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The aims of this study were to identify factors that a) predict whether people experience housing related discharge delay (HRDD) from a mental health inpatient unit; and b) predict the length of HRDD for people affected. By identifying the groups most affected by HRDD, clinicians and policy makers can prioritise and address barriers to timely discharge at both an individual and systemic level. A case control study using a detailed medical record review was conducted in one Australian mental health service. Demographic, clinical, contextual and systemic variables were collected for patients with HRDD in one calendar year (n = 55) and a random comparison sample (n = 55). Logistical and multiple regression analyses were conducted to identify variables that predict HRDD and length of HRDD. A model that correctly predicted 92% of HRDD and 78% of non-HRDD cases using five variables was developed. These variables were: diagnosis of schizophrenia or other psychotic disorder, physical comorbidity, having a history of violence or aggressive behaviour, being employed and being involved as a defendant in the justice system. The first three variables increased the likelihood of HRDD, while the second two reduced the likelihood of HRDD. For people who experienced HRDD, the only variable that predicted length of delay was staff reported difficulty finding appropriate support services. This model can be used to rapidly identify patients who might be at risk of HRDD and commence coordinated actions to secure appropriate housing and supports to facilitate timely discharge, thereby addressing a current practice gap. These findings highlight the intersection between health, housing and disability services in the lives of people with serious mental illness, and the need for a whole of government approach to investment and integration to address systemic barriers to suitable housing and supports.

Delayed discharge from inpatient mental health units is the continued hospitalisation of consumers after being assessed as ready to be discharged. This is common in adult inpatient mental health services and is usually due to a lack of appropriate housing for discharge. Research indicates a range of possible negative impacts, but no studies have explored consumers' perspectives on this issue. This study explores consumers' perspectives of the experience of housing related delayed discharge (HRDD).Using a grounded theory approach, in-depth interviews were conducted with 10 consumers. All consumers were experiencing HRDD from inpatient mental health units in one Sydney local health district. The data were analysed using constant comparative analysis.A lack of choice and control was the central theme that characterised participants' experiences. The combined experience of being delayed in hospital and being homeless led to a lack of choice and control over the basics in life, how consumers spent their time and with whom, and their futures. This lack of autonomy was shaped by the features of the hospital and participants' personal circumstance. The hospital features included rules and routines, physical and social environments, resources, and support from staff. Personal circumstances included individual situations, social networks, and support from community organisations. Participants described a variety of impacts, including reduced mental and physical well-being, and anticipated difficulty transitioning back into the community.This study is the first of its kind and provides consumer perspectives on the impacts of HRDD on their well-being and recovery. The inability to participate in meaningful and necessary occupations is an occupational injustice and implies the need for occupational therapists to advocate for both the prevention of HRDD through government investment in affordable and readily available housing and the mitigation of its effects through modified hospital environments and practices.

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.

IntroductionRecovery in mental health is both a policy imperative and a contested concept with individual and systemic elements. Occupational therapy research and pre-registration education have no...

Purpose Let’s Talk about Children (LTC) is a structured intervention which aims to improve outcomes for children of parents with a mental illness. An enhanced form of training has been developed to support clinician uptake of this intervention. The purpose of this paper is to explore clinicians’ experiences of this form of training and of implementing LTC. Design/methodology/approach A qualitative research design was adopted, underpinned by social constructionism. Semi-structured interviews were conducted with adult community mental health clinicians (n=10) and were audio-recorded. The interview data were transcribed verbatim, coded and thematically analysed. Findings Participants experienced both the training and the LTC intervention as a step in the right direction, with the enhanced training seen as superior to standard online modules, but not sufficient for implementation in practice. Additional training support, partnership working with families and service partners and overcoming challenges by adapting the model are some strategies that may support routine implementation of LTC. Originality/value This study is the first to explore clinician experiences of this enhanced face-to-face training format followed by the implementation of LTC in an Australian context. Findings suggest strategies for enhancing clinician skills and confidence, improving fidelity to the model and identifying success factors for services looking to implement LTC. The potential value of face-to-face over online training and common barriers to implementation at an organisational level are identified and require further exploration in future studies.

usc Refereed/Peer-reviewed Introduction: Recovery-oriented practice policies and occupational therapy education accreditation standards require that consumers are engaged in the design, delivery and evaluation of curricula. This consumer involvement (sometimes referred to as service-user involvement or patient involvement in other contexts) should go beyond consumers simply ‘telling their stories’ to more meaningful collaboration in curricula. This study was designed to map the current patterns of consumer involvement in occupational therapy programs across Australia and Aotearoa New Zealand. Method: A survey was distributed to all occupational therapy programs across Australia and Aotearoa New Zealand. The survey included questions related to: (a) perceived enablers and barriers to consumer involvement in education; (b) organisational structures and support; (c) ways in which consumer are involved in the design, delivery and evaluation of curricula; (d) access to remuneration for consumers; (e) overall ratings of the level of consumer involvement in curricula; and (f) academic confidence in working with consumers. Results: Usable responses were received for 23 programs from 19 universities (83% response rate). Every program reported some consumer involvement in the curriculum. Consumer participation tended to be mainly focussed on curriculum delivery with less frequent involvement in curriculum design or evaluation. The most common barrier to consumer involvement in curricula was ‘funding/remuneration for consumers’ and the most common enabler of consumer involvement was ‘positive attitudes of teaching staff’. Conclusion: In comparison to previous reports, consumer involvement in occupational therapy curricula has increased over the past decade. However, ongoing effort is required to support true collaboration in all aspects of curriculum design, delivery and evaluation. While this will require attention and effort from academic teams, changes at a university level to establish systems to engage and effectively remunerate consumers for their involvement (especially in design and evaluation elements) are also required.

Introduction Brain cancer diagnoses are rising, and the prognosis is commonly life-limiting. Brain cancer symptoms and the side effects of treatment are imposing and harmful. Little is known about the effect of these symptoms and treatments on occupational participation or about the role that occupational therapy can play for people with brain cancer. Methods Sixteen participants with brain cancer were purposively recruited from a single site. Data was collected using semi-structured interviews. Interviews were analysed thematically. Results Three overarching themes were identified: (a) ‘there’s a lot of things that I can’t do anymore’: adverse effects of tumour and treatments; (b) ‘you adjust with adversity’: accepting altered occupational participation levels; (c) occupational therapy: ‘why is she here?’ Conclusions Findings highlight a connection between brain cancer symptoms, treatment side effects and occupational participation. A disconnect was found between occupational therapy services and occupational needs. Further research could explore whether realigning occupational therapy services to address the concerns identified in this study leads to enhanced occupational participation through the journey of brain cancer.

Background/aim Consumer participation in design, delivery and evaluation of occupational therapy educational programs is a recently introduced requirement for accreditation. It aligns with the principle of recovery, which underpins Australian mental health policy. Graduates' capabilities for recovery-oriented practice are thought to be enhanced through learning from consumers' lived experience. This structured literature review evaluates the current evidence for mental health consumer participation in health professional education to inform occupational therapy educators. Method Searches were completed in five online databases, one journal and published reading lists on the topic. Studies were included if they addressed mental health consumer participation in health professional education programs, were published in peer reviewed journals between 2000 and 2014 and were in English. Articles were critically reviewed, and analysed for key findings related to stages of the educational process and recovery-oriented practice capabilities. Results An emerging body of evidence for consumer participation in mental health education was identified. Studies are characterised by a lack of quality and a low to medium level of evidence. Findings relate to design, planning, delivery and evaluation of education as well as to most aspects of recovery-oriented practice. Emphases on exploratory research and proximal outcomes, and a reliance on published outcome measurement instruments designed for other purposes are key limitations in this body of evidence. Conclusion and significance of the study This study identifies a weak evidence base for the requirement for consumer participation in occupational therapy programs, specifically related to mental health curricula. A research agenda is proposed in response.

Background/aim: Occupational therapy programs must prepare graduates for work in mental health. However, this area of practice is complex and rapidly changing. This study explored the alignment between educational priorities identified by occupational therapists practising in mental health and level of coverage of these topics in occupational therapy programs in Australia and New Zealand. Methods: Surveys were distributed to heads of all occupational therapy programs across Australia and New Zealand. The survey included educational priorities identified by occupational therapists in mental health from a previous study. Respondents were requested to identify the level of coverage given to each of these priorities within their curriculum. These data were analysed to determine a ranking of educational topics in terms of level of coverage in university programs. Results: Responses were received for 19 programs from 16 universities. Thirty-four topics were given High-level coverage' in university programs, and these were compared against the 29 topics classified as Essential priorities' by clinicians. Twenty topics were included in both the Essential priorities' and High-level coverage' categories. Topics considered to be Essential priorities' by clinicians which were not given High-level coverage' in university programs included the following: mental health fieldwork experiences; risk assessment and management; professional self-care resilience and sensory approaches. Conclusion: While there appears to be overall good alignment between mental health curricula and priorities identified by practising occupational therapists, there are some discrepancies. These discrepancies are described and establish a strong foundation for further discussion between clinicians, academics and university administration to support curriculum review and revision. Refereed/Peer-reviewed

This pilot study explored the effectiveness of workplace training programme that aimed to enhance the work-related behaviours in individuals with autism and intellectual disabilities. Fourteen participants with autism and mild to moderate intellectual disability (mean age = 24.6 years) were recruited. The workplace training programme included practices in work context and group educational sessions. A pre-test–post-test design was used with the Work Personality Profile, the Scale of Independent Behaviour Revised and the Observational Emotional Inventory Revised to evaluate the targeted behaviours. Improvement in social and communication skills specific to the workplace was achieved. For emotional control, participants became less confused and had a better self-concept. However, improvement in other general emotional behaviours, such as impulse control, was limited. The results indicated that a structured workplace training programme aimed at improving social, communication and emotional behaviours can be helpful for people with autism and intellectual disability. Further study with a larger sample size and a control group is recommended. The development of specific programme to cater for the emotional control needs at workplace for people with autism is also suggested. Copyright © 2013 John Wiley & Sons, Ltd.

The purpose of this study was to describe the demographic and employment characteristics of Australian occupational therapists working in youth mental health and explore the relationship between these characteristics and the occupational therapist's role. Sixty-three occupational therapists completed a postal survey during 2006–2007. Numerical data were analyzed using descriptive statistics and qualitative data were analyzed using thematic analysis. The majority (86%) of participants were female, with a mean age of 31.8 years. Over half of the participants were employed as occupational therapists (60%). While most participants reported less than five years experience working with young people (92.5%), thirty-nine participants (61.9%) expressed optimism about the future of occupational therapy in youth mental health. Factors such as funding, staff retention, support, training, and attitudes surrounding professional roles were identified as barriers to role expansion. Occupational therapists work in a range...

This pilot study explored the effectiveness of workplace training programme that aimed to enhance the work-related behaviours in individuals with autism and intellectual disabilities. Fourteen participants with autism and mild to moderate intellectual disability (mean age = 24.6 years) were recruited. The workplace training programme included practices in work context and group educational sessions. A pre-test-post-test design was used with the Work Personality Profile, the Scale of Independent Behaviour Revised and the Observational Emotional Inventory Revised to evaluate the targeted behaviours. Improvement in social and communication skills specific to the workplace was achieved. For emotional control, participants became less confused and had a better self-concept. However, improvement in other general emotional behaviours, such as impulse control, was limited. The results indicated that a structured workplace training programme aimed at improving social, communication and emotional behaviours can be helpful for people with autism and intellectual disability. Further study with a larger sample size and a control group is recommended. The development of specific programme to cater for the emotional control needs at workplace for people with autism is also suggested.