Increasing pressure to return to work coupled with increasing feelings of inadequacy. Reached rock bottom, and was persuaded to start lithium, and after all this time, started to slowly improve.

This chapter discusses the general principles relating to the assessment of compensation for loss resulting from a civil wrong. Since courts and legislatures often lay down legal rules for a particular area of law, the assessment of compensation differs between areas. This is why Part 2 contains separate chapters for contract, tort, the Australian Consumer Law and equity. However, there are several commonalities between the areas, in particular, contract and tort. This chapter discusses the rules that are common to at least contract and tort. Most of them also apply in equity and under the Australian Consumer Law. Deviations from those rules in equity or under the Australian Consumer Law are discussed in the relevant chapters. This chapter also provides a brief introduction to those matters that differ between contract and tort. Comprehensive treatment is given to the date of assessment; even though there are significant differences between the causes of actions, there has been considerable convergence.

The Australian Consumer Law (‘ACL’) is the national consumer law and applies across Australia. It came into force on 1 January 2011. At the same time, the Trade Practices Act 1974 (Cth) changed its name to the Competition and Consumer Act 2010 (Cth). Schedule 2 of that Act now contains the ACL. The ACL replaced a number of consumer protection provisions in federal, state and territory laws. It was enacted with the cooperation of the federal, state and territory governments. This cooperation was necessary since the Commonwealth lacks the power to comprehensively legislate on consumer law.

The ACL applies as a federal law, or as a law of the relevant state or territory, or both. It is not necessary here to go into all the details of the demarcation since the same body of law generally applies. Broadly, the ACL applies as a law of the Commonwealth to the conduct of corporations and certain natural persons, and applies as a law of a state or territory to the conduct of corporate and natural persons with a connection to the relevant jurisdiction. The application of the ACL as a federal law and the application of the ACL as a state or territory law are not mutually exclusive (where there is no conflict).

Common law damages cannot be awarded in respect of a purely equitable wrong such as breach of trust or breach of fiduciary duty. Instead, a compensatory remedy has developed in equity’s exclusive (or inherent) jurisdiction: equitable compensation. This remedy originated in cases involving breach of trust, although for many years it was not explicitly recognised as a compensatory remedy and was known instead as one of the forms of ‘account’ that a trustee must make when a breach of trust occurs. It is therefore necessary to have a brief look at the main forms of account, which are still used today.

Following an extreme disturbance, the ecosystem may go through the process of primary succession, which is characterized by a predictable series of developmental stages that culminate in a climax community – a stable biotic community that represents the final stage of succession. In many cases a disturbance will only kill some of the organisms within the ecosystem. In these cases, the ecosystem may go through a process of secondary succession, in which many factors, including the intensity of the disturbance, the life history traits of colonizing species, and the presence of biological legacies influence the recovery process. Ecologists have described three conceptual models of succession – facilitation, tolerance, and inhibition – that apply under different conditions in different ecosystems. Animals play an important role in the recovery process. Many animal species are excellent dispersers and can quickly return to a disturbed ecosystem. Even if they are unable to establish a breeding population, animals can import seeds or nutrients into a disturbed habitat. Alternatively, animals can inhibit the recovery process by eating seeds or young plants before they get established. In some cases, disturbance can cause ecosystems to experience a regime shift – a very rapid change from one stable state to another.

Increasingly, secure forensic mental health services must balance reducing restrictive practices on one hand with keeping a violence free environment on the other. Nursing staff and other hospital staff have the right to work in a safe environment. They should not be subject to intimidation and assaults in the work setting. Patients have the right to care in a safe environment and they need to have confidence that staff members can keep them safe during their in-patient stay. Minimising in-patient violence and minimising past violence for forensic patients is undermining an area of significant treatment need and may seriously limit the patient’s chance of a future successful discharge in the community. We posit in this chapter that active and careful management of ward milieu and dynamics, and active treatment of psychotic and other symptoms, together with proportionate use only of restrictive practice and thorough evaluation of any and all restrictive practice is the most effective way of managing a forensic in-patient setting to effectively reduce and prevent incidents of violence.

This chapter considers how to care for patients who meet the criteria for a diagnosis of personality disorder. We reflect on the role of the psychiatrist in creating a resilient, honest and caring clinical environment, delivering interventions in a considered and coherent manner. Central to this is the relationship between doctor and patient, which includes not only direct clinical care but also the orchestration of work across the multi-disciplinary team and other agencies through clinical leadership.

We approach personality disorders as a relational problem in which the patient experiences their difficulties through their relationships with themselves and the world around them. These difficulties often, though not exclusively, are a developmental consequence of adverse childhood experiences, brought to life within the therapeutic relationship itself. This inevitably means the work is challenging, but it also means that the way we comport ourselves and lead becomes central to the therapeutic culture.

Much has been written on the challenges of working with people who are diagnosable with personality disorder, but perhaps less acknowledged is how these challenges represent not only the very material fundamental to our primary task but also the reason it is such rewarding work given the right circumstances.

This chapter covers psychosocial and physical health approaches to the management of bipolar disorder. These include psychosocial and physical health approaches to the condition that should be offered by every psychiatrist, as well as specialist psychological treatments delivered by psychological therapists. The approach outlined is supported by the National Institute for Care Excellence (NICE) in its 2014 clinical guideline for bipolar disorder as well as other clinical guidelines for bipolar disorder more recently published from Canada, Australia and New Zealand. Overall, the current best standard of practice for bipolar disorder is to adopt a collaborative proactive holistic approach attending to both mental health and physical health stability without the use of unnecessarily high doses of medication, particularly when they may impact on physical health. The approach should be consistent with the life goals and wishes of the person with bipolar disorder, convey a message of hope, and consider lifestyle and cognitive factors alongside symptoms and function. Bipolar disorder is a long-term condition where there is a potential for normal function and a high quality of life for many. A psychologically informed approach to management enables people with bipolar disorder to be proactive in their care, practice self-management and do their best.

Problems relating to alcohol or drugs occur across a spectrum of levels of consumption and may be physical, psychological or social in nature. At one extreme, there is a small but significant proportion of people who develop dependence and may require both intensive and extensive support. However, on a population level, huge reductions in the harm caused by psychoactive substances could be made if everyone was encouraged to use a bit less. All health and social care professionals should be able to screen for potential alcohol use disorders, deliver brief advice and refer on to specialist services where appropriate. They should also have an awareness of the common illicit drugs and the potential problems these drugs are associated with. The evidence base for treatment of substance use disorders has developed over the past 30 years, and clinicians should be positive and optimistic that meaningful change in behaviour can be achieved. Prompt referral to the right level of support and treatment may prevent future problems. Recovery support services play a crucial part in sustaining any gains made in treatment, and many people recover without using professionally directed treatment at all. It is estimated that approximately 10 per cent of the population of the USA is in remission from a substance use disorder of any severity.

Evidence-based interventions include psychological and social treatments and modes of service delivery such as early intervention for psychosis teams. Family work and individual cognitive behaviour therapy are the psychological approaches that have been best researched but remain limited in availability: assessment, engagement, case conceptualisation and specific work with hallucinations, delusions and negative symptoms have been adapted for clinical practice. The goal is self-determined recovery that will take into account key physical and mental health and social concerns (e.g. accommodation, employment and relationships).

This chapter deals with public health and pandemic preparedness. It recognises the five stages of a new pandemic (detection, assessment, treatment, escalation and recovery). The chapter also deals with the issue of laboratory preparedness and the need to maintain a critical mass of laboratory and skilled staff expertise at all times in order to be able to respond rapidly and effectively to a new emerging pandemic.

This chapter seeks to promote both awareness and understanding of evidence-based psychosocial factors that enhance well-being, adjustment, and recovery in older people admitted to hospital.

The chapter begins by exploring ageing from biological, psychosocial, and existential perspectives. It then focusses upon the psychological sequel of illness and disability in this population and goes on to identify components of psychological well-being drawn from both qualitative and quantitative research studies that promote recovery in older people who have been admitted to hospital.

The chapter also explores the role of culture, faith, and ethnicity in the well-being of hospitalised older people and concludes by highlighting essential components in the development of a positive, recovery-focused culture of care.

This chapter seeks to promote both awareness and understanding of anxiety-based conditions that many older people experience in acute settings and in evidence-based medical and psychosocial interventions that support recovery.

The chapter begins by exploring and identifying the conditions, difficulties, and circumstances that give rise to anxiety in hospitalised older people. This is followed by a description of common anxiety types, their symptomatic presentation, and ther causes. The chapter goes on to explore those evidence-based medical and psychosocial treatment interventions that promote recovery and adjustment