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Purpose: The purpose of this study was to identify and understand the barriers and enablers to the implementation of youth peer support in a clinical mental health service. The development of a lived experience workforce in mental health is a key component of policy at both the state and the federal level in Australia. Implementing a peer workforce within existing clinical services, however, can be a challenging task. Furthermore, implementing peer support in a youth mental health setting involves a further degree of complexity, involving a degree of care for young people being invited to provide peer support when they may be still early in their own recovery journey. Design/methodology/approach: This paper reports on a formative evaluation of the beginning stages of implementation of a youth peer workforce within an existing clinical mental health service in Melbourne. Findings: The project found that it was feasible and beneficial to implement youth peer support; however, significant challenges remain, including lack of appropriate training for young people, uncertainty amongst clinical staff about the boundaries of the peer role and the potential for "tokenism" in the face of slow cultural change across the whole service. Originality/value: Very little evaluation has yet been undertaken into the effectiveness of implementing peer support in youth mental health services. This paper offers an opportunity to investigate where services may need to identify strengths and address difficulties when undertaking future implementation efforts. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the impact of stressors and the strategies staff use to cope with these at a detention facility. It documents through case studies some of the triggers of trauma, possible coping mechanisms that might assist in navigating the associated stressors in a workplace and recommendations as to what might assist staff. Design/methodology/approach: A naturalist approach was used in this research, using an ethnographic qualitative methodology. Grounded theory assisted in the analysis of the data to capture naturalistically the subjective experience of the participants of the study. Conversations occurred with staff who had worked in a detention facility using face to face semi-structured interviews. The structure was open-ended to allow the staff to discuss and share their experiences freely. Findings: Stressors that impacted staff working in a detention facility resulted from areas such as heightened reactions from detainees because of the length of their detainment, detainee self-harm, dealing with the effects of an increase of substance abuse through detainees obtaining contraband and the associated violent reactions that can occur as a result. Adverse symptoms noted within the lives of staff included acute anxiety, sleeplessness, depression and tension within impersonal relationships, including family. What compounded the issue was staffs' reluctance to talk about work stressors. Research limitations/implications: The research used nine participants for case studies of staff who had formerly experienced various adverse impacts of stressors. This is not a comprehensive study, however, of the broader experiences of staff at an Australian detention facility. It does provide, however, a snapshot of the experiences of a small group who had significantly been impacted by the stressors of the workplace. Practical implications: This paper provides fresh perspectives or initiatives that are needed to assist staff to navigate the changing environment of working in a detention facility. In particular, some support mechanisms and protective factors that could be put in place to curb the negative impact of stressors in the workplace and to mitigate against long term stress disorders developing in the personal lives of staff. Social implications: Many staff are not getting the help they need to cope with the emotional distress they experience in their workplace. However, there are practical interventions to support staff in managing the stressors they face. These will be outlined in this article. Originality/value: This study was carried out with the goal of giving staff a voice and to capture their former experiences in their vocational responsibilities in a venue that has had very limited research attention. This study has presented the challenges staff faced in a unique venue of working in a detention facility. It has documented some of the common stressors staff faced, the impact of such and some coping mechanisms used to handle them. [ABSTRACT FROM AUTHOR]

Purpose: Approximately 20 per cent of Australian children live with a parent who experiences mental illness. These children have poorer health and psychosocial outcomes than their peers. While family-focused practice (FFP) can improve these outcomes, family-focused service provision is inconsistent. The purpose of this paper is to understand clinicians' experiences of FFP and associated workplace factors. Design/methodology/approach: In-depth interviews were conducted with ten community mental health clinicians. Interviews were audio recorded and transcribed. Data were analysed using thematic analysis. Findings: A global theme of "navigating rocky terrain" captured clinicians' experiences of working with families. The rocky terrain encompassed both family complexity and workplace barriers to FFP. Clinicians navigated this terrain by using multiple strategies to support families, working in partnership with families and other clinicians and services, and drawing on personal resources. Interactive approaches to enhancing knowledge and skills were preferred over paper-based information. While an organisation-wide approach to support FFP was beneficial, clinicians continued to feel challenged in implementing FFP. Research limitations/implications: Working with families in which parents experience mental illness is affected by systemic issues at the family and organisational levels. Systemic approaches to both delivering and supporting this work are required. Partnership working and organisation-wide capacity building strategies emphasising interactive approaches to learning appear to have positive effects. Originality/value: This study explores the challenges of FFP in a real-world multidisciplinary context where there has been a systemic approach to enabling this work. It highlights the challenges clinicians face in family-focused practice in spite of substantial organisational supports and suggests some approaches that might be effective. This is a topic which has received minimal attention in the literature. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to report on the findings of a qualitative study that explored the views of 53 service providers assisting Indigenous young people (known in Australia as Aboriginal and Torres Strait Islander youth) transitioning from out-of-home care (OOHC) in Australia. Design/methodology/approach: A qualitative approach was adopted involving semi-structured interviews and focus groups with 53 representatives of state and territory government departments, non-government organisation service providers and Aboriginal community-controlled organisations (ACCOs) across Australia. The project was designed to gain the perspectives of those working within the system and their views on how it interacts with Indigenous care leavers. Interview questions aimed to ascertain the strengths and weaknesses of the leaving care support systems available to this cohort, as well as the key challenges facing service providers in supporting them. Finally, the study aimed to make recommendations for policy development in this area and identify potential best practice service responses. Findings: The study found that the OOHC service systems continue to fail Indigenous care leavers, their families and communities. Study findings revealed that Indigenous care-leavers face substantial challenges and that the support systems for those leaving OOHC are often culturally insensitive and ineffective. Many Indigenous OOHC leavers lacked the supports they needed to develop safe and ongoing relationships with their traditional Country, family and communities. To promote more positive transitions and outcomes, effective practice responses were identified, including culturally safe programmes and proportional funding for ACCOs to advance greater self-determination. Originality/value: This research is the first national study in Australia to examine the specific transition from care pathways and experiences of Indigenous young people. The findings add to the limited existing knowledge on Indigenous care leavers globally and should inform practice and policy innovations with this cohort in Australia and beyond. [ABSTRACT FROM AUTHOR]

Purpose In recent years, the employment of peer providers (PPs) has grown with the wider acceptance of lived experience expertise in recovery-oriented service provision. Although its effectiveness, theoretical foundations and factors influencing outcomes have been studied, a framework accounting for the dynamics of the PP–peer relationship has yet to be formulated. The purpose of this paper is to employ a qualitative approach to explore the journeys undertaken by PPs with their peers and form it into a cohesive framework of understanding.Design/methodology/approach In-depth interviews were conducted with PPs who were employed specifically to use their lived experience in supporting someone through mental distress. These interviews were recorded, transcribed and coded using a framework approach. To enhance rigour, this framework was verified with the latter author and three other participants recruited after data analysis.Findings A stepped model of peer provision practice was crafted to capture the non-linearity of recovery, as well as the PP–peer relationship. This model is founded upon trust in the milieu of shared experience and involves: creating a safe place – a stage of building trust and rapport to a point where a PP is given permission to enter into their peer's headspace; a working partnership – stage of setting and working towards goals collaboratively; and stepping out – a stage marked by the termination of the PP–peer relationship.Originality/value This paper proposes a tangible framework underpinning the dynamics of peer provision practice, which furthers our understanding and complements current practice models in peer provision services. [ABSTRACT FROM AUTHOR]

Purpose Co-existing health conditions and frequent hospital usage are pervasive in homeless populations. Without a home to be discharged to, appropriate discharge care and treatment compliance are difficult. The Medical Respite Centre (MRC) model has gained traction in the USA, but other international examples are scant. The purpose of this paper is to address this void, presenting findings from an evaluation of The Cottage, a small short-stay respite facility for people experiencing homelessness attached to an inner-city hospital in Melbourne, Australia.Design/methodology/approach This mixed methods study uses case studies, qualitative interview data and hospital administrative data for clients admitted to The Cottage in 2015. Hospital inpatient admissions and emergency department presentations were compared for the 12-month period pre- and post-The Cottage.Findings Clients had multiple health conditions, often compounded by social isolation and homelessness or precarious housing. Qualitative data and case studies illustrate how The Cottage couples medical care and support in a home-like environment. The average stay was 8.8 days. There was a 7 per cent reduction in the number of unplanned inpatient days in the 12-months post support.Research limitations/implications The paper has some limitations including small sample size, data from one hospital only and lack of information on other services accessed by clients (e.g. housing support) limit attribution of causality.Social implications MRCs provide a safe environment for individuals to recuperate at a much lower cost than inpatient admissions.Originality/value There is limited evidence on the MRC model of care outside of the USA, and the findings demonstrate the benefits of even shorter-term respite post-discharge for people who are homeless. [ABSTRACT FROM AUTHOR]

Purpose: Suicide is a major cause of preventable mortality and primary healthcare professionals, including pharmacists, require appropriate training to communicate with and support people at risk of suicide. Mental Health First Aid (MHFA) training teaches participants how to communicate with and support people experiencing suicidal thoughts. The purpose of this paper is to use a novel MHFA assessment approach involving simulated role-plays enacted by people with a lived experience of mental illness and explore MHFA participants' and simulated patients' views of participating in simulated role-plays of mental health crises. Design/methodology/approach: MHFA is embedded into the Sydney School of Pharmacy curriculum. Post-MHFA training, pharmacy students were randomly allocated to participate in or observe a simulated role-play of one of three suicide crisis scenarios, with a person with a lived experience of mental illness. Two purpose-designed, semi-structured interview guides were used to conduct student focus groups and interviews with simulated patients to explore their views. Focus groups and interviews were digitally recorded, transcribed verbatim and thematically content analysed using a constant comparison approach. Findings: In total, 22 pharmacy students participated in two focus groups and three simulated patients participated in interviews. Five themes emerged including: the benefits of participating; the value of having a lived experience; challenges with suicide assessment; communication; and the value of immediate feedback and debrief. Originality/value: Students and simulated patients both benefited from participating in the role-plays. Students valued practicing their MHFA skills post-training with simulated patients with lived experiences. This unique approach to post-training assessment provides an opportunity to practice skills realistically and authentically, in a safe, learning environment. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to present a mixed method study of social capital development and use, based on an intervention which provided women from refugee backgrounds with social capital development skills and tools.Design/methodology/approach In total, 111 Afghan, Burmese and Sudanese women living in Melbourne, Australia, received peer-support training and a free unlimited fixed-dial mobile phone for one year.Findings Interview and call log data suggest that the training sessions and mobile phones played important roles in bonding social capital development, resulting in a complex support network among participants. To a lesser extent, there was also evidence of bridging social capital creation. By providing linkages to government institutions through an interpreter service, the mobile phones gave participants easy access to linking social capital, in their heritage language.Originality/value The program supplements existing community resources with mobile phone technology to create social capital rich networks within these disadvantaged communities, and the authors describe the community characteristics that make participants amenable to such an intervention. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is report on a study exploring the views of service providers, both within disability service sectors and in mainstream violence response sectors, about ways of effectively supporting people with intellectual disability who may be experiencing abuse and violence.Design/methodology/approach Semi-structured interviews were conducted with seven participants and analysed both thematically and in more depth from a socio-ecological perspective.Findings Participants highlighted five key factors facilitating or hindering professionals working with individuals with intellectual disability who may be experiencing abuse and violence: connecting clients with services and establishing a rapport; access to information about histories of trauma; policy context; inaccessibility and unavailability of mainstream violence response services; client understanding of what happens “next” after identification of harm.Originality/value Overall the study indicates a strong need for the development of resources, information and tools designed to educate and enhance the understanding of professionals supporting people with ID and to better facilitate learning and understanding for people with ID regarding what happens “after” disclosure of sexual violence or other experiences of harm. [ABSTRACT FROM AUTHOR]

Purpose Evidence from Australia and worldwide has highlighted the ongoing marginalisation, discrimination, abuse, violence and neglect of people with disability. One of the main areas of concern is that despite such evidence there remain fundamental barriers for people with disability to report violence and/or access supports. Significantly few studies have canvased the perspectives of people with intellectual disability (ID), family members or disability service providers. Accordingly as a first step, the purpose of this paper is to explore the perceptions of disability and violence-response professionals’ regarding the barriers and facilitators of effective support for people with ID reporting sexual violence and accessing mainstream supports.Design/methodology/approach A qualitative research design informed the basis of this study. Semi-structured interviews were conducted with seven participants who held roles within disability services and mainstream violence response. Interviews were recorded and transcribed. These transcripts were then analysed individually using a combination of thematic analysis and discourse analysis to bring to light the social and material structures within service systems in terms of how they disempower or empower supports for people with ID.Findings Participants from both services reported that professionals (particularly those outside the disability sector) lacked awareness of practical ways in which they could support people with ID to report and access services outside of disability-specific services. Participants also felt the capacity for people with ID to have a voice about what happens in the “aftermath” of reporting sexual violence was rarely acknowledged. Participants called for education and development of resources which could guide professional practice across disability and wider violence-response services. Participants saw investment in building interagency relationships across sectors as key to supporting the citizenship of people with ID.Originality/value This study suggests that there is a strong need for better community engagement and understanding of the multi-faceted issues surrounding responses to violence concerning people with ID. The findings of this study also outline implications for practice and policy which may be of interest to professionals both within disability and wider violence-response sectors in Australia and internationally. [ABSTRACT FROM AUTHOR]

Purpose: Remote and regional Australia have comparatively fewer mental health services than their urban counterparts, what is more, mental health remains profoundly stigmatised. This study aims to understand how, if at all, the process of group art-making then publicly displaying the artworks can contribute to stigma reduction for young people (YP) experiencing mental health challenges in regional Australia. Design/methodology/approach: Interviews were conducted with six young artists who use regional mental health services and 25 people who viewed their displayed art using a thematic analysis of the coded interview data. Findings: Findings of this study demonstrated how art-making as a process increased self-esteem, social interaction and artistic expression; while the viewers experienced an emotional connection to the art. The viewer's response enhanced YP's confidence in their abilities. Originality/value: Incorporating art-making and exhibiting the art in public spaces could be incorporated into YP's mental health services to support well-being and inform the perception the general public hold of mental health, thus reducing stigma. [ABSTRACT FROM AUTHOR]