Kerrie E Doyle

Stereotyping Stigma: Undergraduate Health Students’ Perceptions at Handover

The World Health Organization (WHO) has recognized that errors in communication are one of the leading causes of adverse patient outcomes. Consequently, the WHO developed the High 5s Project to review, among other variables, handover of patients between shifts, professionals, and organizations. Seven countries were involved in the initial project. Australia responded by using the ISOBAR (Identify, Situation, Observations, Background, Agreed plan, and Read-back) tool as a template. However, none of the countries involved considered the social and emotional effects of handover on the staff or patients, although research has demonstrated that attitudes and values can be handed over from one nurse to another during this process. This article shows how the nurse who hands over care from one shift to the next can transfer stigma and labeling and offers suggestions for nurse educators and clinicians to apply national standards and core values to clinical practice and education.

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

Aboriginal and Torres Strait Islander people in Australia suffer from poorer mental health than non-Aboriginal people, especially in remote and rural settings. Even with the ongoing adoption of the World Health Organisations ‘Closing the Gap’ recommendations, the determinants of mental health, including suicide rates, hospitalisation rates and access to healthcare are not noticeably improving. One of the issues for this gap is the poor cultural proficiently of mental health services, creating a cultural security threat to the workers and service users. In my work as a senior Aboriginal Mental Health worker, I have observed incidents of ongoing cultural incompetence across the spectrum of healthcare. This embeds institutionalised racism that in turn fosters poor mental health. I offer examples of operational cultural proficiency and make recommendations to increase the appropriateness of services for Aboriginal people.

Recovery outcome measures: Is there a place for culture, attitudes, and faith?

Purpose Utilization of the Recovery Knowledge Inventory (RKI) and Recovery Attitudes Questionnaire (RAQ) in southeastern Australia raised questions about the RAQ, including links between attitudes, faith, and culture in supporting the recovery journey. These questions are particularly important when considered in the context of people with mental illness who live in secular multicultural societies. Conclusions This paper discusses the cultural appropriateness of the RAQ in Australian settings, and identifies the need to develop rigorous, inclusive recovery outcome measures. Practice Implications It is important to identify what best motivates people in their recovery journey, and to find a way to harness these motivating factors to achieve the best possible outcomes.PURPOSE Utilization of the Recovery Knowledge Inventory (RKI) and Recovery Attitudes Questionnaire (RAQ) in southeastern Australia raised questions about the RAQ, including links between attitudes, faith, and culture in supporting the recovery journey. These questions are particularly important when considered in the context of people with mental illness who live in secular multicultural societies. CONCLUSIONS This paper discusses the cultural appropriateness of the RAQ in Australian settings, and identifies the need to develop rigorous, inclusive recovery outcome measures. PRACTICE IMPLICATIONS It is important to identify what best motivates people in their recovery journey, and to find a way to harness these motivating factors to achieve the best possible outcomes.

Adapting Evidence-Based Interventions to Accommodate Cultural Differences: Where Does this Leave Effectiveness?

Evidence-based interventions are an essential part of delivering contemporary mental health services. Many such interventions, however, are developed with and for mainstream population groups. Practitioners and researchers alike will often adapt tools, practices, processes or programmes to meet the needs of culturally diverse populations groups, but wonder if and how such adaptations will affect outcomes. This paper considers the processes by which evidence-based interventions can be adapted by health professionals in any context; and includes an example of a successful cultural adaptation to an evidence-based intervention. The successful implementation of the Aboriginal Mental Health First Aid programme in Australia illustrates the potential for adapted interventions to support improvements in the health outcomes of people from culturally diverse backgrounds. The paper concludes by outlining the steps mental health professionals can take when adapting evidence-based interventions for use in their own workplace settings.

Leadership as a Personal Journey: An Indigenous Perspective.

Indigenous Australians have higher levels of mental illness, self-harm, suicide and substance abuse than non-Indigenous Australians, as well as more frequent contact with the criminal justice system. These indices point to the need for strong leadership to support Close the Gap programmes that have now been implemented across Australia. This article considers leadership as a journey of learning for Australian Indigenous leaders. Through the use of story, it is suggested that a situational leadership approach, incorporating the principles of mindfulness, provides the most appropriate framework for Indigenous leaders who work with Indigenous communities. Flexible approaches are needed to meet the needs of diverse Indigenous populations, and address the complex challenges involved, including lateral violence. Such flexibility will enable Indigenous leaders and communities to work together to achieve improvements in the health outcomes, not only for Indigenous Australians, but also for Indigenous populations worldwide.

The Yerin Dilly Bag Model of Indigenist Health Research

In this article, we discuss indigenist approaches to health research, including indigenist knowledges, cultural proficiency, and core values. We also highlight the importance of conducting Indigenous research in ways that are congruent with the needs and interests of Indigenous peoples. The discussion includes consideration of how indigenist approaches can be utilized to generate new Indigenous knowledges, in culturally appropriate ways. We then introduce the Yerin Dilly Bag Model for indigenist health research, an approach that allows for indigenist knowledges to be employed and created by the research/er/ed within an Indigenous framework. Use of the Yerin Dilly Bag Model enables research/er/ed concordance, together with the privileging of Indigenous voices. This is achieved by guiding researchers to align their research with the core values of the researched, with the Yerin Dilly Bag a metaphor for the holder of these core values.

Australian Aboriginal Peoples and Evidence-Based Policies: Closing the Gap in Social Interventions

Australian Aboriginal people are some of the most researched people on earth, yet their life expectancy and other well-being indices lag significantly behind non-Aboriginal Australians. The reach of evidence-based practice (EBP) in social interventions has not yet informed Aboriginal policy even though it is based on clinical expertise and systematic research. This is due to criticism of the processes of EBP, most commonly its supposed limitations and misperceptions, which are easily refuted. EBP continues to be a tool that is needed to inform practice across all disciplines of human service, and needs to be the core value of any intervention with indigenous peoples.