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This article reviews the development of forensic psychiatry and mental health services in Australia for the international reader. It covers the legacy of a series of colonial systems that have contributed to a modern health service that interacts with justice systems. The development of relevant legislation, hospitals, prison services, community, and courts services is reviewed. The training and academic development of professionals is covered. Gaps in service delivery and future directions are considered.

Objectives: The aim of this paper is to describe the development and technical specifications of a framework and national key performance indicators (KPIs) for Australian mental health Court Liaison Services (CLSs) by the National Mental Health Court Liaison Performance Working Group (Working Group)., Methods: Representatives from each Australian State and Territory were invited to form a Working Group. Through a series of national workshops and meetings, a framework and set of performance indicators were developed using a review of literature and expert opinion., Results: A total of six KPIs for CLSs have been identified and a set of technical specifications have been formed., Conclusions: This paper describes the process and outcomes of a national collaboration to develop a framework and KPIs. The measures have been developed to support future benchmarking activities and to assist services to identify best practice in this area of mental health service delivery.

Forensic mental health nursing is a recognized field of nursing in most countries. Despite a growing body of literature describing aspects of practice, no publication has been found that captures the core knowledge, skills, and attitudes of forensic mental health nurses. One group of nurses in Australia have pooled their knowledge of relevant literature and their own clinical experience and have written standards of practice for forensic mental health nursing. This paper identifies the need for standards, provides a summary of the standards of practice for forensic mental health nurses, and concludes with how these standards can be used and can articulate to others the desired and achievable level of performance in the specialty area.

Objective: This paper provides an overview of the National Mental Health Benchmarking Project (NMHBP) which explored the value of benchmarking within the four main program areas of public sector mental health (general adult, child and adolescent, older persons and forensic). The NMHBP involved a series of forums which enabled participating organizations to benchmark themselves against each other, with a view to understanding variability in performance against a range of key performance indicators (KPIs)., Method: Twenty-three mental health organizations took part in the NMHBP. The forums culminated in each mental health organization documenting its performance against relevant KPIs. The processes, impacts and outcomes of the NMHBP were evaluated via a multi-methods evaluation., Results: There was considerable variability across program streams for many of the KPIs, much of which could be explained by contextual factors. Within program streams there was considerable intra-organization variability. Participants found the examination of intra-organization variability on particular indicators to be useful., Conclusions: The NMHBP has shown that benchmarking is possible. Managers and clinical leaders will need to champion benchmarking and highlight its utility in relation to quality improvement and service development if the accountability goals of the Fourth National Mental Health Plan are to be realized.

This paper explains the educational principles and strategies underpinning a nursing course offered at an Australian university. The course is entitled 'Self-harm and therapeutic responses' and explores contemporary theories and practices to improve understanding and responses to people who self-harm. The course aims to shape the practices of nurses in developing healthier clinical and social environments for people who self-harm.

Objective: The aim of this study is to analyse the ethical underpinning of involuntary treatment and to create a guide for psychiatric practice which clarifies its relationship with modern mainstream clinical ethics., Method: Literature on ethics, involuntary treatment, civil commitment, diagnosis and law was searched and examined., Result: Hospitalisation for involuntary treatment and control has blurred two important discriminations: the discrimination between clinical and social constructions of mental illness and the discrimination between therapeutic actions and policing control. Plotting these discriminations creates a map of ethics in involuntary treatment. Although there are clinical roles throughout involuntary treatment, the ethical issues vary according to whether clinical actions are taken on clinically or socially constructed diagnosis and whether the purpose of the actions is therapy or control., Conclusion: Paternalist involuntary treatment should be undertaken more readily when it is for clinically defined illness and for the benefit of the patient. Where the conditions are defined by social behaviours alone, where treatment is not useful to the patient, or where actions have policing intent, particular ethical approaches need to be taken to defend the patient, the clinician-patient relationship and the reputation of the profession.

Objective and Method: This article examines some of the ethical and legal issues which confront the psychiatrist who is asked to provide a forensic psychiatric assessment. Theory is explained and illustrated by way of a case study., Results: Recent cases demonstrate a tendency by some psychiatrists to adopt an advocacy role in legal proceedings, to the potential disadvantage of not only those involved in the proceedings, but also to the wider community., Conclusion: Ideally, there is a need for a greater collaborative effort between the College's Ethics Committee and this Country's Courts and Law Societies to establish and monitor an ethical framework in the area of expert psychiatric evidence.