Journal articles on the topic 'Community mental health services Victoria'
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Griffiths, Daniel, Luke Sheehan, Dennis Petrie, Caryn van Vreden, Peter Whiteford, and Alex Collie. "The health impacts of a 4-month long community-wide COVID-19 lockdown: Findings from a prospective longitudinal study in the state of Victoria, Australia." PLOS ONE 17, no. 4 (April 7, 2022): e0266650. http://dx.doi.org/10.1371/journal.pone.0266650.
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Objectives To determine health impacts during, and following, an extended community lockdown and COVID-19 outbreak in the Australian state of Victoria, compared with the rest of Australia. Methods A national cohort of 898 working-age Australians enrolled in a longitudinal cohort study, completing surveys before, during, and after a 112-day community lockdown in Victoria (8 July– 27 October 2020). Outcomes included psychological distress, mental and physical health, work, social interactions and finances. Regression models examined health changes during and following lockdown. Results The Victorian lockdown led to increased psychological distress. Health impacts coincided with greater social isolation and work loss. Following the extended lockdown, mental health, work and social interactions recovered to an extent whereby no significant long-lasting effects were identified in Victoria compared to the rest of Australia. Conclusion The Victorian community lockdown had adverse health consequences, which reversed upon release from lockdown. Governments should weigh all potential health impacts of lockdown. Services and programs to reduce the negative impacts of lockdown may include increases in mental health care, encouraging safe social interactions and supports to maintain employment relationships.
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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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Adams, Karen, Chris Halacas, Marion Cincotta, and Corina Pesich. "Mental health and Victorian Aboriginal people: what can data mining tell us?" Australian Journal of Primary Health 20, no. 4 (2014): 350. http://dx.doi.org/10.1071/py14036.
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Nationally, Aboriginal people experience high levels of psychological distress, primarily due to trauma from colonisation. In Victoria, Aboriginal Community Controlled Health Organisations (ACCHOs) provide many services to support mental health. The aim of the present study was to improve understanding about Victorian Aboriginal people and mental health service patterns. We located four mental health administrative datasets to analyse descriptively, including Practice Health Atlas, Alcohol and Other Drug Treatment Service (AODTS), Kids Helpline and Close The Gap Pharmaceutical Scheme data. A large proportion of the local Aboriginal population (70%) were regular ACCHO clients; of these, 21% had a mental health diagnosis and, of these, 23% had a Medicare Mental Health Care Plan (MHCP). There were higher rates of Medicare MHCP completion rates where general practitioners (GPs) had mental health training and the local Area Mental Health Service had a Koori Mental Health Liaison Officer. There was an over-representation of AODTS episodes, and referrals for these episodes were more likely to come through community, corrections and justice services than for non-Aboriginal people. Aboriginal episodes were less likely to have been referred by a GP or police and less likely to have been referrals to community-based or home-based treatment. There was an over-representation of Victorian Aboriginal calls to Kids Helpline, and these were frequently for suicide and self-harm reasons. We recommend primary care mental health programs include quality audits, GP training, non-pharmaceutical options and partnerships. Access to appropriate AODTS is needed, particularly given links to high incarcerations rates. To ensure access to mental health services, improved understanding of mental health service participation and outcomes, including suicide prevention services for young people, is needed.
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Silburn, Kate, and Virginia Lewis. "Commissioning for health and community sector reform: perspectives on change from Victoria." Australian Journal of Primary Health 26, no. 4 (2020): 332. http://dx.doi.org/10.1071/py20011.
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Commissioning health and community services is a complex task involving planning, purchasing and monitoring services for a population. It is particularly difficult when attempting system-level reform, and many barriers to effective commissioning have been documented. In Victoria, the state government has operated as a commissioner of many services, including mental health community support and alcohol and other drug treatment services. This study investigated the perceived consequences of a reform process in these two sectors after recommissioning was used as a mechanism to achieve sector-wide redesign. Semi-structured interviews were conducted with 23 senior staff from community health, mental health and drug and alcohol services 6 months after implementation. The process was affected by restructuring in the commissioning department resulting in truncation of preparatory planning and technical work required for system design. Consequently, reform implementation was reportedly chaotic, costly to agencies and staff, and resulted in disillusionment of enthusiastic reform supporters. Negative service system impacts were produced, such as disruption of collaborative and/or comprehensive models of care and strategies for reaching marginalised groups. Without careful planning and development commissioning processes can become over-reliant on competitive tendering to produce results, create significant costs to service providers and engender system-level issues with the potential to disrupt innovative models focused on meeting client needs.
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Tobin, Margaret J. "Rural Psychiatric Services." Australian & New Zealand Journal of Psychiatry 30, no. 1 (February 1996): 114–23. http://dx.doi.org/10.3109/00048679609076079.
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Objective: The objective was to describe and evaluate a community mental health service developed during 1991–1992 in an attempt to meet the mental illness needs of an isolated rural community. The setting was the Grampians health region in Western Victoria: this region has an area of 45,000 square kilo-metres and a population of 182,000. Method: The method involved firstly describing the evolution of the service delivery model. This comprised a team of travelling psychiatrists and community psychiatric nurses which succeeded in providing a combined inpatient and outpatient service which was integrated with general practitioners. Secondly, diagnostic and case load descriptions of patients receiving service were compared for both the inpatient and outpatient settings. Results: The results were that reduced reliance on inpatient beds and increased consumer satisfaction were achieved. Conclusion: It was concluded that on initial evaluation of the service it was seen to be meeting its objective of treating the seriously mentally ill in an isolated rural community based setting.
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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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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.
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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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McDonald, Paul. "Through the wall: An address to practitioners at a forum on the Working Together Strategy." Children Australia 25, no. 1 (2000): 27–32. http://dx.doi.org/10.1017/s1035077200009585.
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This address was given at a forum in November J999 for practitioners in the juvenile justice, alcohol and drug, mental health and child protection services in Victoria as part of the Department of Human Services’ Working Together Strategy’ (WTS). The WTS is a quality improvement initiative of the DHS in partnership with adolescent mental health and drug treatment service providers.WTS provides an organisational framework for the Community Care Division, the Aged, Community and Mental Health Division and the Public Health Division (specifically in reference to the mental health, child protection and care, juvenile justice and drug treatment services programs) to achieve better outcomes for shared clients. WTS is a response to perceived deficits in cross-program collaboration and communication in cases involving high need adolescent clients.
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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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Manning, Victoria, Nicki A. Dowling, Simone N. Rodda, Ali Cheetham, and Dan I. Lubman. "An Examination of Clinician Responses to Problem Gambling in Community Mental Health Services." Journal of Clinical Medicine 9, no. 7 (July 1, 2020): 2075. http://dx.doi.org/10.3390/jcm9072075.
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Gambling problems commonly co-occur with other mental health problems. However, screening for problem gambling (PG) rarely takes place within mental health treatment settings. The aim of the current study was to examine the way in which mental health clinicians respond to PG issues. Participants (n = 281) were recruited from a range of mental health services in Victoria, Australia. The majority of clinicians reported that at least some of their caseload was affected by gambling problems. Clinicians displayed moderate levels of knowledge about the reciprocal impact of gambling problems and mental health but had limited knowledge of screening tools to detect PG. Whilst 77% reported that they screened for PG, only 16% did so “often” or “always” and few expressed confidence in their ability to treat PG. However, only 12.5% reported receiving previous training in PG, and those that had, reported higher levels of knowledge about gambling in the context of mental illness, more positive attitudes about responding to gambling issues, and more confidence in detecting/screening for PG. In conclusion, the findings highlight the need to upskill mental health clinicians so they can better identify and manage PG and point towards opportunities for enhanced integrated working with gambling services.
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Vacher, Catherine, Nicholas Ho, Adam Skinner, Jo Robinson, Louise Freebairn, Grace Yeeun Lee, Frank Iorfino, et al. "Optimizing Strategies for Improving Mental Health in Victoria, Australia during the COVID-19 Era: A System Dynamics Modelling Study." International Journal of Environmental Research and Public Health 19, no. 11 (May 26, 2022): 6470. http://dx.doi.org/10.3390/ijerph19116470.
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The ongoing COVID-19 pandemic has impacted the mental health of populations and highlighted the limitations of mental health care systems. As the trajectory of the pandemic and the economic recovery are still uncertain, decision tools are needed to help evaluate the best interventions to improve mental health outcomes. We developed a system dynamics model that captures causal relationships among population, demographics, post-secondary education, health services, COVID-19 impact, and mental health outcomes. The study was conducted in the Australian state of Victoria. The model was calibrated using historical data and was stratified by age group and by geographic remoteness. Findings demonstrate that the most effective intervention combination includes economic, social, and health sector initiatives. Assertive post-suicide attempt care is the most impactful health sector intervention, but delaying implementation reduces the potency of its impact. Some evidence-based interventions, such as population-wide community awareness campaigns, are projected to worsen mental health outcomes when implemented on their own. Systems modelling offers a powerful decision-support tool to test alternative strategies for improving mental health outcomes in the Victorian context.
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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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Loi, Samantha, and Anne Hassett. "Evolution of aged persons mental health services in Victoria: The history behind their development." Australasian Journal on Ageing 30, no. 4 (July 3, 2011): 226–30. http://dx.doi.org/10.1111/j.1741-6612.2011.00529.x.
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Ong, Kevin, Andrew Carroll, Shannon Reid, and Adam Deacon. "Community Outcomes of Mentally Disordered Homicide Offenders in Victoria." Australian & New Zealand Journal of Psychiatry 43, no. 8 (January 1, 2009): 775–80. http://dx.doi.org/10.1080/00048670903001976.
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Objective: The aim of the present study was to describe characteristics and post-release outcomes of Victorian homicide offenders under the Crimes (Mental Impairment and Unfitness to be Tried) Act 1997 (and/or its forerunner legislation) released from forensic inpatient psychiatric care since the development of specialist forensic services. Method: A legal database identified subjects meeting inclusion criteria: hospitalized in forensic psychiatric care due to finding of mental impairment or unfitness to stand trial for homicide in Victoria; released into the community; and released between 1 January 1991 and 30 April 2002. Using clinical records, demographics, index offence, progress in hospital, diagnosis, psychosocial and criminological data were obtained. Outcomes (offending or readmission into secure care) were obtained from the clinical records. Results: Of the 25 subjects, 19 (76%) were male. Primary diagnoses on admission to forensic hospital care were schizophrenia, n = 16 (64%); other psychotic disorder, n = 5 (20%); depression, n = 3 (12%); and personality disorder, n = 1 (4%). Mean time in custodial supervision was 11 years and 2 months, less for those whose offence occurred after the development of forensic rehabilitation services. In the first 3 years after release, there was a single episode of criminal recidivism, representing a recidivism rate of 1 in 25 (4%) over 3 years. Twelve subjects (48%) were readmitted at some point in the 3 year follow up. Conclusion: There was a very low rate of recidivism after discharge, but readmissions to hospital were common. Lengths of custodial care were reduced after the introduction of forensic rehabilitation facilities. Recidivism is low when there are well-designed and implemented forensic community treatment programmes, consistent with other data suggesting a reciprocal relationship between safe community care and a low threshold for readmission to hospital, lessening re-offending at times of crisis. Further research should be directed at timing of release decisions, based on reducing identified risk factors to acceptable levels.
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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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King, Robert. "Caseload Management, Work-Related Stress and Case Manager Self-Efficacy Among Victorian Mental Health Case Managers." Australian & New Zealand Journal of Psychiatry 43, no. 5 (January 1, 2009): 453–59. http://dx.doi.org/10.1080/00048670902817661.
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Objective: In Australia and comparable countries, case management has become the dominant process by which public mental health services provide outpatient clinical services to people with severe mental illness. There is recognition that caseload size impacts on service provision and that management of caseloads is an important dimension of overall service management. There has been little empirical investigation, however, of caseload and its management. The present study was undertaken in the context of an industrial agreement in Victoria, Australia that required services to introduce standardized approaches to caseload management. The aims of the present study were therefore to (i) investigate caseload size and approaches to caseload management in Victoria's mental health services; and (ii) determine whether caseload size and/or approach to caseload management is associated with work-related stress or case manager self-efficacy among community mental health professionals employed in Victoria's mental health services. Method: A total of 188 case managers responded to an online cross-sectional survey with both purpose-developed items investigating methods of case allocation and caseload monitoring, and standard measures of work-related stress and case manager personal efficacy. Results: The mean caseload size was 20 per full-time case manager. Both work-related stress scores and case manager personal efficacy scores were broadly comparable with those reported in previous studies. Higher caseloads were associated with higher levels of work-related stress and lower levels of case manager personal efficacy. Active monitoring of caseload was associated with lower scores for work-related stress and higher scores for case manager personal efficacy, regardless of size of caseload. Although caseloads were most frequently monitored by the case manager, there was evidence that monitoring by a supervisor was more beneficial than self-monitoring. Conclusion: Routine monitoring of caseload, especially by a workplace supervisor, may be effective in reducing work-related stress and enhancing case manager personal efficacy.
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Bigby, Christine. "A demographic analysis of older people with intellectual disability registered with Community Services Victoria." Australia and New Zealand Journal of Developmental Disabilities 19, no. 1 (January 1994): 1–10. http://dx.doi.org/10.1080/07263869400035061.
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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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Constantine, Sarah. "Book review: Dementia Care in Victoria: Building a Pathway to Excellence, Final Report, Ministerial Task Force on Dementia Services in Victoria. Aged, Community and Mental Health Division, Victorian Government Department of Human Services, Australia." International Journal of Geriatric Psychiatry 15, no. 3 (March 2000): 286. http://dx.doi.org/10.1002/(sici)1099-1166(200003)15:3<286::aid-gps926>3.0.co;2-m.
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Atwell, R., I. Correa‐Velez, and S. Gifford. "Ageing Out of Place: Health and Well‐Being Needs and Access to Home and Aged Care Services for Recently Arrived Older Refugees in Melbourne, Australia." International Journal of Migration, Health and Social Care 3, no. 1 (July 1, 2007): 4–14. http://dx.doi.org/10.1108/17479894200700002.
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Recently arrived older refugees in resettlement countries are a particularly vulnerable population who face many risks to their health and well‐being, and many challenges in accessing services. This paper reports on a project undertaken in Victoria, Australia to explore the needs of older people from 14 recently arrived refugee communities, and the barriers to their receiving health and aged care. Findings from consultations with community workers and service providers highlight the key issues of isolation, family conflict and mental illness affecting older refugees, and point to ways in which policy‐makers and service providers can better respond to these small but deserving communities.
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Vine, Ruth, Holly Tibble, Jane Pirkis, Fiona Judd, and Matthew J. Spittal. "Does legislative change affect the use and duration of compulsory treatment orders?" Australian & New Zealand Journal of Psychiatry 53, no. 5 (November 18, 2018): 433–40. http://dx.doi.org/10.1177/0004867418812683.
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Objective: Victoria, Australia, introduced reformed mental health legislation in 2014. The Act was based on a policy platform of recovery-oriented services, supported decision-making and minimisation of the use and duration of compulsory orders. This paper compares service utilisation and legal status after being on a community treatment order under the Mental Health Act 1986 (Vic) with that under the Mental Health Act 2014 (Vic). Methods: We obtained two distinct data sets of persons who had been on a community treatment order for at least 3 months and their subsequent treatment episodes over 2 years under the Mental Health Act and/or as an inpatient for the periods 2008–2010 (Mental Health Act 1986) and 2014–2016 (Mental Health Act 2014). The two sets were compared to assess the difference in use, duration and odds of having a further admission over 2 years. We also considered the mode of discharge – whether by the treating psychiatrist, external body or through expiry. Results: Compared with the Mental Health Act 1986, under the Mental Health Act 2014, index community treatment orders were shorter (mean 227 days compared with 335 days); there was a reduction in the mean number of community treatment orders in the 2 years following the index discharge − 1.1 compared with 1.5 (incidence rate ratio (IRR) = 0.71, 95% confidence interval = [0.63, 0.80]) – and a 51% reduction in days on an order over 2 years. There was a reduction in the number of subsequent orders for those whose order expired or was revoked by the psychiatrist under the Mental Health Act 2014 compared to those under the Mental Health Act 1986. The number of orders which were varied to an inpatient order by the authorised psychiatrist was notably greater under the Mental Health Act 2014. Conclusion: The reformed Mental Health Act has been successful in its intent to reduce the use and duration of compulsory orders in the community. The apparent increase in return to inpatient orders raises questions regarding the intensity and effectiveness of community treatment and context of service delivery.
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Trauer, Tom, Tom Callaly, Paul Hantz, John Little, Robert B. Shields, and Jenny Smith. "Health of the Nation Outcome Scales." British Journal of Psychiatry 174, no. 5 (May 1999): 380–88. http://dx.doi.org/10.1192/bjp.174.5.380.
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BackgroundIn Victoria, Australia, systematic assessment of outcomes in mental health services are being instituted.AimsTo carry out a large-scale field trial of the Health of the Nation Outcome Scales (HoNOS).Method2137 clients were rated by mental health workers on the HoNOS, and about half were rated again within a few months.ResultsWhile interrater reliability of the total score was satisfactory, that of some individual items was unacceptable. Significant associations with age and gender were found, and clients with non-psychotic disorders obtained higher (i.e. worse) ratings than those with psychotic disorders. There were relationships between service use and HoNOS total score. For the group as a whole, total scores had not changed at the second rating, but admissions and discharges were associated with increases and decreases in total score. Among clients in the community, there was no relationship between change in HoNOS total score and frequency of contacts.ConclusionsCertain items, notably 11 and 12, were unreliable. The absence of evidence of sensitivity to change may be due to the short re-rating interval, little real change in the clients, or the characteristics of the scale itself.
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Cheng, Melanie S., Angela Clarke, Timothy D. Moore, and Phyllis M. Lau. "Making the connection: a qualitative study of brokerage in Aboriginal health in a metropolitan area of Victoria and a regional area of New South Wales." Australian Health Review 35, no. 1 (2011): 18. http://dx.doi.org/10.1071/ah09809.
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Objective. Health brokerage is one method being employed by government health agencies in an attempt to improve Aboriginal and Torres Strait Islander people’s access to primary healthcare. This qualitative study explores key stakeholders’ understanding and acceptance of the health brokerage model, prior to the implementation of brokerage services. Methods. Semistructured interviews and focus groups were conducted with key stakeholders. The resulting data was analysed using a grounded theory approach. Results. Qualitative analysis of the interviews and focus groups revealed five major themes. These were: (1) the perceived limitations of brokerage as a service delivery model; (2) the benefits of health brokerage such as increased flexibility; (3) issues relating to patient independence; (4) the necessity for broker independence; and (5) a mistrust of health brokerage and the authority handling the brokerage funds. Conclusions. Since this study was conducted in 2008, ongoing funding for urban brokerage services has been suspended. Although the reasons for this are unclear, our study suggests that barriers to the acceptance of brokerage services by the community may have existed even before such services were implemented, thus highlighting the need for transparency when launching new health initiatives that hope to engage the Aboriginal community. What is known about the topic? Brokerage models have previously been described in the areas of mental health and aged care. In these examples, brokerage agencies have provided patients with a key entry point into the healthcare system. Benefits of the brokerage model, such as flexibility, have been contrasted with its limitations, such as a heavy reliance upon existing services. What does this paper add? This paper provides insight into the acceptability of health brokerage, as a service delivery model, to the Aboriginal community. Although findings from the study reinforce many of the benefits and limitations already described in the literature, they also introduce the new and important themes of patient empowerment and mistrust. What are the implications for practitioners? This study provides vital information about community perceptions of health brokerage. It is important that policy makers take heed of such insights when planning attempts to close the gap in Aboriginal health.
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Burke, David. "Dementia Care in Victoria: Building a Pathway to Excellence Final Report, Ministerial Taskforce on Dementia Services in Victoria. Melbourne, Australia: Aged, Community & Mental Health Division, Victorian Government Department of Human Services, 1997, 398 pp., No charge." International Psychogeriatrics 11, no. 1 (March 1999): 102–3. http://dx.doi.org/10.1017/s1041610299225628.
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He, Ling, and Melissa Petrakis. "Spiritual Diversity in Personal Recovery from Mental Health Challenges: A Qualitative Study from Chinese-Australian Service Users’ Perspectives." International Journal of Environmental Research and Public Health 20, no. 3 (January 26, 2023): 2210. http://dx.doi.org/10.3390/ijerph20032210.
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Spiritual diversity and the positive role of spirituality in personal recovery have received growing attention in mental health literature. However, the spiritual experiences and views of service users from cultural communities, particularly the Chinese community, are understudied in Australia. This research explores Chinese service users’ spiritual identities and their views and perspectives on the roles of spirituality in their mental health recovery and attempts to provide inspiration for practitioners to engage with service users’ spirituality in non-clinical mental health practice. A qualitative exploratory approach guided this study. Semi-structured interviews were employed with four Chinese participants with spiritual identities, who were recruited through the community Psychosocial Support Service in Victoria. The template analysis method supported the data analysis. The results indicate that spirituality has a positive impact on the mental health recovery of participants, primarily through coping, self-regulatory, and social support mechanisms. The findings also present that Chinese service users’ understanding and approaches to spirituality are shaped by both original and Australian Cultures. These findings suggest that practitioners should provide a creative understanding and cultural awareness when discussing with service users their spiritual identities, perspectives, and spirituality in the wider context. The research fills a gap in the spiritual views and perspectives of service users accessing a non-clinical mental health service from the Chinese community.
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McLean, Karen, Harriet Hiscock, Dorothy Scott, and Sharon Goldfeld. "What is the timeliness and extent of health service use of Victorian (Australia) children in the year after entry to out-of-home care? Protocol for a retrospective cohort study using linked administrative data." BMJ Paediatrics Open 3, no. 1 (January 2019): e000400. http://dx.doi.org/10.1136/bmjpo-2018-000400.
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IntroductionChildren entering out-of-home care have high rates of health needs across all domains of health. To identify these needs early and optimise long-term outcomes, routine health assessment on entry to care is recommended by child health experts and included in policy in many jurisdictions. If effective, this ought to lead to high rates of health service use as needs are addressed. Victoria (Australia) has no state-wide approach to deliver routine health assessments and no data to describe the timing and use of health service visits for children in out-of-home care. This retrospective cohort data linkage study aims to describe the extent and timeliness of health service use by Victorian children (aged 0–12 years) who entered out-of-home care for the first time between 1 April 2010 and 31 December 2015, in the first 12 months of care.Methods and analysisThe sample will be identified in the Victorian Child Protection database. Child and placement variables will be extracted. Linked health databases will provide additional data: six state databases that collate data about hospital admissions, emergency department presentations and attendances at dental, mental and community health services and public hospital outpatients. The federal Medicare Benefits Schedule claims dataset will provide information on visits to general practitioners, specialist physicians (including paediatricians), optometrists, audiologists and dentists. The number, type and timing of visits to different health services will be determined and benchmarked to national standards. Multivariable logistic regression will examine the effects of child and system variables on the odds of timely health visits, and proportional-hazards regression will explore the effects on time to first health visits.Ethics and disseminationEthical and data custodian approval has been obtained for this study. Dissemination will include presentation of findings to policy and service stakeholders in addition to scientific papers.
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Jablensky, Assen, John McGrath, Helen Herrman, David Castle, Oye Gureje, Mandy Evans, Vaughan Carr, Vera Morgan, Ailsa Korten, and Carol Harvey. "Psychotic Disorders in Urban Areas: An Overview of the Study on Low Prevalence Disorders." Australian & New Zealand Journal of Psychiatry 34, no. 2 (April 2000): 221–36. http://dx.doi.org/10.1080/j.1440-1614.2000.00728.x.
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Objective: This paper reports on a study designed within the framework of the National Survey of Mental Health and Wellbeing to: estimate the prevalence of psychoses in urban areas of Australia; identify profiles of symptomatology, impairments and disabilities; collect information on services received and needed; and explore quality of life issues in a broadly representative sample of people with psychotic illnesses. Method: The study was conducted over four areas in the Australian Capital Territory, Queensland, Victoria and Western Australia, as a two-phase survey: (i) a census and screening for psychosis of all individuals who made contacts with mental health services during a period of 1 month in 1997; and (ii) interviews with a stratified random sample (n = 980) of the screen-positive individuals (n = 3800) using a standardised instrument. Results: The point prevalence (1 month) of psychotic disorders in the urban population aged 18–64 is in the range of 4–7 per 1000 with a weighted mean of 4.7 per 1000. People with psychotic disorders experience high rates of functional impairments and disability, decreased quality of life, persistent symptoms, substance-use comorbidity and frequent side effects of medication. Although the utilisation of hospital-based and community mental health services, as well as of public and non-governmental helping agencies, is high, the majority live in extreme social isolation and adverse socioeconomic circumstances. Among the many unmet needs, the limited availability of community-based rehabilitation, supported accommodation and employment opportunities is particularly prominent. Conclusions: The so-called ‘low-prevalence’ psychotic disorders represent a major and complex public health problem, associated with heavy personal and social costs. There is a need for a broad programmatic approach, involving various sectors of the community, to tackle the multiple dimensions of clinical disorder, personal functioning and socioeconomic environment that influence the course and outcome of psychosis and ultimately determine the effectiveness of service-based intervention.
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Lennox, Nicholas, and Robert Chaplin. "The Psychiatric Care of People with Intellectual Disabilities: The Perceptions of Consultant Psychiatrists in Victoria." Australian & New Zealand Journal of Psychiatry 30, no. 6 (December 1996): 774–80. http://dx.doi.org/10.3109/00048679609065044.
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Objective: This study was undertaken to establish the perceptions of psychiatrists regarding the care of people with intellectual disabilities. Method: A 28-item self-administered questionnaire was developed, piloted and sent on two occasions to 467 psychiatrists who receive the newsletter of the Victorian branch of the Royal Australian and New Zealand College of Psychiatrists. The questionnaire incorporated a Likert scale to document the opinions of the respondents. Results: A response rate of 51.1 % was achieved. The respondents indicated that, in their opinion, people with intellectual disabilities receive a poor standard of care in the inpatient and community setting. To improve this situation, the following strategies were recommended: the development of improved liaison between services; improved training for all personnel who provide services to people with intellectual disabilities; the development of greater resources; and support for professionals working in the area. The study also indicates that there is a core group of very interested psychiatrists who are currently practising and that people with intellectual disabilities are accessing private psychiatric services. In addition, the results suggest that diagnostic overshadowing is not a major barrier to psychiatric assessment, and that disorders which were presumed to be commonly overlooked by doctors (such as depression) are in fact frequently being diagnosed. Conclusions: Despite some positive findings, the majority of psychiatrists who responded held major concerns about the situation of people with intellectual disabilities. To improve the care provided to these people, it is recommended that these concerns are addressed by the psychiatric profession and responsible government departments in conjunction with university departments of psychiatry.
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Singh, I., M. I. Khalid, and M. J. Dickinson. "Psychiatric admission services for people with learning disability." Psychiatric Bulletin 18, no. 3 (March 1994): 151–52. http://dx.doi.org/10.1192/pb.18.3.151.
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As the care of people with learning disability has shifted from large Victorian hospitals to the community, provision for in-patient psychiatric treatment has, in many districts, also moved. Purpose built district or supra-district admission services represent the most common model. An alternative is the use of existing general psychiatric beds. In this article we describe the first 18 months of the Hillingdon district service where this latter model has been adopted.
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Ervin, Kaye, Jacqueline Phillips, and Jane Tomnay. "Establishing a clinic for young people in a rural setting: a community initiative to meet the needs of rural adolescents." Australian Journal of Primary Health 20, no. 2 (2014): 128. http://dx.doi.org/10.1071/py12157.
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This paper describes the establishment and evaluation of a rural clinic for young people. A conceptual approach to community development was used to establish the clinic in a small north Victorian rural health service, with qualitative methods used to evaluate services. Study participants were members of an operational committee and advisory committee for the establishment of the rural clinic for young people. The clinic was evaluated against the World Health Organization framework for the development of youth-friendly services. With robust community support, the clinic was established and is operational. Most consultations have been for sexual and mental health. Qualitative evaluation identifies that not all the World Health Organization benchmarks have been met, but this is hampered predominantly by financial constraints. In conclusion, establishing clinic for young people in a small rural setting can be achieved with community support and the development of referral pathways.
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Pirkis, Jane, Philip Burgess, and Damien Jolley. "Suicide Among Psychiatric Patients: A Case-Control Study." Australian & New Zealand Journal of Psychiatry 36, no. 1 (February 2002): 86–91. http://dx.doi.org/10.1046/j.1440-1614.2002.00993.x.
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Objective: To examine patient- and treatment-based differences between psychiatric patients who do and do not die by suicide. Method: By linking databases of deaths and psychiatric service use in Victoria, we compared 597 cases who suicided over 5 years with individually matched controls. Results: Cases and controls could not be distinguished on the majority of patient- or treatment-based characteristics. The exceptions were that cases were more likely to be male, less likely to be outside the labour force, more likely to have recent contact with inpatient and community services, and more likely to have a registration as their last contact. Conclusions: Patients who suicide ‘look’ similar to those who do not, suggesting prevention approaches should ensure that all psychiatric patients receive optimal care, including appropriate detection, diagnosis, assessment and treatment of mental health problems, and careful, individualised assessment of suicide risk.
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O. Moraleja, Mark Paul. "Establishing Psychological Assessment and Counseling Center at LSPU – SPCC: A Descriptive Feasibility Study." International Multidisciplinary Research Journal 3, no. 3 (September 14, 2021): 270–75. http://dx.doi.org/10.54476/iimrj258.
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This study was conducted to assess the possible establishment of psychological assessment and counseling center at Laguna State Polytechnic University, San Pablo City Campus. Specifically, it aimed to assess its feasibility, acceptability and potential sustainability. Opinion of community stakeholders were also gathered as one of the research’s primary objectives, which is to provide basic mental health services to the community. This study used exploratory mix method of quantitative and qualitative research which utilized a researcher-made survey questionnaire with 150 working respondents from which 15 were subjected to unstructured in-depth interview. They were the ones who were residents of San Pablo City and other nearby municipalities namely: Victoria, Calauan, Alaminos, Nagcarlan, Rizal, and Liliw. Findings revealed that establishing a psychological assessment and counseling center at LSPU, San Pablo was feasible in terms of the number of psychometricians and other mental health professionals available. In addition, it was acceptable in terms of the qualification of test administrators and its location as it lies at the center of 3 rd district of Laguna. Moreover, it was sustainable in terms of the number of clients it can possibly have. However further considerations were raised by the respondents such as the existing conditions of LSPU-SPCC and its potential capacity to establish the said centers such as the aspects of human resources, physical facilities, funding and community eagerness.
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Jackson, Lara, Boyce Felstead, Jahar Bhowmik, Rachel Avery, and Rhonda Nelson-Hearity. "Towards holistic dual diagnosis care: physical health screening in a Victorian community-based alcohol and drug treatment service." Australian Journal of Primary Health 22, no. 2 (2016): 81. http://dx.doi.org/10.1071/py15097.
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The poorer health outcomes experienced by people with mental illness have led to new directions in policy for routine physical health screening of service users. By contrast, little attention has been paid to the physical health needs of consumers of alcohol and other drug (AOD) services, despite a similar disparity in physical health outcomes compared with the general population. The majority of people with problematic AOD use have comorbid mental illness, known as a dual diagnosis, likely to exacerbate their vulnerability to poor physical health. With the potential for physical health screening to improve health outcomes for AOD clients, a need exists for systematic identification and management of common health conditions. Within the current health service system, those with a dual diagnosis are more likely to have their physical health surveyed and responded to if they present for treatment in the mental health system. In this study, a physical health screening tool was administered to clients attending a community-based AOD service. The tool was administered by a counsellor during the initial phase of treatment, and referrals to health professionals were made as appropriate. Findings are discussed in terms of prevalence, types of problems identified and subsequent rates of referral. The results corroborate the known link between mental and physical ill health, and contribute to developing evidence that AOD clients present with equally concerning physical ill health to that of mental health clients and should equally be screened for such when presenting for AOD treatment.
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Ingram, Graham, and Mary Jane Tacchi. "Service innovation in a heated environment: CATS on a hot tin roof." Psychiatric Bulletin 28, no. 11 (November 2004): 398–400. http://dx.doi.org/10.1192/pb.28.11.398.
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Over the past few years, numerous articles have highlighted the strain on (and drain of staff from) our specialty. Many general adult psychiatrists are developing bleak views of themselves, the world and the future. Encouragingly, consultants such as Hampson (2003) are structuring their roles with some success. However, we are going through a major overhaul of the model of delivery of care and need to adapt our roles accordingly. Although tuning a Triumph Spitfire might make it run more smoothly for a while, it is still an inferior beast compared with a modern car and might be better on the scrap heap. A more radical approach is needed, which we outline in this article. One of the authors (G.I.) has experience of working as a consultant psychiatrist in Australia, where the state of Victoria changed the model of delivery of general adult psychiatric services to adopt a superior American model, leading to improved patient and carer satisfaction (Joyet al, 2001). The same model has been adopted by the UK government (Department of Health, 2001) through the creation of crisis assessment and treatment services (CATS), assertive outreach teams, and specialist community and in-patient services. Consultant psychiatrists are challenged to adapt their practice accordingly. The Royal College of Psychiatrists has recently set up a Working Group to address this issue (Royal College of Psychiatrists, 2004).
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Tran, Jonathan, Karen Willis, Margaret Kay, Kathryn Hutt, and Natasha Smallwood. "The Workplace and Psychosocial Experiences of Australian Senior Doctors during the COVID-19 Pandemic: A Qualitative Study." International Journal of Environmental Research and Public Health 19, no. 5 (March 5, 2022): 3079. http://dx.doi.org/10.3390/ijerph19053079.
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The coronavirus disease 2019 (COVID-19) pandemic has had significant mental health impacts among healthcare workers (HCWs), related to resource scarcity, risky work environments, and poor supports. Understanding the unique challenges experienced by senior doctors and identifying strategies for support will assist doctors facing such crises into the future. A cross-sectional, national, online survey was conducted during the second wave of the Australian COVID-19 pandemic. Inductive content analysis was used to examine data reporting workplace and psychosocial impacts of the pandemic. Of 9518 responses, 1083 senior doctors responded to one or more free-text questions. Of the senior doctors, 752 were women and 973 resided in Victoria. Four themes were identified: (1) work-life challenges; (2) poor workplace safety, support, and culture; (3) poor political leadership, planning and support; and (4) media and community responses. Key issues impacting mental health included supporting staff wellbeing, moral injury related to poorer quality patient care, feeling unheard and undervalued within the workplace, and pandemic ill-preparedness. Senior doctors desired better crisis preparedness, HCW representation, greater leadership, and accessible, authentic psychological wellbeing support services from workplace organisations and government. The pandemic has had significant impacts on senior doctors. The sustainability of the healthcare system requires interventions designed to protect workforce wellbeing.
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Keeves, Jemma, Sandra C. Braaf, Christina L. Ekegren, Ben Beck, and Belinda J. Gabbe. "Access to Healthcare Following Serious Injury: Perspectives of Allied Health Professionals in Urban and Regional Settings." International Journal of Environmental Research and Public Health 18, no. 3 (January 29, 2021): 1230. http://dx.doi.org/10.3390/ijerph18031230.
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Barriers to accessing healthcare exist following serious injury. These issues are not well understood and may have dire consequences for healthcare utilisation and patients’ long-term recovery. The aim of this qualitative study was to explore factors perceived by allied health professionals to affect access to healthcare beyond hospital discharge for people with serious injuries in urban and regional Victoria, Australia. Twenty-five semi-structured interviews were conducted with community-based allied health professionals involved in post-discharge care for people following serious injury across different urban and regional areas. Interview transcripts were analysed using thematic analysis. Many allied health professionals perceived that complex funding systems and health services restrict access in both urban and regional areas. Limited availability of necessary health professionals was consistently reported, which particularly restricted access to mental healthcare. Access to healthcare was also felt to be hindered by a reliance on others for transportation, costs, emotional stress and often lengthy time of travel. Across urban and regional areas, a number of factors limit access to healthcare. Better understanding of health service delivery models and areas for change, including the use of technology and telehealth, may improve equitable access to healthcare.
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Johnson, Hilary, Barbara Solarsh, Karen Bloomberg, and Denise West. "Supporting people with complex communication needs through community capacity building: the Communication Access Network." Tizard Learning Disability Review 21, no. 3 (July 4, 2016): 130–39. http://dx.doi.org/10.1108/tldr-10-2015-0044.
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Purpose – The purpose of this paper is to describe specific features of a Victorian (Australia) state-wide hub and spoke model of speech pathology provision established for adults with complex communication needs (CCN). Two case studies highlighting successful examples of services developed to enhance community inclusion will be described and the challenges discussed. Design/methodology/approach – The route to community inclusion is described through a case study illustration of one communication accessible community site and one disability service study. The disability service research involved focus groups, survey and interview data and demonstrated the efficacy and sustainability of a support worker training model. Findings – Sustainable change in the community and in disability services can occur through partnerships, training, and long-term commitment. Support workers who can facilitate interactions for people who have cognitive and communicative disabilities are an essential component of building the capacity of communities to include people with CCN. Collaboration between community members, specialised supports and people with disabilities enhances active community participation. Originality/value – This innovative, state-wide model has the capacity to be replicated elsewhere. On-going speech pathology services are integral to support adults with CCN providing both short-term individualised services, sustainable staff training and community engagement.
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Hall, Teresa, Sharon Goldfeld, Hayley Loftus, Suzy Honisett, Hueiming Liu, Denise De Souza, Cate Bailey, et al. "Integrated Child and Family Hub models for detecting and responding to family adversity: protocol for a mixed-methods evaluation in two sites." BMJ Open 12, no. 5 (May 2022): e055431. http://dx.doi.org/10.1136/bmjopen-2021-055431.
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IntroductionIntegrated community healthcare Hubs may offer a ‘one stop shop’ for service users with complex health and social needs, and more efficiently use service resources. Various policy imperatives exist to implement Hub models of care, however, there is a dearth of research specifically evaluating Hubs targeted at families experiencing adversity. To contribute to building this evidence, we propose to co-design, test and evaluate integrated Hub models of care in two Australian community health services in low socioeconomic areas that serve families experiencing adversity: Wyndham Vale in Victoria and Marrickville in New South Wales.Methods and analysisThis multisite convergent mixed-methods study will run over three phases to (1) develop the initial Hub programme theory through formative research; (2) test and, then, (3) refine the Hub theory using empirical data. Phase 1 involves co-design of each Hub with caregivers, community members and practitioners. Phase 2 uses caregiver and Hub practitioner surveys at baseline, and 6 and 12 months after Hub implementation, and in-depth interviews at 12 months. Two stakeholder groups will be recruited: caregivers (n=100–200 per site) and Hub practitioners (n=20–30 per site). The intervention is a co-located Hub providing health, social, legal and community services with no comparator. The primary outcomes are caregiver-reported: (i) identification of, (ii) interventions received and/or (iii) referrals received for adversity from Hub practitioners. The study also assesses child, caregiver, practitioner and system outcomes including mental health, parenting, quality of life, care experience and service linkages. Primary and secondary outcomes will be assessed by examining change in proportions/means from baseline to 6 months, from 6 to 12 months and from baseline to 12 months. Service linkages will be analysed using social network analysis. Costs of Hub implementation and a health economics analysis of unmet need will be conducted. Thematic analysis will be employed to analyse qualitative data.Ethics and disseminationRoyal Children’s Hospital and Sydney Local Health District ethics committees have approved the study (HREC/62866/RCHM-2020). Participants and stakeholders will receive results through meetings, presentations and publications.Trial registration numberISRCTN55495932.
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Gillard, Steve, Christine Edwards, Sarah Gibson, Jess Holley, and Katherine Owen. "New ways of working in mental health services: a qualitative, comparative case study assessing and informing the emergence of new peer worker roles in mental health services in England." Health Services and Delivery Research 2, no. 19 (July 2014): 1–218. http://dx.doi.org/10.3310/hsdr02190.
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BackgroundA variety of peer worker roles are being introduced into the mental health workforce in England, in a range of organisational contexts and service delivery settings. The evidence base demonstrating the effectiveness of peer worker-based interventions is inconclusive and largely from outside England. An emerging qualitative literature points to a range of benefits, as well as challenges to introducing the peer worker role.AimsIn this study we aimed to test the international evidence base, and what is known generally about role adoption in public services, in a range of mental health services in England. We also aimed to develop organisational learning supporting the introduction of peer worker roles, identifying learning that was generic across mental health services and that which was specific to organisational contexts or service delivery settings.TeamThe research was undertaken by a team that comprised researchers from a range of academic and clinical disciplines, service user researchers, a peer worker, and managers and service providers in the NHS and voluntary sector. Service user researchers undertook the majority of the data collection and analysis. We adopted a coproduction approach to research, integrating the range of perspectives in the team to shape the research process and interpret our findings.Study designThe study employed a qualitative, comparative case study design. We developed a framework, based on existing evidence and the experiential insight of the team, which conceptualised the challenges and facilitators of introducing peer worker roles into mental health services. The framework was used to inform data collection and to enable comparisons between different organisational contexts, service delivery settings and the perspectives of different stakeholders.SettingsThe study took place in 10 contrasting cases comprising mental health NHS trusts, voluntary sector service providers and partnerships between the NHS and voluntary sector or social care providers. Peer workers were employed in a variety of roles, paid and unpaid, in psychiatric inpatient settings, community mental health services and black and minority ethnic (BME)-specific services.ParticipantsParticipants were 89 people involved in services employing peer workers, recruited purposively in approximately equal proportion from the following stakeholder groups: service users; peer workers; (non-peer) coworkers; line managers; strategic managers; and commissioners.Data collectionAll participants completed an interview that comprised structured and open-ended questions. Structured questions addressed a number of domains identified in the existing evidence as barriers to, or facilitators of, peer worker role adoption. Open-ended questions elicited detailed data about participants’ views and experiences of peer worker roles.Data analysisStructured data were analysed using basic statistics to explore patterns in implementation across cases. Detailed data were analysed using a framework approach to produce a set of analytical categories. Patterns emerging in the structured analysis informed an in-depth interrogation of the detailed data set, using NVivo 9 qualitative software (QSR International Pty Ltd, Victoria, Australia) to compare data between organisational contexts, service delivery settings and stakeholder groups. Preliminary findings were refined through discussion with a range of stakeholders at feedback workshops.FindingsMany of the facilitators of peer worker role adoption identified in the existing evidence base were also evident in mental health services in England, although there were issues around pay, leadership, shared understanding of the role, training and management where good practice was uneven. A number of examples of good practice were evident in the voluntary sector, where peer worker roles had been established for longer and organisations were more flexible. In the NHS there were a range of challenges around introducing peer worker roles into existing structures and cultures of practice. Peer workers were able to engage people with services by building relationships based on shared lived experience – the language they used was particularly important in BME-specific services – but barriers to engagement could be created where roles were overformalised.ConclusionsKey barriers to, and facilitators of, peer worker role adoption were identified, including valuing the differential knowledge and practice that peer workers brought to the role (especially around maintaining personally, rather than professionally defined boundaries); maintaining peer identity in a role of work; changing organisational structures to support peer workers to remain well in their work; and challenging organisational cultures to empower peer workers to use their lived experience. Recommendations for future research include developing a theoretical framework articulating the change mechanisms underpinning ‘what peer workers do’, piloting and formally evaluating the effectiveness and cost-effectiveness of peer worker interventions, and mixed-method research to better understand the impact of working as a peer worker.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Minas, I. H., G. W. Stuart, and S. Klimidis. "Language, Culture and Psychiatric Services: A Survey of Victorian Clinical Staff." Australian & New Zealand Journal of Psychiatry 28, no. 2 (June 1994): 250–58. http://dx.doi.org/10.1080/00048679409075636.
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In planning psychiatric services for non-English speaking immigrant communities it is essential to know what resources are available for the implementation of service plans. A survey of 991 professionals from a variety of disciplines working in Victorian state operated inpatient and community psychiatric services demonstrates that, although there is a substantial number of bilingual clinicians working in the system, there is a poor match between languages spoken by patient groups and clinicians, infrequent contact between bilingual clinicians and patients speaking the same language, and inadequate availability of interpreting services. Clinicians' knowledge of cultural issues relevant to assessment and treatment is inadequate, and there is some enthusiasm among clinical staff for remedying this deficiency. Clinicians express the opinions that services to non-English speaking patients are inferior, and clinical outcome is worse than for the Australian-born. There appears to be general support for changes which would seek to more adequately meet the psychiatric service needs of immigrants.
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Manning, Victoria, Joshua BB Garfield, David Best, Lynda Berends, Robin Room, Janette Mugavin, Andrew Larner, et al. "Substance use outcomes following treatment: Findings from the Australian Patient Pathways Study." Australian & New Zealand Journal of Psychiatry 51, no. 2 (July 11, 2016): 177–89. http://dx.doi.org/10.1177/0004867415625815.
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Background and Aims: Our understanding of patient pathways through specialist Alcohol and Other Drug treatment and broader health/welfare systems in Australia remains limited. This study examines how treatment outcomes are influenced by continuity in specialist Alcohol and Other Drug treatment, engagement with community services and mutual aid, and explores differences between clients who present with a primary alcohol problem relative to those presenting with a primary drug issue. Method: In a prospective, multi-site treatment outcome study, 796 clients from 21 Alcohol and Other Drug services in Victoria and Western Australia completed a baseline interview between January 2012 and January 2013. A total of 555 (70%) completed a follow-up assessment of subsequent service use and Alcohol and Other Drug use outcomes 12-months later. Results: Just over half of the participants (52.0%) showed reliable reductions in use of, or abstinence from, their primary drug of concern. This was highest among clients with meth/amphetamine (66%) as their primary drug of concern and lowest among clients with alcohol as their primary drug of concern (47%), with 31% achieving abstinence from all drugs of concern. Continuity of specialist Alcohol and Other Drug care was associated with higher rates of abstinence than fragmented Alcohol and Other Drug care. Different predictors of treatment success emerged for clients with a primary drug problem as compared to those with a primary alcohol problem; mutual aid attendance (odds ratio = 2.5) and community service engagement (odds ratio = 2.0) for clients with alcohol as the primary drug of concern, and completion of the index treatment (odds ratio = 2.8) and continuity in Alcohol and Other Drug care (odds ratio = 1.8) when drugs were the primary drugs of concern. Conclusion: This is the first multi-site Australian study to include treatment outcomes for alcohol and cannabis users, who represent 70% of treatment seekers in Alcohol and Other Drug services. Results suggest a substantial proportion of clients respond positively to treatment, but that clients with alcohol as their primary drug problem may require different treatment pathways, compared to those with illicit drug issues, to maximise outcomes.
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Lennox, Nicholas, and Robert Chaplin. "The Psychiatric Care of People with Intellectual Disabilities: The Perceptions of Trainee Psychiatrists and Psychiatric Medical Officers." Australian & New Zealand Journal of Psychiatry 29, no. 4 (December 1995): 632–37. http://dx.doi.org/10.3109/00048679509064978.
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Objective: The main aim of this study was to document the perceptions of trainee psychiatrists and psychiatric medical officers regarding the psychiatric care of people with intellectual disabilities. Method: A 28-item self-administered questionnaire was developed by the investigators and pretested on eight psychiatrists and psychiatric trainees. A revised version of the questionnaire was then sent to 128 psychiatric trainees and 27 medical officers working in the public psychiatric services in Victoria. 116 questionnaires were returned, and the responses analysed. Results: The results indicate a high degree of interest in the psychiatry of intellectual disability, however this was tempered by a feeling that the respondents and their senior colleagues are inadequately trained. The respondents expressed major concerns regarding the care of people with dual disabilities in the hospital and community setting, and significant support for the development of specialised units and subspecialisation within psychiatry. The major concerns which were identified would in part explain why 30% of the respondents felt that they would prefer not to treat people with an intellectual disability and a psychiatric disorder. Conclusion: We can only support the assertion made by the Burdekin Report [12] that “there is an urgent need for academic research, increased clinical expertise and substantial increased resources in the much neglected area of dual disability.”
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Fulford, Megan, and John Farhall. "Hospital Versus Home Care for the Acutely Mentally Ill? Preferences of Caregivers Who Have Experienced Both Forms of Service." Australian & New Zealand Journal of Psychiatry 35, no. 5 (October 2001): 619–25. http://dx.doi.org/10.1080/0004867010060510.
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Objective: Demonstration studies of community treatment as an alternative to hospitalization have reported high degrees of satisfaction by family carers. We aimed to determine the extent of carer preference for hospital versus community treatment for acute mental illness in a routine setting where carers had experienced both service types. Method: Patients who had contact with both a hospital inpatient service and a Crisis Assessment and Treatment (CAT) team within the previous 5 years were identified. Seventy-seven family carers of these patients completed a questionnaire which identified their preference for services, and psychological and demographic variables likely to be predictive of their choice. Results: Only half the carers preferred a CAT service to treat their relative in the event of a future relapse. Psychological variables were better predictors of choice than were demographic variables. Conclusions: The proportion of caregivers who prefer community treatment for acute psychosis may be smaller than previously thought. The lower carer satisfaction found here may be associated with the short-term interventions of Victoria's CAT teams, the severity of acute relapses and the duration of the patient's mental health problem.
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Walmsley, Tom. "Undesirable reading: the real role of the clinical tutor." Psychiatric Bulletin 14, no. 3 (March 1990): 165–68. http://dx.doi.org/10.1192/pb.14.3.165.
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I was appointed clinical tutor at Knowle Hospital seven years ago with little idea of what my responsibilities would be. From the College literature (which I have not found very helpful) it seemed I was responsible in a more or less indirect way for the psychiatric education of most of those working in the hospital as well as of those local general practitioners who might refer patients here. In addition, all medical students in the place are my responsibility – a considerable number of young people. To complicate this task, our academic unit had moved out of Knowle two years before my arrival and new trainees were advised that Knowle Hospital (usually described as a ‘traditional Victorian mental hospital’) would be closing in the near future as modern community services were provided. Finally, the advent of proper management, welcomed by me, was spoiled by an indifference to psychiatric education which bordered on absurdity.
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Trauer, Tom, Glenda Pedwell, and Lisa Gill. "The effect of guidance in the use of routine outcome measures in clinical meetings." Australian Health Review 33, no. 1 (2009): 144. http://dx.doi.org/10.1071/ah090144.
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Routine outcome measures (ROM) have now been introduced into all Australian public mental health services, but experience suggests that many clinical staff lack expertise in using them. In 2005 under the Quality Through Outcomes Network (QUATRO), the Victorian Department of Human Services set up three teams aimed at consolidating the use of ROM and furthering sustainability through a variety of peer-support activities. We report on an initiative undertaken by one of these teams. QUATRO team members attended team meetings of four adult community teams (three metropolitan and one rural) fortnightly over about 3 months. QUATRO staff contributed to discussion of outcome measures during routine clinical review, using local and national outcome measurement data and tools, and their own expertise. Attitudes of clinicians toward ROM in general and the specific instruments were assessed at the beginning and end of the period, and again after about 5 months. Qualitative findings consist of observations of factors that assist and hinder use of ROM. The initiative identified steps that staff can take to make ROM more useful in their work.
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Brinsmead, M., A. Maur, and T. Gardner. "O01 Meeting the needs of the Huntington's Disease community with allocated Individual Support Packages (ISP) located within the doctrine of the existing disability service system in the State of Victoria, Australia." Journal of Neurology, Neurosurgery & Psychiatry 83, Suppl 1 (August 29, 2012): A50.2—A50. http://dx.doi.org/10.1136/jnnp-2012-303524.157.
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Garrido-Cumbrera, M., V. Navarro-Compán, C. Bundy, R. Mahapatra, S. Makri, J. Correa-Fernández, L. Christen, C. J. Delgado-Domínguez, and D. Poddubnyy. "AB0809 Assessment of the Impact of Axial Spondyloarthritis on Patient’s Social Life. Results from the European Map of Axial Spondyloarthritis (EMAS)." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 1531.2–1532. http://dx.doi.org/10.1136/annrheumdis-2022-eular.2608.
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BackgroundAs spinal mobility becomes progressively impaired and pain levels escalate, difficulty in performing simple physical routines places a huge burden on axial spondyloarthritis (axSpA).ObjectivesThe aim is to evaluate the impact of axSpA on patients’ social life and to identify the factors associated with this.MethodsData from 2,846 unselected patients participating in EMAS, an online survey (2017-2018) across 13 European countries, were analysed. Impact of axSpA on social life was assessed by: “Score your relationships since you have been affected by Spondylitis / Spondyloarthritis” [Much worse to much better relationships with spouse, family, friend, and neighbours], and “Please indicate the frequency with which you do the following activities since you became affected by Spondylitis/ Spondyloarthritis?” [Much less frequent to much more frequent engagement in restaurants, cultural outings, travel, and sports]. Patients who rated at least one relationship as “worse/much worse” and at least one of social activity as “less/much less frequent” were considered to have a negatively impacted social life. BASDAI (0-10), spinal stiffness (3-12), functional limitation (0-54), and mental health via the General Health Questionnaire GHQ-12 (0-12) were assessed. Univariable and multivariable binary logistic regression were used to identify variables possibly explaining negative impact on social life (n= 2,120).ResultsMean age was 43.8±12.3 years, 61.5% female, 49.2% had a university degree, and 68.2% married. 44.9% (n= 1,205) patients had their social life negatively impacted since the onset of axSpA.Those experiencing a negative impact on their social life were more frequently females (49.5% vs. 37.5% males, p<0.001), divorced/separated (59.5% vs. 34.4% widowed, p<0.001), and on sick leave (temporary and permanent) or unemployed (63.9%, 60.9% and 57.0% vs. 36.8% employed, p<0.001). Furthermore, those whose social life was negatively impacted reported greater BASDAI (6.2 vs. 5.0), functional limitation (24.4 vs. 17.4), spinal stiffness (8.4 vs. 7.3), longer diagnostic delay (9.7 vs. 7.4), poorer mental health (6.7 vs. 3.6), anxiety (62.6% vs. 37.1% no anxiety), depression (61.9% vs. 38.5% no depression), or sleep disorders (55.7% vs. 37.5% no sleep disorders), all p<0.001.The variables associated with negative impact on social life in the multivariable logistic regression were higher disease activity (OR=1.15), poor mental health (OR=1.14), being on a sick leave/unemployed (OR=1.49), divorced/separated (OR=1.46), anxiety (OR= 1.41) and female gender (OR= 1.30; Table 1).Table 1.Factors associated with a worsening social life (n= 2,120)Univariable logistic analysisMultivariable logistic analysisORCI 95%ORCI 95%Age0.990.98, 0.991.000.99, 1.01Gender. Female11.631.39, 1.911.301.06, 1.60Marital status. Divorced/separated21.931.48, 2.501.461.05, 2.04Employment status. Sick Leave/Unemployed32.662.24, 3.171.491.20, 1.85BASDAI (0-10)1.411.35, 1.481.151.08, 1.22Functional Limitation (0-54)1.031.02, 1.031.021.09, 1.02Spinal Stiffness (3-12)1.201.16, 1.241.061.01, 1.11Diagnostic delay1.021.01, 1.031.010.99, 1.02GHQ-12 (0-12)1.221.19, 1.241.141.11, 1.17Anxiety2.842.39, 3.371.411.08, 1.83Depression2.592.17, 3.101.140.87, 1.49Sleep disorders2.101.79, 2.461.020.81, 1.271Female vs. male; 2Divorced/separated vs. single/married/widow; 3Sick leave/unemployed vs. other employment status.ConclusionAlmost half of the axSpA patients reported to have negatively impacted their social life. Being female, divorced/separated, on sick leave/unemployed, with higher disease activity, poor mental health, and anxiety increase the likelihood of worsening social life. As relationships with others and engagement in social or community activities influence quality of life, greater attention to enabling individuals to participate socially through controlling disease activity and addressing mental health comorbidity in the management of axSpA.AcknowledgementsThis study was supported by Novartis Pharma AG. The authors would like to thank all patients who participated in the study.Disclosure of InterestsMarco Garrido-Cumbrera Grant/research support from: has a research collaboration with and provides services to Novartis Pharma AG, Victoria Navarro-Compán Grant/research support from: Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche and UCB, Christine Bundy Speakers bureau: AbbVie, Celgene, Janssen, Lilly, Novartis and Pfizer, Raj Mahapatra: None declared, Souzi Makri Grant/research support from: Novartis, GSK and Bayer, José Correa-Fernández: None declared, Laura Christen Employee of: Novartis Pharma AG, Carlos Jesús Delgado-Domínguez: None declared, Denis Poddubnyy Speakers bureau: AbbVie, BMS, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Roche and UCB, Grant/research support from: AbbVie, MSD, Novartis and Pfizer
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McCann, Warren. "Redeveloping Primary Health and Community Support Services in Victoria." Australian Journal of Primary Health 6, no. 4 (2000): 36. http://dx.doi.org/10.1071/py00032.
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Why Primary Care Reforms?: It gives me very great pleasure to have been asked to speak at this major international Conference about redeveloping primary health and community support services in Victoria. While opening the Conference, the Victorian Minister for Health, the Honourable John Thwaites, launched the Primary Care Partnership Strategy which is one of the most ambitious and far reaching primary health and community support reform agendas in Australia.
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Piperoglou, Michael. "Greeks in Victoria: implications for mental‐health services." Medical Journal of Australia 151, no. 1 (July 1989): 55–56. http://dx.doi.org/10.5694/j.1326-5377.1989.tb128462.x.
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Islam, Rezaul. "Mental health services in the Seychelles." Psychiatric Bulletin 23, no. 9 (September 1999): 565–67. http://dx.doi.org/10.1192/pb.23.9.565.
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When I reached Seychelles to start my new job with the Ministry of Health as a consultant psychiatrist at the Victoria Hospital I had hardly any idea about the islands, let alone its mental health service. But I decided to take the job partly out of curiosity and an interest to see what psychiatry would be on a tourist island in the middle of the Indian Ocean.