A new study led by Australia's first Indigenous doctor and child psychiatrist has revealed Aboriginal people in the psychiatric care system do not receive culturally safe care, which is contributing to persistent health disparities.
Palyku woman and The University of Western Australia's (UWA) Medical School Associate Dean (Indigenous), Professor Helen Milroy, led the study in collaboration with UWA researchers and the WA Country Health Service.
Published in Jama Network Open, the study involved 20 Aboriginal adults accessing the Great Southern Mental Health Service in regional Western Australia and combined more than 1,100 documented clinical interactions with in-depth yarning interviews.
The study's results revealed a fragmented system of hospital care which had limited links to family, community and other services involved in a patient's care.
"Aboriginal patients in mental health crisis often carry the burden of connection with family and external services involved in their care at the very time they need support the most," Professor Milroy said.
Data analysis from a novel network algorithm developed by Professor Michael Small, from UWA's School of Physics, Mathematics and Computing, found Aboriginal mental health workers played a uniquely important role in bridging the gap, by linking hospital care with family and services involved in patient care.
Quantitative findings were integrated with yarning interviews where participants spoke about Country, kinship and culture not as background context but as the substance of their wellbeing and described services that were routinely missed.
"What the numbers mapped structurally, participants described experientially and the two accounts aligned in ways that strengthened both," Professor Milroy said.
UWA said the findings highlight priorities for reform: growing and better supporting the Aboriginal mental health workforce, embedding cultural safety across the organisation, and redesigning care around the way Aboriginal people experience health and healing.
"Our mixed-method study confirms what Aboriginal communities have long known - that culturally safe care isn't an add-on, it's structural," Professor Milroy said.
"When Aboriginal mental health workers are present, people feel safer and care works better. When they're not, the whole system becomes more fragile."
The research was part of the Transforming Indigenous Mental Health and Wellbeing project, funded through the Medical Research Future Fund and was guided by Aboriginal leadership and the Aboriginal Participatory Action Research framework.
