Primary health care nurse perception and men’s expectation of the role of the primary health care nurse in providing men’s health services in the primary care setting in Victoria

 This study adds significantly to the current paucity of knowledge around men's health in Australian primary care and in particular stresses the need for men's health care education to be more reliable and systematic foundation for men's sexual health, mental health and health promotion.

A rational (unapologetically pragmatic) approach to dealing with the irrational - the setencing of offenders with mental disorders

People with mental impairment are so heavily over-represented in prisons and jails that jails have been labeled “warehouses for the mentally ill.” In many parts of the United States, there are more mentally impaired offenders in prisons than in hospitals for the mentally unwell. Offenders laboring with impaired mental functioning are often regarded as being less morally culpable for their crimes and hence less deserving of punishment. However, the reduced mental functioning of offenders does not diminish the harm caused to victims. People are no less dead if mentally unwell offenders kill them rather than offenders who are mentally sound. This tension has proven an intractable problem for sentencing law and practice. There are no clear, fair, and effective principles or processes for accommodating impaired mental functioning in the sentencing inquiry. It is an under-researched area of the law. In this Article, I explore this tension. Key to ascertaining the proper manner in which to incorporate mental illness into the sentencing system is clarity regarding the importance of consequences to the offender, as opposed to moral culpability. I analyze current approaches to sentencing offenders with mental health problems in both the United States and Australia. Despite the vastly different sentencing regimes in these countries, both systems are deficient in dealing with mentally ill offenders, but for different reasons. I propose a solution to administering sentences to offenders with a mental disorder that is equally applicable to both sentencing systems. Mental impairment should mitigate penalty. However, in determining the extent and circumstances in which it should do so, it is cardinal not to lose sight of the fact that those who are sentenced for a crime are not insane, and they were aware that their acts were wrong--otherwise they would not have been found guilty in the first instance. I argue that a standard ten percent sentencing discount should be accorded to offenders who were mentally disordered at the time of sentencing. There should be an even more substantial discount when it is likely that offenders will find the sanction--in particular imprisonment--more burdensome due to their mental state. This difference would ensure some recognition of the reduced blameworthiness of mentally impaired offenders and the extra hardship that some forms of punishment inflict on mentally *2 ill offenders, while not compromising the important objectives of proportionality and community protection. The only situations when mental disorder should not mitigate penalty are when the offender is a recidivist, serious sexual or violent offender. In these circumstances, the interests of the community are the paramount consideration. The analysis in this paper applies most directly when a term of imprisonment is imposed. However, the reasoning also extends to the threshold decision of whether or not a term of imprisonment should be imposed in the first place.

Liveable & just: a toolkit for local governments to address the social and equity impacts of climate change

The Liveable & Just Toolkit is the culmination of a project to explore how local governments across Victoria are responding to the social and equity impacts of climate change.In June 2009 the Victorian Local Governance Association (VLGA) and Melbourne University’s McCaughey Centre travelled across the state to hear directly from local governments about issues of priority, success stories, challenges, and lessons learned in addressing the social and equity impacts of climate change. Workshops covered crucial issues such as heatwaves and bushfires, rising costs of water, energy and transport, physical and mental health, and the heightened vulnerability of groups such as the mentally ill, homeless, aged, and infants. In response to workshop outcomes and recommendations, the Liveable & Just Toolkit provides a practical framework to help integrate responses to the social and equity impacts of climate change across council activities. It also presents ideas and suggestions for local government to respond to climate change in ways that simultaneously promote social justice.

Stigma toward mental illness : a cross-cultural comparison of Taiwanese, Chinese immigrants to Australia and Anglo-Australians

This study investigated the relationship between culture and attitudes toward mental illness. In total, 196 men and 347 women were recruited from Australia and Taiwan. All participants completed a questionnaire assessing their attitudes toward mental illness. Australian-born Chinese and Chinese immigrants to Australia also completed a questionnaire assessing cultural values. Chinese immigrants to Australia and Taiwanese held more stigmatizing attitudes than Australian-born Chinese and Anglo-Australians. Australian-born Chinese adopted Australian cultural practices more than Chinese immigrants, but these groups did not differ in terms of adherence to Chinese cultural practices. The adoption of Australian cultural practices was significantly associated with lower stigmatizing attitudes. These findings reveal the influence of culture and acculturation processes on stigmatizing attitudes toward the mentally ill.

Police stress : the role of psychological contract and perceptions of fairness

Purpose – The overall purpose of this paper is to examine the extent to which breaches in psychological contracts and perceptions of organizational fairness account for variations in job stress experienced by operational police officers (as measured by psychological distress and employee performance), after controlling for the variance associated with more established job stressors (i.e. job demands, job control and social support).

Design/methodology/approach – This study is based on data collected through a self-report survey involving operational members of a large Australian police force (n=582).

Findings – Results of hierarchical multiple regression analyses indicate that vast majority of explained variance in psychological distress and extra-role performance is attributed to the additive effects of demand, control, and support. Furthermore, only one of the social exchange dimensions (interpersonal fairness) is predictive of either target variable.

Research limitations/implications – The limitations that need to be taken into account are the cross-sectional nature of the study design and the focus on a single police service.

Practical implications – Despite the generally weak support for the social exchange variables, there are signs that dimensions of justice (particularly interpersonal justice) should be included in future police-stress investigations. The results also suggest that job characteristics such as job demand, job control and social support should be taken into account when developing strategies to prevent and/or reduce chronic job stress in policing services.

Originality/value – This is one of the first studies to examine the relationships between psychological contract breach, perceptions of fairness and police stress.

Primary mental health care reform in Australia : the vision and the reality

Reports on primary mental health care reform in Australia 1991-2001 and the involvement of general practioners as the key providers. Investigates the degree to which the vision of policy makers and key stakeholders for a more integrated and effective system had been achieved. Findings suggested there is a considerable mismatch between the policy vision and the implementation reality and that the current system falls short of providing the support and systemic changes necessary for GPs to provide effective mental health care.

Dual disability : the inherent difficulties in service provision and client management

Dual disability is a particularly important area of study, as the co-occurence of intellectual and psychiatric disability presents signficant challenges to professionals within the health and disability services. Four case studies are presented.

Social media in disaster response : Queensland Police Service - public engagement during the 2011 floods

Social Media, particularly Microblogging services, are now being adopted as an additional tool for emergency service agencies to be able to interact with the community at all stages of a disaster. Unfortunately, no standard framework for Social Media adoption for disaster management exists and emergency service agencies are adopting Social Media in an ad-hoc fashion. This paper seeks to provide a general understanding of how Social Media is being used by emergency service agencies during disasters, to better understand how we might develop a standardised framework of adoption. In this study of the 2010/11 Queensland Flood event, Facebook broadcast messages from the Queensland Police Service to the general public, were analysed by genre. Findings show that these Microblogging activities were mostly about information distribution and warning broadcasts and that the strength of Social Media for two-way communication and collaboration with the general public, was under-utilised during this event.

Correlates of criminal victimisation among police cell detainees in Victoria, Australia

People with mental illness are more likely to be crime victims than others; however, little is known about the relationship between offending and victimisation among mentally ill offenders. This study investigated the rates and types of victimisation among people detained in police cells (N = 764), with and without histories of mental illness. Those with mental disorders were 1.56 times (95% CI = 1.11–2.17) more likely to be victims of violent crimes than other detainees. Some subgroups of people with mental disorders were not over-represented as victims, raising the possibility that they were less inclined to report certain types of crimes. Implications are discussed with reference to police practice.

Psychopathology in police custody: The role of importation, deprivation and interaction models

People experiencing mental illness are over-represented among police cell detainees, however limited work has sought to investigate the occurrence of psychopathology in police custody. The present study sought to examine the predictive power of personal factors (e.g., history of psychiatric hospitalisation), situational factors (e.g., police cell conditions), and their interactive effects to explain the occurrence of psychopathology in police custody. A total of 150 detainees were recruited from two metropolitan police stations in Melbourne, Australia. Personal factors were significantly associated with psychiatric symptomatology, with situational factors and interaction terms yielding no association. Detainees with preexisting vulnerabilities and those unsatisfied with police cell conditions demonstrated the highest levels of psychopathology. While all detainees experience some difficulties in police cells, it is those with pre-existing vulnerabilities that suffer the most. This may be due to the exacerbation of vulnerabilities by police cell conditions. The implications of these findings for provision of health care services in police cells are discussed.

Beacon of Hope? Lessons learned from efforts to reduce civilian deaths from police shootings in an Australian state

In the 1990s, the police service in Victoria, Australia, faced a crisis of community confidence due to a spate of civilian deaths from police shootings. In that decade, twice as many civilians died at the hands of the police in Victoria than in every other Australian state combined. Most of those killed were mentally ill and affected by drugs and alcohol, and were rarely a serious threat except to themselves. The problem was also almost entirely an urban phenomenon. Shootings in rural communities, where mentally ill people were more likely to be personally known to local police, were (and remain) almost unknown. The large number of fatalities was recognised as a serious threat to public confidence, and Victoria Police introduced a ground-breaking training programme, Operation Beacon. Operating procedures and weapons training were fundamentally changed, to focus on de-escalation of conflict and avoiding or minimising police use of force. In the short term, Operation Beacon was successful. Shooting incidents were dramatically reduced. However, during the first decade of the new century, the number of civilians being killed again increased. This article examines Operation Beacon, both as a successful model for reducing civilian deaths at the hand of police and as a cautionary tale for police reform. We argue that the lessons of Operation Beacon have been gradually forgotten and that old habits and attitudes resurfaced. Fatal shootings of mentally ill civilians can be prevented, but if success is to be other than temporary, the Beacon philosophy must be continually reemphasised by police management.

Black and white is always grey-the power of the police to conduct a strip search in Victoria

The performance of a strip search by a police officer is a serious interference with the liberty and dignity of an individual. However, it is considered by police to be an important part of their law enforcement armory and one that is increasingly necessary to utilise to assist in the investigation and prosecution of drug-related crimes. This article considers the troublesome issue of whether and in what circumstances the common law may extend to police the power to conduct a strip search. In addition, there is an examination of the statutes and regulations that purportedly give police in Victoria the power to strip search with particular attention given to ss 81 and 82 of the Drugs, Poisons and Controlled Substances Act 1981 (Vic).

Report of the mid-term review of Victoria's maternity services program

Substantial State Government funding has bun committed in Victoria for the enhancement of maternity services. The funding is intended to improve the quality of care for women and meet consumer expectations for choice and continuity of care in maternity services. This paper reports on a mid-term review (the 'review') of the Victorian Maternity services Program. which was conducted by the authors on behalf of the Victorian Department of Human Services. Documentary analysis was conducted for the review, and workshops and key informant interviews were held throughout Victoria with midwives, medical staff and Department of Human Services staff. The review found that there had been many gains as a result of the Maternity services Program and identified directions for further development. Issues of change and facilitators of change processes in maternity services are highlighted in this article.

Not the same : a comparison of female and male clients seeking treatment from problem gambling counselling services

Previous studies of problem gamblers portray this group as being almost exclusively male. However, this study demonstrates that females comprised 46% of the population (n = 1,520) of persons who sought assistance due to concerns about their gambling from the publicly-funded BreakEven counselling services in the state of Victoria, Australia, in one 12-month period. This suggests that the model of service delivery which is community based counselling on a non-residential basis may be better able to attract female clients than treatment centres where males predominate such as veterans centres. A comparative analysis of the social and demographic characteristics of female and male gamblers within the study population was undertaken. As with previous studies, we have found significant differences between males and females who have sought help for problems associated with their gambling. Gender differences revealed in this study include females being far more likely to use electronic gaming machines (91.1% vs. 61.4%), older (39.6 years vs. 36.1 years), more likely to be born in Australia (79.4% vs. 74.7%), to be married (42.8% vs. 30.2%), living with family (78.9% vs. 61.5%) and to have dependent children (48.4% vs. 35.7%), than males who present at these services. Female gamblers (A$7,342) reported average gambling debts of less than half of that owed by males (A$19,091). These gender differences have implications for the development and conduct of problem gambling counselling services as it cannot be assumed that models of service which have demonstrated effectiveness with males will be similarly effective with females.