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Evaluate the utility of brief online training for facilitating mental health professionals' perceived knowledge, confidence, and comfort in working with non-binary clients, and building positive attitudes. Baseline participants were 79 Australian registered mental health professionals, of whom 38 completed online training and a one-week follow-up assessment. Participants completed an assessment of attitudes, comfort, confidence, and perceived knowledge pertaining to non-binary people before and after completing online training. The training (30-minute average completion time) provided information on non-binary people's lives using text, images, embedded video, and links to optional resources. Follow-up measures completed one-week post-intervention indicated engagement in the training may lead to increased perceived knowledge, confidence and comfort. Attitudes were positive at baseline and were not significantly different at follow-up. Providing brief online training for working with non-binary people in mental health might improve practitioner perceived knowledge, confidence and competence at low cost and with easy access. Future research is required to account for limitations and build on current outcomes. Key Points What is already known on this topic: Little is known about the effects of brief online training regarding non-binary genders on mental health practitioner's attitudes, confidence, comfort, and perceived knowledge. Previous research has shown that brief training can increase positive attitudes for, knowledge of, behavioural intent, and cultural competence for working with sexual and gender minorities, though has not specifically focused on non-binary people. Previous literature has highlighted positive associations between practitioner knowledge and the well-being of non-binary people accessing health services. What this paper adds: This paper adds to the ongoing genesis of options for training mental health practitioners about non-binary people and relevant issues. Findings suggest beneficial outcomes from both prior professional training in this area and the brief training used in the study. The brief online training used in the study was associated with higher perceived knowledge, confidence, and comfort for working with non-binary clients, but further research is needed to understand reasons for change in these variables. [ABSTRACT FROM AUTHOR]

Recent mental health policy endorses a personal recovery framework that focuses on individual purpose and meaning. Therefore, psychology pre-registration training needs to promote knowledge and attitudes that are aligned with this framework.The 5 + 1 training pathway was recently established in Australia and emphasises readiness for practice. This study examined how provisional psychologists undertaking the 5 + 1 pathway perceived recovery. Semi-structured interviews were completed with nine provisional psychologists completing the coursework component of the 5 + 1 pathway. Interviews focused on perspectives of recovery and were analysed with thematic analysis. Three themes related to perspectives of (i) recovery as a process that involved building capacity to undertake key life roles, (ii) ways that psychologists can promote recovery through their stance and their practices and (iii) factors that have influenced participants' views of recovery. The findings indicate that provisional psychologists in the 5 + 1 pathway are able to develop appropriate but limited perspectives that are generally consistent with the personal recovery framework. Participants were more influenced by client contact than coursework. Learning about recovery could be enhanced by explicitly teaching models of recovery and incorporating views of people with lived experience. Key Points What is already known about this topic: Mental health clinicians' attitudes and perspectives of their work have an impact on the nature of the support they provide. Training plays an important role in developing psychologists' attitudes and perspectives towards recovery. The 5 + 1 internship is a recently established training pathway to registration as a psychologist. What this paper adds: This paper reports on one of few studies related to the Australian 5 + 1 training pathway for psychologists. Although unfamiliar with formal models of recovery, students' perspectives were mostly consistent with personal recovery but there were some indications of conceptual confusion. Recommendations are made for extending development of students' perspectives of recovery. [ABSTRACT FROM AUTHOR]

Background: The prevalence of dementia is increasing with more healthcare workers being required to care for people living with this progressive neurological disorder. The knowledge level and attitude of healthcare workers caring for those living with dementia need to be assessed and resources targeted effectively to ensure best quality care is provided. Healthcare workers for the purpose of this paper include anyone employed to care for those living with dementia. Aim: To investigate the attitudes of healthcare workers towards people living with dementia. Methods: A survey of 110 healthcare workers was undertaken between October 2016 and December 2017, using the Dementia Attitude Scale to measure attitudes towards people living with dementia. Demographic data were collected by a survey to explore whether a person's age; cultural background; qualification level; or experience level had an impact on their attitude towards people living with dementia. Results: The full survey was completed by n = 85 healthcare workers with the majority having strongly positive views about people living with dementia, with an average score of 88.31/100. However, a large number reported being afraid of people living with dementia (n = 76, 89.4%) and would avoid people with dementia who were agitated (n = 51, 61.4%). While 100% (n = 85) agreed or strongly agreed that it was possible to enjoy interacting with people living with dementia, they were more ambivalent with n = 26 (31.6%) strongly agreeing with the statement that working with people living with dementia is rewarding. A significant difference in attitude was found using one-way analysis of variance within groups due to age (p <.000) and cultural background (p <.035). Conclusions: Healthcare workers within this study had mainly positive attitudes towards people with dementia as demonstrated by the high attitude scores. However, this paper has shown that healthcare workers may require further education to improve attitude and care towards those living with dementia. [ABSTRACT FROM AUTHOR]

Schizophrenia is a global concern, and, this paper, describes the caring roles of health professionals who are mothers of adult children with schizophrenia. A thematic analysis of data from a doctoral study identified a blending of expertise into an informed care model. Caring roles included: constant carer; coordinator carer; watchful bystander carer; and life coach carer. Previous research has not explored these dual roles. This paper elucidates their responsive approaches and contributions to mothering and caregiving roles. Informed by a fusion of professional and mothering knowledges, their insights into mental health care have been forged by their experiences and is an untapped resource. [ABSTRACT FROM AUTHOR]

Complementary and alternative medicine (CAM) degrees in Australian and British universities have come under attack from sceptics who argue that such courses teach only 'pseudoscience'. Moreover, CAM academics have themselves been publicly labelled 'quacks'. Comparatively little is known about this group of health professionals who span the two worlds of CAM practice and academia. How do they navigate between these domains, and how are their collective and individual professional identities constructed? Drawing on 47 semi-structured interviews, this paper explores the professional identities of academics working in three university-based CAM disciplines in Australia and the UK: osteopathy, chiropractic and Chinese medicine. By analysing these individuals' accounts, and building on prior research on health professions in the academy, the paper contributes to understanding how contests about professionalism and professional knowledge take place against the academic-practice divide. By focussing on a domain where knowledge claims are conspicuously contested, it highlights the salience of navigating 'epistemic stress' for both group and individual professional identity. [ABSTRACT FROM AUTHOR]

The quality of paid relationships is key for effective support, yet little is known about how people receiving and providing support understand and experience the relationship. This paper reports on recent research that explored the role of relationships with paid support workers in strengthening the rights and wellbeing of young people with cognitive disability in Australia. The research used photo-rich participatory methods with 42 pairs of young people and their support workers and drew on Honneth's recognition theory to specifically explore experiences of being valued, respected and cared about in their work together. The findings point to the importance of these connected aspects of recognition in paid support relationships, highlighting both the presence and absence of these, as well as experiences of misrecognition. The implications of recognition for strengthening support need close consideration in an international context characterised by personalisation of support, resource constraints and inquiries into poor practice. Relationships are key to good quality support. We wanted to know whether and how paid support relationships between young people with cognitive disability and support workers in Australia contribute to feeling valued, respected and cared about. Young people felt valued when the worker noticed what they did and found ways to help them achieve what they wanted to do. They felt respected when they could make decisions about choices and control over their lives. They felt cared about when they felt personal warmth, they were listened to, they felt their views mattered and they trusted each other. When young people felt harmed, they felt it deeply. The worker often did not intend to cause harm with their words or actions. The careless harm sometimes was from unequal power in the relationship. The inequality sometimes took away the voice of the young person. Sometimes the support worker also felt like their voice could not be heard. The research is important because how we feel about being with another person is key to how we know who we are. It develops the self-esteem, self-respect and self-confidence of the young person and the support worker. Knowing this matters for improving the quality of personal support. [ABSTRACT FROM AUTHOR]

This two-year (2016–2018) study aimed to identify what a good life is for Aboriginal people with disability in remote Central Australia and how service providers can support them to achieve a good life. This paper presents the findings that relate to barriers to delivering services for Aboriginal people with disability. In-depth interviews and focus groups were held with Aboriginal people with disability and their carers aged at least 18 years from the Ngaanyatjarra Pitjantjatjara Yankunytjatjara (NPY) Lands and community organisations providing services there. The data were analysed using thematic analysis. There were 109 participants, of whom 47 were workers in service provider organisations and 62 were Aboriginal people. From the data, barriers to delivering services to support Aboriginal people to live a good life and solutions to overcome the barriers, were identified and described under the headings of environmental barriers and systemic issues. We discuss the policy implications of these findings with regard to addressing Indigenous disadvantage and how governments, service providers, communities, and Aboriginal people with disability and their families can work in partnership to address these barriers. Indigenous people with disability living in remote and very remote communities experience significant access and equity barriers to culturally responsive services that enable them to live a socially and culturally engaged life. Localised government and service provider disability policy approaches in Indigenous communities need to focus on both environmental and systemic issues. Greater investment in local remote communities is required to build the capacity of Indigenous families to support Aboriginal people with a disability to live a culturally and socially included life. [ABSTRACT FROM AUTHOR]

Advances in the management of chronic diseases, combined with an aging population, have escalated the prevalence of people with life-limiting conditions and demand for palliative care. In Australia, this has prompted calls for change in policy frameworks, service systems and funding models that underpin care. The complex social, cultural and policy transformation required to enact these changes has been problematic. This paper reports on qualitative research into a unique, Australian Community Palliative Care program reflecting these aspirational changes. The research examined the program design and its implementation through the perspectives of program staff and volunteers. [ABSTRACT FROM AUTHOR]

Background:Indigenous health matters have largely been neglected in the speech-language pathology literature and have particular import for the aphasia clinician. The influence of culture on people’s experiences and expectations after an event such as stroke can vary widely and there is a need to understand the impact of context on assessment and therapy. Standard approaches may not be adequate or relevant, nor always ethical to apply. Examination of aphasia in contexts with Indigenous populations provides an opportunity to explore methods and approaches with socially complex and marginalised communities and to expand our understanding of the lived experience of aphasia. Aims:The goal of this paper is to explore the role of culture in aphasia in Indigenous populations and drawing from a body of emerging research, highlight relevant dimensions of understanding and practice for the aphasia clinician. Main Contribution:A series of qualitative studies undertaken with Indigenous people with aphasia in two separate contexts – Australia and South Africa – will be described and their findings considered along several dimensions. A consideration of methods of approach and understanding will be provided, followed by discussion of some central constructs. A series of conceptual and clinical propositions for culturally safe research and practice in aphasia will be derived from this evidence. Models of collaboration are derived which are decolonising and potentially transformative and supplement models of knowledge and intervention in a local community. Particular attention is paid to temporal and spatial issues, the role of family, identity and community, the notion of resilience in such communities and addressing some of the specific challenges that may be involved such as working with cultural brokers. A series of recommendations is provided which allows for a critical engagement with interdisciplinary frameworks of understanding aphasia in context. Conclusion:As a reflective piece, this paper has enabled a collation of knowledge about aphasia in two Indigenous cultures and has helped consolidate some novel principles and insights and the need for expanded skills, attitudes, insights, explanations and methodologies – ones that acknowledge and accommodate diversity and difference, and that are relevant to Indigenous communities. Language difficulties are only one cause of social exclusion and issues such as poverty and identity make a huge impact on the lives of our clients and their families, and on the approach we adopt. A shift from the primary framework of our profession is required to accommodate the central role of culture in communication. [ABSTRACT FROM PUBLISHER]

Aims: Life expectancy for both sexes in Australia exceeds 80 years, with individuals with intellectual disability also increasingly living into older age. This research aimed to comparatively examine perceptions of staff supporting either older adults or age peers with lifelong intellectual disability. Methods: This project asked 420 medical, health, and support workers about training adequacy, health services access, and trigger points for premature institutionalisation. This paper is based on a subsample of 196 respondents who provided quantitative and qualitative responses. Results: There was considerable variation in confidence in supporting ageing individuals, while only 23.7% of doctors reported their training was adequate to support adults ageing with intellectual disability. A lack of services and poor carer health were identified as triggers for premature institutionalisation. Conclusions: The study revealed key differences in staff perceptions of support provision and training adequacy when comparing ageing individuals with intellectual disability to the general ageing population. [ABSTRACT FROM AUTHOR]

In most developed countries, competent patients have the legal right to refuse any medical treatment; Advance Care Planning mechanisms extend this right to non-competent patients. However, some groups, including lesbian, gay, bisexual, transgender and intersex (LGBTI) people, risk their wishes not being respected if they lose capacity, more than others. Little is known about medical practitioners' knowledge of, or attitudes to, the law in this area, especially in relation to LGBTI people, or how the law influences their decision-making. An Australian postal survey explored knowledge and attitudes of medical specialists to legal issues relating to withdrawing/ withholding life-sustaining treatment from adults without capacity. One scenario (the focus of this paper) asked which of four plausible substitute decision-makers, including a same-sex partner, had the legal authority to make such decisions. The overall response rate was 32% (867/2702). Less than one-third of respondents correctly identified the same-sex partner as the legally authorised decision-maker. LGBTI people face multiple obstacles to having their end-of-life wishes respected. Where healthcare providers are also ignorant of the partner's legal right to make such decisions, the problem is compounded. Improved legal education for clinicians and promotion of educational resources for members of the LGBTI community is needed. [ABSTRACT FROM AUTHOR]

Food literacy education at senior secondary school could provide immediate health benefits to adolescents. In the long term, this will help strengthen the relationship between citizens and the food system. The aim of this paper is to explore food system professionals’ opinions of the importance of senior secondary school food literacy education. A purposive sample of 34 food system professionals from different sub-sectors within the Australian food system were interviewed individually in late 2015 and early 2016. Interviews were analysed using the template analysis technique. Many participants indicated that food literacy education helps students establish healthier eating patterns. Some participants suggested that food literacy education helps students join in food-related career pathways and some believed that this education helps students understand and question the food system and related issues. Moreover, some participants mentioned that the senior secondary school years are when it is most appropriate to deliver some of the broad aspects of food literacy, while some pointed out the importance of starting food literacy education in primary school. Furthermore, participants indicated the importance of food literacy education in school, referring to low food and nutrition knowledge and skills among modern consumers and inadequate family support for students to develop healthier food patterns. In conclusion, senior secondary school food literacy education helps students develop healthy eating patterns, and prepare them to make wise decisions in relation to food. This highlights the importance of provision of comprehensive food literacy education for senior secondary school students. [ABSTRACT FROM PUBLISHER]

Australia has been implementing routine outcome measurement in its specialized public sector mental health services for over a decade. It uses a range of clinician-rated and consumer-rated measures that are administered at set times during episodes of inpatient, ambulatory and community residential episodes of care. Routine outcome measurement is now embedded in service delivery, and data are made available in a variety of ways to different audiences. These data are used by policy-makers and planners to inform decisions about system-wide reforms, by service managers to monitor quality and effectiveness, and by clinicians to guide clinical decision-making and to promote dialogue with consumers. Consumers, carers and the general community can use these data to ensure that services are accountable for the care they deliver. This paper describes the status quo in Australia with respect to routine outcome measurement, discusses the factors that led to its successful implementation, and considers the steps that are necessary for its continued development. [ABSTRACT FROM AUTHOR]

Background Physical activity (PA) programs for adults with intellectual disability (ID) have positive impacts, at least in the short term. No research has been reported on the effect of long-term engagement in PA programs for adults with ID. This paper explores the physical and psychosocial benefits gained by two individuals with mild ID who participated in a long-term PA program. Method Accelerometery was used to collect PA data during the program and for 7-day periods outside of the program. To explore the psychosocial outcomes gained from participating in the program, participants and their caregivers were interviewed about their participation experiences. Results Across time, a decrease in the amount of light activity engaged in during sessions was found, with participants gradually increasing their moderate to vigorous activity. Psychosocial benefits, including meeting new people and gaining social acknowledgement were reported by participants and caregivers. Conclusions Long-term, sustainable, low cost PA programs (such as the one under investigation) can minimise barriers to physical activity for people with ID. [ABSTRACT FROM AUTHOR]

It is claimed that an interprofessional approach to health care aims to provide optimal client care, reduce duplication of services, address gaps in service delivery and prevent adverse consequences to patients. Hence there is widespread international interest in interprofessional education in undergraduate programs. However, after employment in the Australian health care workforce, there is limited opportunity for this. The continued education and training of health professionals and other care workers frequently occurs in a climate where professional development is dominated by the existence of professional demarcations. In order to enhance interprofessional collaboration in health care practice and education, mechanisms to guide individual performance within a multi-professional health team are required. This paper presents both the process and outcomes of a consultancy undertaken in order to determine core competencies for collaborative interprofessional practice in a community and aged care service. [ABSTRACT FROM AUTHOR]