Evaluation and results
The SEMWT embedded in TAIHS has seen 79 new patients since it began at the beginning of 2018. These are people living with moderate-severe mental illness who have not, and are unlikely to, engage with mainstream mental health services.
Aboriginal and Torres Strait Islander people experience high or very high psychological distress at twice the rate of non-Indigenous people with mental illness emerging as the highest contributor (20 per cent) to the Indigenous burden of disease in Queensland. As part of the collaborative intake process for SEMWS, professionals with both Social and Emotional Wellbeing and Mental Health expertise provide input into what care might assist a patient. This process enabled patient referral directly to a Townsville HHS psychiatrist.
Since the service has been operating out of TAIHS, SEMWT has provided care to a large cohort of significantly unwell people who were previously challenging for mainstream health services to reach. The Cultural Assessment and Liaison Team integrates 35 mental health service group health workers into one team has improved the consistency of cultural support in clinical practice and provided a career path for health workers. The team now comprises junior health workers with more experienced health workers and identified Aboriginal and Torres Strait Islander team leaders. The ATSIWAES model provides workers with a career pathway, exposure to a larger variety of clinical experience and mentorship from experienced Aboriginal and Torres Strait Islander health workers.
The model has provided more flexibility to appropriately allocate staff resources on a patient-by-patient basis matching the health worker with the right set of skills and experience with the patient. It has also ensured that a health worker is assigned to a consumer right through their health care journey, even if their treating team may change. The manager of ATSIWAES sits on the mental health service group executive. ATSIWAES also has a clinical director which helps foster clinical buy-in from medical staff. These senior leads are represented in the membership of the Mental Health Service Group Senior Management Team, supporting strategic capability in the development and delivery of mental health services to the Aboriginal and Torres Strait Islander population.
Lessons learnt
ATSIWAES is a unique model of delivering culturally capable mental health care to Aboriginal and Torres Strait Islander people that has been developed by the Townsville Hospital and Health Service (HHS) Mental Health Service Group. Across Australia there has been an ongoing challenge to engage Aboriginal and Torres Strait Islanders with mainstream care and this is particularly true for mental health care. In the Townsville HHS catchment about eight per cent of population identify as Aboriginal and Torres Strait Islander people; however, this cohort made up approximately 23 per cent of referrals to the mental health service group. The referral pathway for this cohort is more likely to be through the emergency department or through the justice system rather than self-referral.
The typical model for mental health services is to provide in-reach care to organisations such as Aboriginal and Torres Strait Islander Health Services or NGOs. Having a permanent and dedicated in-house service operating out of an Aboriginal and Torres Strait Islander Health Service has opportunistically allowed vulnerable people to be engaged in services immediately. This has already provided a significant improvement in health outcomes for these people who for the first time are receiving mental health care.
Further Reading
Townsville Aboriginal and Torres Strait Islander Corporation for Health Services (TAIHS)
