• Access - The ability “to reasonably and equitably provide services based on need irrespective of geography, social standing, ethnicity age, race, level of income or sex” (NSW Health (1998)).
• Acculturation* - Adaptation to a different culture.
• Advocacy# - Representing the concerns and interests of consumers and carers, speaking on their behalf, and providing training and support to enable them to represent themselves.
• Anxiety* - An unpleasant feeling of fear or apprehension accompanied by increased physiological arousal.
• Anxiety disorder* - An unpleasant feeling of fear or apprehension accompanied by increased physiological arousal defined according to clinically derived standard psychiatric diagnostic criteria.
• Assessment* - Ongoing process beginning with first client contact and continuing throughout the intervention and maintenance phases to termination of contact. The major goals of assessment are (a) identification of vulnerable or likely cases; (b) diagnosis; (c) choice of optimal treatment; and (d) evaluation of the effectiveness of the treatment.
• CALD - Culturally and linguistically diverse.
• Carer# - A person whose life is affected by virtue of a close relationship and a caring role with a consumer.
• Chronic* - Of lengthy duration or recurring frequently, often with progression seriousness.
• Comorbidity* - ‘The co-occurrence of two or more disorders such as depressive disorder with anxiety disorder, or depressive disorder with anorexia’ (NHMRC, 1997, p. 154).
• Community capacity building# - Developing investment in mental health on multiple levels in government and non-government sectors, and utilising the knowledge and expertise of consumers, carers and others in the general population.
• Community development* - Refers to the process of facilitating the community’s awareness of the factors and forces that affect its health and quality of life, and ultimately helping to empower the community with the skills needed to take control over and improve those conditions. It involves helping communities to identify issues of concern and facilitating their efforts to bring about change in these areas (Hawe, Degeling and Hall, 1990).
• Community education* - An organised campaign designed to increase awareness of an issue.
• Complex conditions# - Conditions in which a person experiences mental illness as well as other multiple and complex social, emotional and/or physical health problems. Complex conditions include mental illness with problematic substance abuse, histories of abuse, intellectual disability, and challenging, at risk, suicidal and criminal behaviours. People with complex conditions often have needs that require a co-ordinated response from multiple service sectors.
• Connectedness* - A person’s sense of belonging with others. A sense of connectedness can be with family, school or community.
• Consumer# - A person utilising, or who has utilised, a mental health service.
• Continuity of care# - Linkage of components of individualised treatment and care across health service agencies according to individual needs.
• Culture - Can be defined as a “set of guidelines (both explicit and implicit) which individuals inherit as members of a particular society, and which tells them how to view the world, how to experience it emotionally, and how to behave in it in relation to other people, to supernatural forces or gods and to the natural environment” (Helman 1990).
• Cultural competency - The ability “to see beyond the boundaries of (one’s) own cultural interpretations, to be able to maintain objectivity when faced with individuals from cultures different from (one’s) own and be able to interpret and understand behaviours and intentions of people from other cultures non-judgemental and without bias (Walker, 1991, p. 6)
• Cultural diversity - 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.
• Depressed mood* - A sad or unhappy mood state.
• Depressive disorder* - A constellation of emotional, cognitive and somatic signs and symptoms including sustained sad mood or lack of pleasure and defined according to standard diagnostic criteria.
• Diagnosis* - A decision based on the recognition of clinically relevant symptomatology, the consideration of causes that may exclude a diagnosis of another condition, and the application of clinical judgement.
• Early interventions# - Timely interventions which target people displaying the early signs and symptoms of a mental health problem or a mental disorder. Early intervention also encompasses the early identification of patients suffering from a first episode of disorder.
• Effectiveness* - Effectiveness studies test the ‘real world’ impact of interventions that have been shown to be efficacious under controlled conditions. These studies are imperative to determine the generalisability of controlled studies in the real world, because interventions conducted under highly controlled conditions may not translate well into the uncontrolled environment that is the real world.
• Efficacy* - Efficacy studies, usually randomised controlled trials, are undertaken under experimental or ‘controlled’ conditions to develop and refine strategies. They provide important, but limited, information regarding the outcomes of interventions under ideal circumstances. They do not, however, yield information related to all the outcomes of interest (Aveline, 1997).
• Epidemiology# - The study of the distribution and determinants of mental health and illness as applied to a whole community.
• Evaluation* - The process used to describe the process of measuring the value or worth of a program or service.
• Evidence-based practice* - 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.
• Good practice guidelines* - Good practice is the benchmark against which programs can be evaluated. Good practice guidelines are statements based on the careful identification and synthesis of the best available evidence in a particular field. They are intended to help people in that field, including both practitioners and consumers, make the best use of available evidence.
• Incidence* - In community studies of a particular disorder, the rate at which new cases occur in a given place at a given time.
• Integrated mental health services# - A network of specialised mental health service components within the general health system, coordinated across inpatient and community settings, to ensure continuity of care for consumers. The components can encompass assessment, crisis intervention, acute care, extended care, treatment, rehabilitation, specialised residential and housing support services and domiciliary care services. The network can be coordinated through area/regional management and uses a case management system across service components.
• Integration# - The process whereby inpatient and community components of a mental health service become coordinated as a single, specialist network and include mechanisms which link intake, assessment crisis intervention, and acute, extended and on-going treatment using a case management approach to ensure continuity of care.
• Intersectoral services# - The process whereby inpatient and community components of a mental health service become coordinated as a single, specialist network and include mechanisms which link intake, assessment crisis intervention, and acute, extended and on-going treatment using a case management approach to ensure continuity of care.
• Inter-sectoral linkages# - Collaboration between mental health policies/programs/services and other relevant policies/programs/services at Commonwealth, State and Territory and local government levels, as well as in the private and non-government sectors, designed to ensure the overall needs of people with mental illness are addressed effectively.
• Mainstream health services# - Services provided by health professionals in a wide range of agencies including general hospitals, general practice and community health centres. Mental health services will be delivered and managed as an integral part of mainstream health services so they can be accessed in the same way as other services.
• Media* - ‘Channel for mass communication of information to general and/or specific audiences (electronic media—radio, television, film; print media—newspapers, magazines)’ (Commonwealth Department of Health and Family Services, 1998, p. 258).
• Mental disorder* - A diagnosable illness that significantly interferes with an individual’s cognitive, emotional or social abilities.
• Mental health# - A state of emotional and social wellbeing in which the individual can cope with the normal stresses of life and achieve his or her potential.18 It includes being able to work productively and contribute to community life. Mental health describes the capacity of individuals and groups to interact, inclusively and equitably, with one another and with their environment in ways that promote subjective wellbeing, and optimise opportunities for development and the use of mental abilities.5 Mental health is not simply the absence of mental illness. Its measurement is complex and there is no widely accepted measurement approach to date. The strong historical association between the terms ‘mental health’ and ‘mental illness’ has led some to prefer the term emotional and social wellbeing, which also accords with holistic concepts of mental health held by Aboriginal peoples and Torres Strait Islanders and some other cultural groups,6 or alternatively, the term mental health and wellbeing.
• 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 problems# - A disruption in the interaction between the individual, the group and the environment, producing a diminished state of mental health.
• Mental health professionals* - ‘Professionally trained people working specifically in mental health, such as social workers, occupational therapists, psychiatrists, psychologists and psychiatric nurses’ (Commonwealth Department of Health and Family Services, 1998, p. 258).
• Mental health promotion* - ‘Action to maximise mental health and wellbeing among populations and individuals’ (Australian Health Ministers, 1998, p. 12).
• Mental health sector# - Includes the specialist mental health sector (both public and private) and elements of the primary care sector providing mental health care.
• Mental health service provider - A person who manages and delivers mental health services in a paid or voluntary capacity. Some providers may work with NGOs but usually they have professional qualifications and receive payment for providing services. They include nurses (mental health & general), general practitioners, psychiatrists, occupational therapists, social workers and psychologists.
• Mental illness# - A clinically diagnosable disorder that significantly interferes with an individual’s cognitive, emotional or social abilities. The diagnosis of mental illness is generally made according to the classification systems of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IVR)19 or the International Classification of Diseases, Tenth Edition (ICD-10).20 These classification systems apply to a wide range of mental disorders for the DSM-IV and mental and physical disorders for the ICD-10. Not all the DSM-IV mental disorders are within the ambit of the National Mental Health Plan (2003-2008). In Australia, drug and alcohol problems are the primary responsibility of the drug and alcohol service system and there is a separate, but linked, national strategy. Similarly, dementia is treated primarily in aged care settings. Both are considered important in terms of their comorbidity with mental illness.
• Multiculturalism - The term multiculturalism summarises the way Australia address the challenges and opportunities of our cultural diversity. It is a term which recognises and celebrates Australia's cultural diversity. It accepts and respects the right of all people in Australia to express and share their individual cultural heritage within an overriding commitment to Australia and the basic structures and values of Australian democracy. It also refers specifically to the strategies, policies and programs that are designed to make our administrative, social and economic infrastructure more responsive to the rights, obligations and needs of our culturally diverse population; promote social harmony among the different cultural groups in our society; and optimise the benefits of our cultural diversity for all people in Australia.
• Multidisciplinary clinical team# - The identifiable group of mental health personnel comprising a mix of professionals responsible for the treatment and care of people with mental illness.
• Monitoring* - The ongoing evaluation of a control or management process (Noah, 1997). The continuous measurement and observation of the performance of a service or program to see that it is proceeding according to the proposed plans and objectives (Vaughan and Morrow, 1989).
• Morbidity# - The incidence of disease within a population.
• Mortality# - Death attributable to mental illness.
• New and emerging communities - Communities:
  · Lacking institutional resources and being unable to draw on the collective experience;
  · Needing to attract members who are settling in and have growing family commitments;
  · Which are not part of the existing network of funding;
  · Where the numbers they call on are small and newly arrived;
  · Which have not created a media and lack communications interstate and within a metropolis;
  · Where family networks are likely to form a substitute for formal organisations due to lack of information about, or access to, wider services;
  · Which lack completed family networks, numbers and collective resources, knowledge of existing services, or effective organisations within a national network; and
  · Which are unfamiliar with submission based government funding and have little influence on political processes, while also having ineffective links with others in a similar situation. (Ethnic Affairs Commission of NSW)
• Non-government organisations# - Private, not-for-profit, community-managed organisations that provide community support services for people affected by mental illness. Non-government organisations may promote self-help and provide support and advocacy services for consumers and carers or have a psychosocial rehabilitation role.
• Outcome# - A measurable change in the health of an individual, or group of people or population, which is attributable to interventions or services.
• Partnership* - An association intended to achieve a common aim.
• Performance indicators# - Measures of change in the health status of populations and in service delivery and clinical practice, collected in order to monitor and improve clinical, social, vocational, and economic outcomes.
• Population-based approach# - An understanding that the influences on mental health are complex and occur in the events and settings of everyday life. A population health approach encourages a holistic approach to improving mental health and well being and develops evidence-based interventions that meet the identified needs of population groups and span the spectrum from prevention to recovery and relapse prevention across the lifespan.
• Population health - Programs which attend to the health status of the whole population, or whole population sub-groups within the totality of a population. Population health programs are designed to promote health, reduce morbidity, and include monitoring and evaluating populations’ health status. A population health approach is based on the premise that health at the individual, local and global levels is the result of a complex interplay of biological, psychological, social, environmental, civil and economic factors.
• Postnatal depression* - An episode of major depressive disorder occurring in the first 12 months after childbirth.
• Prevalence* - The percentage of the population suffering from a disorder at a given point in time (point prevalence) or during a given period (period prevalence).
• Prevention* - ‘Interventions that occur before the initial onset of a disorder’ (Mrazek and Haggerty, 1994, p. 23).
  Universal intervention* : A preventive intervention ‘targeted to the general public or a whole population group that has not been identified on the basis of individual risk’ (Mrazek and Haggerty, 1994, p. 24).
  Selective intervention*: A preventive intervention ‘targeted to individuals or a subgroup of the population whose risk of developing mental disorders is significantly higher than average’ (Mrazek and Haggerty, 1994, p. 25).
  Indicated intervention*: A preventive intervention ‘targeted to high-risk individuals who are identified as having minimal but detectable signs and symptoms foreshadowing mental disorder … but who do not meet DSM-IV diagnostic levels at the current time’ (Mrazek and Haggerty, 1994, p. 25).
• Primary care sector# - The primary care sector includes GPs, and many other primary care providers such as emergency departments and community health centres, as well as others who are integrally involved in the detection, diagnosis and treatment of mental illness, and/or have much to offer in terms of promoting mental health.
• Private sector mental health services# - Specialised health services that are specifically designed for the people with a mental health problem or mental disorder seeking treatment in the private sector. In Australia, private sector mental health services include the range of mental health care and services provided by psychiatrists in private practice, and those inpatient and day only services provided by private hospitals, for which private health insurance funds pay benefits. Private sector services may also include services provided in general hospital settings and services provided by general practitioners and by other allied health professionals.
• Protective factors* - Those factors that ‘produce a resilience to the development of psychological difficulties in the face of adverse risk factors’ (Spence, 1996, p. 5).
• Psychosocial rehabilitation# - Services with a primary focus on interventions to reduce functional impairments that limit the independence of people whose independence and physical/psychological functioning has been negatively impacted upon as a result of a mental illness. Psychosocial rehabilitation focuses on disability and the promotion of personal recovery giving people the opportunity to work, live and enjoy a social life in the community. They are also characterised by an expectation of substantial improvement over the short to mid-term. This term is sometimes used interchangeably with the term rehabilitation.
• Quality of life# - This term embraces a spectrum of uses and meanings. Within this document ‘quality of life’ is a multidimensional concept that includes subjectively and objectively ascertained levels of physical, social and emotional functioning. (adapted from Katschnig, H., Freeman, H., Sartorius,N., John Wiley and Sons(1998) Quality of Life in mental Disorders, England)
• Recovery# - A personal process of changing one’s attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful and contributing life. Recovery involves the development of new meaning and purpose as the person grows beyond the effects of psychiatric disability. (Adapted from W.A. Anthony, (2000)).
• Rehabilitation# - Intervention to reduce functional impairments that limit the independence of consumers. Rehabilitation services are focused on disability and the promotion of personal recovery. Consumers who access rehabilitation services usually have a relatively stable pattern of clinical symptoms and there is an emphasis on relapse prevention. This term is sometimes used interchangeably with the term psychosocial rehabilitation.
• Reliability* - The extent to which a test, measurement or classification system produces the same scientific observation each time it is applied.
• Relapse prevention# - Reducing recurrence of illness and strengthening functioning capacity.
• Resilience* - 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 factors* - ‘Those characteristics, variables, or hazards that, if present for a given individual, make it more likely that this individual, rather than someone selected at random from the general population, will develop a disorder’ (Mrazek and Haggerty, 1994, p. 127).
• Rural and remote communities* - The rural, remote and metropolitan areas (RRMA) classification was developed in 1994 by the then Commonwealth Department of Primary Industries and Energy and Commonwealth Department of Human Services and Health, 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. Based on population density, the following three zones and seven area categories are recognised:

Structure of the rural, remote and metropolitan areas (RRMA) classification

Zone: Metropolitan - Capital cities; Other metropolitan centres (urban centres population ³ 100,000)

Zone: Rural(index of remoteness <10.5) - Large rural centres (urban centres population 25,000–99,000); Small rural centres (urban centres population 10,000–24,999); Other rural areas (urban centres population < 10,000).

Zone: Remote(index of remoteness >10.5) - Remote centres (urban centres population 5,000); Other remote areas (urban centres population < 5,000)

• Schizophrenia* - A constellation of signs and symptoms which may include delusions, hallucinations, disorganised speech or behaviour, a flattening in emotions and a restriction in thought, speech and goal-directed behaviour (American Psychiatric Association, 1994, pp. 274–75).
• Self-harm* - This includes the various methods by which young people may harm themselves, such as self laceration, self-battering, taking overdoses, or deliberate recklessness. Recent research suggests that self-harm is more common than attempted suicide and is itself a serious youth health problem.
• Shared Care# - Care provided collaboratively by GPs and specialist mental health care providers or by public sector mental health services and private psychiatrists.
• Social and cultural diversity* - Refers to the wide range of social and cultural groups that make up the Australian population and Australian communities. It includes groups and individuals who differ according to gender, age, disability and illness, social status, level of education, religion, race, ethnicity, and sexual orientation.
• Socioeconomic status* - A relative position in the community as determined by occupation, income and amount of education.
• Specialist mental health sector# - Comprises both public and private mental health services and providers, including some specialist non-government organisations.. The primary function of these services is to provide treatment, rehabilitation or community support targeted towards people affected by mental illness. Such activities are delivered by providers, services or facilities that are readily identifiable as both specialised and serving a mental health function.
• Stakeholders* - ‘The different groups that are affected by decisions, consultations and policies.’ (Commonwealth Department of Health and Family Services, 1998, p. 259).
• Standards - Clinical practice standards are defined and agreed clinical procedures and practices for the optimal treatment and care of people with mental illness. Service standards define what is required for a quality mental health service.
• Stressor* - An event that occasions a stress response in a person.
• Substance dependence* - The misuse of a drug accompanied by a physiological dependence, made evident by tolerance and withdrawal symptoms.
• Substance misuse* - ‘A maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the repeated use of substances’ (American Psychiatric Association, 1994, p. 182). Use may be to such an extent that the person is often intoxicated throughout the day and fails in important obligations and in attempts to abstain, but where there is not necessarily physical dependence.
• Substance use disorders* - Disorders in which drugs are used to such an extent that behaviour becomes maladaptive; social and occupational functioning is impaired, and control or abstinence becomes impossible. Reliance on the drug may be psychological, as in substance misuse, or physiological, as in substance dependence.
• Suicide* - Suicide is a conscious act to end one’s life. By conscious act, it is meant that the act undertaken was done in order to end the person’s life.
• Suicidal behaviour* - 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.
• Symptom* - An observable physiological or psychological manifestation of a disorder or disease, often occurring in a pattern group to constitute a syndrome.
• Surveillance* - Close monitoring of selected health conditions in the population. The term has been expanded to include not only information on diseases, injuries and other conditions, but also information such as the prevalence of risk factors, both personal and environmental. Surveillance means continuous watchfulness over the distribution and trends of incidence through the systematic collection, consolidation, and evaluation of morbidity and mortality reports and other relevant data, together with timely and regular dissemination to those who need to know (Berkelman, Stroup and Buehler, 1997).
• Transcultural mental health - Extends the definition of mental health to look at the interactions of individuals and groups within a culturally diverse environment, to identify specific risk and protective factors for those individuals and groups who may be marginalised within the dominant culture, and to address societal and structural issues within the environment in order to promote their mental health and wellbeing.
• Transcultural services# - Transcultural services promote access to mental health services for people from culturally and linguistically diverse populations. Transcultural services work with consumers, carers, health professionals and the community to promote positive attitudes to mental health and to ensure that the needs of people from culturally and linguistically diverse populations (including access, equity and cultural safety and appropriateness) are addressed at policy, planning and service delivery level.