Adopting a collaborative approach within clinical relationships is illustrative of consumers' and nurses' positive beliefs, values, and attitudes towards each other and their partnership. However, for collaboration to be successful, how roles are determined, how each partner relates to the other, and how decisions are to be made need to be clearly defined and agreed upon. The research study described here utilized a mixed-method approach comprising focus groups and surveys to explore the subjective understandings, attitudes, and experiences of consumer-nurse collaboration within a mental health rehabilitation context in order to more clearly determine the conditions for successful nurse-consumer collaboration. The study found that although consumers and nurses conceptualized collaboration in similar ways, their lived experiences were disparate. A key finding of the study was that mutual recognition of each others' knowledge and expertise is needed for successful collaboration. The study reinforced the need for consumers and nurses to establish common ground on which to collaborate and to articulate the behaviours and expectations of working collaboratively. While collaboration was acknowledged as a significant and desirable basis for therapeutic relationships, it was challenged by determinants of power, such as knowledge, information, and expertise.

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People with serious mental illness have higher morbidity and mortality rates than general populations, and overweight/obesity-related conditions are prevalent. Psychotropic medications are a primary factor in significant weight gain. Adolescents and young adults, particularly those with first-episode psychoses taking atypical antipsychotics, are susceptible to weight gain. This paper reports findings from an integrative review of research investigating the impact and treatment of psychotropic-induced weight gain. Four databases were searched, yielding 522 papers. From these and hand-searched papers, 36 research reports were systematically classified and analysed. The review revealed people experiencing psychotropic-induced weight gain perceive it as distressing. It impacts on quality of life and contributes to treatment non-adherence. Weight management and prevention strategies have primarily targeted adults with existing/chronic illness rather than those with first-episode psychoses and/or drug naiveté. Single and multimodal interventions to prevent or manage weight gain produced comparable, modest results. This review highlights that the effectiveness of weight management interventions is not fully known, and there is a lack of information regarding weight gain prevention for young people taking psychotropics. Future research directions include exploring the needs of young people regarding psychotropic-related weight gain and long-term, follow-up studies of lifestyle interventions to prevent psychotropic-related weight gain.

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Despite a fall in smoking activity among the general population, individuals with schizophrenia continue to smoke at alarming rates and suffer poor health as a consequence. It would appear that limited and conflicting knowledge, outdated perceptions, and ineffective interventions have hindered efforts to promote healthy behaviours among this group. This paper reviews the literature on the association between nicotine dependence and schizophrenia and explores explanations for the phenomenon. Complex psychopathological, biochemical, and neuropharmacological interactions between smoking and schizophrenia are revealed. The interface of schizophrenia and smoking behaviour, particularly among those hospitalized in mental health facilities, and rationales for the management of this manifestation are examined. In addition, inferences regarding the role of mental health nurses in the care of this population are reached, and implications for nursing practice are discussed.

Physical health in people with mental illness is often compromised. Chronic physical conditions and disease risk factors occur at higher rates than in the general population. Although substantial research exists regarding mental-physical comorbidities in middle to older-aged adults and mental illness consequential to childhood physical illness, research addressing physical health in young people/emerging adults of 16-24 years with primary mental illnesses is minimal. Health problems often track from youth to adulthood, indicating a need to better recognize and understand the overall health of young people with mental illness. This paper reports findings from an integrative review of published research investigating physical health of emerging/young adults with mental illness. A total of 18 research papers were systematically analysed. The review found that comorbid mental-physical illness/conditions were evident across a wide age span. Specific physical health problems, including pain, gastrointestinal, and respiratory disorders, were apparent in those 16 years to those in their mid-late 20s, and/or with first episode psychosis. Lifestyle risk factors for cardiometabolic disorders occurred with some frequency and originated prior to adulthood. These findings highlight the need for targeted health screening and illness prevention strategies for emerging/young adults with mental health problems and draws attention to the need for young people to be supported in their health-care behaviours.

A B S T R AC TChildren in families with mental health problems may encounter multiple risks to their well-being. General aims of peer support programmes for these children include fostering resilience and effective coping strategies, and enhancing self-esteem and social skills. This study aimed to evaluate outcomes from a pilot multi-site implementation of the ON FIRE peer support programme. The purpose of ON FIRE is to cultivate hope, resilience and well-being in children and adolescents aged 8-17 years living in families affected by sibling or parental mental health problems. We employed a pre-post test (baseline and 4 months) evaluation using a suite of outcome measures. The Strengths and Difficulties Questionnaire (SDQ), Children's Hope Scale, Kids Connections Scale and Positive and Negative Affect Scale for Children (PANAS-C) were completed for 64 child/adolescent participants. At baseline, participants had significantly greater difficulties compared with Australian norms. At 4 months, there were significant differences in children's hope and in connections outside the family. There were no significant differences in the SDQ or the PANAS-C.

This article explores the implementation of an innovative approach to mental health care in a private health setting. Open Dialogue is a recovery-oriented approach to mental health that emerged in Finland, which emphasises family involvement, interdisciplinary collaboration and a flexible, needs-adapted approach. Early research is promising; however, little research has explored Open Dialogue outside Finland. This study aimed to explore the introduction of this approach at a private, inpatient young-adult mental health unit in Australia. Drawing on data from a long-term ethnographic field study that included 190 hours of observation and qualitative interviews, the findings show that despite staff members being inspired by and supportive of Open Dialogue, the existing ideology and organisational structures of the unit conflicted with the integration of Open Dialogue principles. Dialogical ways of working were challenged by medical dominance and emphasis on economic efficiencies. This study emphasises the importance of a ‘good’ fit between organisational cultures and innovations. It also highlights the challenges of moving towards recovery-oriented and family-focused models of care in the Australian neoliberal health care context. There is a need for organisational and ideological change in health services that is receptive to, and meaningfully supports, efforts to implement recovery-oriented care.