Contrasting views and experiences of health professionals on the management of comorbid substance misuse and mental disorders

Objectives: To determine opinions and experiences of health professionals concerning the management of people with comorbid substance misuse and mental health disorders. Method: We conducted a survey of staff from mental health services and alcohol and drug services across Queensland. Survey items on problems and potential solutions had been generated by focus groups. Results: We analysed responses from 112 staff of alcohol and drug services and 380 mental health staff, representing a return of 79% and 42% respectively of the distributed surveys. One or more issues presented a substantial clinical management problem for 98% of respondents. Needs for increased facilities or services for dual disorder clients figured prominently. These included accommodation or respite care, work and rehabilitation programs, and support groups and resource materials for families. Needs for adolescent dual diagnosis services and after-hours alcohol and drug consultations were also reported. Each of these issues raised substantial problems for over 70% of staff. Another set of problems involved coordination of client care across mental health and alcohol and drug services, including disputes over duty of care. Difficulties with intersectoral liaison were more pronounced for alcohol and drug staff than for mental health. A majority of survey respondents identified 13 solutions as practical. These included routine screening for dual diagnosis at intake, and a range of proposals for closer intersectoral communication such as exchanging client information, developing shared treatment plans, conducting joint case conferences and offering consultation facilities. Conclusions: A wide range of problems for the management of comorbid disorders were identified. While solution of some problems will require resource allocation, many may be addressed by closer liaison between existing services.

Can Risk Management boost the supply of Affordable Housing Development and Management?

A shortage of affordable housing is a major problem in Australia today. This is mainly due to the limited supply of affordable housing that is provided by the non-government housing sector. Some private housing developers see the provision of affordable housing for lower income people as a high risk investment which offers a lower return than broader market-based housing. The scarcity of suitable land, a limited government ‘subsidy’, and increasing housing costs have not provided sufficient development incentives to encourage their investment despite the existing high demand for affordable housing. This study analyses the risk management process conducted by some private and not-for-profit housing providers in South East Queensland, and draws conclusions about the relationship between risk assessments/responses and past experiences. In-depth interviews of selected non-government housing providers have been conducted to facilitate an understanding of their approach to risk assessment/response in developing and in managing affordable housing projects. These developers use an informal risk management process as part of their normal business process in accordance with industry standards. A simple qualitative matrix has been used to analyse probability and impacts using a qualitative scale - low, medium and high. For housing providers who have considered investing in affordable housing but have not yet implemented any such projects, affordable housing development is seen as an opportunity that needs to be approached with caution. The risks associated with such projects and the levels of acceptance of these are not consistently identified by current housing providers. Many interviewees agree that the recognition of financial risk and the fear of community rejection of such housing projects have restrained them from committing to such investment projects. This study suggests that implementing improvements to the risk mitigation and management framework may assist in promoting the supply of affordable housing by non-government providers.

The Innovation Management Program (IMP) : a holistic approach to managing change in knowledge based firms

Innovation Management (IM) in most knowledge based firms is used on an adhoc basis where senior managers use this term to leverage competitive edge without understanding its true meaning and how its robust application in organisation impacts organisational performance. There have been attempts in the manufacturing industry to harness the innovative potential of the business and apprehend its use as a point of difference to improve financial and non financial outcomes. However further work is required to innovatively extrapolate the lessons learnt to introduce incremental and/or radical innovation to knowledge based firms. An international structural engineering firm has been proactive in exploring and implementing this idea and has forged an alliance with the Queensland University of Technology to start the Innovation Management Program (IMP). The aim was to develop a permanent and sustainable program with which innovation can be woven through the fabric of the organisation. There was an intention to reinforce the firms’ vision and reinvigorate ideas and create new options that help in its realisation. This paper outlines the need for innovation in knowledge based firms and how this consulting engineering firm reacted to this exigency. The development of the Innovation Management Program, its different themes (and associated projects) and how they integrate to form a holistic model is also discussed. The model is designed around the need of providing professional qualification improvement opportunities for staff, setting-up organised, structured & easily accessible knowledge repositories to capture tacit and explicit knowledge and implement efficient project management strategies with a view to enhance client satisfaction. A Delphi type workshop is used to confirm the themes and projects. Some of the individual projects and their expected outcomes are also discussed. A questionnaire and interviews were used to collect data to select appropriate candidates responsible for leading these projects. Following an in-depth analysis of preliminary research results, some recommendations on the selection process will also be presented.

Behaviour disorders and teacher negligence

The purpose of this paper is to examine the legal implications of the continuing rise in the number of school children diagnosed with behaviour disorders. Not only are teachers now subject to a dense grid of legal regulation, they are also increasingly vulnerable to actions in tort. It will be argued here that as more and more children are labelled ‘disordered’, the duty of care become more onerous, and hence harder for teachers to meet. As a consequence, teachers are more likely to face claims of negligence. It is concluded that while the schooling system needs to retain a healthy scepticism about each new pathologising disorder that seeks special status for its sufferers, it also needs to provide greater training and resources for teachers regarding disorder management. It is also concluded that recent changes to negligence law regarding the issue of ‘reasonable foreseeability’ within breach of duty of care, may not be as significant as might have been hoped by the teaching community. Indeed, the elevated standard of care required by the increasing numbers of disordered pupils, places teachers in an ever more difficult legal position.

The Influence of Farm Management on NSW Rural Property Income and Total Average Annual Returns

The importance of agriculture in many countries has tended to reduce as their economies move from a resource base to a manufacturing industry base. Although the level of agricultural production in first world countries has increased over the past two decades, this increase has generally been at a less significant rate compared to other sectors of the economies. Despite this increase in secondary and high technology industries, developed countries have continued to encourage and support their agricultural industries. This support has been through both tariffs and price support. Following pressure from developing economies, particularly through the World Trade Organisation (WTO), GATT Uruguay round and the Cairns Group developed countries are now in various stages of winding back or de-coupling agricultural support within their economies. A major concern of farmers in protected agricultural markets is the impact of a free market trade in agricultural commodities on farm incomes, profitability and land values. This paper will analyse both the capital and income performance of the NSW rural land market over the period 1990-1999. This analysis will be based on several rural land use classifications and will compare the total return from rural properties based on the farm income generated by both the average farmer and those farmers considered to be in the top 20% of the various land use areas. The analysis will provide a comprehensive overview of rural production in a free trade economy.

Youth, personhood and 'practices of the self'

In contrast to most previous research in the field, this paper argues that the concept of 'youth' is best understood as an example of the governmental formation of a specific type of person. It is constructed at the intersection of a variety of diverse problematisations, being produced by the processes of individuation/ normalisation and the regulation of relations of time. Within programs such as those pertinent to the management of sex, an array of technologies structure the practices by which individuals pattern their own conduct - thereby fashioning a kind of habitus. This forms part of a general strategy of enrolling the objects of these programs in their own self-reformation. Consequently, `youth' can be understood as `the doing of specific types of work on the self'. By utilising this framework, the paper not only seeks to identify and better understand some of the sexual subjectivities associated with the construction of youth, it also seeks to offer some new directions for research in the area.

Pathologising difference, governing personality

Recent research has stressed the integral part played by teachers in both preliminary diagnosis and ongoing treatment of a range of conduct and personality disorders. Teachers are not only required to be aware of a variety of new categories of difference (Attention Deficit Disorder, Selective Mutism, Borderline Personality Disorder, Antisocial Personality Disorder, to name but a few), but are also now lauded for extending the role of education into new areas of social management. This paper will take issue with this understanding on two counts: first, teachers have always sought to mould the personalities of students, and the pathologisation of specific forms of conduct is simply a new tactic within a very old and familiar strategy. Second, schools do not simply discover disorders such as ADD as objective facts of nature. Rather, they are part of the process through which such differences are created, and by which individuals can be more effectively governed.

Behaviour disorders and the negligent teacher

The purpose of this paper is to examine the legal implications of the continuing rise in the number of school children diagnosed with behaviour disorders. Not only are teachers now subject to a dense grid of legal regulation, they are also increasingly vulnerable to actions in tort. It will be argued here that as more and more children are labelled ‘disordered’, then the concomitant duty of care requirements for teachers becomes more onerous. As a consequence, teachers are less likely to be able to defend themselves against claims of negligence. It is concluded that while the schooling system needs to retain a healthy scepticism about each new pathologising disorder that seeks special status for its sufferers, it also needs to provide greater training and resources for teachers regarding disorder management. It is also concluded that recent changes to negligence law regarding the issue of ‘reasonable foreseeability’ within breach of duty of care, may not be as significant as might have been hoped by the teaching community. Indeed, the elevated standard of care, as required by increasing numbers of disordered pupils, place teachers in an ever more difficult legal position.

Youth, sex, and 'practices of the self'

The intention of this paper is to describe ways of avoiding the normalising, globalising and dichotomising tenor of previous research into 'youth'. With a specific focus upon the management of sex, it will be argued that the concept of 'youth' is best understood as an example of the governmental formation of specific types of person, and that 'youth' can be formulated in terms of 'the doing of certain kinds of work on the self'.

Shaping the at-risk youth

The category of the `at-risk' youth currently underpins a good deal of youth policy. Primarily, it centres around a range of programs associated with the need for state intervention. The `at-risk' youth tenuously appears at the intersection of a variety of knowledges/problematisations, such as vocational guidance, youth welfare, family management, and so on. Whilst it is argued that in some ways, the `at-risk' youth simply replaces older characterisations used in the policing of the young, it will also be argued that the preventative policies associated with `risk' are constituted in terms of factors rather than individuals, that prevention is no longer primarily based upon personal expertise, but rather upon the gathering and collation of statistical knowledge which identifies `risks' within given populations, and that `risk' legitimates unlimited governmental intervention. Importantly, the category of the `at-risk' youth underpins crucial sections of policy documents such as the Finn Report (into credentialling/education and vocational competency). In this case, youth is deemed to be `at-risk' of not making the transition to adulthood successfully. It will be argued that not only is the Finn Report significant in the administrative and cultural shaping of the category of `youth', but also by employing the notion of `risk', the Report puts in place yet another element of an effective network of governmental intelligibility covering the young. Finally, it will be argued that young women, as a specific an example of a `risk' group (vis-a-vis obtaining certain types of employment), require particular forms of intervention, primarily through changing the vocational aspirations of their parents.

Historical timelines : analyzing multimodal text design

The recent focus on literacy in Social Studies has been on linguistic design, particularly that related to the grammar of written and spoken text. When students are expected to produce complex hybridized genres such as timelines, a focus on the teaching and learning of linguistic design is necessary but not sufficient to complete the task. Theorizations of new literacies identify five interrelated meaning making designs for text deconstruction and reproduction: linguistic, spatial, visual, gestural, and audio design. Honing in on the complexity of timelines, this paper casts a lens on the linguistic, visual, spatial, and gestural designs of three pairs of primary school aged Social Studies learners. Drawing on a functional metalanguage, we analyze the linguistic, visual, spatial, and gestural designs of their work. We also offer suggestions of their effect, and from there consider the importance of explicit instruction in text design choices for this Social Studies task. We conclude the analysis by suggesting the foci of explicit instruction for future lessons.

Can theories about leadership in schools inform the work of Principals in schools?

This paper explores recent theorising on the ways in which Principals exercise leadership in their schools with reference to the Leading 21st Century Schools Project in Australia. First, it provides an historical overview of approaches to leadership. Second, it utilises a rhetorical question about leadership to analyse the ways in which leadership and management tensions pose challenges to Principals' efforts to capacity build their staff. Third, it and suggests that the notion of distributed leadership has been the most useful method in fostering Asia literacy in the Leading 21st Century Schools Project.

In Pursuit of Excellence : A Policy Driven Systemic Initiative to Embed Gifted Education

Embedding gifted education practices requires major professional development strategies supported by transparent, credible and enforceable policy. This paper describes an analysis of a state-wide initiative involving the establishment of a series of schools tasked to develop and disseminate gifted education principles. The authors have been involved with this initiative at a number of levels over a ten-year period. Their involvement culminated in a commissioned review of the program. Extensive qualitative data were purposively collected from all stakeholders and the effectiveness of the initiative is examined from a theoretical framework of policy development and excellence. The findings summarised in this proposal, indicate the achievement of excellence at a systemic level was constrained by lack of vision, leadership and commitment to long term achievements of excellence. At a local level evidence exists that excellence can be manifested when there is synchronicity of vision, purpose, decisions, and actions.

When 'listeners can't talk' : comparing active listening in opening sequences of telephone and online counselling

While there is growing use of online counselling, little is known about its interactional organisation and how it compares to telephone counselling. This is despite past research suggesting that both counsellors and clients report the impact of the different modalities on the presentation and management of the counselling interaction. This paper compares the interactional affordances of telephone and online web counselling in opening sequences on Kids Help Line, a 24-hour Australian counselling service for children and young people up to the age of 25. We examine two ways that counsellors show active listening through response tokens and formulations. The analysis describes how counsellors’ use of minimal response tokens facilitate the clients’ problem presentation and are used in the management of turn taking and sequence organisation. For example, counsellors use the response token Mm hm to show that they understand that the client’s unit of talk to is not yet complete, and to affirm or invite the client to continue speaking. Formulations in phone and web counselling are another way that counsellors display active listening to re-present stretches of the clients’ preceding talk. In phone and web counselling, however, the respective modalities can complicate matters of turn transition and sequence organisation. By examining actual phone and online counselling sessions, this paper offers empirical demonstrations of the interactional affordances of phone and online counselling, and shows how the institutional practice of active listening is accomplished across different counselling modalities