The role of an Indigenous health worker in contributing to equity of access to mental health and substance abuse service for Indigenous young people in a youth detention centre

Abstract

Indigenous youth in detention have been identified as a priority category in national and state policies in relation to their mental health and drug and alcohol service needs. This article describes the development of the role of Indigenous Health Worker in the Mental Health Alcohol Tobacco and Other Drugs Service (MHATODS) at a youth detention centre. It provides an account of the process as well the outcomes achieved to date.

A retrospective and descriptive account is given of the development of the role, and of strategies aimed at improving access to MHATODS for Indigenous young people. Over a one-year period, data were compiled on all young people admitted to a Queensland youth detention centre, which was then cross referenced with MHATODS' own service records to determine the proportion of Indigenous young people who had been referred and subsequently received a service.

The Indigenous Health Worker has decreased barriers to access for Indigenous young people who require treatment for mental health or substance abuse problems while in detention. There was no significant difference in referral or service provision rates for Indigenous compared to non-Indigenous youth. Indigenous young people were statistically more likely to refuse an assessment by MHATODS, though given the low rates of refusal the clinical significance was small. MHATODS' use of an Indigenous Health Worker significantly contributes to the needs of Indigenous young people in youth detention by reducing barriers to access for the assessment of mental health problems and substance misuse. MHATODS has achieved equity in referral and service provision between Indigenous and non-Indigenous youth admitted into detention. Clinical and cultural supervision play an important part in the development and maintenance of the Indigenous Health Worker role.

Authors

Stephen Stathis
Child and Family Therapy Unit, Royal Children's Hospital, Herston QLD

Paul Letters
Mental Health Alcohol Tobacco and Other Drugs Service, Fortitude Valley QLD

Eva Dacre
Mental Health Alcohol Tobacco and Other Drugs Service, Fortitude Valley QLD

Ivan Doolan
Mental Health Alcohol Tobacco and Other Drugs Service, Fortitude Valley QLD

Karla Heath
Mental Health Alcohol Tobacco and Other Drugs Service, Fortitude Valley QLD

Bec Litchfield
Iona College, Wynnum QLD

References

Abram KM, Teplin LA, McClelland GM and Dulcan MK (2003) Comorbid psychiatric disorders in youth in juvenile detention. Archives of General Psychiatry 60(11), 1097-1108.

Abrantes AM, Hoffman NG and Anton R (2005) Prevalence of co-occurring disorders among juveniles committed to detention centers. International Journal of Offender Therapy and Comparative Criminology 49(2), 179-193.

Almond P (2002) An analysis of the concept of equity and its application to health visiting. Journal of Advanced Nursing 37, 598-606.

Australian Bureau of Statistics (2001) Census of Population and Housing. Canberra: Australian Bureau of Statistics.

Australian Bureau of Statistics (2002) National Health Survey: Aboriginal and Torres Strait Islander Results, Australia (cat. no. 4715.0.) Canberra: Australian Bureau of Statistics.

Australian Health Ministers (1992a) National Mental Health Plan. Canberra: Australian Government Publishing Service.

Australian Health Ministers (1992b) National Mental Health Policy. Canberra: Australian Government Publishing Service.

Australian Health Ministers (1998) Second National Mental Health Plan. Canberra: Australian Government Publishing Service.

Bennett B and Zubrzycki J (2003) Hearing the stories of Australian Aboriginal and Torres Strait Islander social workers: challenging and educating the system. Australian Social Work 56(1), 61-70.

Bickel R and Campbell A (2002) Mental health of adolescents in custody: the use of the 'Adolescent Psychopathology Scale' in a Tasmanian context. Australian and New Zealand Journal of Psychiatry 36(5), 603-609.

Brown R (2001) Australian Indigenous mental health. Australian and New Zealand Journal of Mental Health Nursing 10(1), 33-41.

Casey W (2000) Cultural empowerment: Partnerships of practice. In P Dudgeon, H Pickett and D Garvey (Eds) Working with Indigenous Australians: A Handbook for Psychologists. Perth: Curtin University, Centre of Indigenous Studies.

Chitsabesen P and Bailey S (2006) Mental health, educational and social needs of young offenders in custody and in the community. Current Opinion in Psychiatry 19(4), 355-360.

Coleborne C and MacKinnon D (2006) Psychiatry and its institutions in Australia and New Zealand: An overview. International Review of Psychiatry 18(4), 371-380.

Department of Communities (2004) Detention Centres: Year by Selected Characteristics, Queensland, 1996-97 to 2003-04. Brisbane: Queensland Government.

Folds R (1985) Constraints on the role of Aboriginal Health and Education Workers as community developers. Australian Journal of Social Issues 20(3), 228-233.

Forde L (1999) Report of the Commission of Inquiry into Abuse of Children in Queensland Institutions. Brisbane: Queensland Government.

Forde Inquiry Implementation Monitoring Committee (2001) Report to the Queensland Parliament. http://www.communities.qld.gov.au/department/past-initiatives/forde/publications/documents/pdf/forde_parliament.pdf (Accessed 15 March 2007)

Hunter E (2004) Communication and Indigenous health. Australian Doctor 4, 35-42.

Kataoka SH, Zima BT, Dupre DA, Moreno KA, Yang X and McCracken J.Y (2001) Mental health problems and service use among female juvenile offenders: their relationship to criminal history. Journal of the American Academy of Child and Adolescent Psychiatry 40(5), 549-55.

MHATODS (2004) Summary Paper 4, 2003-2004. Unpublished Internal Queensland Health Document.

Ministerial Council on Drug Strategy (1998) National Drug Strategic Framework 1998-99 to 2002-03: Building Partnerships. Canberra: Ministerial Council on Drug Strategy.

Ministerial Council on Drug Strategy (2001) National Alcohol Strategy: A Plan for Action 2001 to 2003-04. Canberra: Ministerial Council on Drug Strategy.

Parker R (2003) The Indigenous Mental Health Worker. Australasian Psychiatry 11(3), 295-297.

Pervin L (2003) The Science of Personality (2nd ed.). New York: Oxford University Press.

Queensland Health (1999) Our Jobs, Our Health, Our Future: Queensland Health Indigenous Workforce Strategy. Brisbane: Queensland

Quist RM and Matshazi DG (2000) The child and adolescent functional assessment scale (CAFAS): a dynamic predictor of juvenile recidivism. Adolescence 35(137), 181-92.

Human Rights and Equal Opportunities Commission (1993) Human Rights and Mental Illness. Report of the National Inquiry into Human Rights of People with Mental Illness (Burdekin Report). Canberra: Australian Government Publishing Service.

Swan P and Raphael B (1995) National Consultancy Report on Indigenous and Torres Strait Islander Mental Health: 'Ways Forward', Part I & Part II. Canberra: Office of Indigenous and Torres Strait Islander Health.

Vicary DA (2002) Engagement and Intervention for Non-Indigenous Therapists Working with Western Australian Indigenous People. Perth: Curtin University, Department of Psychology.

Wagstaff A and van Doorslayer E (2000) Equity in Health Care Finance and Delivery. In AJ Culyer and JP Newhouse (Eds) Handbook of Health Economics: Volume 1B (pp.1803-1862). Amsterdam: Elsevier.

Wasserman GA, McReynolds L, Lucas C, Fisher PW and Santos L (2002) The Voice DISC-IV with incarcerated male youth: prevalence of disorder. Journal of the American Academy of Child & Adolescent Psychiatry 41(3), 314-321.

Westerman TG (2004) Engagement of Indigenous clients in mental health services: What role do cultural differences play? Australian e-Journal for the Advancement of Mental Health 3(3), http://amh.e-contentmanagement.com/archives/vol/3/issue/3/article/3369/engagement-of-indigenous-clients-in-mental-health

Keywords

Indigenous mental health, substance misuse, youth detention, youth, Indigenous, equity

Meta

PP: 026 - 035

Introduction

The need for equity in accessing mental health and substance abuse services

In 1992, the National Mental Health Policy identified young people, and Aboriginal and Torres Strait Islanders as being at particular risk for mental health problems (Australian Health Ministers, 1992b). In the following year, the Human Rights and Equal Opportunities Commission (1993) addressed the serious issue of poor delivery of mental health services to the most socially and economically disadvantaged sections of the community, including those in youth detention. National and State policies have also recognised that mental health service delivery to socially marginalised children and young people was an important area of unmet need. Collaborative ventures between the Commonwealth, State and Territory governments have since been developed, committing them to a process of major reform of mental health services (Australian Health Ministers 1992a, 1992b, 1998). These key strategies in mental health provision were paralleled in the National Drug Strategic Framework and the National Alcohol Strategy (Ministerial Council on Drug Strategy 1998, 2001), both of which noted the high incidence of dual diagnoses among Indigenous young people, and recommended that steps be taken to strengthen the links between mental health services and drug treatment services in order to provide better and timelier access to therapeutic interventions.

Youth in detention rank among the most socially disadvantaged in the community, and are at an increased risk of a broad range of mental health and substance misuse problems (Abram, Teplin, McClelland & Dulcan, 2003; Abrantes, Hoffman & Anton, 2005; Bickel & Campbell, 2002; Wasserman, 2002). In Queensland, a high proportion of these young people identify themselves as being of Aboriginal or Torres Straight Islander descent (Department of Communities, 2004). Longstanding deficiencies in the provision of health services to young people in detention in Queensland were highlighted in 1999 by the Queensland Commission of Inquiry into Abuse of Children in Queensland Institutions, which noted the need for a mental health service to youth in detention centres that would more adequately address their needs (Forde, 1999). The development of the Mental Health Alcohol Tobacco and Other Drugs Service (MHATODS) was part of a wider response to recommendations of the Inquiry and has been detailed elsewhere (Forde Inquiry Implementation Monitoring Committee, 2001).

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