{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T09:24:03Z","timestamp":1787649843104,"version":"build-2736575974"},"reference-count":46,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Mental Health Nurs"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Mental health reform represents a sustained effort to improve the accessibility, quality and human rights orientation of mental health systems through changes to policy, legislation and service delivery. The scale and pace of growth in the lived and living experience workforce (LLEW) is unprecedented within mental health services, with a marked increase in roles representing a significant shift in the contemporary mental health landscape. In Australia, the state of Victoria is currently undergoing the most significant mental health reform in its history. This study aimed to explore mental health nurses' perceptions of the impacts of mental health reform on (1) their delivery of care in relation to consumer and carer safety and wellbeing and (2) their experiences of working alongside lived experience workers within reformed service contexts. This study employed a qualitative descriptive design, with secondary analysis of existing qualitative data (Szabo and Strang 1997), which were thematically analysed using Braun and Clarke and reported in accordance with CORE\u2010Q guidelines. Semi\u2010structured interviews were conducted with mental health nurses working in Victoria (\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u200914), Australia, with three themes generated through reflexive thematic analysis: (1) Mind the gap: Reform impacts to safety and risk; (2) When care comes too late: reform impacts to care and treatment; and (3) Between sympathy and resistance: ambivalent attitudes towards LLEW roles. Persistent integration challenges related to LLEW influenced nurses' perceptions of usefulness. Nurses also described that an increased legislative emphasis on consumer choice, relative to clinical decision\u2010making, contributed to uncertainty and hesitancy in intervention, which nurses perceived as negatively affecting care outcomes in some situations.\n                  <\/jats:p>","DOI":"10.1111\/inm.70319","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T08:45:44Z","timestamp":1784709944000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Between Autonomy and Duty. Mental Health Nurses' Experiences of Early Intervention in a Rights\u2010Prioritised Reform Context: A Qualitative Descriptive Study"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1686-1476","authenticated-orcid":false,"given":"Louise","family":"Alexander","sequence":"first","affiliation":[{"name":"Deakin University, School of Nursing &amp; Midwifery  Burwood Australia"},{"name":"Deakin University, Institute for Health Transformation  Geelong Australia"},{"name":"Alfred Hospital, Mental and Addiction Health  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4752-258X","authenticated-orcid":false,"given":"Whitney","family":"Johnson","sequence":"additional","affiliation":[{"name":"Alfred Hospital, Mental and Addiction Health  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7457-3221","authenticated-orcid":false,"given":"Adam","family":"Searby","sequence":"additional","affiliation":[{"name":"Monash University, School of Nursing &amp; Midwifery  Clayton Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Rozario","sequence":"additional","affiliation":[{"name":"Alfred Hospital, Mental and Addiction Health  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Belmore","sequence":"additional","affiliation":[{"name":"Alfred Hospital, Mental and Addiction Health  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cally","family":"Mills","sequence":"additional","affiliation":[{"name":"Deakin University, School of Nursing &amp; Midwifery  Geelong Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/inm.70127"},{"key":"e_1_2_14_3_1","volume-title":"Royal Commission Into Victoria's Mental Health System \u2013 Final Report","author":"Armytage P.","year":"2021"},{"key":"e_1_2_14_4_1","unstructured":"Australian Government.2023.Elevating People With Lived Experience of Mental Ill\u2010Health to Drive Reform.https:\/\/www.health.gov.au\/ministers\/the\u2010hon\u2010mark\u2010butler\u2010mp\/media\/elevating\u2010people\u2010with\u2010lived\u2010experience\u2010of\u2010mental\u2010ill\u2010health\u2010to\u2010drive\u2010reform."},{"key":"e_1_2_14_5_1","unstructured":"Australian Institute of Health & Welfare.2023a.Restrictive Practices in Mental Health Care.https:\/\/www.aihw.gov.au\/getmedia\/714d1543\u2010da20\u201041fc\u2010aec3\u20105abe011f7a44\/restrictive\u2010practices\u2010in\u2010mental\u2010health\u2010care.pdf.aspx."},{"key":"e_1_2_14_6_1","unstructured":"Australian Institute of Health and Welfare.2023b.Mental Health Services in Australia.https:\/\/www.aihw.gov.au\/reports\/mental\u2010health\u2010services\/mental\u2010health\u2010services\u2010in\u2010australia."},{"key":"e_1_2_14_7_1","unstructured":"Australian Institute of Health and Welfare.2024.Mental Health 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K.","year":"2023"},{"key":"e_1_2_14_42_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.20230607"},{"key":"e_1_2_14_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/00012272\u2010199712000\u201000008"},{"key":"e_1_2_14_44_1","doi-asserted-by":"publisher","DOI":"10.1192\/j.eurpsy.2023.2465"},{"key":"e_1_2_14_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_2_14_46_1","unstructured":"World Health Organization.2018.Mental Health Human Rights and Standards of Care: Assessment of the Quality of Institutional Care for Adults With Psychosocial and Intellectual Disabilities in the WHO European Region.https:\/\/iris.who.int\/bitstream\/handle\/10665\/342203\/9789289053204\u2010eng.pdf?sequence=1&isAllowed=y."},{"key":"e_1_2_14_47_1","unstructured":"World Health Organization.2022.World Mental Health Report: Transforming Mental Health for 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