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INSIDE THIS ISSUE:

11 June 2012 - ISSUE 11Visit us online for the latest jobs and articles

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NAHRLS (Inside Cover) ............................................00

Quick N Easy Finance .............................................01

News: Mental Health Funding Freeze ......................03

Medacs Healthcare .......................... ......................04

CQ Nurse.......................... ......................................05

Article: Needle Free Injections! ................................06

Hays Recruitment ...................................................07

FEATURE: Mental Health Nursing .............................08

Article: Mentally Ill Draining Police Resources .........09

Article: Mental Ilness - An Overview ........................10, 11

RNS Nursing ...........................................................11

Continental Travel Nurse .........................................12

Mediserve Nursing Agency .....................................14, 21, 37

McGrath Foundation ...............................................15

Articel: The Dangers of Psychiatric Nursing .............16, 17

CONTENTSThe Jake Howe Fundraiser .....................................18

Health Staff Recruitment .........................................19

Pulse International ..................................................20

WA Department of Health ........................................21

Article: Why Call Someone Mentally Ill .....................22

Educational Courses,Conferences & Events .............26, 27

Ausmed Article: Skin Cancer Rate Rising .................28, 29

Conference: Chronic Mental Illness .........................30

Oceania University of Medicine ...............................31

Crossword ..............................................................32, 33

Book Review: Community Mental Health .................34

Conference: Clinical Nursing ...................................35

Healthy Recipe: Crispy Skinned Lemon Chicken ......36

Crossword Answers.................................................36

St John Ambulance .................................................BC

From the Editor...

Inside this Issue Next Issue Mental Health Nursing Paediatrics / Child Health Nursing

ABN: 28 105 044 282 | PO BOX 6213, East Perth, WA, 6892Ph: +(618) 9325 3917 | Fax: +(618) 9325 4037E: admin@nursingpost.com.au | W: www.nursingpost.com.au

Next Publication Details: Issue 12: 25 June 2012 Material Deadline: 18 June 2012

Editor: Ciaran O’Neill

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Hello readers and welcome to Issue 11 of The Nursing Post.

Our feature inside looks at mental health nursing. Turn to page 8 to find all stories mental health related.

On page 9 we look at how police time is often taken up arresting people who need medical intervention, rather than judicial intervention.

The job of a psychiatric nurse can be challenging, turn to page 16 to read about some of the dangers associated with psychiatric nursing.

We also encourage our readers in Perth to attend a fundraiser for Jake Howe on the 14th of July. Details for this worthwhile event are on page 18.

Our next issue is out on June 25th and we look at child health nursing.

This is my last edition as Editor of The Nursing Post as i am travelling around Australia. Keep an eye out for my travel blog in the near future. Untill we meet again stay classy readers!

Welcome to Issue 11

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After a funding freeze on a program bringing nurses to the mentally ill, mental health practitioners and administrators are growing increasingly angry.By placing mental health nurses in GP clinics, The Mental Health Nurse Incentive Program aims to fill service gaps.

Five years ago, the program was established with the aim to provide further assessment and referral for people with mental illness who are at risk of falling through the gaps.

The uptake has been massive, according to local practitioners.

Brett McKinnon, the leading Psychiatric Nurse at Mildura’s Tristar Clinic says:

“The uptake of our service has been enormous”, “We have scope to extend - and that’s where this funding freeze has become a real dilemma for us; you know there’s lots of people requiring the service.”

Kim Ryan, Chief Executive of the Australian College of Mental Health Nurses has expressed his concern over the Federal Government’s decision to freeze funding for the program, saying the program has brought more services to country areas.

The leading mental health administrator believes that cuts to the sector will threaten the recruitment of staff and the provision of services to clients.

“We know that there are a number of nurses that work in this program that are located in regional and rural areas of Australia, and so I think potentially it does, because the message it gives to people is a level of uncertainty about the future of the program, whether they continue to work in the program.”

Rashall Ryan, a mental health nurse based in Swan Hill, which already struggles to cater for the mental health needs of its community says the freeze will leave many patients without a service.“It will sort of be a one in, one out type thing, which really isn’t going to work. If there’s 15-20 people who are new patients that I haven’t seen before, then I have to go back and find 15-20 people who no longer need service and close their files,” she says.

“It’s such a growing area, that we won’t be able to keep it going at the rate that it’s going at the moment.”

Mark Butler, Minister for Mental Health, has been contacted for a response.

Workers Left In The Dark Over Mental Health Freeze

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Drugs can be shot through the skin using this magnetic jet injection device, no needle required.

A high-velocity jet of liquid is delivered by this device which breaches the skin at the speed of sound.

Future injections could be far less painful if the new gadget, developed at MIT, is a success. At the speed of sound, a jet of medicine is fired through your skin rather than the traditional sterile metal point penetrating your skin to deliver the medicine.

The device is similar to a normal syringe, the difference is it uses a Lorentz force actuator instead of a needle plunger. A Lorentz force actuator is made from a magnet surrounded by a conductive coil. The magnetic field interacts with the current to produce a force when the current is turned on. That force kicks a piston, this ejects the drug that has been embedded inside the capsule. By altering the current, the speed of the ejection and the depth it will reach can be controlled

The injection happens at an ultra-high speed, almost equal to the speed of sound, a high speed is important in order for the medicine to penetrate the skin. According to MIT News, The drug flows through an opening that’s about as wide as a mosquito proboscis.

A prototype device was tested at two velocities by researchers led by Ian Hunter and Catherine Hogan. One velocity can breach the skin and reach deep

into tissue, and another can deliver drugs slower, so they can be absorbed by the skin. Different piston velocities would be needed for different people - “If I’m breaching a baby’s skin to deliver vaccine, I won’t need as much pressure as I would need to breach my skin,” Hogan said.

Other existing types of jet injectors are limited by their design, this is key for this device. Other jet injectors use a spring-loaded injector, which can only work at one velocity.

Although the supersonic variable-speed delivery is new; it is not the first device to seek elimination of the hated hypodermic needle. There already many alternatives in existence, such as super-thin microneedles, as wide as a human hair, and a microneedle patch, which deliver drugs with no pain and simply dissolve on the skin. However, those would require a drug-specific design.

Many people have a fear of needles, for these trypanophobes, the prospect of sticking oneself with a needle is a nightmare, so a more universal system like this could improve patient compliance with the doctor’s orders.

The researchers have also pointed out that it could prevent needle-stick injuries by health care workers and others. According to the US Centre for Disease Control and Prevention, workers in US hospitals accidentally prick themselves 385,000 times per year. This problem would be an issue of the past if a jet injector was introduced.

Needle-Free Injections!

6

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Mental HealthNursing

Mentally Ill Draining Police Time.............................................................

Mental Illness - An Overview...................................................................

The Dangers of Psychiatric Nursing........................................................

Why Call A Person Mentally Ill If They Are Happy?................................

// INSIDE THIS FEATURE9

10, 11

16, 17

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Police time is being taken up with arresting mentally ill people who usually need medical rather than judicial intervention, a new study shows.

According to Professor James Ogloff of Monash University, most police members come into contact with about three to four mentally ill people a week.

Professor Ogloff’s has based his research around the information from the Victoria Police Mental Health Transfer Forms which were completed between December 2009 and November 2010.

The research has shown that on average, it takes eight times longer to deal with this type of transfer, two hours for the majority of cases.

Of all the mentally ill people arrested, just 11 per cent of these people are charged with a criminal offence.

According to Troy Hargadon, Bendigo Police Acting Senior Sergeant, local police deal with people suffering from a mental illness on a regular basis and in a variety of circumstances.

“It is accepted that this is part of our day-to-day policing duties,” he said.

The vast majority of police contact with disturbed people occurred because the person had attempted suicide or engaged in self-harming behaviour,

Mentally Ill Draining Police Resourcesaccording to Professor Ogloff’s research.

Due to aggression and property damage, most of the incidents required a police response. In most cases, family members contacted the police for assistance.

“Importantly, police are engaging these people when they are in crisis with limited or no forewarning of the person they will encounter and limited support, a context that represents a highly challenging scenario,” the report read.

The research suggests that police officers need more training to address these issues, as well as better communication between the police and mental health services.

Acting Senior Sergeant Hargadon said that responding to incidents involving people suffering from mental illness is part of internal police training.“Bendigo Police have a good working relationship with a number of local stakeholders including, but not limited to, Ambulance Victoria, Crisis Assessment Teams, Bendigo Health and the Alexander Bayne Centre,” he said.

“In accordance with policy aligned to the Mental Health Act we all strive to ensure every effort is made to afford assistance to such persons and their families within our community and engage them with appropriate support services.”

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If your heart breaks down, it’s usually (relatively) easy to isolate what’s wrong. When you fall over and break a leg, you know the bone has snapped or cracked in a particular place. But when a glitch appears in your brain, the infinite range of errors occurring within the complicated network of neurons is simply unfathomable.

Feelings of anxiety, confusion, fear, forgetfulness and happiness are natural reactions to the world unfolding around us. They are, in a sense, a part of being human and usually instinctual. But when adverse thoughts, behaviour and emotions become a recurrent problem, it may actually be the result of mental illness. According to the World Health Organization (WHO), about 450 million people worldwide are affected by mental, neurological or behavioural problems at any time.

Determining that someone has a mental illness, and in fact which of the 400 disorders listed in the “psychiatrists’ bible” or Diagnostic and Statistical Manual of Mental Disorders it might be, is sometimes problematic. Finding a suitable treatment path can be just as tricky.

Mental Illness: An OverviewDiversity of disorders

• Depression - characterised by a wide-ranging low mood matched by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities. It often affects a person’s family, work or school life, sleeping and eating habits, and general health. Its impact on functioning and well-being has been equated to that of chronic medical conditions such as diabetes. Dissociative disorders bring about sudden changes in consciousness and ones concept of self.

• Personality disorders – Characterised by difficulties in cognition, emotiveness, interpersonal functioning and control of impulses. In general, personality disorders are diagnosed in 40-60 per cent of psychiatric patients.

• Anxiety disorders - Characterised by feelings of stress due to environmental cues for no obvious reason. Each has its own characteristics and symptoms and requires

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different treatment. Anxiety disorders are divided into:

• Generalised anxiety disorder - excessive, uncontrollable and often irrational worry about ordinary things, unequal to the actual cause of worry.

• Phobic disorder - a persistent fear of an object or situation in which the sufferer commits to great lengths in avoiding.

• Panic disorder - recurring severe panic attacks have a sudden or out-of-blue cause that’s short lived with very intense symptoms.

Treatment of mental illness can take on a variety of forms. Psychotherapy encourages the patient to recognise and understand their problems so as to develop coping strategies in order to overcome their problems.

Medications are also available to help treat more severe symptoms. Mood stabalisers aim to moderate manic episodes of bipolar disorder for instance. Antipsychotics aim to reduce the surreal symptoms of schizophrenia. Antidepressants can slow the removal of serotonin (a neurotransmitter) in ones brain, thus making it more available. The use of medications is frequently offered as a partial solution. Their effectiveness can however, be controversial. Especially when prescribed to children, or when used for long-term treatment, where non-pharmaceutical avenues may exist.

Other treatments sought by people afflicted by mental illness include personal development and self-hep courses, religion and even virtual reality to overcome post traumatic stress disorder and also certain phobias.

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The McGrath Foundation raises money to place McGrath Breast Care Nurses in communities right across Australia and to increase breast awareness in young women.

With 74 McGrath Breast Care Nurses having helped support more than 12,000 Australian families through a breast cancer experience, the McGrath Foundation will continue to work tirelessly towards fulfilling Jane McGrath’s dream of a breast care nurse to support every Australian family experiencing breast cancer.

“I feel honoured and privileged to be given the opportunity to care for and support families experiencing breast cancer as a McGrath Breast Care Nurse. I want to treat the person experiencing breast cancer, their families and carers with respect and compassion and to provide the highest standard of care, knowing that, together we can make a difference.” Catherine Brophy, McGrath Breast Care Nurse, Grafton.

Please help the McGrath Foundation support Australian women and their families.

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74 AND COUNTING …

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Violence and injuries on inpatient psychiatric units towards staff and patients are well documented as significant problems. As psychiatric nurses when we come into the building to work with aggressive patients we have 5-6 locked doors to get to our work area. When we step into the door we rarely know in advance what is on the other side.

On a acute psychiatric unit the clients range from rapist murders, schizophrenia, Bi-polar, depression, impulse control issues, addictions, personality disorders, Psychotic disorders.

In a 13 hour shift – nurses on a psychiatric unit can go from calm, quiet and everyone having good conversation. To an explosive situation in a matter of minutes.

A few years a go when the administration was ask why was our hospital not classified as a hazard duty pay. He claims because we are an “acute” hospital. The week before he was ask this question one of the “acute” nurses was removed from the hospital on a stretcher and placed in ICU with head injuries because a violent patient beat her until she was

unconscious. This is not counting the broken arms we have had, the multi scratches, black eyes and ruined clothes that staff have experienced.

Psychiatric nursing is not always dangerous but it is always unpredictable.It takes a special breed of nurse to do psychiatric nursing.

In psych nursing, things are not black and white. You have to be able to tolerate ambiguity, be calm in the midst of chaos and, at times, be in situations that can become violent.

Psych nurses treat patients who are delusional, angry, manic, depressed, have attempted suicide, are out of control due to substance abuse, or are suffering from eating disorders and everyone from children to elders. They work everywhere from dedicated psychiatric hospitals to inpatient/outpatient units at,clinics and in private general hospitals practice if they are certified to prescribe medications.

I think a lot of people don’t really understand what

The Dangers of Psychiatric Nursing

16

psychiatric nurses do.They work with patients who are often at their worst and most vulnerable, when their mental illnesses are acute. They have to treat patients with dignity and rationality even though patients may be out of control.

Those who choose psych nursing have deep personal feelings for why they choose this field.I personally enjoy hearing the stories of their lives. How did they get in the situation they are now in and what they were like when they were younger.

Psych nursing requires a wide range of skills from the practical to the creative. Nurses in the field say that those who do well in it are caring and compassionate but are also assertive. They have a strong sense of themselves but enjoying reaching out to others.

To be a good psychiatric nurse, you need three things,

1)You must be able to listen.2)You must be nonjudgmental.3)You must be decisive.

Psych nursing calls for expert assessing skills.Nurses must observe patients closely, and document even the slightest changes in behavior, facial expressions, hand movements, tones of voice to determine patients’ condition and progress.

To reach patients, psych nurses will sit with them over a meal, over a game or an art project even sit up with them all night if they’re under a suicide watch or suffer acute anxiety. If one nurse makes progress establishing good rapport with a particular patient, that nurse will often be assigned to the patient daily on their shift. Psych nurses also administer medications and talk with patients about dealing with often unpleasant side effects. They must persuade patients that the discomfort is something they must tolerate in order to get better.

Psych nurses also have to be tough-skinned, as patients will blame them for medication side

effects and, worse,hurl insults at them, make racial or ethnic slurs and ask highly personal questions that violate nurse/patient boundaries.

You can’t take cruel remarks or anger directed at you as personal afronts. That can be hard to do sometimes. But you have to accept that it’s the patients’ illnessesthat trigger this kind of behavior.

If patients are too intrusive or otherwise causing problems with others on a unit, psych nurses have to restrict them to their rooms or even put them in “quiet” rooms to keep them from harming themselves or others.The potential for violence is the most difficult part of the job,for psych nurses. Patients who are acting up have tobe physically restrained.

It can get very scary, And that’s where having a team of nurses, attendants and patient assistance can be critical for your own safety. The work can beemotionally and physically draining.

You need to be able to find a place of peace within yourself, After working with with psych nurses for over 20 years who you work with helps you deal with some of the difficult experiences. It creates a strong bond between us. As a team and as protection for each other. Working as a team in this environment has to be a strong link.

More people understand that mental illness stems from biological malfunctions in the brain, nurses working with people with psychiatric problems fight perceptions that there must be something wrong with them to want to do this kind of work. There’s still a stigma attached to doing this kind of nursing in the medical profession,although it is getting better.

Very special nurses work under these conditions. I have the honor of being elbow to elbow with some of the finest staff under some of the most dangerous conditions. It takes a team like the one we have to give the best care – and the best family working unit.

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21

I’ve always been curious about the classification of mental ‘illness’. It makes sense to call someone mentally ill if their condition could drive them to commit murder or cause other types of harm, but what about people with mental conditions where the individual is happy, maybe even happier than most people who do not suffer from a mental condition?

There are many abnormal personality traits and behaviours; however a person with these traits or behaviours is not typically labelled as “mentally ill”. An example of this is an individual whose behaviour is affected because he or she suffers from some of the typical obsessive compulsive symptoms. The symptoms could cause distress for an individual and his/her “obsessive-compulsive” behaviour could get on the nerves of friends/colleagues. How do we distinguish between someone with abnormal personality traits and behaviours, and someone who is mentally ill?

After researching mental conditions I came to the conclusion that an individual is often labelled “mentally ill” if their condition affects their thinking or behaviour to the point that their life is impaired as a result. The existence of a “mental illness” would conflict with important activities in life such as work, interacting with others, romance and daily routines etc. To sum it up, individuals have many abnormal personalities and behaviours; however, if these cause a high level of emotional distress, impairment or disability, then they may be considered mentally ill.

The behaviour of an individual which may be caused as a result of obsessive compulsive

symptoms will vary from case to case. Many people who say they have obsessive compulsive symptoms are highly organised or perfectionists. This could irritate co-workers and friends; however this is not a mental disorder and could actually be helpful in many ways, especially in careers which demand a high attention to detail. Irritating co-workers is not a disorder, in fact many people do it for entertainment; this does not mean they are ‘mentally ill’! Although some OC symptoms may be helpful in a career in art or accountancy, they could impair the abilities of someone pursuing a career in the emergency services for example.

To classify someone as “mentally ill”; we must look at the severity of impairment suffered by the individual. Having a number of abnormal personality traits and behaviours does not make an individual mentally ill; however it may be considered a personality disorder. If these abnormalities such obsessive-compulsive symptoms cause major distress or impairment; then the diagnosis becomes obsessive compulsive disorder, which is more severe and requires treatment.

In conclusion, a mental illness is based on the severity of distress and impairment caused by the symptoms. A variety of abnormal personality traits and behaviours are not necessarily mental disorders if they do not cause distress for the individual and do not severely impair the individual’s abilities.

Loving Life: Adam Goddard

Why Call a Person

‘Mentally ill’ If They

Are Happy?

22

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Educational Courses, Conferences & Events

Ausmed Education: Skin Cancer Rates Rising.............................

Conference: Caring For People With Chronic Mental Illness........

Oceania University of Medicine....................................................

Crossword Puzzle.........................................................................

Book Review : Community Mental Health....................................

Conference: Clinical Nursing........................................................

Healthy Recipe: Lime & Sweet Chilli Fish Parcels........................

Crossword Answers......................................................................

// CONTENTS28, 29

30

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32, 33

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3626

JBI National Australian ConferenceEvidence-based Clinical Leadership13, 14 August 2012, Adelaidewww.joannabriggs.edu.au

7th International Nurse PractitionerAdvanced Practice Nursing Network Conference20-22 August 2012, London, UKwww.rcn.org.uk/newsevents

Australian and New Zealand Childrens Haematology/Oncology Group (ANZCHOG)Annual Scientific Meeting 201224-26 August 2012, Surfer’s Paradisewww.anzchog2012.org

4th Congress of the Wound Union of Wound Healing SocietiesBetter care - Better lifeWound Union of Wound Healing Societies2-6 September 2012, Yokohama, Japanwww.wuwhs2012.com

Australian College of Nurse Practitioners ConferenceClosing the gaps and clearing the barriers5-8 September 2012, Outrigger Hotel, Surfers Paradise, Qld.www.dcconferences.com.au/acnp2012/

ACNN 20127th Annual ConferenceGravens Seminar on the Physical and Developmental Environment of the High Risk Infant7 - 8 September 2012CROWNE PLAZA HOTEL, LOVEDALE, HUNTER VALLEY, NEW SOUTH WALES, AUSTRALIAwww.acnn.org.au

AusmedTrauma NursingSeminar For Nurses13-14 September 2012, Sydney, NSWwww.Ausmed.com.au

National Association of Childbirth Educators’ Biennial ConferenceGeneration Now - the fears, the fantasy and finding the balanceNational Association of Childbirth Educators16-18 October 2012, Luna Park, Sydneywww.nace.org.au

16th South Pacific Nurses Forum 2012South Pacific Nurses Forum19-22 November 2012, Melbourne, Leonda by the Yarra.www.spnf.org.au

// Events + Conferences 2012

27

According to research from the Mayo Clinic published in Mayo Clinic Proceedings (April, 2012), skin cancer rates are continuing to rise, despite the fact that rates of other cancers are falling. Indoor tanning beds are one possible cause, according to the lead researcher, and young women are especially vulnerable.

The increase in the rates of skin cancer were not the surprise- what surprised the researchers was that the numbers were even higher than anticipated, surpassing numbers reported by the National Cancer Institute, particularly in young women in the prime of their life. The researchers examined the numbers of newly diagnosed skin cancer patients in Olmstead County, Minnesota over almost 40 years and discovered that the incidence of skin cancer has risen eightfold among young women and fourfold for young men (aged 18 to 39). In regards to melanoma, the lifetime risk is higher for males, but the opposite occurs in adolescents and young adults, according to the researchers.

Skin Cancer Rates RisingOn the positive side, mortality rates have improved, probably as a result of increased awareness, early detection and improved medical care. Cases of skin cancer are being detected earlier, before they advance to a deep melanoma which is more difficult to treat (and thus more deadly).

What is melanoma?

Melanoma is a type of skin cancer that develops from melanocytes, specialised cells in the skin that are responsible for pigmentation (colour) of the skin. It is the most serious form of skin cancer due to its ability to become invasive and spread to other areas of the body.

What are the signs of melanoma?

The ABCDs can be used to identify possible melanoma (the term lesion simply refers to an abnormal area of skin, which may be an innocuous mole or a cancer):

• Asymmetry- one section/half of a lesion

28

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appears different from the other section/half.

• Borders- the borders of a skin lesion may be irregular and rough, rather than regular and smooth.

• Colour- the lesion contains several different colours or is markedly different in colour from other moles.

• Diameter- the lesion is larger than a pencil eraser in diameter; growing in size.

This is a guideline only; some moles may be irregular and have a different colour, while some melanomas may be very small and relatively smooth. For this reason, it is prudent to monitor all moles regularly for any change in size, shape, colour or general appearance.

The following factors raise the risk of developing melanoma:

• Sunburn.• White (Caucasian) ancestry.• Having light hair, light eye color and fair

skin.• History of excessive exposure to sunlight

during childhood (frequent sunburns).• More than 100 moles.• Irregular, large or abnormally appearing

moles.• Family history of melanoma (first-degree

relative).• Use of tanning beds.

Are there different types of melanoma?

There are three major types of melanoma:• Superficial spreading melanoma (70

per cent of all cases)- these melanomas may show a variety of colors and may be slightly raised above the skin surface; are amenable to early detection and treatment; commonly affect people between the ages

of 30 and 50; commonly appear on men’s backs and women’s legs but can appear anywhere at any age.

• Nodular melanoma (20 per cent of all cases) - appear as bluish/black or purplish lumps; may grow more quickly and are more likely to spread.

• Lentigo maligna- this type of melanoma tends to appear on body parts constantly exposed to the sun (i.e. face, hands, neck); may appear as a coloured freckle which may have an irregular shape; develops slowly (may take years before this type of melanoma evolves into a deadly melanoma).

Rarer forms of melanoma may occur on the scalp, under the nails, on the soles of the feet or palms of the hands, inside the body or in/on the eye.

How is melanoma diagnosed?

Skin biopsy is the gold standard for diagnosis. Thin melanomas (less than 1 mm thick) offer a greater likelihood of complete cure than thicker melanomas.

What is the recommended treatment for melanoma?

Removal of the lesion(s) is the usual treatment for melanoma. For melanoma that has spread to other areas of the body, immunotherapy or other treatments may be used.

29

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30

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31

3232

Answers on page 36

ACROSS

1. Gumdiseasewithinflammationofthegums.

6. Theroundedbonyprominenceoneithersideoftheanklejoint.

8. Somethingthatcanbefelt.

9. Inflammationoftherectum.

11. Thepartoftheskullthatenclosesthebrain(plural).

13. Toperformasurgicalprocedure.

14. Aproteinfoundmainlyinthebrain.

16. Theopportunityorrighttoreceivehealthcare.

18. Apairofbreathingorganslocatedwiththechest.

19. Oneofthefourmajortissuesthatmakeupthetooth.

20. Identicaltwinsthatdidnotseparatefullyfromoneanother.

DOWN

1. Anabnormalandpersistentfearofnudity.

2. Adrugthatantagonizesmorphineandotheropiates.

3. Tothicken.

4. Theincrustationthatformsoverasoreorwoundduringhealing.

5. Aparticulartypeofinflammatoryreactionoftheskin.

7. Permanentremovalofbodyhair.

10. Agroupofgeneticdisordersthatinvolveunderproductionofhemoglobin.

12. Adeviationorirregularity.

15. Pertainingtothenewbornperiod,specificallythefirst4weeksafterbirth.

17. Anabnormalgrowthofcellswhichtendtoproliferateinanuncontrolledway.

3333

This book is about the promises and failures of community mental health. It is also about hope and recovery. This book outlines the substantial challenges facing contemporary community mental health. It contains a collection of 20 original chapters by leading scholars, consumers, and practitioners and offers a wealth of knowledge. Many of the chapters present original research. The book is intended for use with both undergraduate and graduate students in social work, psychology, sociology, psychiatry, and related disciplines. Practitioners will also find many chapters to be of great interest. It is a comprehensive text that addresses the following issues: Best practices, Consumer perspectives, Diversity, Homelessness, Substance abuse, and Policy. The book is divided into an introductory discussion, which provides an excellent overview, and five sections, each of which is introduced by a heading that outlines the major themes of the section. Section I is composed

Community Mental Health Challenges For The 21st Century

Published:

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Jessica Millet Rosenberg, Samuel Rosenberg

BOOK REVIEW

Overviewof five chapters that examine one of the most exciting developments in community mental health today. Section II presents innovative research-based treatment approaches. Section III focuses on community mental health with populations that have traditionally been discriminated against by the community mental health field. Section IV concerns one of the most serious issues in community mental health: homelessness. Section V turns to policy and the organizational context for services. The book represents a coherent and comprehensive presentation of the salient issues that constitute the manifold challenges for the improvement in the provision of community mental health services in the early years of the 21st century. As such, it supplies fundamental information for students, practitioners, and consumers in their quest to jointly construct an effective and humane mental health delivery system.

34

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35

Crossword Answers:

Ingredients (serves 4)

1 (about 1.8kg) fresh whole chicken, cut into portionsSaxa natural salt grinder½ cup (125ml) honey½ cup (125ml) lemon juice1 tablespoon thick soy sauce5cm piece fresh ginger, peeled, cut into matchsticks1 teaspoons toasted sesame seeds1 lemon, cut into wedges2 green shallots, cut into matchsticksCoriander leaves, to serveSteamed jasmine rice, to serve

Method:1. Preheat oven to 200°C. Place the chicken,

skin-side up, in a large roasting pan. Season well with salt. Roast in preheated oven for 20 minutes or until golden brown and cooked through.

2. Meanwhile, combine the honey, lemon, soy sauce and ginger in a medium saucepan over low heat. Cook, stirring, for 5 minutes or until sauces boils and thickens. Remove from heat.

3. Brush the chicken with a little of the honey sauce and bake for a further 10 minutes or until chicken caramelises slightly.

4. Meanwhile, heat a medium non-stick frying pan over high heat. Add the lemon wedges and cook for 2 minutes each side or until golden brown. Remove from heat.

5. Place the shallots in a bowl of ice water and set aside for 5 minutes to cur. Drain well.

6. Arrange the chicken on serving plates. Drizzle with remaining honey sauce and sprinkle with sesame seeds, green shallots and coriander leaves. Serve with lemon wedges and steamed rice.

Healthy recipesCrispy Skinned Lemon ChickenPreparation time: 20 minutes Cooking time: 30 minutes

Nutritional factsEnergy (kJ)Protein (g)Total fat (g)Saturated fat (g)Carbohydrate-total (g)Carbohydrate sugars (g)Dietary fibre (g)Cholesterol (mg)Sodium

1045kJ47.70g12.80g5.40g16.80g-4.10g91mg102mg

Average quantity per Serving ACROSS DOWN

1. Gingivitis6. Malleolus8. Palpable9. Proctitis11. Crania13. Operate14. Reelin16. Access18. Lungs19. Enamel20. Siamese

1. Gymnophobia2. Naloxone3. Inspissate4. Scab5. Eczema7. Electrolysis10. Thalassemia12. Aberration15. Neonatal17. Cancer

36

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