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Joining the cultural dots

News story

Fluttering in the breeze above the Richmond Wellbeing building, the Aboriginal flag may not attract much attention from the casual passer-by. But for the Aboriginal people coming to seek help from the mental health service provider, the flag makes a world of difference and represents just how far the organisation has come in creating a culturally secure place for them.

Illustration of a human head profile in warm, orange colours.

The flag, décor and work practices of Richmond staff, in addition to changes instituted by other mental health and drug and alcohol service providers around Perth, all stem from the Looking Forward Moving Forward Project, which is a National Health and Medical Research Council (NHMRC) funded project located at Curtin Perth.

Now into its fifth year, the project led by Dr Michael Wright – a Yuat Nyungar man from the Moora and New Norcia region – aims to improve the access and responsiveness of Perth’s mental health and drug and alcohol services for Aboriginal people.

The project expanded out of Dr Wright’s 2010 PhD project where he investigated experiences of caregiving within Aboriginal families living with a mental illness.

“Aboriginal people told me lots of stories about how the mental health system was failing them at all levels in regard to the lack of cultural safety and lack of attentiveness to issues,” Dr Wright explains.

“The biggest issue was the system’s lack of understanding of the importance of kinship systems and how family is so important in supporting the person suffering from a mental illness. The very individualistic idea of health delivery does not fit within an Aboriginal world view.

“This can cause enormous problems for the families because they are not included in the recovery process. The person who is unwell also becomes quite distressed as they are alienated from their family when the health system takes over.”

Consulting with Nyungar Elders, the project’s research team found suicide, especially among young people, was the most serious issue identified by the community. The community also reported feeling frustrated that substance abuse and other serious mental health concerns remained unresolved.

“We arranged for Elders to meet with the senior management of 14 mental health and drug and alcohol service providers around Perth, such as Richmond Wellbeing, to pass on their knowledge and let that advice filter down into the organisation itself,” Dr Wright says.

“Over the last five years, the Elders have demonstrated that a lack of understanding and recognition of the importance of kinship through connection of family can seriously impede the recovery journey for Aboriginal people suffering from mental health conditions.

“That means services are moving away from an individualistic model of care and are thinking about how families are very much a part of the recovery process.

“Now there is a greater acknowledgement around sense of compliance and what that looks like and how they can do that differently. We are changing work practices inside the various organisations and that is directly as a result of their work with the Elders.”

Richmond Wellbeing Executive Manager of Operations Adrian Munro said that five years ago they had no Aboriginal clients and thought at the time that if Aboriginal people did not want to access services, that was their issue.

“The Elders helped us realise that Aboriginal people desperately wanted mental health services, but our services were not culturally safe and appropriate, and that everything we did was like putting up a sign out front saying Aboriginal people are not welcome,” Munro says.

The Elders have been able to guide Richmond Wellbeing to make a number of changes including cultural awareness training for staff, raising an Aboriginal flag outside the building and having an Acknowledgment of Country in every room in Richmond.

“You will not find an Aboriginal person who comes into our building who doesn’t immediately realise the flag is present. We have had people come in and say ‘I have never accessed any service from a white man ever before but the fact you have an Aboriginal flag out there I am prepared to give you a chance’.”

Richmond Wellbeing now employs 18 Aboriginal staff, and in 2017 provided support to close to 200 people, representing 15 per cent of the company’s total client base.

Dr Wright and the service providers are now developing metrics to measure changes that have occurred within each organisation to determine the sustainability of the service delivery model beyond the life of the project.

Health at Curtin

This article features in the 2018 Health at Curtin magazine, an annual showcase of some of the University’s most recent, innovative health research.

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