Journal articles: 'Mental illness Treatment Victoria'

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Segal, Steven P., Leena Badran, and Lachlan Rimes. "Accessing acute medical care to protect health: the utility of community treatment orders." General Psychiatry 35, no. 6 (December 2022): e100858. http://dx.doi.org/10.1136/gpsych-2022-100858.

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BackgroundThe conclusion that people with severe mental illness require involuntary care to protect their health (including threats due to physical—non-psychiatric—illness) is challenged by findings indicating that they often lack access to general healthcare and the assertion that they would access such care voluntarily if available and effective. Victoria, Australia’s single-payer healthcare system provides accessible medical treatment; therefore, it is an excellent context in which to test these challenges.AimsThis study replicates a previous investigation in considering whether, in Australia’s easy-access single-payer healthcare system, patients placed on community treatment orders, specifically involuntary community treatment, are more likely to access acute medical care addressing potentially life-threatening physical illnesses than voluntary patients with and without severe mental illness.MethodsReplicating methods used in 2000–2010, for the years 2010–2017, this study compared the acute medical care access of three new cohorts: 7826 hospitalised patients with severe mental illness who received a post-hospitalisation, community treatment order; 13 896 patients with severe mental illness released from the hospital without a community treatment order and 12 101 outpatients who were never psychiatrically hospitalised (individuals with less morbidity risk who were not considered to have severe mental illness) during periods when they were under versus outside community mental health supervision. Logistic regression was used to determine the influence of community-based community mental health supervision and the type of community mental health supervision (community treatment order vs non-community treatment order) on the likelihood of receiving an initial diagnosis of a life-threatening physical illness requiring acute care.ResultsValidating their shared elevated morbidity risk, 43.7% and 46.7%, respectively, of each hospitalised cohort (community treatment order and non-community treatment order patients) accessed an initial acute-care diagnosis for a life-threatening condition vs 26.3% of outpatients. Outside community mental health supervision, the likelihood that a community treatment order patient would receive a diagnosis of physical illness was 36% lower than non-community treatment order patients—1.30 times that of outpatients. Under community mental health supervision, their likelihood was two times greater than that of non-community treatment order patients and 6.6 times that of outpatients. Each community treatment order episode was associated with a 14.6% increase in the likelihood of a community treatment order patient receiving a diagnosis. The results replicate those found in an independent 2000–2010 cohort comparison.ConclusionsCommunity mental health supervision, notably community treatment order supervision, in two independent investigations over two decades appeared to facilitate access to physical healthcare in acute care settings for patients with severe mental illness who were refusing treatment—a group that has been subject to excess morbidity and mortality.

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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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Campbell, Helen, Magee Miller, Janet Stretch, and Rivian Weinerman. "A Quality Improvement Initiative for Depression: Finally, a Model for use in “Real” Family Physician Time." Canadian Journal of Community Mental Health 27, no. 2 (September 1, 2008): 191–99. http://dx.doi.org/10.7870/cjcmh-2008-0028.

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Many patients with mental illness depend on family physicians (FPs) for their physical and mental health care, yet FPs often report dissatisfaction with the quality of mental health care they provide. A 2-year, quality improvement (QI) manual-based initiative was developed to increase FPs' diagnostic, cognitive-behavioural, and interpersonal treatment skills for depression. Two teams, each consisting of a psychiatrist and a mental health therapist, rotated through 18 family practices in Victoria, British Columbia, mentoring the model on-site with physicians and patients. Feedback suggests that this initiative enhanced the ability of FPs to diagnose depression and comorbid disorders, organize problems, and treat depression using non-pharmaceutical approaches.

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Haw, Camilla M. "John Conolly and the treatment of mental illness in early Victorian England." Psychiatric Bulletin 13, no. 8 (August 1989): 440–44. http://dx.doi.org/10.1192/pb.13.8.440.

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This year, 1989, marks the 150th anniversary of the abolition of mechanical restraints at the Hanwell Asylum. It was, of course, John Conolly who carried out this large-scale experiment in the application of non-restraint at Hanwell. He was in charge of the diagnosis and treatment of the 800-odd pauper lunatics in this, the largest of the county asylums. Most of his patients had been insane for many years before their admission to Hanwell from the parish workhouses. The prospects of curing them were slim: Hanwell had the second lowest cure rate among the county asylums, a meagre 6% for the period 1835–1845 (Conolly, 1847).

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Kenny, Amanda, Susan Kidd, Jenni Tuena, Melanie Jarvis, and Angela Roberston. "Falling Through the Cracks: Supporting Young People with Dual Diagnosis in Rural and Regional Victoria." Australian Journal of Primary Health 12, no. 3 (2006): 12. http://dx.doi.org/10.1071/py06040.

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Research has indicated that people with a dual diagnosis of mental illness and substance abuse are more difficult to manage than any other group of mentally ill clients. For young people with a dual diagnosis, particularly in rural and regional areas, there are significant barriers to the provision of optimal care. Currently, a lack of communication between mental health, drug and alcohol services and consumers results in the inadequate provision of treatment for young people, with a resultant significant service gap. Dual diagnosis programs that focus on both substance abuse and mental health issues demonstrate greatly improved client outcomes. Developing a peer education program provides one constructive way of involving dual diagnosis consumers in developing more responsive health services. It provides a highly structured and supported way of involving consumers who ordinarily find mental health services bewildering and inaccessible. By drawing on the knowledge and skills of young people with dual diagnosis, and involving them as peer educators, the notion of expertise in lived experience is captured and harnessed to provide the establishment of a consumer-focused service that better meets the needs of this complex, often neglected, client group.

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Maylea, Chris, and Asher Hirsch. "The right to refuse: The Victorian Mental Health Act 2014 and the Convention on the Rights of Persons with Disabilities." Alternative Law Journal 42, no. 2 (June 2017): 149–55. http://dx.doi.org/10.1177/1037969x17710622.

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This article considers how the Victorian Mental Health Act 2014 extinguishes the right of people with a mental illness to refuse treatment in light of the Convention on the Rights of Persons with Disabilities, which prohibits detention or compulsory treatment on the basis of a person’s disability. Three possible resolutions of this inconsistency are proposed and considered: repealing the Mental Health Act 2014, de-linking disability from compulsory treatment, and maintaining legal capacity by supporting mental capacity.

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Albers, Wendy M. M., Yolanda A. M. Nijssen, Diana P. K. Roeg, Inge M. B. Bongers, and Jaap van Weeghel. "Development of an Intervention Aimed at Increasing Awareness and Acknowledgement of Victimisation and Its Consequences Among People with Severe Mental Illness." Community Mental Health Journal 57, no. 7 (January 29, 2021): 1375–86. http://dx.doi.org/10.1007/s10597-021-00776-y.

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AbstractIndividuals with severe mental illness have a significant risk of (anticipated) discrimination and (criminal) victimisation, which is not structurally and systematically addressed by mental health practitioners. The aim of this study was to develop and pilot an intervention which supports professionals to address victimisation and its consequences, in order to reinforce safe social participation and improve recovery. Following the rehabilitation and positive risk management literature, in addition to current practice, intervention components were developed in two focus groups and four subsequent expert meetings. The intervention was piloted in two outpatient teams before being finalised. The Victoria intervention includes positive risk management, focusing on clients’ narratives and strengths, and awareness of unsafe (home) environments: it comprises four steps: exploring issues with social participation, analysing victimisation experiences, clarifying the context of these experiences, and determining future steps, including victimisation-sensitive rehabilitation planning and optional trauma treatment. Future research should further test this intervention.

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Holloway, Frank. "Risk: more questions than answers." Advances in Psychiatric Treatment 10, no. 4 (July 2004): 273–74. http://dx.doi.org/10.1192/apt.10.4.273.

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The rise of the risk industry in psychiatry in England and Wales can be given a precise date: 17 December 1992. That was the day that Christopher Clunis, a man who had been in contact with psychiatric services for some 6 years, murdered Jonathan Zito in an unprovoked attack. This tragedy received enormous publicity and resulted in a flurry of activity within the Department of Health. As a result of the moral panic surrounding Clunis, which crystallised long-term trends, the assessment and management of risk became a central focus of mental health policy and practice (Holloway, 1996). Risk remains a core issue, and indeed mental health services have come to be seen as a key element in a strategy for public protection that aims to keep people who are identified as a potential risk to others off the streets. (We await, with some professional trepidation, the legislation that will provide a sufficiently broad definition of mental illness to fully legitimate this social role.) Mental health staff are now required by government policy and their employers to assess an ever-expanding range of risks – most recently, following the Victoria Climbié Inquiry (House of Commons Health Committee, 2003), risks to dependent children, generally with the aid of unvalidated risk assessment tools. Increasingly, mainstream mental health services are being expected to provide interventions for people whose presenting problems are risky behaviours (or even risky feelings) rather than to offer treatment for mental illness.

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Carta, Bill, Brenda HappeIl, and Jaya Pinikahana. "Mental Health Professionals' Knowledge and Perceptions of Problematic Alcohol and Substance Use: A Questionnaire Survey." Australian Journal of Primary Health 8, no. 3 (2002): 67. http://dx.doi.org/10.1071/py02045.

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The drug and alcohol related knowledge and perceptions of clinicians were examined in order for the Substance Use and Mental Illness Treatment Team to develop a relevant training curriculum for clinicians. A questionnaire on knowledge, skills, attitudes, and practices was distributed to 378 clinicians in Victoria. One hundred and seventy-three clinicians returned the questionnaire giving an overall response rate of 46%. The survey results showed that, although both a knowledge and skills gap exists in assessment and management of alcohol and drug problems, knowledge levels were of an adequate standard overall. Notable areas of weakness included basic knowledge of alcohol and drugs, such as the number of grams of alcohol in a standard drink and the number of alcohol-free days per week recommended by the National Health and Medical Research Council. While positive attitudes towards problematic drug and alcohol issues were expressed, specific educational programs to enhance skills in assessment and management of problematic drug and alcohol users are needed.

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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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Poss, C., C. Fernandes, M. Columbus, and K. Wood. "LO029: Undetected serious medical illness in mental health patients seen in an academic emergency department." CJEM 18, S1 (May 2016): S39—S40. http://dx.doi.org/10.1017/cem.2016.66.

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Introduction: Mental health concerns make up 5-10% of all adult presentations to Canadian emergency departments (ED). One challenge for the emergency physician (EP) is determining if a patient with a mental health concern has concomitant underlying medical illness. We defined “serious medical illness” (SMI) as a pathological condition that requires inpatient treatment on a medical or surgical ward. SMI undetected by emergency physicians in patients presenting with mental health concerns may result in adverse patient outcomes. The aim of this study was to determine the prevalence, timing, and etiology of undetected SMI in the ED among adult patients presenting with mental health concerns. Methods: A retrospective chart review was performed on all patients age 18 and older who presented to the ED at Victoria Hospital, London Health Sciences Centre between October 1, 2014 and April 30, 2015, who were subsequently referred to psychiatry by the EP. The primary outcome was the number of patients transferred to a medicine or surgery inpatient unit for treatment of their SMI within seven days of psychiatry admission from the ED. Results: 1,255 patients were referred to psychiatry during the study period. 803 patients were admitted and 452 were discharged. Of the admitted patients, 14/803 patients (1.7%) met our primary outcome. The mean age of patients in the SMI group (n=14) was 64 years. The mean age in the non-SMI group (n=1,241) was 38. In the SMI group, 3/14 patients died, 2/14 patients required an ICU admission, and 2/14 patients underwent a surgery for their missed SMI. The average length of psychiatry admission prior to transfer was 3.7 days. The average length of medical/surgical admission after transfer from psychiatry was 8.3 days. Undetected diagnoses included NSTEMI, serotonin syndrome, lithium toxicity, thoracic aortic aneurysm, gastrointestinal stromal tumour, forearm abscess, Parkinsonian crisis, and others. Conclusion: This chart review demonstrated a 1.7% rate of undetected serious medical illness in patients who presented to the ED with mental health concerns. Adverse outcomes included death, ICU admissions, and surgeries. This rate is similar to other studies on the topic. The SMI group tended to be older than the non-SMI group. This research may have implications on the appropriate workup and disposition of elderly patients presenting to the ED with mental health concerns.

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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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Cotton, Sue M., Annemarie Wright, Meredith G. Harris, Anthony F. Jorm, and Patrick D. Mcgorry. "Influence of Gender on Mental Health Literacy in Young Australians." Australian & New Zealand Journal of Psychiatry 40, no. 9 (September 2006): 790–96. http://dx.doi.org/10.1080/j.1440-1614.2006.01885.x.

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Objectives: To determine the effects of gender on mental health literacy in young people between 12 and 25 years of age. Design: Computer-Assisted Telephone Interviewing was employed to conduct a crosssectional structured interview focusing on young people's awareness of depression and psychosis. Participants: The sample comprised 1207 young Australians (539 males and 668 females) between the ages of 12-25 recruited from two metropolitan and two regional areas within Victoria. Six hundred and six respondents were presented a depression vignette and 601 were presented a psychosis vignette. Results: Female respondents (60.7%) were significantly more likely to correctly identify depression in the vignette as compared to male respondents (34.5%). No significant gender differences were noted for the psychosis vignette. Males were less significantly likely to endorse seeing a doctor or psychologist/counsellor for the treatment of psychosis. Males were also significantly more likely than females to endorse alcohol as a way of dealing with depression and antibiotics as useful for dealing with psychosis. Conclusion: Gender differences in mental health literacy are striking. Males showed significantly lower recognition of symptoms associated with mental illness and were more likely endorse the use alcohol to deal with mental health problems. Such factors may contribute to the delays in help seeking seen in young males. Further research is needed to delineate how these gender differences in young people may obstruct help seeking, early intervention and other aspects of mental health service delivery.

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McCauley-Elsom, Kay, and Jayashri Kulkarni. "Managing Psychosis in Pregnancy." Australian & New Zealand Journal of Psychiatry 41, no. 3 (March 2007): 289–92. http://dx.doi.org/10.1080/00048670601172798.

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Objective: This article provides an introduction to the complex issues surrounding the management of women who have a history of psychosis and who become pregnant. Balancing the mental wellbeing of the woman and the safety and wellbeing of the baby is a complex task for both the expectant mother and the health professionals involved in her care. Clinical picture: Within this article the complexity of the issues will be outlined as a case report of a woman with a history of psychotic related disorders, who was also pregnant. Treatment: The woman was being case managed by a Mental Health Service in Victoria, Australia, and was included on the National Register of Antipsychotic Medications in Pregnancy Register (NRAMP) recently established at the Alfred Psychiatry Research Centre (APRC). Outcome: The profile of women with a history of previous mental illness, and who are pregnant, often includes a poor psychosocial history and involvement with child protection agencies with regard to custody of the children. Well meant but poorly coordinated decisions by health professionals result in sub-optimal outcomes for both mother and infant. Conclusion: There is a need for the exploration of the management and experiences of women who have a history of psychosis and who are pregnant. This case example highlights the complexity of issues surrounding the management of this vulnerable group of women and their babies.

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Turner, Trevor. "Rich and mad in Victorian England." Psychological Medicine 19, no. 1 (February 1989): 29–44. http://dx.doi.org/10.1017/s0033291700011004.

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SynopsisClinical analyses of 19th century psychiatric practice have been limited by the paucity of available records. Using the richly detailed casebooks of Ticehurst House Asylum, it was possible to study over 600 admissions and assess them using the Research Diagnostic Criteria. Over 80% of cases conformed to recognizable psychiatric illness, mainly schizophrenia and manicdepressive psychosis. Movement disorder, often equivalent to tardive dyskinesia, was noted in nearly one-third of schizophrenics. Violence, masturbation and severe psychopathology were also common features. The implications of these findings in terms of treatment, diagnosis and the rise of the asylum are discussed.

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Davidson, Sandra K., Helena Romaniuk, Patty Chondros, Christopher Dowrick, Jane Pirkis, Helen Herrman, Susan Fletcher, and Jane Gunn. "Antidepressant treatment for primary care patients with depressive symptoms: Data from the diamond longitudinal cohort study." Australian & New Zealand Journal of Psychiatry 54, no. 4 (January 20, 2020): 367–81. http://dx.doi.org/10.1177/0004867419898761.

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Background: In light of emerging evidence questioning the safety of antidepressants, it is timely to investigate the appropriateness of antidepressant prescribing. This study estimated the prevalence of possible over- and under-treatment with antidepressants among primary care attendees and investigated the factors associated with potentially inappropriate antidepressant use. Methods: In all, 789 adult primary care patients with depressive symptoms were recruited from 30 general practices in Victoria, Australia, in 2005 and followed up every 3 months in 2006 and annually from 2007 to 2011. For this study, we first assessed appropriateness of antidepressant use in 2007 at the 2-year follow-up to enable history of depression to be taken into account, providing 574 (73%) patients with five yearly assessments, resulting in a total of 2870 assessments. We estimated the prevalence of use of antidepressants according to the adapted National Institute for Health and Care Excellence guidelines and used regression analysis to identify factors associated with possible over- and under-treatment. Results: In 41% (243/586) of assessments where antidepressants were indicated according to adapted National Institute for Health and Care Excellence guidelines, patients reported not taking them. Conversely in a third (557/1711) of assessments where guideline criteria were unlikely to be met, participants reported antidepressant use. Being female and chronic physical illness were associated with antidepressant use where guideline criteria were not met, but no factors were associated with not taking antidepressants where guideline criteria were met. Conclusions: Much antidepressant treatment in general practice is for people with minimal or mild symptoms, while people with moderate or severe depressive symptoms may miss out. There is considerable scope for improving depression care through better allocation of antidepressant treatment.

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Renvoize, Edward B., and Allan W. Beveridge. "Mental illness and the late Victorians: a study of patients admitted to three asylums in York, 1880–1884." Psychological Medicine 19, no. 1 (February 1989): 19–28. http://dx.doi.org/10.1017/s0033291700010990.

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SynopsisThe case histories of the patients newly admitted to the Retreat Asylum in York between 1880–1884 were examined. Most patients were aged under 50 years, single and non-Quaker, and a majority satisfied the Research Diagnostic Criteria for a diagnosis of schizophrenia or affective disorder. It was found that 72·9% of the patients were deluded, the most common delusions being of persecution, grandeur and guilt; in 34·9% of the deluded patients, the delusion had a religious content. Suicidal ideation was recorded in the case records of 31·4% of the patients. Drug therapy was commonly prescribed, a history of assault on other patients or asylum staff was recorded in 38·1% of the patients, and 11% of patients were force fed at some stage during their illness. Within a year of admission 49·1% of the patients were discharged, the prognosis being better for patients with an affective illness than for schizophrenia, but 31·4% remained in the asylum for five or more years.The characteristics, alleged causes of mental illness, and treatment and outcome of the Retreat patients were compared with those of patients admitted during the same period to the two other York asylums which served different socio-economic groups of the population. Mortality rates were higher in the asylum admitting mainly pauper patients, and possible reasons for this are explored.

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Vine, Ruth, Holly Tibble, Jane Pirkis, Matthew Spittal, and Fiona Judd. "The impact of substance use on treatment as a compulsory patient." Australasian Psychiatry 27, no. 4 (June 10, 2019): 378–82. http://dx.doi.org/10.1177/1039856219852286.

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Objectives: This paper considers the impact of having a diagnosis of substance use disorder on the utilisation of compulsory orders under the Victorian Mental Health Act (2014). Methods: We analysed the subsequent treatment episodes over 2 years of people who had been on a community treatment order for at least 3 months and determined the odds of a further treatment order if there was a diagnosis of substance use at or about the time the index community treatment order ended. Results: An additional diagnosis of a substance use disorder was coded in 47.7% and was associated with significantly increased odds of a subsequent treatment order in the following 2 years for those with a main diagnosis of schizophrenia (AOR = 3.03, p<0.001) and ‘other’ disorders (AOR = 11.60, p=0.002). Those with a main diagnosis of mood disorder had a significant increase in odds for an inpatient treatment order if there was an additional substance use disorder diagnosis (AOR = 3.81, p=0.006). Conclusions: Having an additional diagnosis of substance use disorder was associated with increased likelihood of being placed on an order. This study supports greater emphasis being given to treatment of substance use concurrently with that of mental illness.

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Taylor, Steven J. "Children, poverty and mental health in rural and urban England (1850–1907)." Rural History 31, no. 2 (October 2020): 151–64. http://dx.doi.org/10.1017/s0956793319000372.

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Abstract Over the course of the nineteenth century children increasingly became social, economic and scientific concerns. Their physical and mental well-being was deemed intrinsic to the future development of Britain and its Empire, and thus maintaining healthy youngsters was, by the turn of the twentieth century, considered a national priority. This article explores the interconnectivity between poverty and the child residents of pauper lunatic asylums in England. It draws on a corpus of extant patient case files from four pauper lunatic asylums between 1851 and 1907 and engages with detailed information about the children and their mental conditions. Additionally, there will be a focus on understanding family backgrounds, parental occupations, the correlation between diagnoses and class, and methods of ‘treatment’ designed to equip children for independent working lifestyles. The overarching objective is to consider the socio-economic ramifications of child mental illness for parents and families and better understand how Victorian institutions accommodated this specific class of patient.

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Sanders, Rachael. "Understanding Troubled Minds: A Guide to Mental Illness and Its Treatment (2nd edition) Sidney Bloch (2011). Victoria, Australia: Melbourne University Press, ISBN 978 0 522 85754 2, 371 pp." Children Australia 37, no. 1 (March 2012): 49–50. http://dx.doi.org/10.1017/cha.2012.9.

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Donovan, Stephen, and Matthew Rubery. "Amateur Lunatics: Investigative Journalism, Asylum Reform, and the Undercover Authorship of Lewis Wingfield." Victorian Literature and Culture 50, no. 4 (2022): 721–55. http://dx.doi.org/10.1017/s1060150321000152.

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This essay examines the literary career of Anglo-Irish peer Lewis Strange Wingfield (1842-1891) in relation to the rise of investigative journalism and Victorian debates over the treatment of mental illness. Situating his work in the context of the first covert investigations into asylums in Britain and the United States, it focuses on Wingfield's use of disguise to infiltrate a private London asylum for the purpose of researching his novel Gehenna; or, Havens of Unrest (1882). Wingfield's pioneering experiment in undercover authorship, we argue, sheds new light on investigative journalism's impact on both the form and thematics of the nineteenth-century realist novel.

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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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Garvey, William, Rachel Schembri, Frank Oberklaid, and Harriet Hiscock. "A health-education intervention to improve outcomes for children with emotional and behavioural difficulties: protocol for a pilot cluster randomised controlled trial." BMJ Open 12, no. 6 (June 2022): e060440. http://dx.doi.org/10.1136/bmjopen-2021-060440.

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IntroductionOne in seven (14%) children aged 4–17 years old meet criteria for a mental illness over a 12-month period. The majority of these children have difficulty accessing clinical assessment and treatment despite evidence demonstrating the importance of early intervention. Schools are increasingly recognised as universal platforms where children with mental health concerns could be identified and supported. However, educators have limited training or access to clinical support in this area.Methods and analysisThis study is a pilot cluster randomised controlled trial of a co-designed health and education model aiming to improve educator identification and support of children with emotional and behavioural difficulties. Twelve Victorian government primary schools representing a range of socio-educational communities will be recruited from metropolitan and rural regions, with half of the schools being randomly allocated to the intervention. Caregivers and educators of children in grades 1–3 will be invited to participate. The intervention is likely to involved regular case-based discussions and paediatric support.Ethics and disseminationInformed consent will be obtained from each participating school, educator and caregiver. Participants are informed of their voluntary participation and ability to withdrawal at any time. Participant confidentiality will be maintained and data will be secured on a password protected, restricted access database on the Murdoch Children’s Research Institute server. Results will be disseminated via peer-reviewed journals and conference presentations. Schools and caregivers will be provided with a report of the study outcomes and implications at the completion of the study.Trial registration numberACTRN12621000652875.

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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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Schooler, Nina R. "Pharmacologic Treatment for Mental Illness." Contemporary Psychology: A Journal of Reviews 35, no. 6 (June 1990): 585–86. http://dx.doi.org/10.1037/028709.

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Kesic, Dragana, Stuart D. M. Thomas, and James R. P. Ogloff. "Mental Illness Among Police Fatalities in Victoria 1982–2007: Case Linkage Study." Australian & New Zealand Journal of Psychiatry 44, no. 5 (May 2010): 463–68. http://dx.doi.org/10.3109/00048670903493355.

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Mclaren, Stuart, and John Cookson. "COMMUNITY TREATMENT ORDERS FOR MENTAL ILLNESS." Lancet 334, no. 8677 (December 1989): 1457. http://dx.doi.org/10.1016/s0140-6736(89)92067-9.

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Singh, A. "Treatment of mental illness in India." Canadian Medical Association Journal 176, no. 13 (June 19, 2007): 1862. http://dx.doi.org/10.1503/cmaj.1070045.

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Ward, Martha C., and Benjamin G. Druss. "Treatment Considerations in Severe Mental Illness." JAMA Psychiatry 76, no. 7 (July 1, 2019): 759. http://dx.doi.org/10.1001/jamapsychiatry.2019.0903.

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Clapperton, Angela, Stuart Newstead, Charlotte Frew, Lyndal Bugeja, and Jane Pirkis. "Pathways to Suicide Among People With a Diagnosed Mental Illness in Victoria, Australia." Crisis 41, no. 2 (March 2020): 105–13. http://dx.doi.org/10.1027/0227-5910/a000611.

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Abstract. Background: People who have mental illness are at increased risk of suicide. Therefore, identifying "typical" trajectories to suicide in this population has the potential to improve the effectiveness of suicide prevention strategies. Aim: The aim of this study was to explore the pathways to suicide among a sample of Victorians with a diagnosed mental illness. Method: Victorian Suicide Register (VSR) data were used to generate life charts and identify typical life trajectories to suicide among 50 Victorians. Results: Two distinct pathways to suicide were identified: (1) where diagnosis of mental illness appeared to follow life events/stressors; and (2) where diagnosis appeared to precede exposure to life events/stressors. Some events acted as distal factors related to suicide, other events were more common as proximal factors, and still others appeared to act as both distal and proximal factors. Limitations: The data source might be biased because of the potential for incomplete information, or alternatively, the importance of some factors in a person's life may have been overstated. Conclusion: Strategies to reduce suicide need to consider the chronology of exposure to stressors in people's lives and clearly need to be different depending on whether proximal or distal risk factors are the target of a given strategy or intervention.

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Clapperton, Angela, Stuart Newstead, Lyndal Bugeja, and Jane Pirkis. "Differences in Characteristics and Exposure to Stressors Between Persons With and Without Diagnosed Mental Illness Who Died by Suicide in Victoria, Australia." Crisis 40, no. 4 (July 2019): 231–39. http://dx.doi.org/10.1027/0227-5910/a000553.

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Abstract. Background: Mental illness is an established risk factor for suicide. To develop effective prevention interventions and strategies, the demographic characteristics and stressors (other than, or in addition to, mental illness) that can influence a person's decision to die by suicide need to be identified. Aim: To examine cases of suicide by the presence or absence of a diagnosed mental illness (mental illness status) to identify differences in factors associated with suicide in the groups. Method: Logistic regression analyses were used to investigate mental illness status and exposure to stressors among 2,839 persons who died by suicide in Victoria, Australia (2009–2013), using the Victorian Suicide Register. Results: Females, metropolitan residents, persons treated for physical illness/injury, those exposed to stressors related to isolation, family, work, education, and substance use and those who had made a previous suicide attempt had increased odds of having a diagnosed mental illness. Employed persons had decreased odds of having a diagnosed mental illness. Limitations: The retrospectivity of data collection as well as the validity and reliability of some of the data may be questionable owing to the potential for recall bias. Conclusion: The point of intervention for suicide prevention cannot always be a mental health professional; some people who die by suicide either do not have a mental illness or have not sought help.

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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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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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Wallace, Cameron, Paul E. Mullen, Philip Burgess, Simon Palmer, David Ruschena, and Chris Browne. "Serious criminal offending and mental disorder." British Journal of Psychiatry 172, no. 6 (June 1998): 477–84. http://dx.doi.org/10.1192/bjp.172.6.477.

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BackgroundA relationship exists between mental disorder and offending behaviours but the nature and extent of the association remains in doubt.MethodThose convicted in the higher courts of Victoria between 1993 and 1995 had their pyschiatric history explored by case linkage to a register listing virtually all contacts with the public psychiatric services.ResultsPrior psychiatric contact was found in 25% of offenders, but the personality disorder and substance misuse accounted for much of this relationship. Schizophrenia and affective disorders were also over-represented, particularly those with coexisting substance misuse.ConclusionsThe increased offending in schizophrenia and affective illness is modest and may often be mediated by coexisting substance misuse. The risk of a serious crime being committed by someone with a major mental illness is small and does not justify subjecting them, as a group, to either increased institutional containment or greater coercion.

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McFadyen, John. "Assertive community treatment and severe mental illness." British Journal of Community Health Nursing 1, no. 5 (September 1996): 295–99. http://dx.doi.org/10.12968/bjch.1996.1.5.7359.

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Holmes, Alex, Mark Hodge, Simon Lenten, John Fielding, David Castle, Dennis Velakoulis, and Gail Bradley. "Chronic Mental Illness and Community Treatment Resistance." Australasian Psychiatry 14, no. 3 (September 2006): 272–76. http://dx.doi.org/10.1080/j.1440-1665.2006.02284.x.

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Gove, W. R. "Mental Illness and Psychiatric Treatment Among Women." Psychology of Women Quarterly 34, no. 3 (September 1, 2010): 345–62. http://dx.doi.org/10.1111/j.1471-6402.2010.tb01109.x.

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FLYNN, WILLIAM R. "Treatment and Rehabilitation of Severe Mental Illness." American Journal of Psychiatry 161, no. 5 (May 2004): 937. http://dx.doi.org/10.1176/appi.ajp.161.5.937.

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Saddichha, S. "Who decides on treatment for mental illness?" BMJ 337, jul22 3 (July 22, 2008): a899. http://dx.doi.org/10.1136/bmj.a899.

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Merrens, Matthew R. "Treatment and Rehabilitation of Severe Mental Illness." Psychiatric Services 56, no. 2 (February 2005): 224. http://dx.doi.org/10.1176/appi.ps.56.2.224.

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Watson, J. P. "COMPULSORY TREATMENT EARLY IN SEVERE MENTAL ILLNESS." Lancet 327, no. 8488 (May 1986): 1037. http://dx.doi.org/10.1016/s0140-6736(86)91309-7.

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Arehart-Treichel, Joan. "Mental Illness Treatment Still Elusive for Many." Psychiatric News 40, no. 14 (July 15, 2005): 10–11. http://dx.doi.org/10.1176/pn.40.14.00400010.

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Matthews, Alicia K., Patrick W. Corrigan, Barbara M. Smith, and Frances Aranda. "A Qualitative Exploration of African-Americans' Attitudes Toward Mental Illness and Mental Illness Treatment Seeking." Rehabilitation Education 20, no. 4 (October 1, 2006): 253–68. http://dx.doi.org/10.1891/088970106805065331.

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Siegloff, Shari, and Rosalie Aroni. "Mental illness and "self"-management in rural Australia: caregivers' perspectives." Australian Journal of Primary Health 9, no. 3 (2003): 90. http://dx.doi.org/10.1071/py03029.

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Current models of chronic disease self-management incorporate an understanding that people with chronic illnesses, their carers and clinicians need to work together in addressing illness management issues (Von Korff, Gruman, Schaefer, Curry, & Wagner, 1997) and that this process enhances personal control of health (Lorig, Ritter et al., 2000). The question we ask is whether the understandings in these models, both implicit and explicit, apply to those people living with mental illness in rural areas in Australia. In-depth interviews were used to explore and examine the way in which carers of people living with mental illness in rural Victoria experienced and perceived the nature of chronic disease self-management. Our findings indicate that illness management in rural areas occurs predominantly as a partnership between the person with mental illness and the family members who act as caregivers, rather than a partnership with health professionals. This confirms that the lack of resources in the rural mental health care system results in a crisis-oriented service rather than a service that is able to respond to preventative and ongoing mental health care. This is recognised as a considerable burden for many families and requires further examination. In addition, a finding of considerable clinical and policy importance in this arena is the experience of family caregivers as partners in not only the support of the ?management? aspects of self-management of mental illness, but also in supporting the person living with mental illness in the maintenance of the ?self? aspect of self-management.

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Marino, Raul, and G. Rees Cosgrove. "NEUROSURGICAL TREATMENT OF NEUROPSYCHIATRIC ILLNESS." Psychiatric Clinics of North America 20, no. 4 (December 1997): 933–43. http://dx.doi.org/10.1016/s0193-953x(05)70353-1.

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Levine, Bruce E. "Mental Illness or Rebellion?" Ethical Human Psychology and Psychiatry 7, no. 2 (June 2005): 125–29. http://dx.doi.org/10.1891/1559-4343.7.2.125.

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The rate of emotional difficulties and self-destructive behaviors has increased since the advent of the Industrial Revolution, with dramatic deterioration in the last generation. In attempting to understand root causes of our malaise, common sense tells us that rather than focus on our genes, which have not changed, we should focus on society, which has significantly changed. It is argued here that much of what we call mental illness is essentially a rebellion—more often passive rather than active—against an increasingly dehumanizing society in which consumption, production, and technology are worshipped at the expense of life. It is also argued that society, including mental health treatment, has become radically industrialized and commercialized, resulting in a loss of historical antidotes to emotional malaise such as autonomy, meaning, and community.

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Orchard, Christa, Nancy Carnide, Cameron Mustard, and Peter M. Smith. "Prevalence of serious mental illness and mental health service use after a workplace injury: a longitudinal study of workers’ compensation claimants in Victoria, Australia." Occupational and Environmental Medicine 77, no. 3 (January 2, 2020): 185–87. http://dx.doi.org/10.1136/oemed-2019-105995.

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ObjectivesSerious mental illness is common among those who have experienced a physical workplace injury, yet little is known about mental health service use in this population. This study aims to estimate the proportion of the workplace musculoskeletal injury population experiencing a mental illness, the proportion who access mental health services through the workers’ compensation system and the factors associated with likelihood of accessing services.MethodsA longitudinal cohort study was conducted with a random sample of 615 workers’ compensation claimants followed over three survey waves between June 2014 and July 2015. The primary outcome was receiving any type of mental health service use during this period, as determined by linking survey responses to administrative compensation system records for the 18 months after initial interview.ResultsOf 181 (29.4%) participants who met the case definition for a serious mental illness at one or more of the three interviews, 75 (41.4%) accessed a mental health service during the 18-month observation period. Older age (OR=0.96, 95% CI 0.93 to 0.99) and achieving sustained return to work (OR=0.27, 95% CI 0.11 to 0.69) were associated with reduced odds of mental health service use. Although not significant, being born in Australia was associated with an increased odds of service use (OR=2.23, 95% CI 0.97 to 5.10).ConclusionsThe proportion of injured workers with musculoskeletal conditions experiencing mental illness is high, yet the proportion receiving mental health services is low. More work is needed to explore factors associated with mental health service use in this population, including the effect of returning to work.

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Widge, Alik S. "Deep Brain Stimulation for Treatment-Resistant Mental Illness." Psychiatric Annals 52, no. 7 (July 2022): 283–87. http://dx.doi.org/10.3928/00485713-20220621-02.

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Kane, Micki. "Deep Brain Stimulation in Treatment of Mental Illness." Neuroscience and Neurological Surgery 1, no. 1 (February 11, 2017): 01–02. http://dx.doi.org/10.31579/2578-8868/002.

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Kane, Micki. "Deep Brain Stimulation in Treatment of Mental Illness." Neuroscience and Neurological Surgery 1, no. 1 (February 11, 2017): 01–02. http://dx.doi.org/10.31579/2578-8868/053.

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Journal articles on the topic 'Mental illness Treatment Victoria'

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