BackgroundVideo-algorithmic patient monitoring (VAPM) combines remote, noncontact sensors and algorithmic analysis and is increasingly trialed in acute psychiatric and other care settings. While promoted for improving safety and reducing risk, it raises ethical concerns regarding safety, privacy and surveillance. Little is known about how those encountering VAPM in mental health care contexts anticipate its use and potential impacts, including where it has not yet been implemented. ObjectiveThis study aimed to explore the views of patients or mental health consumers, specialized mental health nurses and nurse academics, hospital managers, and technology vendors regarding the appropriateness and anticipated implications of VAPM in mental health inpatient care. MethodsThis qualitative study identified key stakeholders in Australia via networking techniques for participation in a deliberative workshop. A deliberative workshop was held, and the workshop discussion was audio-recorded, transcribed, and thematically analyzed, consistent with methods in health technology research, which enable exploration of different viewpoints, including convergences and divergences across stakeholder groups. ResultsIn total, 16 stakeholders participated, exploring themes concerning (1) contestation over the rationale for VAPM in mental health settings, (2) VAPM reshaping care and relationships, (3) perceived harms of VAPM, (4) perceived observational support for safety and reduced disruption, (5) serious privacy implications of VAPM, (6) the need for appropriate governance, and (7) the potential for VAPM to transform, not augment, service delivery. General views differed across groups. Patients or service users expressed concerns about privacy, coercion, and the potential to intensify stigma. Mental health nurses were cautious but interested in possible benefits for safety and suicide prevention. Hospital managers and technology vendors largely emphasized safety gains. ConclusionsThe findings suggest that the anticipated risks of VAPM are primarily experienced subjectively, as infringements on privacy, dignity, and trust, while purported benefits remain largely untested and unquantified. From a utilitarian perspective, direct comparison is therefore difficult—the risks are set out in the anticipated experiences of those with lived experience, and the benefits remain hypothetical. From this view, robust, independent evidence of real-world outcomes is required. Yet, for some participants, the very premise of such calculation was rejected, with privacy, dignity, and trust regarded as nonnegotiable, rather than items for trade-off. If VAPM is to be pursued at all, it should proceed only with extreme caution, with transparent evidence of outcomes, and with meaningful participation from those whose lives and care are most directly impacted.

Nations such as Australia rely on foster care to provide for children who cannot live with their family. The foster care role is challenging and unique, combining elements of personal motivations, public responsibility, and intersections of private and public space. Foster carer shortages are also a challenge for many nations. This study presents findings regarding foster carer identity that emerged from a qualitative study exploring foster carers' experiences. Semi-structured interviews were conducted with foster carers (n = 16) and foster agency staff (n = 7) and analysed thematically using interpretive content analysis. Study findings indicated that foster carers experienced their role as both professionals and parents. However, though they experienced both professional and parental elements, foster carers presented their professional identity over their parental. Foster carers also experienced limitations within each role making them 'almost parents' and 'almost professionals' ultimately resulting in a need to operate in a liminal space. The study suggests foster carers' promotion of professional identity may be the expression of a wider social negotiation seeking respect and raises questions regarding the sustainability of the present foster care model. Foster care is used by nations such as Australia to care for children who cannot live with their families. Most nations have significant foster carer shortages, and the foster caring role is unique. Foster carers need to nurture the children in their care and be trained, accredited and subject to State supervision. Consequently, foster caring can be seen as part 'work/professional' and part 'parent'. This study explores how foster carers understand their role. We found that foster carers experienced foster caring as both parental and professional, however, not quite either. We also found that foster carers promoted their role as 'professional' more than 'parental'. We argue that foster carers are operating in a liminal or 'in-between' space and may be promoting their professional identity as an attempt to gain greater respect and recognition. We conclude by noting the study raises questions regarding the sustainability of the present foster care model.

INTRODUCTION:Safewards effectively reduces restrictive practices within acute inpatient mental health units. Consumers' experiences of Safewards impact on broader experiences within these settings. Given the influence mental health nurses have on consumers' experiences, nurses' responses to these experiences require further exploration. AIM:To explore the responses of mental health nurses to consumers' experiences of Safewards within acute inpatient mental health units. METHODS:A qualitative exploratory method was used for this study, involving semi-structured focus groups with mental health nurses from two acute inpatient mental health units. Participants were asked to respond to a summary of themes about consumers' experiences of Safewards. RESULTS:Thematic analysis uncovered three themes: (1) Prioritising respectful communication and investing time with consumers; (2) Relating Safewards to everyday work with consumers; (3) Safewards and its impact on restrictive practices. DISCUSSION:Participants acknowledged consumers' experiences of Safewards and their frustrations when mental health nurses were unavailable. Some participants expressed uncertainty about the suitability of Safewards, despite consumers' endorsement, highlighting a possible discrepancy between mental health nurses' and consumers' views. Most participants perceived Safewards to be effective but inconsistently applied, in part due to varying acceptance and understanding of Safewards. LIMITATIONS:Differences between the units may not be captured in combined data analyses and other views about the consumers' experiences of Safewards may not be represented. Researcher bias may have influenced the way in which data were collected, analysed and reported. IMPLICATIONS FOR PRACTICE:Safewards requires partnership between mental health nurses and consumers, and a more nuanced understanding of its application within an acute inpatient mental health setting to realise its full potential. Task-based approaches that hinder mental health nurse engagement with consumers may impact Safewards' effectiveness. RECOMMENDATIONS:Discrepancies between the views of mental health nurses and consumers' experiences require further exploration. Increasing consumers' involvement in the everyday application of Safewards should be considered.

Following the Adverse Childhood Experiences study (1998), a wealth of similar studies has strongly associated experiences of trauma and adversity in childhood with increased risk of poor physical and mental health and undesirable social outcomes in adulthood. The medical model interprets this data through a pathologizing lens which assumes that trauma and adversity are harmful and lead to impairment and pathology. Trauma-informed and Adverse Childhood Experience aware approaches can perpetuate this pathologizing framing, despite prioritising asking "What's happened to you?" over "What's wrong with you?" In this paper, we draw on The Neuroplastic Narrative, a novel, non-pathologizing biological theory which foregrounds people's adaptation to their ecological niche. This narrative offers a compelling reinterpretation of data that associates early trauma and adversity with poor adult health and social outcomes. We introduce an evolutionary perspective, Life History Theory, to reframe the Adverse Childhood Experiences (ACEs) study through an evolutionary lens, yielding the insight that populations with ACEs strategically adapt to their environment. We evidence the perspective that the human species' capacity to adapt to a diverse range of environments during development is strategic and not of itself pathological. Adapting to diverse ecologies produces commensurately diverse brains and physiologies. We term the diversity across brains and physiologies resulting from adapting to experiences: Neuro-ecological diversity An ecological framing that privileges experiences and considers how and why people adapt to traumatising relationships and adverse environments both physiologically and behaviourally calls for novel formulations and responses from practitioners and ultimately for a non-pathologizing foundation for trauma-informed nursing. This less shaming response also orientates our attention towards issues of inequity and social justice. The aim of this position paper is to articulate a trauma-informed framework for nursing that does not focus on pathology but rather on adaptation, offering nurses a new way to understand, formulate and respond to distress and suffering associated with trauma and adversity. We will demonstrate that trauma-informed nursing needs a foundation that is not premised in pathology but honours experience; offer the Neuroplastic Narrative as a biological, non-pathologizing (less shaming) foundation for trauma informed nursing, and introduce the concept of Neuro-Ecological Diversity to support nurses' understandings of, and responses to, different consumer presentations.

The Safewards model and its ten interventions have been effective in reducing restrictive practices and preventing conflict within acute inpatient mental health units. However, few studies in the current literature explore the consumers' experiences of Safewards. This exploration also needs to consider the views of Mental Health Nurses and the Lived Experience Workforce, who are both important stakeholders in the application of Safewards and how it impacts on consumers' experiences. Despite this, the views of Mental Health Nurses and the Lived Experience Workforce about consumers' experiences of Safewards are limited. This qualitative study explored the views of Lived Experience Workforce leaders about consumers' experiences of Safewards, and Mental Health Nurses' responses to these experiences in acute inpatient mental health units in Australia. Six Lived Experience Workforce leaders participated in individual interviews. Data were analysed using thematic analysis, revealing four themes: (1) consolidating Safewards through understanding consumers' experiences, (2) consumers as leaders in Safewards, (3) acknowledging the realities of acute inpatient mental health units and (4) practice foundations underpinning Safewards. Results highlighted the positive impact of improved consumer involvement in Safewards. Additionally, mechanisms to develop strategic partnerships between Lived Experience Workforce leaders and mental health nurses warrant further investigation. This study highlighted the restrictive nature of acute inpatient mental health units and the need to acknowledge the impact this has on consumers. Further embedding of foundational approaches, such as trauma-informed and recovery-oriented practice within Safewards, is also required to align with consumers' expectations. Greater recognition of consumers' experiences and their agency within the model, and consideration of other Safewards interventions, is also needed. This is required to increase safety, reduce harms associated with restrictive practice, and enhance Safewards effectiveness.

ABSTRACT Introduction Worldwide, mental health systems continue to grapple with providing recovery‐oriented services as part of broader reform efforts. Critical to the objective of transforming mental health services is the employment of a rights‐based, non‐clinical lived experience workforce. Vital to undertaking the roles, and supporting this workforce, is a comprehensive understanding of the knowledge and practices of the discipline, particularly in situations where rapid growth may see this workforce developing in an ad hoc way. The aim of this review was to determine how members of the mental health lived experience workforce describe and enact our discipline, by synthesising evidence and illustrations. Methods A narrative review methodology employed searches for international peer reviewed literature and policy documents related to lived experience work. Resources required at least one mental health lived experience author. We used a deductive approach to the categorisation of three designated mental health lived experience role types: service delivery (such as peer support); leadership; and Indigenous. An inductive approach was then taken to identify the knowledge and practices informing the three role types. Relevant texts were allocated amongst the research team, independently read, coded and themed, followed by team discussions to reach consensus where there were conflicts. Results After full text reading, we identified 25 resources. There were many more resources about the knowledge and practices of lived experience direct service delivery than about leadership roles. Three themes emerged from the knowledge and practices for each role type. For direct service roles knowledge was: having been there; knowing helpful qualities of relationships; and knowing how to use your own lived experience intentionally. Practices for direct service roles were: working relationally, sharing lived experiences in a meaningful way and working in a values and rights‐based way. Knowledge required for leadership was: ethical decision‐making; being informed by collective/shared history and knowing how to create change. Required practices were: transforming services from within; embedding the lived experience workforce and championing justice. Themes describing Indigenous knowledge were: challenging exclusively Euro‐centric modes of treatment, truth‐telling and self‐determination. Emerging themes on practices of designated Indigenous lived experience workforces were: relational and community approaches, trauma informed, and culturally sensitive and safe practices. Conclusion Articulation of the knowledge and practices underpinning the lived experience discipline is required for this workforce to be confident in the scope, purpose and history of their roles and for organisations to successfully establish them and provide effective supports. For Indigenous workers in designated lived experience roles, approaches to wellbeing and cultural practices cannot be separated from the way that the roles are carried out. Embedding Indigenous leadership, knowledge and practices would strengthen the human rights, justice‐based and non‐clinical nature of these roles, is a necessary response to colonial violence and would guide workforce development for other LE staff, mental health professionals, and mental health service development.

Advance statements are instruments under the Mental Health Act (2014) (Vic) (the Act) in Victoria, Australia that support advance care planning, should a person become a compulsory patient under the Act. Advance care planning supports consumers to have their values and preferences known to the service and other decision makers. Uptake of advance statements in mental health has been poor, and minimal literature is available that explores direct experiences of these instruments by consumers. Feminist Standpoint theory was used in this study as it centres the experience of the marginalised person within the study. This study comprised four in-depth interviews and a survey with 59 responses that explored consumers' direct experiences of using advance statements in Victoria. Results are consistent with past research identifying that many mental health advance statements were consenting documents, although some issues remained with locating the advance statement and identifying the most beneficial staff members to notify. Analysis of the interviews identified four main themes in people's experiences: not being read, working/not working, the use of advocacy and adjusting expectations. Consumers suggested how advance statements could be improved. Specific examples of advocacy by nurses were identified, and as the largest body of mental health workers, nurses have a key role in supporting consumers throughout their journey. Nurses are best placed to enact supported decision making, a key factor in advance care planning. With greater understanding of advance statements, and better resourcing of supported decision-making mechanisms, there is potential for advance statements to contribute to an improved experience for consumers in mental health services.

BACKGROUND:At least 50 % of child sexual abuse involves perpetration by children, referred to as "harmful sexual behavior". Recently, the sexual abuse sector has focused, importantly, on the child behind the "perpetrator" to support developmentally-appropriate and trauma-informed practice. However, the experiences of victim-survivors of children's sexually abusive behavior are underexplored. OBJECTIVE:The aim of this study, funded by the National Centre for Action on Child Sexual Abuse, was to describe the experiences of victim-survivors sexually abused by other children, including their profiles and those of children with harmful sexual behaviors. Also explored was what victim-survivors say about patterns of perpetration, cessation, and disclosure. PARTICIPANTS AND SETTING:Twenty-five victim-survivors of children's harmful sexual behavior participated. Twenty-one were female, three were male, and one non-binary. They were aged between 18 and 69 years, and from a range of Australian states. METHODS:The study was informed by the research question: What is the nature of victim-survivors' experiences of children's harmful sexual behavior? In-depth individual interviews were conducted between October 2023 and January 2024 and the data were investigated using Content Analysis. The purpose of this paper is to present a map of survivor experiences (not to provide in-depth qualitative analysis) to gauge their range and patterns, and to identify potential trends. Ethics clearance was obtained from the University of Melbourne Human Research Ethics Committee (ID: 26926). RESULTS:Most victim-survivors reported that the sexual abuse by another child began in preschool and primary school, and more than half disclosed their abuse to one or more person. Victim-survivors identified 56 children involved in carrying out their sexual abuse. Eight perpetrators continued to abuse the victim into adulthood. Most harmful sexual behaviour (86 %) involved victimising intent, and physical coercion and violence (71 %). The most long-term and severe abuse was carried out by brothers and male cousins. CONCLUSION:The findings are discussed in terms of dominant constructs and narratives about children's harmful sexual behaviour, and a model of "safe, problematic, and harmful sexual experience" is proposed to augment therapeutic practice. It is our hope that the voices of victim-survivors can be amplified in policy and practice so that the child behind the victim becomes as visible as the child behind the harmful sexual behaviors.

Victim-survivors of children's harmful sexual behaviors have rarely been given a voice in academic research. The aim of this study, funded by the Australian National Centre for Action on Child Sexual Abuse, was to establish how victim-survivors interpret their experiences of harmful sexual behavior. Research questions were as follows: (1) How do victim-survivors interpret their experiences of harmful sexual behavior? (2) How do researchers inform those interpretations? Twenty-five victim-survivors of children's harmful sexual behavior participated. Interpretivist Phenomenological Analysis (IPA) was adopted for the methodological design. Semi-structured interviews were carried out between October 2023 and January 2024. Five constructs emerged through the data analysis: (1) Shifting identities; (2) Unspeakable betrayal; (3) Tenacious resistance; (4) Alternative justice; and (5) Hard-won recovery. The results are discussed in relation to knowledge translation into policy and practice, and the current evidence base.

INTRODUCTION:The prevalence of restrictive practices in residential aged care (RAC) remains unacceptably high. To address this, feasible, evidence-informed interventions that can be integrated into routine practice are needed. Safewards, a model and set of ten interventions that explains and reduces conflict and restrictive practice use in mental health care settings, presents a promising approach for application within RAC. This study evaluated the feasibility of implementing Safewards to reduce restrictive practice use in RAC. METHODS:This pilot and feasibility study used a mixed methods process and outcomes evaluation. Safewards was implemented in two Australian care homes. Implementation outcomes were assessed using the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance) and the Consolidated Framework for Implementation Research (CFIR) guided qualitative data collection to identify the contextual factors that facilitated or hindered implementation. RESULTS:Eight Safewards interventions were suggested for implementation in RAC. Three Safewards interventions were implemented at site 1 and five interventions at site 2 with between 28-52 % staff attending training across sites. Physical restraint use decreased at site 2 but not at site 1. Most implementation enablers and barriers were identified within the CFIR domains of inner setting and implementation process. CONCLUSION:Safewards was feasible to implement in RAC, with 5/8 interventions contributing to reduced physical restraint use. The variation in findings across sites, including greater reach and adoption and stable and engaged leadership at site 2, emphasises the importance of contextual factors for successful implementation. Findings from this study can inform future implementation of Safewards into RAC. PATIENT OR PUBLIC CONTRIBUTION:A person with lived experience as a caregiver for a family member with dementia was employed as a Safewards facilitator and as a member of the project steering committee and had input into all stages of the project.

Video-algorithmic patient monitoring (VAPM) combines remote, non-contact sensors and algorithmic analysis, and is increasingly trialled in acute psychiatric and other care settings. While promoted for improving safety and reducing risk, it raises significant ethical concerns regarding privacy and surveillance. Little is known about how those encountering VAPM in mental healthcare contexts perceive its use and potential impact. This study aimed to explore the views of patients/mental health consumers, specialised mental health nurses and nurse academics, hospital managers, and technology vendors regarding the appropriateness and implications of VAPM in mental health inpatient care. This qualitative study identified key stakeholders in Australia via networking techniques for participation in a deliberative workshop. A deliberative workshop was held, with audio recorded, transcribed and thematically analysed, consistent with methods in health technology research, which enable exploration of different viewpoints, including convergences and divergences across stakeholder groups. 15 stakeholders participated, exploring themes concerning (1) contestation over the rationale for using VAPM in acute psychiatric settings; (2) humanising versus dehumanising effects; (3) perceived harms; (4) risk and protection; (5) support for observational assistance; (6) privacy implications; (7) the need for appropriate governance; and (8) potential service transformation. General views differed across groups. Patients/service users expressed concerns about privacy, coercion, and the potential to intensify stigma. Mental health nurses were cautious but interested in possible benefits for safety and suicide prevention. Hospital managers and technology vendors largely emphasised safety gains. Conclusions The findings suggest that the risks of VAPM are primarily experienced subjectively, as infringements on privacy, dignity, and trust, while purported benefits remain largely untested and unquantified. From a utilitarian perspective, direct comparison is therefore difficult – the risks are tangible in lived experience, whereas the benefits are still hypothetical. From this view, robust, independent evidence of real-world outcomes is required. Yet, for some participants, the very premise of such calculation was rejected, with privacy, dignity, and trust regarded as non-negotiable, rather than items for trade-off. If VAPM is to be pursued at all, it should proceed only with extreme caution, with transparent evidence of outcomes, and with meaningful participation from those whose lives and care are most directly impacted. N/A

Psychiatric advance directives have been a prominent theme in mental health system reform. This study aimed to investigate psychiatrists' attitudes towards advance statements following their introduction in the Mental Health Act 2014 in Victoria, Australia (Mental Health Act 2014 (Vic) ss 19-22). Advance statements are non-binding legal documents that permit mental health consumers to outline their treatment preferences, should they become subject to compulsory treatment. The mixed methods design involved psychiatrists completing an online survey based on a clinical vignette (n = 18) followed by in-depth interviews (n = 4). Results showed that psychiatrists viewed insufficient support from their institutions and peers as primary barriers to the effective use of advance statements, suggesting the need for deliberate implementation strategies to ensure psychiatrists make reasonable efforts to give effect to advance statements.

INTRODUCTION:Mental health legislation authorises involuntary psychiatric intervention in certain circumstances. Although human rights concerns are becoming more prominent, debates among legal experts, clinicians and activists continue to swirl around people's rights to equal recognition before the law, such as described in the (United Nations Convention on the Rights of Persons with disabilities, 2006). AIM:This qualitative descriptive study aimed to better understand diverse views of people known to hold a critique of coercion in mental health services, on the practical expression of upholding human rights in the context of mental health laws. METHOD:Individual semi-structured interviews were conducted with 15 key informants from five different countries and data was analysed using an inductive, thematic approach. RESULTS:Overall, informants characterised mental health laws as discriminatory, harmful and unjustifiable. Three themes and six sub-themes were identified. This study reports on the major themes which include: an ethical position (focusing on the present harms associated with mental health laws), strategies, (an expression of the opportunity to bring about change) and a visionary position. We explore these three features in the views of key informants as important positions in the field of abolition, and analyse each for the 'hermeneutic resources' - forms of collective interpretive resources - they provide. CONCLUSIONS:Abolition of mental health laws is often seen as not feasible in the context of psychiatry. However, abolition theories and practices are hermeneutic resources that need to be better understood because they offer social justice and community-led solutions beyond mental health laws and systems.

Safewards is a model and set of interventions with demonstrated effectiveness in reducing conflict and containment which are associated with negative consumer experiences within inpatient mental health settings. Safewards has been widely adopted internationally as a way of enhancing safety and reducing restrictive practices. Despite this, consumers' experiences of Safewards and its effect on their personal safety are less understood and therefore require further exploration. This qualitative exploratory study sought to explore consumers' experiences of Safewards in acute inpatient mental health units. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used for reporting purposes. Fifteen consumers across two sites participated in semi-structured focus groups. Thematic analysis generated four themes: (1) engaging consumers in Safewards, (2) consumers supporting each other, (3) interacting and communicating and (4) access, availability and expectations. Participants expressed positive views about Safewards and wanted to be more involved in its day-to-day application. Enhanced consumer involvement in Safewards was associated with improved safety and wellbeing for consumers within acute inpatient mental health units. These findings have the potential to influence practice towards improving the consumers experience of Safewards. This requires an exploration of ways to harness informal consumer supports, recognising that consumers need to spend meaningful time with nurses to feel safe and acknowledging that all forms of restrictive practice have an impact on consumers within acute inpatient environments.

Clinical supervision is widely regarded as an important part of both pre-graduate and post-registration education and training of healthcare professionals. To ensure comprehensive implementation of effective supervision practices, it is crucial that supervisors, healthcare organisations and researchers have valid and reliable instruments to measure these practices. The Manchester Clinical Supervision Scale (MCSS) is the most widely used instrument for measuring supervision effectiveness in nursing and allied health. According to the developers of MCSS, it is based on Proctor's three functions of supervision as being normative, formative and restorative. The purpose of this paper was to report a test of the content validity of MCSS-26, which is the latest version. Methods included: 1. A qualitative text analysis of MCSS-26's syntax and wording. 2. A Content Validity Index with an expert panel rating the relevance of MCSS-26 items for measuring effectiveness of supervision and their clarity. 3. A linguistic reordering of items and a tabulation of panel classifications of MCSS-26 items according to Proctor's three functions. Findings revealed heterogeneity in MCSS-26's wording and an uneven flow with negative/general questions being frontloaded. The CVI identified 46% of items (n = 12/26) as relevant for directly or indirectly measuring effectiveness of clinical supervision. The expert panel was not able to consistently link items to Proctor's functions. The results have important implications for how to interpret MCSS-26 ratings of effectiveness of clinical supervision and can be used to consider psychometric studies examining the potential for an abbreviated version of MCSS-26 with a single focus on effectiveness.

Clinical supervision is claimed to benefit nurses' wellbeing, professional development and practice. However, evaluations highlight implementation challenges, and universal uptake among nurses is uncommon, which limits benefits and the quality of evaluations. This paper reports outcomes of a government policy initiative to implement clinical supervision in Victoria, Australia, with survey data generated through a program logic evaluation. AIM:To explore nurses' perceptions of the implementation of clinical supervision, specifically addressing training adequacy, participation rates, organisational support, cultural growth and relational capacity development. DESIGN:A cross-sectional survey of nursing supervisees was conducted within a program of research investigating the governmental implementation of clinical supervision. METHOD:A survey of 366 participating nurses across four separate organisations addressed the following outcome evaluation questions, arising from program logic objectives: Are nurses currently engaged in clinical supervision? What is the relationship between clinical supervision implementation and: (1) nurses' preparation for clinical supervision, (2) their experience of the organisation valuing clinical supervision and (3) valuing nurses' own wellbeing and (4) nurses' perception of their own growth in relational practice? RESULTS:The findings affirm the clinical supervision implementation program by showing positive associations for the intended outcomes. Nurses reported: they had sufficient training in clinical supervision; their workplaces were experienced as supportive of clinical supervision and nurturing of the participants; and they had growth in relational ability. Each positive finding was significantly stronger for the sub-sample (65%) of study participants who were currently engaged in clinical supervision compared to those who were not. CONCLUSION:The study foregrounds the contribution of program logic, within a multifaceted initiative and including a strong authorising environment, to the implementation of clinical supervision. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE:Implementation of clinical supervision across services can be enabled by values-congruent strategies, including high-level authorising, stakeholder objective setting, training and coalition of change agents. IMPACT:This paper addresses the gap between numerous local intervention studies of clinical supervision for nurses and the lack of empirical studies informing system-wide implementation approaches. Our survey investigating implementation outcomes shows that nurses experience of the implementation was aligned to program objectives: participating nurses considered themselves effectively trained for clinical supervision and supported by the organisation, with a positive impact on their own practice. This study can assist organisations in considering large-scale implementation of clinical supervision, with a future focus on levels of uptake and impact on practice. REPORTING METHOD:We have adhered to relevant EQUATOR guidelines for survey method (i.e., the CROSS checklist). PATIENT OR PUBLIC CONTRIBUTION:Mental Health Consumer and Carer Advisors within the Office of the Chief Mental Health Nurse, Department of Health and Human Services, Victoria, contributed to the establishment of the research evaluation objectives and related survey items. They contributed perspectives via initial project design meetings and further feedback informing the final version of the program logic.