Objective: To determine, by the use of a telephone survey, the mental health status of SA adults (18+ years) using the GHQ-28, SF-12 and self-report as indicators of

Variable rates of staff-patient interaction were found between three wards, which differed in the degree of programme structure, staff-patient ratios, and patient chronicity. Highest rates of staff-patient interaction occurred where a highly structured ward programme operated in a closed ward with chronically disturbed patients, and this was more likely to increase as staff-patient ratios decreased. The lowest staff-patient interaction rates occurred in acute, open and closed wards. Further, acute ward patients received negligible attention from nurses in terms of staff-patient interaction after 10 days following admission.

Data from 2 studies investigating staff-patient and staff-staff interaction rates are presented. In the first the staff-patient ratio was varied by holding patient numbers constant and systematically varying staffing levels. The results showed that although the percentage of time nurses spent interacting with patients did not change, staff-staff interaction increased as a function of increased staffing levels. In the second study the interaction rates from 4 wards were combined. These data showed that, as in the first study, staff-patient interaction remained constant, as staff numbers increased, whilst staff-staff interaction increased. However, unlike the first study, when analysed in terms of the staff-patient ratio, both categories of interaction increased as the staff-patient ratio increased.

Providers of mental health and substance abuse care cannot afford to ignore the existence of casemix descriptions of their services. As casemix comes to be the predominant language used to describe the products of hospital care, its use will inevitably impinge upon psychiatric services. The psychiatric components of the Australian national diagnosis‐related groups classification 1 and 2 (AN‐DRG 1 and 2) do not describe the relevant products with great accuracy. We review some possible reasons for this and the effects on the homogeneity of resource consumption of technical procedures, such as trimming of data sets, in the context of the current casemix system and that proposed for AN‐DRG‐3. The evolution of a casemix system which does justice to current and future psychiatric services will be a complex process. Some of the crucial areas are discussed. Clinicians involved in mental health and substance abuse care must continue to advocate for the resources and effort needed to improve casemix information in their area.