Dr Dominiek Coates

© 2019 John Wiley & Sons Ltd Perinatal mental health problems are linked to poor outcomes for mothers, babies and families. Despite a recognition of the significance of this issue, women often do not receive the care they need and fall between the gap of maternity and mental health services. To address this, there is a call for reform in the way in which perinatal mental healthcare is delivered. This paper responds to this by exploring the role and competence of midwives in delivering mental healthcare. Using a scoping review methodology, quantitative and qualitative evidence were considered to answer the research question ¿what is the nature of the evidence relevant to the provision of mental health interventions by midwives?¿ To identify studies, the databases PubMed, Maternity and Infant Care, Science Citation Index, Social Sciences Citation Index, Medline, Science Direct and CINAHL were searched from 2011 to 2018, and reference lists of included studies were examined. Studies relevant to the role of midwives in the management and treatment of perinatal mental health issues were included; studies focussed on screening and referral were excluded. Thirty papers met inclusion criteria, including studies about the knowledge, skills, and attitudes of midwives and student midwives; the effectiveness of educational interventions in improving knowledge and skills; the delivery of counselling or psychosocial interventions by midwives; and barriers and enablers to embedding midwife-led mental healthcare in practice. Synthesis of the included studies indicates that midwives are interested in providing mental health support, but lack the confidence, knowledge and training to do so. This deficit can be addressed with appropriate training and organisational support, and there is some evidence that midwife-led counselling interventions are effective. Further research is needed to test midwife-led interventions for women with perinatal mental health problems, and to develop and evaluate models of integrated perinatal mental healthcare.

© 2017 John Wiley & Sons Ltd The perinatal period is a time of great vulnerability for many women, in particular those with a range of psychosocial vulnerabilities and mental health risk factors. This paper outlines the psychosocial and mental health profile of consumers and their partners of a perinatal and infant mental health (PIMH) service in Australia. To establish the consumer profile, we analysed client vulnerabilities and demographical information maintained over a 6-year period for 406 consumers. Consumer information, including mental health problems, psychosocial vulnerabilities and demographical information, was entered into a standalone database by the allocated clinicians upon service allocation and throughout treatment. The women accepted by PIMH presented with an average of nine different vulnerabilities. Frequently endorsed risk factors included depression (72.66%), anxiety (71.43%), comorbid depression and anxiety (58.13%), self-harm (past, 7.88%, present, 16.26%), a history of family mental health issues (39.66%), childhood trauma (57.88%), limited support (68.84%), relationship conflict with partners (38.92%) and financial stress (47.29%). The women's partners also presented with a range of vulnerabilities, in particular childhood trauma (34.11%) and mental health issues (30.81%). This study contributes to our understanding of the profile of vulnerable women in the perinatal period, and in particular contributes to the literature by highlighting that in addition to depression, anxiety, self-harm and trauma are also significant in PIMH service delivery.

© 2018, Emerald Publishing Limited. Purpose: There has been a significant growth in the employment of peer workers over the past decade in youth and adult mental health settings. Peer work in mental health services for older people is less developed, and there are no existing peer work models for specialist mental health services for older people in Australia. The authors developed and implemented a peer work model for older consumers and carers of a specialist mental health service. The purpose of this paper is to describe the model, outline the implementation barriers experienced and lesson learned and comment on the acceptability of the model from the perspective of stakeholders. Design/methodology/approach: To ensure the development of the peer work model met the needs of key stakeholders, the authors adopted an evaluation process that occurred alongside the development of the model, informed by action research principles. To identify stakeholder preferences, implementation barriers and potential solutions, and gain insight into the acceptability and perceived effectiveness of the model, a range of methods were used, including focus groups with the peer workers, clinicians and steering committee, consumer and carer surveys, field notes and examination of project documentation. Findings: While the model was overall well received by stakeholders, the authors experienced a range of challenges and implementation barriers, in particular around governance, integrating the model into existing systems, and initial resistance to peer work from clinical staff. Originality/value: Older peer workers provide a valuable contribution to the mental health sector through the unique combination of lived experience and ageing. The authors recommend that models of care are developed prior to implementation so that there is clarity around governance, management, reporting lines and management of confidentiality issues.

© 2015 Wiley Publishing Asia Pty Ltd Aim: Almost a quarter of young Australians experience a mental health issue that may become chronic if left untreated. Children and Young People's Mental Health (CYPMH) is a specialist tertiary service for young people with moderate to severe mental health problems on the Central Coast in Australia. This paper presents an overview of client data and service use collected over a 1 year period specific to the Youth Mental Health (YMH) component of the service. Method: Client data, including demographic characteristics, service usage, presenting issues and standardized outcome measures, were analysed using SPSS. Clinicians routinely collect MH-OAT (Mental Health Outcomes and Assessment Tools) measures at different points in a client's episode of care, and each of these measures was analysed separately. Wilcoxon Z and a series of McNemar's tests were used to report on the difference between admission and discharge scores. Results: During a designated 1 year period, 830 referrals to YMH were received. The most prevalent presenting issue was suicidal ideation followed by deliberate self-harm and depression. A comparison of admission and discharge outcome scores shows significant improvement by discharge on a range of measures. Specifically, analysis identified significant differences between admission and discharge HoNOSCA (Health of the Nation Outcomes Scales for Children and Adolescents) and CGAS (Children's Global Assessment Scale) scores for young people aged 12¿17 and HONOS (Health of the Nation Outcomes Scale) scores for young people aged 18¿24. Conclusion: The clinical outcomes for young people are positive with improvements seen on a range of measures.

© 2016 Crown copyright. Youth participation in mental health settings is fundamental to service design and delivery, and is beneficial for the young people involved as well as the organisation. This paper presents the findings of an evaluation of a youth participation model where tiered participation was attempted in a clinical youth mental health setting. To inform the ongoing development and improvement of a youth participation model, an evaluation was conducted consisting of three focus groups with the youth consultants, consultations with management about the implementation of the tiered participation model, and a review of records. The purpose of this evaluation was to identify possible barriers to implementation early on so these could be addressed and a youth participation model that meets the needs of all key stakeholders could be developed. The findings of this evaluation and the way in which these findings informed the model's development are discussed.

© 2015 Elsevier Ltd. The 'dependency inducing practices', sometimes called 'brainwashing', that are commonly alleged to occur in deviant "religious" groups such as a cult movements or new religious movements are not well understood and have promoted considerable debate. There is a general agreement that many of these groups are controlled environments in which conformity to behavioural, emotive, cognitive and social expectations as determined by leadership is expected and enforced; however, whether conformity is the result of normal processes of socialisation or deviant practices such as brainwashing that cause harm continues to be disputed. To gain an increased understanding of the conformity and commitment inducing practices that occur in 'cult movements', the accounts of group life of 23 former members of 11 different groups were analysed. A conceptualisation of 'brainwashing' as on a continuum of social influence is proposed, and some legal implications are discussed.

© 2014 Published by Elsevier Ltd. Objectives: Young people's participation in decision making that affects them is increasingly recognised and valued as a right. Youth participation in mental health settings is fundamental to service design and delivery, and is beneficial for the young people as well as the organisation. Headspace recognises the many benefits of youth participation with its national and local youth participation initiatives. In 2013, headspace Gosford in Australia established its current youth participation model, called the Youth Alliance (YA), consisting of 12 young people. These young people contribute ideas and opinions around service design and delivery, and participate in a range of activities. Method: This paper presents the findings of a focus group conducted with the YA immediately following recruitment. All 12 young people participated in a two hour focus group which sought to identify the key reasons these young people joined the YA, and what they hope to achieve in their capacity of YA consultants. Results: The two main reasons participants joined the YA are to help 'overcome barriers to help seeking and ensure young people get the support they need' and 'to build confidence, social skills and make new friends'. The barriers to help seeking identified by the participants are consistent with those outlined in the literature. Conclusion: Youth participation in youth mental health settings is beneficial to young people as well as organisations and the community, and it is crucial that strategies are put in place to increase youth participation. The ways in which these young people perceive their participation as beneficial to themselves as well as the organisation and the community is the focus of this paper.

Objectives: Despite the high prevalence of mental health problems for young Australians, many do not have ready access to treatment or are reluctant to seek help. Until recently there was a tendency for young Australians to fall between the gap of Child and Adolescent Mental Health Services and Adult Mental Health Services, and this has contributed to low rates of service use for young people. In 2006, the Australian Government sought to redress this gap in service delivery with its establishment of the Australian National Youth Mental Health Foundation, headspace. This paper presents demographic data collected at headspace Gosford over a 5.5-year period. Conclusions: The data presented indicates that headspace Gosford has been successful in improving early access to mental health treatment for young people on the Central Coast, in particular for young people aged 14-18. Headspace Gosford has attracted young people of both sexes, with a higher proportion of females. The majority of young people access headspace for mental health problems, predominantly depression and anxiety; however, a significant proportion report physical health or alcohol and drug-related reasons. The likelihood of these referral reasons is informed by gender and age. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Challenging the view that people join New Religious Movements because they have fallen victim to powerful brainwashing techniques, the analysis of in-depth life history interviews of 23 former members from 11 different Australian 'cults' suggests that membership was personally negotiated and motivated by a desire for stronger social connections, albeit for different reasons. While for some participants, a desire for social connectedness was related to a strong need for guidance and direction from 'stable' others, for others it reflected a desire for self-change or self-enhancement. To make sense of the participant narratives, symbolic interactionist understandings of the self are applied.

The current study investigates the construction of self in New Religious Movement (NRM) membership and argues that there is significant variation in the way in which members construct their sense of self. While the majority of the literature suggests that differences in the way in which former members describe and experience NRM membership can be attributed to gender and the nature of the group, analysis of the life histories of 23 former members identified variations in the way in which these participants construct their sense of self as significant to understanding NRM membership. While some participants describe selves that are high in conformity or social connectedness, and depict NRM membership as motivated by a need for guidance and direction, others describe selves that appear high in individuality and personal autonomy and depict membership as motivated by a desire to overcome isolation and develop social connectedness. Even though these two narratives are conceptualised as distinct, they are not viewed as dichotomous but understood as on a continuum. To make sense of the selves of the participants in this study symbolic interactionist understandings of the self as to varying degrees informed by both "self" and "others" are applied. © 2013 Taylor & Francis.

There has been limited research into the types of customer satisfaction experienced by residents in leisure-oriented retirement communities, particularly in Australia and the United Kingdom. Focus groups were conducted at a series of retirement communities. Results have lead to the development of a typology of retirement community resident satisfaction containing five different domains, including the Built Environment, the Financial Environment, the Service Delivery Environment, the Social Environment, and the Spiritual Environment. Furthermore, these five satisfaction domains encompass up to 24 distinct types or facets of customer satisfaction experienced by residents. This proposed typology of leisure-oriented retirement communities' resident satisfaction is the most comprehensive investigation of retirement village customer satisfaction to date. Implications for both researchers and practitioners are discussed, including recommendations for the measuring, managing, and marketing of customer satisfaction with retirement community living. © 2008 by The Haworth Press. All rights reserved.