How an urban Aboriginal and Torres Strait Islander primary health care service improved access to mental health care

International Journal for Equity in Health

Lesley-Ann Clements²  Michelle Combo²  Patricia Shuter³  Deb Duthie¹  Wendy Foley²  Deborah Askew²  Julie Hepworth³ 

[1] Oodgeroo Indigenous Support Unit, Queensland University of Technology, Brisbane, Australia;Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Brisbane, Australia;School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia

关键词: Social work;    Psychology;    Qualitative research;    Integrated care;    Primary health care;    Mental health services;    Aboriginal and Torres Strait Islander;    Indigenous;    Cultural safety;    Access;   

Others  :  1220151
DOI  :  10.1186/s12939-015-0183-x

 received in 2014-12-03, accepted in 2015-05-01,  发布年份 2015

【 摘 要 】

Introduction

Aboriginal and Torres Strait Islander people experience higher levels of psychological distress and mental ill health than their non-Indigenous counterparts, but underuse mental health services. Interventions are required to address the structural and functional access barriers that cause this underuse. In 2012, the Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care employed a psychologist and a social worker to integrate mental health care into its primary health care services. This research study examines the impact of this innovation.

Methods

A mixed-method research design was used whereby a series of qualitative open-ended interviews were conducted with 7 psychology clients, 5 social work clients, the practice dietician, and the social worker and psychologist. General practitioners, practice nurses, Aboriginal Health Workers and receptionists participated in 4 focus groups. Key themes were identified, discussed, refined and agreed upon by the research team. Occasions of service by the psychologist and social worker were reviewed and quantitative data presented.

Results

Clients and staff were overwhelmingly positive about the inclusion of a psychologist and a social worker as core members of a primary health care team. In one-year, the psychologist and social worker recorded 537 and 447 occasions of service respectively, and referrals to a psychologist, psychiatrist, mental health worker or counsellor increased from 17 % of mental health clients in 2010 to 51 % in 2012. Increased access by Aboriginal and Torres Strait Islander people to mental health care was related to three main themes: (1) Responsiveness to community needs; (2) Trusted relationships; and (3) Shared cultural background and understanding. The holistic nature and cultural safety of the primary health care service, its close proximity to where most people lived and the existing trusted relationships were identified as key factors in decreasing barriers to access.

Conclusions

Improving social and emotional well-being is critical to addressing the health inequalities experienced by Aboriginal and Torres Strait Islander peoples. This study demonstrates the benefits for clients and health professionals of integrating culturally safe mental health services into primary health care.

【 授权许可】

   
2015 Hepworth et al.

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