Practice learnings from the Psychologist Integration into Primary Health Care Pilot Program on the Tiwi Islands, Northern territory

Abstract

ABSTRACT Objective: In 2017, a Northern Territory PHN funded pilot program integrating psychology into remote Aboriginal Health Centres, was launched at Julanimawu Health Centre at Wurrumiyanga, Bathurst Island, Tiwi Islands (pop.1600). Psychology was identified as the allied health approach most attuned to the influential socio-cultural needs of Australian Aboriginal people when negotiating health care and effecting behavioural change; namely, providing a time rich, systemic, behaviourally focused, empathic perspective with a story telling method. Method: The program was designed to address the psychological needs of the community through two clearly stated pathways: supporting and educating the staff of the Health Centre on the effects of trauma, and providing a psychological service directly to the community. The psychologist recorded program participant demographic information and kept a diary that acknowledged the program intentions in relation to her experience. Results: Overall, the pilot program demanded non-traditional responses in a non-traditional psychology setting and the capacity to maintain equilibrium without expectation in the face of intergenerational trauma. Aboriginal culture impacted significantly on psychological practice, resulting in a process of decolonisation. The psychologist responded to different perceptions of time, resources, communication, connection and obligation and championed the Social Emotional Wellbeing approach to Aboriginal health. On a systemic level, while the program model recognised that behaviour largely determines health outcomes, the program outcomes suggested that culture largely determines behaviour. Conclusions: A Social Emotional Wellbeing approach is highly applicable, however, the approach requires champions to further support integration into the Health Centre system. Key Points What is already known: The health and wellbeing of Australian Aboriginals is impacted by the consequences of colonisation. The integration of psychology into health care is beneficial when addressing trauma related health issues. Behaviour largely determines health outcomes. What this topic adds: Behaviour largely reflects culture. Decolonising psychology requires an active process contingent on cultural knowledge. Privileging the multi-dimensional connections of social emotional wellbeing is a pathway forward.