Mental health and Victorian Aboriginal people: what can data mining tell us?

Abstract

Nationally, Aboriginal people experience high levels of psychological distress, primarily due to trauma from colonisation. In Victoria, Aboriginal Community Controlled Health Organisations (ACCHOs) provide many services to support mental health. The aim of the present study was to improve understanding about Victorian Aboriginal people and mental health service patterns. We located four mental health administrative datasets to analyse descriptively, including Practice Health Atlas, Alcohol and Other Drug Treatment Service (AODTS), Kids Helpline and Close The Gap Pharmaceutical Scheme data. A large proportion of the local Aboriginal population (70%) were regular ACCHO clients; of these, 21% had a mental health diagnosis and, of these, 23% had a Medicare Mental Health Care Plan (MHCP). There were higher rates of Medicare MHCP completion rates where general practitioners (GPs) had mental health training and the local Area Mental Health Service had a Koori Mental Health Liaison Officer. There was an over-representation of AODTS episodes, and referrals for these episodes were more likely to come through community, corrections and justice services than for non-Aboriginal people. Aboriginal episodes were less likely to have been referred by a GP or police and less likely to have been referrals to community-based or home-based treatment. There was an over-representation of Victorian Aboriginal calls to Kids Helpline, and these were frequently for suicide and self-harm reasons. We recommend primary care mental health programs include quality audits, GP training, non-pharmaceutical options and partnerships. Access to appropriate AODTS is needed, particularly given links to high incarcerations rates. To ensure access to mental health services, improved understanding of mental health service participation and outcomes, including suicide prevention services for young people, is needed.

A Systematic Review of the Antecedents and Prevalence of Suicide, Self-Harm and Suicide Ideation in Australian Aboriginal and Torres Strait Islander Youth

“…The results were therefore synthesised narratively. Studies were grouped into five (not mutually exclusive) categories, including studies that evaluated the prevalence of suicide among indigenous youth via analysis of coronial data ( k = 8), [26,27,28,29,30,31,32,33]; studies that evaluated the prevalence of self-harm and attempted suicide via analysis of hospital admissions records ( k = 3), [34,35,36]; studies that evaluated the prevalence of suicide, self-harm, or suicide ideation among Indigenous youth in the community ( k = 7), [37,38,39,40,41,42,43]; studies that involved samples of incarcerated Indigenous youth ( k = 4), [44,45,46,47]; and studies that evaluated risk factors associated with suicide, self-harm, and suicidal ideation among Indigenous youth ( k = 5), [33,38,39,40,41]. The characteristics of the studies included in this review are summarised in Table 1.…”

“…Sample sizes ranged from n = 47 to n = 5289. Most studies involved data collected in Western Australia ( k = 5), [27,34,36,41,45] followed by four studies in the Northern Territory [30,35,38,40], four studies in Queensland, [29,32,33,43] three studies in South Australia [26,28,46] two studies in Victoria [37,39] and one study in New South Wales [44]. Two studies involved data collection from all states and territories in Australia [31,42].…”

“…The majority of studies reviewed reported analysis of morbidity or mortality data (i.e., hospital admission records or coronial reports) with a focus on the prevalence of suicide and self-harm ( k = 11) [26,27,28,29,30,31,32,33,34,35,36]. The majority of studies involved adolescent groups (10–19 years; k = 17), [26,27,28,29,32,33,34,35,38,40,41,42,43,44,45,46,47] followed by young adult (15–24 years) ( k = 11) [27,29,30,31,34,35,36,37,39,42,43] and child samples (0–14 years; k = 6). [27,29,32,33,35,43].…”

“…Seven studies reported prevalence estimates of suicidal ideation among Indigenous youth, with estimates ranging from 9.1 to 46% [32,37,39,40,42,44,46,47].…”

“…Time periods over which prevalence rates were estimated however varied between studies (two weeks ( k = 1), 12 months ( k = 1), lifetime prevalence ( k = 2) and not reported ( k = 3), thus limiting comparisons between studies. One study [37] indicated that almost half (46% n = 450) of all calls made to a telephone counselling service by Aboriginal young people related to suicidal ideation or suicide related concerns. Studies also suggested that the prevalence of suicidal ideation was higher among Aboriginal youth who were incarcerated [47] compared to Aboriginal youth living in the community [39,40].…”