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To describe the provision of evidence-based psychological therapies for the treatment of psychosis in a large Australian mental health service; and to explore the barriers and facilitators to providing these therapies. Mixed-methods study including: 1) a retrospective audit of 100 clients with schizophrenia spectrum disorder to estimate adherence to guideline recommended psychological therapies; and 2) a cross-sectional survey of community based mental health practitioners, based on the Theoretical Domains Framework, to understand the barriers and facilitators to delivering psychological therapies to clients with psychosis. Twenty-five percent (25/100) of the audited sample engaged with psychological services. Of those who did, two received the recommended dose of evidence-based therapy. Thirty-three percent (37/112) of mental health practitioners completed the survey. Barriers to the delivery of psychological therapies related to perceived lack of knowledge, skills, and confidence with the therapies, and beliefs about who will (and will not) benefit. Other barriers included lack of time, demanding caseloads, and a culture of risk and crisis management. People with psychosis have poor access to evidence-based psychological therapies. The barriers to providing psychological therapies are multifactorial and should be systematically addressed to improve health and quality of life outcomes for people living with psychosis. Abbreviations: CBT: Cognitive behaviour therapy; CBTp: cognitive behaviour therapy for psychosis; CRT: cognitive remediation therapy; FIp: family intervention for psychosis; PORT: Patient Outcomes Research Team; RANZCP: Royal Australian and New Zealand College of Psychiatrists; NICE: UK National Institute of Clinical Excellence; TDF: The Theoretical Domains Framework; HoNos: Health of the Nation Scale; EBPIs: Evidence Based Psychological Interventions; ACT: Acceptance and Commitment Therapy. What is already known about this topic: Clinical practice guidelines for the past two decades have recommended psychological interventions be routinely offered to clients with psychosis. There exists a substantial and widely acknowledged evidence-practice gap concerning the implementation of evidence-based psychological interventions for psychosis within public mental health services. Despite knowledge of effective interventions, the translation into clinical practice continues to fall short. Barriers to the provision of evidence-based psychological interventions for psychosis are evident at various levels, including challenges among staff, service recipients and organisational culture. These factors collectively impede the translation of evidence-based psychological interventions into routine psychosis care. What this topic adds: Identifying and understanding local structural, cultural, resourcing, and attitudinal barriers, while emphasising enablers, becomes essential. This understanding forms the foundation for enhancing access to evidence-based psychological interventions, ultimately elevating the quality of care outcomes for people with psychosis. To foster equitable access and awareness of evidence-based psychological interventions for psychosis, initiatives such as increased staff training, service redesign emphasising the value of psychological interventions, improved referral processes, advocacy, role clarification for clinicians, and enhanced supervision opportunities are crucial. These multifaceted strategies collectively may contribute to a more informed and effective approach to evidence-based psychological interventions for psychosis, promoting optimism and treatment choice. Once local structural, cultural, resourcing, and attitudinal factors are recognised and understood targeted improvements in service delivery for psychosis can be strategically implemented, aligning with the unique dynamics of the local context and care setting. [ABSTRACT FROM AUTHOR]

The article informs about the increasing prevalence of dementia in Australia, highlighting the anticipated doubling of cases by 2058 and the significant number of individuals affected by the condition. Topics include the symptoms and types of dementia, emphasizing its progressive nature and impact on daily functioning, which may necessitate interactions with first responders and emergency services.

The article highlights the dementia friendly health service of the East Metropolitan Health Service (EMHS) in Western Australia. Topics include its official recognition as "working towards being dementia friendly" by Dementia Australia; the Awareness-raising events that are hosted across the health service; and the Dementia Friendly Communities (DFC) program, run through Dementia Australia.

The article reports on the a Tailored Training Program in dementia care, aimed at Ambulance Transport Officers developed by health services in Western Australia, Dementia Training Australia along with St John Ambulance Western Australia. It discusses that the scope of the ambulance service must be widened to include the development of psychosocial skills, which can help prevent people living with dementia n their own home from being unnecessarily transferred to hospital.

Aims.: Incorporating consumer perspectives into mental health services design is important in working to deliver recovery-oriented care. One of the challenges faced in mental health rehabilitation services is limited consumer engagement with the available support. Listening to consumers' expectations of mental health services, and what they hope to achieve, provides an opportunity to examine the alignment between existing services and the priorities and preferences of the people who use them. We explored consumer understandings and expectations of three recovery-oriented community-based residential mental-health rehabilitation units using semi-structured interviews; two of these units were trialling a staffing model integrating peer support with clinical care. Methods.: Twenty-four consumers completed semi-structured interviews with an independent interviewer during the first 6 weeks of their stay at the rehabilitation unit. Most participants had a primary diagnosis of schizophrenia or a related psychotic disorder (87%). A pragmatic approach to grounded theory guided the analysis, facilitating identification of content and themes, and the development of an overarching conceptual map. Results.: The rehabilitation units were considered to provide a transformational space and a transitional place. The most common reason given for engagement was housing insecurity or homelessness rather than the opportunity for rehabilitation engagement. Differences in expectations did not emerge between consumers entering the clinical and integrated staffing model sites. Conclusions.: Consumers understand the function of the rehabilitation service they are entering. However, receiving rehabilitation support may not be the key driver of their attendance. This finding has implications for promoting consumer engagement with rehabilitation services. The absence of differences between the integrated and clinical staffing models may reflect the novelty of the rehabilitation context. The study highlights the need for staff to find better ways to increase consumer awareness of the potential relevance of evidence-based rehabilitation support to facilitating their recovery.

In the present study, we explored the experiences of staff working at a recovery-oriented, community-based residential mental health rehabilitation unit in Brisbane, Australia, called a 'community care unit' (CCU). A pragmatic approach to grounded theory was taken in the analysis of the transcripts of semistructured interviews with eight staff. Convenience sampling was used, and there was representation of junior and senior staff across nursing, allied health, and non-clinical support roles. Four key themes emerged from the analysis: (i) rehabilitation is different to treatment; (ii) the CCU is a positive transitional space; (iii) they (consumers) have to be ready to engage; and (iv) recovery is central to rehabilitation practice. Staff understandings of recovery in rehabilitation work were complex and included consideration of both personal and clinical recovery concepts. Rehabilitation readiness was considered important to the ability to deliver recovery-oriented care; however, the shared role of staff in maintaining engagement was acknowledged. Threats to recovery-oriented rehabilitation practice included staff burnout and external pressure to accept consumers who are not ready. The reality of working at a community-based recovery-oriented rehabilitation unit is complex. Active vigilance is needed to maintain a focus on recovery and rehabilitation. Leadership needs to focus on reducing burnout and in adapting these services to emergent needs. [ABSTRACT FROM AUTHOR]

Objective: This paper describes the establishment of training in cognitive remediation for psychosis within a community mental health service.Methods: Clinical staff working in the community of a mental health service were surveyed to ascertain their interest in cognitive aspects of psychosis and skills training in cognitive remediation (CR). Based on the results of the survey a tiered training programme was established with attendance figures reported for each level of training. Fidelity assessment was conducted on the five CR programmes operating.Results: Of 106 clinical staff working in the community with people diagnosed with a psychotic illness 51 completed the survey (48% response rate). The training needs varied with all 106 staff receiving the fundamental (mandatory) training and 51 staff receiving CR facilitator training. Thirty three percent of staff trained as facilitators were delivering CR.Conclusions: Up skilling the mental health workforce to incorporate an understanding of the cognitive aspects of psychosis into care delivery can be facilitated by a tiered training structure. Fundamental training on the psychosocial aspects of psychosis can act as a platform for focussed CR skills based training. There is also a need for accessible therapy based supervision for staff wishing to develop competencies as CR therapists. [ABSTRACT FROM AUTHOR]

The article discusses Ellie Newman describing a successful partnership between Dementia Training Australia (DTA) and Nurse West, developed in response to the COVID-19 pandemic, to equip qualified nurses with dementia and delirium training. Topics include the Western Australia Department of Health has run nursing and midwifery temporary staff pool, known as Nurse West; and the health service reached out to Dementia Training Australi to see and how DTA has assist.