Please use this identifier to cite or link to this item:
Scopus Web of Science® Altmetric
Type: Theses
Title: Stopping the run-around: addressing Aboriginal community people's mental health and alcohol and drug comorbidity service needs in the Salisbury and Playford local government areas of South Australia
Author: Francis Jebaraj, Hepsibah Sharmil
Issue Date: 2015
School/Discipline: School of Nursing
Abstract: In Australia, many mental health (MH) and alcohol and drug (AOD) services treat people‟s MH and AOD problems separately, depending on the particular service‟s primary focus. Commonly, this leaves people with co-existing MH and AOD conditions (MH-AOD comorbidity) in a service gap. Once in the MH or AOD service, they are referred backwards and forwards – getting the “run-around” – rather than being treated holistically. This leads to poor treatment outcomes or no treatment when people drop out of treatment or stop seeking help. This situation is particularly problematic for Aboriginal people, whose overall social, physical and mental wellbeing is significantly challenged compared with the rest of the Australian population. Despite Aboriginal and non-Aboriginal health care professionals being committed to closing the gap between Aboriginal and non-Aboriginal health and wellbeing, the MH-AOD service gap is widening. This gap is identifiable in underprivileged areas like the research site – the Salisbury and Playford LGA region of Adelaide – one of the most socio-economically underprivileged regions in Australia. Home to approximately one quarter of South Australia‟s total Aboriginal population, it has high unemployment and incarceration, and poor housing and education that seriously compromise the local population‟s physical, social, economic and mental health. This research, an offshoot of the larger project titled Stopping the run-around: Comorbidity Action in the North (CAN), aimed to determine the MH-AOD service needs of Aboriginal people aged 12 years and over living in the study region, identify and devise strategies to “stop the run-around” for Aboriginal people through local, culturally-appropriate, on-the-ground service, and make recommendations for holistic, coordinated MH-AOD care. Participatory action research (PAR) ensured inclusion of the people most affected by the MH-AOD service issue. Importantly, the researcher formed a co-researcher partnership with a respected Kaurna Aboriginal Elder and local Aboriginal people who became regular members of the CAN Aboriginal Working Party (AWP). People from the local Aboriginal community (n=19), Aboriginal and non-Aboriginal clinicians and workers from government and non-government MH or AOD services (n=9), and support service staff (n=5) participated in individual and joint interviews, and focus groups. All co-researchers and participants engaged in reflective PAR cycles of “look and listen, think and reflect, collaborate and plan, consult and act”, combined with the Aboriginal concepts of Ganma (sharing knowledge) and Dadirri (respectful listening). This research uncovered three overarching themes: comorbidity, a complex problem; current structure of MH and AOD services; and the future: needs-based MH-AOD services. The major finding was that the Salisbury and Playford LGA region had no dedicated service providing holistic MH-AOD care. Some services treat MH issues; others treat AOD issues. Looking to the future, local Aboriginal people stated that this structure needs “healing”. It concluded that MH and AOD services should stop “lip service” and provide “real service”. Action must be taken to meet the local Aboriginal community‟s real MH-AOD service needs by providing locally-available, culturally-appropriate MH-AOD care. This responsive MH-AOD care approach will enable a “no wrong door” service for consumers and help close the MH-AOD service gap for Aboriginal people in the study region.
Advisor: de Crespigny, Charlotte Francis Champion
Galletly, Cherrie Ann
Kelly, Janet
Dissertation Note: Thesis (Ph.D.) -- University of Adelaide, School of Nursing, 2015.
Keywords: Aboriginal
mental health
dual diagnosis
participatory action research
Provenance: This electronic version is made publicly available by the University of Adelaide in accordance with its open access policy for student theses. Copyright in this thesis remains with the author. This thesis may incorporate third party material which has been used by the author pursuant to Fair Dealing exceptions. If you are the owner of any included third party copyright material you wish to be removed from this electronic version, please complete the take down form located at:
DOI: 10.4225/55/5a209124255ca
Appears in Collections:Research Theses

Files in This Item:
File Description SizeFormat 
01front.pdf492.58 kBAdobe PDFView/Open
02whole.pdf5.3 MBAdobe PDFView/Open
  Restricted Access
Library staff access only275.24 kBAdobe PDFView/Open
  Restricted Access
Library staff access only5.4 MBAdobe PDFView/Open

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.