Caring for clients with dual diagnosis in rural communities in Australia: the experience of mental health professionals

This paper identifies and describes the experiences of 13 rural mental health professionals who care for clients diagnosed with a mental illness and a coexisting alcohol and other drug disorder (dual diagnosis). Dual diagnosis is a common problem which is often poorly understood and managed by mental health professionals. The effect of excessive substance use on a person's mental well-being can present as a diagnostic challenge as each condition may mask symptoms of the other. The authors utilized a phenomenological approach to discover the experiences of a group of mental health professionals working in rural communities in Victoria, Australia. Caring for clients diagnosed with dual diagnosis was found to be a complex and stressful role that involved high levels of skill and knowledge. Despite the fact that health professionals in rural areas are expected to deliver the most appropriate care to individuals with a dual diagnosis, a number of these rural health professionals have limited preparation and experience in dealing with arising clinical diagnosis issues. Clinicians experience frustration, resentment and powerlessness in their attempt to understand their clients' drug misuse whilst simultaneously endeavouring to provide a quality mental health service. © 2005 Blackwell Publishing Ltd.C

Knowledge-Based Jobs and the Boundaries of Firms Agent-based Simulation of Firms Learning and Workforce Skill Set Dynamics

The article explores emergence and survival of human resource management strategies and organisational types in a knowledge-based job market. The analysis considers a dynamic environment in which skill requirements change rapidly. We built an agent-based model to simulate a market where firms post job offers to fill vacancies and decide how to select and reward employees; employees, bearing skills, select firms comparing job offers. Taking an evolutionary approach, we explore how hiring strategies, which guarantee survival, emerge from interconnected variation, selection and retention processes. The simulation experiments suggest that, as the rate of change of the environment increases, long-term employment and firm-specific knowledge building emerge as the survival strategy