Glossary

The terms listed here represent those presented in this training package and other possibly related terms.

Many, though not all, of the following entries are taken from Auseinet Glossary (AG), National standards for mental health services (NS) or The Kit (K).

A

Accountability (K)

Liability, answerability; a requirement to account for one’s actions, writings, expenditure, usually in the context of a position of responsibility one occupies.

Acute inpatient units

Provide care for people requiring hospitalisation. They operate 24 hours a day and care is provided by a multidisciplinary team.

Advocacy (AG)

The action of supporting another’s needs or rights. ALSO: A combination of individual and social actions designed to gain political commitment, policy support, social acceptance and systems support for a particular health goal or programme. Such action may be taken by and/or on behalf of individuals and groups to create living conditions which are conducive to health and the achievement of healthy lifestyles. Advocacy is one of the three major strategies for health promotion and can take many forms including the use of the mass media and multi-media, direct political lobbying, and community mobilization through, for example, coalitions of interest around defined issues. Health professionals have a major responsibility to act as advocates for health at all levels in society.

Advocate (AG)

A person (or organisation) who actively supports or represents another person’s rights or needs or a cause such as consumer rights to service information and basic human rights.

Aetiology (AG)

All the factors that contribute to the development of an illness or disorder.

Assessment (NS)

The systematic and ongoing evaluation of information about a consumer in order to ascertain his / her diagnosis, needs and desired outcomes of care. Assessment forms the basis for the development and review of an individualised care plan in collaboration with the consumer, their family, carers and significant others.

At risk

Having a high potential to complete suicide. (In the context of this package).

C

CALD (Culturally and Linguistically Diverse) (AG)

Can refer to individual people, communities or populations.

Care (NS)

All services and interventions provided to a person with a mental disorder and/or mental health problem by health and other sectors, community organisation, family and carers.

Care environment (NS)

The environment in which the Mental Health Service delivers treatment and support. It could be a living skills centre, a psychiatric inpatient unit, community centre, school or hostel.

Carer (K)

People close to (often living with) someone who lives with mental illness/distress. Includes ‘family carers’ and friends or allies who offer support in times of need. Many people ‘care about’ what is happening to a friend or relative but do not identify with the term ‘carer’.

Clinical indicator (NS)

A measure of the clinical management and outcome of care; a method of monitoring care and services, which attempts to flag problem areas, evaluate trends and so direct attention to issues requiring further review.

The EQuIP Guide, The Australian Council on Healthcare Standards (ACHS), 1996.

Community education (K)

Usually takes the form of some kind of organised campaign to increase people’s awareness and understanding of a particular issue or set of issues. A campaign might include advertising in the media; distribution of pamphlets; appearances on radio and TV talk shows; talks and workshops run for school students and others.

Community living (NS)

The ability of the consumer to live independently in the community with the best possible quality of life.

Community Treatment teams

Provide a multidisciplinary case management consultancy service with an emphasis on assisting people to develop skills in self care and independent living in their own environment.

Comorbidity (AG)

A person diagnosed as having an alcohol or drug abuse problem in addition to some other diagnosis, usually psychiatric, for example, mood disorder and schizophrenia. Can also refer to a person with chronic physical and mental health problem.

Confidentiality (K)

Privacy of certain information and how information is stored and used.

Connectedness (AG)

A person’s sense of belonging with others. A sense of connectedness can be with family, school or community.

Consultation Liaison Psychiatry

Provides assessment, consultation and referral for patients of theEmergency Department.

Consumer

A person who has used (or is using) a service in relation to suicide.

Continuity of care (NS)

The provision of barrier-free access to the necessary range of health care services, across hospital, community and other support services, over any given period of time with the level of support and care varying according to individual needs.

Crisis state

A state where active and constructive solutions are no longer able to be generated.

Cultural diversity (AG)

Refers to the wide range of cultural groups that make up the Australian population and Australian communities. It includes groups and individuals who differ according to religion, race, or ethnicity.

Culture

Culture should be regarded as the set of distinctive spiritual, material, intellectual and emotional features of society or a social group, and that it encompasses, in addition to art and literature, lifestyles, ways of living together, value systems, traditions and beliefs. UNESCO Universal Declaration on Cultural Diversity 2002.

D

Debriefing (K)

The act of discussing or talking through a recent experience, such as a crisis of some kind.

Deinstitutionalisation (K)

Often used (over simply) to describe the process by which individuals who have previously received services in a ‘hospital’ or ‘home’ are moved out of that place into the community. Also includes the process by which those individuals need to ‘unlearn’ a whole set of behaviours and expectations that have been acquired during their institutional lives. The political/social process of ‘deinstitutionalisation’ should (but in the main has failed to) include adequate provision of services, housing and other supports ‘in the community’.

Deliberate self harm

Deliberate self harm is when you deliberately inflict physical harm on yourself, usually in secret and often without anyone else knowing. Some examples are cutting, burning, biting or hitting your body, pulling out hair or scratching and picking at sores on your skin. Deliberate self harm is not necessarily a suicide attempt and engaging in self harm may not mean that someone wants to die. Most commonly deliberate self harm is a behaviour that is used to cope with difficult or painful feelings.

Disability (NS)

A disability is any restriction or lack of ability to perform an activity within the expected range for a human being.

Mental Health Statement of Rights and Responsibilities, Australian Government Publishing Service, 1991.

Disability support service (NS)

A range of service responses which enable the individual to live as independently as possible and be included in the ordinary life of their community.

Duty of care

Health workers owe a duty of care to the people they treat. This means that they must take steps to ensure that the people they care for do not come to foreseeable harm by their actions or their failure to act.

E

Early intervention (AG)

Interventions targeting people displaying the early signs and symptoms of a mental health problem or mental disorder. Early intervention also encompasses the early identification of people suffering from a first episode of disorder.

e-health (NS)

e-health is an emerging field in the intersection of medical informatics, public health and business, referring to health services and information delivered or enhanced through the Internet and related technologies. In a broader sense, the term characterizes not only a technical development, but also a state-of-mind, a way of thinking, an attitude, and a commitment for networked, global thinking, to improve health care locally, regionally, and worldwide by using information and communication technology. J Med Internet Res 2001;3 (2):e20).

Empirical (NS)

Verifiable or provable by means of observation or experiment.

Empowerment (K)

Used to encapsulate a complex set of issues around an individual’s subjective and objective experience of the world, his/her position in it and his/her ability to undertake certain things. No one can ’empower’ another person, but individuals, institutions, systems, social traditions and practices can and do disempower individuals and groups of individuals. When an individual is empowered he/she feels able and strong enough to make decisions about his/her life; to ask questions rather than blindly accepting the opinions of others who hold greater status; to make mistakes and to enjoy successes.

Enabling (K)

The process by which empowerment occurs.

Entry process

The process provided by the mental health service which assists the consumer and their carers to make contact with the mental health service and receive appropriate assistance.

Epidemiology (AG)

The study of the incidence, distribution, and control of disease, and trends in health, as applied to the whole community.

Evaluation (AG)

The process used to describe the process of measuring the value or worth of a program or service.

Evidence-based practice (AG)

A process through which professionals use the best available evidence integrated with professional expertise to make decisions regarding the care of an individual. It is a concept which is now widely promoted in the medical and allied health fields and requires practitioners to seek the best evidence from a variety of sources; critically appraise that evidence; decide what outcome is to be achieved; apply that evidence in professional practice; and evaluate the outcome. Consultation with the client is implicit in the process.

Exsanguination

To drain of blood.

F

Facilitator (K)

A person who works with a group to assist it to make decisions and achieve outcomes by focusing on the process of group discussion and decision-making.

Feedback (K)

Information, opinion, commentary, revision received from concerned individuals or groups in response to a proposal, project, process that has repercussions for that person or group. Feedback can be verbal or written, formal or informal.

F

Holistic approach

An holistic approach to health incorporates a comprehensive approach to service delivery and treatment where coordination of client’s needs and total care takes priority.

I

Individual care plan (NS)

A documented set of goals collaboratively developed by the consumer and the Mental Health Service (usually the case manager). The individual care plan sets the direction for treatment and support, identifies necessary resources and specifies outcomes for the consumer. It is recorded in the consumer’s individual clinical record.

Informed consent (NS)

Informed consent is consent obtained freely, without coercion, threats or improper inducements, after questions asked by the consumer have been answered, after appropriate disclosure to the patient of adequate and understandable information in a form and language demonstrably understood by the patient.

Such answers and disclosures must be sufficient to enable the consumer to make a fully informed decision based on all relevant factors including the nature of treatment involved, the range of other options and the possible outcomes and implications for the consumer and others.

Adapted from the UN Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care, June 1992 with the assistance of the Mental Health Legal Centre (Vic).

J

Jargon (K)

Technical or otherwise limited/specific terminology; a kind of ‘slang’. Different professional and other groups use certain kinds of words that have little or no meaning beyond the context of their area of expertise. While most people use jargon to some extent, medical, bureaucratic, scientific, psychological or other jargon can be used in a way that alienates and disempowers consumers and carers.

Jurisdiction (AG)

The area for which a particular government (Commonwealth, State or Territory, local) is responsible.

L

Links (NS)

The formal and informal aspects of the relationship between the mental health service and another service provider, agency or sector.

M

Mainstreaming (K)

The process of integrating mental health services with e-health, housing, social, welfare and recreational services for the general community, with the aim of reducing stigma and providing an appropriate range of services.

Medical model (K)

An approach to mental health problems based on medical assumptions that ‘abnormal’ thoughts and behaviours are mental illnesses which can appropriately be controlled by medication and hospitalisation, not unlike physical illnesses.

Mental disorder (NS)

A mental disorder may be defined as a significant impairment of an individual’s cognitive, affective and/or relational abilities which may require intervention and may be a recognised, medically diagnosable illness or disorder. Mental Health Statement of Rights and Responsibilities, Australian Government Publishing Service, 1991

Mental health

Mental health is not just the absence of mental disorder. It is a state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.

The positive dimension of mental health is stressed in World Health Organisation’s definition of health as contained in its constitution: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” WHO’s 191 member states have endorsed this sweeping statement. World Health Organisation http://www.who.int/mediacentre/factsheets/fs220/en/

A mental healt

Mental health problem (NS)

h problem is a disruption in the interactions between the individual, the group and the environment producing a diminished state of mental health. Mental Health Statement of Rights and Responsibilities, Australian Government Publishing Service, 1991.

Mental health literacy

‘The ability to recognise specific disorders; knowing how to seek mental health information; knowledge of risk factors and causes, of self-treatments and of professional help available, and attitudes that promote recognition and appropriate help-seeking’ (Jorm et al, 1997, p. 182).

Mental health professionals

People who have been professionally trained to work specifically in mental health. These may include psychiatrists, psychologists and psychiatric nurses, social workers and occupational therapists.

Mobile Assertive Care Service

Provides intensive and medium term support to people with a severe and chronically disabling mental health illness or disorder.

N

Networking (K)

(Jargon) Getting to know and connecting to people who may be helpful to one’s cause, career, task, project, organisation; developing a range of helpful contacts.

NGO – Non-government organisation (K)

Includes charitable and other non-profit organisations not directly answerable to any government department, although some are wholly or partly government funded. Independence is an important attribute of NGOs which are usually concerned with such issues as human rights, legal rights, the environment, food and housing. Examples of high profile non-government organisations are Amnesty International and Greenpeace.

NMHS – National Mental Health Strategy

An agreement between the Commonwealth and all State and Territory governments that aims to improve the lives of people with a mental illness.

NSPS – The National Suicide Prevention Strategy

The National Suicide Prevention Strategy (NSPS) focuses on people of all age groups and those identified as being at risk of suicide in the community.

The National Suicide Prevention Strategy (NSPS) commenced in 1999 and builds on the former National Youth Suicide Prevention Strategy (NYSPS).

The key outcomes of the NSPS are:

  • to support national suicide prevention activities across the life span
  • the development and implementation of a strategic framework for a whole of government and whole of community approach to suicide prevention across all levels of government, the community and business.

O

Other service provider (NS)

Another organisation or individual practitioner who provides a direct health or welfare service to the consumer.

Outcome (AG)

A measurable change in the health of an individual, or group of people or population, which is attributable to an intervention or series of interventions. Australian Health Ministers, 1998, p. 27.

P

Postvention (AG)

Intervention that takes place after a suicide largely in the form of support for the bereaved (friends, family, agency workers and peers). The aim is to facilitate the expression of feelings about the suicide and to minimise romanticisation of the death; provide support and debriefing to those affected; and reduce the possibility of suicide contagion. Interventions recognise that those bereaved by suicide may be vulnerable to suicidal behaviour themselves and may develop complicated grief reactions.

Primary health care (AG)

Primary health care has two meanings. The narrow definition (sometimes called primary medical care) focuses on the provision of medical services treating individual, generally acute medical conditions. It forms only a part of comprehensive primary health care which is the broader, holistic approach to health problems. As well as primary medical care, comprehensive primary health care addresses a range of health concerns that have no specific medical intervention.

http://amsant.com.au/site/index.php?option=com_content&task=view&id=69&Itemid=77

Process (K)

The manner in which issues are discussed and decisions made; a set of operations that are applied to specific issues.

Protective factors (AG)

Factors that give people resilience in the face of adversity and moderate the impact of stress and transient symptoms on the person’s social and emotional wellbeing. Protective factors reduce the likelihood that a disorder will develop.

Psychiatric inpatient unit (NS)

A ward/unit/facility in a general hospital, private psychiatric hospital, stand alone psychiatric hospital or some other location used primarily for the treatment of mental disorders and / other mental health problems.

(For example: might also be called a special care suite or ward in a house).

Q

Quality assurance (K)

Processes and practices to ensure services and their means and manner of delivery are appropriate to the needs of consumers and carers. Includes ensuring that consumers and carers are listened to both individually and through representatives. Quality assurance requires that user-friendly complaints mechanisms are in place, and that decisions about mental health services and issues are not made in the absence of those who are most affected by them.

Quality improvement process (NS)

A process which measures performance, identifies opportunities for improvement in the delivery of care and services, and includes action and follow-up.

R

Resilience (AG)

Capacities within a person that promote positive outcomes, such as mental health and wellbeing, and provide protection from factors that might otherwise place that person at risk of adverse health outcomes. Factors that contribute to resilience include personal coping skills and strategies for dealing with adversity, such as problem-solving, good communication and social skills, optimistic thinking, and help-seeking.

Risk assessment

Risk assessment is the process which involves determination of the degree of probability that a certain event may occur.

Risk factors (AG)

Factors that increase the likelihood that a disorder will develop, and exacerbate the burden of existing disorder. Risk factors indicate a person’s vulnerability, and may include genetic, biological, behavioural, socio-cultural and demographic conditions and characteristics. Most risk (and protective factors) for mental health lie outside the domain of mental health and health services – they derive from conditions in the everyday lives of individuals and communities. Risk and protective factors occur through income and social status, physical environments, education and educational settings, working conditions, social environments, families, biology and genetics, personal health practices and coping skills, sport and recreation, the availability of opportunities, as well as through access to health services.

Risk-taking behaviours (AG)

Risk taking behaviours are behaviours in which there is some risk of immediate or later self-harm. Risk-taking behaviours might include activities such as dangerous driving, train surfing, alcohol abuse and self-harming substance use.

Rural and remote communities (AG)

The rural, remote and metropolitan areas (RRMA) classification was developed… based primarily on population numbers and an index of remoteness. The RRMA categories show a natural hierarchy, providing a model for incremental health disadvantage with rurality and remoteness as risk factors.

S

Self-harm

‘The intentional injuring of one’s own body without apparent suicidal intent.’ Other words sometimes used are parasuicide and self mutilation. Not all people who self-harm are suicidal, but a significant proportion does die by suicide.

Service provider (K)

Includes nurses, psychologists, occupational therapists, psychiatrists, social workers.

Significant others (NS)

Those people that the consumer identifies as being significant in their life. (For example: might be a friend, family, clergy, employer).

Stakeholders (K)

The different groups that are affected by decisions, consultations and policies.

Stigma

A distinguishing personal trait that is perceived as or actually is physically, socially, or psychologically disadvantageous. MedicineNet.com

Stigma surrounding mental health is a pervasive problem. It can make people reluctant to seek help at all or to discontinue use of services. Many people living with mental illness find that the associated stigma is as difficult to handle as the symptoms of their illness.

Suicidal behaviour

The whole spectrum of suicide attempts from:

  1. Death
  2. Highly lethal (in which survival is due to good fortune)
  3. Low-lethality attempts in the context of a social crisis (often containing a strong element of an appeal for help).

Suicidal ideation

Thinking about suicide without action. Is more common than suicidal behaviour.

Suicidality

Individual’s level of intent to complete suicide.

Suicide

The deliberate taking of one’s own life.

Suicide attempt

A deliberate or ambivalent act of self-destruction or other life-threatening behaviour, that does not result in death.

“Suicide by cop”

This behaviour is typified by individuals threatening public safety in highly visible ways, the aim being to force police to shoot them.

Suicide prevention

Concerned with preventing suicide by reducing the risk factors associated with suicide and increasing the protective factors, such as promoting mental health and resilience within the community.

Suicidal behaviour

includes the spectrum of activities related to suicide and self-harm including suicidal thinking, self-harming behaviours not aimed at causing death and suicide attempts. Some writers also include deliberate recklessness and risk-taking behaviours as suicidal behaviours.

Systems advocacy (K)

Any advocacy activities designed to bring about system-wide changes rather than changes to the circumstances of an individual.

T

Therapies

The range of therapeutic approaches which reflect best available evidence and are used in mental health care excluding medication and other medical technologies).

For example: could include psycho-therapeutic, psycho-educational, rehabilitative, collaborative approaches using individual and/or group methods).

Treatment

Specific physical, psychological and social interventions provided by health professionals aimed at the reduction of impairment and disability and/or the maintenance of current level of functioning.

Triage

Triage aims to ensure that patients are treated in order of clinical urgency. It also facilitates the patient being seen in the most appropriate assessment and treatment area.

V

Validation (K)

Process of determining the correctness of some proposition or conclusion.