for an upcoming issue on mental health services in Australia and New Zealand. It is estimated that mental health problems and mental illness will affect more than 20% of the adult population in their lifetime and between 10%?15% of young people in any one year. In Australia, through the National Mental Health Strategy, all levels of Australian government have recognised the need to work together to reform services and policy to ensure that, wherever possible, people with a mental illness are able to enjoy the same opportunities as other Australians. In New Zealand, the Mental Health Commission envisions a place where people with mental illness have personal power, full participation in their communities and access to a fully developed range of recovery-oriented services. To help inform policy and practice, Australian Health Review is looking to publish research papers, case studies and commentaries related to mental health. Some potential topic areas include: � Governance and management � Consumer and community perspectives � Program evaluation and economic analysis � Impact of policy. Submissions related to international programs with lessons for Australia and New Zealand will also be welcomed. Submissions can be short commentaries of 1000 to 2000 words, or a more comprehensive review of the topic of 2000 to 3000 words. The deadline for submission is 15 February 2006.
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Lien, On. "Attitudes of the Vietnamese Community towards Mental Illness." Australasian Psychiatry 1, no. 3 (August 1993): 110–12. http://dx.doi.org/10.3109/10398569309081340.
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There are approximately 155,000 Vietnamese born people in Australia, with 46,000 in Victoria. The majority came to Australia as refugees. Many were subjected to the reality or threat of war, persecution, imprisonment, discrimination, economic deprivation, violence, the loss of family or other major stressors. These stressors have included the hazards of the escape, lengthy stays in refugee camps and, on arrival in Australia, lack of familiarity with English and with the culture. The Vietnamese Community in Australia was expected to have a high prevalence of mental illness, especially when newly arrived from refugee camps. In a study published in 1986 as “The Price of Freedom” [1] 32% of the young Vietnamese adult group was found to suffer from psychiatric disorder. At follow-up two years later, the prevalence of psychiatric disorder, without any major intervention, had dropped to 5–6%, a prevalence lower than that in the Australian-born community. In addition, the Vietnamese community's use of mental health services (inpatient and community-based) is lower than that of any other ethnic group.
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Waghorn, G. "Integrating vocational services into Australian community mental health services." Acta Neuropsychiatrica 18, no. 6 (December 2006): 273. http://dx.doi.org/10.1017/s0924270800030878.
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Kingi, Roman, Wani Erick, Vili Hapaki Nosa, Janine Paynter, and Debra de Silva. "Pasifika preferences for mental health support in Australia: focus group study." Pacific Health Dialog 21, no. 7 (June 22, 2021): 373–79. http://dx.doi.org/10.26635/phd.2021.110.
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Introduction: Mental wellbeing is a growing health issue for Pacific Islands communities (Pasifika), particularly amongst people who have resettled in a different country. We explored whether Pasifika people living in Australia think mental health services meet their needs. Methods: We ran eight two-hour focus groups with 183 adults living in Queensland, Australia. There were representatives from the following ethnic groups: Cook Islands, Fiji, Maori, Niue, Papua New Guinea, Samoa, Tokelau and Tonga. We also included mental health providers. We analysed the feedback using thematic analysis. Findings: Pasifika people welcomed having an opportunity to discuss mental wellbeing openly. They said that economic issues, social isolation, cultural differences, shame and substance use contributed to increasingly poor mental health amongst Pasifika communities in Australia. They wanted to work with mainstream services to develop culturally appropriate and engaging models to support mental wellbeing. They suggested opportunities to harness churches, community groups, schools, social media and radio to raise awareness about mental health. Conclusions: Working in partnership with Pasifika communities could strengthen mainstream mental health services and reduce the burden on acute services in Australia. This could include collecting better ethnicity data to help plan services, empowering community structures to promote mental wellbeing and training staff to support Pasifika communities. The key message was that services can work ‘with’ Pasifika communities, not ‘to’ them.
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Milner, Karla, and Nigar G. Khawaja. "Sudanese Refugees in Australia: The Impact of Acculturation Stress." Journal of Pacific Rim Psychology 4, no. 1 (May 1, 2010): 19–29. http://dx.doi.org/10.1375/prp.4.1.19.
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AbstractRefugees from Sudan are the fastest growing community in Australia. Australian mental health professionals have to be prepared to offer services to this ethnic group along with the other mainstream and diverse consumers. In order to offer culturally competent services, these mental health professionals are required to be familiar with this emerging community. As such, a review was undertaken with two main goals. Firstly, the review aimed to educate Australian mental health professionals about the demographics and culture of Sudan, the traumas encountered as a result of the civil war, factors leading to massive exodus and the difficulties of the transit and postmigration phase. Secondly, the review intended to inform Australian mental health professionals about the possible acculturation stress that is manifested in the form of intergeneration and role conflict and marital difficulties. The review highlights limitations on the number of studies addressing acculturation stress of Sudanese refugees and even fewer on the impact it has on relationships. Future research directions are discussed.
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Ronnau, Peggy, Arthur Papakotsias, and Glen Tobias. ""Not for" sector in community mental health care defines itself and strives for quality." Australian Journal of Primary Health 14, no. 2 (2008): 68. http://dx.doi.org/10.1071/py08025.
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This paper briefly describes the history and service context of the Psychiatric Disability Rehabilitation and Support sector (PDRSS) in Victoria, and, to a lesser extent, in New South Wales, South Australia and Western Australia. In describing the sector we will call upon the experience of a particular PDRSS - Neami - in operating and developing services, and the challenges it faced in establishing a culture of quality that directly improves consumer outcomes. Elements of this experience may serve as a guide in the development of mental health service policy at state and federal level.
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Browne, Graeme, and Mary Courtney. ""Are We There Yet?" - Consumer Participation in Mental Health Services." Australian Journal of Primary Health 12, no. 1 (2006): 8. http://dx.doi.org/10.1071/py06002.
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Public policy in Australia recommends that the relationship between consumers and mental health professionals should be one of equals and that consumers be encouraged to have input into service delivery at every level. This approach requires a significant change in attitude for mental health professionals and within services. Although consumer input into mental health service delivery has improved, there is still a long way to go. Unfortunately, consumers consider many of the efforts by mental health services to be tokenistic. This paper considers some of the issues regarding consumer participation, including the changing community attitudes towards people with a mental illness, the concept of recovery, challenges for health professionals and the impediments to consumer participation.
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Reilly, Stephen P. "Australian Sojourn." Bulletin of the Royal College of Psychiatrists 9, no. 8 (August 1985): 155–56. http://dx.doi.org/10.1192/pb.9.8.155.
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Community psychiatry means different things to different people. Since the 1970s the American model of community psychiatry based on mental health clinics has attracted heavy criticism, whilst the UK concept of rooting community psychiatric services firmly within primary health care has gained increasing support. The need for community-orientated psychiatric services is generally agreed upon but definition of community and the mode of delivery are not. In Australia both free and private health care are available; community health centres and community mental health clinics exist (sometimes literally) side by side.
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Castle, David J. "Letter from Australia: mental healthcare in Victoria." Advances in Psychiatric Treatment 17, no. 1 (January 2011): 2–4. http://dx.doi.org/10.1192/apt.bp.110.008375.
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SummaryMental health services in the state of Victoria, Australia, have undergone enormous change over the past 15 years, with the closure of all stand-alone psychiatric hospitals and a shift of resources and services into the community. Although successful overall, various areas cause concern, including pressure on acute beds, a paucity of alternative residential options, and suboptimal integration of government and non-government agencies concerned with the care of people with mental illnesses. Certain groups, notably those with complex symptom sets such as substance use and mental illness, intellectual disability and forensic problems, remain poorly catered for by the system. Finally, community stigma and lack of work inclusion for mentally ill individuals are ongoing challenges.
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Apat, Daniel Kwai, and Wellington Digwa. "Mental health data: A case for the African communities in New South Wales." Australasian Review of African Studies 42, no. 1 (June 1, 2021): 64–80. http://dx.doi.org/10.22160/22035184/aras-2021-42-1/64-80.
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This paper examines mental health policies in relation to African communities residing in New South Wales, Australia and the attitudes of African communities toward mental disorders and mental health services. Current mental health policy frameworks have shown an inadequate inclusion of African communities. This may negatively affect the design of mental health interventions and how African communities engage with mental health services. The available mental health literature on African communities showed disjointed and uncoordinated data which focuses on specific community-groups within African communities. Insufficient mental health or suicide data, combined with African community members’ perception toward mental disorders and mental health services, makes it very difficult to progress engagement and interventions. There is a need for proper and sizable data on mental health related to people of African descent in NSW and Australia wide, if positive outcomes are to be realised.
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Carroll, Andrew, Jane Pickworth, and David Protheroe. "Service innovations: an Australian approach to community care – the Northern Crisis Assessment and Treatment Team." Psychiatric Bulletin 25, no. 11 (November 2001): 439–41. http://dx.doi.org/10.1192/pb.25.11.439.
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The recent White paper, Modernising Mental Health Services, recommended the provision of home treatment teams for acute mental illness (Department of Health, 1998). Such services are not widespread in the UK and have been the subject of recent debate (Smyth et al, 2000). In Australia, multi-disciplinary teams providing 24–hour community assessment and treatment of psychiatric emergencies have been in place now for over a decade, and form the cornerstone of the public mental health service.
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Callaly, Tom, and Anna Fletcher. "Providing Integrated Mental Health Services: A Policy and Management Perspective." Australasian Psychiatry 13, no. 4 (December 2005): 351–56. http://dx.doi.org/10.1080/j.1440-1665.2005.02213.x.
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Objective: To review the challenge of providing integrated mental health services from a policy and health management perspective. Conclusions: The provision of integrated mental health services involving specialist mental health services, general practitioners, psychiatric disability and rehabilitation services and public community health services is a major challenge in the Australian health care context and is increasingly an expectation of the community. Government, Divisions of General Practice and public community health policy and many Government, State and local initiatives have attempted to address this challenge. However, much remains to be done, including culture change within services and professions and the development of technology to support integrated service provision.
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Bourke, Sharon L., Claire Harper, Elianna Johnson, Janet Green, Ligi Anish, Miriam Muduwa, and Linda Jones. "Health Care Experiences in Rural, Remote, and Metropolitan Areas of Australia." Online Journal of Rural Nursing and Health Care 21, no. 1 (May 4, 2021): 67–84. http://dx.doi.org/10.14574/ojrnhc.v21i1.652.
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Background: Australia is a vast land with extremes in weather and terrain. Disparities exist between the health of those who reside in the metropolitan areas versus those who reside in the rural and remote areas of the country. Australia has a public health system called Medicare; a basic level of health cover for all Australians that is funded by taxpayers. Most of the hospital and health services are located in metropolitan areas, however for those who live in rural or remote areas the level of health service provision can be lower; with patients required to travel long distances for health care.
Purpose: This paper will explore the disparities experienced by Australians who reside in regional and remote areas of Australia.
Method: A search of the literature was performed from healthcare databases using the search terms: healthcare, rural and remote Australia, and social determinants of health in Australia.
Findings: Life in the rural and remote areas of Australia is identified as challenging compared to the metropolitan areas. Those with chronic illnesses such as diabetes are particularly vulnerable to morbidities associated with poor access to health resources and the lack of service provision.
Conclusion: Australia has a world class health system. It has been estimated that 70% of the Australian population resides in large metropolitan areas and remaining 30% distributed across rural and remote communities. This means that 30% of the population are not experiencing their health care as ‘world-class’, but rather are experiencing huge disparities in their health outcomes.
Keywords: rural and remote, health access, mental health issues, social determinants
DOI: https://doi.org/10.14574/ojrnhc.v21i1.652
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Segal, Leonie, Sophie Guy, and Gareth Furber. "What is the current level of mental health service delivery and expenditure on infants, children, adolescents, and young people in Australia?" Australian & New Zealand Journal of Psychiatry 52, no. 2 (July 14, 2017): 163–72. http://dx.doi.org/10.1177/0004867417717796.
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Objectives: The study aim was to estimate the current level of ambulatory mental health service delivery to young people aged 0–24 years in Australia and associated government expenditure. Recognising the importance of the early years for the development of mental illness and socioeconomic outcomes, we were particularly interested in service access by infants and young children. Methods: We extracted information from government administrative datasets on the number of people who received mental health services, number of services and expenditure through the health sector for 2014–2015. Results are primarily reported by age groups 0–4, 5–11, 12–17 and 18–24 years. Results: Less than 1% of 0- to 4-year-olds received a mental health service in any one service setting, whereas nearly 11% of 18- to 24-year-olds received a mental health service through the Medicare Benefits Schedule Better Access programme alone. Many more services were delivered to 12- to 24-year-olds (>4 million) than to 0- to 11-year-olds (552,000). Medicare Benefits Schedule Better Access delivers services to more children and youth than do state/territory community mental health services, although the latter provide more services per client. In 2013–2014, Australian Government expenditure on ambulatory mental health services for 0- to 24-year-olds was AUD428 million, similar to the AUD491 million spent by state/territory governments. Conclusion: The study provides a benchmark for data-driven service planning to ensure that the mental health needs of infants, children and young people are met. Our results indicate that the youngest age group are underserviced relative to need, even noting infants and children may receive services for behavioural/mental health issues from providers not captured in our study (such as paediatricians). The developmental origins of mental illness underlies the urgency of adequate provision by governments of perinatal, infant and child mental health services to avoid loss of life potential and reduce the pressures on the justice, child protection and welfare systems.
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Light, Edwina M., Michael D. Robertson, Philip Boyce, Terry Carney, Alan Rosen, Michelle Cleary, Glenn E. Hunt, Nick O'Connor, Christopher J. Ryan, and Ian H. Kerridge. "How shortcomings in the mental health system affect the use of involuntary community treatment orders." Australian Health Review 41, no. 3 (2017): 351. http://dx.doi.org/10.1071/ah16074.
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Objective The aim of the present study was to examine stakeholder perspectives on how the operation of the mental health system affects the use of involuntary community treatment orders (CTOs). Methods A qualitative study was performed, consisting of semi-structured interviews about CTO experiences with 38 purposively selected participants in New South Wales (NSW), Australia. Participants included mental health consumers (n = 5), carers (n = 6), clinicians (n = 15) and members of the Mental Health Review Tribunal of NSW (n = 12). Data were analysed using established qualitative methodologies. Results Analysis of participant accounts about CTOs and their role within the mental health system identified two key themes, namely that: (1) CTOs are used to increase access to services; and (2) CTOs cannot remedy non-existent or inadequate services. Conclusion The findings of the present study indicate that deficiencies in health service structures and resourcing are a significant factor in CTO use. This raises questions about policy accountability for mental health services (both voluntary and involuntary), as well as about the usefulness of CTOs, justifications for CTO use and the legal criteria regulating CTO implementation. What is known about this topic? Following the deinstitutionalisation of psychiatric services over recent decades, community settings are increasingly the focus for the delivery of mental health services to people living with severe and persistent mental illnesses. The rates of use of involuntary treatment in Australian community settings (under CTOs) vary between state and territory jurisdictions and are high by world standards; however, the reasons for variation in rates of CTO use are not well understood. What does this paper add? This paper provides an empirical basis for a link between the politics of mental health and the uptake and usefulness of CTOs. What are the implications for practitioners? This paper makes explicit the real-world demands on the mental health system and how service deficiencies are a significant determinant in the use of CTOs. Practitioners and policy makers need to be candid about system limitations and how they factor in clinical and legal justifications for using involuntary treatment. The results of the present study provide data to support advocacy to improve policy accountability and resourcing of community mental health services.
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Lederman, Oscar, Bonnie Furzer, Kemi Wright, Grace McKeon, Simon Rosenbaum, and Rob Stanton. "Mental Health Considerations for Exercise Practitioners Delivering Telehealth Services." Journal of Clinical Exercise Physiology 10, no. 1 (March 1, 2021): 20–28. http://dx.doi.org/10.31189/2165-7629-10.1.20.
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ABSTRACT In Australia, exercise practitioners (i.e., clinical professionals specializing in exercise assessment and delivery) are increasingly recognized as core mental health team members. In response to the COVID-19 pandemic, exercise practitioners, like other mental health professions, have had to adapt methods of clinical service delivery to ensure social distancing and reduce risk of community transmission. As such, telehealth interventions have rapidly replaced most face-to-face services. To date, evidence surrounding the application of telehealth exercise interventions for people living with mental illness is scarce, and currently there is no consensus or recommendations on how exercise practitioners can provide telehealth services for this population. As such, the aim of this article is to draw on existing research and expert opinion to provide practical and service-based guidance for exercise practitioners delivering telehealth services to people with mental illnesses. Specifically, we explore the potential benefits of telehealth exercise interventions, the various challenges and considerations of telehealth exercise among those with mental illness, and some practical solutions to guide exercise practitioners in delivering telehealth services.
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Khoo, Joanna, Helen Hasan, and Kathy Eagar. "Utilisation patterns of privately funded mental health services in Australia." Journal of Health Organization and Management 33, no. 1 (March 18, 2019): 5–17. http://dx.doi.org/10.1108/jhom-02-2018-0062.
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Purpose The purpose of this paper is twofold: first, to present patient-level utilisation patterns of hospital-based mental health services funded by private health insurers; and second, to examine the implications of the findings for planning and delivering private mental health services in Australia. Design/methodology/approach Analysing private health insurance claims data, this study compares differences in demographic and hospital utilisation characteristics of 3,209 patients from 13 private health insurance funds with claims for mental health-related hospitalisations and 233,701 patients with claims for other types of hospitalisations for the period May 2014 to April 2016. Average number of overnight admissions, length of stay and per patient insurer costs are presented for each group, along with overnight admissions vs same-day visits and repeat services within a 28-day period following hospitalisation. Challenges in analysing and interpreting insurance claims data to better understand private mental health service utilisation are discussed. Findings Patients with claims for mental health-related hospitalisations are more likely to be female (62.0 per cent compared to 55.8 per cent), and are significantly younger than patients with claims for other types of hospitalisations (32.6 per cent of patients aged 55 years and over compared to 57.1 per cent). Patients with claims for mental health-related hospitalisations have significantly higher levels of service utilisation than the group with claims for other types of hospitalisations with a mean length of stay per overnight admission of 15.0 days (SD=14.1), a mean of 1.3 overnight admissions annually (SD=1.2) and mean hospital costs paid by the insurer of $13,192 per patient (SD=13,457) compared to 4.6 days (SD=7.3), 0.8 admissions (SD=0.6) and $2,065 per patient (SD=4,346), respectively, for patients with claims for other types of hospitalisations. More than half of patients with claims for mental health-related hospitalisations only claim for overnight admissions. However, the findings are difficult to interpret due to the limited information collected in insurance claims data. Practical implications This study shows the challenges of understanding utilisation patterns with one data source. Analysing insurance claims reveals information on mental health-related hospitalisations but information on community-based care is lacking due to the regulated role of the private health insurance sector in Australia. For mental health conditions, and other chronic health conditions, multiple data sources need to be integrated to build a comprehensive picture of health service use as care tends to be provided in multiple settings by different medical and allied health professionals. Originality/value This study contributes in two areas: patient-level trends in hospital-based mental health service utilisation claimed on private health insurance in Australia have not been previously reported. Additionally, as the amount of data routinely collected in health care settings increases, the study findings demonstrate that it is important to assess the quality of these data sources for understanding service utilisation.
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Meadows, Graham, Bruce Singh, Philip Burgess, and Irene Bobevski. "Psychiatry and the Need for Mental Health Care in Australia: Findings from the National Survey of Mental Health and Wellbeing." Australian & New Zealand Journal of Psychiatry 36, no. 2 (April 2002): 210–16. http://dx.doi.org/10.1046/j.1440-1614.2002.00990.x.
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Objective: This paper describes the pattern of consultations reported with psychiatrists and primary mental health care providers in the Australian adult population. It explores whether inequalities found in utilization of psychiatric services according to area are different in degree from inequalities in utilization of medical and surgical specialists, and describes the meeting of perceived needs for mental health care within those seen by psychiatrists. Method: The National Survey of Mental Health and Wellbeing (NSMHW) was a community survey employing clustered probability sampling, with a computerized field questionnaire which included sections of the composite international diagnostic interview (CIDI), as well as self-reported service utilization and perceived needs for care. Results: By survey estimates, 1.8% of the Australian population consulted a psychiatrist in the last year. Among people with an ICD 10-diagnosed mental disorder, 7.3% consulted a psychiatrist. Only about one in five people seen by a psychiatrist report the psychiatrist as the only mental health care provider. Disadvantaged areas of the cities and remote areas, when compared with the least deprived areas of the cities, showed lower rates of utilization. This effect is stronger in psychiatry than in other specialities. Patients seeing psychiatrists seem to be a more satisfied group than those seeing only other providers; nonetheless, some needs are not well met, and the role of the psychiatrist cannot be isolated as the cause of this satisfaction. Conclusions: Most care delivered by psychiatrists is de facto shared care. Psychiatrists as clinical professionals need to be continually mindful of the need to communicate with others providing care. Psychiatric services in Australia are not delivered in an equitable manner, and the inequalities are greater for psychiatric services than for other medical specialities.
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Macdonald, Elspeth, Heather Mohay, Debra Sorensen, Neil Alcorn, Brett Mcdermott, and Erica Lee. "Current Delivery of Infantmental Health Services: Are Infant Mental Health Needs Being Met?" Australasian Psychiatry 13, no. 4 (December 2005): 393–98. http://dx.doi.org/10.1080/j.1440-1665.2005.02232.x.
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Objective: To identify services supporting the well-being of infants and their families in an area of South Brisbane, Australia, highlight problems of accessing these services and recommend strategies to make them more readily available. Method: Semistructured interviews were conducted with staff from 18 service providers offering antenatal services, or programmes primarily focused on children under the age of 2 years and/or their families. The interview aimed to identify the precise nature of the services offered, problems encountered in providing those services, perceived gaps in services and potential strategies for improvement. Results: Services were diverse, provided by a range of different professionals, in varying locations (home, community, hospital) and with funding from various sources. The major findings were:(i) the fragmentation of services, lack of communication between them, and lack of continuity in services from one stage of family formation to another; (ii) the shortage of services working with the parents and infant together; and (iii) the difficulty ofproviding services for some at-risk populations. Conclusions: Recommendations included: (i) maintaining a range of different services networked through a centralized resource/referral centre; (ii) expandingjoint mother–infant services and providing training for such services; and (iii) supporting outreach services for difficult to engage populations.
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Ftanou, Maria, Anna Machlin, Angela Nicholas, Kylie King, Justine Fletcher, Carol Harvey, and Jane Pirkis. "Mental Health Professional Online Development (MHPOD): a web-based training tool for the non-government community mental health workforce." Journal of Mental Health Training, Education and Practice 9, no. 3 (September 2, 2014): 177–89. http://dx.doi.org/10.1108/jmhtep-05-2014-0014.
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Purpose – The purpose of this paper is to evaluate the usefulness and relevance of the Mental Health Professional Online Development (MHPOD) training package in further developing the skills in mental health and recovery-informed practice of the Australian non-government community mental health workforce. MHPOD is an evidence-based, self-paced, online learning resource that consists of 58 mental health topics. Design/methodology/approach – A total of 349 e-learners were recruited from seven non-government community mental health services across Australia. E-learners were invited to complete up to twelve online surveys, a baseline survey, a topic completion survey for each completed topic, and a follow-up survey towards the end of the pilot. Findings – The majority of e-learners indicated that MHPOD was useful for professional development and relevant to their current employment. E-learners identified that MHPOD led to significant improvement in their knowledge and confidence in their ability. A number of enabling factors such as managerial and organizational supports, technical supports and up-to-date and relevant content materials need to be present for the successful implementation of online programs such as MHPOD. Originality/value – Online training packages such MHPOD that a relatively easy to use are helpful in developing knowledge, and confidence in the skills of the mental health workforce. The evaluation findings suggest that MHPOD is a relevant and appropriate training tool for the non-government community mental health sector within Australia.
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Champion, Katrina Elizabeth, Cath Chapman, Nicola Clare Newton, Mary-Ellen Brierley, Lexine Stapinski, Frances Kay-Lambkin, Jack Nagle, and Maree Teesson. "A Web-Based Toolkit to Provide Evidence-Based Resources About Crystal Methamphetamine for the Australian Community: Collaborative Development of Cracks in the Ice." JMIR Mental Health 5, no. 1 (March 20, 2018): e21. http://dx.doi.org/10.2196/mental.8891.
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Background The use of crystal methamphetamine (ice) and the associated harms for individuals, families, and communities across Australia has been the subject of growing concern in recent years. The provision of easily accessible, evidence-based, and up-to-date information and resources about crystal methamphetamine for the community is a critical component of an effective public health response. Objective This paper aims to describe the codevelopment process of the Web-based Cracks in the Ice Community Toolkit, which was developed to improve access to evidence-based information and resources about crystal methamphetamine for the Australian community. Methods Development of the Cracks in the Ice Community Toolkit was conducted in collaboration with community members across Australia and with experts working in the addiction field. The iterative process involved the following: (1) consultation with end users, including community members, crystal methamphetamine users, families and friends of someone using crystal methamphetamine, health professionals, and teachers (n=451) via a cross-sectional Web-based survey to understand information needs; (2) content and Web development; and (3) user testing of a beta version of the Web-based toolkit among end users (n=41) and experts (n=10) to evaluate the toolkit’s acceptability, relevance, and appeal. Results Initial end user consultation indicated that the most commonly endorsed reasons for visiting a website about crystal methamphetamine were “to get information for myself” (185/451, 41.0%) and “to find out how to help a friend or a family member” (136/451, 30.2%). Community consultation also revealed the need for simple information about crystal methamphetamine, including what it is, its effects, and when and where to seek help or support. Feedback on a beta version of the toolkit was positive in terms of content, readability, layout, look, and feel. Commonly identified areas for improvement related to increasing the level of engagement and personal connection, improving the ease of navigation, and balancing a “low prevalence of use, yet high impact” message. A total of 9138 users visited the website in the 3 months immediately post launch, and over 25,000 hard-copy Cracks in the Ice booklets and flyers were distributed across Australia. Of these resources, 60.93% (15,525/25,480) were distributed to relevant organizations and mailing list subscribers, and 39.07% (9955/25,480) were ordered directly by individuals, services, and community groups via the Cracks in the Ice website. Conclusions The codevelopment process resulted in an engaging Web-based resource for the Australian community to access up-to-date and evidence-based resources about crystal methamphetamine. The Cracks in the Ice Community Toolkit provides much-needed information and support for individuals, families, and communities.
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Fauk, Nelsensius Klau, Anna Ziersch, Hailay Gesesew, Paul Ward, Erin Green, Enaam Oudih, Roheena Tahir, and Lillian Mwanri. "Migrants and Service Providers’ Perspectives of Barriers to Accessing Mental Health Services in South Australia: A Case of African Migrants with a Refugee Background in South Australia." International Journal of Environmental Research and Public Health 18, no. 17 (August 24, 2021): 8906. http://dx.doi.org/10.3390/ijerph18178906.
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International mobility has increased steadily in recent times, bringing along a myriad of health, social and health system challenges to migrants themselves and the host nations. Mental health issues have been identified as a significant problem among migrants, with poor accessibility and underutilisation of the available mental health services (MHSs) repeatedly reported, including in Australia. Using a qualitative inquiry and one-on-one in-depth interviews, this study explored perspectives of African migrants and service providers on barriers to accessing MHSs among African migrants in South Australia. The data collection took place during the COVID-19 pandemic with lockdown and other measures to combat the pandemic restricting face to face meetings with potential participants. Online platforms including Zoom and/or WhatsApp video calls were used to interview 20 African migrants and 10 service providers. Participants were recruited from community groups and/or associations, and organisations providing services for migrants and/or refugees in South Australia using the snowball sampling technique. Thematic framework analysis was used to guide the data analysis. Key themes centred on personal factors (health literacy including knowledge and the understanding of the health system, and poor financial condition), structural factors related to difficulties in navigating the complexity of the health system and a lack of culturally aware service provision, sociocultural and religious factors, mental health stigma and discrimination. The findings provide an insight into the experiences of African migrants of service provision to them and offer suggestions on how to improve these migrants’ mental health outcomes in Australia. Overcoming barriers to accessing mental health services would need a wide range of strategies including education on mental health, recognising variations in cultures for effective service provision, and addressing mental health stigma and discrimination which strongly deter service access by these migrants. These strategies will facilitate help-seeking behaviours as well as effective provision of culturally safe MHSs and improvement in access to MHSs among African migrants.
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Whiteford, Harvey, Bill Buckingham, and Ronald Manderscheid. "Australia's National Mental Health Strategy." British Journal of Psychiatry 180, no. 3 (March 2002): 210–15. http://dx.doi.org/10.1192/bjp.180.3.210.
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BackgroundAustralia commenced a 5-year reform of mental health services in 1993.AimsTo report on the changes to mental health services achieved by 1998.MethodAnalysis of data from the Australian National Mental Health Report 2000 and an independent evaluation of the National Mental Health Strategy.ResultsMental health expenditure increased 30% in real terms, with an 87% growth in community expenditures, a 38% increase in general hospitals and a 29% decrease in psychiatric hospitals. The growth in private psychiatry, averaging 6% annually prior to 1992, was reversed. Consumer and carer involvement in services increased.ConclusionsMajor structural reform was achieved but there was limited evidence that these changes had been accompanied by improved service quality. The National Mental Health Strategy was renewed for another 5 years.
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Diminic, S., E. Hielscher, M. G. Harris, Y. Y. Lee, J. Kealton, and H. A. Whiteford. "A profile of Australian mental health carers, their caring role and service needs: results from the 2012 Survey of Disability, Ageing and Carers." Epidemiology and Psychiatric Sciences 28, no. 6 (August 31, 2018): 670–81. http://dx.doi.org/10.1017/s2045796018000446.
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AbstractAimsPlanning mental health carer services requires information about the number of carers, their characteristics, service use and unmet support needs. Available Australian estimates vary widely due to different definitions of mental illness and the types of carers included. This study aimed to provide a detailed profile of Australian mental health carers using a nationally representative household survey.MethodsThe number of mental health carers, characteristics of carers and their care recipients, caring hours and tasks provided, service use and unmet service needs were derived from the national 2012 Survey of Disability, Ageing and Carers. Co-resident carers of adults with a mental illness were compared with those caring for people with physical health and other cognitive/behavioural conditions (e.g., autism, intellectual disability, dementia) on measures of service use, service needs and aspects of their caring role.ResultsIn 2012, there were 225 421 co-resident carers of adults with mental illness in Australia, representing 1.0% of the population, and an estimated further 103 813 mental health carers not living with their care recipient. The majority of co-resident carers supported one person with mental illness, usually their partner or adult child. Mental health carers were more likely than physical health carers to provide emotional support (68.1%v.19.7% of carers) and less likely to assist with practical tasks (64.1%v.86.6%) and activities of daily living (31.9%v.48.9%). Of co-resident mental health carers, 22.5% or 50 828 people were confirmed primary carers – the person providing the most support to their care recipient. Many primary mental health carers (37.8%) provided more than 40 h of care per week. Only 23.8% of primary mental health carers received government income support for carers and only 34.4% received formal service assistance in their caring role, while 49.0% wanted more support. Significantly more primary mental health than primary physical health carers were dissatisfied with received services (20.0%v.3.2%), and 35.0% did not know what services were available to them.ConclusionsResults reveal a sizable number of mental health carers with unmet needs in the Australian community, particularly with respect to financial assistance and respite care, and that these carers are poorly informed about available supports. The prominence of emotional support and their greater dissatisfaction with services indicate a need to better tailor carer services. If implemented carefully, recent Australian reforms including the Carer Gateway and National Disability Insurance Scheme hold promise for improving mental health carer supports.
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Fan, Cynthia, and Wally Karnilowicz. "Attitudes Towards Mental Illness and Knowledge of Mental Health Services Among the Australian and Chinese Community." Australian Journal of Primary Health 6, no. 2 (2000): 38. http://dx.doi.org/10.1071/py00017.
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The study aimed to examine the attitudes toward mental illness and knowledge of mental health services among Anglo-Australian and Chinese-Australian adults. Participants included 105 Anglo-Australians and 129 Chinese-Australians. Participants were requested to complete a questionnaire on attitudes toward mental illness and knowledge of mental health service available in the community. The results indicated that there was a significant ethnic difference in attitudes towards mental illness. Chinese-Australians endorsed authoritarian, restrictive attitudes towards people with mental illness and interpersonal etiology more than Anglo-Australians. There was also a significant difference in attitudes towards mental illness due to the amount of contact with people with mental illness. The more contact the participants had with people with mental illness, the less they endorsed authoritarian, and restrictive attitudes toward people with mental illness. Though there was a non-significant difference in knowledge of mental health services due to ethnic origin or amount of contact with people with mental illness, there were ethnic differences in the type of mental health services preferred. Among Chinese-Australians, age was positively related to knowledge of services for acute and chronic cases of mental illness. Implications for community mental health education programs are discussed.
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O'connor, Daniel, and Pamela Melding. "A Survey of Publicly Funded aged Psychiatry Services in Australia and New Zealand." Australian & New Zealand Journal of Psychiatry 40, no. 4 (April 2006): 368–73. http://dx.doi.org/10.1080/j.1440-1614.2006.01804.x.
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Objective: To map the size and distribution of publicly funded aged psychiatry (psychogeriatric) services in Australia and New Zealand in 2003. Method: Services were tracked exhaustively through personal, professional and academic contacts, electronic searches and word-of-mouth. Directors or managers of services were asked to complete a brief questionnaire concerning their locality, services, staff profile and patient contacts. Results: Services varied widely with respect to their numbers, size and community outreach. Victoria was the only Australian state to provide specialist, multidisciplinary aged psychiatry teams with community, acute inpatient and residential arms in all its major cities. New South Wales, the state with the largest aged population, performed relatively poorly on most indicators. New Zealand performed relatively well despite its small size and widely dispersed population. Conclusions: Publicly funded aged mental health services are effective and reach frail, multiply disabled old people who cannot access private psychiatrists and are often overlooked by services for younger adults. At the time of our survey, such services were distributed in Australia in a highly inequitable fashion.
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Thompson, Catherine. "Lessons from an Australian community dialectical behaviour therapy programme for borderline personality disorder." International Psychiatry 5, no. 1 (January 2008): 15–16. http://dx.doi.org/10.1192/s1749367600005427.
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In 2003, the National Institute for Mental Health in England (NIMHE) published guidelines for the development of services for people with personality disorders (NIMHE, 2003), prompting community mental health teams (CMHTs) to reassess their service provision for this patient group. The guidelines did not recommend any particular treatment approach, but CMHTs were encouraged to develop specialist programmes. For many CMHTs the focus has been on borderline personality disorder, as it is one of the most prevalent personality disorders seen in adult mental health services and has high costs for both the patient and the service (Moran, 2002). The evidence base for which treatment may be most effective within the community remains small, however, and this has left many CMHTs unclear regarding a suitable programme. Here I will outline a CMHT-based dialectical behaviour therapy (DBT) programme operating in Western Australia and reflect on why I feel it is an option that CMHTs in the UK looking to develop their service should consider.
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Mullen, P., and J. Ogloff. "Providing mental health services to adult offenders in Victoria, Australia: Overcoming barriers." European Psychiatry 24, no. 6 (September 2009): 395–400. http://dx.doi.org/10.1016/j.eurpsy.2009.07.003.
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AbstractPurposeTo illustrate the development of the interface between general and forensic mental health services in Victoria, Australia.MethodDeveloping effective cooperation between the general and forensic mental health services requires overcoming a number of barriers. The attitude of general services that antisocial behaviour was none of their business was tackled through ongoing workshops and education days over several years. The resistance to providing care to those disabled by severe personality disorders or substance abuse was reduced by presenting and promoting models of care developed in forensic community and inpatient services which prioritised these areas. The reluctance of general services to accept offenders was reduced by involving general services in court liaison clinics and in prisoner release plans. Cooperation was enhanced by the provision of risk assessments, the sharing of responsibility for troublesome patients, and a problem behaviours clinic to support general services in coping with stalkers, sex offenders and threateners.ConclusionsActive engagement with general services was promoted at the level of providing education, specialised assessments and a referral source for difficult patients. This generated a positive interface between forensic and general mental health services, which improved the quality of care delivered to mentally abnormal offenders.
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Northam, Jaimie Chloe, and Lynne Elizabeth Magor-Blatch. "Adolescent therapeutic community treatment – an Australian perspective." Therapeutic Communities: The International Journal of Therapeutic Communities 37, no. 4 (December 12, 2016): 204–12. http://dx.doi.org/10.1108/tc-01-2016-0002.
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Purpose The purpose of this paper is to provide an overview of the adolescent therapeutic community (ATC) literature – drawing on studies primarily from the USA with consideration made to the Australian context. Design/methodology/approach A review of the efficacy research for ATCs is considered, and the characteristics of Australians accessing ATC treatment are discussed in the context of developmental needs. Findings Similarities are found in what precipitates and perpetuates adolescent substance use in the USA and Australia, and therefore, what appears to facilitate effective treatment utilising the therapeutic community model. Originality/value The paper provides a valuable perspective for Australian services, and explores the application of the ATC model within the Australian treatment context.
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Emden, Carolyn, Inge Kowanko, Charlotte de Crespigny, and Helen Murray. "Better medication management for Indigenous Australians: findings from the field." Australian Journal of Primary Health 11, no. 1 (2005): 80. http://dx.doi.org/10.1071/py05011.
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This paper reports findings from interviews and focus groups conducted within a multi-dimensional action research project concerning medication management among Indigenous Australians. Participants were Aboriginal people with mental health problems, carers and family members, and health and social service workers from different regions in South Australia. A meta-analysis of findings from each regional project component was conducted, and major themes conceptualised and developed into a coherent summary. The findings revealed problems of a magnitude not previously realised - mental health problems (including alcohol and drug problems) and medication management among Aboriginal people clearly are major issues requiring immediate and sustained attention if the health and welfare of the Australian Indigenous population are to be improved. Findings concerned eight major areas: social and emotional wellbeing issues; stressors on Aboriginal health services and providers; training for the Aboriginal health workforce; mainstream health services for Aboriginal people; trust and confidentiality within Aboriginal health services; English language literacy and numeracy skills of Aboriginal clients; remote living arrangements for many Aboriginal people; problems with alcohol use; and institutionalised and individual racism in the community at large.
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Herrman, Helen, Tom Trauer, and Julie Warnock. "The Roles and Relationships of Psychiatrists and Other Service Providers in Mental Health Services." Australian & New Zealand Journal of Psychiatry 36, no. 1 (February 2002): 75–80. http://dx.doi.org/10.1046/j.1440-1614.2002.00982.x.
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Objective: A number of the problems facing psychiatry are identified as having common origins in unresolved issues about teamwork. The aim is to identify the issues and to formulate recommendations for dealing with these obstacles. Method: The Royal Australian and New Zealand College of Psychiatrists Professional Liaison Committee (Australia) of the Board of Professional and Community Relations convened a number of meetings and discussions, with external assistance from JW and TT. Results: Much of contemporary mental health care is delivered either directly or indirectly by several persons, often working in teams. Teamwork and collaboration are central to good working relationships and service delivery. Effective teamwork and collaboration is supported by key elements including agreed goals, an agreed approach, effective communication styles, established ground rules, clear team roles, and competent leadership. The obstacles to effective teamwork and collaboration are discussed in terms of the following: ambiguity and conflict over roles; conflict and confusion over leadership; differing understandings of clinical responsibility and accountability; interprofessional misperceptions; and differing rewards between the professions. Conclusions: Developing an understanding of these issues opens the way to a series of recommendations in relation to education, professional organizations, and workplaces and government, which can be considered by a number of sectors and groups.
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Teresa Dawson, Maria, Paul Grech, Brendan Hyland, Fiona Judd, John Lloyd, Anne M. Mijch, Jennifer Hoy, and Alan C Street. "A Qualitative Approach to the Mental Health Care Needs of People Living with HIV/AIDS in Victoria." Australian Journal of Primary Health 8, no. 3 (2002): 30. http://dx.doi.org/10.1071/py02041.
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This article reports on the findings of the qualitative stage of a larger project on the mental care needs of people with HIV/AIDS and mental illness (Tender T1176 Department of Human Services, Mental Health Branch, Victoria - Research on the Mental Health Care Needs of People with HIV/AIDS and Mental Illness). The purpose of the larger research was to evaluate the needs and treatment requirements of persons with HIV/AIDS, who also suffer from mental health problems, with a view to developing proposals for improving existing service delivery in Victoria, Australia. The qualitative stage was designed to complement and elucidate data obtained through the quantitative stages of the project. Thirty in-depth open-ended interviews were carried out with service providers including HIV physicians, general practitioners, psychiatrists, clinical and managerial staff of Area Mental Health Services, Contact Tracers and forensic mental health services staff, as well as representatives of community groups such as People Living with HIV/AIDS and Positive Women and carers. The interviews explored the perspective of both service providers and users of such services with respect to needs for psychiatric care and service delivery, ease of access or barriers to mental health services, and the perceived strengths and weaknesses in current service provision. This paper presents the main findings and recommendations submitted to the funding body.
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Valibhoy, Madeleine Claire, Josef Szwarc, and Ida Kaplan. "Young service users from refugee backgrounds: their perspectives on barriers to accessing Australian mental health services." International Journal of Human Rights in Healthcare 10, no. 1 (March 13, 2017): 68–80. http://dx.doi.org/10.1108/ijhrh-07-2016-0010.
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Purpose The purpose of this paper is to examine barriers to accessing mental health services, from the perspective of young people of refugee background who have been service users, and to suggest strategies to improve access to mental health services. Design/methodology/approach A qualitative study was conducted with 16 young people (aged 18-25), who had been refugees and who had attended mental health professionals in Australia. Interview transcripts were analysed thematically to examine participants’ perspectives on what hinders initial access to mental health services. Findings Stigma about mental health problems was particularly prominent. Many believed a high level of disturbance was the threshold for entering services, and for some there was no knowledge of such services’ existence. Options for assistance other than mental health services were often preferred, according to young people’s explanatory models. Apprehension was expressed that sessions would be uncomfortable, distressing or ineffective. The desire to be self-reliant functioned as a further barrier. Finally, structural obstacles and social exclusion deterred some young refugees from accessing services. Practical implications Implications include the need for service providers to be equipped to provide culturally sensitive, responsive services that ideally offer both practical and psychological assistance. Potential referrers, including health professionals and community leaders, could facilitate increased access if trained to recognise and address barriers. Finally, findings indicate potential content for awareness-raising initiatives for young refugees about mental health problems and services. Originality/value This paper is original in its sample, method, topic and findings; being drawn from the first known qualitative research exploring views of young mental health service users who have been refugees about barriers to accessing mental health services.
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Spittal, Matthew J., Fiona Shand, Helen Christensen, Lisa Brophy, and Jane Pirkis. "Community mental health care after self-harm: A retrospective cohort study." Australian & New Zealand Journal of Psychiatry 51, no. 7 (November 12, 2016): 727–35. http://dx.doi.org/10.1177/0004867416676366.
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Objective: Presentation to hospital after self-harm is an opportunity to treat underlying mental health problems. We aimed to describe the pattern of mental health contacts following hospital admission focusing on those with and without recent contact with community mental health services (connected and unconnected patients). Methods: We undertook a data linkage study of all individuals admitted as a general or psychiatric inpatient to hospital after self-harm in New South Wales, Australia, between 2005 and 2011. We identified the proportion of admissions where the patient received subsequent in-person community mental health care within 30 days of discharge and the factors associated with receipt of that care. Results: A total of 42,353 individuals were admitted to hospital for self-harm. In 41% of admissions, the patient had contact with a community mental health service after discharge. Patients connected with community mental health services had 5.33 (95% confidence interval = [5.09, 5.59]) times higher odds of follow-up care than unconnected patients. Other factors, such as increasing age and treatment as a psychiatric inpatient, were associated with lower odds of follow-up community care. Conclusion: Our study suggests that full advantage is not being taken of the opportunity to provide comprehensive mental health care for people who self-harm once they have been discharged from the inpatient setting. This is particularly the case for those who have not previously received community mental health care. There appears to be scope for system-level improvement in the way in which those who are treated for self-harm are followed up in the community.
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Ryan, Brigid, Manrenga Viane, Fran Timmins, Alex Smith, and Claire Anstey. "Bridging the ocean: Kiribati Australia alliance in mental health." Australasian Psychiatry 25, no. 5 (June 29, 2017): 474–77. http://dx.doi.org/10.1177/1039856217706822.
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Objective: The objective of this study was to demonstrate the benefits of collaboration between Australia and Kiribati, a Pacific island nation, to enhance Kiribati’s mental health system. Method: The collaboration involved a training program for a Kiribati senior mental health leader in Melbourne, Australia, and service planning including prioritisation of key areas for development. Results: As well as receiving general training in community-based mental health, the Kiribati mental health leader gained skills in modification of the inpatient environment, with plans for implementation in Kiribati within the current limited resources. Future planning will focus on shifting from an emphasis on acute psychiatric treatment and custodial care to a recovery-oriented approach. Conclusion: The international exchange was a positive experience for both the Kiribati participants and their Australian colleagues. Knowledge transfer was achieved in a short time, and service development appropriate and realistic for the Kiribati environment was planned.
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Bryant, Lia, Bridget Garnham, Deirdre Tedmanson, and Sophie Diamandi. "Tele-social work and mental health in rural and remote communities in Australia." International Social Work 61, no. 1 (November 27, 2015): 143–55. http://dx.doi.org/10.1177/0020872815606794.
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Rural and remote communities often have complex and diverse mental health needs and inadequate mental health services and infrastructure. Information and communication technologies (ICTs) provide an array of potentially innovative and cost-effective means for connecting rural and remote communities to specialist mental health practitioners, services, and supports, irrespective of physical location. However, despite this potential, a review of Australian and international literature reveals that ICT has not attained widespread uptake into social work practice or implementation in rural communities. This article reviews the social work literature on ICT, draws on research on tele-psychology and tele-education, and provides suggestions on how to enhance engagement with ICT by social workers to implement and provide mental health services and supports tailored to community values, needs, and preferences that are commensurate with the values of the social work profession.
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Salinas-Perez, Jose A., Mencia R. Gutierrez-Colosia, Mary Anne Furst, Petra Suontausta, Jacques Bertrand, Nerea Almeda, John Mendoza, et al. "Patterns of Mental Health Care in Remote Areas: Kimberley (Australia), Nunavik (Canada), and Lapland (Finland): Modèles de soins de santé mentale dans les régions éloignées: Kimberley (Australie), Nunavik (Canada) et Laponie (Finlande)." Canadian Journal of Psychiatry 65, no. 10 (July 28, 2020): 721–30. http://dx.doi.org/10.1177/0706743720944312.
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Objective: Mental health (MH) care in remote areas is frequently scarce and fragmented and difficult to compare objectively with other areas even in the same country. This study aimed to analyze the adult MH service provision in 3 remote areas of Organization for Economic Cooperation and Development countries in the world. Methods: We used an internationally agreed set of systems indicators, terminology, and classification of services (Description and Evaluation of Services and DirectoriEs for Long Term Care). This instrument provided a standard description of MH care provision in the Kimberley region (Australia), Nunavik (Canada), and Lapland (Finland), areas characterized by an extremely low population density and high relative rates of Indigenous peoples. Results: All areas showed high rates of deprivation within their national contexts. MH services were mostly provided by the public sector supplemented by nonprofit organizations. This study found a higher provision per inhabitant of community residential care in Nunavik in relation to the other areas; higher provision of community outreach services in the Kimberley; and a lack of day services except in Lapland. Specific cultural-based services for the Indigenous population were identified only in the Kimberley. MH care in Lapland was self-sufficient, and its care pattern was similar to other Finnish areas, while the Kimberley and Nunavik differed from the standard pattern of care in their respective countries and relied partly on services located outside their boundaries for treating severe cases. Conclusion: We found common challenges in these remote areas but a huge diversity in the patterns of MH care. The implementation of care interventions should be locally tailored considering both the environmental characteristics and the existing pattern of service provision.
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Frazer, Neil. "Reflection on Mental Health System and Quality Assurance: Considering the Relevance of the Australian Experience for Indonesia." Jurnal Keperawatan Indonesia 1, no. 2 (April 24, 2014): 51–58. http://dx.doi.org/10.7454/jki.v1i2.76.
Full textAbstract:
Pelayanan kesehatan jiwa di Australia telah berkembang menjadi pelayanan yang berorientasi pada komunitas dan sensitive terhadap kebutuhan dan hak klien dengan gangguan jiwa. Perkembangan ini mempunyai implikasi pada system kesehatan jiwa komunitas., kebijakan tentang kesehatan jiwa, legalisasi, pelayanan kesehatan jiwa, pelayanan pembauran, begitu pula implikasi terhadap praktek keperawatan. Perubahan dalam pelayanan kesehatan jiwa menuntut perawat untuk memiliki pengetahuan yang teoritis yang lebih baik dan kemampuan untuk melakukan praktek keperawatan secara professional.Di Indonesia, kajian yang ekstensif tentang kebutuhan masyarakat dengan masalah kesehatan jiwa, sumber yang tersedia untuk memenuhi kebutuhan tersebut, serta keyakinan, nilai dan sikap tenaga professional kesehatan jiwa tentang ilmu kedokteran dan perilaku dari negara barat yang mempengaruhi pelayanan kesehatan jiwa, sangat diperlukan untuk pengembangan system kesehatan jiwa yang lebih efektif dan efesien. The mental health services in Australia have been developed to be more community based services and sensitive to the needs and rights of the mentally ill. This development has implications for mental health system and the community, mental health policy, legislation, mental health services, mainstreaming services as well as implications for nursing practice. The change in mental health services required the nurse to have the better theoretical knowledge and competence to practice professionally. In Indonesia, the extensive study on the needs of the people with mental health problem and the existing resource to meet those needs, as well as the current beliefs, values and attitudes held by mental health professionals towards the Western medical and behavioral science influence on mental health services is an important process in developing more efficient and effective mental health system.
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Dedman, Paul. "Community Treatment Orders in Victoria, Australia." Psychiatric Bulletin 14, no. 8 (August 1990): 462–64. http://dx.doi.org/10.1192/pb.14.8.462.
Full textAbstract:
It is one of the failures of contemporary psychiatry that many patients who respond well to neuroleptic medication given to them when they are in-patients relapse after discharge due to not taking any further medication. Those working closely with the acute psychiatric patient in the community are often forced to stand by powerlessly as a patient deteriorates, causing damage to himself and his social milieu until such a point is reached when he is again ill enough to warrant compulsory admission and treatment. This process is, of course, devastating for a patient's family and also disheartening for professionals involved, and is perhaps partly responsible for the high turnover of staff involved in front line services. Even if assertive outreach methods are employed such as those involved in a number of comprehensive community-based programmes (Stein & Test, 1980; Borland et al, 1989) so that contact with the patient is not lost, it is not possible without the necessary legislation to enforce treatment in the community.
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Myles, Nicholas, Matthew Large, Hannah Myles, Robert Adams, Dennis Liu, and Cherrie Galletly. "Australia’s economic transition, unemployment, suicide and mental health needs." Australian & New Zealand Journal of Psychiatry 51, no. 2 (October 31, 2016): 119–23. http://dx.doi.org/10.1177/0004867416675035.
Full textAbstract:
Objective: There have been substantial changes in workforce and employment patterns in Australia over the past 50 years as a result of economic globalisation. This has resulted in substantial reduction in employment in the manufacturing industry often with large-scale job losses in concentrated sectors and communities. Large-scale job loss events receive significant community attention. To what extent these mass unemployment events contribute to increased psychological distress, mental illness and suicide in affected individuals warrants further consideration. Methods: Here we undertake a narrative review of published job loss literature. We discuss the impact that large-scale job loss events in the manufacturing sector may have on population mental health, with particular reference to contemporary trends in the Australian economy. We also provide a commentary on the expected outcomes of future job loss events in this context and the implications for Australian public mental health care services. Results and conclusion: Job loss due to plant closure results in a doubling of psychological distress that peaks 9 months following the unemployment event. The link between job loss and increased rates of mental illness and suicide is less clear. The threat of impending job loss and the social context in which job loss occurs has a significant bearing on psychological outcomes. The implications for Australian public mental health services are discussed.
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Dax, E. Cunningham. "The Evolution of Community Psychiatry." Australian & New Zealand Journal of Psychiatry 26, no. 2 (June 1992): 295–301. http://dx.doi.org/10.3109/00048679209072042.
Full textAbstract:
Community Psychiatry is sometimes regarded as a separate and even as a recent study. The history of its evolution in Australia shows it to have resulted from a logical progression since the earliest days of the psychiatric services. The demand for care completely outstripped the accommodation available so two separate but parallel methods of dealing with this problem were evolved. The first explored how the numbers in the overcrowded hospitals could be reduced, and the second, the ways in which admission could be avoided. Both methods resulted in the expansion of community services. Present day activities must be viewed in this light and community services recognised to be an indivisible portion of a professionally organised total mental health organisation.