Academic literature on the topic 'South Australia People with mental disabilities'

The stigmatisation, control, criminalisation and incarceration of people with disability have a long history. While in recent decades there has been increasing commitment to the rights of people with disabilities by governments in western nations, the over-representation of people with mental and cognitive disability in criminal justice systems has continued. Although there are similarities amongst Western jurisdictions in regard to the treatment of people with disability in justice systems, there are particularities in Australia that will be drawn out in this article. We argue that disadvantaged people with mental and cognitive disability are being managed by and entrenched in criminal justice systems across Australia’s six states and two territories, including so-called diversionary and therapeutic measures that appear to accommodate their disability. In the absence of early and appropriate diagnosis, intervention and support in the community, some disadvantaged and poor persons with mental and cognitive disability, in particular Indigenous Australians, are being systematically criminalised. Criminal justice agencies and especially youth and adult prisons have become normalised as places of disability management and control. Drawing on research that focuses in detail on the jurisdictions of the Northern Territory and New South Wales, we argue for a reconstruction of the understanding of and response to people with these disabilities in the criminal justice system.

This paper explores issues relating to access to physical and mental health care for people with mental health problems in light of Australia’s endorsement in 2008 of the Convention of the Rights of Persons with Disabilities, which established the right to health and to health care. Interviews were conducted with 10 key stakeholders with legal, policy, clinical and advocacy roles within South Australia and at a national and international level. Participants identified several barriers to the achievement of the right to health for people with mental illness, with discussion highlighting the legal definition of rights, governance of health and mental health, and structural barriers to receipt of care as the primary barriers. The data are explored in relation to social models of disability.

Leaving statutory out-of-home care (OOHC) is a challenging time for many young people; however, certain groups have greater difficulty transitioning to independence. This includes young people with multiple and complex needs, such as those suffering from mental health problems and disabilities, as well as young people with borderline conditions or who disengage from services. The aim of this study was to gain a deeper understanding of the service issues pertaining to these vulnerable groups in South Australia, as well as to identify ways that policy and practice can be enhanced to better facilitate service engagement. Twenty-nine individual interviews and focus groups were conducted with people working in organisations who have knowledge of, or contact with, young people leaving care (N = 66). Thematic analysis was used to organise responses according to two overarching themes: (1) Issues with current leaving care services and preparation, and (2) Enhancing policy and practice. The principal challenges related to difficulties in matching the structure of formal services to a population with highly unstructured living arrangements, a history of problematic engagement with the care system, and difficulties arising due to service ineligibility issues. Potential improvements to the current system and program delivery are discussed.

Human awareness of plants in Australia goes back 50,000 years when the aboriginal first began using plants to treat, clothe and feed themselves. The European influence came in 1778 with the First Fleet landing in New South Wales. Australia's earliest records of using horticulture for therapy and rehabilitation were in institutions for people with intellectual disabilities or who were incarcerated. Eventually, legislation created greater awareness in the government and community for the needs of persons with disabilities, and many worthwhile projects, programs and organizations were established or gained greater recognition. Horticultural therapy programs may be found in nursing homes, rehabilitation centers, adult training support services, hospitals, day centers, community centers and gardens, educational institutions, supported employment, and the prisons system. This article reviews the history and development of Australian horticulture as a therapy in the treatment of disabilities and social disadvantaged groups, and includes an overview of programs offered for special populations and of Australia's horticultural therapy associations. It also discusses opportunities for research, teaching and extension for horticultural therapy in Australia.

We are old age psychiatrists; T.A. based in Britain, J.S. in Australia. A return visit by T.A. to Australia allowed us to focus attention on differences between the two countries in their provision of long-term care for old people with mental disabilities. What works well? What constrains development?

The closure of large psychiatric institutions has led to alternative accommodation being developed for people with long-term psychiatric disabilities, with an emphasis on group living. Despite this, very little is known about where these people live, about the accommodation needs of this group, or whether men and women have differing needs. This paper examines the accommodation of all people with long-term and severe psychiatric disabilities in one South London borough who were in contact with a specialist service. It was found that the majority of people either live with their families – although the family member differed for men and women – or live alone. Men were more likely than women to live in hostels or alone, while women were more likely than men to live with their families.

ObjectiveThe aim of this study was to describe the current state of carer engagement and partnership in two mental health (MH) services in South Australia and the implementation of the six partnership standards in A Practical Guide to Working with Carers of People with a Mental Illness. MethodsAnonymous surveys of carer experiences and clinician self-ratings of their own practice against the six partnership standards were completed by 94 staff and 58 carers within public and private MH in-patient units before and after exposure of clinicians to education about the partnership standards. Descriptive statistical analysis was performed and, where applicable, a comparative analysis used the two-sample Z-test of proportions. Qualitative data was analysed thematically. ResultsConsiderable gaps were evident between carer experiences and clinician self-ratings of their own practice. Overall, the surveys point to the lack of a consistent approach by both public and private services, and suggest potential barriers to fostering carer participation and engagement. Confidentiality was a particularly noted barrier to partnership with carers. ConclusionSignificant improvement is needed to meet the partnership standards. Brief exposure to the Guide is not, in itself, sufficient to effect change in the overall attitudes, skills and knowledge of clinical staff about engaging carers. Significantly more focus on staff education, clinical discussions and supervision is needed to meet the MH carer partnership standards. What is known about the topic?Partnership with MH consumers and carers is an established key principle within national MH policies and accreditation standards. Family carers play an important role in supporting consumers’ recovery, yet many carers continue to report being excluded, particularly by in-patient clinical staff. What does this paper add?This is the first study to investigate the partnership standards in practice by comparing the perspectives of carers and in-patient MH clinical staff. What are the implications for practitioners?Improving partnership with carers of people with mental illness will require significant MH service leadership support shifts in current practice and culture. In addition, a more nuanced understanding of confidentiality is required to overcome the barriers to involving family carers more meaningfully in care.

We aimed to evaluate the impacts of disability on the diagnosis, treatment, and prognosis of bile duct cancer (BDC) according to the severity and type of disability. Patients diagnosed with BDC were selected from an age- and sex-matched population (1:3 ratio) with or without disabilities from the National Disability Database, the Korean Central Cancer Registry, and the Korean National Health Insurance claims database. The cohort included 15,065 patients with BDC, with a significantly lower rate in those with severe disabilities than in people without or with mild disabilities (110.6 vs. 136.5 vs. 147.6 per 105 persons, respectively). People with severe disabilities were diagnosed with BDC at an earlier age but were less likely to undergo surgery (adjusted odds ratio (aOR) = 0.52, 95% confidence interval (CI): 0.45–0.61) or chemotherapy (aOR = 0.76, 95% CI: 0.61–0.95) compared to those without disabilities. This trend was more evident in patients with mental disabilities. The overall and cancer-specific mortality rates were higher in patients (especially women) with disabilities than in those without. There needs systemic approach to ensure equal access to quality cancer care for people with disabilities.

For a long time the rights of disabled persons have been ignored worldwide. A major obstacle faced by disabled persons is discrimination in the workplace. Due to the development of a social approach to disability and the efforts of the Disability Rights Movement, legislation has been passed throughout the world to improve this dire situation. The thesis considers the efficacy of some of these statutes. It is concluded that stigma and negative stereotypes remain a constant hurdle in overcoming discrimination. The forthcoming UN Disability Convention is demonstrative of the recognition of the importance of the needs and rights of disabled people. The convention proposes some innovative measures to overcome stigma and stereotyping. Mental health problems constitute one of the leading causes of disability. The thesis explores how people with mental health problems fit within the concept of people with disabilities and whether they are included in anti-discrimination legislation and affirmative action measures. Special attention is given to statutory definitions of disability, the different forms of discrimination and the concept of reasonable accommodation. A comparative approach is taken to analyse how South Africa's disability law measures up against that of Britain and Australia in terms of its substantive provisions and enforcement thereof. In considering the South African position American and Canadian jurisprudence is consulted in order to aid in interpretation. It is concluded that although South Africa has a comparatively good legislative framework, it is held back by an overly restrictive and medically focused definition of disability. As a result many individuals with mental health difficulties, desirous of obtaining and retaining employment may be excluded from protection against discrimination in the workplace. It is argued that it will be necessary either to amend the Employment Equity Act or for the courts to adhere strictly to the concept of substantive equality in order to ensure that the rights and dignity of people with mental health difficulties are adequately protected.

Thesis (Ph.D.) -- La Trobe University, 2008.
Research. "A thesis submitted in total fulfilment of the requirements for the degree of Doctor of Philosophy [to the] School of Social Work and Social Policy, Faculty of Health Sciences, La Trobe University, Bundoora". Includes bibliographical references (leaves 302-318)

The meaning of caregiving for a relative with mental illness has been explored in many research studies: however, there is a lack of studies on the caregiving experience within the Egyptian culture. This study aimed at getting closer to Egyptian families caring for a relative with mental illness in Australia in order to reveal how these families live and cope with mental illness, their attitudes, their beliefs and practices and how the experience affected them. Qualitative hermeneutic phenomenology informed by the work of Heidegger was used. Seven participants from Egyptian background, caring for a relative with mental illness participated and all interviews were audio-taped. Interviews were conducted in the Arabic language and were then translated and transcribed into English. All interviews were compared and five common themes were identified. Why did it happen?: How do I protect my loved ones?: What has it done to me?: What has it done to us?: and How do I survive? Findings of the study have the potential to raise health care professionals’ awareness of the needs of Egyptian families, their beliefs, values and coping with mental illness. Strengths and limitations of the study are also presented to inform future research
Doctor of Philosophy (PhD)

The purpose of the study was to examine the experiences of both people with disabilities and elderly people and to identify their perceptions of quality as it relates to living in a service or being supported by a service to live in the community. The study was naturalistic in design and used a phenomenological approach and inductive analysis. It involved immersion in living services for a two year period, in-depth interviews with people living and working in services and participant observation. Fifty service users between the ages of twenty-one and ninety-six, and twenty-six service workers between the ages of twenty-six and fifty-four were informants in the study. The study comprised of three phases, the first phase involved repeated in-depth interviews with service users in two disability and two aged care living services to examine the experiences of people living in services and their perceptions of quality. As a result of the consistency with which relationships with key staff members emerged in the context of quality experiences, selected service workers who were named by service users were also interviewed. The findings in this phase indicated that relationships experienced by service users in their encounters with service workers were more significant in service users' evaluation of quality than tangible acts of physical and environmental care. Relational experiences of people living in services were variable. Some informants experienced consistent validation and socio-emotional support, whilst others experienced role distancing and negative communication experiences. Service workers who were interviewed as a result of being identified by service users in the context of quality, attached importance to the relational domain in the acts and behaviours of providing a service. They also attached personal meaning to their roles as service workers and shared the view that their role as service worker was underpinned by an ethos of communality. The second phase of the study involved accessing another five disability and five aged care services to collect further data to support or refute the findings from phase one. As a result a large data bank was established to confirm the consistency with which relational experiences in living services were linked to perceptions of quality by both service users and service providers. Acts and behaviours which were consistently present in the context of quality were also identified and the need for emotional support in the living context was further confirmed. The third phase of the study involved an in-depth analysis and identification of commonly experienced categories of relationships between service users and workers. Relationships were categorised into ethical and technical living service experiences and exemplars used to illustrate findings. Data analysis indicated that service experiences lie on a continuum, with mutually supportive relationships between service users and workers at one end, and physical and psychological abuse at the other. Experiences were variable in singular service contexts. This highlighted the individual nature of service relationships between service users and workers and the need to articulate human service as relationship. It also highlighted the inadequacies of using standard measures to evaluate quality in living services.

This research was undertaken within the broader concept of Corporate Social Investments and how this concept is integrated within the context of staff retention and what this means for business and creating employment opportunities for people with disabilities. Illustrated through the description of CSI literature and intending to explain the link between CSI and employee retention, research questions presented as part of the outcomes for the research examines notion that there is a relationship between Corporate Social Investment and Employee Retention. Reference to the case study "Rhodes / Kuyasa Partnership" illustrates how such partnerships attempt to create opportunities for the community, the organisation, people with disabilities and employees at large. The case study was written to be used as a teaching case study in the context of Human Resources, Business Sustainability and Corporate Social Investment. The effectiveness and viability of the Kuyasa / Rhodes partnership will highlight acceptance and or non acceptance of people with disability by the non-disabled workforce. This case study will highlight CSI linkages that lead to staff retention, higher job satisfaction, lower turnover of staff, enhanced community engagement, creating opportunities that accommodate people with special needs, developing models that can be replicated in other organisations, creating additional opportunities for existing staff. Metcalf (2008:61) suggests that organisations need to ensure that the leadership and organisation culture within organisations is appropriate to engage staff with disabilities and non-disabled staff, and that their most senior managers demonstrate their commitment to develop, and help others develop, in the same way. The Kuyasa Rhodes Partnership may have started off as a Retention Strategy, however has given rise to a social initiative that can be replicated in other enabling organisations. The case study material was acquired through one on one interviews, and a focus group session on the effectiveness with the retention of such employees with intellectual disabilities, internship and mentoring issues, and as well as issues such as affirmative action, and the benefits and shortcomings of staff retention to the organisation. Key stakeholders interviewed for this case study expressed differing view -points, and in particular the benefits and shortcomings of this initiative. The Rhodes Kuyasa initiative appears to have achieved some success in enabling young adults / learners to work in a mainstream working environment by developing employment skills and life skills, and by improving their employment opportunities. Factors critical to the continuation of such initiatives included: the close involvement with both partners (Rhodes and the Kuyasa Special School), the sensitive treatment of the learners, and creating internal departmental partnerships within the Rhodes environment. A selected group of ten learners were mentored and provided with full time employment within the industrial Campus Food Services facility. Discussion that was highlighted in the case study must give consideration to a more investigative approach into overcoming the barriers of discrimination in the workplace and the major barriers to skills development. These have highlighted a number of relatively consistent themes around what were the successful and unsuccessful strategies. Integration of people with disabilities within the Rhodes University service areas has had positive effects for the disabled learner and employee workplace. People with disabilities indicated on how having mainstream employment allowed them to be independent, have a purpose in life and enhance their self worth in their communities and place of employment. Furthermore, being employed had positive repercussions on the person‘s co-workers. By demonstrating their competence, people with disabilities have had significant impact on other people‘s attitudes to disabled persons. Discussions held with the Principal of the Kuyasa Specialised School highlighted the need for crucial planning within special schools for disabled people in the area of transition from school to skills development and work. Skills development guidance is important in ensuring a choice of relevant interventions and obtaining the necessary information. Some staff expressed frustration at being with co-workers who questioned their presence and placement in the kitchen environment. Even though the disabled person was suitably placed they faced stereotypical behaviour and attitudes from their co-workers on what people with disabilities can or cannot do. Staff with intellectual disabilities commented that their co-workers see them as needing constant attention and care and not being capable of working. Some of the staff with disabilities had to work much harder to be recognised by their co-workers and supervisors. Currently few people with disabilities seem to be receiving career guidance while at school, as reflected in the case studies. One person with an intellectual disability described how the intervention of developing a comprehensive school leaving plan, which was then implemented by the school, allowed for good transition from school to Rhodes University. The role of personal factors such as life skills, personal motivation, the desire for personal achievement and a positive attitude were common themes that came out of the focus group. Initiatives to ensure that people accept themselves, their circumstances and are able to express their desires and realise their dreams are important factors. In addressing the barriers, co-worker attitudes make a big difference to how effectively the disabled person is able to participate in the training and employment. The future focus must be enabling and in line with successes and failures in the areas of employee integration in the workplace, life-skills development for people with disabilities. A clear career guidance plan should be developed for all disabled children before they leave school. This plan should include provision of adequate information on different career options and training. The negative attitudes of co-workers and supervisors should be changed by providing training support to ensure that they feel confident to meet the needs of disabled staff. Employers should be providing support and information on how to meet the needs of disabled employees. People with intellectual disabilities are an integral part of the South African population. Business and social enterprises need to have a focused inclusive strategy to integrate people with intellectual disabilities within the South African society to ensure equity and diversity awareness. Working with people with intellectual disabilities has been the focus of this research to ensure long term sustainable employment, CSI and Employment equity. Integrating Corporate Social Investment policies with Human Resources Equity policies are important factors in ensuring that people with intellectual disabilities are a fundamental focus in recruitment and retention strategies within business and social enterprises. Initiatives such as the Kuyasa / Rhodes Partnership are attempting to align to the overall objectives of incorporating people with intellectual disabilities into mainstream work, in particular, with the objective of incorporating people with disabilities in some accessible sections within the organisation. This contributes to the Rhodes University Campus Food Services becoming an example of excellence in the CSI and employee retention field. It is hoped that this teaching case study will make an important contribution to students learning about sustainable business practices, and for business focusing on employment recruitment and retention strategies to integrate people with intellectual disabilities within their organisations.

Thesis (MPhil (Sociology and Social Anthropology))--University of Stellenbosch, 2009.
ENGLISH ABSTRACT: South Africa has transformed its mental health service provision from in-hospital care to community-based rehabilitation. Although the idea is sound, the process places the caregiving families under an immense pressure. The aim of this study was to explore the impact that the de-institutionalisation process has had on the families as they care for their child with intellectual disability. The study was conducted by means of qualitative, unstructured interviews with families that have had a child de-institutionalised from Alexandra Hospital in the Western Cape. All of the patients were diagnosed with a dual diagnosis of intellectual disability and mental illness. Even though the patients were in group-homes or attended a day care centre, final responsibility for the patients lay with the parents. Three main themes emerged from the interviews that describe the impact of deinstitutionalisation, viz. the characteristics of the family member with intellectual disability (aggressive, abusive and self-destructive behaviour of the patient), the effect that these characteristics had on the family (marital stress and health risks to the care giver), and community and resource factors. The study placed the family central to its environment and discussed the impact deinstitutionalisation had on its environment as a whole. It was concluded that the burden that de-institutionalisation places on the families far exceeded their ability to cope with these circumstances. This status quo could be improved if adequate resources and skills are given to families prior to de-institutional
AFRIKAANSE OPSOMMING: In Suid-Afrika is geestesgesondheidsorg van hospitaliserende na gemeenskapsgebaseerde rehabilitasie, omskep. Terwyl hierdie stap wel as lewensvatbaar mag voorkom, plaas die proses ‘n hewige las op die sorggewende gesin. Die doel van hierdie studie was om die omvang van die impak hiervan op ‘n gesin met ’n lid met intellektuele gestremdheid en psiegiatriese siekte, te bepaal – nadat so ‘n pasient uit die inrigting ontslaan is. Die ondersoek is uitgevoer by wyse van kwalitatiewe, ongestruktureerde onderhoude met gesinne wie se lede met die diagnose uitgeplaas is deur die Alexandra Hospitaal in die Wes-Kaap. Elkeen van die pasïente is gediagnoseer met ernstige intellektuele gestremdheid, asook bykomende gedragsafwykings. Ten spyte van die feit dat die betrokke pasïente deur groepshuise of dagsorg eenhede versorg word, bly hulle hul ouers se verantwoordelikheid. Drie temas het ontstaan wat die impak van ontslag uit die inrigting omskryf, te wete die karaktertrekke van die gestremde gesinslid (aggressie, misbruikende en vernielsugtige gedrag van die pasïent), die effek van hierdie karaktertrekke op die gesin (stres op die huwelik en potensiële gesondheidsrisiko wat dit vir die versorger inhou), en die gemeenskap en ondersteunende faktore. Tydens die ondersoek is die gesin sentraal geplaas ten opsigte van die omgewing. Die impak van ontslag van die gediagnoseerde pasïent uit die inrigting op die omgewing as geheel, word bespreek. Daar is tot die slotsom gekom dat die vermoë van die gesin wat die las moet dra as gevolg van die ontslag, ver oorspan word. Hierdie toedrag van sake sou egter verlig kon word indien toereikende hulpbronne en vaardighede aan sulke gesinne beskikbaar gestel word alvorens so ‘n pasïent ontslaan is.

This study examined, within the South African context, the prevalence of mental retardation in a forensic observation setting, and the impediments of and successes to forensic rehabilitation. The results of the study indicated that a significant amount of forensic observation patients (25.16%) are ultimately diagnosed as being mentally retarded, with 39.24 percent of such offenders being found unfit to plead. Further 32.91 percent of the same sample was found to be not responsible for their actions. A link was also drawn between the mentally retarded offender and violent offenses. The advantages and disadvantages of a current rehabilitative process are discussed in light of alternate community-based forms of rehabilitation that are being implemented in other countries, for example the United States of America, with a view towards investigated their usefulness and adaptability to South African circumstances. The findings of the study have implications for mental health professionals working within forensic settings concerning the future management of mentally retarded offenders, particularly within the rehabilitative process .

The aim of this chapter is to contribute to addressing issues of access and equity in social work education for people with mental health disabilities. The objective is to carefully consider the introduction of inherent requirements in universities, and particularly in relation to social work education, in Australia. A targeted review of relevant literature including legislation, policy, and practice standards frameworks identifies the parameters of inherent requirements and possible areas of discrimination. Consideration of the use of inherent requirements in social work education is from a human rights social justice perspective that acknowledges the strength and resources of people and communities and actively advocates for the protection of disability rights.

The aim of this chapter is to contribute to addressing issues of access and equity in social work education for people with mental health disabilities. The objective is to carefully consider the introduction of inherent requirements in universities, and particularly in relation to social work education, in Australia. A targeted review of relevant literature including legislation, policy, and practice standards frameworks identifies the parameters of inherent requirements and possible areas of discrimination. Consideration of the use of inherent requirements in social work education is from a human rights social justice perspective that acknowledges the strength and resources of people and communities and actively advocates for the protection of disability rights.

The MHEC-RAP project involves the innovative application of video conferencing to mental health assessment in rural NSW. The preliminary evaluation findings of the project are presented. Mental health emergencies in rural and remote settings cause particular problems and are not amenable to conventional health service solutions. Patients and local health care staff may be isolated from specialist mental health staff and from acute inpatient services. Decisions to transport patients for specialist assessments or treatment may be required at night or at weekends and may involve families, police, ambulance services and local health staff. Such decisions need to be made promptly but carefully and the ability to obtain a specialist assessment may assist in making a decision about how best to care for the patient bearing in mind the need to provide a responsive, high quality and safe service to patients and local clinicians. In this chapter we examine a novel approach which uses audio-visual technology to conduct remote emergency mental health patient assessment interviews and provide consultations to local clinicians in rural communities in western NSW. The Mental Health Emergency Care – Rural Access Project or ‘MHEC-RAP’ was developed in 2007 following a series of consultations held in rural towns and implemented in 2008 within the Greater Western Area Health Service (GWAHS), New South Wales, Australia. GWAHS is a primary example of a rural and remote health service. It serves 287,481 people (8.3% of whom are Indigenous Australians) in an area that is 445,197sq km or 55% of the state of New South Wales (Australian Bureau of Statistics, 2001; Greater Western Area Health Service, 2007, 2009). The communities within GWAHS are mostly small, the towns are widely dispersed and local services are “limited by distance, expense, transport, and the difficulty of recruiting health professionals to these areas” (Dunbar, 2007 page 587). The chapter focuses on the design of the service, its implementation and its performance in the first year. We conclude with a discussion about the service, its broader relevance, transferability and its sustainability.