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• Historically the engagement of mental health services and service delivery model has had an individual focus, which, for Aboriginal people, has been identified as having an insufficient connection to the social and cultural network of the consumer.
• Furthermore, the significant levels of undiagnosed mental illness or co-morbidity both for individuals and in collective cultural networks remain an area of unmet need requiring a service and support model that is based on cultural and community engagement. This lends weight to the development and implementation of a holistic treatment and support approach.
• The project creates a level of care coordination between care stakeholders that engages a broad range of service stakeholders in the provision of care and support services to identified Aboriginal wellbeing networks.
• The Aboriginal wellbeing networks are identified through a process of cultural mapping and the project creates significant innovation in service delivery by being able to provide coordinated services in a manner that strengthens the network in a culturally sustainable way, leading to increased independence in the management of wellness.
• Health, Housing and the non government sector (HASI partnership) are the key stakeholders in linking to various agency networks in the provision of care. This project has enhanced the innovative nature of this existing program by developing a cultural responsiveness that creates equity of access and participation for Aboriginal people with a mental illness.

• Increase the participation of Aboriginal mental health consumers and carers in housing and accommodation support initiatives.
• Implement cultural competence across broad service networks through joint participation in the training and development of Richmond Fellowship support workers and increasing the cultural competency of all service stakeholders.
• Develop a care coordination process that facilitates the delivery of support services to clusters of social and emotional wellness around an Aboriginal person with a mental illness to create a sustainable wellness management capacity in the identified cluster.

• Create sustainable and community wellness clusters For Aboriginal people with a mental illness and their community.
• Extend service provision to a number of social and emotional wellbeing nelworks around Aboriginal mental health consumers to grow community wellness capacity in Bourke.
• Modify housing and accommodation circumstances to be culturally responsive to the needs of Aboriginal mental health consumers, their wellness network and the Bourke community.
• Create local partnerships that support the recovery, social inclusion and rehabilitation of Aboriginal mental health consumers.

• Cultural mapping provides an Identification of the member's specific to the social and emotional wellbeing networks that are intrinsic to the cultural lifestyle of an Aboriginal mental health consumer.
• Care coordination will engage a range of agencies to provide systems and programs that link the social and wellbeing networks to service deliveries surrounding Aboriginal mental health consumers.
• Identification of Wellbeing clusters.
• Cultural competence training, reorientate a range of agency staff, workplaces and service models to be culturally responsive in the provision of housing and accommodation circumstances for Aboriginal consumers.
• Evaluation of the significance of improved social and emotional wellbeing as an indicator for mental health recovery and rehabilitation.
• Service coordination of identified services in a joint services plan thai is implemented as an integrated service response. This also provides an entree to the Aboriginal community for effective value adding programs such as Aboriginal Mental Health First Aid.
• Provision and access to brokerage funds for network members in community development and drug and alcohol interventions that genuinely exceed their local or corporate service provision capacity.

• Reduction in the use of hospital and health care services.
• Increased participation in the use of broad agency services.
• Mental health recovery and rehabilitation.
• Community development in cultural awareness and mental health care supports.
• Secure long term housing and accommodation provisions.

The HASI program in all health Areas reported the limited participation and retention of Aboriginal mental health consumers. Through discussions with various Aboriginal mental health staff, Aboriginal consumers and communities it was identified that current health care models had an individual morbidity focus which for Aboriginal people had an insufficient connection to the social and emotional wellbeing networks of the consumer.

Information obtained through consultations and a review of the literature, informed the development of an issues paper which described some important key elements for a change in service methodology.  Attachment A - Housing and Accommodation Support Initiative (HASI) Issues in Implementation (pdf - 168 KB) 

Field investigations and the introduction of innovative cultural components with a number of current Aboriginal consumers, demonstrated significant improvements in program outcomes.

A model design was constructed and validated through a series of community consultations. The Walgett Aboriginal elders group was significant in identifying historical problems and with pathways to procure a holistic cultural response.

The HASI program provides the opportunity to introduce service innovations and was seen as the vehicle to support a holistic service model.

The project brief reports the key elements and cultural impactors that have been identified through various investigations.  Attachment B - Project Brief: Bourke Housing and Support Initiative (pdf - 110 KB)

The implementation process is:

• agency and community consultations,
• cultural competence training,
• local cultural reference groups,
• care collaboration committee,
• service engagement.

In preliminary investigations it would appear that there are no social and emotional wellbeing evaluation tools. The 2006 ABS Census employed a version of the Kessler 10 assessment tool to perform a qualitative social and emotional wellbeing assessment across a broad spectrum of Aboriginal identifiers and those outcomes are currently being scrutinised.

However, the project model implements a number of predictors. They are:

• cultural mapping - identifies the social and emotional wellbeing issues that are indicators to periods of unwellness and wellness network disruption,
• care collaboration - identifies the systems and programs that address the social and emotional wellbeing unwellness,
• HASI program participation - reports the clinical and social presentation of consumers, and
• Mental health presentations - report the use of health care services.

The Community development capacity of the service and support model will be evaluated to identify indicators of increased community cultural cohesion and community wellness management.

The predicted outcome for the project is an increase in the capacity to provide support and service provision to Aboriginal people with a mental illness that fundamentally changes the historical approach taken by mental health service agencies. The model is responsive to commentary by Aboriginal consumers and communities about the elements that need to inform a culturally holistic and community based approach that identifies a person's essential wellbeing network and strengthens that networks capacity both internally and externally as part of a community culturally empowered to manage social and emotional wellness.

 Attachment A - Housing and Accommodation Support Initiative (HASI) Issues in Implementation (pdf - 168 KB)

 Attachment B - Project Brief: Bourke Housing and Support Initiative (pdf - 110 KB)

Aboriginal Mental Health Worker, Greater Western Area Health Service
Phone: 02 6841 2205