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A bst ractThere is limited literature on the experience of caring for an intimate partner with a mental health condition. Posttraumatic stress disorder (PTSD) is a common mental health condition for military veterans; yet, little is known about how partners experience and cope with these caring relationships. Using an interpretive phenomenological approach, we collected data through individual interviews with 20 female partners of male veterans diagnosed with PTSD living in South Australia. W e found the emotional features of caring to be directly derived from the strength of commitment these carers had to their relationships. W e show that lack of understanding of carers' lives, particularly by health providers and government, has resulted in a sense of social disconnect and invisibility that has contributed to stress and is a barrier to coping. Of vital importance to these carers was that partners of younger veterans do not have to suffer the same experiences.

Introduction: Social support, particularly support from an intimate partner, is both a significant protective factor for trauma-exposed Veterans and critical for recovery in mental health, yet we know little about the experiences and support needs of their partners, particularly in the Australian context. This study examined the multidimensional nature of experiences of being an intimate partner of a contemporary Veteran with posttraumatic stress disorder (PTSD). Methods: The authors used a qualitative phenomenological approach to conduct an inductive thematic analysis of data collected through individual interviews with a purposive sample of 10 partners of contemporary Veterans living in Australia. Interviewees were recruited through a range of community support organizations. Results: Analysis revealed intimate partners are crucial participants in supporting the recovery journey for traumatized Veterans, effectively managing day-to-day care, encouraging autonomy and instilling hope. However, descriptions highlighted that lack of understanding of partners’ daily lives, and particularly their commitment to maintaining their intimate relationship, by health care providers and government results in a sense of invisibility and is the key barrier to receiving the support they need in order to support recovery in their Veteran partners. Discussion: The findings underscore the importance of recognizing the role of intimate relationships in trauma recovery and of responding to the support needs of intimate partners. In particular, the findings have clear implications for improving the engagement by health care providers of partners of Veterans with PTSD in Veteran clinical treatment. More formal recognition of the indirect impact of PTSD on partners of Veterans is also needed within organizational policies and procedures. Finally, there is clearly a need for continuing education of health care providers, government staff and the general community about the nature of PTSD and its impacts on relationships, particularly the intimate type.

Unintentional injuries, or accidents, are common among older adults and can lead to long-term disability and even death. However, injuries are preventable and should not be considered a normal part of aging. Recent FallsFalls, the most common cause of injury among older adults nationally and in NYC, result from a complex set of factors including loss of gait and balance, environmental hazards, the use of multiple medications, and vision problems. 1,2 Comparable to national estimates among adults aged 65 and older 3 three in 10 (29%) older NYCHA residents reported a recent fall. Unlike the prevalence of falls in the US, which are more commonly reported among women than men and increase in prevalence with age, the prevalence of recent falls among older NYCHA residents did not vary by gender or age. 3 Black residents reported fewer recent falls than white and Hispanic residents, and older residents living alone were more likely to report a recent fall than those living with others.Falls can be caused by current disability but can also contribute to disabling conditions and poor quality of life. 2,4 Adults who have experienced a fall may also develop a fear of falling that causes them to limit their physical activity and become isolated. This, in turn, decreases physical and mental health and increases risk for future falls. 2,4 Similar to older adults nationally, 2 older NYCHA residents who reported a recent fall were more likely to report being physically inactive than those who did not (39% vs. 27%). Severe vision trouble, a risk factor for falling, 2,4 was also associated with recent falls among older NYCHA residents: those with severe vision trouble were more likely than those without to report a recent fall (36% vs. 26%).Chronic health conditions, whether the condition itself or the side effects of prescribed medication to treat the condition, have been associated with an increased risk of falling. 3 Older residents diagnosed with multiple chronic conditions were more likely to report a recent fall than those with one or no conditions (32% Editor's Note. The following survey is reprinted and adapted for the Care Management Journals format with permission from the New York City Housing Authority. Part 1 appeared in Care Management Journals, 13(3), 2012.

ObjectiveThe aim of this study was to describe the current state of carer engagement and partnership in two mental health (MH) services in South Australia and the implementation of the six partnership standards in A Practical Guide to Working with Carers of People with a Mental Illness. MethodsAnonymous surveys of carer experiences and clinician self-ratings of their own practice against the six partnership standards were completed by 94 staff and 58 carers within public and private MH in-patient units before and after exposure of clinicians to education about the partnership standards. Descriptive statistical analysis was performed and, where applicable, a comparative analysis used the two-sample Z-test of proportions. Qualitative data was analysed thematically. ResultsConsiderable gaps were evident between carer experiences and clinician self-ratings of their own practice. Overall, the surveys point to the lack of a consistent approach by both public and private services, and suggest potential barriers to fostering carer participation and engagement. Confidentiality was a particularly noted barrier to partnership with carers. ConclusionSignificant improvement is needed to meet the partnership standards. Brief exposure to the Guide is not, in itself, sufficient to effect change in the overall attitudes, skills and knowledge of clinical staff about engaging carers. Significantly more focus on staff education, clinical discussions and supervision is needed to meet the MH carer partnership standards. What is known about the topic?Partnership with MH consumers and carers is an established key principle within national MH policies and accreditation standards. Family carers play an important role in supporting consumers’ recovery, yet many carers continue to report being excluded, particularly by in-patient clinical staff. What does this paper add?This is the first study to investigate the partnership standards in practice by comparing the perspectives of carers and in-patient MH clinical staff. What are the implications for practitioners?Improving partnership with carers of people with mental illness will require significant MH service leadership support shifts in current practice and culture. In addition, a more nuanced understanding of confidentiality is required to overcome the barriers to involving family carers more meaningfully in care.