Engaging Indigenous people in therapy in a remote psychiatric inpatient setting in the Kimberley

Caroline Phillips1, Ann Cuypers2

1Kimberley Mental Health & Drug Service, PO Box 64 Broome WA 6725, Caroline.Phillips@health.wa.gov.au
2Bunbury (WA) Child and Adolescent Mental Health Services, PO Box 553 Bunbury WA 6725, Ann.Cuypers@health.wa.gov.au

Background: We conduct therapy within group and individual contexts on a remote psychiatric ward in Broome, Kimberley, Western Australia. Approximately 70-80% of our patients are Indigenous, therefore therapy and clinical interventions are required to be culturally meaningful. Patients come from all over the Kimberley and Pilbara regions where often facilities and access to fresh food are limited. Many Indigenous people speak different tribal languages, often English/ literacy a barrier to conventional therapy. Westernised mental health approaches can be incompatible with traditional beliefs.

Methods: Therapy must be meaningful, individually tailored and culturally and gender sensitive. Aboriginal Liaison Officers (ALOs) and sometimes cultural healers are involved in multidisciplinary team assessments, reviews and therapy programs. The ALOs assist clinicians to meet individual need areas such as managing humbugging, substance use, nutrition and healthcare needs. They advise on cultural appropriateness of interventions. ‘Back to Country’ group promotes engagement in culturally traditional activities such as bush tucker, outings to national parks, art and music. Creativity is paramount in exposure of health and recovery messages. Working collaboratively with patients to identify goals and assist with community integration i.e. referrals to vocational providers is required for effective recovery.

 Results: Regular verbal feedback from Indigenous patients as well as the Mental Health Advocacy and the ALO teams has been positive.

Discussion: When working with Indigenous patients it is important to work collaboratively with the ALOs and be creative in delivery of healthcare messages. There is a need for further development of therapeutic resources, assessment tools and programs for Indigenous persons.

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