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The process of medical scientific journal publishing merits further explanation for authors and readers. Prospective authors need to understand the scope of the journal and the article types that are published. We give an overview of the editorial process, including selection of reviewers, peer review and decisions regarding revision, acceptance and rejection of papers for Australasian Psychiatry. We encourage authors and readers to submit papers, and volunteer as peer reviewers, working together with the journal editorial team. [ABSTRACT FROM AUTHOR]

The document titled "The Thought Broadcast: How to critique a paper" is a podcast episode from Australasian Psychiatry. In this episode, Dr. Ed Miller, Dr. Andrew Amos, and Dr. Michael Weightman discuss the importance of psychiatric journal clubs and the significance of knowing how to critique scientific papers. They explore the history of journal clubs in medicine and highlight common flaws in academic publishing that can be addressed through effective critique. The episode also provides insights into best practices for running psychiatric journal clubs. [Extracted from the article]

The article discusses the importance of respectful scientific debate in the field of psychiatry. The journal, Australasian Psychiatry, welcomes correspondence from readers and authors who have views about papers published in the journal. The correspondence should focus on evidence and reasoned arguments, avoiding personal attacks or offensive language. The journal encourages the submission of letters to the editor, which are subject to peer review, and limits further rounds of correspondence to avoid repetition. The goal is to challenge the evidence and arguments within a paper to promote independent assessment by readers. [Extracted from the article]

The article advises psychiatrists on how to successfully publish high-quality articles in peer-reviewed journals. Topics covered include the steps involved in publishing a paper, the common reasons why a paper is rejected by journal editors, some examples of reviewer comments including the absence of clear objectives and limitations of the study, and the qualities of successful articles.

Australasian Psychiatry is a journal that aims to provide evidence-based substance and experience-based sustenance for integrating the art and science of psychiatry. The journal focuses on clinical psychiatric practice, service delivery, and the well-being of psychiatrists and trainees. The new editorial team plans to expand the scope and reach of the journal, welcoming submissions from various fields to enrich psychiatric practice. They also aim to increase the speed of reviews and depth of expertise by involving early and mid-career clinical academic psychiatrists in new roles as Deputy and Associate Editors. The journal encourages respectful discourse and offers various submission options for papers, subject to formal peer review. The team also plans to enhance learning and discourse through podcasts and social media updates. [Extracted from the article]

Objective: To examine the peer-reviewed literature on psychiatric formulation. Methods: The term (formula*) was used to systematically search Australasian Psychiatry, Australian and New Zealand Journal of Psychiatry, British Journal of Psychiatry, BJPsych Bulletin, American Journal of Psychiatry and Academic Psychiatry. The resulting papers were reviewed. Results: Of the 42 papers located, 22 (52%) were published between 2002 and 2019; 90% papers were published in Australasian Psychiatry (15), Academic Psychiatry (12) or BJPsych Bulletin (10), journals that focus on training and clinical practice. The papers varied in their aims and recommendations and not all justified the need for formulation. Formulation was recommended as a necessity for training, a communication tool and a guide to treatment. No article provided evidence for the superiority of any type of formulation, and the role of consumers in formulation was conspicuously lacking. Conclusion: There are many ways to structure formulation. However, the existing literature does not support any particular approach. More consideration needs to be given to the needs of consumers in conceptualising and practicing formulation. [ABSTRACT FROM AUTHOR]

Objective: This paper aims to provide an introductory resource for beginner peer reviewers in psychiatry and the broader biomedical science field. It will provide a concise overview of the peer review process, alongside some reviewing tips and tricks. Conclusion: The peer review process is a fundamental aspect of biomedical science publishing. The model of peer review offered varies between journals and usually relies on a pool of volunteers with differing levels of expertise and scope. The aim of peer review is to collaboratively leverage reviewers' collective knowledge with the objective of increasing the quality and merit of published works. The limitations, methodology and need for transparency in the peer review process are often poorly understood. Although imperfect, the peer review process provides some degree of scientific rigour by emphasising the need for an ethical, comprehensive and systematic approach to reviewing articles. Contributions from junior reviewers can add significant value to manuscripts. [ABSTRACT FROM AUTHOR]

--- B About the Cunningham Dax Collection b The Cunningham Dax Collection consists of over 15,000 artworks created by people with an experience of mental illness and/or psychological trauma. Leslie has a long association with Prahran Mission's art programmes, through which he has exhibited his work several times. Cover art The cover art entitled I My version of Ned Kelly inspired by Sidney Nolan i is the work of artist Leslie Holding. [Extracted from the article]

The article discusses the importance of ethical and respectful debate in scientific publishing, particularly in the field of mental science and psychiatric practice. The editor plays a critical role in facilitating this debate and protecting authors from external influences. The article emphasizes the need for justified interpretations and arguments in scientific papers, as well as the importance of balanced viewpoints and mutual respect. It also discusses the use of technology in advancing scientific communication and the ethical responsibility of publishers and editors to ensure the quality and integrity of published work. [Extracted from the article]

Objectives: This paper critiques the haematological monitoring guidelines for clozapine. It describes the history of clozapine, as well as the pathophysiology and epidemiology of clozapine-induced neutropenia (CIN) and agranulocytosis (CIA). The paper appraises the extant literature on mandatory clozapine haematological monitoring. Conclusion: Contemporary Australian protocols for clozapine haematological monitoring are not consistent with the current evidence base. CIN and CIA are rare occurrences, and the associated risk of death is low. Potential modifications to existing guidelines include changing neutrophil thresholds for patients with benign ethnic neutropenia and reducing the frequency or removing haematological monitoring after two years of clozapine treatment. [ABSTRACT FROM AUTHOR]

Cover Art The cover art entitled I Immersing Plume i is the work of artist Julie Goodwin. Starting her family in Europe, Dr Sonja Cabarkapa is taking an international approach to her psychiatry training. The Thought Broadcast - An Interview with Sonja Cabarkapa: "Think Globally, Act Locally". [Extracted from the article]

Keywords: Clinical; psychiatry; quality improvement; psychiatry training EN Clinical psychiatry quality improvement psychiatry training 7b 7b 1 03/09/22 20220201 NES 220201 Cover Art The cover art entitled Factory street is the work of Melbourne-based artist Leslie Holding. Alisha is interviewed by Associate Trainee Editor Michael Weightman, Deputy Editor Andrew Amos and Trainee Editor Oliver Robertson. Clinical, psychiatry, quality improvement, psychiatry training. [Extracted from the article]

Clinical, psychiatry, quality improvement, psychiatry training Keywords: Clinical; psychiatry; quality improvement; psychiatry training EN Clinical psychiatry quality improvement psychiatry training 7a 7a 1 03/09/22 20220201 NES 220201 Cover Art The cover art entitled Factory street is the work of Melbourne-based artist Leslie Holding. Nick is interviewed by Trainee Editor Oliver Robertson, Associate Trainee Editors Bryan Bui and Michael Weightman, and Deputy Editor Andrew Amos. [Extracted from the article]

Objective: Mother Baby Units provide mental health care to parents experiencing severe perinatal mental illness. The majority of admitted parents identify as mothers and are the birthing parent and primary caregiver for their infants. However, there is increasing recognition of transgender and gender diverse people who birth and parent infants, as well as awareness of the mental health needs of fathers, people in same-sex relationships, and other non-birthing parents. As such there are moves to use ungendered language for health services including renaming these units as Parent Baby Units. This paper explores this debate, critically reflecting on emergent tensions. Conclusion: Movements towards, and resistance against, changing language in perinatal mental health care are attempts to ensure the visibility of groups within mainstream services. Whether to adopt new terminology is a complex question. But ensuring MBUs meet the needs of people who require them should remain paramount. [ABSTRACT FROM AUTHOR]

About the Cunningham Dax Collection The Cunningham Dax Collection consists of over 15,000 artworks created by people with an experience of mental illness and/or psychological trauma. Cover Art The cover art entitled I Sunlite i is the work of artist Patricia Stewart. We aim to change community attitudes to mental illness by increasing empathy and understanding of mental illness, psychological trauma and the mind through art, thereby reducing stigma against mentally ill people. [Extracted from the article]

Objectives: The principles of gender equity are important to achieve the Royal Australian and New Zealand College of Psychiatrists (the College) strategic goals. (1) To present the data on gender equity, (2) To describe how the action plan was developed, (3) To discuss how this work aligns with a commitment to inclusion and diversity. Methods: Firstly, the formation of a working group with representation from across the College. Secondly, undertaking a data snapshot and discussion paper on gender equity to support consultation. Thirdly, reviewing similar action plans, a literature review, and undertaking broad consultation across the College. Finally, collating data using a thematic analysis to support the development of an action plan. Results: Data obtained on gender equity identified clear gaps in leadership roles, academic activities and awards. Our review and consultation identified themes focused on gaps in gender equity including a role for organisational leadership approach. Together this has then informed an action plan for gender equity for the College. Conclusions: There are no simple solutions that will solve gender inequity; this requires systemic solutions to achieve meaningful change. However, the development of the action plan is a significant step towards addressing the current gender inequities. [ABSTRACT FROM AUTHOR]

In a letter to the editor of Australasian Psychiatry, Christopher James Ryan and Amy Corderoy criticize a recent paper by Halasz and Amos. The authors argue that Halasz and Amos were wrong to base their argument on the findings of a UK court case, Bell v Tavistock (Bell No. 1), as it was overturned on appeal by a higher court in a case referred to as Bell No. 2. The judges in Bell No. 1 made findings that Halasz and Amos used to support their conclusions, but failed to inform readers of the appeal's outcome. Ryan and Corderoy suggest that Halasz and Amos' paper should be revised and read with knowledge of the lack of legal foundation. [Extracted from the article]

Objective: To convert screening tools for depression and suicide risk into algorithmic decision support on smartphones for use by community health nurses (CHNs), and to evaluate the efficiency, effectiveness, and usability of the mHealth tool in providing mental health (MH) care.Method: Two scenarios of depression and suicide risk were developed and presented to 48 nurses using paper-based and mobile-based guidelines under laboratory (nonclinical) conditions. Participants read through the case scenarios to provide summaries, diagnoses, and management recommendations. Audiotapes were transcribed and analyzed for accuracy in scoring guidelines, therapy decisions, and time for tasks completion. The validated System Usability Scale (SUS) was used to measure mobile app usability.Results: Using mHealth-based guidelines, nurses took significantly less time to complete their tasks, and generated no errors of addition, as compared to paper-based guidelines. Although coding errors were noted when using the mHealth app, it did not influence treatment recommendations. The system usability scores for both guidelines were over 84%.Conclusions: Usable mHealth technology can support task-sharing for CHNs in Fiji, for the efficient and accurate screening of patients for depression and suicide risks in a nonclinical setting. Studies on clinical implementation of the mHealth tool are needed and planned. [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]

Objective: To describe the importance of scientifically rigorous journal clubs in psychiatric education, and to provide a framework to effectively run journal clubs and appraise articles in a journal club format. This paper explores the concept of journal clubs and describes issues with the current state of academic science. It then lists factors associated with effectiveness of journal clubs and outlines a structure for appraising articles relevant to psychiatric practice in a journal club format. Conclusions: Current models of academic research and publishing, which can reward practices vulnerable to multiple forms of bias, make the consistent and valued use of journal clubs in psychiatric education and continuing professional development more important than ever. The literature shows that journal clubs can provide a valuable forum for mental health clinicians to update themselves on recent medical and scientific knowledge, while practicing and teaching skills in critical appraisal of research, statistics, clinical decision-making and epidemiology. [ABSTRACT FROM AUTHOR]

Objective: The Australian federal government is considering a 'digital front door' to mental healthcare. The Brain and Mind Centre at the University of Sydney has published a discussion paper advocating that the government should adopt a comprehensive model of digital triage and monitoring (DTM) based on a government-funded initiative Project Synergy ($30 million). We critically examine the final report on Project Synergy, which is now available under a Freedom of Information request. Conclusion: The DTM model is disruptive. Non-government organisations would replace general practitioners as care coordinators. Patients, private psychiatrists, and psychologists would be subjected to additional layers of administration, assessment, and digital compliance, which may decrease efficiency, and lengthen the duration of untreated illness. Only one patient was deemed eligible for DTM, however, during the 8-month regional trial of Project Synergy (recruitment rate = 1/500,000 across the region). Instead of an unproven DTM model, the proposed 'digital front door' to Australian mental healthcare should emphasise technology-enabled shared care (general practitioners and mental health professionals) for the treatment of moderate-to-severe illness. [ABSTRACT FROM AUTHOR]

Objective: The recent debate around the College's Clinical Practice Guidelines on mood disorders have highlighted differences in opinion on interpreting evidence from randomised control trials (RCTs) for psychodynamic psychotherapy. This paper discusses new techniques of synthesising research evidence (e.g., umbrella reviews) that may help minimise disagreements in the interpretation of RCTs and foster greater consensus on treatment guidelines. Conclusions: Findings from the latest umbrella review suggest that psychodynamic therapy is an evidence-based approach, among several, for common mental disorders. [ABSTRACT FROM AUTHOR]

Objective: Trainees and Fellows of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) work in complex interpersonal and organisational environments. Engagement in supervision can be a helpful way for trainees and Fellows to achieve interpersonal, professional, and organisational success. Supervision comes in many forms depending on the stage and state of one's career. An awareness of different supervision models is relevant to trainees' understanding of what is expected of them and their supervisors in their work and educational contexts. This paper explores the taxonomy of supervision models available to RANZCP trainees and Fellows in Australia and New Zealand. Conclusion: Supervision is a heterogeneous concept with multiple aims, outcomes, and processes that change with ones' stage of career. [ABSTRACT FROM AUTHOR]

Objective: The paper conducts a network analysis of the fragmented literature on brand and addiction. Method: A thematic map, thematic evolution, word cloud, co-citation analysis, and cooperation networks were utilized to identify brand addiction study trends and topics. Results: The data show that marketing and psychiatry have interdisciplinary groupings and multidisciplinary publications. These groups reflect societal changes, particularly the shift from traditional to digital challenges. Fast food addiction is different from alcohol and cigarette addictions due to its ease and extensive marketing. The decline in internet and gambling addiction suggests a shift in priorities. Conclusions: This research helps researchers, policymakers, and practitioners in addiction prevention and intervention. The study also understands brand addiction and its effects on psychology, psychiatry, and management by providing insights into emerging topics, thematic maps and evolution of studies, collaboration opportunities, geographical distribution of studies, and more. [ABSTRACT FROM AUTHOR]

Objective: Diversity in the workforce is a recognised component of highly functioning teams but remains aspirational in the Australian mental health context. There continue to be significant obstacles to true workforce diversity. The objective of this paper is to outline some of the skills and advantages women in established leadership roles have by dint of their lived workforce experience and how these skills may inform leadership approaches and capacity building potential for the benefit of the system. Conclusions: Leaders must synthesise, capacity build, maintain a systems and future focus and hold a vision to harness the skills of others. This paper outlines why women may have some unique capabilities as a consequence of a gender socialised world and describes approaches that contribute to cohesive, diverse and engaged teams. [ABSTRACT FROM AUTHOR]

Objective: This study examined differences in the types of mental health research that were conducted in the states and territories of Australia in 2008. Differences in both the disorder focus (e.g. depression, psychosis) and goal or methodology (e.g. epidemiological, biological) of published papers were examined. The structural differences underlying research output were examined by comparing output with funding and research infrastructure.Method: A random sample of 1008 Australian-authored mental health research publications and all 126 competitive mental-health related research grants from 2008 were coded in terms of their state or territory of origin, disorder focus and research goal.Results: Victoria and the Australian Capital Territory had the highest per capita rates of mental health research publications in 2008, while Tasmania and the Northern Territory had less per capita output. Research in New South Wales had greater focus on substance use and anxiety disorders, while Victoria was dominant in research on affective disorders and psychosis. Research in Queensland and Western Australia was broader in scope. Research output was more closely linked with number of successful grants than amount of funding.Conclusions: State and territory support for mental health research may have important implications for research output. [ABSTRACT FROM AUTHOR]

This letter to the editor highlights methodological and interpretational issues with a recent paper on private outpatient psychiatric consultation fees in Australia. The authors argue that the study's data collection is incomplete and does not accurately reflect real-world clinical practice. They also point out that the paper fails to acknowledge certain factors, such as state-to-federal cost-shifting and government subsidies, which can affect the estimation of out-of-pocket costs for patients. The authors question the validity of the study's findings and criticize the discussion for proposing actions that are not supported by the data. They suggest that broader consideration of the healthcare context and access to cost subsidies may be necessary to improve equitable accessibility to care. [Extracted from the article]

Objective: This paper aims to redress the shortage of published guidance for registrars on selecting suitable patients for the RANZCP Psychotherapy Written Case Summative Assessment. Conclusions: This article offers a common-sense approach to patient selection using psychiatric nomenclature and organises patients into proposed categories of likely suitable, possibly suitable, and unsuitable. A flowchart tool is offered for screening patients stressing a Global Assessment of Function (GAF) and the premorbid capacity to adhere to social frames such as school, university, employment, and relationships. [ABSTRACT FROM AUTHOR]

Objective: Commentary on the debate concerning the effectiveness of headspace, including the most recent independent evaluation of its services. Conclusions: The available evaluations indicate that headspace does not deliver therapy of adequate duration that results in clinically significant improvement. Most evaluations have used either short-term process measures or uncontrolled satisfaction surveys, and where there have been data on outcomes using standardised instruments, findings have been disappointing. Costs are poorly quantified and probably underestimated. Even so, headspace as a primary care intervention costs twice as much as a mental health consultation by a general practitioner and, depending on the assumptions, may not be cost effective. [ABSTRACT FROM AUTHOR]

Objectives: Doctors' mental health has received renewed attention given the epidemic of burnout, high suicide rates and the recent pressures of the COVID-19 pandemic. Internationally, various service designs and primary prevention initiatives have been trialled to address these needs. Systemic barriers such as stigma as well as individual characteristics of doctors have historically prevented access to mental health services. This paper outlines the Australian service context from which a new publicly funded doctors' mental health programme emerged. Methods: A narrative review of current services and a description of the challenges is outlined. Results: A picture of urgency and unmet needs emerged with particular challenges, such as the need for privacy. Conclusions: Doctors' mental health is an urgent priority with direct impacts on patient safety and care. The complex context and the unmet need suggest the focus must go far beyond burnout and has prompted the establishment of a new service model designed to complement existing services in the Australian context, to be described in a sister paper. [ABSTRACT FROM AUTHOR]

The cover art by NEG comes from the Cunningham Dax Collection. The Cunningham Dax Collection consists of over 15,000 artworks created by people with an experience of mental illness and/or psychological trauma. The Dax Centre is a not-for-profit organization that relies on the generosity of the community to carry out its mission of promoting mental health through art. [Extracted from the article]

The untitled cover art by Graeme Doyle comes from the Cunningham Dax Collection. The Cunningham Dax Collection consists of over 15,000 artworks created by people with an experience of mental illness and/or psychological trauma. We aim to change community attitudes to mental illness by increasing empathy and understanding of mental illness, psychological trauma and the mind through art, thereby reducing stigma against mentally ill people. [Extracted from the article]

The article presents the information of a podcast titled "Trainee welfare: psychiatrist, heal thyself?", on working conditions of psychiatric trainees and medical trainees.

The article offers information on the podcast related to the perinatal psychiatry including the hypothetical protective effects of pregnancy; and the importance of the psychosocial factors such as supportive relationships and secure finance for the mental wellbeing of mothers and their children.

Aim: The COVID-19 pandemic has created barriers to the running of group therapies due to the need to maintain social distance. This paper aims to describe modifications of existing therapeutic groups delivered to people diagnosed with serious and enduring mental illnesses (SMIs) to enable the therapies to continue in an online format due to the COVID-19 restrictions. Conclusions: Therapists and consumers were motivated to find a way to continue the therapies described despite the context of the restrictions imposed due to COVID-19. This paper describes what was involved in 'pivoting' to a new mode of practice and modifications that were required over time and as new regulations were put in place. Formal research is required to establish an evidence base if these therapies were required to be regularly delivered in an online mode. [ABSTRACT FROM AUTHOR]

Objectives: This paper describes Australian psychiatrist John Bostock's 1923 concept of suggestion and compares it to our understandings, in 2023, of the placebo effect. Conclusions: Bostock's 1923 article on "suggestion" gives us a glimpse of the history of Australian psychiatry. It also stimulates thought about the current understandings of the placebo effect. Now, as then, placebo effects can play a critical role in patient outcomes. However, careful consideration is required to ensure contemporary ethical standards are met and harm is not done. [ABSTRACT FROM AUTHOR]

Objective: There are many burgeoning treatments, and a large range of therapeutic options for 21st century psychiatry. This paper briefly comments upon considerations for balancing treatment to suit the patient, their illness, and their milieu. Conclusions: Therapeutic equipoise, for psychiatric care, is an aspiration rather than a position easily achieved. In day-to-day clinical practice, there will be unexpected demands and barriers that cannot always be accommodated or surmounted. Psychiatrists can work collaboratively with patients, carers, and colleagues in conceptualising and care-planning to avoid extremes of therapeutic hubris and despair, and to adapt evidence-based care more effectively so that it is suited to the patient and their circumstances. [ABSTRACT FROM AUTHOR]

Objective: The primary objective of this article was to systematically review the prevalence of somatic symptoms in patients, healthcare workers and general population during the COVID-19 pandemic. The secondary objectives were to record the association between somatic symptoms and indices of mental distress and to record the qualitative characteristics of such somatic complaints. Methods: Following the PRISMA methodology we systematically searched PubMed, Scopus and Google Scholar for primary research reporting on somatic symptoms in association with mental distress. We specifically sought papers reporting on bodily distress disorder, somatic symptoms disorder or medically unexplained symptoms. Results: 1569 papers were retrieved, which yielded 36 relevant studies after screening. 15 studies referred to healthcare workers, 13 to general population, 5 to COVID-19 patients, 2 compared medical with non-medical professionals and 1 was studying COVID-19 patients some of which were also healthcare workers. The reported prevalence of somatic symptoms ranged from 7.4% to 67.8%. Commonly seen symptoms were shortness of breath, dyspnea, palpitations and pain in arms, legs and joints. Conclusions: Our systematic review suggests that somatic symptoms are very frequent during the pandemic and are often linked to mental distress. All three population groups are affected. [ABSTRACT FROM AUTHOR]

Dear Sir, In an "historical analysis", Lugg asserted: The biopsychosocial (BPS) model remains the predominant theoretical framework underpinning contemporary psychiatric training and practice ... An aetiological model for mental disorders that involves psychological, biological and sociocultural factors has existed since at least the 1940s.[1] After giving some historical background, he attributed this model in its current form to the late gastroenterologist, George Engel, whose paper, I The need for a new medical model: a challenge for biomedicine i , was published in I Science i in 1977.[2] There is now a substantial secondary literature, reviewed in my 2020 paper,[3] which shows how Engel made a common-enough mistake. The only integrative model of mind available to psychiatry, extending to mental and personality disorder, is the biocognitive model, 68,000 words starting with first principles, compared with Engel's three.[5] How can people continue to make this mistake? I throw down the gauntlet: in claiming that it has an articulated, integrative "aetiological model for mental disorders", psychiatry is deceiving itself, the funding agencies, the general public, I and i , inexcusably, our students, trainees, and patients. [Extracted from the article]

Post-traumatic stress disorder (PTSD) can affect anyone as the result of public or personal disaster, but is particularly associated with defence and emergency services personnel. Professor McFarlane's research has focused on the epidemiology and longitudinal course of PTSD, and the neuroimaging of cognitive deficits associated with this disorder. Professor McFarlane described how dysfunctional brain-stem arousal may disrupt basic cognitive processes and maintain pathological features of PTSD such as dissociation, and may also lead to novel treatments such as stellate ganglion block. [Extracted from the article]

Objective: This study aims to highlight cognitive 'brain fog' as a key depression sub-typing symptom, being weighted to melancholic (as against non-melancholic) depression and note its common persistence after episode remission. Method: This paper weights clinical observation but considers several salient overview papers and research findings. Results: While 'brain fog' is intrinsically non-specific in that it has multiple causes, when assessed as a second-order depressive sub-typing symptom, it has seemingly distinctive specificity to the melancholic sub-type, with many patients with melancholia resonating with such a descriptor question. As it may persist (albeit attenuated) after episode remission, psychostimulant medication may be of benefit in some patients. Conclusion: In the clinical assessment and differential diagnosis of those with a depressive disorder, inquiring into 'brain fog' can have distinct diagnostic benefit in differentiating melancholic and non-melancholic depression. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to describe the circumstances surrounding the only paper published in Australia by Sigmund Freud – his only publication in the Southern Hemisphere – in 1911. Conclusions: The invitations in 1911 from a Sydney psychoanalysis study group to Sigmund Freud, Carl Jung and Havelock Ellis to present papers at the Australasian Medical Congress, came at a time when the world was barely aware of Freud’s new psychology, and well in advance of many other countries. Sparring by Freud and Jung over a joint presentation was evident in the respective papers they sent, and they soon parted. A review of other papers presented at the congress indicates that Australian psychiatry, notwithstanding its slow progress, was well informed on recent developments, which was to manifest with biological treatments, as well as with the establishment of psychoanalysis. Despite its distance from Vienna, Australia seemed to have a special place in Freud’s mind that was to surface in various ways over the years, not least in Totem and Taboo. [ABSTRACT FROM AUTHOR]

Objective: This paper outlines the evolution of mental health rehabilitation in NSW, where allocation of health resources has repeatedly contradicted the policy intention to reorient services from inpatient to community-based services, leaving community rehabilitation the poor and disconnected cousin of inpatient services. The expanding role of community-managed organisations (CMOs) in psychosocial rehabilitation, the introduction of the National Disability Insurance Scheme (NDIS), and emerging service models have helped foster a maturing housing and social care environment, but present reality and the integration of health and social care services remains at a distance from best evidence practice. Conclusion: The challenge of the next decade of mental health reform is to embrace and consolidate greater service diversity and complexity. Understanding what factors influenced present reality is important in providing guardrails for the future, enabling the current wave of renewal and reinvestment in NSW to build on the strengths of past developments and steer a course around their weaknesses. [ABSTRACT FROM AUTHOR]

Objective: Managing mental health patients during the COVID-19 pandemic has been a global challenge. Current workforce arrangements tend to separate those skilled in caring for highly infectious medical patients from those whose specialism is in managing co-morbid mental health, substance misuse and/or behaviours of concern, including potential non-compliance with community or health care directives. This paper reports an innovative service development through the emergency establishment of a temporary COVID-positive mental health ward in response to a local outbreak in Melbourne. Method: A case study of service reorientation is presented, examining barriers and enablers to effective care of co-morbid mental illness, addiction and COVID-19. Results: Establishing a skilled multidisciplinary workforce across mental health and infectious disease is the most important consideration in optimising care. Other issues included suitable physical space, security arrangements and inter-disciplinary communication. Conclusions: The paper holds insights for managing mental health care during potential future infectious disease outbreaks across the country. [ABSTRACT FROM AUTHOR]