AIM: To describe the health needs identified in children attending a comprehensive health assessment at a tertiary hospital, multidisciplinary clinic for children following entry to out-of-home care and timeliness of referral and assessment compared with national recommendations. METHODS: This was a retrospective audit of all the children who attended the Pathway to Good Health clinic at The Royal Children's Hospital, Melbourne from May 2013 until 31 August 2016. RESULTS: A total of 119 children aged 0-12 years attended the clinic during the audit period. Of these children, 17% (including more than 30% of 0-2-year-olds) were not up-to-date with immunisations, and 87% had physical health concerns that were addressed on the day or needed further management. Over 50% had mental health concerns identified (76% of 7-12-year-olds). In children aged 3-6 years, 64% had behavioural problems and 77% had developmental problems identified. Only a third of the children was referred to the Pathway to Good Health clinic within the national standard of 30 days post-entry to care, and 24% of children attended within 3 months of entry to care. CONCLUSION: Children in out-of-home care within Victoria have high rates of physical, mental and developmental health concerns, consistent with previous studies. Timeliness of attendance at the clinic was low compared with national recommendations, even within a programme designed to facilitate timely health checks. This is the second and largest Australian study exploring timeliness of health checks. Further research would establish whether these results are more systemic.

This paper critiques the Safewards model through the lens of lived experiences of psychiatric hospitalization, diagnosis of mental illness, and distress. Special focus is given to the model's tested 10 interventions and to five lesser known interventions, identifying the impact they can have on hospitalized consumers. We highlight the role and prevalence of trauma, as well as the need to prevent harm in hospital settings. We draw upon notions of hospital as a sanctuary for people and the importance of providing a safe ward. 'Sanctuary harm' and 'Sanctuary trauma' are thus defined, with emphasis placed on the Safewards interventions as means by which sanctuary can be achieved. Finally, the consumer-perspective authors propose expansions to the model, critiquing the defining literature and moving towards a consumer experience of safety that is beyond the model's original intention: to reduce seclusion and restraint practices. Throughout the paper, the term 'consumer' is used in this context to mean people who have experienced or are experiencing psychiatric inpatient care.

Abstract This article explores parental experiences over nearly seven years that followed catastrophic Australian bushfires in 2009. Principles of pragmatism and the constructionist tradition guided the use of semi-structured interviews with parents (nineteen mothers and three fathers) and inductive thematic analysis to distil what participants said about the trauma, loss and disruption caused by the fires, and ways in which they responded as parents. Changes described in their parenting role and family life were themed as ‘losing normal’ which encompassed managing additional exposures, losing fun and living at their capacity. Parents then evinced the struggle of settling and seeking to regain a sense of normal. This theme highlighted tensions, pressures and expectations they faced (their own and external) in trying to get back to normal, along with extended recovery timeframes. Participants valued strategies to provide stability, familiarity and manage their own emotions. The analysis highlights the influence of the parental role on an experience of trauma, the range of losses and the extended experience of disaster recovery for parents. Insights for social work practice are discussed, including the potential to inform expectations of recovery timeframes and supporting parents and their families to reconstruct their sense of normal in their new, post-disaster context.

OBJECTIVE: Online psychological therapies provide a way to connect adolescent and young adult (AYA) cancer survivors to evidence-based support. We aimed to establish the feasibility, acceptability, and safety of Recapture life, a six-session group-based online cognitive-behavioural intervention, led by a facilitator, for AYAs in the early post-treatment period. METHODS: A randomised-controlled trial compared Recapture Life to an online peer-support group control and a waitlist control. Participants could nominate a support person. Acceptability was assessed using study opt-in and retention rates, participant-reported benefits/burdens of participation, and group facilitator burden. We also assessed the feasibility (eg, frequency/impact of technological difficulties) and psychological safety (ie, occurrence of clinically concerning distress) of the program. RESULTS: Sixty-one participants took part (45 AYAs, 51.1% female; 19 support people). The opt-in rate was 30%, the enrolment rate was 87%, and 75% of participants took part in ≥5/6 sessions. AYAs reported high benefit and low burden of participation. Overall, 95 online group sessions were conducted; few required rescheduling by group facilitators (3%), but many took place outside of office hours (~90 hours). It took 40 days on average to create online groups, but established weekly sessions commenced quickly (M = 4.0 minutes). Technological difficulties were common but had a low impact on intervention delivery. Although 54% of AYAs returned a clinically concerning distress screen at some point, none reflected acute mental health risks. CONCLUSIONS: The data largely indicate that Recapture Life is an acceptable, feasible, and safe model of evidence-based psychological support for AYAs during early survivorship, which nevertheless experienced common challenges in online/AYA intervention delivery.