The Place of Psychiatric Rehabilitation in New Zealand Communities

<p>Supported Residential Care Facilities (SRCF's) play a distinctive role in the integration of mental health consumers within host communities. Despite the vast quantity of research on the sociological impacts of discrimination against mental health consumers, such as societal and self stigmatisation, little to no research is conducted on the effects that the built environment have upon mental health consumers in SRCF's in New Zealand post deinstitutionalisation. This study examines the 23 existing SRCF's within the Wellington region, examining their socioeconomic context, city planning context, physical environment context and the built typology of these facilities. Each of these research subjects are examined to identify and understand the implications they have on the integration of mental health consumers within their host communities at three scales; host community, location and facility design. The findings and insight drawn from sociological literature and empirical research are summarised within the design guideline and tested through a design based case study. The conclusions of this research can be summarised as follows: 1. It is desirable for host communities to be socioeconomically diverse with an appropriate level of public and mental health amenities 2. It is advantageous for SRCF's to be located within the 'inner edge context,' promoting a diverse urban context, socioeconomic context, diverse planning context and safe pedestrian access to public amenities. 3.The facility design of SRCF's should promote a 'recovery oriented practice,' achieved partially through context specific 'integration programs'. The majority of SRCF's within the research sample are located within residential suburbs. This research identifies that SRCF's and facilities alike must be located within the 'inner edge context'. The findings are of particular usefulness to Wellington's SRCF's yet are also helpful in understanding and improving the built environment of SRCF's within New Zealand communities.</p>

The Place of Psychiatric Rehabilitation in New Zealand Communities

<p>Supported Residential Care Facilities (SRCF's) play a distinctive role in the integration of mental health consumers within host communities. Despite the vast quantity of research on the sociological impacts of discrimination against mental health consumers, such as societal and self stigmatisation, little to no research is conducted on the effects that the built environment have upon mental health consumers in SRCF's in New Zealand post deinstitutionalisation. This study examines the 23 existing SRCF's within the Wellington region, examining their socioeconomic context, city planning context, physical environment context and the built typology of these facilities. Each of these research subjects are examined to identify and understand the implications they have on the integration of mental health consumers within their host communities at three scales; host community, location and facility design. The findings and insight drawn from sociological literature and empirical research are summarised within the design guideline and tested through a design based case study. The conclusions of this research can be summarised as follows: 1. It is desirable for host communities to be socioeconomically diverse with an appropriate level of public and mental health amenities 2. It is advantageous for SRCF's to be located within the 'inner edge context,' promoting a diverse urban context, socioeconomic context, diverse planning context and safe pedestrian access to public amenities. 3.The facility design of SRCF's should promote a 'recovery oriented practice,' achieved partially through context specific 'integration programs'. The majority of SRCF's within the research sample are located within residential suburbs. This research identifies that SRCF's and facilities alike must be located within the 'inner edge context'. The findings are of particular usefulness to Wellington's SRCF's yet are also helpful in understanding and improving the built environment of SRCF's within New Zealand communities.</p>

Developing resilience and promoting positive mental health strategies in university students

AimsSuicide is one of the leading causes of death in young people living in Australia, accounting for 7.3% of all deaths among individuals aged 15–19 years. Historically, high levels of suicide have been recorded in Australian university students. This project aims to develop and test a massive online course-program (MOOC) for university students, underpinned by literature and strength-based suicide prevention principles, building resilience and awareness of mental health promoting activities.MethodA scoping review of the literature was undertaken to explore the effectiveness of current suicide prevention programs for undergraduate university students, and the effective elements contributing to the success of these programs. Six electronic databases were searched to identify relevant literature. Further, mental health consumers and university students were involved in co-producing the content of the six modules of the ‘Talk-to-me' MOOC.ResultNine articles were included in the review, discussing four types of programs including; gatekeeping, education, promotional messaging and online consultation. It was apparent from this review that there is a significant dearth of interventions and programs currently available to reduce the risk of suicide among undergraduate students, with many of the programs having limited efficacy. Despite this, a number of program elements were identified as beneficial to preventing suicide among post-secondary students including upskilling of students, and improving resilience, and self-management. These findings and further consultation with mental health consumers and undergraduate university students underpinned the development of the content of the ‘Talk-to-me' MOOC which is tailored to meet the needs of university students. The MOOC contains six modules: Mental fitness; strategies to increase mental fitness; self-harm; suicidal behaviour in young adults; interventions for suicidal behaviour; and, gatekeeper interventions. Two case study senarios depicting mental health challenges commonly experienced by yound adults portraying appropriate crisis communication skills were developed and filmed complementing the six ‘Talk-to-me' modules.ConclusionOverall, studies included in the review provide evidence to suggest that preventative programs, incorporating an educational component may be effective to be used in the MOOC to improving help-seeking behaviours among post-secondary education students. Findings from this review have underpinned the development of the ‘Talk-to-Me' MOOC which was launched in March 2020. To date this MOOC has enrolled over 45,000 participants from over 150 countries, with the average age of users being 24 years. Collectively, this line of work highlights that MOOCs are an effective means of mental health promotion to young adults.

Oral health promotion practices of Australian community mental health professionals: a cross sectional web-based survey

Background This study explored the oral health promotion practices of Australian community mental health professionals working with people living with severe mental illness (SMI). Methods An anonymous cross-sectional web-based survey was distributed to all Community Rehabilitation and Support Workers (CRSWs) working at Neami National (n = 471), an Australian community mental health service. The validated questionnaire assessed participants’ self-rated oral health knowledge and confidence (7 questions); their perceived barriers (9 questions) and attitudes (5 questions) to oral health promotion; and their oral health promotion practices (7 questions). Differences in responses between groups were analysed using Chi-square, Fisher’s exact and Mann–Whitney U tests. Logistic Regression Analysis served to explore the probability of providing oral health support to mental health consumers. Results A total of 141 CRSWs were included in this study, achieving a response rate of 30 percent. Roughly two-fifths (39.0%) of participants had oral health training in the previous 12-months. The majority of CRSWs (89.3%) believed (‘Agreed’ or ‘Strongly agreed’) that mental health support workers have a role to play in promoting oral health. However, less than half (44.0%) of CRSWs practiced oral health promotion activities when working with mental health consumers. When asked about barriers to promoting oral health, ‘lack of consumer interest’ was the most prevalent issue. CRSWs who had oral health training were over three-times (OR 3.5, 95% CI 1.25–9.83, p = 0.017) more likely to provide oral health support. Results showed the provision of oral health support was most strongly associated with self-rated knowledge and confidence (OR 4.089, 95% CI 1.629–10.263, p = 0.003) and attitudes to oral health promotion (OR 3.906, 95% CI 1.77–8.65, p = 0.001). Conclusion The results of this study suggest that mental health support workers who have more positive attitudes to oral health promotion and who have higher self-rated oral health knowledge and confidence are more likely to provide oral health support in their professional role. Training for community mental health professionals is essential to build confidence and skills to promote oral health for mental health consumers.

Participation in creative workshops supports mental health consumers to share their stories of recovery: A one-year qualitative follow-up study

Participation in creative activities has been linked with positive outcomes for people with mental illness. This longitudinal qualitative study is a one-year follow-up of eight mental health consumers who participated in a series of creative workshops in Brisbane, Australia that aimed to increase participants’ capacity and skills in sharing their stories of recovery with others. It also sought to understand successful factors of the creative workshops to inform future workshops. Semi-structured interviews gathered information regarding participants’ memories of the workshops and how they had shared their stories with others over the preceding 12 months. Interpretative phenomenological analysis identified that participants’ enjoyed being engaged in a range of creative mediums in a group setting; that peer mentor support was highly valued; and that participants’ recovery stories had become more positive and were shared more often and openly with others. Overall, participation in the creative workshops had long-lasting benefits for participants with respect to improved confidence and understanding about their illness. Future creative workshops should consider the inclusion of peer mentors with lived experience as a support for participants to reauthor their recovery story.

Mental health consumers’ perspectives on using an occupation-focused assessment to initiate change in everyday activities

Introduction Engagement in meaningful activities is central to recovery for people with mental health conditions. The aim of this study was to examine the utility of an occupation-focused assessment, the Daily Experiences of Pleasure, Productivity, and Restoration Profile, as a means to guide engagement in meaningful activity. Methods Eight consumers who were receiving services from a community-based behavioural health centre utilized the Profile to set and work towards self-identified goals. Data derived from audiotaped sessions, notes, and a focus group were analysed using an iterative content analysis process. Results Three themes emerged: completion of the Profile was ‘burdensome, but right on’, moving from insights gained to choosing and working towards a goal required guidance from the therapist, and insights gained from the Profile supported some changes in actions and perspectives. Conclusion The findings support preliminary utility of the Daily Experiences of Pleasure, Productivity, and Restoration Profile to guide engagement in meaningful activity among people living with mental health conditions. Moreover, the support and guidance of the occupational therapist is critical. Continued examination of the use of the Profile is warranted to help support occupational therapy’s role in promoting recovery for people with mental health conditions through meaningful activities.