Mental Health Leadership Research Articles

Consumers in mental health service leadership: A systematic review.

Contemporary mental health policies call for greater involvement of mental health service consumers in all aspects and at all levels of service planning, delivery, and evaluation. The extent to which consumers are part of the decision-making function of mental health organizations varies. This systematic review synthesizes empirical and review studies published in peer-reviewed academic journals relating to consumers in leadership roles within mental health organizations. The Cochrane Library, Medline, and PsycINFO were searched for articles specifically analysing and discussing consumers' mental health service leadership. Each article was critically appraised against the inclusion criteria, with 36 articles included in the final review. The findings of the review highlight current understandings of organizational resources and structures in consumer-led organizations, determinants of leadership involvement, and how consumer leadership interacts with traditional mental health service provision. It appears that organizations might still be negotiating the balance between consumer leadership and traditional structures and systems. The majority of included studies represent research about consumer-run organizations, with consumer leadership in mainstream mental health organizations being less represented in the literature. Advocates of consumer leadership should focus more on emphasizing how such leadership itself can be a valuable resource for organizations and how this can be better articulated. This review highlights the current gaps in understandings of consumer leadership in mental health, including a need for more research exploring the benefits of consumer leadership for other consumers of services.

BARRIERS TO ACCESSING MENTAL HEALTH CARE IN THE EASTERN CAPE PROVINCE OF SOUTH AFRICA

The aim of this study was to explore and describe the perceptions of professional nurses concerning barriers to care for people with mental illness in the Eastern Cape Province, South Africa. The study was based on a qualitative, explorative and descriptive design.  A total of nine professional nurses working in primary, secondary and tertiary health care facilities were purposively selected. Unstructured interviews were conducted to collect data. Participants’ responses were captured on an audio recorder and later transcribed verbatim.Participants’ responses were then analysed thematically. Two main themes and their related sub-themes were identified. The first theme concerns the perceptions of professional nurses regarding the societal barriers that may hinder people with mental illness from accessing and utilising mental health services. These barriers include socioeconomic hardships, lack of knowledge and insight, lack of family support, embedded cultural beliefs and practices and stigma. The second theme highlights the barriers that professional nurses perceive within the health care system that influence access and utilisation of mental health services. These barriers include inadequate support from stakeholders and leaders in the mental health sector and lack of financial, human and infrastructure resources. Professional nurses made recommendations to improve mental health care. Those of high priority included enhanced mental health literacy among members of the public and a need for mental health stakeholders and leaders to increase their support of the mental health sector in an effort to improve access to mental health care.

"We Are Not Really Marketing Mental Health": Mental Health Advocacy in Zimbabwe.

IntroductionFew people with mental disorders in low and middle-income countries (LMICs) receive treatment, in part because mental disorders are highly stigmatized and do not enjoy priority and resources commensurate with their burden on society. Advocacy has been proposed as a means of building political will and community support for mental health and reducing stigma, but few studies have explored the practice and promise of advocacy in LMICs.MethodsWe conducted 30 semi-structured interviews with leaders in health and mental health in Zimbabwe to explore key stakeholder perceptions on the challenges and opportunities of the country’s mental health system. We coded the transcripts using the constant comparative method, informed by principles of grounded theory. Few interview questions directly concerned advocacy, yet in our analysis, advocacy emerged as a prominent, cross-cutting theme across participants and interview questions.ResultsTwo thirds of the respondents discussed advocacy, often in depth, returning to the concept throughout the interview and emphasizing their belief in advocacy’s importance. Participants described six distinct components of advocacy: the advocates, to whom they advocate (“targets”), what they advocate for (“asks”), how advocates reach their targets (“access”), how they make their asks (“arguments”), and the results of their advocacy (“outcomes”).DiscussionDespite their perception that mental health is widely misunderstood and under-appreciated in Zimbabwe, respondents expressed optimism that strategically speaking out can reduce stigma and increase access to care. Key issues included navigating hierarchies, empowering service users to advocate, and integrating mental health with other health initiatives. Understanding stakeholder perceptions sets the stage for targeted development of mental health advocacy in Zimbabwe and other LMICs.

Measuring Use of Research Evidence: The Structured Interview for Evidence Use.

This article describes the Standard Interview for Evidence Use (SIEU), a measure to assess the level of engagement in acquiring, evaluating, and applying research evidence in health and social service settings. Three scales measuring input, process, and output of research evidence and eight subscales were identified using principal axis factor analysis and parallel analysis of data collected from 202 state and county child welfare, mental health, and juvenile justice systems leaders. The SIEU scales and subscales demonstrate strong internal consistency as well as convergent and discriminant validity. The SIEU is easy to use and can be administered as a complete scale or as three smaller scales to separately examine evidence in acquisition, evaluation, or application. The measure demonstrates potential in understanding the role of research evidence in service settings and in monitoring the process of evidence-based practice and application of scientific principles in social work practice.

The Gayaa Dhuwi (Proud Spirit) Declaration – a Call to Action for Aboriginal and Torres Strait Islander leadership in the Australian mental health system

ABSTRACTThe Gayaa Dhuwi (Proud Spirit) Declaration aims to improve the mental health of Aboriginal and Torres Strait Islander peoples by supporting their leadership in those parts of the mental health system that work with Aboriginal and Torres Strait Islander populations. A further aim is to promote an appropriate balance of clinical and culturally-informed mental health system responses, including by providing access to cultural healing, to mental health problems in Aboriginal and Torres Strait persons. Developed by the National Aboriginal and Torres Strait Islander Leadership in Mental Health (NATSILMH) as a companion document to the international Wharerātā Declaration, the Gayaa Dhuwi (Proud Spirit) Declaration also sets out principles for governments, professional bodies and other stakeholders to support Aboriginal and Torres Strait Islander leadership in the Australian mental health system; and principles for working with Aboriginal and Torres Strait Islander mental health leaders as they exercise culturally informed leadership within the Australian mental health system. The Gayaa Dhuwi (Proud Spirit) Declaration is being promoted by NATSILMH as a new paradigm for shaping mental health system responses to Aboriginal and Torres Strait islander mental health problems.

APA Foundation Recognizes Leaders in Minority Mental Health

Back to table of contents Previous article Next article Association NewsFull AccessAPA Foundation Recognizes Leaders in Minority Mental HealthLindsey McClenathanLindsey McClenathanSearch for more papers by this authorPublished Online:24 Jun 2016https://doi.org/10.1176/appi.pn.2016.7a14AbstractThe awards honor individuals and programs that are making a difference in improving the care of underserved minority members with mental illness.The 2016 APA Foundation Awards for Advancing Minority Mental Health were announced at the annual benefit of the American Psychiatric Association Foundation, held in conjunction with APA’s 2016 Annual Meeting in Atlanta in May.Gathering for a photo after presentation of the APA Foundation Awards for Advancing Minority Mental Health were (from left) Ranna Parekh, M.D., director of APA’s Division of Diversity and Health Equity; Saul Levin, M.D., M.P.A., APA CEO and medical director and chair of the Foundation’s Board of Directors; Altha Stewart, M.D., a member of the APA Board of Trustees; award winners Kenneth Fung, M.D., Nubia Lluberes-Rincon, M.D., and Olga El Sehamy and her son, Alex El Sehamy; and Uyen-Khanh Quang-Dang, M.D., M.Sc., a member of the APA Foundation’s Board of Directors. Parekh, Stewart, and Quang-Dang presented the awards.David HathcoxThe awards, created in 2003, recognize psychiatrists, other health professionals, and organizations that have undertaken innovative efforts to raise awareness of mental illness in underserved minority communities, increase access to care, overcome cultural barriers to care, and improve the quality of care for underserved minorities, particularly those in the public health system or with severe mental illness.Here are brief descriptions of this year’s winners:Kenneth Fung, M.D., of Toronto is a co-founder of the Asian Initiative in Mental Health Program (AIM) at the Toronto Western Hospital. This program serves the local, underserved Cantonese- and Mandarin-speaking communities and is a training ground for medical students and residents interested in cross-cultural psychiatry. In addition to his efforts to increase culturally competent mental health care through AIM, Fung provides psychiatric consultation and training to minority mental health care service organizations. Also, he has engaged with local media to promote mental health and advocate for stigma reduction in local minority populations and has co-led numerous research studies.Nubia Lluberes-Rincon, M.D., of Freedom, Pa., is pursuing a fellowship in forensic psychiatry to allow her to help close the gap between psychiatric services and the correctional system in the United States. Lluberes-Rincon, a former APA Diversity Leadership Fellow, has spent time providing mental health education to the Hispanic community in Texas and creating a documentary on bipolar disorder. In West Virginia, where African Americans, LGBT, and other minority groups are in need of additional support, she re-established electroconvulsive therapy at a hospital serving these populations and provided community education to fight stigma surrounding mental illness.Deaf and Hard of Hearing Program of Lifeline Connections of Vancouver, Wash., provides high-quality treatment and support for people who are deaf and have a substance use disorder, allowing equal access to treatment in American Sign Language (ASL), the clients’ first language. This dynamic eliminates complications and barriers that a third-party interpreter may introduce to the therapeutic relationship and therefore improves treatment outcomes. The program offers both individual and group counseling and hosts an alumni program to help clients live sober lives. The Deaf and Hard of Hearing Program has clients who have been sober and in recovery for many years. Adelante of Suffolk County Inc. in Central Islip, N.Y., serves local low-income families, many of whom are Hispanic. In order to address the mental health of its clients, Adelante runs a Supported Housing and Behavioral Program in which all staff are bilingual (English-Spanish) and able to provide care in the clients’ first (and potentially only) language. Adelante collaborates with Alcoholics Anonymous and a local clinical facility offering treatment for adults with serious mental illness. Additionally, the Supported Housing and Behavioral Program offers pre-vocational services to prepare their clients for employment and training in life skills to provide a holistic approach to the overall well-being of the individual. ■More information on the Awards for Advancing Minority Mental Health can be accessed here.Lindsey McClenathan is the development officer in the APA Foundation. ISSUES NewArchived

Organizational Characteristics of Veterans Affairs Clinics With High and Low Utilization of Clozapine.

Twenty to thirty percent of patients with schizophrenia experience treatment resistance. Clozapine is the only medication proven effective for treatment-resistant schizophrenia. However, in most settings less than 25% of patients with treatment-resistant schizophrenia receive clozapine. This study was conducted to identify facilitators of and barriers to clozapine use to inform development of interventions to maximize appropriate clozapine utilization. Seventy semistructured phone interviews were conducted with key informants of clozapine processes at U.S. Department of Veterans Affairs medical centers in various U.S. regions, including urban and rural areas, with high (N=5) and low (N=5) rates of clozapine utilization. Interviewees included members of mental health leadership, psychiatrists, clinical pharmacists, and advanced practice nurses. Interviews were analyzed by using an emergent thematic strategy to identify barriers and facilitators related to clozapine prescribing. High utilization was associated with integration of nonphysician psychiatric providers and clear organizational processes and infrastructure for treatment of severe mental illness, for example, use of clozapine clinics and mental health intensive case management. Low utilization was associated with a lack of champions to support clozapine processes and with limited-capacity care systems. Obstacles identified at both high- and low-utilization sites included complex, time-consuming paperwork; reliance on a few individuals to facilitate processes; and issues related to transportation for patients living far from care facilities. Implementation efforts to organize, streamline, and simplify clozapine processes; development of a multidisciplinary clozapine clinic; increased capacity of existing clinics; and provision of transportation are reasonable targets to increase clozapine utilization.

Challenges in the Operationalization of Mental Health Quality Measures: An Assessment of Alternatives.

Interest in measuring the quality of mental health services has increased, but challenges remain in moving from general standards of quality and best practices to specific, implementable quality measures. The International Initiative for Mental Health Leadership identified 656 mental health quality measures and then applied a modified Delphi approach to assess various available alternative quality measures. Panel members considered issues of data source, segmentation, and thresholds. Policy makers and organizations will need to make difficult choices about accountability, purpose, feasibility, and validity in order to operationalize quality measurement. Empirical data can help guide them in this process.

Erratum to: Development and refinement of a clinician intervention to facilitate primary care patient use of the PTSD Coach app.

Posttraumatic stress disorder (PTSD) is common and undertreated among Veterans Affairs (VA) primary care patients. A brief primary care intervention combining clinician support with a self-management mobile app (Clinician-Supported PTSD Coach, CS-PTSD Coach) may improve patient outcomes. This study developed and refined an intervention to provide clinician support to facilitate use of the PTSD Coach app and gathered VA provider and patient qualitative and quantitative feedback on CS-PTSD Coach to investigate preliminary acceptability and implementation barriers/facilitators. VA primary care providers and mental health leadership (N = 9) completed a survey and interview regarding implementation barriers and facilitators structured according to the Consolidated Framework for Implementation Research (CFIR). Clinicians who delivered CS-PTSD Coach (N = 3) and patients (N = 9) who received it provided feedback on the intervention and implementation process. CS-PTSD Coach has high provider and patient acceptability. Important implementation factors included that CS-PTSD Coach be compatible with the clinics' current practices, have low complexity to implement, be perceived to address patient needs, and have strong support from leadership. Diverse factors related to CS-PTSD Coach delivery facilitate implementation, provide an opportunity to problem-solve barriers, and improve integration of the intervention into primary care.

Innovating team-based outpatient mental health care in the Veterans Health Administration: Staff-perceived benefits and challenges to pilot implementation of the Behavioral Health Interdisciplinary Program (BHIP).

In the past decade, the demand for Veterans Health Administration (VHA) mental health care has increased rapidly. In response to the increased demand, the VHA developed the Behavioral Health Interdisciplinary Program (BHIP) team model as an innovative approach to transform VHA general outpatient mental health delivery. The present formative evaluation gathered information about pilot implementation of BHIP to understand the struggles and successes that staff experienced during facility transitions to the BHIP model. Using a purposive, nonrandom sampling approach, we conducted 1-on-1, semistructured interviews with 37 licensed and nonlicensed clinical providers and 13 clerical support staff assigned to BHIP teams in 21 facilities across the VHA. Interviews revealed that having actively involved facility mental health leaders, obtaining adequate staffing for teams to meet the requirements of the BHIP model, creating clear descriptions and expectations for team member roles within the BHIP framework, and allocating designated time for BHIP team meetings challenged many VHA sites but are crucial for successful BHIP implementation. Despite the challenges, staff reported that the transition to BHIP improved team work and improved patient care. Staff specifically highlighted the potential for the BHIP model to improve staff working relationships and enhance communication, collaboration, morale, and veteran treatment consistency. Future evaluations of the BHIP implementation process and BHIP team functioning focusing on patient outcomes, organizational outcomes, and staff functioning are recommended for fully understanding effects of transitioning to the BHIP model within VHA general mental health clinics and to identify best practices and areas for improvement. (PsycINFO Database Record

Think Outside the Box: Participate in APA’s Innovation Lab

Back to table of contents Previous article Next article Association NewsFull AccessThink Outside the Box: Participate in APA’s Innovation LabSteven Chan,M.D., M.B.A.Steven Chan,Search for more papers by this authorM.D., M.B.A.Published Online:8 Apr 2016https://doi.org/10.1176/appi.pn.2016.4b23AbstractIf you’ve ever dreamed of a way that technology could advance psychiatric care or the profession, you won’t want to miss this session.APA’s first-ever Psychiatry Innovation Lab contest will be held at APA’s 2016 Annual Meeting in Atlanta. This event will bring together teams of physicians, entrepreneurs, advocates, technology professionals, and administrators and challenge them to come up with new ways to improve the delivery of mental health care. We are inviting all psychiatrists attending the Annual Meeting to participate. There are two ways to get involved:Want to pitch an idea and lead a team? Individuals or groups can pitch their idea at the contest site. The seven most promising pitches will be selected as finalists and presented at the event. Applications are due by April 29.Want to join a finalist team? If you are an APA member attending the Annual Meeting, you do not have to register for the session—just come. If you are a nonmember, businessperson, technologist, entrepreneur, or patient advocate, getting involved is extremely easy! Tell us about why you want to join at www.psychiatryinnovation.com by April 29. Forty nonmembers will be selected to serve as “innovation leaders.”Those selected as finalists and innovation leaders will be notified by May 1. They will be invited to join us on Sunday, May 15, from 1 p.m. to 4 p.m. in Room B211/212 in the Georgia World Congress Center. Prizes include $2,500, sponsored by the telemedicine startup Doctor on Demand, and an audience prize presented by Tristan Gorrindo, M.D., APA’s director of education.“This is a groundbreaking time for new ideas, new technology, and new models of care,” said APA Leadership Fellow Nina Vasan, M.D., chair of the event. “We are excited by all of the new developments occurring in mental health: new smartphone apps, mobile devices, wearables, digital health, and medical informatics, along with new models and policies encouraging prevention, collaborative care, telemedicine, and mental health parity and equality.”Dr. Vasan, a Harvard-trained physician, is completing her residency at Stanford University School of Medicine and doing further training at the Stanford Graduate School of Business. Psychiatrists and mental health leaders are already discussing a diverse range of topics that can be incorporated into the Psychiatry Innovation Lab. Opportunities abound to address issues such as cultural and diversity inequities; advocacy for psychotherapy research; prevention and public health initiatives; psychiatric education; partnerships among nonprofit, government, academic, and community agencies; and the delivery of appropriate mental health treatment for incarcerated individuals.Attendees will get to learn from a stellar panel of judges from academia, patient advocacy groups, commercial startups, and business incubators. Judges include Grayson Norquist, M.D., chair of APA’s Council on Quality Care and chief of the psychiatry Service at Grady Health System; Philip Wang, M.D., Dr.P.H., APA’s director of research; Mary Giliberti, J.D., chief executive officer of the National Alliance on Mental Illness; Kana Enomoto, M.S., acting administrator of the Substance Abuse and Mental Health Services Administration; Dena Bravata, M.D., M.S., chief medical officer of Lyra Health; Mimi Winsberg, M.D., a psychiatrist at Lyra Health; NeuroLaunch’s Jordan Amadio, M.D., M.B.A., an Emory neurosurgery resident; and Donovan Wong, M.D., medical director of behavioral health for Doctor on Demand. ■Read more about the Innovation Lab contest here. A Psychiatric News article about the lab, “Resident Wants to Jump-Start Thinking on Quality Improvement,” is also posted at the site.Steven Chan, M.D., M.B.A., is a current APA/SAMHSA MFP fellow and vice chair of the APA Smartphone App Evaluation Workgroup. ISSUES NewArchived

Expanding the Pipeline: The New York University School of Medicine–University of Ghana School of Medicine and Dentistry Psychiatric Education Initiative

:As many low- and middle-income countries (LAMICs), Ghana is affected by a severe shortage of mental health specialists: there are 11 practicing psychiatrists for a population of 25 million. The pipeline for Ghanaian psychiatrists remains restricted for the foreseeable future given the low expressed interest in the field by junior medical trainees. The few senior psychiatric specialists are overextended with clinical and professional duties leaving them with minimal time to teach and mentor trainees. This limits opportunities for mentorship, modeling, teaching, and curricular development, leaving trainees with little exposure to psychiatric practice, and therefore, little motivation to enter a highly stigmatized and underresourced field. To support the training of Ghanaian medical students in psychiatry, the New York University School of Medicine–University of Ghana School of Medicine and Dentistry (NYUSOM-UGSMD) Psychiatric Education Initiative, and the NYU Global Mental Health Elective were formed (1) to provide educational support to medical students and residents at UGSMD and (2) to provide a sustainable international experience for NYUSOM residents with a strong interest in leadership in global mental health and underserved populations.

Youth leadership in mental health: Views from EFPT and IFMSA

The world today is more challenging than ever before. Discrimination, stigma, and ever-changing lifestyles are just a few examples of elements that have a profound impact on the mental health status of our global population. Even though the burden of mental illness is well documented and increasing, mental health remains a neglected area of health worldwide.Youth Associations, like the International Federation of Medical Students’ Associations (IFMSA) and the European Federation of Psychiatric Trainees (EFPT) recognize the importance of tackling this problem, taking an active role on promoting education in our communities, tackling stigma and advocating for more action. Medical students worldwide, from Slovenia, Australia, Lebanon, Brazil, Quebec and Grenada – among at least 42 other countries, organise expansive, creative and engaging mental health projects.With particular interest we can mention the winner of the last Rex Crossley Award, attributed to a Slovenian project ‘in Reflection’: a suicide prevention project, which tackles the different factors associated with vulnerable groups through a series of workshops and campaigns that seek to destigmatize the mental health problems and offer the opportunity to high school students to get the help they need.This talk will give an insight into strengths, weaknesses and challenges faced by youth in tackling mental health, specially in the role of the IFMSA, displaying some of our most interesting and innovative projects from future mental health leaders around the world, together with the initiatives of EFPT.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Development and refinement of a clinician intervention to facilitate primary care patient use of the PTSD Coach app.

Posttraumatic stress disorder (PTSD) is common and undertreated among Veterans Affairs (VA) primary care patients. A brief primary care intervention combining clinician support with a self-management mobile app (Clinician-Supported PTSD Coach, CS-PTSD Coach) may improve patient outcomes. This study developed and refined an intervention to provide clinician support to facilitate use of the PTSD Coach app and gathered VA provider and patient qualitative and quantitative feedback on CS-PTSD Coach to investigate preliminary acceptability and implementation barriers/facilitators. VA primary care providers and mental health leadership (N = 9) completed a survey and interview regarding implementation barriers and facilitators structured according to the Consolidated Framework for Implementation Research (CFIR). Clinicians who delivered CS-PTSD Coach (N = 3) and patients (N = 9) who received it provided feedback on the intervention and implementation process. CS-PTSD Coach has high provider and patient acceptability. Important implementation factors included that CS-PTSD Coach be compatible with the clinics' current practices, have low complexity to implement, be perceived to address patient needs, and have strong support from leadership. Diverse factors related to CS-PTSD Coach delivery facilitate implementation, provide an opportunity to problem-solve barriers, and improve integration of the intervention into primary care.

Mental health leadership and complexity

Leaders in the helping professions need to realise the power that language has to potentially stigmatise; it also has the potential to create positive outcomes for mental health patients. After an examination of language and leadership effectiveness in adapting to the complex perspective of patients, professionals can improve treatment outcomes. The use of language in rephrasing and reframing clinical observations of complex experiences can be understood within the framework of complexity theory. This theory has strengthened positive outcomes in other relevant areas including economics and organisational studies. Complex adaptive systems have the potential to self-organise and adapt which makes it crucial in the undertaking of theorising for mental health leadership. Many benefits in the care of mental health consumers would best come from adaptation and self-organising principles.

Confidence, competence and commitment: Public Health England ' s leadership and workforce development framework for public mental health

Purpose – The purpose of this paper is to describe a national framework for leadership and workforce development in public mental health, published by Public Health England in 2015. Design/methodology/approach – It has been developed with national partners and the local public health workforce, responding to local need and national policy. It aims to build the capacity and capability of leaders and a workforce that is confident, competent and committed to: promoting good mental health across the population, preventing mental illness and suicide, and improving the quality and length of life of people living with mental illness. Findings – The framework outlines six ambitions for change and suggests the core principles and competencies needed in the workforce, and in leaders, to make that change happen, alongside practical actions. Practical implications – A call to action approach is used to gain commitment from strategic partners and key organisations. Planners and practitioners are encouraged to use the framework to inform the commissioning and delivery of workforce development. Originality/value – This is the first time a national framework for workforce development in public mental health has been published and as such it sets direction for national and local bodies and provides a practical approach to inform and influence action.

Fight Against Misuse of Psychiatry Wins Sharfstein Award for Courage

Fight Against Misuse of Psychiatry Wins Sharfstein Award for Courage

Connecting the dots: Understanding the flow of research knowledge within a research brokering network

Networks are frequently cited as an important knowledge mobilization strategy; however, there is little empirical research that considers how they connect research and practice. Taking a social network perspective, I explore how central office personnel find, understand and share research knowledge within a research brokering network. This mixed methods case study focused on the first two cohorts of school district Mental Health Leaders participating Ontario’s Child and Youth Mental Health program (N=37). Data were collected and analyzed in two phases: 1) the administration of a social network survey to all participants (response rate = 97%), and 2) follow-up interviews with key informants identified by the social network analysis (N=11). The findings indicate that this is a sparse network and the pattern of incoming ties tends to focus on a subset of individuals. When the identified key players (who are sometimes but not always program staff) are removed, network activity is cut by more than half; the removal of the remaining program staff members renders the network virtually non-existent. Research knowledge typically flowed in a single direction as there were few reciprocal ties within the network. Interview data yielded some important insights indicating that participants perceived formal CYMH events as their main access points to research knowledge and that Mental Health Leaders who were identified as prominent sources of research knowledge had pre-existing relationships with CYMH program staff.

'Forgotten': a personal comment and communiqué on West Papuan refugees.

To raise awareness of the ongoing human rights violations of the Indigenous residents of West Papua and their mental health consequences. The author, herself a refugee from West Papua, provides a summary comment from a presentation to the Leadership in Mental Health: Island Nations course, based on personal experience in West Papua and Papua New Guinea, and a telephone survey of West Papuan refugees resident in Australia. A communiqué in solidarity from all course delegates was produced and is included. Human rights violations continue in West Papua, and the plight of its indigenous residents and West Papuan refugees in Papua New Guinea and Australia are dire and should not be 'forgotten'.

Mental health in the island nations of the Western Pacific: a rapid review of the literature.

The aim of the study was to identify mental-health-relevant literature accessible to policy makers and healthcare workers in the island nations of the Western Pacific. Material collated to support the inaugural Leadership in Mental Health: Island Nations course held in Cairns in May 2015 was used as the basis of a "rapid review". The rapid review considered 303 documents identified by a search carried out using James Cook University's OneSearch, Google Scholar, and the authors' knowledge. Search terms included mental health and the like, and terms with Pacific and current Pacific island country names. Findings were classified by region/country, year of release/publication, mental health issue addressed, peer-reviewed or grey literature, and type of study. Almost half of the findings had been released in the previous five years. However, only 36% were peer-reviewed publications and only 3.6% of the findings were intervention studies. There is limited easily accessible documentation to confidently direct practice or policies regarding which strategies are likely to be effective in responding to the high rates of mental ill-health experienced in the Pacific island nations, or to plan for increases as a consequence of rapid social and demographic changes that are transforming Pacific island societies.