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Objectives: Inequities in physical health outcomes exist for people with mental health and substance use conditions and for Indigenous populations (Māori in Aotearoa New Zealand). These inequities may be partly explained by poorer quality of physical healthcare services, including discrimination at systemic and individual levels. This study investigated the experiences of people with mental health and substance use conditions accessing physical healthcare and differences in service quality for non-Māori relative to Māori. Methods: A cross-sectional online survey of people with mental health and substance use conditions in New Zealand asked about four aspects of service quality in four healthcare settings: general practice, emergency department, hospital and pharmacy. The quality domains were: treated with respect; listened to; treated unfairly due to mental health and substance use conditions; mental health and substance use condition diagnoses distracting clinicians from physical healthcare (diagnostic and treatment overshadowing). Results: Across the four health services, pharmacy was rated highest for all quality measures and emergency department lowest. Participants rated general practice services highly for being treated with respect and listened to but reported relatively high levels of overshadowing in general practice, emergency department and hospital services. Experiences of unfair treatment were more common in emergency department and hospital than general practice and pharmacy. Compared to Māori, non-Māori reported higher levels of being treated with respect and listened to in most services and were more likely to report 'never' experiencing unfair treatment and overshadowing for all health services. Conclusion: Interventions to address discrimination and poor-quality health services to people with mental health and substance use conditions should be tailored to the physical healthcare setting. More needs to be done to address institutional racism in systems that privilege non-Māori. [ABSTRACT FROM AUTHOR]

Discrimination against people with mental health and substance use conditions (MHSUC) by health professionals contributes to the poor physical health outcomes this group experiences. We surveyed people with MHSUC in Aotearoa New Zealand to explore how they experienced and responded to discrimination from physical health services. Participants identified 6 strategies used to avoid or minimize the impact of discrimination. Avoidance strategies included not seeking help, not disclosing MHSUC diagnoses and changing or seeking out health professionals who did not behave in discriminatory ways. Minimizing strategies were being a "model patient," taking a support person to consultations or advocating for what they needed, even in the face of discrimination. Physical health services must focus on providing non-discriminatory care to reduce the need for compensatory strategies and improve care of physical illness for people with MHSUC. [ABSTRACT FROM AUTHOR]

Peer support has been proposed as a way to enhance the provision of mental health care; however, research has predominantly centred around formalised peer support programmes, with a dearth of studies exploring the anecdotally described phenomenon of naturally occurring peer support. This paper reports how naturally occurring peer support took place among service users in adult acute mental health unit settings, drawing on a thematic analysis of qualitative interviews gathered from four New Zealand facilities. Our analysis revealed three themes in relation to how peer support naturally occurred: (1) fulfilling a need to connect, (2) desire to improve the unit experience for others and (3) a sense of solidarity among service users. These interwoven but distinct themes provide a means for understanding naturally occurring peer support in the context of busy, under-resourced acute mental health settings and draw attention to its strengths, helping to fulfil service users' need for support and connection in the absence of talking therapies or staff available to talk to. The findings highlight the potential for staff to recognise and facilitate these interactions in the acute care setting, and may help to dismantle stigmatising perspectives, demonstrating service users' capacity for kindness despite being acutely unwell. [ABSTRACT FROM AUTHOR]

Renewed focus on mental health has put the spotlight on the 'black box' that is the acute mental health facility. Drawing on a larger programme of research, key issues relevant to the planning and design of mental health units were identified from in-depth interviews with those using the facilities. Contemporary issues included visibility from the outside and wayfinding, the need to accommodate cultural needs extending to the family and community, safety and violence, the need for access to nature and fresh air, and facilitating meaningful activities. Stigma and its spatial expression were a crosscutting theme throughout. Trial registration: Australian New Zealand Clinical Trials Registry; identifier: ACTRN12617001469303. [ABSTRACT FROM AUTHOR]

Humor plays a key role in effective coaching, particularly among younger players. A study conducted on the impact on coaches' use of humor on female volleyball players revealed that players liked coaches who demonstrated some sense of humor. Results also revealed a link between players' liking for their coaches and their rating of coaches' ability. For older players, the use of humor did not affect perceptions of coaching ability., Humor has fascinated people since recorded history. Humor has been studied by scholars in a variety of fields such as psychology, biology, anthropology, and sociology (Vinton, 1989). Humorous effects have [...]

Aim: The study explored whether the reported experience of primary healthcare differs for survey respondents in Aotearoa New Zealand who self-report having a mental health (MH) condition in comparison with those who do not., Method: Responses to the New Zealand Health Quality & Safety Commission's adult primary care patient experience survey received from August 2020 to May 2022 were analysed. Comparative analysis of patient-reported experience measures were completed to contrast experiences reported by those with and without a MH condition, with results stratified by ethnicity (Māori/non-Māori), age group and gender. Age/gender-standardised estimates for proportions of positive responses to each question were developed for each group alongside standardised risk differences., Results: Our sample comprised 201,650 responses, with 21% reporting a current diagnosed MH condition. While most respondents reported positive experiences of primary healthcare, we found a consistent pattern of fewer positive experiences for those with MH conditions across dimensions of care quality, age and gender groups. When responses were separated by ethnicity, this difference was amplified among Māori., Conclusion: This analysis adds to the increasing body of evidence that experience of MH conditions is associated with worse healthcare experiences. It demonstrates that data are available in Aotearoa New Zealand to routinely monitor and report on primary care experiences for this group. Interventions to improve healthcare should focus on care for Māori with MH conditions as a priority., Competing Interests: Nil., (© PMA.)