Mental health recovery and occupational therapy in Australia and New Zealand

Every individual with mental illness has the right to be safe and cared for. Most people will receive the love and care from their families and friends, but they will also expect mental-health professionals, occupational therapists and the community to work together to provide the necessary services to support their recovery from mental illness. This article highlights the development of the recovery approach for people with mental illness in Australia and New Zealand. The implications of recovery concepts for occupational therapy, in the areas of individualized approach, participation of service users and carers, person-centred assessment and intervention, intersectoral links and mental-health promotion, are discussed. There are a number of key areas requiring further research and debate, notably the most effective means of implementing and evaluating recovery-focused interventions.

The International Consortium on Mental Health Policy and Services: objectives, design and project implementation

The concept of the burden of disease, introduced and estimated for a broad range of diseases in the World Bank report of 1993 illustrated that mental and neurological disorders not only entail a higher burden than cancer, but are responsible, in developed and developing countries, for more than 15% of the total burden of all diseases. As a consequence, over the past decade, mental disorders have ranked increasingly highly on the international agenda for health. However, the fact that mental health and nervous system disorders are now high on the international health agenda is by no means a guarantee that the fate of patients suffering from these disorders in developing countries will improve. In most developing countries the treatment gap for mental and neurological disorders is still unacceptably high. To address this problem, an international network of collaborating institutions in low-income countries has been set up. The establishment and the achievements of this network-the International Consortium on Mental Health Policy and Services-are reported. Sixteen institutions in developing countries collaborate (supported by a small number of scientific resource centres in industrialized nations) in projects on applied mental health systems research. Over a two-year period, the network produced the key elements of a national mental health policy; provided tools and methods for assessing a country's current mental health status (context, needs and demands, programmes, services and care and outcomes); established a global network of expertise, i.e., institutions and experts, for use by countries wishing to reform their mental health policy, services and care; and generated guidelines and examples for upgrading mental health policy with due regard to the existing mental health delivery system and demographic, cultural and economic factors.

Australia's National Mental Health Strategy and deinstitutionalization: some empirical results

Objective: To determine the role of the National Mental Health Strategy in the deinstitutionalization of patients in psychiatric hospitals in Queensland. Method: Regression analysis (using the maximum likelihood method) has been applied to relevant time-series datasets on public psychiatric institutions in Queensland. In particular, data on both patients and admissions per 10 000 population are analysed in detail from 1953-54 to the present, although data are presented from 1883-84. Results: These Queensland data indicate that deinstitutionalization was a continuing process from the 1950s to the present. However, it is clear that the experience varied from period to period. For example, the fastest change (in both patients and admissions) took place in the period 1953-54 to 1973-74, followed by the period 1974-75 to 1984-85. Conclusions: In large part, the two policies associated with deinstitutionalization, namely a discharge policy ('opening the back door') and an admission policy ('closing the front door') had been implemented before the advent of the National Mental Health Strategy in January 1993. Deinstitutionalization was most rapid in the 30-year period to the early 1980s: the process continued in the 1990s, but at a much slower rate. Deinstitutionalization was, in large part, over before the Strategy was developed and implemented.

Modeling of adsorption on nongraphitized carbon surface: GCMC simulation studies and comparison with experimental data

We model nongraphitized carbon black surfaces and investigate adsorption of argon on these surfaces by using the grand canonical Monte Carlo simulation. In this model, the nongraphitized surface is modeled as a stack of graphene layers with some carbon atoms of the top graphene layer being randomly removed. The percentage of the surface carbon atoms being removed and the effective size of the defect ( created by the removal) are the key parameters to characterize the nongraphitized surface. The patterns of adsorption isotherm and isosteric heat are particularly studied, as a function of these surface parameters as well as pressure and temperature. It is shown that the adsorption isotherm shows a steplike behavior on a perfect graphite surface and becomes smoother on nongraphitized surfaces. Regarding the isosteric heat versus loading, we observe for the case of graphitized thermal carbon black the increase of heat in the submonolayer coverage and then a sharp decline in the heat when the second layer is starting to form, beyond which it increases slightly. On the other hand, the isosteric heat versus loading for a highly nongraphitized surface shows a general decline with respect to loading, which is due to the energetic heterogeneity of the surface. It is only when the fluid-fluid interaction is greater than the surface energetic factor that we see a minimum-maximum in the isosteric heat versus loading. These simulation results of isosteric heat agree well with the experimental results of graphitization of Spheron 6 (Polley, M. H.; Schaeffer, W. D.; Smith, W. R. J. Phys. Chem. 1953, 57, 469; Beebe, R. A.; Young, D. M. J. Phys. Chem. 1954, 58, 93). Adsorption isotherms and isosteric heat in pores whose walls have defects are also studied from the simulation, and the pattern of isotherm and isosteric heat could be used to identify the fingerprint of the surface.

Obsessive-compulsive disorder across developmental trajectory: Cognitive processing of threat in children, adolescents and adults

Background. While the cognitive theory of obsessive-compulsive disorder (OCD) is one of the most widely accepted accounts of the maintenance of the disorder in adults, no study to date has systematically evaluated the theory across children, adolescence and adults with OCD. Method. This paper investigated developmental differences in the cognitive processing of threat in a sample of children, adolescents and adults with OCD. Using an idiographic assessment approach, as well as self-report questionnaires, this study evaluated cognitive appraisals of responsibility, probability, severity, thought-action fusion (TAF), thought-suppression, self-doubt and cognitive control. It was hypothesised that there would be age related differences in reported responsibility for harm, probability of harm, severity of harm, thought suppression, TAR self-doubt and cognitive control. Results. Results of this study demonstrated that children with OCD reported experiencing fewer intrusive thoughts, which were less distressing and less uncontrollable than those experienced by adolescents and adults with OCD. Furthermore, responsibility attitudes, probability biases and thought suppression strategies were higher in adolescents and adults with OCD. Cognitive processes of TAF, perceived severity of harm, self-doubt and cognitive control were found to be comparable across age groups. Conclusions. These results suggest that the current cognitive theory of OCD needs to address developmental differences in the cognitive processing of threat. Furthermore, for a developmentally sensitive theory of OCD, further investigation is warranted into other possible age related maintenance factors. Implications of this investigation and directions for future research are discussed.

Evaluation of different models to describe egg and pupal development of Xyleborus fornicatus Eichh. (Coleoptera: Scolytidae), the shot-hole borer of tea in Sri Lanka

Abstract Development data of eggs and pupae of Xyleborus fornicatus Eichh. (Coleoptera: Scolytidae), the shot-hole borer of tea in Sri Lanka, at constant temperatures were used to evaluate a linear and seven nonlinear models for insect development. Model evaluation was based on fit to data (residual sum of squares and coefficient of determination or coefficient of nonlinear regression), number of measurable parameters, the biological value of the fitted coefficients and accuracy in the estimation of thresholds. Of the nonlinear models, the Lactin model fitted experimental data well and along with the linear model, can be used to describe the temperature-dependent development of this species.

The National Mental Health Strategy and Geographical Access to Mental Health Services: Some empirical results

In 1992 the Australian Government adopted the National Mental Health Strategy in an attempt to improve the provision of mental health services. A component was to improve geographical access to hospital-based mental health services. This paper is concerned with determining if this objective has been achieved. Time-series data on patients (at a regional level) with mental illness in the State of Queensland are available for the years from 1968-69 to 2002-03. A change in regional classification by the Australian Bureau of Statistics complicates the analysis by precluding certain empirical tests such as converging utilisation rates by region. To overcome this problem, it was decided to apply concepts of concentration and equality that are commonly employed in industrial economics to the regional data. The empirical results show no evidence of improving regional access following the National Mental Health Strategy: in fact the statistical results show the opposite, i.e. declining regional access.