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Aim: Partnered Pharmacist Medication Charting (PPMC) in patients admitted under general medical units has been shown to reduce medication errors. The aim of this study is to evaluate the impact of the PPMC model on medication errors in patients admitted under cancer units in Victorian hospitals. Methods: A prospective cohort study comparing cohorts before and after the introduction of PPMC was conducted. This included a 2-month pre-intervention phase and 3-month intervention phase. PPMC was implemented during the intervention phase as new model of care that enabled credentialed pharmacists to chart all admission medications, including pre-admission or new medications and cancer therapies, in collaboration with the admitting medical officer. The proportion of medication charts with at least one error was the primary outcome measure. Results: Seven health services across Victoria were included in the study. The majority of health services were using paper-based prescribing systems for oncology. Of the 547 patients who received standard medical medication charting, 331 (60.5%) had at least one medication error identified compared to 18 out of 416 patients (4.3%) using the PPMC model (p < 0.001). The median (interquartile range) inpatient length of stay was 5 (2.9–10.6) days in pre-intervention and 4.9 (2.9–11) days in intervention (p = 0.88). In the intervention arm, 42 patients had cancer therapy charted by a pharmacist with no errors. Conclusions: PPMC was successfully scaled into cancer units as a collaborative medication safety strategy. The model was associated with significantly lower rates of medication errors, including cancer therapies. PPMC should be adopted more widely in cancer units in Australia. [ABSTRACT FROM AUTHOR]

Australian early childhood education and care [ECEC] has faced a series of change and reform since 2009, including the introduction and later revisions of key curriculum and qualify frameworks, increased qualifications, shifting theoretical knowledge and pedagogies, and challenges from the COVID-19 pandemic. Consequently, early childhood professionals [ECPs] have been confronted with a succession of substantial changes impacting their professional practice. This paper reports on a qualitative, post-structural study identifying workplace and learning discourses as key influences for the reform engagement of eleven ECPs from kindergarten settings in Victoria, Australia. Foucauldian Discourse Analysis [FDA] revealed specific subjective positions and discursive practices among participants. Recommendations are offered to address issues related to the uptake of reform initiatives. It is anticipated that these findings may generate greater opportunities to support our existing, emerging and future generations of ECPs as they lead the transformation of ECEC and transition through complex times of uncertainty. [ABSTRACT FROM AUTHOR]

Objectives: This paper describes the rationale for and development of an innovative mental health service for people aged over 65 years living in Northern and Eastern Melbourne, Victoria, Australia. Conclusion: The Healthy Ageing Service (HAS) was established in July 2020 to provide care for people aged over 65 years experiencing mild-to-moderate mental health concerns. It embraces a prevention and early intervention model of care. It provides primary consultation and brief intervention, secondary consultation, and capacity building to the primary healthcare sector. This innovative service is a Commonwealth-funded partnership between two tertiary mental health service providers that incorporates the recommendations from two major Royal Commissions. It demonstrates a service that acts as a bridge between primary and specialist mental health care, thereby extending mental health services to target the 'missing middle' and is potentially a model for mental health service provision throughout Victoria and Australia. [ABSTRACT FROM AUTHOR]

Recovery Colleges are an innovative education-based approach to support mental health recovery that, following the recent Royal Commission, will have to be established in every area mental health service within the state of Victoria. This paper describes the rationale, benefits and some of the key considerations to successfully establish Recovery Colleges. The establishment of Recovery Colleges has the potential to drive culture change within mental health services and embed recovery orientation within service provision as well as engaging service users in their own recovery journey. There are significant challenges, however, in implementing the collaborative, co-produced model within the constraints of a publicly funded mental health clinical service. This paper considers some of the practice implications for public mental health services in developing and integrating Recovery Colleges. The paper, like everything we do at the Recovery College, is co-produced and co-authored – in this case, by a lived experience expert, a medically trained expert and a research/writing expert. [ABSTRACT FROM AUTHOR]

This paper, drawing on the published medical literature and unpublished medical record archives, provides an in-depth account of the introduction of malaria therapy for general paralysis of the insane into Australia in 1925–6, at Victoria's Sunbury Hospital for the Insane. This study reveals a complex and ambiguous picture of the practice and therapeutic impact of malaria therapy in this local setting. This research highlights a number of factors which may have contributed to some physicians overestimating malaria therapy's effectiveness. It also shows that other physicians of the era held a more sceptical attitude towards malaria therapy. Finally, this paper discusses the relevance of this history to contemporary psychiatry. [ABSTRACT FROM AUTHOR]

Voluntary Assisted Dying is a process whereby terminally ill patients are provided a lethal dose of medication for them to voluntarily ingest to end their life. Victoria, Australia, implemented legislation permitting Voluntary Assisted Dying for terminally ill adult patients with a life expectancy less than 6 months. Ethical dilemmas arise when terminally ill patients with a comorbid mental illness attempt to access Voluntary Assisted Dying because of the complex relationship between psychiatric conditions and suicidal ideation. This paper seeks to investigate the most ethical approach for doctors to respond to such a request by discussing objections raised in other literature to patients with a comorbid psychiatric illness aiming to access Voluntary Assisted Dying in Victoria. To answer this question, objections to terminally ill patients with a comorbid psychiatric illness accessing Voluntary Assisted Dying were found through review of literature. Discussion of these objections centred around unpacking the two historical ethical justifications for Voluntary Assisted Dying: respect for autonomy and relief of suffering. Regarding autonomy, contention focused on competency to make autonomous decisions. Not all psychiatric patients lack competency to decide about Voluntary Assisted Dying, and there are comparable competency assessments used in psychiatry today. Considering suffering, objections related to the authenticity of the intolerable nature of a patient's suffering out of concerns that it has been influenced by their condition, and that the psychiatric illness may still be treatable. However, given suffering is subjective, its perception is not lessened if the source is psychological in nature. Furthermore, it is challenging to justify a position where a patient is forced to spend the last months of their life enduring suffering that has been historically refractory to multiple, genuine treatment efforts. Not all terminally ill patients with a comorbid psychiatric disorder will lack competency to choose Voluntary Assisted Dying, and many will have genuine suffering for which they are requesting Voluntary Assisted Dying. Multidisciplinary, holistic assessments for these patients are not mandated, but would be useful to address the issues, overcome barriers to access and determine that applicants are making an authentic request. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) can involve patterns of physical, sexual and emotional abuse. Women typically experience physical IPV in combination with emotional IPV, while emotional IPV is often experienced in the absence of other types of IPV. There is very little known about women's experiences of these different types of IPV over time. The primary aim of this paper is to describe patterns in women's individual experiences of physical and/or emotional IPV across the first 10 years of motherhood. Data were drawn from a prospective pregnancy cohort of 1507 first-time mothers in Melbourne, Australia. Emotional, physical, and combined physical and emotional IPV were reported in the first, fourth and tenth year of motherhood using the Composite Abuse Scale. The overall prevalence of each type of IPV remained consistent across the three time-points, with emotional IPV alone being the most prevalent. There was substantial variability in women's experiences of IPV over time and there was no common progression from one type of IPV to another. Women were more likely to report IPV at more than one time-point if they experienced combined physical and emotional IPV, while for women who reported emotional or physical IPV alone this was more likely to be at a single time-point. A number of socio-demographic characteristics in early pregnancy were associated with a higher risk of reporting IPV at all three time-points, including being unemployed (RRR = 3.6; 95% CI: 2.1, 6.2) and being aged 18–24 years (RRR = 3.1; 95% CI: 1.8, 5.4). Knowledge of the variability and persistence of IPV in the first 10 years of motherhood, and factors associated with these experiences, can help tailor effective health and social service responses. [ABSTRACT FROM AUTHOR]

John Davies Thomas (1844-1893) described a two-ounce drop-bottle for chloroform in 1872 while he was a resident medical officer at University College Hospital, London. After working as a ship's surgeon, he settled in Australia. In May 1875, Thomas presented a paper on the mortality from ether and chloroform at a meeting of the Medical Society of Victoria in Melbourne, Victoria. Surveys conducted in Europe and North America had established that the mortality from chloroform was eight to ten times higher than that from ether. At that time, chloroform was the most widely administered anaesthetic in Australia. Thomas' paper was published in The Australian Medical Journal and reprinted by the Medical Society of Victoria for distribution to hospitals in the Colony of Victoria. Later that year, Thomas moved to Adelaide, South Australia, where he may have been influential at the Adelaide Hospital in ensuring that ether was administered more often than chloroform. It does not appear that Thomas' papers on anaesthesia had a significant effect on the conduct of anaesthesia in Victoria or New South Wales. [ABSTRACT FROM AUTHOR]

This paper reports on recommendations made by Métis women, two-spirit, and gender diverse people for improving access to health and social services in Victoria, British Columbia. Expanding on research conducted in Toronto, Ontario, this study applied a conversational interview method to further explore and understand experiences of self-identifying Métis women, two-spirit, and gender diverse people (n = 24) who access health and social services in Victoria. Participants provided wholistic and practical recommendations for improving access to health and social services, including (1) warm and inviting service spaces, (2) Métis-specific cultural safety training, (3) Indigenous specific clinic, (4) wholistic or integrative service delivery, and (5) non-judgemental service providers. This research demonstrates that Métis women, two-spirit and gender diverse community members hold practical solutions for improving access to health and social services for the larger Métis community. [ABSTRACT FROM AUTHOR]

There is ample evidence to demonstrate that a positive group climate in juvenile justice centers contributes to improvements in motivation for positive behavior and reducing incidents and even recidivism. Being provided opportunities for growth and development and being actively supported by well-trained staff creates a positive atmosphere and minimal repression. Such a pedagogical group climate is strongly related to fulfilling the basic psychological needs of the young people and is promoted by relational security. Following a series of challenging situations inside youth justice centers in Australia, we explored the opportunities for investing in staff training on awareness of basic psychological needs of these young people and introducing the concept of an open, positive group climate. This study reports the results of an explorative measurement of perceived group climate in four units of two juvenile justice centers in Victoria (Australia). The young people (N = 57) were provided with the Prison Group Climate Instrument. The results of the group climate research and a cross-cultural comparison show that there are inherent strengths but also important opportunities for improvement in the group climate experienced by young people. Recommendations to improve the group climate are discussed in this paper. [ABSTRACT FROM AUTHOR]

Objectives: This narrative paper describes the influences behind the development of, and key components of a specialist younger-onset dementia service located in metropolitan Victoria, Australia.Conclusion: The Melbourne Young-Onset Dementia Service was established in 2013 and provides diagnosis and ongoing care for people with younger-onset dementia and their families, through collaboration with other medical units, allied health and community services. It is potentially a model for other younger-onset dementia services nationally and internationally. [ABSTRACT FROM AUTHOR]

This paper explores the policy concept and community enactments of 'shared responsibility' for disaster resilience in the context of wildfires in Victoria, Australia. Since the state-wide Black Saturday fires of 2009, we contend, first, the State's decreasing ability to protect its citizens has shifted the responsibility for adapting to uncertainty to individuals, and second, this responsibility has been translated into compliance approaches to disaster risk management. We develop the concept of two distinct imaginaries at play: the reactive and the relational life. Policy discourse invokes a reactive life, a normative resilience maintaining the status quo, rather than a potentially transformative relational process enabling citizens to be 'response-able'. Facing uncertainties, government legitimacy hinges on increasing citizen safety, with decentralised community resilience programs intended to manage and reduce disaster risk by emphasising shared responsibility. For citizens, however, 'shared responsibility' reveals an increasing tension in relation to the risk and uncertainty associated with life on the newly designated 'fire-prone' periphery, and within expectations of government. We conclude that the emphasis on responsibility as the work to be done in community-based resilience programs demands a more nuanced set of expectations that reflect citizens' relational life as a starting place for rethinking safety and security. [ABSTRACT FROM AUTHOR]

This paper investigates mothers' views regarding the purpose of shared reading with their two-year-old children, confidence in using printed and electronic texts, and selfreported practice, framed around a focus on mothers' motivation to engage in shared reading with their children. Research into adult--child shared reading experiences has traditionally focused on early reading behaviours and talk patterns captured in video data, reporting on the literacy or cognitive benefits of these experiences as viewed by researchers. Parent contributions have typically been sought to provide background information such as parent education, frequency of home reading and socio-economic factors. There is limited research that invites parents' voices. Findings from this study have been drawn from quantitative and qualitative data, collected from questionnaires and individual interviews with 12 reading-proficient mothers of two-year-old children in Victoria, Australia. Findings show that mothers acknowledged the educational affordances of shared reading, and the love of reading that the practice invites. Self-reported practices and confidence levels showed a strong preference for using printed picture storybooks as part of a bedtime routine, and that access to electronic texts does not necessarily equate to the same guided engagement with electronic texts as with printed texts. [ABSTRACT FROM AUTHOR]

This paper argues that whilst inclusive education in early childhood is gaining wider acceptance in the equity and diversity movement, the value and contribution of educators' voices about what is working and challenging are frequently ignored. This small-scale research explored five early childhood educators' understandings and experiences of inclusive education in two kindergartens in Victoria, Australia. A thematic analysis of the data highlights inclusion as a right to belong and fully participate; the need for modifications to orchestrate a culture of acceptance, diversity and inclusion; a lack of support and inadequate professional learning; and supporting effective practice through relationship with families, experts and children. The findings draw implications of evidencebased professional learning that is less focused on the interests of academic researchers and policy makers and more on the everyday needs of early childhood educators. [ABSTRACT FROM AUTHOR]

Objective: Discussions of capacity to consent in mental health care usually revolve around capacity to consent to treatment. This paper instead explores the issue of capacity to consent to sexual activity in a mental health inpatient setting as a way of exploring capacity from a different perspective. This is not a purely theoretical exercise, with both consensual sexual activity and sexual assault commonplace in mental health inpatient units, current policy and practice approaches are clearly not working and require re-examination. Methods: Four key frameworks are explored: human rights law, mental health law, the criminal law and the law of tort governing the duty of care. These frameworks are explored by highlighting relevant case law and statutes and considering their potential application in practice. This is undertaken using the state of Victoria, Australia, as a case study. Results: The four frameworks are shown to be consistent with each other but inconsistent with contemporary policy. All four legal frameworks explored require clinicians to take a case-by-case assessment to ensure that a person's right to make their own decisions is preserved ' unless the contrary is demonstrably justified ' or where it is ' legally demanded '. While Victorian inpatient units attempt to enforce a blanket ban on consensual sexual activity in inpatient settings, this ban may be without legal basis and may be in breach of both human rights and mental health law. Conclusion: In policing the lawful bodily interactions of their patients and pushing sexual activity out of sight, clinicians may be breaching their duty of care to provide sexual health support and risk creating an environment in which the therapeutic relationship will be sacrificed to the enforcement of institutional policy. Clinicians and policymakers must understand the relevant legal frameworks to ensure that they are acting ethically and lawfully. [ABSTRACT FROM AUTHOR]

Objective: To critically examine a recent decision of the Victorian Supreme Court that found that the Mental Health Tribunal and the Victorian Civil and Administrative Tribunal erred in the application of the capacity test in the Mental Health Act 2014 (Vic) and that compulsory electroconvulsive therapy would infringe upon the human rights of two patients who had no insight into their chronic schizophrenia.Conclusions: After considering the concepts of insight and capacity to consent to treatment, the paper concludes that the decision in NJE and PBU v Mental Health Tribunal [2018] VSC 564 is problematic clinically. [ABSTRACT FROM AUTHOR]

Objective: This paper aims to describe current approaches in Victoria to the development of perinatal and infant mental health services in regional areas.Method: The paper outlines the significance of perinatal mental disorder for maternal wellbeing and impact on infant development, and describes the model of care at the Agnes Unit.Results: The Agnes Unit has been established as a residential therapeutic unit offering short-term treatment that focusses on promoting parental mental health, parenting sensitivity and the parent-infant relationship.Conclusions: A coordinated and integrated approach with focus on early intervention is needed to deliver perinatal and infant mental health services. Services need to focus on the infant and parent-infant relationship in addition to parental mental health. [ABSTRACT FROM AUTHOR]

Objective:: The purpose of this paper is to provide some learnings for the NDIS from the referral pattern and cost of implementing the Partners in Recovery initiative of Gippsland.Method:: Information on referral areas made for each consumer was collated from support facilitators. Cost estimates were determined using budget estimates, administrative costs and a literature review and are reported from a government perspective.Results:: Sixty-three per cent of all referrals were made to organisations that provided multiple types of services. Thirty-one per cent were to Mental Health Community Support Services. Eighteen per cent of referrals were made to clinical mental health services. The total cost of providing the service for a consumer per year (set-up and ongoing) was estimated to be AUD$15,755 and the ongoing cost per year was estimated to be AUD$13,434. The cost of doing nothing is likely to cost more in the longer term, with poor mental health outcomes such as hospital admission, unemployment benefits, prison, homelessness and psychiatric residential care.Conclusions:: Supporting recovery in persons with Severe and Persistent Mental Illness is likely to be economically more beneficial than not doing so. Recovery can be better supported when frequently utilised services are co-located. These might be some learnings for the NDIS. [ABSTRACT FROM AUTHOR]

Objective: To assess depression literacy, help-seeking and help-offering to others in members of the police force in the state of Victoria, Australia. Methods: All staff in police stations involved in a cluster randomised controlled trial of an integrated workplace mental health intervention were invited to participate. Survey questions covered sociodemographic and employment information, recognition of depression in a vignette, stigma, treatment beliefs, willingness to assist co-workers with mental health problems, help-giving and help-seeking behaviours, and intentions to seek help. Using the baseline dataset associated with the trial, the paper presents a descriptive analysis of mental health literacy and helping behaviours, comparing police station leaders and lower ranks. Results: Respondents were 806 staff, comprising 618 lower-ranked staff and 188 leaders. Almost 84% of respondents were able to correctly label the problem described in the vignette. Among those who had helped someone with a mental health problem, both lower ranks and leaders most commonly reported ‘talking to the person’ although leaders were more likely to facilitate professional help. Leaders’ willingness to assist the person and confidence in doing so was very high, and over 80% of leaders appropriately rated police psychologists, general practitioners, psychologists, talking to a peer and contacting welfare as helpful. However, among both leaders and lower ranks with mental health problems, the proportion of those unlikely to seek professional help was greater than those who were likely to seek it. Conclusion: Knowledge about evidence-based interventions for depression was lower in this police sample than surveys in the general population, pointing to the need for education and training to improve mental health literacy. Such education should also aim to overcome barriers to professional help-seeking. Interventions that aim to improve mental health literacy and help-seeking behaviour appear to be suitable targets for better protecting police member mental health. [ABSTRACT FROM AUTHOR]

Wildfire is a global environmental ‘problem’ with significant socioeconomic and socionatural impacts that does not lend itself to simple technical fixes (Gill et al., 2013: 439). In Australia, a country with a pronounced history of disastrous landscape fires, these impacts are expected to increase as the peri-urban population continues to grow and the climate continues to change. This paper draws upon the burgeoning literature on anticipatory regimes to analyse an in-depth case study of a government pilot in the highly fire-prone State of Victoria, where practitioners have utilised a simulation model to measure and intervene in the distribution of wildfire risk. The pilot presents the ‘calculative collective device’ (Callon and Muniesa, 2005) of wildfire management at a moment of what I label ‘calculative rearticulation’, wherein figurations of the future are rebooted, reconstructed or recalibrated; such moments, I suggest, can reorient the institutionally conservative spaces – such as environmental or risk management – providing opportunities for practitioners and others to interrogate the existing distribution of hazards and anticipatory interventions. Through such opportunities ‘hazardous’ more-than-human landscapes can be imagined otherwise. [ABSTRACT FROM AUTHOR]

The importance of the arts to the creative, cultural and social development of children is increasingly acknowledged. In recognition of this, ArtPlay was established in 2005 by the City of Melbourne. Open to children aged three to 12 years, the facility provides a wide range of artist-led programs that serve a broad community, including parents and teachers. While institutions such as ArtPlay are emerging in response to a growing community demand, there has yet to be significant and sustained research into processes and outcomes of such organisations. This paper reports on a three-year Australia Research Council-funded research project (2007-2009) that has been designed to identify, map and evidence the practices of ArtPlay in relation to engagement, learning and cultural citizenship. Throughreference to the responses of children, families and artists to one key ArtPlay program, Pocketfool for preschoolers, this paper explores the question: What factors influence the engagement of children and families in an artist-led community-based workshop? [ABSTRACT FROM AUTHOR]

Objective: A recovery-based outreach program for people with severe mental illness in regional Victoria is described. The paper covers a description of the program, the services provided and outcomes achieved. The program emphasized active collaboration between patients and clinicians as outlined in the collaborative recovery model and recognized that recovery from mental illness is an individual, personal process. Conclusions: The program provided service to 108 people over 3 years and had a positive impact on clinicians, patients and carers. The benefits of recovery orientation, multidisciplinary teams, collaborative relationships and carer involvement are discussed. The paper highlights the need for a focus on recovery and comprehensive care for people with severe mental illness. [ABSTRACT FROM AUTHOR]

The need for all people with disability to have access to reliable information before they can make informed choices in individualised funding programmes is well documented. However, little guidance exists on how information can be provided to ensure it reaches its target audience. While information provision is important everywhere, there is a pressing need in the Australian context to ensure all people have access to information as the National Disability Insurance Scheme is designed and introduced. The authors identified key principles of information provision documented in the literature and used these to analyse their data from Australian studies of individualised funding programmes. The data came from 143 transcripts and records of interview in five studies conducted from 2011 to 2013. The analysis confirmed the importance of the principles previously documented and identified two additional principles, these being related to gender and ‘hard to reach’ groups. This analysis informs a new framework to increase equity and improve people’s access to information in individualised funding programmes. Information needs to be: (i) accessible and diverse in format, mode, source and location; (ii) personalised and targeted; (iii) accurate, consistent and timely; (iv) from a trusted source; (v) independent; (vi) culturally appropriate; (vii) actively promoted to ‘hard to reach’ groups and (viii) gender appropriate. This paper provides a new framework to guide information in individualised funding programmes for professionals in roles ranging from policy makers to service delivery. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to describe 'The Tofts', a private psychiatric hospital in the reigns of Edward VII and George V. Conclusions: An addendum to the history of psychiatry, in Australia is the conduct or treatment for the mentally ill in private hospitals during the nineteenth and early twentieth centuries. This paper describes one such small private hospital in Victoria, called The Tofts, and its founder, patients and treatment methods employed. [ABSTRACT FROM AUTHOR]

This paper reports an investigation of Chinese-speaking and English-speaking children's general visual perceptual abilities. The Developmental Test of Visual Perception was administered to 41 native Chinese-speaking children of mean age 5 yr. 4 mo. in Hong Kong and 35 English-speaking children of mean age 5 yr. 2 mo. in Melbourne. Of interest were the two interrelated components of visual perceptual abilities, namely, motor-reduced visual perceptual and visual-motor integration perceptual abilities, which require either verbal or motoric responses in completing visual tasks. Chinese-speaking children significantly outperformed the English-speaking children on general visual perceptual abilities. When comparing the results of each of the two different components, the Chinese-speaking students' performance on visual-motor integration was far better than that of their counterparts (ES = 2.70), while the two groups of students performed similarly on motor-reduced visual perceptual abilities. Cultural factors such as written language format may be contributing to the enhanced performance of Chinese-speaking children's visual-motor integration abilities, but there may be validity questions in the Chinese version. [ABSTRACT FROM AUTHOR]

With the advent of environmental 'governance by commission', associated with evidence-based policy and market mechanisms, there is a need to (re)imagine Australia's nature politics. I identify two distinct domains of nature politics - one associated with distribution of goods produced in nature, and another concerned with constituting nature itself. The paper offers two analytically distinct readings of a tender bids hearing to select a contractor to assemble a diagnostic design for a government funded project of river rehabilitation. The tool that enables these incommensurable accounts is a purposefully crafted ethnographic story of the hearing. These dual readings engage alternative framings in order to see alternative political domains. The first reading mobilises an orthodox relativising framing to show a familiar politics evident in the competition for the contract; a politics over the distribution of goods produced from nature. This can be read as a politics over valuing nature. The second reading, proposing an alternative nature politics that should be understood as sitting alongside, utilises an alternative analytic framing. It offers a reading of the tender bids hearing as a politics contesting the form of the entities that should order Australian nature. In concluding I propose that the juxtaposed alternative readings, analyses made with disparate explicit metaphysical commitments, which reveal separate but connected political domains, constitute a politics of imagination, and ask how to configure the analyst who can engage such a politics? [ABSTRACT FROM AUTHOR]

Objective: The objectives of this paper are to provide an overview of recovery-focused models of care and discuss the implementation of the Strengths Model at St. Vincent's Mental Health Melbourne (SVMH), Victoria, Australia. Conclusions: The implementation of the Strengths Model at SVMH is discussed with particular emphasis on the process of implementation, service implications, practical challenges and dilemmas that have arisen, and proposed evaluation. Recovery-focused care is feasible and can enhance current practice of mental health services. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to outline the impact of Community Treatment Orders over a 20-year period on service delivery and clinical practice in Victoria. Conclusions: Community Treatment Orders, as utilized in Victoria, have undermined optimal service delivery and supported paternalistic, reductionistic clinical practice. The psychiatric profession has failed to advocate adequately for better mental health resourcing and human rights protection of those subject to Community Treatment Orders. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to describe the use of the Health of the Nation Outcome Scale (HoNOS) in an outreach-based rehabilitation program in regional Victoria, Australia. Method: Routine outcome measures (ROM), including the HoNOS, were introduced in the Stepping Stones Recovery Program (SSRP) in 2002. HoNOS data routinely collected for 122 patients between 2003 and 2006 was examined for sensitivity in capturing clinical changes by using paired t-tests. Results: There was a statistically significant decrease in total HoNOS scores as well as scores on subsets of 'impairment' and 'symptomatic problems'. HoNOS scores reflected positive changes in patients and were useful as a global overview, but did not tap into process issues that are more clinically meaningful. Conclusions: The SSRP provided a wide range of interventions and promoted a structured collaborative approach which could be the main reason for the uptake of ROM in this service. There are significant hurdles in integrating ROM in routine clinical practice, such as feasibility issues and clinician attitudes, along with larger systemic issues that need to be addressed. The introduction of ROM in Australia has resulted in strongly polarized viewpoints. Suggestions for facilitating the administration and use of ROM in routine clinical practice are discussed. [ABSTRACT FROM AUTHOR]

Objective: To describe the introduction of an ongoing professional development programme for clinicians in a rural area mental health service. The programme involved a series of workshops delivered by clinical psychologists. The training component of each workshop focused on discrete cognitive behavioural strategies, targeted at the amelioration of anxiety and mood symptoms.Conclusions: The paper emphasizes contextual aspects of the programme: its setting, the modality of delivery, resourcing issues and maximizing engagement by the participants. Preliminary evaluation data are reviewed, and it is argued that programmes that focus on local capacity building in rural settings are an important component of redressing the urban-rural imbalance in the availability of evidence-based psychological treatments. [ABSTRACT FROM AUTHOR]

Commonplace incivility is a topic of longstanding interest within social theory, perhaps best exemplified by Goffman's studies of the interaction order. Nevertheless we know very little about its distribution and expression in everyday life. Current empirical work is dominated by criminological agendas. These tend to focus on more serious and illegal activities rather than minor deviant acts that are simply inconsiderate or rude. The paper reports findings from a focus group study conducted in Melbourne, Australia that set out to benchmark everyday incivilities. The results suggest that perpetrators of incivility have a surprisingly broad social distribution as does the range of locales that might be characterised as 'high risk'. Turning to the work of Putnam and Wolfe, we call for a research focus on low-level incivilities as key symptoms of the state of civic virtue and the strength of moral ties within civil society. Drawing on Virilio, Bauman and Durkheim, it is suggested that the experience of incivility is underpinned by the growth of freedom and movement in contemporary urban settings, and has ambivalent implications that not only invoke boundary maintenance and retreatism, but also offer the possibility for boundary expansion and tolerance of difference. [ABSTRACT FROM AUTHOR]

Objectives: This paper reviews the use of clinical indicators in a consultation–liaison (C–L) service over a 12-month period at the Royal Melbourne Hospital, Melbourne, Australia. Method: Clinical indicators and C–L data were collected during the 1999 calendar year. A review of the process was conducted during and after completion of the 12-month period. Results: The system was found to be practical and useful. The use of clinical indicators led to the identification of problems and stimulated effective interventions. The use of the clinical indicators was associated with improvement in communication between C–L staff, parent units and practitioners providing follow-up. Conclusions: The implementation of a database and clinical indicators was a useful addition to the C–L service. The use of clinical indicators was effective in improving clinical performance. These benefits need to be balanced against increased administrative burden. [ABSTRACT FROM AUTHOR]

This paper aims to provide the context and model of the development of a new, innovative state-wide service for people with a mental illness and intellectual disability (Dual Disability). Preliminary data on referral patterns and assessments are also discussed. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this paper is: to compare the utility of four approaches to the diagnosis of depression in patients with human immunodeficiency virus (HIV) disease; to examine the utility of four rating scales to assess the presence and severity of depression; and to devise a set of substitutive criteria that would be appropriate in patients with HIV disease. Method: A group of inpatients was assessed using standard clinical interview. Patients found to have major depression using DSM-III-R (aetiological) criteria were assessed using inclusive, substitutive and exclusive criteria for the diagnosis of depression. Severity was assessed using the Hamilton Depression Rating Scale (HDRS), the Montgomery Asberg Depression Rating Scale (MADRS), the Beck Depression Inventory (BDI), and the Centre for Epidemiological Studies Depression Rating Scale (CES-D). A group of control patients were matched for age and severity of HIV illness. Results: Seventeen patients met DSM-III-R (aetiological criteria) for major depression. All were male; they had a mean age of 40.6 years and one-third had acquired immune deficiency syndrome (AIDS). Using alternative approaches to the diagnosis of depression, up to five additional ‘depressed’ patients were identified (‘false positives’). All 17 patients meeting the DSM-III-R criteria also met the substitutive and exclusive criteria but only 15 exclusive criteria. Of the 17 controls (not meeting DSM-III-R criteria), two met substitutive, five inclusive and one exclusive criteria for depression. The mean (± SD) scores for the patients and controls were significantly different on all four rating scales. Analysis of individual items on the rating scales revealed that a number did not show significant differences between the depressed and non-depressed groups: on the MADRS the items lassitude and inner tension; on the HDRS the three items depicting anxiety symptoms, loss of libido, hypochondriasis, lo... [ABSTRACT FROM AUTHOR]

Objective: The paper describes the origin, and establishment of a gender dysphoria clinic at Monash Medical Centre, Melbourne. It aims at describing the various components of the service, especially the triadic notions of assessment, real life experience and surgery for gender identity disorders. Conclusion: This is a unique service offered by a public psychiatric service, and the viability of the service depends upon new resources and renewed interest from psychiatrists. Besides clinical services, the clinic offers enormous research, teaching and training opportunities. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this paper is to document the processes towards ensuring that all psychiatrists in training in Victoria have appropriate Indigenous mental health experience and training. Conclusions: This paper describes the process of implementation of the 2004 Indigenous Mental Health Royal Australian and New Zealand College of Psychiatrists (RANZCP) Training By-Laws within Victoria. It is likely that the challenges of ensuring access to this training experience, within the Victorian RANZCP Training Program, have been experienced to varying degrees within other Australian training programs. The vertical integration of Indigenous health curriculum extends work being done in all undergraduate medical schools in Australia and New Zealand, and which the Australian Medical Council have incorporated into their accreditation of medical schools. [ABSTRACT FROM AUTHOR]