Emergency department mental health triage scales improve outcomes.

The assessment and management of clients with mental illness is an important facet of providing emergency care. In Australian emergency departments, it is usually the generalist registered nurses* without adequate preparation in the assessment and care for clients with mental illness who conduct the initial assessment at triage. A search of the literature revealed a limited number of publications addressing the provision of triage and management guidelines to assist nurses to make objective clinical decisions to ensure appropriate care for clients with mental illness. This paper examines the need for such guidelines and reviews a number of mental health triage scales that have been evaluated for use in emergency departments. Findings show that these triage scales have led to improvements in staff confidence and attitudes when dealing with clients with mental health problems, resulting in improved outcomes for clients. Strengths and limitations of the evaluations have also been explored. Highlighted is the need for consideration of the inclusion of clients' reactions to the impact of this change to service delivery in future evaluations.

Brief intervention: a promising framework for child and youth mental health?

There is a discrepancy between the demand for mental health treatment amongst children, young people and their carers, and the capacity of the current service system to provide evidence based interventions. Innovative models of care are required to redress this discrepancy. One such model is the single session model, which provides a single or small number of solution focused sessions targeting one or two identified problems. Single session interventions have been trialled across a range of presenting concerns including child and youth mental health services. This paper provides a rationale for offering a brief focused intervention as part of a broader Child and Youth Mental Health Service, and introduces a model of how brief intervention fits within a broader system of care.

Co-morbid depression and chronic illness related to coping and physical and mental health status

A partial latent structural regression analysis was used to evaluate the role of coping resources, depression, diet and exercise on mental and physical health status. The sample consisted of 113 participants (59 females and 54 males) with a mean age of 59.38 years (SD = 10.52). Coping resources, depression and exercise explained 52 and 26% of the variance in mental and physical health status, respectively. Fewer coping resources predicted higher levels of depression and both predicted worse mental health. Only higher levels of depression predicted worse physical health status. There were also significant indirect effects of coping on mental and physical health status through depression. The development of cognitive, social and emotional coping strategies is important for managing depression and supporting positive mental health. These results highlight the important role of health psychologists in the care of individuals with chronic illness. Additionally, the management of depression is important in maintaining positive physical health.

Clinical placements in mental health: a literature review

Gaining experience in clinical mental health settings is central to the education of health practitioners. To facilitate the ongoing development of knowledge and practice in this area, we performed a review of the literature on clinical placements in mental health settings. Searches in Academic Search Complete, CINAHL, Medline and PsycINFO databases returned 244 records, of which 36 met the selection criteria for this review. Five additional papers were obtained through scanning the reference lists of those papers included from the initial search. The evidence suggests that clinical placements may have multiple benefits (e.g. improving students' skills, knowledge, attitudes towards people with mental health issues and confidence, as well as reducing their fears and anxieties about working in mental health). The location and structure of placements may affect outcomes, with mental health placements in non-mental health settings appearing to have minimal impact on key outcomes. The availability of clinical placements in mental health settings varies considerably among education providers, with some students completing their training without undertaking such structured clinical experiences. Students have generally reported that their placements in mental health settings have been positive and valuable experiences, but have raised concerns about the amount of support they received from education providers and healthcare staff. Several strategies have been shown to enhance clinical placement experiences (e.g. providing students with adequate preparation in the classroom, implementing learning contracts and providing clinical supervision). Educators and healthcare staff need to work together for the betterment of student learning and the healthcare professions.

Majors in mental health nursing: issues of sustainability and commitment

PURPOSE: Major streams in mental health nursing in undergraduate nursing programs were introduced in Australia as a strategy to address current and projected workforce shortages. Of the 14 programs originally planned or implemented, only five are continuing. DESIGN AND METHODS: A qualitative exploratory study was conducted involving in-depth interviews with representatives of universities that had ceased the major streams or abandoned plans to introduce them. FINDINGS: Significant themes from interview material on abandoned programs were efficient use of resources, expertise, and problems with registration. On the programs now terminated significant themes were viability and commitment to mental health nursing. PRACTICE IMPLICATIONS: These findings suggest demonstrable and sustainable commitment to mental health nursing is a precursor to success of major streams and advancement of the mental health nursing specialty.

Staff experiences of providing support to students who are managing mental health challenges: a qualitative study from two Australian universities

The prevalence and consequences of mental health challenges amongst university students is now widely acknowledged and university staff provide an important but often hidden service to these students. While completing a university degree is important to the student’s long-term outcomes there remains a paucity of literature on the support role provided to these students by staff. To contribute to knowledge in this area, a qualitative exploratory study was completed with academic and professional staff at two Australian universities in 2013. Data were collected using semi-structured interviews with 26 participants to document their experiences and to identify the barriers and enablers to their support role to students. Data were analysed using thematic analysis and four themes emerged: (1) Factors that facilitate initiation of staff support; (2) barriers to providing support; (3) challenges facing staff; and (4) how universities support students with mental health challenges. Staff acknowledged the personal and organisational challenges they experienced but also highlighted the rewards they received associated with the role. The provision of training and the acknowledgement of the hidden role and workload by universities were important to ensuring positive outcomes for this group of students.

Consumer involvement in the tertiary-level education of mental health professionals: a systematic review

A systematic review of the published work on consumer involvement in the education of health professionals was undertaken using the PRISMA guidelines. Searches of the CINAHL, MEDLINE, and PsychINFO electronic databases returned 487 records, and 20 met the inclusion criteria. Further papers were obtained through scanning the reference lists of those articles included from the initial published work search (n = 9) and contacting researchers in the field (n = 1). Thirty papers (representing 28 studies) were included in this review. Findings from three studies indicate that consumer involvement in the education of mental health professionals is limited and variable across professions. Evaluations of consumer involvement in 16 courses suggest that students gain insight into consumers' perspectives of: (i) what life is like for people with mental illness; (ii) mental illness itself; (iii) the experiences of admission to, and treatment within, mental health services; and (iv) how these services could be improved. Some students and educators, however, raised numerous concerns about consumer involvement in education (e.g. whether consumers were pursuing their own agendas, whether consumers' views were representative). Evaluations of consumer involvement in education are limited in that their main focus is on the perceptions of students. The findings of this review suggest that public policy expectations regarding consumer involvement in mental health services appear to be slowly affecting the education of mental health professionals. Future research needs to focus on determining the effect of consumer involvement in education on the behaviours and attitudes of students in healthcare environments.

Mental health service delivery : a profile of mental health non-government organisations in south-east Queensland, Australia.

Non-government organisations make a substantial contribution to the provision of mental health services; despite this, there has been little research and evaluation targeted at understanding the role played by these services within the community mental health sector. The aim of the present study was to examine the depth and breadth of services offered by these organisations in south-east Queensland, Australia, across five key aspects of reach and delivery.

Opportunity lost? The major in mental health nursing in Australia

The ongoing difficulty in educating and sustaining an adequate nursing workforce in mental health settings has been identified throughout the world. Different strategies have been implemented internationally to deal with this situation. In Australia major streams in mental health nursing were introduced in some Australian universities to promote mental health nursing as a viable career choice for nursing students. Fourteen universities had implemented or planned to implement a major stream in mental health nursing. From a survey of these programs a lack of consistency in the structure and content of programs was evident. For most programs the intakes had been relatively small, although retention rates appeared promising.

Mental health care system optimization from a health-economics perspective: where to sow and where to reap?

Health care expenditure (as % of GDP) has been rising in all OECD countries over the last decades. Now, in the context of the economic downturn, there is an even more pressing need to better guarantee the sustainability of health care systems. This requires that policy makers are informed about optimal allocation of budgets. We take the Dutch mental health system in the primary care setting as an example of new ways to approach optimal allocation.

International perspectives on psychosocial working conditions, mental health, and stress of dairy farm operators

Dairy farm operators-farmers, workers, and family members-are faced with many demands and stressors in their daily work and these appear to be shared across countries and cultures. Dairy operators experience high psychosocial demands with respect to a hard work and production ethos, economic influences, and social and environmental responsibility. Furthermore, both traditional and industrial farms are highly dependent on external conditions, such as weather, fluctuating markets, and regulations from government authorities. Possible external stressors include disease outbreaks, taxes related to dairy production, and recent negative societal attitudes to farming in general. Dairy farm operators may have very few or no opportunities to influence and control these external conditions, demands, and expectations. High work demands and expectations coupled with low control and lack of social support can lead to a poor psychosocial work environment, with increased stress levels, ill mental health, depression, and, in the worst cases, suicide. Internationally, farmers with ill mental health have different health service options depending on their location. Regardless of location, it is initially the responsibility of the individual farmer and farm family to handle mental health and stress, which can be of short- or long-term duration. This paper reviews the literature on the topics of psychosocial working conditions, mental health, stress, depression, and suicide among dairy farm operators, farm workers, and farm family members in an international perspective.

Family violence happens to everybody: gender, mental health and violence in Australian media representations of filicide 2010–2014

This discussion of three cases of filicide reported and reviewed extensively by the Australian news media between 2010 and 2014 is concerned with the politics of representation and its links to material violence. Moving through the architecture of the coverage rather than focusing on it this article observes popular, if mostly tacit, assumptions about masculinity and femininity in representing ‘family violence’. It locates coverage patterns to illustrate perceptions of violence against women and children and inaccurate stereotyping of such family violence as the extraordinary consequences of mental illness, which are mostly reproduced by the Australian media. It is suggested that such media representations are part of a downplaying of family violence as a public issue of urgency.