bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depression in the Young, Parental Depression and Parenting Stress
Authors: Tan Susan , Rey Joseph 
Published: December 2009

Objective: To examine the relationship between depression in children and adolescents, parental depression and parenting stress. Methods: Fifty-three depressed youths, 9-16 years, were matched for age and gender and compared with S3 non-depressed controls. Depression was diagnosed using the Diagnostic Interview for Children and Adolescents-Revised (DICA-R). Parents completed questionnaires on depression and parenting stress. Results: Parents of depressed children reported higher parenting stress and were more likely to perceive their children as ‘difficult’. Univariate analysis demonstrated a relationship between children's depression and maternal depression but not with paternal depression. This became non-significant with multivariate analysis, implying that maternal depressive symptoms may have been due to caring for a depressed, thus ‘difficult’ child. Conclusions: Depressed youth were more likely to be perceived by mothers as ‘difficult’ and caused them significant parenting stress. The same phenomenon did not occur among the fathers. Clinicians need to consider the presence of depression among ‘difficult’ children and look for early depression in mothers of depressed youth.
Strategic Planning and Public Mental Health Services
Authors: Goding Margaret 
Published: December 2009

Objectives: To provide an overview of approaches to strategic planning and to examine issues in relation to their applicability to public mental health services. Conclusions: Strategic planning is important for optimal functioning of mental health services in an increasingly complex environment. Although each approach will have advantages depending on context, the overall principles of the learning organization developed by Senge have particular relevance for mental health services.
Organizational Change Management in Mental Health
Authors: Callaly Tom , Arya Dinesh 
Published: December 2009

Objective: To discuss change management as applicable to mental health. Conclusions: As mental health care grows increasingly complex, and the network of accountability widens, change is both inevitable and necessary. Strategies to introduce change effectively are essential. Resistance by medical staff to change often has a sound basis and must be acknowledged and explored. Change in clinical systems and practice is facilitated by careful planning and preparation, and by engaging clinicians in all phases of the change process; change will fail if this is not achieved. A number of management models facilitate the understanding and process of change.
A Survey of Alcohol and Drug Services to General Hospitals in Australia
Authors: Yeatman Richard 
Published: December 2009

Objective: To determine the structure and function of alcohol and drug services to general hospitals in Australia, and to examine the role psychiatry plays in those services. Method: A survey of 15 large metropolitan hospitals was conducted. Results: Services differed considerably between hospitals, and psychiatric involvement was not prominent in most. Conclusions: One of the challenges is to structure the administration of services so that they have a profile within the general hospital as well as close connectionwith community services. Psychiatrists must become more proactive in the area to reinforce what they have to offer these patients and to provide mentorship and training to psychiatric trainees in the field.
Helping Carers Care: An Education Programme for Rural Carers of People with a Mental Illness
Authors: Hayman Faye 
Published: December 2009

Objective: To provide descriptive information about a short-term educational programme for rural carers of people with a mental illness, living in the Loddon Campaspe Southern Mallee region. Method: The Carers Education Exchange Programme is a flexible, needsbased model that can be modified to cater for individual groups. It consists of a number of sessions on topics relevant to caring for someone with a mental illness, held over a period of several weeks. The programme is offered at locations throughout the region, making it accessible to carers in isolated, rural areas. Results: Feedback indicates that the benefits of participating in the programme include the reduction of isolation and stigma, increased understanding of mental illness, development of skills relevant to the caring role and the formation of supportive networks, both professional and personal. Conclusions: Educational group programmes for carers are an effective way of providing both education and support. This programme can assist in reducing some of the distress and difficulties inherent in caring for someone with a mental illness. Carer well-being is enhanced by the promotion of self-care and a positive outlook.
Beyond the Chalkboard: The Interacting Domains in Undergraduate Psychiatric Teaching
Authors: Claassen Johann , Kruger Estie 
Published: December 2009

Objective: To identify and describe interacting domains that are present during undergraduate psychiatric teaching and impress on educators the roles of these domains. Conclusions: Undergraduate psychiatric teaching is an essential part of general family physicians' training and practice. Undergraduate students' exposure to psychiatry might be inadequate. Curricular goals, teaching and evaluation of students need to be aligned. Research and information technology can play a bigger role in teaching. Validation of patients, students and teachers during the teaching process is important, but not always emphasized. Educators should be aware of society's unwritten expectations, judgements and opinions of mental illness sufferers. Identifying and facilitating the various interacting domains during psychiatric teaching may contribute to better education in psychiatry, better retention of knowledge for students and an improved recruitment of students to a psychiatric career.
Hospital Admission in Adolescents with acute Psychiatric Disorder: How Long should it be?
Authors: Swadi Harith , Bobier Candace 
Published: December 2009

Objective: To determine the length of stay in hospital for youth with acute psychiatric illness, and the treatment outcome. Methods: Diagnostic and Statistical Manual of Mental Disorders(4th edn;DSM-IV) psychiatric diagnosis, clinical outcome and the length of stay were sys-tematically gathered for admissions over an 18month period at the Christchurch Youth Inpatient Unit (YIU). Clinical outcome data were collected at admission,3 weeks after admission and at discharge, using the Health of the Nation Out-come Scale for Children and Adolescents (HoNOSCA). The length of stay was determined retrospectively. Discharge was decided on clinical grounds. Results: During the 18 months of the investigation, 72 subjects were admitted for the treatment of acute mental illness. The most common diagnostic category was mood disorder (n = 39, 54%), followed by anxiety or adjustment disorder (n = 18, 25%), and major psychosis (n = 15, 21%). The mean length of admission for the whole population was 27.3 days, 23.7 days for mood disorders, 18.9 days for anxiety disorders and 46.9 days for the major psychosis diagnostic groups. According to HoNOSCA clinician ratings, the major portion of the improvement occurred during the first 3 weeks of admission. Conclusions: For the majority of youth with acute psychiatric illness, a relatively short stay in hospital is feasible, because most health gains tend to occur early during an admission.
Lessons Learnt in Conducting a Clinical Drug Trial in Children with Asperger Syndrome
Authors: Mathai John , Bourne Angela , Cranswick Noel 
Published: December 2009

Objective: To describe the authors' experience of conducting a clinical drug trial in children with Asperger Syndrome, including the pitfalls encountered and lessons learnt. Conclusions: The main barrier encountered was in the recruitment of children: it was not possible to recruit the target of 60 patients. The recruitment of children is often the major barrier to the progress of a successful clinical trial. Conducting the clinical drug trial was greatly facilitated by the appropriate setting and experienced clinical pharmacology staff.
General Practitioners and Mental Health Staff Sharing Patient Care: Working Model
Authors: Horner Deborah , Asher Kim 
Published: December 2009

Objective: The paper describes a shared care programme developed by mental health services and general practitioners for shifting patients with chronic psychiatric disorders to the care of a general practitioner. The programme is characterized by: (i) a dedicated mental health service general practitioner liaison position to manage the programme and provide support to both patients and doctors; (ii) a multidisciplinary care planning meeting that includes mental health staff, the patient, the general practitioner and a carer; and (iii) a jointly developed individual management plan that specifies patient issues, strategies to deal with these issues, persons responsible for monitoring and a review date. Methods: The shared care protocol, the results of a review of patient mental health indicators and general practitioner satisfaction with the programme are described. Results: Outcomes to date suggest that patients' mental health is not compromised and may be enhanced by transfer to general practitioners within the shared care model. Indicators of mental health outcomes (Health of the Nation Outcome Scale and Life Skills Profile scores) show improved patient symptomatology and functioning in most cases. Conclusions: The programme fits the model of recovery-based mental health services and complies with current local, state and Commonwealth policies that encourage integrated and collaborative approaches by mental health services and general practitioners in delivering mental health care to persons with chronic mental illness.
Survey of Depot Antipsychotic Prescribing in Southern Adelaide
Authors: Herriot Peter , Kheirani Kamran 
Published: December 2009

Objective: Depot antipsychotic medication (DAP) is widely used in the treatment of schizophrenia and related disorders. The objectives of this study were to (i) determine whether DAP was being prescribed in accordance with established guidelines in terms of dose, interval of administration and indications; and (ii) assess the quality of the assessment and documentation of tardive dyskinesia (TD) as well as blood glucose and lipid abnormalities. Methods: The survey was carried out between April and June 2003 at all three public hospital affiliated community mental health centres located in the southern region of Adelaide. Data were extracted from three sources: depot prescription charts, community mental health service case notes and hospital case notes. Results: Two hundred and sixty-one patients were receiving DAP. The majority (89%) had a diagnosis of schizophrenia or schizoaffective disorder. The DAP prescribed most frequently was zuclopenthixol decanoate (57%) at a modal dose of 200 mg and a modal administration interval of 2weeks. Fifty-three per cent of patients had at least one dose reduction during the course of treatment. Four per cent of patients had a case note documented diagnosis of TD. Fifty-seven per cent of patients had at least one blood glucose test in the past year, with nearly half showing high results. Forty-seven per cent of patients had at least one lipid study in the past year, with more than half having high total cholesterol and 22% having high triglycerides. Conclusion: The results of this study indicate that DAP is being used mostly for the treatment of schizophrenia and related disorders, which is in agreement with established evidence-based guidelines. The finding of at least one documented attempt at DAP dose reduction or extension of interval of administration in approximately half of the patients receiving DAP is encouraging and may have an impact on reducing the likelihood of TD. A formal TD surveillance programme using a screening tool such as the Abnormal Involuntary Movement Scale is recommended. In addition, more frequent evaluation of blood glucose and lipid levels is needed.
Models and Patterns of Service in Child and Youth Consultation–Liaison Services
Authors: Wagner Ingrid , Stathis Stephen , Harden Scott , Crimmins Jennifer 
Published: December 2009

Objective: The aim was to examine referral pathways to child and youth consultation–liaison (C-L) services to identify patterns associated with demographic characteristics of patients, referral sources, the presenting problem and models of service. Method: A case record review with a cross-sectional design. Data were extracted from the records of all patients referred to the C-L service for a 3month period. Results: Adolescents were more likely to accessmental health services through informal liaison services. Medical specialty areas that were inclusive of nursing and allied health, in both the request for service and initial response to the request, had higher frequencies of referral. There was no difference between the disciplines of medicine and social work in the frequency of referrals. However, medicine, social work and nursing differed in the number of staff who initiated the request for consultation, and the types of problems that were presented as reasons for referral. Conclusions: Inclusive multidisciplinary models may facilitate the development of service relationships in paediatric hospital settings, due to the stability of staffing arrangements. The wider participation of allied health and nursing staff within paediatric hospitals may extend opportunities for the identification of mental health problems and enhance timely management of referrals.
Providing Integrated Mental Health Services: A Policy and Management Perspective
Authors: Callaly Tom , Fletcher Anna 
Published: December 2009

Objective: To review the challenge of providing integrated mental health services from a policy and health management perspective. Conclusions: The provision of integrated mental health services involving specialist mental health services, general practitioners, psychiatric disability and rehabilitation services and public community health services is a major challenge in the Australian health care context and is increasingly an expectation of the community. Government, Divisions of General Practice and public community health policy and many Government, State and local initiatives have attempted to address this challenge. However, much remains to be done, including culture change within services and professions and the development of technology to support integrated service provision.
Mrs Hitler and her doctor
Authors: Macleod Sandy 
Published: December 2009

Objective: The doctor who attended the mother of Adolf Hitler in her terminal illness has been blamed as a cause of the Holocaust. The medical details recorded of this professional relationship are presented and discussed. Conclusions: Dr Bloch's medical care of Mrs Hitler was consistent with the prevailing medical practice of the management of fungating breast carcinoma. Indeed, the general practitioner's care and attention of the family appear to have been astute and supportive. There is nothing to suggest that Dr Bloch's medical care was other than competent. Doctors who have the (mis)fortune to professionally attend major figures of history may be unfairly viewed, despite their appropriate and adequate care.
Contribution of ‘School-Link’ to an Area Mental Health Service
Authors: Maloney Danielle , Walter Garry 
Published: December 2009

Objective: To evaluate the contribution of the ‘School-Link’ initiative to an Area Mental Health Service. Method: Surveys and focus groups of school and health service personnel were conducted to examine the three foci of the School-Link initiative, namely prevention, early intervention and service access. Results: Improvements witnessed since the commencement of School-Link include an increasein the number of evidence-based mental health promotion programmes in schools, improvements in the communication between health and education departments, improvements in referral patterns and better practices, such as improved feedback, in both health and education sectors. School counsellors feel more supported in their role by health services and better able to manage certain patients. Conclusions: The actual and potential benefits of School-Link for young persons appear considerable. School-Link has provided opportunities for communication, upgrading of skills and collaborative work on mental health issues, in both education and health settings.
Data Collection in Consultation– Liaison Psychiatry: An Evaluation of Casemix
Authors: Ellen Steven , Lacey Cameron , Kouzma Nadya , Sauvey Nick , Carroll Rhonda 
Published: December 2009

Objective: To evaluate the usefulness of Casemix as a data collection system for consultation–liaison psychiatry services. Method: Health information staff were requested to code psychiatric assessments and diagnosis prospectively for admissions to the Alfred Hospital, Melbourne, between July 2002 and June 2004 using Casemix. Results: Psychiatric assessments were requested on 2.5% of all hospital admissions (n = 2575). Casemix provided extensive demographic and hospital unit data for referred patients, is easy to set up, and is cost-free for the psychiatry service. Conclusions: Casemix can provide extensive meaningful data for consultation–liaison psychiatry services that could assist in the argument for greater funding of these services.
Psychiatrists in New Zealand: Are They Burning Out, Satisfied at Work and, in any Case, who Cares??
Authors: Kumar Shailesh , Nath Bhagat Ravindra , Lau Trevor , Ng Bradley 
Published: December 2009

Objective: To explore possible contributing or mitigating factors for burn out in New Zealand psychiatrists as well as future research directions in this area. Method: A selective review of the literature pertaining to burnout and reports regarding New Zealand's medical workforce. Results: Possible factors contributing to burnout in New Zealand psychiatrists include rapid changes in the country's health system, the challenge of recruiting and retaining psychiatrists, poor distribution of staff and funds and difficulties in psychiatric training. Potential protective factors against burnout include lifestyle factors, long experience in psychiatry, proposed long lengths of career in New Zealand and potentially positive changes in the health system. Research challenges include subject recruitment, the lack of exploration of personal protective factors and completing longitudinal studies. Conclusions: Given the current state of knowledge, it would be difficult to accurately know whether New Zealand psychiatrists were burnt out or satisfied with their work. Carefully designed studies would help to clarify this issue.
Is Real Reform of the Medicare Benefits Schedule for Psychiatrists in Australia Economically, Socially or Professionally Desirable?
Authors: Hickie Ian , Davenport Tracey , Luscombe Georgina , Scott Elizabeth , Mackenzie Elizabeth , Morgan Hugh , Wilson Andrew , Barton David , Barrett Elaine 
Published: December 2009

Objective: To propose alternative Medicare Benefits Schedule-based funding models for outpatient psychiatric services in Australia. Method: Development of alternative funding schedules for a variety of under-serviced populations. Conclusions: Consideration of alternative systems is necessary to address the restrictive work practices, inequity and poor distribution of the psychiatric workforce.
On being a Supervisor: The Importance of Feedback and how to give it
Authors: Chur-Hansen Anna , Mclean Steven 
Published: December 2009

Objective: We outline some of the dominant opinions regarding the provision of formative feedback, as expressed by both trainees and their supervisors. Methods: Trainee psychiatrists and their supervisors were interviewed and asked to identify ‘good’ as opposed to ‘poor’ supervision. Results: A recurrent theme in interview data was that of formative feedback. Trainees expressed a desire to receive it, but some supervisors discussed misgivings and a lack of skill in providing such feedback. Conclusions: Formative feedback is an essential part of the supervisor's role. We describe the principles of how to best deliver feedback, in order to increase supervisors' confidence and ability in utilizing this learning and teaching skill.
An Interdisciplinary Course for Trainee Psychiatrists: Feedback and Implications
Authors: Chur-Hansen Anna , Koopowitz Leslie , Jureidini Jon , Abhary Sotoodeh , Mclean Steve 
Published: December 2009

Objective: To describe a course for trainee psychiatrists, designed to encourage critical thinking within an interdisciplinary framework. Trainees’ responses to the course, and the implications of these for teaching, learning and clinical practice, are considered. Method: Trainees were interviewed, and their responses subjected to content analysis. Results: To some extent, the course appears to have met its objectives. However, some trainees found parts of the course content threatening, and reported negative perceptions of teaching staff and the process of critical appraisal. Conclusions: Challenging taken for granted beliefs in psychiatry is a fundamental skill, which should be fostered in trainee psychiatrists if the profession is to move forwards as an intellectual and clinical discipline. The lessons learned from the course we describe may be useful to others who wish to pursue integrated, interdisciplinary teaching methods.
Why do Health Professionals Work in a Community Mental Health Service?
Authors: Spear Jonathan 
Published: December 2009

Objective: The aim of this pilot study was to determine the reasons why mental health professionals work in a community mental health service. Methods: A survey of psychiatrists and trainees (n = 13) and other mental health professionals (n = 67) was conducted in an Australian community mental health service with a socioeconomically deprived catchment population. Respondents were asked to list their main reasons for working and to complete measures of job design, well-being, social support, role clarity, teamwork and job satisfaction. The qualitative results were validated using focus groups. Results: The response rate was 53.7% (43/80). Income (31/43), belonging (21/43), self-esteem (30/43) and self-actualization (9/43) were the main reasons given for working. Mental health professionals, who reported self-actualization as a reason for work, had significantly higher well-being and job satisfaction than other subjects. Mental health professionals who cited self-actualization as a reason for work perceived that their work was more significant and had higher task identity compared with other subjects. Conclusions: This study is limited by a small sample size and the inability to exclude confounding variables. Maslow's hierarchy of needs was a useful framework for categorizing reasons for work. Some practical approaches to meet the needs of the mental health workforce are discussed.