The responses of young people to their experiences of first-episode psychosis: harnessing resilience.

There is a burgeoning literature on first-episode psychosis, the focus of which is early intervention. Little emphasis has been placed on the responses of young people to their experiences of psychosis. This study, therefore, aimed to describe and explain the responses of young people to their first episode of psychosis. Data obtained from ten young people who attended a community early intervention recovery program in Perth Western Australia were analysed using a grounded theory method. The results revealed that the basic psychosocial problem experienced by participants was loss of control resulting in disrupted lives and that the core variable, harnessing resilience, accounted for most of the variance in their behaviour to overcome this problem. The resultant framework described and explained how participants resiled and established direction in their lives. Although there are limitations with this qualitative study, such as the small size and the demographics of the sample, the findings have potential implications for approaches to service provision and phase specific interventions.

Challenges faced by mental health peer support workers: peer support from the peer supporter's point of view.

OBJECTIVE: This study aimed to identify the various challenges encountered by peer support workers in Western Australia in the course of their work and to identify possible solutions to those challenges. METHOD: We used the nominal group technique to collect and analyze the data. RESULTS: The main challenge encountered by participants was a lack of understanding of the peer support worker role which caused them to experience a sense of exclusion. The main solution focused on strategies to educate consumers, managers, and health professionals about the peer support worker role. CONCLUSION AND IMPLICATIONS FOR PRACTICE: Managers have a responsibility to be informed about the peer support worker role and communicate role related information to other team members to ensure that peer support workers are included as part of the health team. Implications for practice therefore center on training for managers and inclusion of the peer support worker role in orientation programs. Further, if these steps are not undertaken, a valuable resource could be lost to a health service to the detriment of persons with a mental illness.

The impact of social cognition training on recovery from psychosis.

PURPOSE OF REVIEW: Social cognition training is an emerging intervention, which aims to ameliorate impairment in social interaction and improve functional outcomes in persons with a psychosis. This article reviews the research conducted on the impact of this intervention published in English language journals over the past 2 years. RECENT FINDINGS: Social cognition training comprises three types of programs; targeted, broad-based, and comprehensive - targeted programs being the most effective. Programs largely focus on the domains of facial affect, or emotion recognition (FAR), Theory of Mind (ToM), and attributional bias. There is some evidence that ToM is amenable to change, but not FAR and attributional bias. SUMMARY: Interventions designed to ameliorate impairment in social functioning largely involve a skills training laboratory model underpinned by social learning theory. The evidence for the effectiveness of current social cognition training strategies to improve functional outcome for persons with psychosis in general and schizophrenia in particular remains equivocal. Clearly, further work is required beyond the laboratory training model and future research may well benefit from the inclusion of longitudinal naturalistic studies.

Australian consumer perceptions of peer support.

INTRODUCTION: Peer support in mental health service delivery is a relatively new development in Western Australia, occurring only in the last decade. Consequently, what is known about peer support in mental health has been largely drawn from the overseas literature. The purpose of the present study was to identify how consumers of mental health services in Western Australia viewed the impact that peer support workers had on their life. METHODS: The nominal group technique was the method used to collect and analyze the data from nine participants living in the community who were supported by a peer support worker; the role of the peer support worker was to encourage healthy lifestyle behaviors. RESULTS: The results indicate that the main influences of a peer worker for consumers were motivation, increased social interaction, living a healthier lifestyle, positive mental attitude and building confidence. DISCUSSION: It was concluded that participants viewed the support they received as a positive experience, which contributed to building confidence and enabled participants to make lifestyle changes. However, the results need to be viewed with caution, not only because of the small sample size, but also because the peer workers and the participants were all male. Results may well be different where the role and gender of the support worker and consumer are different.

Too little, too late: mental health nursing education in Western Australia, 1958-1994.

Mental health nursing education in Australia has undergone a significant transition in the last 50 years, influenced by national inquiries, national decisions, and international trends in nursing education. But mental health nursing education had also accumulated decades of history in each state, including sometimes unequal relations with general nursing. Complex inter- and intra-professional relationships at state level influenced this educational transition in each state, and Western Australia provides an example of this influence. Using a range of published and unpublished sources, including oral histories, this paper describes the revision of the mental health nursing curriculum in Western Australia from 1958, responses to the call for transition to the tertiary sector between 1976 and 1984, and the final transition of mental health nursing education to university level in Western Australia in 1994. Mental health nursing's educational standards improved only gradually in Western Australia from 1958 onwards, compared with professional advances in general nursing in the same period. Factors which may have held back these improvements include mental health nursing's professional conservatism, which was outpaced by general nursing's growing radicalization at the national level. A lack of professional confidence and cohesion left mental health nursing unable to respond effectively to rapid external changes in the 1960s and 1970s, and vulnerable to absorption and dominance by general nursing education programs.

A substantive theory of recovery from the effects of severe persistent mental illness.

BACKGROUND: This study investigated Western Australian consumer perspectives of recovery from the effects of a severe mental illness. METHOD: The grounded theory method was used to collect and analyze data acquired through 15 face-to-face interviews. DISCUSSION: Participants described recovery as a three-phase process of overcoming loss in biomedical, psychological and/or social dimensions. This process was facilitated by personal protective factors and external mechanisms and further explained in the context of role theory. CONCLUSIONS: Recovery can occur in any one or all of the three dimensions and thus can be complete or partial. It is important to ask, therefore: recovery from what, recovery of what, and recovery to what?