Liaison Psychiatry with Aboriginal and Torres Strait Islander Peoples

Anne P. F. Wand · Melissa J Corr · Sandra Eades

15 citations0/0 files storedAustralian & New Zealand Journal of Psychiatry

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Indigenous Health, Education, and Rights Psychiatric care and mental health services Mental Health Treatment and Access

Abstract

OBJECTIVE: The aim of the present study was to describe the referral patterns, assessment and suggested management of Aboriginal and Torres Strait Islander peoples referred to an inner-city general hospital psychiatry service. The overarching goal was quality improvement. METHOD: Participants were identified from the consultation-liaison psychiatry database of all referrals to the service from the general hospital and Emergency Department. All people over 18 identifying as Aboriginal and/or Torres Strait Islander seen during the period 1 July 2004-30 June 2007 were included. Information regarding referral and liaison patterns, suggested psychiatric management, disposition and follow up were gathered retrospectively from the medical records, with a particular focus on cultural references. RESULTS: There were 162 referrals to the consultation-liaison psychiatry team of people identifying as Aboriginal and/or Torres Strait Islander. The rate of referral to consultation-liaison psychiatry was 3%. The Emergency Department had the highest rate of referral followed by Obstetrics and Gynaecology. The most common reason for referral was assessment of risk. The patient's Aboriginal ethnicity was mentioned in 52.5% of consultation-liaison assessments. An Aboriginal health worker was consulted in 48.1% of cases. The most common management approach involved pharmacotherapy. The consultation-liaison service instigated legal interventions in 25% of cases. Forty-five patients were referred for psychiatric admission following their assessment. Mental health follow up was arranged in 43.8% of cases. CONCLUSIONS: The range of mental health problems referred and types of diagnoses made in Aboriginal and Torres Strait Islander peoples reflect what has been previously reported, particularly in relation to comorbidity. Aboriginal ethnicity was variably identified and Aboriginal health workers, general practitioners and families were not routinely involved in consultation-liaison psychiatry assessments, highlighting an opportunity to improve communication and the quality of patient care.

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References

2006Anthropology in the Clinic: The Problem of Cultural Competency and How to Fix It 2003The health of indigenous peoples 2004Guest Editorial 2004That’s just the way he is’: Some implications of Aboriginal mental health beliefs 2004Western psychotherapeutic practice: Engaging Aboriginal people in culturally appropriate and respectful ways 2007Indigenous Australians’ Understandings Regarding Mental Health and Disorders 2004Culturally appropriate health promotion: its meaning and application in Aboriginal communities 2002‘Best Intentions’ Lives on: Untoward Health Outcomes of Some Contemporary Initiatives in Indigenous Affairs

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2011Measuring cultural appropriateness of mental health services for Australian Aboriginal peoples in rural and remote Western Australia: a client/clinician's journey

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