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The article discusses a study on the development of Homeless Psychiatric Service Performance Indicators (PI). Researchers collated quality services descriptions from key stakeholders and noted eight parameters which were basis for the development of PI that were tested over 12 months. Results showed that PI were key in initiating practice changes, effective in team dynamics, and were able to clarify team aims.

Objective: The aim of this paper is to describe the establishment of an integrated young person's mental health service and the findings of a qualitative evaluation conducted 2 years after its establishment. Method: A qualitative evaluation of the service was undertaken using a semi-structured interview, a service satisfaction survey and partnership analysis tool. Results: The major problems encountered in establishing the service were insufficient recognition of the cultural challenges in working together, difficulty in recruiting general practitioners, establishing a youth friendly environment and maintaining the quality of the relationship between partners. Conclusion: Despite almost 3 years of preparation, many important aspects of change management were underestimated or inadequately attended to. [ABSTRACT FROM AUTHOR]

Objectives: Most clinicians are poorly informed in relation to the key concepts of organizational learning. Yet the paradigm may offer clinicians a powerful method for using their knowledge and skills to respond to the demands of a changing environment through experimentation and learning. The concept is critically examined. Organizational learning principles are presented, including a conceptual framework for assessing health services as Learning Organizations. Barriers to organizational learning and strategies to overcome these are discussed. Methods: The seminal works of Argyris and Senge are reviewed and a framework for assessing organizational learning in health services is proposed. Current area health service actions are evaluated against the 'diagnostic' framework for a Learning Organization. Results: Although critical examination reveals a poor empirical basis for the concept, the metaphor of the Learning Organization provides a useful conceptual framework and tools for individuals and organizations to apply in developing knowledge and effecting change. The Clinical Practice Improvement and Root Cause Analysis programs being conducted across NSW area health services meet the criteria for effective organizational learning. Conclusions: Key concepts from organizational learning theory provide a diagnostic framework for evaluating area health services as Learning Organizations and support two current strategies for overcoming barriers to organizational learning. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper was to review the basis of the 'youth model' and new 'headspace' service delivery structures, proposed as a solution to the problem of high rates of psychiatric disorder in the youth period of life. Several issues were examined through asking key questions and answering these from the perspective of two academically oriented child and adolescent psychiatrists. Conclusions: As half of all mental disorders appear during childhood and early adolescence, more research into the origin and emergence of these problems should focus on this early period of life. Prevention research should also focus largely on children and adolescents, with interventions targeted through sequential assessment at pivotal stages. The current problem of access to mental health care for youth in the adult mental health service system could be improved with additional funding and culture change - it is not necessary to create a new service system. Indeed, there are dangers in establishing new services for 12-25-year-olds, as the 12-17-year-old population has different needs from 18-25-year-olds. In particular, the younger group are at risk of 'adultification' by being grouped together with young adults, and this risk needs to be actively managed. Health service planning must pay attention to developmental differences. Several suggestions are proposed for addressing the mental health needs of young adults. [ABSTRACT FROM AUTHOR]

Objectives: To outline the principles of continuous quality improvement that can be utilized to develop a clinical governance framework in a mental health service. Conclusions: The term clinical governance is used to describe the framework through which health organizations are accountable for continuously improving the quality of their services and safeguarding high standards of care. Implementing a clinical governance framework requires clear leadership, particularly clinical leadership, the development of structures and processes to facilitate communication and the development of systems for monitoring and evaluating services. Effective implementation can be supported by the development of an open culture that promotes organizational learning from experience and supporting innovation. [ABSTRACT FROM AUTHOR]

Objective: To discuss change management as applicable to mental health.Conclusions: As mental health care grows increasingly complex, and the network of accountability widens, change is both inevitable and necessary. Strategies to introduce change effectively are essential. Resistance by medical staff to change often has a sound basis and must be acknowledged and explored. Change in clinical systems and practice is facilitated by careful planning and preparation, and by engaging clinicians in all phases of the change process; change will fail if this is not achieved. A number of management models facilitate the understanding and process of change. [ABSTRACT FROM AUTHOR]

Objective: To review the role of clinician leadership in the management of mental health services.Conclusions: The literature suggests that clinician leadership is increasingly regarded as an essential element in the effective introduction of innovation and improved quality of clinical care by those who manage mental health services. Psychiatrist leaders have a role to play in ensuring that service change and innovation is based on sound clinical values, is developed in partnership with clinicians and is understood and supported by psychiatrist colleagues. Clinician leaders require clear vision, commitment and courage. The support of their colleagues is essential if the psychiatric profession is to have influence on future development of mental health services. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented on the need to develop a youth-specific mental health services model.

Objective: To familiarize Australasian psychiatrists about differences in the psychiatric systems of the United States and Australasia. A secondary objective is to contribute towards a multi-leveled collaboration between the Australian and New Zealand College of Psychiatrists and the American College of Psychiatry and Neurology. Conclusions: There appear to be multiple differences, including in aspects of training, acquiring credentials, cross accreditation, the effect of managed care on clinical practice, volume of research, and interpersonal relations. Despite differences in the systems, it seems critical to anchor oneself to the bio-psycho-social model in order to maintain the integrity of psychiatric practice. [ABSTRACT FROM AUTHOR]

Focuses on a study which explored the child assessment model of the Initial Consultations initiative of the South Australian Child and Adolescent Mental Health Services Program Committee. Background on Initial Consultations; Methodology of the study; Results and discussion.

An author index for the 2008 issue of "Australasian Psychiatry" is presented.

Objective: To examine the usefulness of the Strengths and Difficulties Questionnaire (SDQ) as an outcome measure for patients referred to a child and adolescent mental health service (CAMHS). Methods: This was a prospective study of new CAMHS attendees. Questionnaires were completed by clinicians, parents, teachers and children (if aged 11 years or older) at initial attendance and after approximately 6 months. Results: At 6-month follow up, positive change was detected on the SDQ. There was a significant reduction in the ‘total difficulties’ score as rated by parents, teachers and children. This positive change corresponded to a sig­nificant reduction in the clinician-rated Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) scores. Furthermore, there were lowered levels of perceived difficulties and burden on the SDQ impact sup­plement, and a decrease in the overall impact score. Conclusion: The SDQ is a useful outcome measure. The HoNOSCA and SDQ complement each other because they provide measures of change from the clinician, the parent and the child. [ABSTRACT FROM AUTHOR]

Lists authors who contibuted to the volume 8, 2000 issue of the periodical 'Australasian Psychiatry.' C. Allcock; C. Bennett; T. Callaly; S.S. Damodaran; V.I. Egorov; C.K. Gale; D. Handrinos; J. Hassall; H. Jackson; A. Keller; M. Large; J. Madden; H.N. New; M. Patfield; G. Riley; K. Samios; L. Terry-Blume; K. Wainright; R. Yeatman; K. Zelas.