Habit or addiction: the critical tension in deciding who should enforce hospital smoke-free policies

Tobacco use is the single most preventable cause of disease, disability and death. Most recently, the US Surgeon General has affirmed that there is no safe level of exposure to environmental tobacco smoke. The adverse affects of smoking and exposure to tobacco smoke on health pervade multiple areas of life. For these reasons, many countries have introduced smoke-free policies in a variety of community, workplace and service settings. Hospitals, in particular, are a focus of smoke-free policy because their primary goal is to promote health by attending to acute health crises or serious exacerbations of chronic conditions, many of which have direct or indirect links to smoking

A behavioural therapy approach to self-management: the Flinders Program

Chronic diseases, including diabetes, represent the most prevalent problem in healthcare today. They are the most common cause of disability and consume the largest part of health expenditures internationally. Most diabetes care is provided by people with diabetes and their family or supporters. Therefore, understanding how to enhance diabetes self-management is of primary importance in addressing this growing burden. The effective self-management of type 2 diabetes is closely linked to environmental factors and a person’s lifestyle. In this article, the authors describe the Flinders Chronic Condition Self-Management Program, which highlights the person’s perspective, and an example of its practical application in an Aboriginal population in South Australia is provided

The person's perspective of chronic condition self-management: Time to shift from rhetoric to reality

This article argues for greater understanding, acknowledgement and inclusion of the person’s perspective of chronic condition self-management as part of the development of health services. This is based on the belief that current debates and initiatives continue to be limited by knowledge that is largely vested within the health professional realm

'The needs of strangers': understanding social determinants of mental illness

This article explores the social determinants of mental illness in order to stimulate debate and advocate for improved services, and greater understanding and acceptance for people with serious mental illness in their community. Systemic and broader social mechanisms that perpetuate stigma and inequity are briefly examined. Research findings from a study of the culture of smoking for psychiatric populations are used to demonstrate the complexity of these mechanisms and to show how they impact on the social determinants of mental illness for people with serious mental illness. From this discussion, broad system and policy options are offered

Integrating service user participation in mental health care: what will it take?

This work is licensed under a Creative Commons Attribution 3.0 Unported License (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedParticipation in mental health care poses many challenges for mental health service users and service providers. Consideration of these issues for improving the integration of service user participation in mental health care can help to inform integrated care within health care systems, broadly. This paper argues for practicing greater empathy and teaching it, stigma reduction, changing what we measure, valuing the intrinsic aspects of care more, employing more people with lived experience within mental health services, raising the visibility of service users as leaders and our teachers within services and redefining integrated care from the service user perspective

The person's experience of chronic condition self-management: a collection of case studies

This collection of case studies provides lessons at many levels for students, health professionals, educators, people with chronic conditions, their carers, managers and health administrators. These case studies are written by experienced health professionals and community workers who as students of the self-management course, took the time to record the life stories of people from a variety of backgrounds including Aboriginal, the elderly, mentally ill, adolescents, carers, and people from rural, remote and urban environments. The students have taken a self-management framework to look at a person beyond their diagnosis taking into account their upbringing and life experience to understand the person and how and why they manage their conditions the way they do

The effect of motivational interviewing on the intradialytic exerciser: a pilot study

Chronic renal failure is a complex condition in which a plethora of psychological and physiological complications may occur and for which haemodialysis is one treatment option. Patients at Hampstead Dialysis Centre, South Australia, are offered the option to exercise whilst undergoing dialysis (intradialytic exercise) with the assistance of dedicated exercise physiologists, as it may ameliorate some of the ubiquitous symptoms of their renal condition. The objectives of this study were to determine whether the provision of motivational interviewing (MI) would increase the uptake of intradialytic exercise in patients who did not exercise at all or who exercise at minimal levels

Foundations for change: Part 1- CONSUMERS: Experiences of CONSUMERS with the diagnosis of borderline personality disorder (BPD)

Copyright (2011) Private Mental Health Consumer Carer Network (Australia) and the Australian Medical Association. Published version of the paper reproduced here with permission from the publishe

The importance of relationship in understanding the experiences of spouse mental health carers

The burden of caring for family members with mental illness has been researched extensively. However, knowledge of spouse carers’ experiences is limited. In this article, we explore this from a carers’ perspective, with 28 spouse carers, using qualitative open-ended semi-structured interviews using a grounded theory approach informed by the social interactionism tradition to collect and analyze the data. We present six interrelated themes around the central theme of this being “a real and genuine relationship”. The findings indicate that caring for a spouse with severe mental illness is a unique role compared with other caring roles. First and foremost, spouse carers strive for the relationship with their partner, and accommodate mental illness into their lives to protect the relationship. Because of this, they often lead surreal lives marked by significant emotional pressure and isolation. This has implications for how mental health service providers work with and support spouse carers