Exploring Mental Health Presentations in Remote Aboriginal Community Controlled Health Services in the Kimberley Region of Western Australia Using an Audit and File Reviews.

Emma Carlin,Zaccariah Cox,Kate L Derry,Pat Dudgeon,Kristen Orazi

doi:10.3390/ijerph19031743

Abstract

The study aims to explore the role of mental health care in remote Aboriginal health services in the Kimberley region of Western Australia and provide a more nuanced understanding of the patients presenting for care, their needs, and the clinical response. Little is currently known about primary health care presentations for mental health, suicide, and self-harm for remote dwelling Aboriginal residents of the Kimberley region, despite high rates of psychological distress, self-harm, and suicide across the area. This study was progressed through a retrospective, cross-sectional audit of the electronic medical records system used by three remote clinics to explore the interactions recorded by the clinics about a patient’s mental health. In addition, an in-depth file review was conducted on a stratified purposive sample of 30 patients identified through the audit. Mental ill-health and psychological distress were found to be prominent within clinical presentations. Psychosocial factors were frequently identified in relation to a patient’s mental health presentation. Optimizing patients’ recovery and wellness through service improvements, including an enhanced mental health model of care, is an important next step.

Highlights

The Aboriginal and Torres Strait Islander people (First Nations people) of Australia have survived colonisation and continue to survive its sequelae of marginalisation, dispossession, and racism
First Nation Australians have experienced a range of barriers that have inhibited engagement with mental health support and services
This study examined data from the electronic medical records of three remote primary health care clinic sites, all Aboriginal Community Controlled Health Services (ACCHS), in the Kimberley region of Western Australia

Summary

Introduction

The Aboriginal and Torres Strait Islander people (First Nations people) of Australia have survived colonisation and continue to survive its sequelae of marginalisation, dispossession, and racism. Reducing rates of mental ill-health, including suicide, amongst First Nations people is recognized by the Australian Government as a matter of national priority [6]. First Nation Australians have experienced a range of barriers that have inhibited engagement with mental health support and services. These include limited knowledge of the mainstream mental health paradigm, parallel cultural beliefs, shame, fear of the consequences of a diagnosis (e.g., removal of children), and inequitable access to culturally secure care [9,10,11,12,13]. Primary health care services, including Aboriginal Community Controlled Health Services (ACCHS) [14], are increasingly engaging and responding to the mental ill-health of First Nations people [15]

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