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Mental health made easy: brief, practical and effective tools for rural and remote settings



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21st April 2011

The last decade has seen a number of positive mental health initiatives. Commonwealth reforms have improved access to psychological services, and the ‘Recovery’ movement began to reorient services to address needs holistically. In addition, Indigenous psychologies are emerging in an environment which increasingly recognises the social determinants of mental health and the impact of economic insecurity and racism on the health of communities.

On the other hand, there is still much to be done. Gaps between specialist services and primary care continue, and barriers between and within services continue to impede good outcomes. Stigma persists, perpetuated by the ‘bio-bio-bio’ models of care that dominate service paradigms. Where cultures collide there is high risk of under detection and misdiagnosis of illness, inadequate treatment and high attrition rates. The cost of high attrition is not only that of staff resources, but also low staff morale and high staff turnover.

The six year Aboriginal and Islander Mental Health Initiative (AIMhi) at Menzies has sought to develop brief practical tools that bridge worldviews. This paper will review current challenges and present findings from our work that are relevant to rural and remote mental health settings.

Tricia Nagel is a consultant psychiatrist who has lived and worked in the Top End of the Northern Territory for 26 years. Tricia is an Associate Professor at both Flinders University and Menzies School of Health Research where she leads the Healing and Resilience Division. Dr Nagel has a particular interest in comorbid disorders and integration of treatment approaches in primary care. Her work encompasses development of systems for delivery of best practice in remote and socially disadvantaged settings, and exploration of low-intensity psychological interventions as treatment. She works with a team of Indigenous researchers on the Aboriginal and Islander Mental health initiative (AIMhi) - an ongoing program of research and training.

Carolyn Griffin (nee Thompson): I was born and raised in Darwin and am of Walpiri/Gurindji descent on my mother’s side.  I am a mother and grandmother.  I have been with AIMHI since August 2003 as a Senior Indigenous Research Officer based at Menzies School of Health Research.  I have collaborated in the development of the AIMHI assessment and care planning tools and service provider training and have been influential in the success of the AIMHI NT project.
For me, the project represented an opportunity to create culturally appropriate resources with a view to helping Aboriginal and Torres Strait Islander people to better understand and recognise mental illness.