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Syllabus and Assessments (Week 6–12)

  • Assessments and weighting:
    • Assessment 1: Test – 15% (Short answer) – Week 6 in normal Tutorial Class.
    • Assessment 2: Case Study – 30% – Due 19 September (Week 8).
    • Assessment 3: Written Essay – 40% – Due 14 October 2025 (Week 12).
    • Assessment 4: Test – 15% (Short answer) – Week 11 in normal Tutorial Class.
  • Topics aligned to weeks: Mental Status Examination (Week 6), Physical Health and Mental Health, Eating Disorders, Dual Diagnosis (Case Study), Mood Disorders (Agitation Management), Psychotic Disorders / Homelessness (Case Study), Anxiety Disorders, and Personality Disorders.
  • Reading and canvas activity structure are noted throughout the transcript; use Canvas for available readings and case studies.

Biopsychosocial Model – Comprehensive Study Notes (Week 1)

  • Medical Model (Definition)
    • Dominant framework in traditional Western medicine. Focuses on identifying pathology, diagnosing → treat → cure.
  • Core assumptions of the Medical Model
    • Illness arises from discrete biological causes located within the body.
    • Objective signs and laboratory findings are privileged over subjective experience.
  • Strengths of the Medical Model
    • Enabled life-saving breakthroughs (antibiotics, vaccinations, surgery).
    • Clear treatment algorithms and measurable end-points (symptom reduction, remission).
  • Limitations in mental-health contexts
    • Reductionism: psychosocial phenomena compressed into diagnostic labels.
    • May ignore social determinants of health and the patient’s personal meaning-making.
    • Can foster stigma or a passive “patient role” that limits recovery potential.
  • Biopsychosocial Model – Overview
    • Coined by George Engel (1977) as a corrective to biomedical reductionism.
    • Health and illness emerge from the intersection of three mutually influencing domains:
    • Biological: genetic vulnerability, neurochemistry, physical health, medications.
    • Psychological: cognition, emotion regulation, personality traits, coping skills.
    • Social: culture, family, community, socio-economic status, oppression.
  • Key added value of the biopsychosocial lens
    • Recognises each individual’s unique, context-embedded experience (“no one size fits all”).
    • Holistic, person-, client-, and relationship-centred lens.
    • Encourages collaboration, empathy and validation of first-person accounts.
  • Historical Foundations & Illustrative Figures
    • Florence Nightingale: integrated environmental, ethical and compassionate dimensions into nursing practice.
    • Alexander Fleming: penicillin discovery shows biomedical progress but cautions against solely biological cures.
  • Sociocultural & Identity Factors Shaping Health Experience
    • Race & ethnicity; sexuality & gender identity (cis/trans experiences).
    • Age & developmental stage; physical health/disability status.
    • Systems of oppression (racism, sexism, classism).
    • Societal narratives (e.g., framing substance use as a “moral failure”).
  • Person-Centred & Lived-Experience Approach
    • Actively seeks first-person narratives to understand problems in context.
    • Shifts clinical gaze from “What is wrong with you?” to “What has happened to you and how are you coping?”
    • Ethically underlines respect, autonomy and shared decision-making.
  • The 4-P Formulation Framework (integrates with biopsychosocial lens)
    • Predisposing factors – make someone more likely to develop a problem.
    • Biological: family history, genetics.
    • Psychological: temperament, perfectionism.
    • Social: early poverty, marginalisation.
    • Precipitating factors – trigger why the problem emerges now.
    • New or increased stressors, losses, trauma.
    • Perpetuating factors – maintain or worsen the problem.
    • Ongoing conflict, lack of social support, maladaptive coping.
    • Protective factors – resources that buffer distress and aid recovery.
    • Coping skills, supportive relationships, spirituality, community services.
  • Case Illustration 1 – Suicidal Ideation / Attempts (Broadening assessment beyond a single depression score)
    • Biological: existing mental illness; substance misuse/abuse; gender-related risk disparities.
    • Psychological: poor distress tolerance; avoidance or emotion-suppressing styles.
    • Social: acute stressors (e.g., job/relationship loss).
    • Clinical takeaway: using the 4-P model broadens assessment beyond a single depressive score to include addictive behaviours, coping repertoires and current life crises.
  • Clinical-Practice Implications
    • Expands clinical gaze to cultural, relational and developmental domains.
    • Promotes holistic care planning: pharmacotherapy plus psychotherapy, family work, social advocacy.
    • Mandates sensitivity to patient’s values, identity, and explanatory model.
    • Enhances therapeutic alliance by demonstrating genuine interest in the person’s life context.
    • Guides understanding of etiology → course → outcome trajectories for mental disorders.
    • Provides patients a felt sense of being understood, fostering hope and engagement.

Schizophrenia – Multidimensional Framework (Case Illustration 2)

  • Biological Dimension
    • Genetic loading: higher concordance in family and twin studies.
    • Post-mortem findings: brain irregularities (e.g., ventricular enlargement ext{(ventricular enlargement)}).
    • Neuro-imaging: enlarged lateral & third ventricles, decreased grey matter & temporal lobe volume; overall reduced brain size (not exclusive to schizophrenia).
    • Neurotransmitter dysregulation supports antipsychotic medication efficacy.
  • Psychological Dimension
    • Low distress tolerance.
    • Maladaptive thought patterns (paranoid interpretations, catastrophic thinking).
    • Poor coping skills and avoidance behaviours.
  • Social Dimension
    • Socio-occupational adversity: unemployment, single status, poverty, overcrowded housing.
    • Trauma history & chronic social adversity elevate risk.
    • Migrant status: increased incidence across generations, implicating acculturative stress.
  • Ethical, Philosophical & Practical Considerations
    • Ethically supports justice by foregrounding systemic inequities.
    • Philosophically aligns with pluralism—rejects single-cause reductionism.
    • Practically demands interdisciplinary teamwork: psychiatry, psychology, social work, peer support.

Reference Touchpoints and Exam Take-Home Points

  • Reference items for deeper study include works by Anand (2024), Huda (2021), Porter (2020); Wright et al. (2019); Karimi & Masoudi Alavi (Nightingale); Tan & Tatsumura (Fleming).
  • Key exam take-home points:
    • Know definitions and contrasts between medical vs. biopsychosocial models.
    • Be able to generate 4-P formulations for any given case vignette.
    • Remember prototypical biopsychosocial factors for suicidal crises and schizophrenia.
    • Articulate how cultural, social and personal histories influence diagnosis, treatment engagement and outcomes.
    • Emphasise ethical imperatives of empathy, patient autonomy and holistic care.

Dual Disability – Comprehensive Study Notes (Video 2)

  • Definition
    • A person who simultaneously meets criteria for a developmental disability (intellectual disability or autism spectrum disorder) and a mental illness.
  • Three-part model
    • ① Developmental/Intellectual Disability
    • ② Autism Spectrum Disorder (may or may not include intellectual impairment)
    • ③ Mental Illness
  • Lecture objectives
    • Differentiate common components of dual disability.
    • Analyse inter-relationships among components.
    • Explore diagnostic criteria & key features of each component.
    • Compare evidence-based treatment options & nursing implications.
  • Intellectual Disability (ID) – Common Causes
    • Genetic abnormalities; syndromes: Down, Fragile X, Prader–Willi.
    • Problems during pregnancy; abnormal cell division; maternal alcohol/drug use; intra-uterine infections.
    • Birth-related problems; perinatal hypoxia; extreme prematurity.
    • Childhood factors; infectious illnesses; environmental toxins (lead, mercury); extreme malnutrition.
  • Frequent Diagnostic Labels
    • Global Developmental Delay (GDD); slower milestones in motor, language, social, sensory & cognitive domains.
    • Fragile X Syndrome: incidence ext{M}= rac{1}{3600}, ext{F}= rac{1}{(4000 ext{– }6000)}; X-chromosome mutation (FMR1); insufficient FMRP; impaired synaptic functioning.
    • Down Syndrome (Trisomy 21): Australia incidence rac{1}{1100} births; extra chromosome 21.
    • Fetal Alcohol Spectrum Disorder (FASD): ethanol crosses placenta; facial dysmorphology; growth retardation; neuro-behavioural sequelae.
  • Autism Spectrum Disorder (ASD)
    • Lifelong neuro-developmental condition; not in itself an ID or mental illness (may co-occur).
    • Key etiological contributors: genetics; advanced parental age; birth complications; prematurity; jaundice; low birth weight.
    • Not causative factors: vaccinations, diet, culture, poor parenting.
    • Communication & Environment: sensory processing differences affect emotional regulation & anxiety; environmental adaptations can mitigate stress.
  • Attention-Deficit / Hyperactivity Disorder (ADHD)
    • Developmental disorder with childhood onset; neurological basis.
    • Terminology: historically ADD; DSM-5 uses ADHD with specifiers.
    • Prevalence: males > females; approx. 75% of children continue into adulthood.
    • Aetiology: prenatal exposures; strong heritability; childhood trauma.
    • Neurobiology: fronto-striatal circuitry dysregulation; catecholaminergic neurotransmission (dopamine, noradrenaline).
    • DSM-5 Specifiers: Predominantly inattentive; Predominantly hyperactive/impulsive; Combined presentation.
  • Common Mental Illnesses in Dual Disability
    • Mood disorders; anxiety disorders; psychotic disorders; personality & behavioural disorders.
  • Warning Signs of Emerging Mental Illness in ID/ASD (Council for ID 2019)
    • Withdrawal; mood changes; self-injury or aggression; hallucinations; changes in sleep/appetite/weight; new/changing challenging behaviours.
  • Assessment & Treatment Principles for Dual Disability
    • Dual assessment: separate evaluation for intellectual/ASD component and mental-health component.
    • Symptom-guided rather than diagnosis-label driven.
    • Multifaceted interventions:
      1) Pharmacology – psychotropics for mood, psychosis, ADHD; titration; monitor side-effects.
      2) Allied health – speech pathology; OT (sensory integration); psychology; social work.
      3) Psychotherapies – CBT adapted for cognitive level; behavioural interventions; social skills training; parent coaching.
  • Nursing Implications
    • Holistic, person-centred planning; involve family/carers.
    • Monitor physical health, side-effects, nutritional status, sleep.
    • Advocate for reasonable adjustments in all care settings.
  • Effective Communication Strategies with Dual Disability
    • Maintain calm, non-threatening presence; speak slowly.
    • Allow ~10 seconds processing time before repetition.
    • Multimodal supports: gestures, pictures, objects, augmentative devices.
    • Positive reinforcement for clear communication or desired behaviour.
    • Team approach – collaborate with carers, supporters & multidisciplinary professionals.
  • Evidence-Based Treatment Highlights (illustrative studies)
    • MTA study: combined medication + behavioural therapy superior to either alone for ADHD with irritability.
    • Caregiver input accurately reflects ASD severity in 2–7 year olds.
    • Sensory, emotional, cognitive factors drive anxiety in ASD; need sensory-informed interventions.
  • Ethical, Philosophical & Practical Considerations
    • Right to equitable healthcare & reasonable adjustments under disability legislation.
    • Risk of diagnostic overshadowing – avoid misattributing psychiatric symptoms to ID/ASD.
    • Informed consent complexities – use supported-decision-making frameworks.
    • Life-course perspective: early interventions, transition planning, ageing with dual disability.
  • Quick-Reference Numerical Facts
    • Fragile X prevalence: ext{M}= rac{1}{3600}, ext{F}= rac{1}{(4000 ext{– }6000)}
    • Down Syndrome births (Australia): rac{1}{1100} births.
    • ADHD symptom persistence into adulthood: rac{75}{100} (approx. 75%).
  • Key References (lecture list)
    • AIHW 2023 – Disability statistics.
    • Council for ID 2019 – Health Fact Sheets.
    • Department of Health 2015 – Dual Disability framework.
    • Fernández de la Cruz et al. 2015 – MTA ADHD outcomes.
    • Jagadeesan et al. 2022 – Parent-reported ASD severity.
    • Orsolini & Ruggerini 2022 – Understanding Intellectual Disability.
    • South & Rodgers 2017 – Anxiety mechanisms in ASD.

Week 2 Recovery Model Framework – Comprehensive Study Notes

  • Historical Context: Biomedical to Recovery Paradigm
    • Biomedical model focused on cause → illness → treatment and elimination of symptoms.
    • Limitations: neglects identity, self-concept, relationships; episodic, long-term nature of mental illness.
    • Emergence of recovery-oriented lens (late 20th – early 21st century) via consumer movements, human rights discourse, WHO advocacy (WHO 2019).
  • Definition of Personal Recovery (WHO 2019)
    • Not about being cured or returning to normal; about gaining or recapturing meaning and purpose in life.
    • Living a self-directed, autonomous life despite ongoing distress.
  • Essential features (WHO paraphrase)
    1) Personal & unique to each individual.
    2) People can and do recover.
    3) Recovery ≠ cure.
    4) Requires collaborative partnerships (consumer + professionals + supports).
    5) Health workers must embrace recovery potential in practice.
    6) No fixed timeframe; journey varies.
    7) Not an intervention done to consumers – it is a shared, lived process.
  • Core Recovery Processes (CHIME model-like)
    • Connectedness (inclusion, belonging, supportive relationships).
    • Hope (optimism about a better future).
    • Identity (re-authoring the self beyond the patient/diagnosis narrative).
    • Meaning in Life (rebuilding purpose, pursuing dreams).
    • Empowerment (control over choices, skills, power balance).
    • Taking Risks (positive risk-taking supports growth and progress).
  • Practical Implications for Mental Health Nursing
    • Collaborative stance; nurse as ally, facilitator, coach – shared decision-making.
    • Partnership over expert-driven care; intervention focus shifts to skill-building, goal-setting, community integration, stigma reduction.
    • Support identity work (narrative therapy, strengths-based assessments).
    • Cultivate hope via role models, peer workers, success stories.
  • Risk and Trauma-informed Practice (risk-enablement)
    • Balance duty of care with patient autonomy; conceptual Risk_{positive} = PotentialGrowth − PotentialHarm.
  • Trauma-informed & Rights-based Practice
    • Aligns with WHO QualityRights; prioritises dignity, freedom from coercion, participation.
  • Benefits from the Consumer Perspective
    • Enhanced quality of life & satisfaction even if symptoms persist.
    • Greater self-efficacy and skill mastery; reduced internalised stigma; stronger social networks.
  • Ethical & Philosophical Dimensions
    • Autonomy vs paternalism; narrative ethics; justice & human rights (UNCRPD).
  • Connections to Foundational Principles
    • Holistic nursing; strengths-based practice; CHIME complements existing recovery frameworks.
  • Evidence-based psychosocial interventions (CBT, IPS, WRAP) operationalise recovery principles.
  • Quick-reference highlights
    • 7 essential recovery features (WHO list).
    • CHIME comprises 5 domains.
    • Mental illness may be episodic (no fixed metric).
    • Lecture context date: 8/07/2025; WHO QualityRights materials released 2019.

Trauma-Informed Care (TIC) – Comprehensive Study Notes (Week 3–4)

  • Definition and purpose
    • TIC = universal lens applied to every person, environment and policy.
    • Trauma Treatment = specialized interventions for selected individuals.
  • Learning objectives
    • Define trauma; describe impacts; outline TIC principles; apply TIC in nursing; recognise and manage vicarious trauma (VT).
  • Epidemiology & Scope (Australia)
    • AIHW 2024: 75% of adults experience at least one traumatic event in lifetime.
    • 11% meet criteria for PTSD.
    • Higher exposure in: homelessness, out-of-home care/youth justice, refugees, survivors of DV, LGBTIQA+, emergency services, armed forces.
  • Neurobiology of Trauma
    • SNS evolution for short-term survival; chronic hyper-arousal impairs daily functioning.
  • Brain Regions Involved (trauma-related alterations)
    • Sensorimotor Cortex: heightened activation → body tension, startle.
    • Thalamus: decreased blood flow → sensory gating problems.
    • Anterior Cingulate (ACC): reduced volume; ↑ resting metabolic activity → impaired emotion modulation.
    • Prefrontal Cortex (PFC): ↓ grey/white matter; blunted responsiveness → poor executive control over emotions.
    • Orbitofrontal Cortex: volumetric reduction → deficits in impulse control & social judgement.
    • Parahippocampal Gyrus: smaller volume, altered connectivity → fragmented memories.
    • Hippocampus: ↑ responsiveness → strong fear cue learning; contextual memory deficits.
    • Amygdala: ↑ responsiveness → hyper-vigilance, exaggerated startle.
    • Overall Fear Circuit: stress sensitivity, fear generalisation, impaired extinction learning.
  • Causes / Types of Traumatic Events (non-exhaustive)
    • Physical, sexual, or psychological abuse; bullying; domestic violence; accidents; crime victimization; severe neglect.
    • Military combat; life-threatening illness; severe hardship; natural disasters; bereavement.
  • Shared Elements Across Traumatic Experiences
    • Event is unexpected; person feels unprepared; person feels powerless.
  • Uniqueness of Trauma Responses
    • Trauma arises from subjective experience; outcomes vary despite identical events.
    • Do not stereotype based on diagnosis or demographics.
  • Common Signs & Symptoms of Trauma
    • Affective: anger, irritability, anxiety, panic attacks.
    • Cognitive: flashbacks, nightmares, intrusive memories, decision-making difficulty, concentration problems.
    • Physiological: hyper-arousal, sleep disturbances, somatic complaints (implied by SNS hyperactivity).
  • Principle Frameworks for TIC
    • Phoenix Australia – 6 Principles: Safety, Connection, Strengths, Control, Belief in Recovery, etc.
    • Blue Knot Foundation – 6 Principles: Safety, Trust, Choice, Collaboration, Empowerment, Diversity.
    • Mental Health Coordinating Council (MHCC, 2013) – 8 Principles: Understanding trauma, safety, cultural competence, consumer control, shared governance, care integration, healing in relationships, recovery is possible.
  • Synthesis & Cross-Links
    • Overarching themes: Safety, Trust, Choice, Collaboration, Empowerment, Cultural awareness, Relational healing, Hope.
    • Nurses to integrate consistent concepts across services.
  • Trauma-Informed Nursing Practice (TICP‑N)
    • What happened to you? → What’s happened to you?
  • Key Nursing Behaviours
    • Recognise trauma prevalence; screen for signs; avoid re-traumatisation; establish safety; demonstrate trustworthiness; share decision timelines; empower patients; consider cultural, historical & gender factors; practitioner self-management.
    • Day-to-day skills: patience, acceptance, non-judgement, limit-setting, grounding & coping skills.
  • Vicarious Trauma (VT)
    • Definition: Indirect trauma from listening to others’ traumatic narratives.
    • Mechanism: Mirror-neuron activation, empathic strain, cumulative exposure.
    • Signs: PTSD-like symptoms (intrusive imagery, emotional numbing, cynicism).
    • Prevention & Management: self-care; supervision; reflective practice; debriefing; mindfulness; work–life boundaries; rotate high-exposure roles; EAP/counselling; manager discussion; possible leave; ongoing self-care.
  • Ethical, Philosophical & Practical Considerations
    • Do no further harm; TIC counters coercive practices; power dynamics; equity & diversity; universal precautions; workforce wellbeing.
  • Numerical/Statistical References (LaTeX-formatted)
    • Lifetime trauma prevalence: 75\%; PTSD prevalence: 11\%.
  • Connections to Earlier Coursework & Real-World Practice
    • TIC links to neurobiology (limbic system, stress pathways, HPA axis).
    • TIC aligns with least-restrictive principles in mental health law.

CALD and First Nations – Cultural Diversity in Mental Health (Week 4)

  • Objectives
    • Understand concept of culture; intersection between culture and mental illness; implications for mental health nursing in Australia.
  • Australia’s Cultural Diversity – Key Data Points
    • Australia hosts one of the world’s oldest continuous cultures.
    • Approximately 20% speak a language other than English at home.
    • Overseas migration contributes ~60% of population growth; about 50% born overseas; ~25% have overseas-born parent.
    • Top migrant origins: China, India, Vietnam (plus UK, NZ implied).
    • 86% of Australians support action against racism.
    • Migrants contribute over $10 billion to Australia’s economy in their first 10 years of settlement.
    • 2014 AHRC data (Face the Facts) cited for anti-racism context; 2021 Census highlights.
  • 2021 Census Highlights (Key Points)
    • Aboriginal and/or Torres Strait Islander population: ~812,728 (≈3.8% of total).
    • CALD Australians: ~48.2% of population.
    • Refugees: ~180,788.
    • Total population ~25,000,000.
  • Migration, Language & CALD Statistics (Slide References)
    • Born overseas: 0.29 (29%).
    • Australians with at least one overseas-born parent: 0.48 (48%).
    • Language diversity: 250 languages; 800 dialects.
  • First Nations – Distribution & Living Context (Page 12–16)
    • Estimated Aboriginal/ Torres Strait Islander population: ~984,000 (~3.8%);
    • State distribution: NSW ~339,500; QLD ~273,200; WA ~120,000; VIC ~78,600; NT ~76,700; SA ~52,000; ACT ~9,500; TAS ~33,800.
    • Geographic distribution: 38% in major cities; 44% inner/outer regional; 17% remote/very remote.
    • Under-counting concerns in census; actual numbers may be higher.
  • First Nations Culture – Core Features
    • Yarning, storytelling, song as knowledge-sharing methods.
    • Strong land connections; belonging to land.
    • Connection to spiritual ancestors and the land shapes identity and community.
    • Kinship networks and family ties are central.
  • Social-Emotional Wellbeing Framework – Framework & Components
    • 8 components: connection to spirit, body, country, mind/emotions, culture, community, family/kinship, historical determinants.
  • Cultural Healing
    • Cultural healers use natural environment, Spirit world, plants; guidance on attitudes and faith in spiritual connections.
  • Cultural Safety – Principles & Practice
    • Power dynamics; culturally appropriate healthcare; trust-building; safe space; inclusion of social and emotional wellbeing.
  • Cultural Competence & Humility
    • Culture is an ongoing learning process; be open to learning; do not rely on consumer to educate about culture.
    • Practical approaches: use interpreters; involve family/community; facilitate cultural practices; provide diet-appropriate options.
  • Practical Implications
    • Co-design, interpreters, family- and community-centered approaches; trauma-informed care.
    • Emphasise culturally safe and gender-sensitive practice.
  • Cross-Links and Synthesis
    • Culture as a determinant of mental illness expression, diagnosis, and treatment.
    • CALD barriers: language, stigma, explanatory models; unique protective cultural responses.
    • First Nations perspectives emphasize holistic wellbeing and connection to land/culture; integrate into care.
  • Quick-Reference Data (Summary)
    • CALD share: ~0.482; Aboriginal/Indigenous share: ~0.038–0.008 (context-dependent in slides); Indigenous total ~984,000.
    • Major city share of First Nations population: ~0.38; inner/outer regional: ~0.44; remote: ~0.17.
    • Overseas-born share: ~0.29; parent-born-overseas: ~0.48; languages: 250 languages; 800 dialects.

Victorian Mental Health Legislation – Mental Health and Wellbeing Act 2022 (MHWA 2022) – Comprehensive Study Notes

  • Purpose & Objectives
    • Provides legislative framework for: assessment of persons with mental illness; treatment; initiation of compulsory treatment orders; establishment of Mental Health Tribunal.
    • Objectives: protect rights; enable support persons to participate; recognise carers; promote voluntary treatment; minimise compulsory treatment; ensure least-restrictive treatment.
  • Principles (Section 15)
    • Dignity and Autonomy; Diversity of Care; Least Restrictive; Supported Decision Making; Family & Carer involvement; Lived experience; Health Needs; Dignity of Risk; Wellbeing of Young People; Diversity Principle; Gender Safety; Cultural Safety; Wellbeing of Dependents.
  • What does NOT constitute a mental illness
    • Political, religious, philosophical beliefs; sexual orientation; engagement in political activity; sexual behaviour patterns; behaviour contrary to community standards; antisocial behaviour; intellectual disability; substance use; socio-economic status; racialized group membership; family conflict; psychological distress; prior diagnosis or treatment.
  • Assessment Orders (Chapter 4; Section 142)
    • Criteria: appears to have mental illness; immediate treatment needed to prevent deterioration or harm; assessability under order; no less restrictive means available.
    • Community vs Inpatient Assessment Orders.
  • Admission Process – Assessment Orders
    • Options: Community Assessment Order; Inpatient Assessment Order.
    • Enforcement by Psychiatrist; determines if criteria are met.
    • Post-assessment outcomes: discharge if criteria not met; order extended; or transition to Temporary Treatment Order (TTO).
  • MHWA 101 Assessment Order Form – Key Details
    • Local identifiers: Local Patient Identifier; Family name; Given names; Date of birth; Sex; Gender; UR number.
    • Completion: by Registered Medical Practitioner or Authorised Mental Health Practitioner; within 24 hours after examination.
    • Contents: Sections 1–9; assessment criteria (section 142); decisions; indicate community vs inpatient setting; designated service; date/time; duration.
    • Duration: Community Order = 24 hours; Inpatient Order = earlier of 24 hours after receipt at service or 72 hours after order is made (unless extended).
    • Signatures: practitioner; name, designation, address, phone.
    • Footer: MHWA 101 form identifiers.
  • Admission Process – Treatment Orders (CTO/ITO)
    • CTO = Community Treatment Order; ITO = Inpatient Treatment Order.
    • CTO/ITO specifics must state duration and setting.
  • Temporary Treatment Orders (TTOs) – Chapter 4
    • Issued by Authorised Psychiatrist; consider patient views, Advance Statements, nominated person; consent and least restrictive criteria required.
    • Enabling treatment in community or designated service; must be examined and criteria must apply.
    • Mental Health Tribunal to conduct a hearing within 28\ ext{days}.
  • Tribunal – Beyond (Chapter 4)
    • Functions: discharge; confirm continued CTO/ITO; transport decisions for assessment or treatment; ECT applications; security patient applications.
    • Tribunal to declare whether CTO or ITO, and duration.
  • Rights and Advance Statements (Chapter 2)
    • Statement of Rights must be provided and explained to patient, support persons, guardian, carer, or parent.
    • Advance Statement of Preferences sets preferences for treatment, care, information sharing; nominate support person and contact details for information in event of illness.
  • Nominated Person (Chapter 2)
    • Role: advocate for patient’s views; assist decision-making; obtain and relay information; support patient to exercise rights.
    • Appointment by written instrument; acceptance by nominated person; revocation as needed; cannot make decisions on behalf of patient.
  • Capacity and Consent (Chapter 3)
    • Presumption of capacity; informed consent required before treatment; exceptions if lacking capacity.
    • Criteria for informed consent: capacity; adequate information; reasonable opportunity to decide; consent freely given; no withdrawal.
    • Capacity criteria: understand; remember; weigh; communicate.
  • Crisis Response (Chapter 5)
    • Leadership by a health professional where possible; least restrictive approach; involve an Authorized Person (police, protective services officer, or prescribed person).
    • Powers during crisis: can take person into care and control to prevent imminent harm; clinical judgment not required for determining illness.
    • Aftercare: arrange prompt examination.
  • Mental Health Tribunal – Chapter 7
    • Functions: hear/determine Treatment Orders; revoke Temporary Treatment Orders; transfer patients; ECT approvals; security patients.
  • Ethical, Practical Considerations & Relevance
    • Balance autonomy with safety; least restrictive approaches; involve family and nominated persons.
    • Practice implications: apply Section 142 criteria; complete MHWA 101 forms accurately; manage community vs inpatient pathways; clarify roles for Nominated Persons and Advance Statements; understand tribunal timelines and outcomes.
  • Quick Reference – Key Durations & Dates (LaTeX)
    • Community Assessment Order duration: 24\ ext{hours}.
    • Inpatient Assessment Order: earliest of 24\ ext{hours} after receipt or 72\ ext{hours} after order.
    • Tribunal hearing timeframe for TTO: 28\ ext{days}.

NMBA Registered Nurse Standards – Overview and Key Points

  • Objectives
    • Understand codes/standards/policies governing nursing practice: NMBA Standards of Practice, NMBA Code of Conduct, Australian College of Mental Health Nurses – Standards of Practice, and organisational policies.
  • Core themes across standards
    • Critical thinking; evidence-informed decision making; reflection; recognition of cultural diversity; ethical practice; accurate documentation; quality improvement; person-centred care.
  • Emphasis areas
    • Professional boundaries; respectful relationships; autonomy; advocacy; accountability.
  • NMBA Registered Nurse Standards (Australia) – Standards 1–6 (as described in transcript)
    • Standard 1: Engages in therapeutic and professional relationships
    • Establishes, sustains & concludes relationships with boundaries.
    • Effective communication; respect for culture, beliefs, dignity, values.
    • Recognises patients as experts in their lived experience.
    • Advocates for autonomy and capacity; uses delegation and referrals to achieve health outcomes.
    • Standard 2: Maintains the capacity for practice
    • Responds to health and wellbeing of self and others in relation to capacity for practice.
    • Provides information/education to enhance patient control; lifelong learning; accountability for decisions and delegated actions; practice reviews and feedback; engage with the profession.
    • Standard 3: Comprehensively conducts assessments
    • Holistic and culturally appropriate assessments; use diverse data sources; partner with patients to determine priorities; assess resources available for planning.
    • Standard 4: Develops a plan for nursing practice
    • Use data and evidence to develop care plans; collaboratively construct plans; document, evaluate, modify outcomes; plan evaluation; coordinate resources.
    • Standard 5: Provides safe, appropriate and responsive quality nursing practice
    • Practice within scope; delegate as appropriate; provide direction/supervision for delegated practice; follow policies and legislation; identify risks and address below-standard practice.
    • Standard 6: Evaluates outcomes to inform nursing practice
    • Monitor progress; revise care plans; communicate future priorities/outcomes.
  • Standards 7–9 (not fully described in transcript)
    • Acknowledged as not detailed in the provided material.
  • NMBA Code of Conduct – Core areas
    • Legal and professional framework: legal compliance, obligations, lawful behaviour, mandatory reporting, person-centred care, informed consent, adverse events open disclosure.
    • Cultural practice and respectful relationships: culturally safe practice, effective communication, non-bullying, confidentiality, end-of-life care, professional boundaries, advertising/representations.
  • Australian College of Mental Health Nurses – Standards of Practice (9 Standards)
    • Standard 1: Acknowledge diversity; nondiscriminatory practice; promote dignity and self-determination.
    • Standard 2: Establish collaborative partnerships to support patient participation.
    • Standard 3: Develop therapeutic relationships that respect patient choices and resilience.
    • Standard 4: Collaboratively plan and provide ethically based care across mental, physical, spiritual, emotional, social, and cultural needs.
    • Standard 5: Value contributions of other agencies; holistic, evidence-based care; ensure comprehensive service provision.
    • Standard 6: Actively pursue reducing stigma and promoting social inclusion.
    • Standard 7: Demonstrate evidence-based practice; promote practice innovation via lifelong learning, supervision, research, etc.
    • Standard 8: Practice aligns with common law, statutes, and professional ethics; integrate policies with standards.
    • Standard 9: Hold specialist qualifications; demonstrate advanced knowledge and leadership in practice.
  • Cross-cutting themes across NMBA & ACNM standards
    • Person-centred care, autonomy, cultural safety, ethical decision-making, collaboration, lifelong learning, evidence-based practice, and risk management.
  • Practice implications
    • Understand and apply boundaries in therapeutic relationships.
    • Use resources/referral mechanisms; document thoroughly; maintain confidentiality.
    • Engage in ongoing professional development and practice reviews.
  • Real-world relevance
    • Aligns with legal and statutory requirements; supports interprofessional collaboration and holistic care.
  • Notes on content gaps
    • Standards 7–9 for RN and some sections of the ACNM Standards are not fully described in the transcript; consult full documents for complete detail.

Quick Recap for Exam Preparation – Key Points to Remember (Synthesis)

  • Distinguish clearly between the Medical Model and the Biopsychosocial Model; understand the three domains and their interactions.
  • Be able to generate a 4-P formulation (Predisposing, Precipitating, Perpetuating, Protective) for case vignettes.
  • Recall prototypical biopsychosocial factors for suicidal crises and schizophrenia (biological vulnerabilities, cognitive distortions, social adversity).
  • Articulate how culture, social history, and personal experiences influence diagnosis, treatment engagement and outcomes.
  • Emphasise ethical imperatives: empathy, patient autonomy, and holistic, person-centred care.
  • For Dual Disability, know the three-part model, common associated conditions (ID, ASD, mood/anxiety/psychosis), and integrated assessment/treatment approaches.
  • Understand Recovery CHIME framework and its practical implications for nursing practice and patient empowerment.
  • Trauma-Informed Care: universal application, key neurobiological implications, strategies to reduce triggering and re-traumatization, and VT prevention.
  • CALD and First Nations content: culture as a central determinant; importance of language access, interpreters, yarning approaches, and culturally safe/humane care.
  • MHWA 2022 (Victoria): structure of assessment orders, CTO/ITO/TTO, tribunal processes, patient rights, advance statements, nominated persons, capacity & consent, crisis response, and ethical governance.
  • NMBA and ACNM standards: core expectations for professional practice, with emphasis on autonomy, culture, evidence-based care, and interprofessional collaboration; know where to find 7–9 (RN) and 6–9 (ACNM) if needed from full documents.

If you want, I can convert this into a PDF-ready outline with page-break cues and a printable version, or tailor it to a specific course outline or exam style (e.g., short-answer prompts, case vignettes, or multiple-choice practice questions).