Australian Mental Health Policy Research Articles

A Prototype Software Framework for Transferable Computational Health Economic Models and Its Early Application in Youth Mental Health.

We are developing an economic model to explore multiple topics in Australian youth mental health policy. To help make that model more readily transferable to other jurisdictions, we developed a software framework for authoring modular computational health economic models (CHEMs) (the software files that implement health economic models). We specified framework user requirements for: a simple programming syntax; a template CHEM module; tools for authoring new CHEM modules; search tools for finding existing CHEM modules; tools for supplying CHEM modules with data; reproducible analysis and reporting tools; and tools to help maintain a CHEM project website. We implemented the framework as six development version code libraries in the programming language R that integrate with online services for software development and research data archiving. We used the framework to author five development version R libraries of CHEM modules focussed on utility mapping in youth mental health. These modules provide tools for variable validation, dataset description, multi-attribute instrument scoring, construction of mapping models, reporting of mapping studies and making out of sample predictions. We assessed these CHEM module libraries as mostly meeting transparency, reusability and updatability criteria that we have previously developed, but requiring more detailed documentation and unit testing of individual modules. Our software framework has potential value as a prototype for future tools to support the development of transferable CHEMs.Code: Visit https://www.ready4-dev.com for more information about how to find, install and apply the prototype software framework.

Empowerment or Holding the Child Responsible? An Australian Recovery-Oriented Mental Health Policy Analysis

Abstract Recovery, as a concept is internationally recognised as a means to empower children to manage their own mental health. Recovery-oriented mental health policy production and service delivery in many Western countries, however, occurs in a discursive field influenced by biomedical and neo-liberal discourses. This article uses Critical Discourse Analysis to investigate an Australian policy—'A National Framework for Recovery-Oriented Mental Health Services: Guide for Practitioners and Providers', to critically analyse the competing versions of recovery. The findings reveal ideological slippages at work and show the operation of biomedical, developmental, collaborative, empowerment and responsibilisation discourses that compete in this mental health policy. This article shows how social workers require critical analysis to discern the consequences of different understandings of recovery in the child and youth mental health field. Despite the collaborative and strengths-based language of recovery, the analysis demonstrates the need to recognise the fine line between empowerment and the neo-liberal imperative for children to self-manage their mental health concerns.

Peer work in Australian mental health policy: What ‘problems’ are we solving and to what effect(s)?

The inclusion of peer work within mental health policy offers potential for lived experience expertise to shape the construction of, and subsequent responses to, mental health ‘problems’. However, increasingly, scholars and activists are highlighting limits to such inclusionary practices. We explore these tensions through a critical analysis of problem representations including peer workers within Australian mental health policy. Drawing on Mad studies and user/survivor scholarship, we suggest that despite popular conceptions of inclusion as having universally positive effects, the inclusion of peer workers within policy has both liberating and troubling effects. Such effects include positioning peer workers as complicit in managing ‘problems’ that reinforce psy-regimes of governance and limiting the political subjectivities available to promote alternative representations. By highlighting such complexity, we endeavour to create opportunities for re-imagining peer work and inclusion in ways that bring such practices closer to achieving self-determination and social justice.

The impact of co-location employment partnerships within the Australian mental health service and policy context: A systematic review.

Adults with a serious persistent mental illness (SPMI) express a strong desire to work. However, they continue to experience higher levels of unemployment, barriers, and occupational exclusion that impact their vocational outcomes and choice of work. The aim of this study was to investigate the impact of co‐location partnerships between adult mental health and disability employment services (DES) on employment outcomes and consumer choice of work for adults with a SPMI. Following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) methodology, a systematic literature review was conducted by searching four databases. The relationship between mental health, employment, and DES was examined. Inclusion criteria were adults with a SPMI; employment services and outcomes; and job retention and sustainability. Twelve studies met inclusion criteria. All studies were peer‐reviewed, Australian‐based, and published between 01 January 2017 and 30 August 2021. Individual placement and support (IPS); DES practice, funding, policy, and reform within the Australian mental health system; and barriers to participation in DES were the three main themes that emerged. Findings highlight the importance of joint, co‐location partnerships between mental health and employment services, including a collaborative approach to policy reform between both services, to assist adults with a SPMI to gain and sustain competitive employment. Vocational, non‐vocational, systemic, and structural barriers still exist; hence, adults with a SPMI continue to face challenges with gaining and sustaining long‐term employment. Hence, it is important for these partnerships to be systematically set up to support the complexity of the employment journey for adults with a SPMI.

Right to Information for People with Intellectual Disability in Australian Mental Health Policy

AbstractBackgroundPeople with intellectual disability do not have adequate access to mental health services and have worse mental health outcomes than the broader community. Access to information about mental health, treatment, and services has been advocated as one strategy to address these inequities. This article presents findings from a policy analysis of how the right to accessible information is represented in Australian mental health policy, with a focus on information access for people with intellectual disability.MethodAn analysis of Australian and New South Wales state policies relevant to mental health services 2007–2017, in current use and available online (49 documents) was conducted. Principles in the United Nations Convention on the Rights of Persons with Disability 2006 and an integrated health literacy framework were used to frame a content analysis. NVivo 11 (QSR 2015) was used to search the policy documents and themes were identified according to the policy type and purpose.FindingsThe right to information is expressed in Australian and New South Wales state policy documents. However, the mental health policies do not refer to the communication needs of people with intellectual disability or incorporate strategies to address their needs. Many of the mental health policy directives incorporate the need for tailored communication. Some documents mention the needs of other groups of people with specific communication needs, but not people with intellectual disability.ImplicationsThe inconsistency between the right to information expressed in policies and processes to communicate information with people who have intellectual disability needs to be addressed. The longstanding disparities in health outcomes, and difficulties accessing mental health service experienced by many people with intellectual disability underline the pressing need for policy to require accessible information practices.

Developing an Evidence-Based Specialist Nursing Role to Improve the Physical Health Care of People with Mental Illness

The substantial physical health disadvantage experienced by people diagnosed with mental illness is now identified in a growing body of research evidence. The recent promulgation of improved physical health care as a goal of contemporary Australian Mental Health Policy should provide impetus for initiatives and strategies to address this inequity. To date increased knowledge of the problem has not resulted in obvious and sustained changes. The aim of this article is to introduce the role of the Physical Health Nurse Consultant as a potential strategy. The potential contribution and value of this role is considered by reviewing the evidence from the perspective of multiple stakeholders and considering the suitability of nursing to meet the complex needs involved in improving physical health. The requirement for a multi-faceted and comprehensive evaluation is also articulated. A robust, prospective and long-term evaluation plan includes physical health measures, changes in health behaviours, cost-benefit analysis and consumer acceptability to ensure the intervention is effective in the long term. This thorough approach is essential to provide the level of evidence required to facilitate changes at the practice and policy levels. The specialist nursing role presented in this article, subject to the comprehensive evaluation proposed, could become an integral component of a comprehensive approach to addressing physical health inequities in people with mental illness.

‘Learning to re-create your life’: an evaluation of a residential mental health recovery program

ABSTRACT Personal recovery is enshrined in Australian and international mental health policy. Services seeking to support people to lead meaningful lives of their choosing require mental health professionals to embrace alternative practices. In this paper, we present the findings of an evaluation of a 15-week residential program aspiring to promote personal recovery in Perth, Western Australia. Group work is the main service delivery mode, and the program is premised on the belief that a therapeutic peer community environment has the potential to create conditions for recovery. Semi-structured interviews were conducted with 13 consumers following graduation, and at six months follow-up (n = 9) which explored their experiences of the program, its strengths, areas for improvement, and impact. Data were analysed using a general inductive approach which was guided by the evaluation objectives. Participants reported that the Recovery House was emotionally challenging, personally transformative, and unlike any other service or program experience. Key elements that supported recovery were the live-in nature of the program; the emphasis on commitment and taking personal responsibility; use of a peer community as a therapeutic tool; and the focus on deep emotional healing and making meaning. Challenges included communal living, and transitioning back into the community post-program. Recovery House represents an attempt to depart from traditional relationships and ways of working within mental health services by emphasising self-determination, equal relationships, and creating opportunities to deeply explore emotional distress. Evaluation findings suggest that intensive therapeutic group work may be a powerful contributor to supporting recovery.

Neoliberal Mental Health Policy Reform in Australia

This paper examines the process of Australian mental health policy reform and explores the extent to which they reflect neoliberal ideals. The mental health policy reform has begun with the National Mental Health Strategy was agreed by Australian Health Ministers following the establishment of the National Mental Health policy in 1992. The National Mental Health Strategy has provided the overarching policy framework that has guided and extensive process of mental health reform in Australia for the last 25 years. The National Mental Health Strategy has been in place including the National Mental Health Policy(1992), the National Mental Health Plan(1993~2020), COAG National Action Plan on Mental Health(2006~2011), the Roadmap for National Mental Health Reform 2012~2022. It argues, through the process of Australian mental health reform, that the families of people with mental health problems have been reconstructed as a fundamental source of informal care. The development of community care and informal care in Australian mental health policy reform reflect a neoliberal understanding of the individual and their family, one that views the family as an autonomous unit responsible for its own maintenance.

Current Representation of People With Intellectual Disability in Australian Mental Health Policy: The Need for Inclusive Policy Development

AbstractPeople with intellectual disability in Australia experience poor mental health, are underrepresented in mental health policy, and encounter major barriers in accessing mental health services and treatments. This study interrogated the current representation of people with intellectual disability and recommended strategies to enhance the inclusion of intellectual disability in mental health policy. A policy analysis framework was developed that included context, stakeholders, process, and content. Nine pieces of Australian mental health legislation and 37 mental health policy documents were analyzed using the framework. Fifteen of the 37 documents included mention of intellectual disability with limited attention to the specific mental health needs of people with intellectual disability and mental illness. Only two documents identified specific strategies or measurable actions and targets to improve the access of people with intellectual disability and mental illness to mental health services. The documents’ strengths that may be applied to develop inclusive intellectual disability mental health policy included being values‐based, recognizing diversity, taking a life‐course approach, focusing on workforce development, and ensuring checks and balances. An inclusive approach to the development and implementation of intellectual disability mental health policy will best meet the mental health needs of individuals with intellectual disability. An inclusive policy approach will be based on a sound evidence‐base and include a comprehensive understanding of the context in which the policy is developed; consultation with key stakeholders including people with intellectual disability and mental illness, their family and carers, and those who work with them; cross‐sector collaboration and workforce training. An inclusive approach to the development and implementation of intellectual disability mental health policy using an integrated knowledge translation approach will address the current lack of attention to the important area of how to best meet the mental health needs of individuals with intellectual disability.

Carers' involvement in decision making about antipsychotic medication: A qualitative study.

BackgroundCurrent Australian mental health policy recommends that carers should be involved in the provision of mental health services. Carers often provide intensive support to mental health consumers and gain detailed insight into their lives. As such, carers could make valuable contributions to well‐informed decisions about mental health consumers' use of antipsychotic medication.ObjectivesThe aim of this study was to explore carers' participation in antipsychotic medication decision making.MethodsSnowball sampling was used to enrol 29 carers in this study. Of these carers, 19 participated in semi‐structured interviews, and ten participated in a focus group. Data were analysed thematically.ResultsFour main themes emerged from the analysis. The findings highlighted that carers typically received little or no information about antipsychotic medication. Carers commonly addressed the shortfall in information by obtaining additional information through online sources or distributing among carer networks material that they had developed themselves. Almost all carers emphasized that they should be involved in decisions about antipsychotic medication, but noted that they were typically excluded. The lack of involvement in medication decisions was a source of frustration, as carers could contribute saliently through sharing detailed knowledge about mental health consumers' lives, address communication gaps that resulted from disjointed care and improve communication between health professionals and mental health consumers.ConclusionHealth professionals could consider improving the extent to which they collaborate with carers in medication decisions.

Mental health service use and need for care of Australians without diagnoses of mental disorders: findings from a large epidemiological survey.

While epidemiological surveys worldwide have found a considerable proportion of people using mental health services not to have a diagnosis of a mental disorder, with possible implications of service overuse, other work has suggested that most people without a current diagnosis who used services exhibited other indicators of need. The aims of the present study were, using somewhat different categorisations than previous work, to investigate whether: (1) Australians without a diagnosis of a mental disorder who used mental health services had other indicators of need; and (2) how rate and frequency of service use in Australia related to level of need, then to discuss the findings in light of recent developments in Australian Mental Health Policy and other epidemiological and services research findings. Data from the Australian National Survey of Mental Health and Wellbeing (NSMHWB) 2007 was analysed. Most people using mental health services had evident indicators of need for mental health care (MHC), and most of those with lower evident levels of need did not make heavy use of services. Only a small proportion of individuals without any disorders or need indicators received MHC (4%). Although this latter group comprises a fair proportion of service users when extrapolating to the Australian population (16%), the vast majority of these individuals only sought brief primary-care or counselling treatment rather than consultations with psychiatrists. Access and frequency of MHC consultations were highest for people with diagnosed lifetime disorders, followed by people with no diagnosed disorders but other need indicators, and least for people with no identified need indicators. Limitations include some disorders not assessed in interview and constraints based on survey size to investigate subgroups defined, for instance, by socioeconomic advantage and disadvantage individually or by characteristics of area. MHC for individuals with no recognised disorders or other reasonable need for such care may be occurring but if so is likely to be an area-specific phenomenon. Rather than revealing a large national pool of treatment resources being expended on the so-called 'worried well', the findings suggested a generally appropriate dose-response relationship between need indicators and service use. Definitive ascertainment of area-specific disparities in this national pattern would require a different survey approach. Government proposals for widespread introduction of stepped-care models that may seek to divert patients from existing treatment pathways need to be implemented with care and well informed by local data.

The PULSAR Specialist Care protocol: a stepped-wedge cluster randomized control trial of a training intervention for community mental health teams in recovery-oriented practice

BackgroundRecovery features strongly in Australian mental health policy; however, evidence is limited for the efficacy of recovery-oriented practice at the service level. This paper describes the Principles Unite Local Services Assisting Recovery (PULSAR) Specialist Care trial protocol for a recovery-oriented practice training intervention delivered to specialist mental health services staff. The primary aim is to evaluate whether adult consumers accessing services where staff have received the intervention report superior recovery outcomes compared to adult consumers accessing services where staff have not yet received the intervention. A qualitative sub-study aims to examine staff and consumer views on implementing recovery-oriented practice. A process evaluation sub-study aims to articulate important explanatory variables affecting the interventions rollout and outcomes.MethodsThe mixed methods design incorporates a two-step stepped-wedge cluster randomized controlled trial (cRCT) examining cross-sectional data from three phases, and nested qualitative and process evaluation sub-studies. Participating specialist mental health care services in Melbourne, Victoria are divided into 14 clusters with half randomly allocated to receive the staff training in year one and half in year two. Research participants are consumers aged 18–75 years who attended the cluster within a previous three-month period either at baseline, 12 (step 1) or 24 months (step 2). In the two nested sub-studies, participation extends to cluster staff. The primary outcome is the Questionnaire about the Process of Recovery collected from 756 consumers (252 each at baseline, step 1, step 2). Secondary and other outcomes measuring well-being, service satisfaction and health economic impact are collected from a subset of 252 consumers (63 at baseline; 126 at step 1; 63 at step 2) via interviews. Interview-based longitudinal data are also collected 12 months apart from 88 consumers with a psychotic disorder diagnosis (44 at baseline, step 1; 44 at step 1, step 2). cRCT data will be analyzed using multilevel mixed-effects modelling to account for clustering and some repeated measures, supplemented by thematic analysis of qualitative interview data. The process evaluation will draw on qualitative, quantitative and documentary data.DiscussionFindings will provide an evidence-base for the continued transformation of Australian mental health service frameworks toward recovery.Trial RegistrationAustralian and New Zealand Clinical Trial Registry: ACTRN12614000957695. Date registered: 8 September 2014.

Promoting recovery-oriented mental health nursing practice through consumer participation in mental health nursing education

Background: Developing recovery-oriented services, and ensuring genuine consumer participation in all aspects of services are central components of contemporary Australian mental health policy. However, attitudes of mental health professionals present a significant barrier. Given the positive impact of education on health professionals’ attitudes, particularly when consumers are involved, further exploration of consumer involvement in education is required.Aims: To enhance understanding of the role consumers can play within mental health nursing education.Method: A qualitative exploratory project was undertaken involving individual interviews with mental health nurse academics and consumer educators.Results: Two main themes emerged from nurse participants: Recovery in action, consumer educators were able to demonstrate and describe their own recovery journey; and not representative, some participants believed consumer educators did not necessary reflect views and opinions of consumers more broadly. Two main themes for consumers were: the truth about recovery, consumer educators demonstrated recovery as an achievable goal; and not a real consumer, where health professionals to dismiss the consumer experience as unrepresentative and therefore not credible.Conclusions: Consumer participation can contribute positively to nurse education, however representativeness presents a major barrier, potentially enabling nurses to dismiss experiences of consumer academics and educators as exceptional rather than typical.

Challenges in implementing individual placement and support in the Australian mental health service and policy context.

Objective Although Australia's service and policy context differs from that of the US, studies have highlighted potential for individual placement and support (IPS) to support competitive employment outcomes for people with severe and persistent mental illness. The aim of the present study was to explore why the model is not yet widely available. Methods A document analysis was conducted to discern reasons for challenges in implementation of IPS practice principles within the Australian service context. Results The document analysis illustrated that although policy acknowledges the importance of increasing employment rates for people with severe and persistent mental illness, consistent measures, change indicators, direction and time frames are lacking in policy and strategy documentation. Further, IPS principles are not consistently evident in guiding operational documentation that government-funded Disability Employment Services (DES) programs are mandated to adhere to. Conclusions For IPS to be readily implemented, it is necessary for government to offer support to agencies to partner and formal endorsement of the model as a preferred approach in tendering processes. Obligations and processes must be reviewed to ensure that model fidelity is achievable within the Australian Commonwealth policy and service context for programs to achieve competitive employment rates comparable to the most successful international programs. What is known about the topic? The IPS model has been established as the most efficacious approach to support people with severe and persistent mental ill health to gain and sustain employment internationally, yet little is known as to why this model has had very limited uptake in the Australian adult mental health service and policy context. What does this paper add? This paper provides an investigation into the achievability of IPS within DES philosophical and contractual arrangements. What are the implications for practitioners? Mental health practitioners are typically skilled in their understanding of individual or micro-level challenges faced by consumers in achieving vocational goals: working with symptoms, medication side effects, motivation and anxiety. The present study was designed to offer practitioners an increased understanding of service-level factors, because these present considerable challenges to achieving sustained employment. This paper is a call for greater advocacy towards better integration of employment and mental health service delivery in the Australian policy and practice context.

Embodying policy-making in mental health: the implementation of Partners in Recovery

ABSTRACTThis paper starts from the premise that embodied knowledge is critical to understanding health policy implementation. We explore this notion through a qualitative investigation of the way that knowledge has functioned in the implementation of an Australian mental health policy, Partners in Recovery (PIR). Analysis uses the theoretical lens of interpretive policy analysis and the ‘embodied, inscribed, enacted’ knowledge schema developed by Freeman and Sturdy [(2014a). Introduction: Knowledge in policy – embodied, inscribed, enacted. In R. Freeman & S. Sturdy (Eds.), Knowledge in policy: Embodied, inscribed, enacted (pp. 1–19). Bristol: Policy Press]. Our analysis reveals a policy problem centred around difficulties of coordination where the inscribed solution lies in individuals who must implement the PIR program in local areas. Our interviews with PIR consortium members and stakeholders show that this implementation happens through the enactment of embodied knowledge. However this implementation is not straightforward and we point to difficulties arising from the centrality of embodied processes in implementation, related to the localisation of systems knowledge in individuals and structural devaluation of certain types of knowledge over others.

Mental health nurses' contributions to community mental health care: An Australian study.

Australian mental health policy is focused on providing mental health care in the community setting and community mental health teams provide services to clients in a shared model with primary care. The historical literature reports that community mental health nurses' experience high levels of stress and are often allocated the most complex and challenging clients managed by the team. Yet information on their specific roles remains limited. This paper reports on research conducted at one Australian public mental health service to identify the components of the community mental health nursing role and to quantify the time nurses spent in each component during the study period. Six focus groups were conducted with community mental health nurses to identify their perceived role within the team. Data analysis identified 18 components of which 10 were related to direct clinical contact with clients and eight covered administrative and care coordination activities. A data collection tool based on the findings of the focus groups was designed and nurses recorded workload data on the tool in 15-min intervals over a 4-week period. Seventeen nurses collected 1528 hours of data. Internal coordination of care was identified as the top workload item followed by clinical documentation and national data collection responsibilities supporting the complexity of the community mental health nursing role. The high rating attached to the internal coordination of care role demonstrates an important contribution that community mental health nurses make to the functioning of the team and the delivery of quality mental health care.

A longitudinal population-based study of carers of people with psychosis.

Few studies have examined the experiences of carers of people with psychosis using a representative sample. Aiming to obtain generalisable results concerning carers in the context of increased emphasis on involving carers in Australian mental health service delivery and policy frameworks, this study recruited carers within the second Australian national survey of psychotic disorders (Survey of High Impact Psychosis, SHIP). Given that most SHIP participants had long-term illness and extended relationships with carers, the health and wellbeing of carers as a group were expected to be relatively stable. However, since it is unknown whether carers' health and wellbeing would change, our main aim was to explore change and stability in carers' health and wellbeing and the relationship between any changes experienced by individual carers and corresponding SHIP participants' functioning over time. Ninety-eight caregivers of SHIP participants were recruited at baseline and completed validated instruments assessing their health and wellbeing. Seventy-eight carers were re-interviewed at 1-year follow-up. Clinical factors were extracted from the SHIP database. Wilcoxon matched-pairs signed-rank test and t-test were used to analyse changes in variables over time. Cross-lagged analyses were conducted to identify possible causative relationships in changes in SHIP participant and carer variables. A substantial percentage of carers experienced social isolation (28.6%), psychological distress (37.7%) and poorer quality of life than population norms. There were no statistically significant changes between baseline and follow-up scores for almost all carers' health and wellbeing variables, other than a poorer perception of their quality of life in relation to their physical health after 1 year. Cross-lagged analyses suggested that poorer functioning of people with psychosis influenced carers' social isolation, grief and psychological distress. Findings show that carers' perception of their health and wellbeing did not improve within current mental health service delivery frameworks over time. Carer's persistently poor health and wellbeing suggests a pressing need to enhance services that improve carers' health and wellbeing especially their physical health and the functioning of people with psychosis whom they support.

Lived experience practitioners and the medical model: world’s colliding?

Background: Australian mental health policy requires that mental health services facilitate meaningful and genuine consumer participation in all aspects of mental health services. Roles for practitioners who work from their own experience of significant mental health challenges and mental health service use have been implemented in many services to promote participation and the development of more consumer focused services.Aims: To enhance understanding of perspectives of individuals working in lived experience roles to more closely understand their experiences and opinions about these roles.Method: A grounded theory study interviews were conducted with 13 lived experience practitioners.Results: The medical model was a core category arising from this work. Participants described the medical model as a prevailing culture within mental health services from their personal and professional experiences. This culture imposed a major limitation on the implementation, effectiveness and development of lived experience roles and themselves as individuals. It was also seen as a major limitation to the progress of Recovery orientated reform.Conclusions: The development of Recovery oriented services requires a strong lived experience practitioner workforce, with appropriate resourcing and support available. The current medical model approach requires critique to facilitate reform and avoid tokenism.

Integration in a nurse practitioner-led mental health service in rural Australia.

Integration of mental health services is a prominent Australian mental health policy goal; however, there is little detail in the literature of how integrated mental health services are established or function. This study aimed to describe a nurse practitioner-led primary healthcare rural mental health service and evidence of how the service was integrated with other services and the community. This pragmatic exploratory study used case study methodology and analysed documents, quantitative data and qualitative data from individual and group semi-structured interviews and a 'stakeholder meeting'. The study was part of a formal evaluation of this nurse practitioner service. Rural New South Wales. Twenty-one service providers and stakeholders. Introduction of a nurse practitioner led mental health service. Not applicable. Purposely sampled participants were interviewed. Documentary evidence included briefing notes, minutes and progress reports and provided important background information. Non-identifiable aggregated client data were analysed. Thematic analysis of the qualitative data produced a description of how and why the service was established, a description of the service and its impact and three analytic themes providing evidence of integration. Challenges to integrating this service are also discussed. The service was highly regarded. It addressed the drug and alcohol and mental health needs of a vulnerable rural community. The inception and implementation of the service were community driven, led by a number of agencies supported by a steering committee and underpinned by a Partnership Agreement. The service demonstrated key features of integration alongside experiencing challenges in optimising integration with acute mental health services.

Mental health consumer participation in education: a structured literature review.

Consumer participation in design, delivery and evaluation of occupational therapy educational programs is a recently introduced requirement for accreditation. It aligns with the principle of recovery, which underpins Australian mental health policy. Graduates' capabilities for recovery-oriented practice are thought to be enhanced through learning from consumers' lived experience. This structured literature review evaluates the current evidence for mental health consumer participation in health professional education to inform occupational therapy educators. Searches were completed in five online databases, one journal and published reading lists on the topic. Studies were included if they addressed mental health consumer participation in health professional education programs, were published in peer reviewed journals between 2000 and 2014 and were in English. Articles were critically reviewed, and analysed for key findings related to stages of the educational process and recovery-oriented practice capabilities. An emerging body of evidence for consumer participation in mental health education was identified. Studies are characterised by a lack of quality and a low to medium level of evidence. Findings relate to design, planning, delivery and evaluation of education as well as to most aspects of recovery-oriented practice. Emphases on exploratory research and proximal outcomes, and a reliance on published outcome measurement instruments designed for other purposes are key limitations in this body of evidence. This study identifies a weak evidence base for the requirement for consumer participation in occupational therapy programs, specifically related to mental health curricula. A research agenda is proposed in response.