Escolar Documentos
Profissional Documentos
Cultura Documentos
Health
SCREENING & ASSESSMENT TOOLS
Crowded households
Poor access to health services for remote
communities
for urbanised Indigenous Australians, cultural
pressures which prevent access to health services
Cultural differences resulting in poor communication
between Indigenous Australians and health workers
Internal conflicts between families especially where
one family gains prominence in the local council
Fair indigenous patients issues
The Gap
Infant mortality rates was almost double (6.2 per
1000)
Death rates 5 or more times higher
4 times more likely to be hospitalised for chronic
conditions
3 times more likely to suffer from diabetes
Death rate for diabetes 7 times higher
maternal death rate 3 times
ASSESSMENT
How Westernised or how traditional
culturally safe practice is simply defined as effective clinical
practice for a person from another culture
unrecognised miscommunication is pervasive
English is usually not the first language
use of Aboriginal mental health workers & translational services
differing belief systems regarding illness
perceived inefficiency of health systems
disempowerment of Aboriginal patients
poor compliance issues
ASSESSMENT TOOLS
structured assessment involving measurement and
rating is likely to be unfamiliar and threatening
History of Screening Tools
Standard reaction times
No need to complete a task quickly
May not see the importance of being able to separate
past and present on a longitudinal calendar axis
Measurement scales including numerical or other
categories of gradation (e.g. mild, moderate, severe)
may have very limited applicability
Talk slowly
Wait for considerable time for the answer
Commence not with questions but with non
threatening statements
Involve AHW as much as possible
Story telling Fictitious third Person
Seek permission to precede with the sensitive topics
(Bereavement/Sorry Business, the breaking of
taboos, ceremonial business, sexuality and fertility,
and domestic habits)
Grog - alcohol
Ganja, mardi - marijuana
Spirit weak - depressed mood
spirit strong - euthymic, sense of well being
tucker - food
shame job - something that would bring shame to the
person
talking rubbish - thought disorder or floridly delusional
thinking backwards - ? subjective description of
though disorder
Tools required:
Comb, Pannikin / cup, Box of matches, Plastic
bottle with top , Watch/ timer for verbal fluency
question
33/39 and below indicates possible dementia
Medical History, smoking & alcohol, cognitive,
depression, family report & history, behaviour, ADL
& KICA Carer (3/16 or above)
KICA Regional/ Urban, KICA Screen
Alternate pictures (dog, horse)
EDUCATIONAL MATERIAL
E-learning modules
Indigenous EPAs in the RANZCP 2012 Fellowship
Program
https://www.ranzcp.org/Publications/Indigenous-mental
-health/Aboriginal-Torres-Strait-Islander-mentalhealth.aspx
http
://www.healthinfonet.ecu.edu.au/key-resources/cours
estraining
Nicheportal website
http://cmhr.anu.edu.au/research/projects/emhprac
REFERENCES
http://www.aams.org.au/mark_sheldon/#top
https://www.mja.com.au/journal/2016/205/ 1
http://aboriginal.telethonkids.org.au/media/57051/
1__intro_final.pdf
http
://www.dpmc.gov.au/publications/docs/closing_the_gap_2014.
pdf
The Aboriginal Concept of Time and its Mental Health
Implications. Australas Psychiatry October 2003 11: S40-S44
Strong Souls: Development and Validation of a Culturally
Appropriate Tool for Assessment of Social and Emotional WellBeing in Indigenous Youth. Aust N Z J Psychiatry January 2010
44: 40-48
REFERENCES
Australias Aboriginal Population and Mental Health (J Nerv Ment Dis
2010;198: 37)
Anxiety prevention in indigenous youth (Journal of Student Wellbeing
1(2):pp. 34-37)
Strong Souls: Development and Validation of a Culturally Appropriate
Tool for Assessment of Social and Emotional Well-Being in Indigenous
Youth (Aust N Z J Psychiatry January 2010 44: 40-48)
Here and Now Aboriginal Assessment: background, development and
preliminary evaluation of a culturally appropriate screening tool
(Australas Psychiatry June 2015 23: 287-292)
Kimberley Indigenous Cognitive Assessment tool (KICA):
development of a cognitive assessment tool for older indigenous
Australians (Int Psychogeriatr 2006;18:269-280)
Indigenous Cognitive Assessment Modification and Validation of the
KICA in Victoria. Phase 1. Final Report February 2013
REFERENCES
AIMH@Menzies School of Research
http://www.menzies.edu.au/page/Research/Projects/
Mental_Health_and_wellbeing/AIMhi_NT_-_
Australian_Integrated_Mental_Health_Initiative/
The development and validation of the Indigenous Risk Impact
Screen (IRIS): a 13-item screening instrument for alcohol and drug
and mental health risk (Drug Alcohol Rev. 2007 Mar;26(2):109-17)
The development of the Westerman Aboriginal Symptom Checklist
for Youth. Abstract of Doctor of Philosophy Thesis (Westerman, T.G
2003)
https://www.indigenouspsychservices.com.au/publications.php
We need transformative change in Aboriginal health
(Med J Aust 2016; 205 (1): 17-18.)
THANK YOU