Torres Strait Islander People Research Articles

Australian Indigenous people and treatment decision-making at end-of-life

This article analyses Australian law and literature to identify the key cultural and legal considerations that can arise in medical treatment decision-making with Aboriginal and Torres Strait Islander peoples at the end-of-life. The authors explore how First Nation peoples’ cultural values, connection to Country, family, and community, history, and health care experiences, intersect with end-of-life medical treatment laws, providing valuable insights for lawyers, policymakers and health practitioners.

"Listen with your ears and eyes and heart and your minds and your soul": Implications for decolonising consultation and occupational therapy from case studies on "Closing the Gap" policy implementation.

Including Aboriginal and Torres Strait Islander people and communities through consultation has been a key feature of policy implementation throughout the Australian Government's "Closing the Gap" (CTG) strategy. However, consultation often reinforces power imbalances between government and local community and can undervalue or marginalise Indigenous knowledge and leadership. Occupational therapy has a short history of examining colonial power structures within the profession, but there has been limited progress to decolonise consultation and practice. Drawing on decolonising research methodology and positioned at the interface of knowledge, comparative case studies were used to understand policy implementation in two regions. In Shepparton, Victoria, CTG policy was implemented predominately through an Aboriginal Community Controlled Health Organisation, and in Southern Adelaide, South Australia, CTG policy was implemented through mainstream state government and non-government providers in the absence of a local Aboriginal-controlled organisation. Findings were examined critically to identify implications for occupational therapy. Our case studies showed that policy stakeholders perceived consultation to be tokenistic and partnerships were viewed differently by Aboriginal and non-Indigenous participants. Participants identified the need to move beyond a rhetoric of "working with" Aboriginal and Torres Strait Islander people, to promote Aboriginal leadership and really listen to community so that policy can respond to local need. The findings of this research show that Aboriginal-controlled services are best positioned to conduct and respond to community consultation. A decolonising approach to consultation would shift the status quo in policy implementation in ways that realign power away from colonial structures towards collaboration with Indigenous leadership and the promotion of Aboriginal-controlled services. There are lessons for occupational therapy from this research on policy implementation on authentic, decolonised consultation as a key feature of policy implementation. Shifting power imbalances through prioritising Indigenous leadership and honouring what is shared can drive change in CTG policy implementation processes and outcomes.

The relationship between justice system non-involvement and the social and emotional wellbeing of young Aboriginal and Torres Strait Islander people

Aboriginal and Torres Strait Islander young people are highly overrepresented within the Australian justice system. Despite an increase in research and policies, it is still unclear which interventions, programs and policies are most effective. The aim of the current study was to investigate the relationship between the Social and Emotional Wellbeing (SEWB) of Aboriginal young people and justice system non-involvement from a strengths-based perspective. The sample consisted of 725 Aboriginal adolescents aged 10–15 years who completed The Next Generation Project’s Youth Well-Being Study survey. Logistic regression was conducted to assess the SEWB factors associated with justice system non-involvement. It was found that self-rated good health, positive scores on the Prosocial Scale of the Strengths and Difficulties Questionnaire and younger age were significant predictors of justice system non-involvement. Policies and programs focusing on systems level approaches to support wellbeing in young Aboriginal people are likely to be beneficial.

Koori Quit Pack: A feasibility study of a multi-component mailout smoking cessation support for Aboriginal and Torres Strait Islander people: "I would recommend it to anybody. It's just so much easier".

Smoking is the leading cause of preventable death among Aboriginal and Torres Strait Islander people. The Koori1 Quit Pack study aimed to assess the feasibility of a multi-component mailout smoking cessation intervention to reduce smoking among Aboriginal and Torres Strait Islander people. A non-randomised, single-group feasibility study conducted among Aboriginal and Torres Strait Islander people who reported current smoking. The intervention package included information pamphlets and resources on quitting, referral offer to Aboriginal Quitline and optional free Nicotine Replacement Therapies (NRT). Follow-up was conducted at 2-weeks, 6-weeks, 10-weeks and 6-months post recruitment. Feasibility outcomes were recruitment and retention rates, uptake of intervention components and smoking abstinence at 6-week follow-up (primary end point). Cessation outcomes were analysed using both a complete case analysis and intention-to-treat approach. 165 participants were recruited, 111 (67.3%), 79 (47.9%), 59 (35.8%), and 94 (57%) participants completed the 2-week, 6-week, 10-week, and 6-month follow-up. At 10-week follow-up, 40.7% of participants used pamphlets and booklets, 13.6% used Quitline and > 90% used NRT. At 6-week follow-up, 87.3% reported a quit attempt and 46.8% sustained quitting. 46.8% were continuously smoke-free at the 6-week timepoint. The complete case analysis and the intention-to-treat analysis at 6-month shows a 7-day self-reported point prevalence abstinence of 34% and 19.4% respectively. The Koori Quit Pack mailout smoking cessation program was feasible to support Aboriginal and Torres Strait Islander people. The intervention resulted in a high smoking cessation rate and should be upscaled, implemented and evaluated nationally. Aboriginal and Torres Strait Islander people are disproportionately impacted by tobacco related harms, however the majority want to quit or wish they never took up smoking. Mailout cessation support is feasible, overcomes access barriers to evidence-based support and increases quitting success. We recommend a national mailout smoking cessation program is implemented for, and by Aboriginal and Torres Strait Islander people to accelerate declines in smoking prevalence to eliminate tobacco related death and disease.

Supporting best practice in the management of chronic diseases in primary health care settings: a scoping review of training programs for Indigenous Health Workers and Practitioners.

Background To improve diabetes management in primary health care for the Aboriginal and Torres Strait Islander peoples population, training programs that are culturally and contextually relevant to the local context are required. Using a scoping review methodology, the aim of this review was to describe the characteristics of chronic disease management training programs for Aboriginal Health Workers and Practitioners, their effectiveness on knowledge and skills, and client-related outcomes, and the enablers, barriers to delivery and participation. Methods Following protocol parameters, a systematic search was conducted in relevant databases and grey literature. Two independent reviewers screened the title and abstract of each paper to determine if the study met the inclusion criteria. Results Of the 23 included studies, most were developed with stakeholders, profession facilitated and delivered by cultural facilitators. All training programs included content knowledge, two included a professional support network, four provided on-the-job support and six had follow-up support post-training. Modes of delivery ranged from didactic, storytelling and hands-on learning. Two studies reported significant improvement in participants' knowledge and confidence; one reported improvement in knowledge (12.7% increase pre-post training), and an increase in confidence in both clinical and non-clinical skills. Enablers (relevance, modes of learning, power of networking, improved knowledge, confidence and clinical practice) and barriers (adult learning capabilities, competing work-family commitments) were reported. Few studies reported on knowledge transfer into clinical practice and client-related outcomes. Conclusions Multifaceted training programs for Aboriginal health workers are well received and may improve workforce capability.

Eliminate all risks: A call to reexamine the link between canine scabies and rheumatic heart disease.

Rheumatic heart disease (RHD) and acute rheumatic fever (ARF) disproportionately affect individuals in low-resource settings. ARF is attributed to an immune response to Group A Streptococcus (GAS) following GAS pharyngitis and potentially GAS impetigo in which infection can be initiated by scabies infestation. The burden of ARF and RHD in Aboriginal and Torres Strait Islander people in Australia is among the highest globally. Following recent calls to include dog management programs in ARF and RHD prevention programs, we believe it is timely to assess the evidence for this, particularly since previous recommendations excluded resources to prevent zoonotic canine scabies. While phylogenetic analyses have suggested that the Sarcoptes mite is host specific, they have differed in interpretation of the strength of their findings regarding species cross-over and the need for canine scabies control to prevent human itch. Given that there is also indication from case reports that canine scabies leads to human itch, we propose that further investigation of the potential burden of zoonotic canine scabies and intervention trials of canine scabies prevention on the incidence of impetigo are warranted. Considering the devastating impacts of ARF and RHD, evidence is required to support policy to eliminate all risk factors.

MEANINGFUL MULTIDISCIPLINARY REHABILITATION FOR HEART AND LUNG CONDITIONS: A COLLABORATION BETWEEN ORGANISATIONS AND SECTORS TOWARDS SELF-MANAGEMENT

It is well documented that mainstream services are not always well attended by Aboriginal and Torres Strait Islander people due to a range of issues including transport and culturally safe practice. Establishing these services within the community-controlled sector is one way to increase access and culturally responsive care. This initiative involved a new model of service delivery, whereby a partnership between Hospital Health Services and community-controlled Aboriginal and Torres Strait Islander primary healthcare organisations enabled the establishment of new Cardiac and Pulmonary Rehabilitation Programs within the Institute for Urban Indigenous Health (IUIH) Network for First Nations people. This Network is comprised of the five Aboriginal and Torres Strait Islander Community Controlled Health Organisations (ATSICCHO’s) who operate as a regional collective with IUIH providing leading strategic direction and coordination. Through a multidisciplinary team, specialised cardiac and pulmonary rehabilitation is provided to First Nations people as a culturally capable alternative to hospital cardiac and pulmonary rehabilitation, particularly for those not currently accessing treatment. The specialised rehabilitation programs are supported by the IUIH System of Care that supports clients to access a wide array of holistic health services and programs designed to meet community needs and strengthen pathways for clients to self-manage their health needs in a self-led manner. The Rehabilitation Programs are a multidisciplinary exercise and education program delivered by a range of health professionals including Accredited Exercise Physiologist’s, Physiotherapists, Nurses and Aboriginal and Torres Strait Islander Allied Health Assistants. Clients also have access to a range of other Allied Health Professionals, including Dieticians Occupational Therapists, Pharmacists, Social Health, Podiatrists, Optometrists, Speech Therapists and Audiologists. Referrals are received from ATSICCHOS, Queensland Health and Primary Health General Practitioners and Specialists. The client journeys through a multidisciplinary assessment to then determine their goals and health needs. This presentation will provide insights into the First Nations-led partnership, challenges and solutions to working across the whole health sector and outcomes for clients.

Healthcare social network research and the ECHO model™: Exploring a community of practice to support cultural brokers and transfer cultural knowledge

BackgroundProject ECHO® networks at Children’s Health Queensland Hospital and Health Service (CHQHHS) are communities of practice designed to mitigate services and systems fragmentation by building collaborative partnerships addressing priority child and youth health needs. Aboriginal and Torres Strait Islander people experience the negative impacts of fragmentation in addition to historical challenges of absent or culturally inappropriate health services. Access to culturally safe and responsive services can be improved by engaging Aboriginal and Torres Strait Islander Health Workers and similar roles in an online community of practice, supporting the integration of cultural and clinical knowledge and self-determination of Aboriginal and Torres Strait Islander consumers in decisions affecting their health.Analysing professional support networks and knowledge sharing patterns helps identify enablers and barriers to partnerships. Using social network research, the multilevel network inclusive of ECHO network members and their colleagues was studied to identify interdisciplinary and cross-sector advice exchange patterns, explore the position of cultural brokers and identify common relational tendencies.MethodsSocial network theories and methods informed the collection of network data and analysis of advice-seeking relationships among ECHO network members and their nominees. Registered members from two ECHO networks were invited to complete the Qualtrics survey. Networks analysed comprised 398 professionals from mainstream health, Aboriginal and Torres Strait Islander Community Controlled Health Organisation, education, disability and child safety service settings.ResultsBrokers were well represented, both those who hold knowledge brokerage positions as well as cultural brokers who incorporate clinical and cultural knowledge enabling holistic care for Aboriginal and Torres Strait Islander patients (38 individuals, 17% of network). Professionals who occupy brokerage positions outside the ECHO network tend to be more connected with co-members within the network.ConclusionsThis study is the first application of contemporary social network theories and methods to investigate an ECHO network. The findings highlight the connectivity afforded by brokers, enabling the coordination and collaboration necessary for effective care integration. Inclusion of cultural brokers in an ECHO network provides sustained peer group support while also cultivating relationships that facilitate the integration of cultural and clinical knowledge.

Australian and New Zealand Living Guideline cholesterol-lowering therapy for people with chronic kidney disease (CARI Guidelines): Reducing the evidence-practice gap.

People with chronic kidney disease experience high rates of cardiovascular disease. Cholesterol-lowering therapy is a mainstay in the management but there is uncertainty in the treatment effects on patient-important outcomes, such as fatigue and rhabdomyolysis. Here, we summarise the updated CARI Australian and New Zealand Living Guidelines on cholesterol-lowering therapy in chronic kidney disease. We updated a Cochrane review and monitored newly published studies weekly to inform guideline development according to international standards. The Working Group included expertise from nephrology, cardiology, Indigenous Health, guideline development and people with lived experience of chronic kidney disease. The guideline recommends people with chronic kidney disease (eGFR ≥15 mL/min/1.73 m2) and an absolute cardiovascular risk of 10% or higher should receive statin therapy (with or without ezetimibe) to reduce the risk of cardiovascular events and death (strong recommendation, moderate certainty evidence). The guidelines also recommends a lower absolute cardiovascular risk threshold (≥5%) for Aboriginal and Torres Strait Islander Peoples and Māori with chronic kidney disease to receive statin therapy (with or without ezetimibe) (strong recommendation, low certainty evidence). The evidence was actively surveyed from 2020-2023 and updated as required. No changes to guideline recommendations were made, with no new data on the balance and benefits of harms. The development of living guidelines was feasible and provided the opportunity to update recommendations to improve clinical decision-making in real-time. Living guidelines provide the opportunity to transform chronic kidney disease guidelines.

Evaluation of online text-based information resources of gynaecological cancer symptoms.

Gynaecological cancer symptoms are often vague and non-specific. Quality health information is central to timely cancer diagnosis and treatment. The aim of this study was to identify and evaluate the quality of online text-based patient information resources regarding gynaecological cancer symptoms. A targeted website search and Google search were conducted to identify health information resources published by the Australian government and non-government health organisations. Resources were classified by topic (gynaecological health, gynaecological cancers, cancer, general health); assessed for reading level (Simple Measure of Gobbledygook, SMOG) and difficulty (Flesch Reading Ease, FRE); understandability and actionability (Patient Education Materials Assessment Tool, PEMAT, 0-100), whereby higher scores indicate better understandability/actionability. Seven criteria were used to assess cultural inclusivity specific for Aboriginal and Torres Strait Islander people; resources which met 3-5 items were deemed to be moderately inclusive and 6+ items as inclusive. A total of 109 resources were identified and 76% provided information on symptoms in the context of gynaecological cancers. The average readability was equivalent to a grade 10 reading level on the SMOG and classified as 'difficult to read' on the FRE. The mean PEMAT scores were 95% (range 58-100) for understandability and 13% (range 0-80) for actionability. Five resources were evaluated as being moderately culturally inclusive. No resource met all the benchmarks. This study highlights the inadequate quality of online resources available on pre-diagnosis gynaecological cancer symptom information. Resources should be revised in line with the recommended standards for readability, understandability and actionability and to meet the needs of a culturally diverse population.

A higher education pedagogy for settler listening with Alexis Wright’s Carpentaria

This article focuses on a higher education pedagogy of reading the exemplary novel of Indigenous Australia, Carpentaria (2006) by Waanyi author, Alexis Wright. The multiply awarded and multiply translated novel gives an epic view of contemporary Aboriginal life. Its dramatization of listening relations is profoundly insightful for the current historical moment in Australian Indigenous-settler relations. Our pedagogy of settler listening emerges from the invitation by the Indigenous signatories to The Uluru Statement from the Heart (2017) calling on all Australians to aim for a “better future” for Aboriginal and Torres Strait Islander peoples. Our pedagogy has even more relevance since the defeat of the 2023 “Voice” referendum that symbolically and practically aimed to ensure that better future through a permanent Aboriginal and Torres Strait Islander advisory body to parliament. We describe our pedagogy through the scholarship in political listening studies and the “ethics of reading” the combination of which engenders responsiveness and responsibility in a reader that is potentially (trans)formative of relationality. We argue that when higher education curriculum is attentive to pedagogies of listening relations to marginalized voices, the conditions for settler listening are being achieved both within higher education and beyond.

Koolangka Infant Life Saving: Culturally responsive infant CPR education for Aboriginal Australian parents

Objectives: Among Aboriginal children, the year between birth and 1 year of age has the highest mortality rate compared with any other age. Prompt administration of cardiopulmonary resuscitation (CPR) leads to better outcomes and a lower likelihood of ongoing sequalae. Current education on infant CPR is not provided to parents except in certain circumstances in a neonatal intensive care unit. Currently, there are no identified CPR education courses specifically available for Aboriginal or Torres Strait Islander people, meaning that current infant CPR education courses are not culturally responsive. Design: Partnering with an Aboriginal community from the Bindjareb region of the Western Australian Noongar nation, the researchers used a co-design approach and an Aboriginal Participatory Action Research (APAR) design to explore how to deliver culturally safe and responsive infant CPR community education. This resulted in the development of the Koolangka Infant Life Saving Education Framework (KILSEF), which can be used to guide future planning and delivery of culturally safe and responsive community level infant CPR education. Results: The study findings identified that members of the Aboriginal community were very interested in receiving infant CPR education, but the barriers identified from mainstream CPR course delivery need to be removed for the community to benefit from culturally responsive ways of learning. Culturally responsive community CPR education should be provided in culturally safe places and the focus of learning should be on the practical applications of CPR and less on the academic pre-reading and written requirements. Explanations should be provided in lay terms and patience is required to communicate ideas in ways that facilitate understanding, and the course may need to be delivered over several days to accommodate community participant availability. Conclusion: Addressing Aboriginal community concerns and barriers allowed for the implementation of culturally responsive infant resuscitation education which was highly valued by community members and led to increased community confidence and participation in CPR education.

Walking together in friendship: Learning about cultural safety in mainstream mental health services through Aboriginal Participatory Action Research.

Culturally safe service provision is essential to improving social and emotional wellbeing among Aboriginal and Torres Strait Islander communities, and to eliminating health inequities. Cultural safety is about ensuring that all people have a safe and healing journey through services, regardless of their cultural background. In this project, we aim to (1) understand how Aboriginal and Torres Strait Islander peoples conceptualise cultural safety, and (2) co-design a qualitative interview for the next phase of this project, where we plan to learn about experiences of cultural safety within mental health services. We conducted six focus groups (in one metro and two regional areas, Western Australia). Following an Aboriginal Participatory Action Research methodology, we yarned with Aboriginal and Torres Strait Islander mental health service users, carers, community members, mental health professionals and Cultural Healers about cultural safety. Participants described a culturally safe service as one where Aboriginal cultural knowledges, life experiences, issues and protocols are understood and acknowledged, and reported that mainstream mental health services are not currently culturally safe. Participants emphasised the importance of building trust, rapport, reciprocity and following appropriate relational processes when designing a qualitative interview for the next phase. A lack of cultural safety in mental health services is likely to contribute to the disparity in outcomes between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Embedding cultural safety into research design allows for authentic community engagement and facilitates knowledge sharing around ways to improve cultural safety in mental health services.

“Talking about something no one wants to talk about”—navigating hepatitis B-related work in remote Australian Aboriginal communities: a decade of learning and growth

Abstract Background Chronic hepatitis B (CHB) is one of the leading causes of liver cirrhosis and liver cancer globally. In Australia, Aboriginal and Torres Strait Islander people of the Northern Territory (NT) have the highest prevalence of CHB (6%) and are six times more likely than non-Aboriginal people to be diagnosed with liver cancer. In 2010, a “liver one-stop shop” model of specialised care and research was initiated to address this disparity. Despite many challenges, the program was accepted in NT Aboriginal communities. This study aimed to identify the key elements linked to this success. Methods We conducted a retrospective case study using Stake’s methodology to understand the hepatitis B phenomenon. A constructivist approach allowed a holistic understanding from the real-life perspectives of those involved in the hepatitis B work. Information was sourced from the Aboriginal workforce, patients of remote clinics, interested community members and service providers. Results We identified six elements critical to the successful conduct of our hepatitis B program, which included the essential role of the local Aboriginal workforce, providing health education in a patient’s preferred language, addressing shame and stigma, respecting culture, taking time, and building trust in the community. Conclusions Commitment over the long term was crucial for the success of our hepatitis B program. Adhering to the identified elements was essential to create a culturally safe environment and engage more Aboriginal people in clinical care and research. This study provides powerful lessons and insights that can be applied to other programs and comparable settings worldwide.

Differences in life expectancy within and between countries: implications for domestic TAVI guidelines in Australia and Aotearoa New Zealand.

The advent of transcatheter aortic valve implantation (TAVI) has caused a paradigm shift in the management of aortic stenosis away from traditional surgical aortic valve replacement (SAVR). However, uncertainty remains about the long-term (>10 year) durability of TAVI valves, especially in younger patients. This viewpoint collates life expectancy data from Australia and Aotearoa New Zealand to propose sex-specific age-based recommendations for choice of SAVR versus TAVI in their respective general populations and among Aboriginal and Torres Strait Islander people in Australia and both Māori and Pacific peoples living in Aotearoa New Zealand.

Priority setting: Development of the South Australian Aboriginal Chronic Disease Consortium RoadMap for Action.

Aboriginal and Torres Strait Islander (Aboriginal) people in South Australia are overburdened by cardiovascular disease, diabetes and cancer. The South Australian Aboriginal Chronic Disease Consortium (Consortium) was established in June 2017 as a collaborative partnership to lead the implementation of three state-wide chronic disease plans using a strategic approach to identifying key priority areas for action. In 2017-2018, the Consortium Coordinating Centre facilitated a priority setting process, which involved extensive consultation, including a prioritisation survey and stakeholder workshops. The Consortium's Aboriginal Community Reference Group was instrumental in leading the identification of priorities for action. The Consortium RoadMap for Action identified seven across-plan priorities and six condition-specific priorities. It acknowledged that: strengthening social and emotional well-being is central to improving health outcomes; prevention and early detection, acute management and ongoing management are all components of the continuum of care; and improving access to services, strengthening the workforce, and monitoring and evaluation are required across the continuum of care. Widespread implementation failure in the past across the health system and health services implementation and research translation highlights the value of the Consortium approach and its commitment to implementing the state-wide chronic disease plans in a collaborative manner. The Consortium relies on and fosters cross-sectoral alignment, with all key players including all public, private and Aboriginal Community Controlled health services, to progress its priorities and aspirations to improve health outcomes for Aboriginal people using evidence-based strategies. SO WHAT?: Rigorous and transparent priority setting processes that bring together research, clinical practice, health services operations, policy and community perspectives can foster intersectoral collaboration and partnership and support the implementation of shared priorities.

"It's changed my life. I'm not smoking anymore. I don't want to smoke anymore": exploring the acceptability of mailout smoking cessation support for and by Aboriginal and Torres Strait Islander people.

Aboriginal and Torres Strait Islander people want to quit smoking. There is global evidence of combination Nicotine Replacement Therapy (c-NRT) alongside behavioural support as best practice approach to smoking cessation care. However, there is limited adherence and acceptability research regarding NRT and behavioural supports for Aboriginal and Torres Strait Islander people. Similarly, there is limited research on what is considered culturally appropriate and safe support for Aboriginal and Torres Strait Islander people to quit smoking. This Aboriginal-led qualitative study explored the acceptability of the Koori Quit Pack. Aboriginal and Torres Strait Islander participants shared experiences of quitting with the mailout c-NRT program and behavioural cessation support through Yarning. Reflexive thematic analysis was used to develop themes. Aboriginal and Torres Strait Islander people are motivated to quit smoking and have accessed cessation supports from health professionals. However, the support(s) received are not always appropriate or culturally safe. The Koori Quit Pack was deemed acceptable and useful for smoking cessation. Having access to smoking cessation care and knowledge of c-NRT helped people quit smoking, and support others to quit too. A combination of NRT products alongside culturally responsive behavioural support(s), delivered through a mailout package was a beneficial strategy to help Aboriginal and Torres Strait Islander people quit smoking. National implementation of such a package could assist to accelerate reductions in tobacco use, helping meet national smoking reduction targets and improve health outcomes. Cessation supports offered to Aboriginal and Torres Strait Islander people are not always culturally-safe or effectively delivered. The Koori Quit Pack provided Aboriginal and Torres Strait Islander people with culturally-safe smoking cessation support delivered for and by Aboriginal and Torres Strait Islander people, demonstrating mailout smoking cessation supports as acceptable and highly valued. Mailout support eliminates accessibility barriers to cessation care while providing tools and knowledge to quit can lead to smoke-free behaviours among individuals and communities. Country-wide availability of this program can accelerate reductions in tobacco use, helping meet national targets and improve health outcomes consistent with the National Tobacco Strategy and the WHO Framework Convention on Tobacco Control.

Weaving Wayapa and cognitive behaviour therapy: applying research topic yarning to explore a cultural interface between Western and Indigenous psychology practice in Australia

ABSTRACT Background Indigenous Psychology within Australia reflects the traditional knowledges of Aboriginal and Torres Strait Islander Peoples and their understanding of the cultivation of relational social and emotional wellbeing (SEWB). However, these perspectives are poorly incorporated into dominant “Western” psychological theories and practice, such as Cognitive Behaviour Therapy (CBT). This represents a barrier to the cultural safety of current mental health practice and its decolonisation within Australia. Objectives This study brought together CBT Practitioners and Practitioners of an Aboriginal Wellbeing practice (“Wayapa”) to engage in a series of yarns (guided focus groups) to share perspectives, insights, and stories on their own and each other’s practices. Method Indigenous qualitative research approaches including Research Topic Yarning were engaged to decolonise the research environment and support dialogue at the cultural interface of the two practices. Results Through experiencing Wayapa, CBT practitioners reflected on gaps in their own practice, with an enthusiasm for the opportunities that Wayapa provided to decolonise their practice. Wayapa practitioners were able to celebrate the holistic nature of their practice and the possibility for it to inform dominant “Western” psychological theories and practice, such as CBT, and encourage a more connected and culturally safe way of working with First Nations peoples. Conclusions Creating safe cultural interfaces between “Western” and Indigenous Psychologies, and building awareness of the value of Aboriginal grounded wellbeing models, can help to promote and expand culturally safe practices within Australian psychological practice.

Evaluating Aboriginal and Torres Strait Islander Social and Emotional Wellbeing services: A collective case study in Far North Queensland.

Access to a coordinated range of strengths-based, culturally appropriate community-led primary mental health and Social and Emotional Wellbeing services is critical to the mental health and wellbeing of young Aboriginal and Torres Strait Islander people, and is a policy commitment of the Australian government. However, complex and fragmented service networks and a lack of standardised service data are barriers in identifying what services are available and what care they provide. A standardised service classification tool was used to assess the availability and characteristics of Social and Emotional Wellbeing services for young Aboriginal and Torres Strait Islander people in two regions in Queensland, Australia. We identified a complex pattern of service availability and gaps in service provision. Non-Indigenous non-governmental organisations provided a significant proportion of services, particularly 'upstream' support, while Aboriginal Community Controlled Organisations were more likely to provide 'downstream' crisis type care. Most services provided by the public sector were through Child Safety and Youth Justice departments. Our findings demonstrate the complexity of current networks, and show that non-Indigenous organisations are disproportionately influential in the care received by young Aboriginal and Torres Strait Islander people, despite community goals of self-determination, and government commitment to increasing capacity of Aboriginal Community Controlled Organisations to support their local communities. These findings can be used to support decision making and planning.

Mental and social wellbeing trajectory during the pandemic for vulnerable populations.

We investigated changes over time in mental and social wellbeing indicators for vulnerable population subgroups during the pandemic. These groups were younger people, people with disabilities, low-income groups, unemployed, culturally, and linguistically diverse communities (CaLD), and Aboriginal and Torres Strait Islander peoples. A series of four repeated population representative surveys were conducted in June 2020, September 2020, January 2022, and June 2022. Questions included items on psychological distress, financial hardship, social connection, and life satisfaction. For most groups, social connection and life satisfaction improved in 2022 relative to 2020. Psychological distress and financial hardship showed the opposite pattern, with some groups having worse results in 2022 relative to 2020. People without any vulnerability had better mental health and social wellbeing outcomes at each time point relative to the vulnerable population subgroups. Pandemic-related policies had differential effects over time and for different population groups. Future policies and research need to closely monitor how they impact population subgroups, and the overall results clearly demonstrate the inequity in mental health and social wellbeing outcomes for vulnerable population cohorts.