The Experiences of Youth Mental Health Peer Workers over Time: A Qualitative Study with Longitudinal Analysis.

Peer work is a rapidly growing part of the mental health workforce, yet few studies explore the implementation of peer work in youth mental health. Qualitative focus groups were conducted with eight youth peer workers at the commencement of their employment, then at 3-months and 6-months after this time. Data were transcribed verbatim and analysed using thematic and trajectory analysis. The three main findings included: (1) there was a trajectory from fear to hope; (2) there was an improved understanding of benefits and role definition over time; and (3) there was an evolving concept of understanding shared experiences as a primary asset. Known barriers to implementing peer work are likely to occur in youth mental health settings as well. Ensuring that adequate training, change management and tailored support strategies are important to maximise the chances of successful youth peer work programs.

The Choice Project: Peer Workers Promoting Shared Decision Making at a Youth Mental Health Service.

OBJECTIVE: In youth mental health services, consumer participation is essential, but few implementation strategies exist to engage young consumers. This project evaluated an intervention implemented in an Australian youth mental health service that utilized peer workers to promote shared decision making via an online tool. METHODS: All new clients ages 16-25 were invited to participate in this nonrandomized comparative study, which used a historical comparison group (N=80). Intervention participants (N=149) engaged with a peer worker and used the online tool before and during their intake assessment. Pre- and postintake data were collected for both groups; measures included decisional conflict, perceived shared decision making, and satisfaction. A series of paired t tests, analyses of variance, and multiple regressions were conducted to assess differences in scores across intervention and comparison groups and pre- and postintake assessments. RESULTS: Ratings of perceived shared decision making with intake workers were higher in the intervention group than in the comparison group (p=.015). In both groups, decisional conflict scores were significantly lower after the intake assessment (p<.001 for both groups). Both perceived shared decision making and lower decisional conflict were associated with satisfaction (p<.015). CONCLUSIONS: Young people who participated in an intervention that combined peer work and shared decision making reported feeling more involved in their assessment. Feeling involved and having lower decisional conflict after seeing an intake worker were important for client satisfaction. These findings demonstrate the importance of both peer work and shared decision making for promoting optimal outcomes in youth mental health services.

Prevalence of parents within an adult mental health service: census results 2008-2011.

OBJECTIVE: The objective of this article is to determine the prevalence of parents of children (aged 0-17 years) within a mental health service system and gather contextual data regarding this population. METHOD: The study uses a census approach. The Census is conducted annually across Central Coast Adult Mental Health Services, NSW, Australia. All five community mental health teams and four acute inpatient units within the service participate, with each team completing Census forms for active clients identified as parents on Census day. The Census form collects data on parents and children including demographic data, parental diagnosis, parental contact and risk factors. RESULTS: Consecutive data shows 25-28% of active clients are parents. Annually, at least 400 children are identified; approximately 60% reside permanently with their parent with a mental illness. CONCLUSIONS: The Census is a valuable tool to determine the prevalence of parenthood. Moreover, it collects contextual data on this population. Data show an emerging relationship between parental diagnosis and parental contact. A picture of level of risk across the system has also been highlighted. Results add to the evidence regarding parental mental illness and circumstances of these families. The data clearly articulate a large need for interventions for children of parents with a mental illness (COPMI) within this population, given the high proportion of children who permanently reside with their parent with a mental illness.

Parenting and mental illness: a pilot group programme for parents.

OBJECTIVE: To describe a pilot group programme for parents with a mental illness that was developed and implemented on the NSW Central Coast. CONCLUSIONS: The Parenting and Mental Illness Group Program is a 6-week group programme that is followed by four weekly, individual home visits. Data from the Eyberg Child Behaviour Inventory and Parenting Scale suggest the programme produced positive outcomes in children's behaviour and parenting practices; the programme was also viewed favourably by participants. While encouraging, these findings require replication, using larger numbers and evaluation of the programme in other sites. Supported by an evidence base, programmes such as this will be important to implement if mental health services are to improve outcomes for parents with mental health problems and their children.