Nicola Hancock

The University of Sydney · Faculty of Health Sciences

Background Information sharing and information privacy are important issues in mental health services. Yet the perspectives of Australians who access mental health services about these issues are poorly understood. This article addresses the research question: What are the concerns of people who use mental health services about the collection and u...

In this article, perceived benefits, facilitators and challenges of peer support offered for and by people living with dementia are explored by comparing peer support provided by Dementia Lifestyle Coach (DLC) and Dementia Alliance International (DAI). Semi-structured interviews were conducted with interviewees from DLC and DAI. Interview recording...

Introduction A peer‐mediated, play‐based intervention has been developed to address social participation challenges experienced by children with ADHD. To facilitate implementation into clinical practice, interventions should be evaluated for appropriateness to the end‐user, as well as effectiveness. Previous research demonstrated the approach is ef...

Personal recovery, a western conceptualisation that focuses on hope and living meaningful lives of choice rather than focusing on symptom reduction, is a more recent concept in many Asian countries including Thailand. One way to promote recovery-oriented service delivery is to use outcome measures that capture self-reported personal recovery. This...

Introduction Routine use of self-rated measures of mental health recovery can support recovery-oriented practice. However, to be widely adopted, outcome measures must be feasible. This study examined the feasibility of Recovery Assessment Scale – Domains and Stages (RAS-DS) from the perspectives of mental health workers. Method Mental health worke...

Purpose. This study sought to gain an understanding of rural and remote rehabilitation healthcare workers’ perceptions and experiences of compassion satisfaction and compassion fatigue. Method. Sixteen rehabilitation workers from four national providers of rehabilitation services to rural and remote communities participated in semistructured interv...

Introduction People with schizophrenia are more likely to be hospitalised than any other psychiatric diagnosis. Occupational therapists working in mental health are often required to assess and recommend supports that will assist people with schizophrenia to live successfully in the community. There is little research exploring consumer perspective...

Objectives To examine preferences for telehealth versus in-person services for people who sought mental health support from an unfamiliar service during the COVID-19 pandemic and to identify the factors that influenced these preferences. Methods Data are drawn from semi-structured interviews with 45 participants (32 people who accessed mental heal...

Introduction Self‐determination is a core component of mental health recovery and a predictor of positive outcomes. The literature calls for occupational therapists to lead practice change to greater recovery‐orientation, including facilitating people's self‐determination. However, systemic challenges thwart translation of policy into practice and...

Background The Recovery Assessment Scale: Domains and Stages (RAS-DS) was designed to be both a recovery outcome measure and a tool to enhance service-user control over their recovery journey. While extensively and globally used in mental health services for the former purpose, routine use for the latter purpose is yet to be realised. The aim of th...

Background The Recovery Assessment Scale: Domains and Stages (RAS-DS) is designed as both a recovery outcome measure and a tool to enhance service-user control over their recovery journey. While extensively and globally used in mental health services for the former purpose, routine use for the latter purpose is yet to be realised. The aim of this s...

Cognitive impairment is common amongst people experiencing homelessness, yet cognitive screening and the collection of history of brain injury rarely features in homelessness service delivery practice. The purpose of this research was to scope and map strategies for screening for the potential presence of cognitive impairment or brain injury amongs...

Background: Students from a range of health disciplines need to learn from people with lived experience of mental distress and recovery to develop recovery capabilities for mental health practice. Aims: The aims of this study are to describe the co-design of a teaching resource, to explore the experience of people with lived experience during th...

Hope is essential to mental health recovery, yet little is known about how mental health services can foster hope. This paper addresses the question: How can mental health services influence the sense of hope experienced by people who access their services? Sixty-one people who accessed a new mental health service were interviewed about their exper...

The National Disability Insurance Scheme (NDIS) was designed to support Australians living with disability. However, public data evidence the low number of people with psychosocial disability in the Scheme. One reason for these low numbers is that many people with psychosocial disability have still not applied to receive NDIS support. The aim of th...

Objectives This study aimed to conduct a feasibility pilot of the Dementia Lifestyle Coach program; an individual coaching and counselling program for people recently diagnosed with dementia, to help them to adjust to the diagnosis and live well. Methods A randomised controlled pilot trial (n = 11) with wait-list control group was undertaken over...

Great controversy surrounds the use of electroconvulsive therapy or ECT. However, it continues to be used internationally. While research on short term effects of ECT abound, there is limited knowledge about long term impacts of ECT on individuals, especially from the lived experience perspective. The aim of this qualitative study was to gain an in...

Background: The COVID-19 pandemic triggered a sudden increase in the need for mental health services and a rapid escalation in the delivery of these services via telehealth. Little is known about how people experience telehealth as part of a new mental health service, where relationships with service providers have not yet been established. In this...

Importance: Research involving the use of the Allen Cognitive Level Screen (ACLS) in mental health practice has been available for more than 40 yr, yet there has been no comprehensive synthesis and review of this body of literature. Objective: To review, summarize, compare, and evaluate the existing literature regarding the relationship between the...

Background: Transitioning from psychiatric hospitalisation back to community presents a period of heightened suicide, homelessness, relapse, and rehospitalisation risk. The Australian state of New South Wales established a state-wide Peer Supported Transfer of Care (Peer-STOC) initiative to enhance recovery-focused supports available during this t...

This paper uses secondary analysis to understand how COVID-19 shaped people’s experiences with psychosocial support services in Australia. Data are drawn from questionnaires (n = 66) and semi-structured interviews (n = 62), conducted for a national service evaluation, with 121 people living with enduring mental health conditions and using psychosoc...

The Recovery Assessment Scale - Domains and Stages (RAS-DS) is a 38-item self-report instrument measuring recovery from serious mental illness. We explored the suitability of the RAS-DS for individuals with anxiety disorders. A parsimonious short-form of the scale was developed. Participants with anxiety disorder symptoms (N = 295) completed the RA...

Objectives The aim of this scoping review was to map and synthesise peer-reviewed literature reporting on the Australian National Disability Insurance Scheme and psychosocial disability. Method The review followed the rigorous and systematic protocol of Arksey and O’Malley. Five databases were searched and, using strict inclusion and exclusion cri...

The study objective was to identify the types of experiences that consumers identify as igniting and maintaining hope, and those most frequently reported. Data were collected through an anonymous online survey. Two open-ended questions elicited reflective personal accounts regarding hope-promoting experiences. Using an interpretive content analysis...

Parents are a critical resource in supporting young people who live with mental health problems. Qualitative research has identified that parents use a wide range of strategies to provide support. However, parents report being unsure which strategies are likely to be helpful, so often struggle in this role. Presently, little empirical evidence exis...

Background: Electroconvulsive therapy (ECT) is a controversial treatment. Research has predominantly focused on clinician assessment of short-term efficacy and, occasionally, on participant experiences of the treatment itself. While service user accounts of the long-term impacts of ECT are reported, they are dispersed throughout the literature and...

Introduction: Occupational therapists are an integral part of Australian mental health services. Recent changes in the mental health sector mean that increasing numbers of occupational therapists now work in generic, non-profession-specific roles in non-government organisations. Previous research has identified a range of challenges faced by occup...

Background: Mothers who live with mental illness face diverse challenges. Research suggests that partner support or otherwise is likely to have a crucial influence on mothers' abilities to manage these challenges, yet little is known about how this plays out. In this study, we aimed to explore the roles played by male partners in the mothering exp...

Introduction Consumer-led and collaborative research is consistent with occupational therapy principles of inclusion and client-centredness, and is increasingly valued in mental health. Our research team of three occupational therapists and three consumers was funded to conduct a consumer-led mental health service evaluation. Because of a lack of p...

Introduction: Numerous factors are involved in successful community living for people with schizophrenia. Support received is one important factor. Little is known about what aspects of support are valuable for thriving in the community. Objective: To explore what aspects of formal and informal support is helpful for people living with schizophreni...

Aim: The Recovery Assessment Scale-Domains and Stages (RAS-DS) is a self-rated measure of mental health recovery. While this instrument has demonstrated good measurement properties and acceptability to clinicians and consumers in adult mental health services, it has not been evaluated in the context of youth-focused mental health services. This st...

Introduction: Australian occupational therapists working on mental health inpatient wards are often requested to assess a person's function and, based on that assessment, recommend the best support environments for that person post-discharge. The Allen Cognitive Level Screen (ACLS) is a tool used by some therapists to screen cognitive functioning...

Introduction Engaging in employment enhances mental health recovery and is therefore of central focus for many occupational therapists working in mental health. Individual placement and support (IPS) is an evidence‐based, supported employment model specifically designed for individuals with severe mental illness who have the desire to work. Despite...

Family inclusion in treatment planning and delivery for people living with mental illness is advocated in government policy but is yet to be widely translated into practice. While external barriers have been identified, including concerns about consumers’ best interests, little is known about consumers’ own views. This study explores consumers’ exp...

Background Transition from prison to community is a challenging time for all people who have been incarcerated. It is particularly challenging for those also living with serious and persistent mental illness. This study explored staff experiences and perspectives of what helped and hindered them in their work to support that transition. Methods Se...

Background: Electroconvulsive therapy (ECT) is one of the most controversial treatments in psychiatry. This controversy and diverse and often strongly held opinions can make decision making processes around ECT more complex. Method: This consumer-led project explored the experiences of individuals who had received ECT in terms of the information...

Background: The aim of this study was to better understand early-stage mental health recovery experiences of people living with severe and persistent mental illness and complex needs. Methods: Semi-structured, in-depth interviews were conducted with 13 people engaged in an Australian program specifically designed for people facing complex barrie...

There is a need for robust outcome measures for use in psychiatric services. Particularly lacking are self-rated recovery measures with evidence of sensitivity to change. This study was established to examine the convergent validity and sensitivity to change over time (responsiveness) of the Recovery Assessment Scale - Domains and Stages (RAS-DS),...

Objective: The aim of this study was to identify aspects of the consumer-provider relationship that consumers saw as important in a care coordination service model. Method: Semi-structured interviews were conducted, between October 2015 and March 2016, with 20 people living with severe and persistent mental illness who used a care coordination serv...

This study explored the social inclusion in high school of Australian students with vision impairment (VI). We sought to understand how students described school social inclusion, whether they felt included and what influenced these perceptions. As part of a larger mixed methods study, 12 students with VI, who had previously answered the Psychologi...

Secure and appropriate housing is critical for the well-being of people living with mental illness (consumers). Yet it is often difficult to achieve. Housing assistance is available, but is often difficult for consumers to access and negotiate. While the need for support is well-recognised, little is known about the active part consumers play in fi...

Background: Recovery oriented service provisions means focusing on outcomes that are important to consumers themselves rather than to clinicians or services. Partners in Recovery (PIR) is an Australia-wide initiative designed to provide service coordination and brokerage for individuals with severe and persistent mental illness. One PIR service en...

Background The time following discharge from psychiatric hospitalisation is a high risk period. Rates of hospital readmission are high and there is increased risk for homelessness and suicide. Transitional and post-discharge support programs have demonstrated positive results in terms of enhanced wellbeing, improved connection with community-based...

Objective Partners in Recovery (PIR) is an Australian government initiative designed to provide support and service linkage for individuals with complex needs living with severe and persistent mental illness. The aim of the present study was to examine whether consumers engaged in PIR programs in two large regions of Sydney experienced: (1) a reduc...

Recovery conversations provide space for consumers of mental health services to identify how life, post diagnosis, might be lived. Anthony (1993) notes that 'recovery is a simple but powerful vision' (p.13) however there is no universally accepted definition of recovery in a context of mental health. Conceptualising recovery as an individual journe...

Introduction We investigated child outcomes and mothers' perspectives following technology-based intervention sessions aimed at improving children's social play skills. Method Participants in this multiple case study included five children with attention deficit hyperactivity disorder, their mothers and five typically developing playmates, who had...

Background/Aim Internationally, mental health policy requires clinicians to shift from a medical to a recovery-oriented approach. However, there is a significant lag in the translation of policy into practice. Occupational therapists have been identified as ideally situated to be recovery-oriented yet limited research exploring how they do this exi...

Introduction This study explores the social experiences in high school of students with visual impairments. Methods Experience sampling methodology was used to examine (a) how socially included students with visual impairments feel, (b) the internal qualities of their activities, and (c) the factors that influence a sense of inclusion. Twelve stud...

Objective: The aim of this study was to understand the strategies women living with mental illness use to balance the demands of mothering with mental health recovery. Method: Semi-structured interviews were conducted with 10 Australian women who self-identified as managing to balance mothering with mental health recovery. The data were analysed us...

Objective The Partners in Recovery (PIR) program is an Australian government initiative designed to make the mental health and social care sectors work in more coordinated ways to meet the needs of those with severe and complex mental illness. Herein we reflect on demographic data collected during evaluation of PIR implementation in two Western Syd...

Introduction Engagement in occupation, including employment, is central to mental health recovery. However, evidence demonstrates that people living with mental illness struggle to maintain their employment. The aim of this qualitative study was to gain a rich understanding of the experiences of people living with mental illness who have managed to...

Mental health care in Australia is fragmented and inaccessible for people experiencing severe and complex mental ill-health. Partners in Recovery is a Federal Government funded scheme that was designed to improve coordination of care and needs for this group. Support Facilitators are the core service delivery component of this scheme and have been...

Measure of mental health recovery developed from the original RAS. Can also be found at ses.library.usyd.edu.au/handle/2123/9317. Manual available and psychometric properties published: Hancock, N., Scanlan, J. N., Honey, A., Bundy, A. C., & O’Shea, K. (2014). Recovery Assessment Scale–Domains and Stages (RAS-DS): Its feasibility and outcome measur...

IntroductionEngagement in meaningful occupations is of central importance in mental health recovery. The purpose of this study was to gain a richer understanding of the relationships between occupations, sources of meaning and recovery for people living with mental illness. Method People living with mental illness (n=78) attending an Australian Clu...

Introduction This study aimed to evaluate parents’ perspectives of the appropriateness of a parent-delivered play-based intervention, The Ultimate Guide to Making Friends. The intervention was designed to improve the social play skills of children with ADHD. Method One month post-intervention, seven parents of children with ADHD participated in in...

Background/Aims Assisting clients to achieve wellbeing, even in the presence of ongoing mental illness, should be a primary goal of mental health services. However, little is known about what wellbeing means for young people living with mental illness. The aim of this study is to explore the ways in which young Australians living with mental illnes...

Background/Aims: Assisting clients to achieve wellbeing, even in the presence of ongoing mental illness, should be a primary goal of mental health services. However, little is known about what wellbeing means for young people living with mental illness. The aim of this study is to explore the ways in which young Australians living with mental illne...

A parent's response to a young person's mental illness can influence their recovery and wellbeing. Many parents devote considerable time and energy to supporting a young person experiencing mental illness and engage in numerous different practices to do so. Yet little is known about why parents use particular practices. This article explores this q...

A self-report instrument of mental health recovery is needed both to facilitate collaborative, recovery-oriented practice and measure recovery-focused outcomes. The Recovery Assessment Scale - Domains and Stages (RAS-DS) has been developed to simultaneously fulfill these goals. The aim of this study was to test the feasibility and measurement prope...

Our paper focuses on the implementation in practice of an integrated care policy for severe and complex mental ill-health: Partners in Recovery. In order to be effective care for people experiencing chronic and complex mental ill-health must be supported by a framework which takes in multiple services whose focus extends throughout and beyond the h...

There is irrefutable evidence that people living with mental illness are much more likely than the general population to experience a number of serious and life threatening physical health conditions. People with mental illness have a life expectancy that is approximately 25 years less than that of the general population. Incidence of diabetes in p...

Parenting is a critical and complex occupational role, requiring different occupations and abilities depending on the developmental stage and specific characteristics of each child. When a young adult child develops a mental illness, assisting and supporting them to overcome or adapt to the mental illness becomes a crucial aspect of this occupation...

Research shows that people with mental illness are not enjoying the same life choices and opportunities as other Australians. As a signatory to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), Australia is obliged to monitor and report on the level and nature of disadvantage faced by Australians with disabilities....

This paper reports on a pilot study testing the feasibility of an app as a survey tool for exploring the social experiences of high school students who are vision impaired. The Participation in Everyday Life Survey app was designed for use with the Experience Sampling Method. This method uses in-the-moment surveys to understand individuals' experie...

The Recovery Assessment Scale (RAS) is a frequently used measure of recovery from mental illness but has previously been shown to poorly differentiate between more recovered consumers. This research aimed to: (1) identify components of later recovery stages; (2) ascertain the extent to which these are measured in the RAS; and (3) suggest modificati...

A call for active inclusion of consumers in research; recognising and valuing the knowledge that arises through lived experience, is made in the literature. However, genuine inclusion of consumers as members of the research team remains rare. Opponents present two barriers: lack of required knowledge and skills and lack of capacity to conduct rigor...

Recovery from serious mental illness refers to the attainment of a meaningful, productive, and satisfying life, regardless of the presence or absence of reoccurring symptoms. A lack of psychometrically sound instruments has thwarted attempts to measure recovery. With the goal of addressing this need, we administered the Recovery Assessment Scale (R...

Pilot study to examine if the addition of a structured framework improved the quality of clinical reasoning demonstrated within clinically based online discussions by occupational therapy students undertaking fieldwork. Cognitive elements of the clinical reasoning process present within students' discussions were compared before (2005 cohort) and a...

This study describes a project that aimed to train people with mental illness in introductory research skills to support the development of a Clubhouse. Eight mental health consumers from the Illawarra region in New South Wales, Australia were recruited to participate in the project. The group met weekly over a 10-week period to participate in trai...

Peer support facilitates recovery. However, little is known about the role of peer support within the Clubhouse model. This article reports on Clubhouse members' experiences of peer support and the outcomes they identify from engaging in this phenomenon. Grounded theory guided the study design involving 17 semi-structured interviews conducted with...

The aim of this study was to examine the feasibility of using routine public mental health outcome data to measure the effectiveness of a non government organization (NGO), specifically Pioneer Clubhouse. We retrieved data from the NSW Mental Health Outcomes and Assessment Tools (MH-OAT) database, for 31 participants who joined Pioneer Clubhouse, N...

Background and Aims: Despite recent initiatives to reduce stigma towards people with mental illness, negative attitudes persist both in the community and among health professionals. Fieldwork experience has been identified as the most powerful way of modifying the attitudes of health professional students. Research to date suggests that later place...

Emerging paradigms of clinical reasoning skills are tending to veer away from linear and clinical competencies towards generic professional skills and decision making processes. In the present study, occupational therapy students have previously complained that they do not receive enough support from the university or their peers during fieldwork p...