Psychiatry - Research Publications
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ItemWorking towards least restrictive environments in acute mental health wards in the context of locked door policy and practice(WILEY, 2019-04-01)There has been a shift towards provision of mental health care in community-based settings in Australia. However, hospitals continue to care for people in acute mental health wards. An increasing proportion of the people in wards are admitted involuntarily, subject to restrictions of movement to minimize risk of harm to self and others. In response to concerns about the safety of people absconding from care, Queensland Health introduced a policy requiring all acute mental health wards in the State to be locked. In response, the Queensland Mental Health Commission funded a project to understand the impact of this policy and develop evidence-based recommendations regarding provision of least restrictive, recovery-oriented practices in acute wards. Facilitated forums were conducted with 35 purposively selected participants who identified as consumers, carers, or staff of acute mental health hospital wards, to test the acceptability, feasibility, and face validity of a set of evidence-informed recommendations for providing least restrictive, recovery-oriented practices. Participant responses were recorded, and data were analysed through an inductive, thematic approach. A recovery-oriented approach was supported by all stakeholders. Reducing boredom and increasing availability of peer support workers were considered key to achieving this. Focusing less on risk aversion was reported as central to enabling true Recovery Orientation. This project enabled recognition of the perspectives of consumers, carers, and staff in the consideration of evidence-informed recommendations that could be implemented to provide least restrictive care in the context of locked doors.
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ItemPrevention and Recovery Care Services in Australia: Describing the Role and Function of Sub-Acute Recovery-Based Residential Mental Health Services in Victoria(FRONTIERS MEDIA SA, 2019-10-24)Background: Prevention and Recovery Care (PARC) services are relatively new sub-acute residential services that have supported people with mental ill-health in Victoria since 2003. Operated from a partnership model between non-governmental agencies and clinical mental health services, PARC services integrate intensive recovery-focused psychosocial input with clinical mental health care. Aim: To describe and contrast the 19 PARC services operating in Victoria at the time of the study, in terms of structures and function, resources, and content and quality of care. Method: Nineteen participants, one representing each PARC, completed two surveys: the first, a purpose-designed survey relating to the government guidelines for PARC services, and the second, the Quality Indicator for Rehabilitative Care. Results: Descriptive analyses highlighted that PARC services have operated in inner-city, urban, and regional areas of Victoria, from between 1 and 14 years. Participants reported that a recovery approach was at the core of service delivery, with a vast array of group and individual programs on offer. Across the state, there was variation in the quality of services according to the Quality Indicator for Rehabilitative Care domains. Conclusions: This study has identified that there is variation in the structure and function, resourcing, and content and quality of care offered across Victoria's PARC services even though, in the main, they are guided by government guidelines. Hence it appears that the services adapt to local needs and changes in service systems occurring over time. The findings indicate emerging evidence that PARCs are providing recovery-oriented services, which offer consumers autonomy and social inclusion, and therefore likely enable a positive consumer experience. The range of individual and group programs is in line with the Victorian guidelines, offering practical assistance, therapeutic activities, and socialization opportunities consistent with consumer preferences. Further research into implementation processes and their impacts on quality of care is warranted concerning this and similar service models.
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ItemMental Health Professional Online Development (MHPOD): a web-based training tool for the non-government community mental health workforce(EMERALD GROUP PUBLISHING LTD, 2014)Purpose – The purpose of this paper is to evaluate the usefulness and relevance of the Mental Health Professional Online Development (MHPOD) training package in further developing the skills in mental health and recovery-informed practice of the Australian non-government community mental health workforce. MHPOD is an evidence-based, self-paced, online learning resource that consists of 58 mental health topics. Design/methodology/approach – A total of 349 e-learners were recruited from seven non-government community mental health services across Australia. E-learners were invited to complete up to twelve online surveys, a baseline survey, a topic completion survey for each completed topic, and a follow-up survey towards the end of the pilot. Findings – The majority of e-learners indicated that MHPOD was useful for professional development and relevant to their current employment. E-learners identified that MHPOD led to significant improvement in their knowledge and confidence in their ability. A number of enabling factors such as managerial and organizational supports, technical supports and up-to-date and relevant content materials need to be present for the successful implementation of online programs such as MHPOD. Originality/value – Online training packages such MHPOD that a relatively easy to use are helpful in developing knowledge, and confidence in the skills of the mental health workforce. The evaluation findings suggest that MHPOD is a relevant and appropriate training tool for the non-government community mental health sector within Australia.