Supervision of the mental health lived experience workforce in Australia: A scoping review.

The mental health Lived Experience workforce (also referred to as peer workforce) is growing rapidly internationally and within Australia. Peer workers are increasingly employed within multi- and inter-disciplinary teams, often directly supervised by mental health professionals such as nurses. Professional supervision has been identified as fundamental for implementing a sustainable peer workforce, but significant gaps in the literature remain, in particular, an understanding of appropriate supervision practices. This scoping review synthesized academic and grey literature on Lived Experience supervision in Australia, exploring current thoughts on best practices. Four electronic databases were searched, and grey literature was located via Google Advanced searches, contacting Lived Experience experts and conducting web-based desktop searches of key mental health organization websites. Thematic analysis identified and described key characteristics in relation to how supervision is conceptualized and operationalized. Eight peer-reviewed and 46 grey literature documents describing supervision and supervisory practices were analysed. Of these studies, 26 were Lived Experience-led. Analysis revealed four key themes: (i) defining peer supervision, (ii) variability in understanding the purpose of supervision, (iii) approaches to supervision and the need for choice and flexibility, and (iv) qualities and skills of the supervisor. Additionally, the establishment of a national professional organization for peer workers was highlighted to protect the authenticity of Lived Experience roles and develop an effective workforce. Clearly, a sustainable Lived Experience workforce cannot develop in isolation, and mental health nurses, as important allies in mental healthcare, need to work alongside, plan and advocate for appropriate supervision practices for this emerging workforce.

Disability Research in Australia: Deciding to Be a Research Participant and the Experience of Participation.

Little is known about why people with disability choose to take part in disability research and what their experience is like. Knowledge of this may help researchers and research ethics committees improve the empowered and ethical participation of people with disability in disability, healthcare, and human service focussed research. This cross-sectional mixed-methods study explored the perspectives and experiences of a group of Australian adults with disability regarding their involvement in research. Online surveys (N = 29) and follow-up interviews (N = 15) were conducted. The study found the decision to participate was a complex appraisal of benefit to self and others, research relevance, value, comfort, convenience, safety and risk. The attitudes and behaviours of researchers in cultivating trust by adopting an empathic approach to the conduct of disability research appear to be an important aspect of participant experience. Research ethics committees may benefit from knowledge of the 'microethical' moments that occur in such research.

Supporting conscious competency: Validation of the Generic Supervision Assessment Tool (GSAT).

OBJECTIVES: Clinical supervision is essential for ensuring effective service delivery. International imperatives to demonstrate professional competence has increased attention on the role of supervision in enhancing client outcomes. Although supervisor competency tools are recognised as important components in effective supervision, there remains a shortage of tools that are evidenced-based, applicable across workforces and freely accessible. DESIGN: An expert multidisciplinary group developed the Generic Supervision Assessment Tool (GSAT) to assess supervisor competencies across a range of professions. Initially the GSAT consisted of 32 items responded to by either a supervisor (GSAT-SR) or supervisee (GSAT-SE). The current study, using surveys, employed a cross-sectional design to test the reliability and construct validity of the GSAT. METHODS: The study consisted of two phases and included 12 professional groups across Australasia. In 2018, exploratory factor analysis (EFA) was undertaken with survey data from 479 supervisors and 447 supervisees. In 2019 survey data from 182 supervisors and 186 supervisees were used to conduct confirmatory factor analysis (CFA). The results were used to refine and validate the GSAT. RESULTS: The final GSAT-SR has four factors with 26 competency items. The final GSAT-SE has two factors with 21 competency items. The EFA and CFA confirmed that the GSAT-SR and the GSAT-SE are psychometrically valid tools that supervisors and supervisees can utilise to assess competencies. CONCLUSION: As a non-discipline specific supervision tool, the GSAT is a validated, freely available tool for benchmarking the competencies of clinical supervisors across professions, potentially optimising supervisory evaluation processes and strengthening supervision effectiveness. PRACTITIONER POINTS: Supervisor competency tools are recognised as important components of safe and effective supervision provision yet there is a dearth of valid, reliable and effective measures. The Generic Supervision Assessment Tool (GSAT-SR and GSAT-SE) are unique psychometrically valid, and reliable measures of supervisor competence. The GSAT-SR and the GSAT-SE can enhance translation of evidence-based supervision competency skills into regular practice. Validated with a broad cross section of professionals in diverse practice settings the GSAT provides a comprehensive conceptualization of supervisor competence.

Help or hinder? An assessment of the accessibility, usability, reliability and readability of disability funding website information for Australian mental health consumers.

This study aimed to assess the accessibility, usability, reliability and readability of those websites most likely encountered by Australian mental health consumers when using the internet to find information regarding the National Disability Insurance Scheme (NDIS). Websites were systematically identified with 127 deemed relevant for assessment in 2018. The LIDA instrument, the Simple Measure of Gobbledygook and Flesch-Kincaid Grade Level were used to evaluate the quality of information provided to mental health consumers. The study identified mediocre results for the accessibility, usability, reliability and readability of websites as they pertain to the needs of mental health consumers. Furthermore, it was identified that mental health support websites did not provide a more appropriate online experience for mental health consumers than general information websites, despite their focus on this demographic. These findings suggest a lack of understanding regarding the needs of mental health consumers and their experience of the online environment, which may in turn affect their access to information, agency and, ultimately, their uptake of the NDIS. The establishment of guidelines around enhancements to the online environment for mental health consumers would provide an experience that instils confidence, returns dignity and aids this group in realising their personal recovery journey.

Participation in creative workshops supports mental health consumers to share their stories of recovery: A one-year qualitative follow-up study.

Participation in creative activities has been linked with positive outcomes for people with mental illness. This longitudinal qualitative study is a one-year follow-up of eight mental health consumers who participated in a series of creative workshops in Brisbane, Australia that aimed to increase participants' capacity and skills in sharing their stories of recovery with others. It also sought to understand successful factors of the creative workshops to inform future workshops. Semi-structured interviews gathered information regarding participants' memories of the workshops and how they had shared their stories with others over the preceding 12 months. Interpretative phenomenological analysis identified that participants' enjoyed being engaged in a range of creative mediums in a group setting; that peer mentor support was highly valued; and that participants' recovery stories had become more positive and were shared more often and openly with others. Overall, participation in the creative workshops had long-lasting benefits for participants with respect to improved confidence and understanding about their illness. Future creative workshops should consider the inclusion of peer mentors with lived experience as a support for participants to reauthor their recovery story.

Consumer engagement in health services in Queensland, Australia: A qualitative study about perspectives of engaged consumers.

Successive health policies demonstrate unwavering commitment to partnering with consumers and communities. However, engaging consumers is complex and replete with priorities, perspectives and values that are firmly held, virtuous and different. In the context of political imperatives and different approaches to partnering with consumers in health services, we sought to explore consumers' experiences of engagement in public, private, primary care and non-government health services in Queensland, Australia. Participants identified themselves as consumers of health services and were currently, or had previously been, involved in planning, designing, delivering, monitoring and/or evaluating health services; were aged over 18 and consented to being involved. This qualitative study used semi-structured individual interviews to collect data which were analysed thematically. Four themes were identified, (a) authentic engagement and representation: asking, listening and acknowledging; (b) a continuum of consumer expertise; (c) contested engagement: transgressing health services thresholds of tolerance and (d) creating value for consumers and health services: reciprocity, trust, respect and remuneration. Findings demonstrated that 'rules of engagement' exist between consumers and staff employed in clinical, managerial, executive and administrative positions within health services in response to a legislated requirement that health services partner with consumers. The rules of consumer engagement centred on authenticity, transparency, expertise and individual capacity to transcend personal experience. If health services and the broader public are to fully benefit from safety and quality advances proposed by partnering with consumers, then it is essential that areas of contestation are identified and addressed.

Codesigned recommendations for increasing engagement in structured physical activity for people with serious mental health problems in Australia.

People with mental health problems are at higher risk of physical health comorbidities and early mortality. A key risk factor for poor health outcomes is a lack of regular physical activity. Mental health services have typically responded by focusing on screening and promoting lifestyle programmes within secondary care mental health settings. The aim of this study was to better understand the barriers and enablers for Australian mental health consumers to participate in physical activity or exercise programmes from the perspectives of consumers and exercise practitioners. Interviews with 15 consumers experiencing serious mental health problems and five exercise practitioners were undertaken, followed by two focus groups (involving eight consumers and two exercise practitioners) to gain consensus on themes from the interviews, and codesign a set of recommendations for services to support and increase the engagement of mental health consumers in regular community-based exercise. Barriers that impacted on engagement in physical activity included: lack of social support, insufficient knowledge and information, difficulties with work/life balance, impact of physical and mental health issues, fear and lack of confidence, and financial cost. Enablers or motivators assisting engagement in community-based physical activity programmes included: social support, access to person-centred individualised exercise options, connection and a sense of belonging, and access to information and education. Recommendations and a checklist were developed to assist services to increase the involvement of mental health consumers in community-based exercise and to ensure that exercise practitioners and their employing organisations are adequately equipped to work with this population.

Partners in Recovery: paving the way for the National Disability Insurance Scheme.

Australians experiencing severe and persistent mental illness and who require services from multiple agencies, experience a fragmented service delivery system. In 2014, the Commonwealth Government introduced the Partners in Recovery (PIR) service, which provides service coordination and flexible funding to improve outcomes for this group of people. This study presents qualitative findings from a research project that aimed to understand the experiences of PIR participants, including aspects of the planning process and the effectiveness of the PIR program in meeting their needs from the perspective of the participant, their carer or family member and other support people within their lives. Semi-structured interviews were conducted with 31 stakeholders involved in the PIR program, of which 14 were participants, 17 were members of the participant's support network and three were members of a consumer and carer advisory group. Overall participation in the PIR program had a positive effect on the participant's lives. Relationships with the support facilitators were seen as an important element of the process, along with a focus on recovery-oriented goals and advocacy and linking to other agencies. These findings are important for informing the roll-out of the National Disability Insurance Scheme in Australia, which will replace PIR.

Preparing mental health professionals for new directions in mental health practice: Evaluating the sensory approaches e-learning training package.

The application of sensory modulation approaches in mental health settings is growing in recognition internationally. However, a number of barriers have been identified as limiting the implementation of the approach, including workplace culture and a lack of accessible and effective sensory approaches training. The aim of this project was to investigate the efficacy of providing this training through a custom-designed e-learning package. Participants in the present study were predominately nurses and occupational therapists working in mental health settings in Queensland, Australia. Data were collected from 121 participants using an online survey. Significant improvements were found between pre- and post-training in participants' real and perceived levels of knowledge, their perceived levels of confidence, and their attitudes towards using sensory modulation approaches in mental health settings. The findings of the study suggest that the custom-designed sensory approaches e-learning package is an effective, accessible, acceptable, and usable method to train health professionals in sensory modulation approaches. As this study is the first to analyse the efficacy of an e-learning sensory approaches package, the results are considered preliminary, and further investigation is required.

Predicting married and cohabiting couples' futures from their descriptions of stepfamily life.

Stepfamily couples experience specific challenges early in their relationships, (e.g., reaching agreement on the role of the stepparent in parenting). The Oral History Interview for Stepfamilies (OHI-S) was developed to assess spouses' cognitive representations of their adaptation to these challenges. It was hypothesized that their responses would predict future relationship satisfaction and stability. One-hundred and 22 stepfamily couples completed the OHI-S and were assessed on relationship satisfaction and stability at Time 1 and 2.5 years later (Time 2). Time 2 relationship satisfaction and stability were both predicted by the OHI-S at Time 1. Couples' perceptions of the stepfamily and couple relationship predict separation, and suggest there is an opportunity for early intervention to enhance stepfamily couple relationships.