'Am I Safe Here? Am I Going to Be Let Down?' Disentangling Tensions in the Pursuit of Person-Centred and Consumer Directed Care in the Australian Mental Healthcare Context.

Healthcare concepts shape the way mental health care is conceived, delivered, experienced and evaluated. Person-centred care and consumer-directed care are two distinct but intertwined concepts that aim to redistribute knowledge and power between healthcare providers and consumers to ensure that healthcare is meeting the needs of consumers. However, despite many years of Australian services attempting to deliver person-centred and consumer-directed care, multiple reviews and inquiries into services find these attempts failing. The concepts of person-centred and consumer-directed care challenge the traditional ways in which mental health and mental health care have been conceived and delivered, reflecting tensions in the mental healthcare system. These tensions are theoretical, legislative and cultural. In this paper, the authors provide a description of these tensions, and highlight scenarios where these tensions have been overcome, and mental healthcare has been designed and delivered in a way that meets the needs of consumers. We provide ways forward that all stakeholders can implement to better our healthcare services, with a particular focus on mental health nurses.