Closing the Gap in Aboriginal and Torres Strait Islander Youth Suicide: A Social-Emotional Wellbeing Service Innovation Project

Abstract Background Multiple culturally-oriented programs, services, and frameworks have emerged in recent decades to support the social and emotional wellbeing (SEWB) of Aboriginal and Torres Strait Islander (Aboriginal) people in Australia. Although there are some common elements, principles, and methods, few attempts have been made to integrate them into a set of guidelines for policy and practice settings. This review aims to identify key practices adopted by programs and services that align with the principles of the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017–2023. Methods A comprehensive review of electronic databases and organisational websites was conducted to retrieve studies of relevance. Twenty-seven publications were included in the review. Next, we identified promising practices through a collaborative review process. We then used the principles articulated in the above-mentioned framework as the basis to complete a framework analysis. This enabled us to explore the alignment between current scholarship about SEWB programs and services with respect to the principles of the framework. Results We found there was a strong alignment, with selected principles being effectively incorporated into most SEWB program and service delivery contexts. However, only one study incorporated all nine principles, using them as conceptual framework. Additionally, ‘capacity building’, ‘individual skill development’, and ‘development of maladaptive coping mechanisms’ were identified as common factors in SEWB program planning and delivery for Aboriginal people. Conclusion We argue the selective application of nationally agreed principles in SEWB programs and services, alongside a paucity of scholarship relating to promising practices in young people-oriented SEWB programs and services, are two areas that need the urgent attention of commissioners and service providers tasked with funding, planning, and implementing SEWB programs and services for Aboriginal people. Embedding robust participatory action research and evaluation approaches into the design of such services and programs will help to build the necessary evidence-base to achieve improved SEWB health outcomes among Aboriginal people, particularly young people with severe and complex mental health needs.

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Self-management programs for Aboriginal and Torres Strait Islander Peoples with chronic conditions: A rapid review

Chronic Illness ◽

10.1177/1742395317750266 ◽

2017 ◽

Vol 15 (2) ◽

pp. 83-123

Author(s):

Ellie Moore ◽

Sharon Lawn ◽

Candice Oster ◽

Andrea Morello

Keyword(s):

Chronic Condition ◽

Torres Strait Islander ◽

Grey Literature ◽

Rapid Review ◽

Self Management ◽

Rigorous Evaluation ◽

Cultural Appropriateness ◽

Evidence Summary ◽

Closing The Gap ◽

Torres Strait

Objectives Review the evidence for the effectiveness of chronic condition self-management programs applied to Aboriginal and Torres Strait Islander Peoples. Methods A rapid review methodology was followed to develop an evidence summary from peer-reviewed and grey literature. Results Only seven peer-reviewed studies were identified. The evidence indicated that group programs, particularly the Stanford Program, and structured individual chronic condition self-management programs were of good quality for Aboriginal and Torres Strait Islander Peoples, although these need to be integrated into practice in order to see the greatest benefits. The Flinders Program showed promise as a standardised program with content designed specifically with and for these populations. Numerous grey literature sources were identified, many using strong participatory approaches developed locally within Aboriginal and Torres Strait Islander Peoples. However, few of these programs have been subject to rigorous evaluation. Discussion Despite the significant focus on chronic condition self-management programs to help address the burden of disease for Aboriginal and Torres Strait Islander Peoples, few studies exist that have been properly evaluated. The Closing the Gap Principles developed by the Australian Institute of Health and Welfare offer important guidance for how to proceed to maximise engagement, cultural appropriateness and ownership of program initiatives.

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Culturally safe and sustainable solution for Closing the Gap-registered patients discharging from a tertiary public hospital

Australian Health Review ◽

10.1071/ah18160 ◽

2020 ◽

Vol 44 (2) ◽

pp. 200

Author(s):

Scott Mitchell ◽

Hayley Michael ◽

Stephanie Highden-Smith ◽

Vivian Bryce ◽

Sean Grugan ◽

...

Keyword(s):

Continuity Of Care ◽

Public Hospital ◽

Torres Strait Islander ◽

Culturally Sensitive ◽

Public Hospitals ◽

Smooth Transition ◽

Cardiac Care ◽

Funding Model ◽

Closing The Gap ◽

Torres Strait

This case study describes the development, implementation and review of a sustainable and culturally sensitive procedure for a hospital-funded discharge medicine subsidy for Aboriginal and Torres Strait Islander patients registered with the Closing the Gap (CTG) program discharging from a public hospital. A 7-day fully subsidised medication supply was approved to be offered to Aboriginal and Torres Strait Islander patients admitted under cardiac care teams, including cardiology and cardiothoracic surgery patients. Patients were offered the option of a 7-day supply free of cost to them or a full Pharmaceutical Benefits Scheme (PBS) supply if preferred. A general practitioner (GP) appointment was organised within 7 days of discharge to ensure patients received ongoing supply of their medications as well as timely clinical review after discharge. Over a 34-month period from September 2015 to June 2018, 535 Aboriginal and Torres Strait Islander patients were admitted to the hospital under cardiac care teams. Of these patients, 296 received a subsidised discharge medication supply with a total cost of A$6314.56 to the hospital over the trial period, with a mean cost of A$21.26 per discharge. The provision of subsidised medications through the CTG program has improved the continuity of care for Aboriginal and Torres Strait Islander patients. The culturally sensitive approach is well received and has allowed smooth transition back to the community. This site-specific and state-based funding model was found to be financially sustainable at a public hospital. What is known about the topic?The CTG PBS program is not applicable to discharge prescriptions from public hospitals. As such, patients are required to either leave the hospital with no medicines or leave the hospital with medicines for which they have to pay full PBS price. This creates a huge financial barrier to the care for CTG-registered patients in the acute care setting. What does this paper add?A sustainable solution to the problem was found via a state-funded model while providing a supportive team to ensure GP follow-up and continuity of care after discharge. What are the implications for practitioners?If similar approvals are granted and supported at other public hospital sites, practitioners will be afforded one less barrier to provide patient-centred care for Aboriginal and Torres Strait Islander patients.

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Programs to Improve the Social and Emotional Wellbeing of Aboriginal and Torres Strait Islander Communities

Australian Social Work ◽

10.1080/0312407x.2015.1069866 ◽

2015 ◽

Vol 69 (3) ◽

pp. 373-380 ◽

Cited By ~ 1

Author(s):

Andrew Day ◽

Martin Nakata ◽

Keith Miller

Keyword(s):

Torres Strait Islander ◽

Emotional Wellbeing ◽

Social And Emotional ◽

The Social ◽

Torres Strait ◽

Social And Emotional Wellbeing

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‘We’re here to listen and help them as well’: a qualitative study of staff and Indigenous patient perceptions about participating in social and emotional wellbeing research at primary healthcare services

BMC Psychiatry ◽

10.1186/s12888-019-2263-8 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Sara Farnbach ◽

◽

Graham Gee ◽

Anne-Marie Eades ◽

John Robert Evans ◽

...

Keyword(s):

Indigenous Peoples ◽

Primary Healthcare ◽

Torres Strait Islander ◽

Healthcare Services ◽

Healthcare Staff ◽

Emotional Wellbeing ◽

Research Project ◽

Social And Emotional ◽

Torres Strait ◽

Social And Emotional Wellbeing

Abstract Background Research can inform culturally-appropriate care to strengthen social and emotional wellbeing (SEWB) among Aboriginal and Torres Strait Islander (hereafter, the term ‘Indigenous Peoples’ is respectfully used and refers to all Aboriginal and/or Torres Strait Islander Peoples of Australia). We acknowledge the cultural diversity of Australia’s Indigenous First Peoples and they do not represent a homogenous group.) (hereafter Indigenous) Peoples. We explore the perspectives of primary healthcare staff and Indigenous patients about their willingness to and experiences participating in SEWB research. Method Process evaluation using grounded theory approaches of Getting it Right: The validation study, a national validation designed Indigenous SEWB research project (N = 500). Primary healthcare staff (n = 36) and community members (n = 4) from nine of ten primary healthcare services involved with the research project completed qualitative semi-structured interviews. Interview data were triangulated with participant feedback (responses to structured questions and free-text feedback collected during Getting it Right), study administrative data (participant screening logs, communication logs, study protocol, deviation logs and ethics correspondence) and interviewer field notes. Results Three themes about staff, patient and community perspectives concerning research participation developed: (1) considering the needs, risk, preferences and impact of participation in research for staff, patients and community; (2) building staff confidence speaking to patients about research and SEWB problems and (3) patients speaking openly about their SEWB. Some staff described pressure to ensure patients had a positive experience with the research, to respond appropriately if patients became upset or SEWB problems were identified during interviews, or due to their dual role as community member and researcher. Patients and staff reported that patients were more likely to participate if they knew the staff outside of the service, especially staff with a shared cultural background, and they perceived SEWB as a community priority. Staff reported their skills speaking to patients about the research and SEWB improved during the research, which built their confidence. Contrary to staff preconceptions, staff and patients reported that many patients appreciated the opportunity to speak about their SEWB and contributing to research that may eventually enhance SEWB in their community. Conclusion Our research project was considered acceptable by most staff and patients. The positive outcomes reported by staff and feedback from patients highlights the importance of providing opportunities for people to speak about their SEWB and for research-informed SEWB PHC care. Trial registration Getting it Right is registered on ANZCTR12614000705684.

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Prevalence of Everyday Discrimination and Relation with Wellbeing among Aboriginal and Torres Strait Islander Adults in Australia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126577 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6577

Author(s):

Katherine Thurber ◽

Emily Colonna ◽

Roxanne Jones ◽

Gilbert Gee ◽

Naomi Priest ◽

...

Keyword(s):

Large Scale ◽

Torres Strait Islander ◽

National Sample ◽

Indigenous Populations ◽

Emotional Wellbeing ◽

Social And Emotional ◽

High Prevalence ◽

High Discrimination ◽

Torres Strait ◽

Everyday Discrimination

Discrimination is a fundamental determinant of health and health inequities. However, despite the high prevalence of discrimination exposure, there is limited evidence specific to Indigenous populations on the link between discrimination and health. This study employs a validated measure to quantify experiences of everyday discrimination in a national sample of Aboriginal and Torres Strait Islander (Australia’s Indigenous peoples) adults surveyed from 2018 to 2020 (≥16 years, n = 8108). It quantifies Prevalence Ratios (PRs) and 95% Confidence Intervals (CIs) for wellbeing outcomes by level of discrimination exposure, and tests if associations vary by attribution of discrimination to Indigeneity. Of the participants, 41.5% reported no discrimination, 47.5% low, and 11.0% moderate-high. Discrimination was more commonly reported by younger versus older participants, females versus males, and those living in remote versus urban or regional areas. Discrimination was significantly associated in a dose-response manner, with measures of social and emotional wellbeing, culture and identity, health behaviour, and health outcomes. The strength of the association varied across outcomes, from a 10–20% increased prevalence for some outcomes (e.g., disconnection from culture (PR = 1.08; 95% CI: 1.03, 1.14), and high blood pressure (1.20; 1.09, 1.32)), to a five-fold prevalence of alcohol dependence (4.96; 3.64, 6.76), for those with moderate-high versus no discrimination exposure. The association was of consistent strength and direction whether attributed to Indigeneity or not—with three exceptions. Discrimination is associated with a broad range of poor wellbeing outcomes in this large-scale, national, diverse cohort of Aboriginal and Torres Strait Islander adults. These findings support the vast potential to improve Aboriginal and Torres Strait Islander peoples’ wellbeing, and to reduce Indigenous-non-Indigenous inequities, by reducing exposure to discrimination.

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Aboriginal and Torres Strait Islander Education

International Journal of Critical Indigenous Studies ◽

10.5204/ijcis.v5i2.90 ◽

2012 ◽

Vol 5 (2) ◽

pp. 50-52

Author(s):

David Singh

Keyword(s):

Student Outcomes ◽

Torres Strait Islander ◽

Indigenous Australians ◽

Australian Government ◽

Education Systems ◽

Indigenous Children ◽

Australian Education ◽

Closing The Gap ◽

Torres Strait

Australian education systems have long been challenged by the gap between Indigenous and nonIndigenous student outcomes. All levels of Australian government, as well as Indigenous leaders and educators, however, continue to meet the challenge through exhortation, strategies and targets. The most prominent of such strategies is ‘Closing the Gap’, which gives practical expression to the Australian Government’s commitment to measurably improving the lives of Indigenous Australians, especially Indigenous children.

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