Reform, revolution and disruption in mental health care: a consumer's perspective.

Mental health leaders, policy makers and successive national and state governments have tried countless incremental reforms. Yet, for decades in Australia, independent inquiries and reports have concluded that our mental health 'system of care' is a misnomer. It is fragmented, ineffective, inefficient and unfair. For far too long, people, families and communities have paid a heavy price for this. Reform in itself will not be the solution that we can hang all our hopes on. Disruptive innovations are now sneaking into the mental health sector and beginning to be taken up en masse. Sitting alongside this is a budding revolution - an unrest stirring in our communities that has not been seen before in the history of mental health. People are raising their expectations and communities are demanding better. With external (revolution, disruption) and internal (reform) forces colliding at a similar time, a perfect storm is being created for what could be the long-awaited and much-needed change we have longed to see. But it will not be without pain because, given a choice, most will opt for stability over change. But ignoring what is coming may not be wise.

Participatory health research: celebrating smoke-free homes.

For community engagement to be successful, the interests of the community must be taken into account and researchers must become facilitators. Patience is required. Meaningful and sustainable relationships that have been developed over time promote mutual learning and capacity building among the partners (Elders, community members, health care providers, and researchers). In addition, community engagement leads to the sharing of available resources (eg, human, time, and financial) and to a sustained commitment by the partners. This mutual commitment makes future projects easier to develop and complete. Thus, authentic transformative health development, informed by participatory health research, becomes an ongoing process.

The pursuit of excellence: engaging the community in participatory health research.

Community-based participatory research approaches are designed to improve health and well-being in communities and to minimize health disparities in general. It is this partnership approach to research that equitably involves community members, organizational representatives and researchers in all aspects of the research process and in which all partners contribute expertise, decision-making and ownership. Further to this, community-based participatory research is utilized to study and address community-identified issues through a collaborative and empowering action-oriented process that builds on the strengths of the community. The results of this research endeavour highlight the need for integrating community-based participatory research, primary health care and social accountability in the pursuit of excellence. The process and the results/findings provide ways that the community are able to enhance their health and wellness, increase capacity and be empowered to direct their education, research and service activities towards addressing and meeting the health priorities of the community.