An Audit of Mental Health Care Plans in Community Mental Health Services for Older Persons in Rural Communities in a State in Australia.

Mental health care planning is an important part of holistic, patient-centred care provision. Rural older adults represent a vulnerable population with unique and complex care needs requiring robust care planning approaches. This study's aim was to audit care plan documentation for rural older Australians against quality standards.

Health professionals working effectively with support workers to enhance the quality of support for adults with intellectual disabilities: A meta-ethnography.

Background: Paid support workers are often central to the quality of life of adults with intellectual disabilities. Health and social care professionals increasingly carry out interventions indirectly through those support workers and therefore need to understand how best to collaborate.

Methods: This article synthesizes findings from the qualitative research of others investigating health professionals' work with support staff.

Mauritius calling: medical care and neurorehabilitation needs in an oceanic idyll.

The tropical island of Mauritius, located off the coast of Southern Africa, has greatly improved its health care system, especially for frontline services and procedures such as cardiac surgery. But the post-acute neurorehabilitation care is still problematic, much to the detriment of disabled patients, their families, and Mauritian society overall. Comparisons with neurorehabilitation care in the United Kingdom suggest the scale of the problem in terms of uncoordinated medical teams, limited follow-ups, lack of expertise, and cultural stigma.

Delivering the Lee Silverman Voice Treatment (LSVT) by web camera: a feasibility study.

Background: Speech disorders are a feature of Parkinson's disease, typically worsening as the disease progresses. The Lee Silverman Voice Treatment (LSVT) was developed to address these difficulties. It targets vocal loudness as a means of increasing vocal effort and improving coordination across the subsystems of speech.

Zinc in health and chronic disease.

Zinc is a trace element essential for the optimal function of a variety of biochemical and physiological processes. Its role in healthy aging is particularly important as it prevents neo plastic cell growth, is involved in mitotic cell division, DNA and RNA repair. Although zinc is widely available in food, the daily intake in many persons may be suboptimal.

Cognitive-behavioural therapy via videoconferencing to a rural area.

Objective: This case report describes the use of cognitive-behavioural therapy via two-way, interactive audiovisual videoconferencing and identifies issues involved in using this form of technology to provide therapy.

Clinical Picture: A 38-year-old married woman living in rural South Australia presented with panic disorder with agoraphobia and major depression. The patient had refused antidepressant treatment.

Telepsychiatry in South Australia.

Telemedicine has evolved to become an integral part of the South Australian Rural and Remote Mental Health Service. The resulting telemedicine service is one of only a few telepsychiatry services around the world that is firmly embedded in normal clinical practice and can be regarded as sustainable. The telepsychiatry service has been operational in Adelaide since January 1994 and more than 2000 clinical consultations have been performed since that time.

The positive family contribution of those with serious mental illness.

Fifty-five patients who met criteria for serious mental illness nominated a relative with whom they had lived for at least the previous 6 months to be sent a questionnaire that included a scale for rating patients' contribution to family life in 10 specific areas. Thirty-six relatives returned completed questionnaires. Patients rated their own contributions using the same scale.

Comorbidity of bipolar and personality disorder.

Objective: The aims of this study were to determine the prevalence of personality disorder in a sample of patients with well-documented bipolar disorder, and to assess the effects of comorbidity.

Method: The sample (n = 42) was drawn from patients currently case-managed within a community treatment program who fully met DSM-IV criteria for bipolar I disorder. The International Personality Disorder Examination, a structured interview, was used to diagnose personality disorder.

The brief admission unit in emergency psychiatry.

The study evaluates a Brief Admission Unit for clients of an emergency service located within a comprehensive community psychiatric program. Eighty-five clients completed the Brief Symptom inventory and a structured interview. Substance abuse disorder (n = 29) and major depression (n = 24) were the most common Axis I diagnoses, of which 30 subjects had two or more.

A referrer and patient evaluation of a telepsychiatry consultation-liaison service in South Australia.

A study was carried out to describe the patient population assessed by a telepsychiatry consultation-liaison service in rural South Australia, and to assess the referrers' and patients' satisfaction rating with this service. The study was performed in two parts, with retrospective and prospective components. The author completed a semi-structured interview for each patient (n = 75) with a Brief Psychiatric Rating Scale (BPRS) for the prospective group (n = 32).

Training case managers in cognitive-behaviour therapy.

Four case managers with a nursing background took part in a 26 week in-service programme aimed at developing basic skills in cognitive-behaviour therapy. The programme occupied about 5 hours each week and included directly supervised therapy with at least 4 patients having serious mental illness. Patients' symptoms improved significantly after an average of less than 12 one hour therapy sessions.

The influence of a therapeutic community on psychiatric disorder.

Forty-eight residents of a therapeutic community took part in a prospective study aimed at assessing overall outcome and which components of the program were most helpful. All subjects had a DSM-III-R axis II diagnosis, usually borderline personality disorder (N = 34). As well, subjects had a mean of 1.

Heavy utilization of inpatient and outpatient services in a public mental health service.

Objective: The purpose of the study was to develop a descriptive profile of heavy users of services in the South Australian Mental Health Services.

Methods: Case notes for 50 heavy users were reviewed to obtain demographic and diagnostic information and data on service use over a three-year period. To supplement and verify this information, 35 of the patients were given structured interviews.

A review of studies of heavy users of psychiatric services.

Objectives: This paper reviews studies of patients who are heavy users of psychiatric services and identifies areas in which further research and evaluation are indicated.

Methods: Extensive searches were conducted of the English language psychiatric and psychological literature before 1994. Important references from initially identified studies were followed up.

Behavioral disturbance in dementia.

Fifty-seven subjects with moderate to severe dementia (49 with Alzheimer's disease) were rated twice, 8 weeks apart, using the Mini-Mental State Examination (MMSE), the Blessed Information-Memory-Concentration Test (BIMC), and the Stockton Geriatric Rating Scale (SGRC). Only three subjects lived at home; the rest were in long-stay hospital beds or nursing homes. For 29 subjects, the first rating coincided with their referral to a comprehensive geriatric psychiatry service.

Borderline personality disorder: a challenge for mental health services.

Objective: This study had two main aims: to determine the stability over time of the diagnosis borderline personality disorder (BPD) in a psychiatric hospital population; and to assess the quality and effectiveness of treatment offered within state mental health service.

Method: The case notes of 47 psychiatric hospital patients followed up for 3 years after the index admission were analysed.

Results: The mean number of previous psychiatric hospital admissions was 9.

The relationship between social factors and frequent use of psychiatric services.

The purpose of the study was to develop a comprehensive demographic, diagnostic and social profile of patients who are heavy service users of hospital and community based services within the South Australian Mental Health Services (SAMHS). This paper concentrates on the relationship of social issues to heavy service use. The 50 heaviest users of public adult acute psychiatric services in a defined catchment area of Adelaide were identified.

Characteristics of police referrals to a psychiatric emergency unit in Australia.

The study examined characteristics of patients referred by police to a psychiatric emergency unit on the campus of a 400-bed psychiatric hospital in Adelaide, South Australia. Of all police referrals (N = 634) during a 21-month period, 437 cases were admitted to the hospital. Most police referrals were young, single, unemployed men.

Self reports of the interaction between substance abuse and schizophrenia.

Fifty-three psychiatric hospital inpatients with a dual diagnosis of substance abuse and schizophrenia were given the Brief Symptom Inventory and the Schizophrenia/Substance Abuse Interview Schedule. Mean age was 29; 49 were men. Only 11% were employed.