By the people for the people: Landmark survey amplifies community voice to reform mental health system
A landmark study, released this month, has engaged Southeast Queensland’s Aboriginal and Torres Strait Islander communities to speak about their mental health, report their preferences for care, and guide lasting mental health system reform.
The four-year project, known as The Staying Deadly Survey (or the Queensland Urban Indigenous Mental Health Survey) commenced in 2018 and was led by The Queensland Centre for Mental Health Research (QCMHR) in partnership with the Institute for Urban Indigenous Health (IUIH).
The cross-sectional population survey of more than 400 adult First Nations Australians in Southeast Queensland (SEQ) was undertaken with considerable planning and community consultation to determine the most suitable and culturally appropriate methods for undertaking the survey.
Lead Investigator and QCMHR researcher, Associate Professor Alize Ferrari said the study is the first of its kind in Australia to provide a comprehensive picture of the mental health needs of Aboriginal and Torres Strait Islander people in an urban setting.
“The study found that members of the SEQ Aboriginal and Torres Strait Islander community who participated in the survey had faced significant mental health adversity and had clear preferences for the type of care they wanted for their mental health,” Associate Professor Ferrari said.
“For instance, in the 12 months prior to the survey 40 per cent of respondents experienced a mental disorder and 10 per cent experienced harmful substance use.
“These rates are high, but it is also important to acknowledge that a large proportion of participating community members were well during this time with many participants reporting that they had abstained from alcohol or illicit drugs use altogether.”
The survey also asked participants to report their experiences with mental health services, with 74.4 percent preferring those provided by Aboriginal Community Controlled Health Services as opposed to mainstream service providers.
“While the majority of respondents did not feel they needed a service for their mental health in the past 12 months, 22 per cent reported that they needed a service but did not access or receive any care,” Associate Professor Ferrari said.
“Some reported this was because services did not help them when they asked for it, or services were too expensive to access.
“These findings offer important information to assist service planning and guide service providers and policy makers to understand where the barriers to care exist and how to address them.
“As expected, we also found the COVID 19 pandemic had an impact on our respondent’s mental health, with more than 22 per cent of participants reporting that they required increased mental health support, often due to changes in work circumstances, distress caused by separation from family or close friends, or restriction of life events or participation in social activities.”
Importantly, participants who reported higher connection and belonging to culture, participation in cultural events and activities, and feelings of empowerment were less likely to experience a mental disorder or hazardous substance use in their lifetime compared to those who reported less cultural connection and participation and felt disempowered by their circumstances.
“We hope these findings highlight the value of future research to understand and quantify the protective role of cultural identity on the health and wellbeing of First Nations People, and how this information can be used to shape intervention strategies and community mental health programs and services,” Associate Professor Ferrari said.
IUIH Chief Executive Officer, Adrian Carson, said the survey provides valuable information for policy makers, service planners and service providers in reforming mental health services to better meet the needs of First Nations people.
“I congratulate the research team and our Indigenous interviewers on completion of this study during particularly difficult circumstances including the COVID-19 pandemic and local floods,” Mr Carson said.
“They have taken a culturally safe and sensitive approach to conduct honest and open yarns with Mob on particularly difficult subjects and have made a significant contribution to the evidence base for mental healthcare reform for Aboriginal and Torres Strait Islander people in Australia.
“Our people have spoken and presented a challenge for the Queensland health system to respond.
“Since the survey, Queensland Health has been quick to act by investing in the development of Aboriginal and Torres Strait Islander community controlled specialised mental health service hubs in SEQ.”
The Queensland Urban Indigenous Mental Health Survey was funded by the Queensland Department of Health and the report is publicly available here.
Media contact: Kate Gadenne, QCMHR, k.gadenne@uq.edu.au