Modified Occupational Questionnaire (MOQ)

The Modified Occupational Questionnaire is a yesterday time diary / time use assessment designed to collect information about meaningful use of time. It can be used for research and clinical applications

Recovery Assessment Scale - Domains and Stages (RAS-DS) Manual - Version 2

Manual to guide administration of the Recovery Assessment Scale - Domains and Stages (RAS-DS). The RAS-DS has 38 items or statements for the consumer to rate. It is a Likert scale with 4 rating categories for consumers to select from: “untrue”; “a bit true”; “mostly true” and “completely true”. The items have been divided into 4 recovery domains: Doing Things I Value (functional recovery); Looking Forward (personal recovery); Mastering My Illness (clinical recovery) and Connecting and Belonging (social recovery)

Breaking down Barriers: Co-designed recommendations to reduce stakeholder identified NDIS access barriers for people with psychosocial disability

The Issue The National Disability Insurance Scheme (NDIS) commenced in 2016 and is designed to support people with all types of disability including those living with psychosocial disability. However, many thousands of Australians living with psychosocial disability have still not applied to access the Scheme and are consequently missing out on their right to receive valuable NDIS supports to advance their social and economic inclusion. The Project Aims The project aims were to work with stakeholders to 1. Understand the barriers to applying to the NDIS for people living with psychosocial disability, and 2. Identify solutions to remove or reduce these barriers and to synthesise these into a practical set of stakeholder-informed recommendations. Across all states and territories, 386 stakeholders collaborated on this project. Stakeholders included: 1. people living with psychosocial disability of mental distress; 2. their family and friends, and 3. workers and organisations engaged in supporting or advocating for them. The Approach The project was conducted over three phases: 1. A scoping review of literature to identify previously reported barriers to applying to the NDIS for people with psychosocial disability – used to inform phase 2 survey. 2. A national survey to identify current, stakeholder informed and prioritised barriers. 3. Co-design of practical, lived experience informed recommendations to address NDIS access barriers with stakeholders. The Barriers Stakeholders described ten broad and interconnected NDIS access barriers for people with psychosocial disability. These included: 1. Key information about NDIS is confusing or not accessible 2. Hard to get supports to help to apply - formal (services) and informal (family and friends) 3. Hard to obtain evidence required by the NDIA 4. Application process is too long, complicated, and inflexible 5. Application process is harmful to mental health and well-being 6. The application process does not accommodate for mental illness and psychosocial disability 7. The negative reputation of NDIA staff and culture 8. Disconnect between ‘disability’ and ‘recovery’ 9. Personal beliefs, fears and stigma, and 10. It is not worth it – NDIS won’t meet my needs anyway. Each of these is detailed within the report. The Recommendations Seven recommendations were identified, reviewed and refined by stakeholders. These recommendations are practical, lived-experience informed actions to address NDIS access barriers faced by people living with psychosocial disability. 1. Build, maintain and disseminate accurate, up-to-date, easily accessible information - Update, enhance and build upon best currently available information. Invest in and maintain the update of a single national source of information. Enhance the dissemination of this information including easy read downloadable one-pagers that can be printed and paper-based fliers to maximise accessibility. 2. Co-develop and co-deliver systemic training and establish workforce support champions – Co-develop and deliver continually available training for health and community service providers. GPs, public, community and private mental health, disability and social services require ongoing access to training about the psychosocial stream of the NDIS. Workforce support champions will provide expert support and guidance to complement this training so that workers can provide accurate and helpful support, advice and evidence to people who are considering or are applying for the NDIS. 3. Establish navigator positions – independent and psychosocial specific - Create a clear, independent NDIS Psychosocial specific Navigator role to assist individuals, family members and service providers throughout the NDIS application process. 4. Cover out-of-pocket expenses - Create funding streams or models of reimbursement to ensure that people have equitable access to the experts required to provide evidence of psychosocial disability without incurring out-of-pocket expenses. 5. Commission and fund an independent evaluation of the application process specifically for people with psychosocial disability - Independent evaluation of the impacts of: a) recent legislative changes; b) the future implementation of the Recovery Framework; and c) adoption and future implementation of the recommendations within this report, on the experiences of the NDIS application process for people living with psychosocial disability. 6. Co-develop and co-deliver recovery and psychosocial disability training for a. NDIA staff, b) NDIA partner staff (Local Area Coordinators - LACs), and c) NDIS service provider staff (community managed/controlled organisations) - All staff within these 3 distinct workforces need to have access to recovery-oriented, trauma-informed psychosocial disability training and education that is co-developed and co-delivered with people with psychosocial disability. 7. Commission and fund an independent review of NDIA culture and workforce issues - Review the impact of implementing the NDIS Psychosocial Recovery-Oriented Framework agenda on NDIA staffing practice and cultural issues. Conclusion Almost 400 stakeholders partnered with us to identify current barriers to applying for NDIS support. They then engaged with us to develop seven key, lived experience informed, recommendations to address those barriers. These seven practical action-oriented recommendations need urgent implementation to enable the people living with psychosocial disability who are most disadvantaged and most in need of NDIS support to be able to apply for that support. The feasibility and value of each of these recommendations is evidenced by them being raised across numerous previous national NDIS-focused reports including for example, the Tune Review and the ‘Mind the Gap’ report. Today, stakeholders are asking for more than policymakers’ awareness of the barriers that deny much needed NDIS access – although these too are re-iterated and further detailed within this report. Stakeholders call for immediate investment in these practical actions to ‘break down barriers’ to accessing NDIS support and by doing so, improve the lives of many Australians living with psychosocial disability

Evaluating allied health students’ readiness for placement learning

Background: Experiential learning opportunities, such as work integrated learning placements, are often challenging for health professional students. It is therefore imperative that students are adequately prepared before engaging in placement learning. Operationalising ‘readiness for learning on placement’ as a construct, is necessary for providing quality student feedback and assessment. Methods: An integrative mixed methods approach was adopted for this study, utilising a survey to canvass the perspectives of academics, students, and placement educators around the construct of readiness to inform potential assessment items. An assessment tool measuring student readiness for placement was then developed. Data from occupational therapy, physiotherapy and speech pathology programs were evaluated using Rasch analysis to explore the unidimensionality of this construct. Results: The online survey was completed by 64 participants, confirming the importance and measurability of foundational skills integral to readiness for placement learning. These foundational skills were then reflected in a pilot 20-item tool covering domains of professional and learner behaviour, communication, information gathering skills and reasoning. The Rasch analysis of 359 pre-registration student assessments confirmed unidimensionality, suggesting that the skills and attributes (operationalised as assessment items) that are considered part of ‘readiness for placement’ are components of this construct. Together, these findings provide support that the items on this tool are relevant and representative of the skills and behaviours that indicate readiness for placement learning. Two items regarding documentation and appropriate professional dress demonstrated some lower importance scores and interpretation variance warranting further investigation. Conclusion: Through the exploration of the construct of readiness for placement learning, we have created and subsequently revised, an innovative assessment tool that measures novice students’ pre-placement capabilities. Further research is now needed to explore the psychometric properties of the tool

How do occupational therapy curricula align with priorities identified by occupational therapists to prepare graduates for working in mental health?

All professional preparation programs need to ensure that university curricula remain reflective of current practice, and also prepare graduates for practice in the future. Upon formation, the Australia and New Zealand Occupational Therapy Mental Health Academics (ANZOTMHA) network identified that there was insufficient or poorly organised information available about how well current occupational therapy curricula prepared students for practice in the field of mental health. One of the first priorities established by ANZOTMHA was to undertake a program of research to examine this issue. The aim of this report is to summarise and integrate the outcomes of two inter-related studies to explore the extent to which current occupational therapy university curricula in Australia and New Zealand match educational priorities identified by practising occupational therapists in mental health

Relationships between burnout, turnover intention, job satisfaction, job demands and job resources for mental health personnel in an Australian mental health service

Abstract Background Burnout and employee turnover in mental health services are costly and can have a negative impact on service user outcomes. Using the Job Demands-Resources model as a foundation, the aim of this study was to explore the relationships between burnout, turnover intention and job satisfaction in relation to specific job demands and job resources present in the workplace in the context of one Australian mental health service with approximately 1100 clinical staff. Methods The study took a cross-sectional survey approach. The survey included demographic questions, measures of burnout, turnover intention, job satisfaction, job demands and job resources. Results A total of 277 mental health personnel participated. Job satisfaction, turnover intention and burnout were all strongly inter-correlated. The job resources of rewards and recognition, job control, feedback and participation were associated with burnout, turnover intention and job satisfaction. Additionally, the job demands of emotional demands, shiftwork and work-home interference were associated with the exhaustion component of burnout. Conclusion This study is the largest of its kind to be completed with Australian mental health personnel. Results can be used as a foundation for the development of strategies designed to reduce burnout and turnover intention and enhance job satisfaction

Evaluation of a peer-delivered, transitional and post-discharge support program following psychiatric hospitalisation

Abstract Background The time following discharge from psychiatric hospitalisation is a high risk period. Rates of hospital readmission are high and there is increased risk for homelessness and suicide. Transitional and post-discharge support programs have demonstrated positive results in terms of enhanced wellbeing, improved connection with community-based services and, in some cases, reductions in hospital re-admission. This paper reports on the outcomes of a peer-delivered post-discharge support program. Methods The program involved peer workers (individuals with their own lived experience of mental illness and recovery) providing individualised practical and emotional support to individuals for six to eight weeks following discharge from an inpatient psychiatric unit. Outcomes measures included self-reported mental health recovery, personal wellness and self-reported re-admission rates. Process and satisfaction measures were also collected and semi-structured follow-up interviews were completed with consenting participants. Results The program provided support for a total of 64 individuals, 38 of whom consented to participate in the evaluation. Participants reported improvements in terms of functional and clinical recovery and in the areas of intellectual, social and psychological wellness. Participants self-report of hospital readmissions suggested that there was a reduction in hospital bed days following engagement with the program. Themes from the follow up interviews included: Easing the transition to the “real world”; Practical and individualised support; Someone to talk to; Positive qualities of the worker, Workers’ lived experience was a positive thing, and It wasn’t long enough. Conclusion Overall, evaluation data suggest that the program supported positive outcomes for participants in terms of recovery, wellbeing and hospital avoidance. Participant feedback suggested that the use of support workers with their own lived experience of mental illness was a particularly powerful aspect of the program

A scoping and systematic review of employment processes and outcomes for young adults experiencing psychosis

Young adults who experience psychosis want to work but are less likely to be employed than their peers. Sixty two studies relating to young adults with psychosis and employment were reviewed following a systematic search of five databases: CINAHL, PsycINFO, MEDLINE, SCOPUS and EMBASE. Publication date ranged from 1973 to 2019 with > 70% between 2010 and 2019. Intervention was considered in 29 papers; critical appraisal revealed 90% of these had moderate to good methodological quality with only three RCTs. Of 11 intervention types “Early Intervention” and “Individual Placement and Support” were most common; both demonstrating positive impact on obtaining employment. The review identified minimal participant perspectives and great variability in: terminology used; the reporting of participant attributes; intervention characteristics and ways employment outcomes were measured. Employment processes identified were preparing for, seeking, obtaining, keeping and re-obtaining employment, with current research efforts focused on obtaining work. More focus is required on keeping and re-obtaining employment