Abstract
ObjectivesTo (1) gain an understanding of current trajectories of Aboriginal young people through the mental health care system in Australia; (2) summarize what mental health care pathways have been developed or evaluated to guide mental health care delivery for Aboriginal young people; and (3) identify barriers and facilitators to the adoption of effective mental health care pathways for Aboriginal young people.MethodsDatabases, including, AMED, Embase, Global Health, Health and Psychosocial Instruments, Healthstar, MEDLINE, PsychINFO via Ovid, CINAHL via EBSCO, The Cochrane Library, Indigenous Collections, Informit and Health Systems Evidence, were searched to identify evidence concerning mental health service delivery for Aboriginal young people in a primary care setting.ResultsWe did not identify any reports or publications explicitly describing the current trajectories of Aboriginal young people through the mental health care system in Australia. Furthermore, we were unable to locate any mental health-related treatment pathways which had been explicitly developed or modified to meet the needs of Aboriginal young people. The use of appropriate assessment tools, engagement of family and community, flexibility, and central coordination have been identified in the literature as potential facilitators of culturally appropriate mental health service delivery for Aboriginal children and adolescents.ConclusionsAboriginal children and adolescents may face additional difficulties navigating the mental health care system in Australia due to complex socio-cultural factors and the dearth of culturally appropriate and effective mental-health related treatment pathways. Additional research regarding (1) practice trends in Aboriginal settings and (2) how Aboriginal child and adolescent mental health can be improved is urgently needed to inform clinical practice and improve mental health service access and outcomes for Aboriginal young people in Australia.
Highlights
The few studies which have sought to estimate the burden of mental health disorders among Aboriginal young people in Australia have found it to be significantly greater than amongst Australian young people in general [1–4]
This review focuses on the general practice (GP) setting as, in Australia, general practitioners (GPs) act as a gateway to specialist health services, including mental health services [31]
The only population-based study to date is the Western Australian Aboriginal Child Health Survey [1] and there are only two longitudinal studies that explore the health of Aboriginal children in Australia [2–4, 35]
Summary
The few studies which have sought to estimate the burden of mental health disorders among Aboriginal young people in Australia have found it to be significantly greater than amongst Australian young people in general [1–4]. Two major studies involving 4– 17 year-old Aboriginal children reported prevalences of high risk of emotional or behavioural problems of 28% [2] and 24% [3] respectively. Research suggests that service providers in Aboriginal communities value defined, written protocols for the screening and assessment of mental health challenges [12]. Such care pathways have been established in Australia in regards to a range of child and adolescent mental health problems such as depression [26], anxiety [27], and ADHD [28]. It is not known if or how well these work for Aboriginal young people
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