Public and private psychiatry: Can they work together and is it worth the effort?

Objective: Partnerships in mental health care, particularly between public and private psychiatric services, are being increasingly recognized as important for optimizing patient management and the efficient organization of services. However, public sector mental health services and private psychiatrists do not always work well together and there seem to be a number of barriers to effective collaboration. This study set out to investigate the extent of collaborative 'shared care' arrangements between a public mental health service and private psychiatrists practising nearby. It also examined possible barriers to collaboration and some possible solutions to the identified problems. Method: A questionnaire examining the above factors was sent to all public sector mental health clinicians and all private psychiatrists in the area. Results: One hundred and five of the 154 (68.2%) public sector clinicians and 103 of the 194 (53.1%) private psychiatrists returned surveys. The main barriers to successful collaboration identified by members of both sectors were: 'Difficulty communicating' endorsed by 71.4% of public clinicians and 72% of private psychiatrists, 'Confusion of roles and responsibilities' endorsed by 62.9% and 66%, respectively, and 'Different treatment approach' by 47.6% and 45.6%, respectively. Over 60% of private psychiatrists identified problems with access to the public system as a barrier to successful shared care arrangements. It also emerged, as hypothesized, that the public and private systems tend to manage different patient populations and that public clinicians in particular are not fully aware of the private psychiatrists' range of expertise. This would result in fewer referrals for shared care across the sectors. Conclusions: A number of barriers to public sector clinicians and private psychiatrists collaborating in shared care arrangements were identified. The two groups surveyed identified similar barriers. Some of these can potentially be addressed by changes to service systems. Others require cultural shifts in both sectors. Improved communications including more opportunities for formal and informal meetings between people working in the two sectors would be likely to improve the understanding of the complementary sector's perspective and practice. Further changes would be expected to require careful work between the sectors on training, employment and practice protocols and initiatives, to allow better use of the existing services and resources.

Alternating offer games and private rulings of the Australian Tax Office

The concept of submitting oneself to a voluntary negotiation is by no means new to big business. Formal bargaining has been quite successful over the years in providing the venue for agents to explore a more logical and mathematical approach to bargaining. However in more recent times external influences have been applied to agents who provide better deals for favored executives. This external influence has displayed itself in taxtion negotiations to the extent that tax office agents have been dismissed for irresponsible conduct. We explore this specific type of negotiation using an alternating offer bargaining game to model the particular influences, which create unfair rulings in negotiations. By the constraints of this systematic mathematical approach to negotiation, we will explore the advantages of a more formal game theoretic approach. In this presentation we will also elaborate on finding Nash Equilibrium in alternating offer games.

The public's knowledge of and support for conservation of Australia's tree-kangaroos and other animals

After providing background on Dendrolagus species in Australia, two consecutive surveys of Brisbane's residents are used to assess public knowledge of tree-kangaroos and the stated degree of support for their conservation in Australia. The responses of participants in Survey I are based on their pre-survey knowledge of wildlife. The same set of participants completed Survey II after being provided with additional information on all the wildlife species mentioned in Survey I. Changes in the attitudes of respondents and their degree of support for the protection and conservation of Australia's tree-kangaroos are measured, including changes in their contingent valuations and stated willingness to provide financial support for such conservation. Reasons for wanting to protect tree-kangaroos are specified and analysed. Furthermore, changes that occur in the relative importance of these reasons with increased knowledge are also examined. Support for the conservation of tree-kangaroos is found to rise with the additional knowledge supplied about all species and is compared with variations in support for protection of other mammals. Support for the conservation of Australia's less well known tropical mammals is found to increase relative to better known mammals (icons) present in temperate areas, such as koalas and red kangaroos. Possible implications of the results for government conservation policies in Australia are examined.

Knowledge, economy, technology and society: The politics of discourse

The WSIS is centrally interested in knowledge and has defined for itself a mission that is broadly humanitarian. Its development ‘talk’ is, rightly, replete with notions of equity, preserving culture, justice, human rights and so on. In incorporating such issues into knowledge society and economy discussions, WSIS has adopted a different posture towards knowledge than is seen in dominant discourses. This study analyses the dominant knowledge discourse using a large corpus of knowledge-related policy documents, discourse theory and an interrelational understanding of knowledge. I show that it is important to understand this dominant knowledge discourse because of its capacity to limit thought and action in relation to its central topic, knowledge. The results of this study demonstrate that the dominant knowledge discourse is technocratic, frequently insensitive to the humane mission at the core of the WSIS, and is based on a partial understanding of what knowledge is and how knowledge systems work. Moreover, I show that knowledge is inherently political, that the dominant knowledge discourse is politically oriented towards the concerns of business and technology, but that an emancipatory politics of knowledge is possible.