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The intention of this thesis is to explore and discuss the experiences of consumers and carers with psychiatric disability support services. In particular their participation in service development and delivery and the degree to which their relationship with services and providers has influenced this participation, is explored and discussed. These relationships are particularly relevant in the context of the dynamics that determine power and the strategies that consumers have adopted so that they become more empowered and have control over their own lives. / Consumers and their carers are placing greater demands on the mental health service system within Victoria. Reforms to mental health and psychiatric disability support service delivery and practice have resulted in deinstitutionalisation, recognition of fundamental human rights and changes to mental health legislation. Participation by consumers and carers in service development and delivery has been viewed by governments as necessary and important in contributing to care, treatment and support systems. / The National Mental Health Policy developed by the Australian Health Ministers paid substantial attention to the need to include consumers and carers in decisions that shape mental health services. These are underpinned by the World Health Organisation’s doctrine that people have the right and duty to participate individually and collectively in the planning and implementation of their health care. (WHO 1990, p. 14). In Victoria, the National Mental Health Policy lead to the development of a framework for mental health services that reinforced consumer and carer participation in service development and delivery. / A qualitative methodology was used for this investigation. In-depth interviews were conducted with consumers and carers to gain a thorough understanding of their experiences and perceptions of the current mental health system. A review of available literature on the developing mental health consumer movement and on the concepts and practices of empowering strategies was undertaken. The opportunities for participation in the design, development and delivery of services in the context of actual experiences, are discussed with consumers and carers with particular emphasis on consumers’ perceptions of power and empowerment. / The transition from institution to community, known as deinstitutionalisation, has not been an easy one to accept by consumers and carers alike. The changes to service design and delivery with a greater focus on community and out reach services, and the necessary changes in attitudes by providers toward consumers as a result of these changes, have established major challenges for the mental health and psychiatric disability support services sector. Consumers and carers argue that the rhetoric inherent in the decision to implement deinstitutionalisation policies and practices that have lead to a shift to services primarily delivered outside of institutions, needs to be taken to another level. They want to ensure that they are recognised and accepted as bringing essential knowledge and experience to a service system that should be designed to support consumers and carers who face life altering circumstances as a result of a mental illness. / The information provided by consumer participants suggests that the reforms to some degree have provided them with more opportunities to take control over their own lives particularly in relation to their involvement in community based psychiatric disability support services. However, they describe the attitudes of providers as remaining the greatest barrier to advancing consumer participation. Carers on the other hand describe their experiences with psychiatric disability support services as disempowering. Their disillusionment with the mental health system is attributed to the lack of support and their perceived lack of recognition in their role as carers.

This research investigated the experiences and practices of mental health registered nurses working within an acute mental health facility. The research explored the workplace environment and sought to gain a greater understanding of the elements that contribute to a safe and healthy workplace setting.The research methodology utilised a critical feminist framework. Thirteen women participants were involved in the research project including myself as a research participant. All participants were employed in an acute mental health facility in New South Wales. Four research methods were incorporated into the study these were focus groups, individual interviews, reflective journaling and creative expression and journaling. The study revealed a diverse range of opinion on nursing culture and profession, linking individual experience with group connectiveness, value and belonging.The findings of this research demonstrated that the women’s experience and practices as registered nurses working in mental health care were influenced directly by the management of the health service organisation and the operational leadership within the mental health facility. The data revealed five themes, these were: stress and mental health nursing practice, coping with violence, professional development, the spirit of nursing and the therapeutic relationship.Overall there were numerous links between the women’s experiences as nurses and their relationships with their colleagues, patients and the community. The results exposed professional pressures and inherent tensions within mental health nursing and highlighted an urgency to review a current health care structureThe study identified environmental factors that impacted upon the workplace and revealed a dichotomy between the nurses’ perception of care and their ability to provide it. The research raised disquiet regarding violence and aggression, inadequate career structure, recruitment, retention and education. Jutxaposed to this, the research identified collegial friendship, spirituality and stress management as contributing factors to a safe and healthy workplace. Finally, the notions of teamwork, diversity and creativity were found to be intrinsically linked to job satisfaction and client outcome.

This research investigated the experiences and practices of mental health registered nurses working within an acute mental health facility. The research explored the workplace environment and sought to gain a greater understanding of the elements that contribute to a safe and healthy workplace setting.The research methodology utilised a critical feminist framework. Thirteen women participants were involved in the research project including myself as a research participant. All participants were employed in an acute mental health facility in New South Wales. Four research methods were incorporated into the study these were focus groups, individual interviews, reflective journaling and creative expression and journaling. The study revealed a diverse range of opinion on nursing culture and profession, linking individual experience with group connectiveness, value and belonging.The findings of this research demonstrated that the women’s experience and practices as registered nurses working in mental health care were influenced directly by the management of the health service organisation and the operational leadership within the mental health facility. The data revealed five themes, these were: stress and mental health nursing practice, coping with violence, professional development, the spirit of nursing and the therapeutic relationship.Overall there were numerous links between the women’s experiences as nurses and their relationships with their colleagues, patients and the community. The results exposed professional pressures and inherent tensions within mental health nursing and highlighted an urgency to review a current health care structureThe study identified environmental factors that impacted upon the workplace and revealed a dichotomy between the nurses’ perception of care and their ability to provide it. The research raised disquiet regarding violence and aggression, inadequate career structure, recruitment, retention and education. Jutxaposed to this, the research identified collegial friendship, spirituality and stress management as contributing factors to a safe and healthy workplace. Finally, the notions of teamwork, diversity and creativity were found to be intrinsically linked to job satisfaction and client outcome.

Thesis (Ph. D.)--University of Texas at Austin, 2007. / Vita. Includes bibliographical references.

Diss. Stockholm : Univ.