Major issues facing primary care mental health in Australia 2001

There are many unanswered research questions regarding mental health in the general practice setting. These need to be adequately researched to inform policy and reform. Developments in services should not be stalled by the fact that there are still many unanswered questions. There are plenty of opportunities for true innovation in the primary care metal health arena. The general practice workforce has an important role in managing these disorders but cannot do it alone. Further development though Divisions needs to be done in a measured way and needs to engage Divisions and their members and meet their agendas firstly. The development of three way partnerships between consumers, GPs and specialist services is essential to future success.Primary Mental Health Care Australian Resource Centre (PARC

Comorbidity of mental disorders and substance use: A brief guide for the primary care clinician

Comorbidity or the co-occurrence of mental disorders and substance use disorders is common. However there are significant problems with the management of people with comorbidity and a dearth of evidence about best practice. This resource has been developed as a result of work that PARC undertook in 2001 with the development of a set of principles for the management of people with comorbidity. These principles are outline at the start of this resource. More detailed information about specific aspects of management of the different types of co-existing mental disorders and substance use problems then follows. The information available is patchy and much of it is not based on high levels of evidence. In addition many people with co-morbidity have more than one mental disorder and may have problematic use of several drugs. This resource is a simple guide for clinicians to start to work.Primary Mental Health Care Australian Resource Centre (PARC

Comorbidity in General Practice

There is a definite role for GPs in providing care for people with coexisting substance use and mental health problems. However, the current level of care being provided by GPs is inconsistent and a number of areas for improvement have been identified. The PARC comorbidity project has explored issues regarding the approaches that GPs use when faced with patients experiencing comorbidity difficulties. The ultimate aim of this project is to improve the level of care provided to people with coexisting mental health and substance use problems by establishing positive changes in the management of comorbidity in the general practice setting. The first step is to establish what the management ought to be. The PARC Comorbidity Project conducted a review of the activities of the Divisions of General Practice in the area of comorbidity, and identified key issues in the identification and management of people with coexisting mental health and substance use problems in the general practice setting. It consulted with GPs, consumers and other health-care professionals to determine pragmatic ‘best practice’ approaches to the detection, assessment and treatment of comorbidity in the general practice setting, established a set of basic principles that will guide GPs in providing care for patients experiencing comorbidity difficulties and identified key areas of change to enhance the level of care provided to people with coexisting mental health and substance use problems in general practice.Primary Mental Health Care Australian Resource Centr

General Practitioners' peer support needs in managing consumer's mental health problems: A literature review and needs analysis.

This literature review was commissioned by the Commonwealth Department of Health and Ageing to inform the development of the Access to Allied Health Services component of the Better Outcomes in Mental Health Care Initiative.Looks at current arrangements for peer support/supervision in Australia in a number of professions which undertake psychotherapy. .A number of different models and issues are examined. The need for peer support/supervision for GPs undertaking psychotherapy is also assessed and an argument is made for its necessity.Commonwealth Department of Health and Ageing Better Outcomes in Mental Health Care Initiative

Mental Health Shared Care in Australia 2001: Report for the Commonwealth Department of Health and Aged Care

This literature review was completed to inform the development of the Access to Psychiatry component of the Better Outcomes in Mental Health Care InitiativeThis study provides a summary of the current policy and research literature on shared care and comments on the current debates around workforce, training and better coordination and integration of care between general practice and mental health services. It contributes to the knowledge base on the current state of mental health care reform in Australia. The review focuses specifically on better ways of integrating mental health care across the general practice and specialty mental health sectors and provides commentary on the points of influence, key players and social, political and economic events, which together have reshaped the culture of mental health care in Australia. Particular attention is paid to key national policy events in Australian general practice and the specialist mental health sector in the last decade, and how policy makers in both contexts have been influential in shaping a shift in emphasis from an isolationist service delivery model to one of partnership and community-based mental health care.Primary Mental Health Care Australian Resource Centre (PARC

Models of Primary Health Care Psychotherapy and Counselling

This literature review was commissioned by the Commonwealth Department of Health and Ageing to inform the development of the Access to Allied Health Services component of the Better Outcomes in Mental Health Care Initiative.This review looks at psychotherapy and counselling services in primary health care provided by persons from the Allied Health Professions. The report makes a number of recommendations regarding location of the service, fundholding and employment, practitioner support, reporting and confidentiality.Commonwealth Department of Health and Ageing Better Outcomes in Mental Health Care Initiative

Reading ‘Fundamental British Values’ Through Children’s Gothic: Imperialism, History, Pedagogy

This paper reads the U.K. Government’s “fundamental British values” project alongside two children’s Gothic novels, Coram Boy (2000) by Jamila Gavin and City of Ghosts (2009) by Bali Rai. In 2011 the U.K. Government outlined what it described as “fundamental British values” (FBV), making it a requirement for U.K. schools to promote these values. Many critics have shown that the root of FBV lies in Islamophobia and imperialist nostalgia and suggested that the promotion of “British” values in school will exclude minority groups already under siege from racist elements in contemporary Britain. Other critics argue that the promotion of FBV reduces opportunities to explore issues of belonging, belief, and nationhood in the classroom. This article argues that the Gothic fictions of Jamila Gavin and Bali Rai offer a space in which to critically examine British history (and so, its values) in a way that is acutely relevant to these education contexts. Coram Boy and City of Ghosts use the Gothic to interrogate aspects of British history elided by the FBV project. That is, they point to Britain’s imperial and colonial history and offer a rejoinder to the Government’s insistence that “British Values” equate to democracy, respect for the rule of law and mutual respect and tolerance of those from different faiths and religions. Furthermore, Gavin’s and Rai’s use of the Gothic creates a space in which the ambiguities and contradictions inherent in FBV can be explored. However, their “gothicized” histories of Britain do not render the idea of shared values invalid. The diversity and interconnectedness of the characters offer an alternative version of identity to the patronising and arrogant FBV project, which is aimed at promoting a national identity based on sameness and assimilation. Rai and Gavin look to Britain’s past through the lens of the Gothic not only to refute nationalism and racism, but also to offer a productive alternative that gestures towards a more cosmopolitan vision of identity

Substance use patterns in newly admitted male and female South Australian prisoners using WHO-ASSIST (alcohol, smoking, and substance involvement screening test)

Objective: To report on the patterns of substance use in newly admitted male and female South Australian prisoners using the WHO-ASSIST screening tool (Alcohol, Smoking and Substance Involvement Screening Test) and observe the feasibility of using the ASSIST and associated Brief Intervention in this population. Data sources: Results of the first 518 prisoners screened using ASSIST in South Australian reception prisons. Results: In the first 10 months of the implementation of the WHO ASSIST, 518 clients were assessed in the 3 metropolitan intake prisons in Adelaide, Australia. This represents 31% of all male and 35% of all female prisoners admitted over this period. Injecting drug use was reported in the previous 3 months by 55% of men and 51% of women. The six most common substances used at high and moderate risk levels, in order of prevalence (from high to low) in males were tobacco, cannabis, amphetamines, opiates, alcohol, and sedatives. In women the order was tobacco, amphetamines, cannabis, opiates and sedatives equal, and alcohol. Fifty percent of men and 33% of women were using four or more substances. Overall rates of substance use related risk amongst men coming into prison are slightly greater than for women. Accessing prisoners for screening within the first few days is difficult with 55% already being released or at court or other external appointments.Chris Holmwood, Michelle Marriott and Rachel Humeniu