When graduates of Australian social work courses embark on a career in mental health, the systems they enter are complex, fragmented and evolving. Emerging practitioners will commonly be confronted by the loneliness, social exclusion, poverty and prejudice experienced by people living with mental distress; however, social work practice may not be focused on these factors. Instead, in accordance with the dominant biomedical perspective, symptom and risk management may predominate. Frustration with the limitations evident in this approach has seen the United Nations call for the transformation of mental health service delivery. Recognising paradigmatic influences on mental health social work may lead to a more considered enactment of person centred, recovery and rights-based approaches. This paper compares and contrasts influences of neo-liberalism, critical theory, human rights and post-structuralism on mental health social work practice. In preparing social work practitioners to recognise the influence of, and work more creatively with, intersecting paradigms, social work educators strive to foster a transformative approach to mental health practice that straddles discourses.
14 August 2023 in International Journal of Mental Health and Addiction
The employment of mental health peer support (PS) is recommended in national and international mental health policy, and widely implemented across many countries. The key components of PS remain to be identified. This study aimed to develop a typology of components involved in one-to-one PS for adults in mental health services. A systematised review was performed to establish a preliminary long list of candidate components, followed by expert consultation (n = 21) to refine the list. Forty-two publications were full-text reviewed, comprising 26 trial reports, nine training manuals, and seven change model papers. Two hundred forty-two candidate components were identified, which were thematically synthesised to 16 components and eight sub-components, categorised into four themes: recruitment, preparation, practice, and PS worker wellbeing. Our typology can inform reflection and planning of PS practice, and allow more rigorous and synthesised studies, such as component network meta-analyses, to characterise the impact of each component and their interactions.
7 September 2021 in Emergency Medicine Australasia
Over the past three decades, “lived experience” designated roles in mental health services in Australia have increased. However, the lived experience of staff in roles not designated in this way is often hidden or unacknowledged. This qualitative study included 33 participants employed in a range of roles at two Victorian mental health services, including 10 social workers. Interviews explored staff perspectives regarding the sharing of lived experience by staff with colleagues and supervisors. Concept analysis identified conflicting ways of thinking about lived experience, which influenced when and how staff shared and how they responded to sharing by other staff. These findings suggest the need to explicitly address the purpose and value of sharing lived experience in the mental health workplace, to better support staff and service users. Recommendations for social workers and their colleagues, working at all levels of the mental health system, are provided.
Background: Public involvement enhances the relevance, quality, and impact of research. There is some evidence that public involvement in Australian research lags other countries, such as the United Kingdom. The purpose of the systematic review was to establish the rates and describe the characteristics of public involvement in Australian clinical trials. Methods: We reviewed evidence of public involvement in all Australian randomised controlled trials published in the first 6 months of 2021. To determine the quality of public involvement, we used the five-item short-form version of the Guidance of Reporting Involvement Patients and the Public, version 2. Results: In total, 325 randomised controlled trials were included, of which 17 (5%) reported any public involvement. Six trials reported public involvement in setting the research aim and seven in developing study methods. The authors of one study reflected on the overall role and influence of public involvement in the research. Conclusion: Rate of public involvement in Australian clinical trials is seemingly substantially lower than those reported in countries with similar advanced public health care systems, notably the United Kingdom. Our observations may be explained by a lack of researcher skills in how to involve the public and the failure by major funding agencies in Australia to mandate public involvement when deciding on how to award grant funding.
Objective: This article explores how the concept of 'recovery' has been much debated and often sits at odds with our notion of rehabilitation. Method: This article provides a Lived Experience and post-structural commentary on the ever-changing meaning of recovery and rehabilitation. Results: Building on the contemporary Consumer Movement’s use of the term recovery, this article explores how constructions of recovery try to create a boundary which stops people being invalidated based on their experience, or perceived experience, of mental distress. The concept of recovery has insufficiently influenced rehabilitation practices. Recovery is also frequently reappropriated, often with no or minimal consumer input, and reconstructed in line with notions of progress and improvement. Conclusion: People with Lived Experience have challenged the concept of rehabilitation; however, rehabilitation may still have relevance if it is redefined according to Lived Experience values and recovery-oriented practice.