Leigh-ann Onnis

Psychosis in Indigenous populations of Cape York and the Torres Strait

Objective: To describe and characterise treated psychotic disorders in the Indigenous populations of Cape York and the Torres Strait.

Psychosis and its correlates in a remote Indigenous population

Objectives: The aim of this study was to describe prevalence and characteristics of psychotic disorders in a remote Indigenous population. Method: Clinical review of all patients with an active diagnosis of a psychotic disorder in remote communities of Cape York and the Torres Strait. Results: 170 patients were identified and demographic, social and treatment variables described. Conclusions: Psychotic disorders are common and more so among young adult Aboriginal men, with high rates of comorbid conditions including substance use, intellectual impairment and diabetes. In parallel to this case complexity, there are high rates of coercive treatments. Certain differences by ethnicity and location are described and possible explanations proposed.

Beasts of burden or organised cooperation: the story of a mental health team in remote, Indigenous Australia

Objective: This paper aims to describe the growth of a regionally-based mental health team providing services to remote Indigenous communities in far north Queensland. Conclusions: By drawing on their experience, the authors are able to identify factors supporting the development and sustained capacity of integrated mental health teams, working in challenging remote settings.

Health professionals working in remote Australia: a review of the literature

Health professionals working in remote Australia have demanding and stressful yet diverse and rewarding roles. The health domain literature examines the challenges of health service delivery non-cognisant of the benefits of a human resource management (HRM) approach. This systematic literature review uses an HRM approach to examine what is already known on this topic, and to identify key extant themes in order to determine: 1) which factors are common across the entire remote health workforce; and 2) whether there are factors that are unique to working in remote Indigenous communities that need further consideration. The findings suggest that the challenges and rewards are similar for health professionals working in remote Indigenous communities and those working in rural and remote regions. Therefore, the emergent themes (Personal, Professional, Organisational and Contextual) presented within a conceptual framework in this article, are pertinent for all health professionals working in remote Australia.

Maintaining hope: the intrinsic role of professional support

Purpose The purpose of this paper is to examine the supportive aspects of a team approach for a remote mental health team that report high stability in senior clinical roles, in a region where voluntary turnover is typically high. Design/methodology/approach This qualitative research study examines the reflections of team members on their role and job characteristics through informal semi-structured interviews. Findings The extant themes identified as supportive aspects of the team approach included engagement and both personal and professional support. The intrinsic role of support in remote work environments, and the impact of intrinsic job satisfaction through client-focussed practices further supported low turnover, improved stability and consistency of service provision. Originality/value Continued support for existing experienced health professionals will contribute to workforce stability in remote regions where needs are complex and continuity of care is improved by consistent, reliable services. With health professionals working in remote Australia reporting high levels of job satisfaction; it follows that the next steps involve minimising dissatisfaction through effective workforce support mechanisms. Health professionals already working in remote regions, suggest that this is about engagement and personal and professional support through flexible work systems. While the findings of this study may not be generalisable, the authors suggest that these supportive aspects are transferable to other multi-disciplinary team settings.

An examination of supportive management practices promoting health workforce stability in remote northern Australia

Objective: The aim of this study is to examine management practices that support the wellbeing of health professionals working in remote regions, which may improve workforce retention. Method: An online questionnaire was distributed to health professionals working in remote regions of the Kimberley and North Queensland. A response rate of 20% was achieved. Results: The findings suggest that, for health professionals working in remote regions of northern Australia, accessing adequate support is one of the most challenging aspects of working in remote regions. Hence, in remote regions where turnover is high, retention of competent health professionals may benefit from management practices that provide improved personal and professional support. Conclusions: Health professionals working in remote Australia face unique pressures due to their geographical and professional isolation. Therefore, providing support improves their professional competence and personal wellbeing, and promotes workforce stability, which benefits the remote community through better access to health services.

The evidence needed to demonstrate impact: A synthesis of the evidence from a phased social and emotional wellbeing intervention

Policy decisions are based on evidence that demonstrates the effectiveness of interventions; however, the quantity and type of evidence that is needed to demonstrate the effectiveness of an intervention is not universally agreed upon. The aim of this study was to collaborate with researchers who have not been involved directly in Family Wellbeing interventions to lead a review of characteristics of the Family Wellbeing intervention evaluation output to date, and to assess for evidence of the FWB interventions impact on participants and their communities. The study found that where it is not appropriate or viable to conduct research, such as randomised control trials, alternative ways of providing evidence to demonstrate the effectiveness of an intervention is vital. This review suggests that Family Wellbeing interventions are having a positive impact and promoting change in the lives of participants, their families and their communities. Hence, for complex interventions, such as those with Indigenous populations, evidence should demonstrate effectiveness against prescribed outcomes, as well as critical aspects behind how and why a complex intervention was successful.

Human resource management policy choices, management practices and health workforce sustainability: remote Australian perspectives

The challenges for health professionals working in remote regions are diverse, particularly where voluntary turnover is high. This study examined the influence of management practices on workforce sustainability in remote regions of northern Australia using human resource management (HRM) policy choices. In this study, 24 semi-structured interviews with HR managers, health professionals and health managers revealed that the impact of HRM policy choices on remote workforce sustainability is significantly influenced by management practices. The emergent themes depict work environments where ineffective management practices for recruitment, remuneration, resourcing and relationships have profound consequences. Despite these contextual challenges, examples emerged where effective management practices created stability and improved retention. Hence, the findings suggest that sustainable remote health workforces are achievable where localised management practices improve equity, where employee–manager relationships are fostered, and where there is equitable access to resources and professional development.

‘This Is Where a Seed Is Sown’: Aboriginal Violence – Continuities or Contexts?

Aboriginal violence has been an issue of major political and public health concern in Australia for some four decades and rates of interpersonal and self-violence are now substantially higher than for the wider national population. Despite research and interventions targeting putative proximal factors there has been little improvement and the situation, particularly across remote Aboriginal Australia, remains grim. In the contested arena of Indigenous affairs the representation of violence and of those involved has powerful political resonances. Constructions in the academic and lay press over the last two decades which foreground ‘tradition’ as cause or major contributor provide the frame for this paper which commences by revisiting an historical analysis of violence in remote Indigenous populations undertaken some two decades ago by the first author. Change over the ensuing decades is presented and the implications for current understandings and approaches considered.