Research projects

Aboriginal Mental Health Worker Program – Phase 1

Principal Researchers

Top End Division of General Practice (TEDGP), NT Department of Health and Community Services (DHCS), Batchelor Institute of Indigenous Tertiary Education (BIITE)

Charles Darwin University (CDU) and beyondblue.

Program evaluation was by Dr Gary Robinson and Dr Amanda Harris, School for Social and Policy Research, Charles Darwin University

Institution

Top End Division of General Practice (TEDGP), NT Department of Health and Community Services (DHCS), Batchelor Institute of Indigenous Tertiary Education (BIITE)

Charles Darwin University (CDU) and beyondblue.

Funding

$1.156 million

Co-Funded with

Initial funding was received from the Australian Government for a four-year period, and further funding (above) was committed by beyondblue

Award Type

beyondblue Grant

Project completion year

2005

Project brief

In 2001, the Top End Division of General Practice (TEDGP) was funded under the Australian Government’s More Allied Health Services (MAHS) program to employ Aboriginal Mental Health Workers (AMHWs) to work alongside General Practitioners in five remote health centres. In 2002, beyondblue joined the Program to extend this to seven centres and to fund an external evaluation.

beyondblue’s involvement initiated the establishment of a Partnership Agreement between the major institutional contributors to the Program: the Top End Division of General Practice, the NT Department of Health and Community Services, Batchelor Institute of Indigenous Tertiary Education and Charles Darwin University.  The Partnership Agreement outlined the commitments of each organisation to support the Program objectives to:

  • develop the role of the Aboriginal Mental Health Worker as a member of a community-based mental health team in participating communities,
  • provide ongoing support, training and mentoring to Aboriginal Mental Health Workers in remote communities,
  • provide more effective mental health care practice through application of the local cultural knowledge and expertise of AMHWs working in conjunction with and in support of general practitioners,
  • improve the level and quality of mental health care services accessed by members of participating communities,
  • form an effective partnership between contributing organisations in the delivery and support of mental health care services in remote indigenous communities.

Services provided by Aboriginal Mental Health Workers include:

  • crisis support to community members
  • mental health promotion eg. establishing sporting teams, encouraging ceremony
  • assisting GPs and health workers in their clinical consultations
  • assisting people to care
  • primary mental health liaison and linkage with specialist acute care.

Key Findings

There is no single model that effectively describes the community roles of the AMHWs in this project.  In health centres, where the role of the AMHWs was most effectively established, GPs and RNs reported that they provided valuable service to other health care practitioners through explaining cultural or relationship matters, assisting in management of difficult clients, or in resolving often complex matters of client welfare.

With variations across the communities, it is reported that AMHWs have significantly contributed to practitioners’ ability to understand background issues and cultural themes relating to clients’ problems. Clients often benefited from the mediation skills of AMHWs who assisted with managing crisis situations in the health centres.  AMHWs also counseled clients with a range of difficulties and variously participated in community health promotion and education activities.

Implications for policy and practice

The AMHW Program has the potential to contribute to significantly improved Indigenous participation in provision of needed health care services.  A success and a challenge for the program is the importance of pre-existing resources, practitioner preferences and programs in each community and the capacity of an AMHW to adapt to local needs.

The possibility that some community mental health workers could primarily work in non-clinical mental health promotion, counselling, or other areas of community services and education without a clinical focus might be considered.  Such a role might need to be supported by a program of community-based public health or social services which is not present in most of the participating communities.  GPs or health centre RNs may have a limited capacity to be able to support this work.

The AMHW Program demonstrates that clinical health services for Indigenous people in remote settings can be effectively supported by employing Aboriginal Mental Health Workers who have the capacity to respond to local issues, are appropriately remunerated for their level of work and who are backed up with effective support for their necessary work outside clinical settings.

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