The Improving Sexual Safety initiative partners with a range of acute inpatient mental health services. Those participating serve regional and metropolitan areas, care for forensic, non-forensic, adult and senior cohorts, and bring a range of established capabilities and capacities to the task of creating safer environments for consumers, carers and staff.

This initiative has involved, with the guidance of the Institute for Healthcare Improvement, building capability in the use of Improvement Science among participating services. It has also involved increasing the self-efficacy and confidence of frontline mental health staff who find themselves involved in groundbreaking work which challenges many familiar ways of working. This initiative's aims are consistent across all participating services, though paths leading to those aims have been as varied as the services themselves.

Trial and periods of reflection has led to the development of an approach to partnering with services which involves honoring the position services are starting from, while building towards an improved state of capability service delivery, and healthcare experiences in future. Learnings and improvements of participating services are shared among them to encourage finding common ground in working toward our common goal of improving sexual safety for all. The lessons learned through this process may have applications in a wide variety of mental health contexts for services seeking to examine and refine the care they provide.

Clinical supervision is an important component of Mental Health Nurse’s professional development. To support clinical supervision for Mental Health Nurses the Office of the Chief Mental Health Nurse (OCMHN) developed the Clinical Supervision for Mental Health Nurses: A framework for Victoria.

OCMHN supported the frameworks release with a 5-year implementation plan and project lead role over the last 2 years. In 2020 Peninsula Health became the pilot site and lead service in this project, and over the following years this spread to five sites and a Statewide Community of Practice. In this period the health sector was met with unprecedented pandemic stressors. Where many pieces of work needed to be put on hold, the value in and thirst for clinical supervision grew.

Five years on, this project is coming to its formal conclusion, but the work will continue. This presentation will look at what we have learnt over the course of this project, how we will continue to embed and sustain clinical supervision for mental health nurses across Victoria and some of the impacts that this project has had.

For people with distressing experiences of hearing voices, psychological therapies can support coping with and making sense of these experiences.[1] Research has confirmed that one-to-one psychological therapies lead to hearing voices being found less distressing and having less negative impact on daily life.[1-3] However, therapy effectiveness could be improved, and therapy may be hard to access.[1] We have been interested in how digital technology can be used to improve access and effectiveness:[4] first, by using telehealth to increase reach of delivery,[5-7] and, second, by simulating voice-like experiences within session for the therapist and client to use in practicing different ways of responding.[8-10]
AMETHYST is an Australian Government-funded randomised controlled trial examining whether technology can improve the outcome of psychological therapy for hearing voices. 212 participants from across Australia receive sessions delivered by videoconferencing from a specialist telehealth-based voices clinic. Participants receive either standard best-practice therapy, or a new therapy using a digital avatar and voice modulation software to create a voice simulation used to support therapy. The day-to-day impact of hearing voices following therapy is the main outcome.
Drawing on our trial experience, we will present initial feasibility and acceptability data, and report on experiences of delivering therapy using technology.

The Mental Health Intensive Discharge (MIND) team is an intensive assessment and discharge facilitation service supporting people with psychosocial disability within acute mental health and extended treatment facilities in Metro North Health (MNH). The MIND service works with existing Metro North Mental Health facilities to assist consumers, their inpatient treating teams, families, and stakeholders where the complexity of a person’s psychosocial disability requires an advanced clinical response to arrange sustainable NDIS supports in appropriate accommodation settings within the community. MIND works intensively to improve overall quality of life outcomes for consumers.

People with psychosocial disability have increased risk of extended length of stay in mental health facilities due to associated complexities and intensive care coordination needed to support their successful transition to community services. Noting evidence supporting intensive assessment and supportive discharge service for people with complex psychosocial disability to facilitate timely transition into the community, this team works proactively with individuals and service providers to ensure evidenced based care is achieved.

Service provision incorporates a disability framework with recovery and trauma informed principles to coordinate successful and sustainable discharge. Interventions include diagnostic and functional assessments and intensive care coordination across multiple networks by advanced level social workers, psychologists, and occupational therapists.
Outcomes achieved relate to reduction of average LOS and improved patient flow across inpatient and extended treatment facilities, improvements in quality of life of the Mental Health consumers through the identification and transition to of sustainable discharge accommodation options and demonstrated improvements in staff wellbeing.

Relational mapping is a tool to validate the differing viewpoints of team members, looking beyond differences to find a common ground and synthesise a whole team perspective. It is based on Cognitive Analytic therapy, an evidence-based approach that supports teams to pay attention to others and themselves, to notice relational patterns as they occur in the work and to use this awareness to enhance understanding of specific practice challenges.

Relational mapping sessions were conducted fortnightly at adult and youth sub-acute services and quantitative and qualitative outcome data collected.

Relational awareness and team cohesion within the team increased after six months of sessions. Practitioners reported they were more able to pick up on patterns of interaction throughout the team and with clients. They also felt they had more insights around noticing, naming and negotiation of relational patterns of interaction, thinking about how they did things and why, rather than automatically acting. The sessions were an opportunity for the team to stop, think and come together to reflect on their practice.

The effectiveness of reflective practice can be enhanced through using structured approaches such as relational mapping, increasing team cohesiveness, team culture, practice conference and reduced work stress.