Tagged: #mentalhealth

How to write a riveting paragraph for ‘Your Reader’: #300wordson3daysfor3weeks

Getting your idea across to Your Reader is an art form!

Some days it can seem like just one paragraph is a mammoth effort… and that Your Reader is a million miles away!

The trick is to carefully determine who your audience is… and be mindful of preparing your writing specifically for them. Get to know Your Reader!

Ask yourself:

  • What are the characteristics of Your Reader. Can you profile Your Reader? You will want to know exactly where your target lies and how to capture their literary attentions.
  • Why would Your Reader be bothered to read your text? Communicating clearly and engagingly with Your Reader is your primary focus.

Short gripping and rich grabs are important handles for Your Reader

Your Reader probably reads in short grabs… most use the punctuation to guide them… but generally it is a grab of 5-10 words at a time…Then, Your Reader pauses to comprehend… and then they go on… and read a bit more… to the next few words… so every few words needs to be rich and meaningful.

Experiment: Pause for a moment now… reflect on how you read new text…? Will Your Reader have a reading pattern like you do… if so, write like you read! If not, adapt to match your writing style to suit Your Reader.

Aim for sentences with about 7 words or less! That way, Your Reader stays engaged, enthralled and most of all – awake!

  • Use punctuation to guide Your Reader through the narrative pathway you have carefully designed.
  • Make sure that your sentence construction is complete, and that you don’t leave the story line hanging… with an unfinished idea.
  • Make sure that what you have written will convey the message you want it to convey, and that it is not possible to misconstrue the content.
  • Don’t use sarcasm or double meanings in text… unless you are an expert story teller (most of us are not).
  • Ideally a paragraph will be about 200- 300 words long, depending on Your Reader, and the complexity of the ideas, or depth of discussion in your paragraph. (Don’t worry – references are not included in the word count)!
  • Use a referencing style that is acceptable to Your Reader. For example, a numbered referencing system might help to keep the text more readable for some audiences, while other readers want to see names and dates of references in text. Use some referencing software such as Endnote, so that your referencing is consistent throughout.
  • Each paragraph needs to tell a concise and discreet part of the larger story that you are telling to Your Reader. Make sure your join the dots!
  • Remember: The first sentence sets the scene for the paragraph. It indicates the big idea you are dealing with, and it outlines the topic or main theme for the discussion you are about to outline.
  • Then, add one, two, three… (or reluctantly/ cautiously …maybe four) supporting sentences. Include evidence to back up your main topic/ main idea or main theme.
  • The final sentence should conclude the paragraph. Summing-up the idea in a convincing crescendo. So Your Reader  will have a ‘Arhhh’ moment, capturing the essence of message. Your Reader will want to feel as though they understand your idea. If Your Reader completes reading the text of your paragraph and then feels ‘dumb’, doesn’t get the gist of your idea… or is bored by it; then your haven’t conveyed a convincing message yet. Re draft, and try again!
  • Each paragraph in the body of a piece of writing needs to contain three distinct elements: an idea, enough convincing evidence and a summary.
  • And remember Your Reader is probably reading on an electronic device – computer, iPad, smartphone… so, write for the screen not the page!

Here are some two resources to help you structure a paragraph for your #300words this week!

  1. Paragraph-writing fact sheets for academic writing. Getting back to the basics.
  2. Writing a thesis – a great writing guide here: http://betterthesis.dk

Happy writing!

Acknowledgement – The Burger Image for this blog is from the following writing resources team…. check it out – handy tips! http://www.readingrockets.org/strategies/paragraph_hamburger


#300words & writers block? Ten remedies

#virtualwritingworkshop #300wordson3daysfor3weeks

Have you hit a writing roadblock already?
Here is how to fix it!
Remedy: read more about your topic, search for relevant literature.
When it is hard to write about a topic, sometimes it is because your understanding of the topic is too limited. So, the best way forward is to read more… here is how:
  1. Read more widely – find some new sources about your topic… a different journal from a different publisher than the one you usually select from! Broaden your horizons – just be sure that you are not selecting from a weak or unreliable source or publisher. Try a different database…
  2. Ask your librarian to help you with a search for relevant sources… they will probably be able to surprise you with a new search strategy… they are experts in finding the right literature to match the right question.
  3. Review the reference list of your already gathered literature… are there some articles that you have overlooked that might also be helpful.
  4. Visit the WHO mental health  website they have some interesting mental health publications that might widen your approach to the topic.
  5. Ask yourself about the setting/context you are writing about… is it local, regional, national, or international. Do you need to expand a little further… Discuss in the local context in a wider setting perhaps, then compare and contrast between your setting in the context of a wider geography/demography.
  6. What is the clinical relevance of your writing. Is there a clinical implication you can state and discuss.
  7. Surf a little on reseachgate! Search about your topic area… are their some interesting  authors you can follow, have they shared some resources that are useful to stimulate your thinking further?
  8. Check out the twitter action about current healthcare conferences… search a relevant # You can find them here:
  9. https://www.symplur.com/healthcare-hashtags/conferences/ Do something else… try again tomorrow! But, DO try again! Some days are not as easy to be sufficiently creative as other days.. for lots of personal, professional reasons… or just because the ideas have not percolated sufficiently and processed enough yet in your own mind. Time will fix that – be patient with yourself, don’t give up and just be kind enough to yourself : take a walk… outside… listen to some outside nosies… feel some outside air on your face… view the skyline… stretch… come back to it all again tomorrow – or the next day!
  10. Talk to a trusted colleague… ask for their tips about overcoming writing block. And, above all – you should know that this is normal! Even the best and most prolific authors have moments of self doubt, block and believe it not …. they too can be stuck for words! So, you are in good company!
There are many more tips that can be added to the list… but ten is a good start! Hopefully one of them hits the spot for you and spurs you on in your #300wordson3daysfor3weeks

Fail fast & Retry, Retry & Retry again… Rural health professional tenacity in a nutshell

I heard a leading rural public health professor speak last night (at the Robb College (@robbcollege) annual Health Lecture and Dinner  – University of New England @healthune) about the challenges and opportunities that exist in rural and regional health in Australia and across the world. I was spurred on… motivated… inspired… to keep pressing forward in contributing to rural health progress. Professor Ian Wronski, Deputy Vice Chancellor  – James Cook University, shared some of what he has learnt along the way while working in public health in rural Australia.

Some of what got me thinking…

  • When you get stuck without many resources… try new things!
  • Rural politics… often not enough marginal seats to attract funding and resources…
  • Sustainability in the primary care workforce is vital for the health of rural communities. Not limited to a sending-in style of health care delivery… but embedding and internally generating health workforce within rural communities.

My entire health career has been played out in rural committees… These three points struck a chord with me because they aligned with what I know of rural communities. A dollar, please, for every time I have had to innovate my practice because the oily rag needed to be squeezed a little tighter!

Trying new things is something that rural people are good at! Using our strengths! That is, the skills that are so much second nature to us that we sometimes forget that they are indeed special skills. Trying something new, and finding a way to make something work, finding the work-around solution, finding a new way using the resources we have at hand… that is innate rural culture. That is… what rural people do extremely well… but of course – there are limits!

Rural people conduct themselves resourcefully. They are not wasteful of resources because they work hard to obtain the resources that are carefully matched to the needs, ensuring they get the last drop of ‘oil out of the rag’. They make do!  Where I grew up we had one (thinking back – very small!) water tank to collect rain water for household use. Nobody wasted a drop – it was valuable, it was used wisely and recycled where possible. Never a tap was left to drip… the sentiment permeates and translates to rural life and culture in general. I think these are key characteristics of rural people and communities, and these attributes help to make up the social capital and the human ecology of rural communities. I have written a bit about that...  and have explored the contributions that nurses in particular make to the mental health care of young rural people.

There is something to be said about the dynamics of rural politics though. Political pressures underpin resources allocation for public health and especially in regard to mental health of rural people. The national and state spend on rural mental health (or mental health generally) is consistently poor. Nationally this bears out with a stable suicide rate over the past ten years  – not a reduction… but rather a complacent stability, with rural communities bearing a disproportionate burden. The reality is that many rural political seats are ‘safe’… and one of the limitations that is associated with this political condition impacts adversely on public health resource allocation. It is a bit like the water tank of my childhood never benefiting from sufficient rains to fill it up… and for us constantly monitoring the water level by tapping the sides of the tank to listen for the tympanic changes to signal volume levels.   Worrying about how much water was left and guessing how far it might need to go before the rain came again… reducing our use to reflect the remaining residue, and not having enough to do anything extra. I could still show you the corrugation groove around the one third full mark that changed the mood in our family to austere use of water and restrictions for our family – indelibly marked in my psyche! When the rain doesn’t fall in the rural mental health budget – there is never enough resource to do the prevention, mental health promotion and early intervention care because those elements of health care provision can be thought of as when the tank is only one third full – so restrictions need to heeded and the valuable resource only used for the most serious circumstances – often too little, too late. But – in marginal seats – it appears that the weather forecast is often more promising… Try someone new might be a good rural political slogan for the future… ?

Professor Wronski had Six Tips to enhance rural public health:

1. Invest in locally driven solutions because local proximity to the problem drives finding solutions. (Rural people are close to the problem so they are likely to also be close to the solution)

2. Take intellectual risks. (Think about things and then do things!)

3. Use evidence to drive decision making. (Not whims and hunches… but take the time and effort to generate and gather the evidence  – then apply it!)

4. Fail fast and use it to learn from. Then, Retry, Retry and Retry again. (Fail fast… I like that… but don’t give up especially if you are doing 3 & 4 above… learn more – try again… love it!)

5. Facilitate collaboration and co-creation. (Working together) 

6. Identify scalable solutions that will have disproportionate impacts as you scale them up. (‘From little things – big things grow’)

A lot of good advice! Some good signposts for keeping public health on track  – out back!

Top 5 reasons I’ll follow you on Twitter

Top 5 reasons I’ll follow you on Twitter.

Check out this blog ^ by Research Whisper … Twitter is a fantastic resource – but yes, you have to invest something of yourself into it to make it work…

The only point of difference for me is I am perhaps a bit more flexible with my following decisions. I am happy to follow back novice twitter nurses in particular, to assist with introducing them to nursing colleagues in the Twittersphere. Just like IRL (in real life), networking relies on investing some relationship and by gaining introductions to key stakeholders. My followship is substantial enough to enable me to ‘play nice’ enough to give others a hand along the way. So – if you appear authentic after I run my checks, and you are interested in conversations about #nursing #mentalhealth #ruralhealth #Indigneoushealth #wellbeing #research #academic #HDR … and your not trying to flog me your latest commercial book or product, or your not trying to sell me (or my followers) something – I will probably follow up back! What I will be very interested in is sharing knowledge, transferring health knowledge to real people and situations – so I will always be keen to promote scholarship (peer reviewed) whether it is mine or others. Why? Because I think it is critical to get new ideas out in the public domain – so ideas about improving the world get out where they matter… accessible to the general public and part of the conversation…

Let’s tweet!

A must read about mental health laws and policies in Croakey

I have blogged about this issue before… Mental health laws and policies inadvertently (at best) or purposefully (at worse) promoting the denial of human right freedoms. I continue to be very concerned for the freedom of people with mental health problems who have mustered up sufficient strength to seek some professional help to address their mental health, and who then find themselves in a voluntary mental health unit only to discover that their freedoms are curtailed because the doors are locked behind them. The very idea that people with mental health problems are a safety risk is a travesty and perpetuates unhelpful sense of stigma and fear in the wider community. People should feel welcomed and encouraged to access mental health help when it is needed… the environment in which help occurs is very important. And, to not have the freedom to come and go at will to places where mental health care is provided is not sufficiently appropriate or evidenced based care. The political and policy debate should be an important focus in all stated and federal elections… the freedoms of people with mental health problems should be  considered carefully. And… human rights and dignity should be the hallmark for policy and governance changes on this matter. The evidence does not adequately support the current practice which allows for the mass detention of voluntary mental health clients in mental health care. See this croakey blog for more good quality discussion on this topic: http://blogs.crikey.com.au/croakey/2015/01/27/queensland-policies-on-mental-health-doing-harm-breaching-the-law/

Undergraduate mental health nursing education in Australia: More than Mental Health First Aid

Another paper… this time addressing the very important topic about pre-registration mental health nursing education in Australia.

Mental Health First Aid training is designed to equip people with the skills to help others who may be developing mental health problems or experiencing mental health crises. This training has consistently been shown to increase: (1) the recognition of mental health problems; (2) the extent to which course trainees’ beliefs about treatment align with those of mental health professionals; (3) their intentions to help others; and (4) their confidence in their abilities to assist others. This paper presents a discussion of the potential role of Mental Health First Aid training in undergraduate mental health nursing education. Three databases (CINAHL, Medline, and PsycINFO) were searched to identify literature on Mental Health First Aid. Although Mental Health First Aid training has strong benefits, this first responder level of education is insufficient for nurses, from whom people expect to receive professional care. It is recommended that: (1) Mental Health First Aid training be made a pre-requisite of pre-registration nurse education, (2) registered nurses make a larger contribution to addressing the mental health needs of Australians requiring care, and (3) current registered nurses take responsibility for ensuring that they can provided basic mental health care, including undertaking training to rectify gaps in their knowledge.

Click here for more details… Happell, Wilson, McNamara 2014 MH Nurse Curriculum

…and follow for latest publication: here… https://www.researchgate.net/publication/265127066_Undergraduate_mental_health_nursing_education_in_Australia_More_than_Mental_Health_First_Aid

Risky door business

Queensland, Australia takes a step backward – Springborg spring-loads the doors slamming shut human rights

I write this post, ironically with an ear to the Johannesburg memorial service for Nelson Mandela screening on my TV. Here I sit reflecting on the life of a remarkable man who fought for the human rights of some of the most vulnerable people in the world, and I wonder, how could people have come to a logical conclusion in years gone by that it could be possible to consider denying the freedom of people as an ‘OK’ human behaviour? How could it be that liberty could be denied to people based on something as illogical as the colour of one’s skin….It defies all reason…… but still it happened…. The fight to freedom was a costly one. South Africa continues to work towards peace and recovery… triggered by the leadership of Nelson Mandela. There is hope…

And then I read of plans afoot for Queensland mental health to deny the freedom of vulnerable people who experience mental health problems and who choose to seek help in the voluntary public mental health system by taking steps to lock people in hospital wards to detain them because of a (misplaced) perception of risk associated with mental illness. And I wonder…. How could people (powerful leaders) have come to a logical conclusion these days, this week … that it anywhere near reasonable to even contemplate denying the freedom of people as an ‘OK’ human behavior based on a suspicion of risk. I wonder who should be scared of who?…. I wonder how far have we come? ….or not…….

And then I see that the some parts of the print media have had a field day scare mongering and doing their utmost to fuel stigma… and I wonder how the editor of the Courier Mail could have come to a conclusion that this article is “OK” – it isn’t. The assumptions about mental illness and risk or danger are erroneous and defame those clever , people who show a great deal of personal health and wellbeing safety by ensuring that they seek help for mental health problems when they need it – in a voluntary capacity. And for this responsible and safe healthy behavior effort….. people will now have the doors locked behind them, detained…..under a suspicion of risk…… and I wonder – why would a person seek mental health help if they know that reaching out for support with result in a deprivation of theirliberty? How can that be ‘OK’ – it is not.

In NSW, behind custodial doors most people have one or more mental health problems…

The NSW Law Reform Commission undertook a general review of criminal law and procedures that are applied to people with cognitive and mental health impairment in NSW, and they reported that in NSW of all the young people (less than 18 years of age) detained in custody in NSW, 87% have at least one mental health problem and 73% have two or more mental health diagnoses (New South Wales Law Reform Commission., 2012). Young people with mental illness are over-represented in the criminal justice system compared with the wider population, where 22% of the general population have a diagnosable mental health problem, while the total prisoner population in NSW experience mental health problems at a rate triple that of the general population (New South Wales Law Reform Commission., 2012).

Policing and health service dealing with unwilling young people affected by mental health issues

Police have powers to detain a person who they believe to be mentally ill or mentally disordered, under the Mental Health Act 2007 (NSW), and they can formally request that the person be admitted to a involuntary mental health facility. This mode of request for admission makes up 23% of all police requests for admissions to mental health facilities, however 26% of those police requests do not meet medical criteria for involuntary admission to a mental health unit (New South Wales Law Reform Commission., 2012). This leaves a substantial number of people who may have a mental health problem, but do not meet the extreme criteria for involuntary treatment in a compromised position of not being able to access mental health help when it is needed, and at risk of reoffending and further complicating their offending track record (New South Wales Law Reform Commission., 2012).

Inadequacy of clinical decision-making based on risk assessment

Collaboration between the State governed Police, Health and Ambulance services in regard to supporting people with a mental health problem to access appropriate care is ideal and fits neatly with the ideals of a ‘no wrong door‘ to seek mental health help which are aspired to by State and National Mental Health Commissions. However, there are significant limitations within clinical decision making capabilities which need to be considered. In particular, no clinical risk assessment tools exist with adequate specificity, sensitivity and accuracy to predict harm to self or others, for example violence, by people affected by mental health disorder or illness (Ryan, Nielssen, Paton, & Large, 2010). It is not possible to accurately conclude that commonly used current clinical assessment of risk investigations will be sensitive enough to predict which clients will need higher levels of resource-heavy interventions and restrictive care, and which people will require fewer and less expensive clinical resources and less restrictive care to achieve the desired safety outcomes (Ryan, et al., 2010).

Ryan et al (2010) reviewed the efficacy of the most commonly used risk assessment instrument, that is, the Macarthur Violence Risk Assessment, which is regarded widely as a valid instrument for use in the prediction of violence amongst people who are acutely mentally ill (Monahan, Steadman, & Robbins, 2005). Ryan, et al., (2010) re-examined the data in the original study and found that the level of sensitively for accurate prediction was ambiguous and that it had very poor sensitivity in regard to accurately detecting risk related to future violence. In fact, the sensitivity of the instrument produced 9% incidence of false-negative cases, where people were categorised as being low-risk and went on to commit violent acts to themselves or others in the 20 weeks immediately following the assessment (Ryan, et al., 2010). Thus, 9% of mentally ill people who were considered to be ‘low-risk’ for harm to themselves or others were in fact ‘high-risk’. These people will slip through gaps in service streams of all types despite having been provided with a clinical mental health risk assessment, because to date no current instruments are available to sufficiently and accurately detect risk. However they are in common use despite this paradox and despite an insufficient body of evidence to underpin the continued use of risk assessment to inform clinical decision making (Ryan, et al., 2010).

Health services from an actuarial perspective are adverse to risk events and wish to be seen to be doing everything possible to reduce the risk of harm to people. The risk of homicide by a person with schizophrenia is 1 in 10,000 (Ryan et al., 2010). However Ryan, et al., (2010) have been able to demonstrate, that based on the fidelity of the most common risk assessment tool, if a usual risk assessment was conducted on every person with schizophrenia, that annually 4117 people would be detained for up to a year in mental health bed-based facilities because they would statistically achieve a ‘high-risk’ categorisation. Thus, in order to prevent one person committing a homicide, using the Macarthur Violence Risk Assessment scale, 4116 people would have to be detained perhaps needlessly (Ryan, et al., 2010). However, of those people assessed as low-risk, 1 in every 22,421 people would in fact go on to commit homicide (Ryan, et al., 2010). The health resources and costs absorbed by keeping false-negative cases in hospital detract from the finances and recourses available to provide care to the low-risk cases. Some of the low-risk cases in fact require higher levels of care, but are not deemed eligible because they did not meet the ‘high risk’ categorisation at assessment (Ryan, et al., 2010). The dispersal of health resources could be better allocated across broader mental health criterion, and improve support for the mental health care of more people if the use of clinical risk assessment was abandoned as having any role in the clinical decision making process (Ryan, et al., 2010).

Risk is the wrong reason to lock a door…

A couple of links that highlight better practice about open doors, open and transparent rapport with mental health clients and reasons keep the doors unlocked….



think about joining the campaign to keep voluntary mental health care an open door policy – sign a campaign here