Coordinated Aboriginal mental healthcare: A model for best practice for rural and metropolitan service delivery.

It is hoped that this will result in strategies and systems that support coordination of mental healthcare that can be transferred and adapted to other settings.

Summary of projected outcomes
The primary objectives of the Coordinated Aboriginal Mental Healthcare project are:

1. To develop a practical and acceptable mental healthcare model for Aboriginal and non-Aboriginal service providers to adopt in South Australia and elsewhere in Australia.
2. To establish a strong partnership of researchers and practitioners from Aboriginal and non-Aboriginal services with the capacity and commitment to conduct mental health research in Aboriginal communities, leading to ongoing improvements in mental health outcomes in Aboriginal communities.

Summary of project implementation
The research focuses on the greater Eyre Peninsula region, in collaboration with health/community services in Port Lincoln and Ceduna, and links with metropolitan Adelaide, focusing on mental health and related services. Participants include staff of the services and other stakeholders (for example, community leaders and groups, policy makers).

The research comprises five overlapping stages:

• exploration;
• development;
• implementation;
• evaluation;
• dissemination.

Timeline
The project originally had a two-year timeline, beginning 2004. However, progress has been slower than anticipated due to other pressures on the partner organisations, and is now scheduled for completion by the end of 2007.

Related links
Centre for Clinical Research Excellence in Aboriginal and Torres Strait Islander Health www.ahcsa.org.au/content/13

Flinders University Aboriginal Health Research (FAHR) aboriginalhealth.flinders.edu.au/index.html

Coordinated Aboriginal Mental Healthcare is both the title and the goal of an ongoing project by a collaborative research team from Flinders University and Aboriginal health service providers in the Eyre Peninsula region of South Australia. The investigators are Inge Kowanko, Charlotte de Crespigny and Helen Murray (Flinders University), Jackie Ah Kit (Port Lincoln Aboriginal Health Service), Colleen Prideaux (Ceduna-Koonibba Aboriginal Health Service) and David Mills (Eyre Peninsula Division of General Practice).

This project builds on their previous work on medication management for Aboriginal people with mental health problems, conducted in Port Lincoln and across South Australia, which consulted widely with Aboriginal people and recommended better integration of services. That research highlighted the problems faced by clients and their families in navigating the multiple services they require, and the need for holistic and culturally appropriate systems of care (final report is available online at nursing.flinders.edu.au/research/index.php?id+108#aboriginalhealth).

In the current project the team is working with the wide range of health, social and human service providers that are involved in the care or support of Aboriginal people from the Eyre Peninsula region who have mental health problems (including alcohol and other drug-use problems). Together with the research team, these key stakeholders are identifying strategies that enhance coordination of services and developing agreed pathways and protocols that are client-focused and holistic, and embedded in systems rather than personality-dependent. Some strategies that promote inter-agency collaboration or communication that have already been identified and implemented by the research team during the project include bringing together workers from different agencies for training in response to shared needs; advocating for Aboriginal community input into the Review of Mental Health Legislation in South Australia; providing health promotion resources; and lobbying for improved out-of-hours telephone help.

Members of the team have worked together over several years, and have put much effort into building trust, nurturing professional and personal relationships, and demonstrating long-term commitment to improving wellbeing of Aboriginal people. They have developed the action-oriented partnership approach to research based on principles of respect, collaboration, meeting needs and participation. As well as linking with its previous studies, the team ensures that its research articulates with related work.

The Coordinated Aboriginal Mental Healthcare project is supported by grants from Flinders University and the CRC for Aboriginal Health. It is also a foundation project of the Centre of Clinical Research Excellence in Aboriginal Health Research, a joint project of Flinders University and The Aboriginal Health Council of South Australia, focusing on chronic condition management in the Eyre region.

Publications
de Crespigny, C., Kowanko, I., Murray, H., Wilson, S. & Ah Kit, J. 2006, 'A nursing partnership for better outcomes in Aboriginal alcohol, other drugs and mental health', Contemporary Nurse, vol. 22, no. 2, p. 275.

Prideaux, C., Ah Kit, J., Ordasi, L., Kowanko, I., Murray, H. & de Crespigny, C. 2006, 'Rural and remote Aboriginal mental health—Meeting the challenges', 16th annual The MHS conference 'Reach Out, Connect', Townsville, 30 August–1 September (invited presentation).

Kowanko, I. 2005, 'Coordinated Aboriginal mental health care—A model for best practice', Indigenous Health Matters, vol. 12 (June), p. 8.

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