Walking together in friendship: Learning about cultural safety in mainstream mental health services through Aboriginal Participatory Action Research

Helen Milroy, Shraddha Kashyap, Jemma Collova, Michael Mitchell, Angela Ryder, Zacharia Cox, Mat Coleman, Michael Taran, Beatriz Cuesta Briand, Graham Gee
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Abstract

Objective:Culturally safe service provision is essential to improving social and emotional wellbeing among Aboriginal and Torres Strait Islander communities, and to eliminating health inequities. Cultural safety is about ensuring that all people have a safe and healing journey through services, regardless of their cultural background. In this project, we aim to (1) understand how Aboriginal and Torres Strait Islander peoples conceptualise cultural safety, and (2) co-design a qualitative interview for the next phase of this project, where we plan to learn about experiences of cultural safety within mental health services.Methods:We conducted six focus groups (in one metro and two regional areas, Western Australia). Following an Aboriginal Participatory Action Research methodology, we yarned with Aboriginal and Torres Strait Islander mental health service users, carers, community members, mental health professionals and Cultural Healers about cultural safety.Results:Participants described a culturally safe service as one where Aboriginal cultural knowledges, life experiences, issues and protocols are understood and acknowledged, and reported that mainstream mental health services are not currently culturally safe. Participants emphasised the importance of building trust, rapport, reciprocity and following appropriate relational processes when designing a qualitative interview for the next phase.Conclusions:A lack of cultural safety in mental health services is likely to contribute to the disparity in outcomes between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Embedding cultural safety into research design allows for authentic community engagement and facilitates knowledge sharing around ways to improve cultural safety in mental health services.
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在友谊中同行:通过原住民参与式行动研究了解主流心理健康服务中的文化安全问题
目标:提供文化安全的服务对于改善土著居民和托雷斯海峡岛民社区的社会和情感福祉以及消除健康不公平现象至关重要。文化安全就是要确保所有人,无论其文化背景如何,都能在服务过程中获得安全和康复。在本项目中,我们的目标是:(1)了解土著居民和托雷斯海峡岛民是如何看待文化安全的;(2)为本项目的下一阶段共同设计一个定性访谈,我们计划在该访谈中了解心理健康服务中的文化安全经验。按照原住民参与式行动研究方法,我们与原住民和托雷斯海峡岛民心理健康服务使用者、护理者、社区成员、心理健康专业人员和文化治疗师就文化安全问题进行了讨论。结果:参与者将文化安全的服务描述为原住民的文化知识、生活经验、问题和规程得到理解和认可的服务,并表示主流心理健康服务目前在文化安全方面并不完善。参与者强调了在设计下一阶段的定性访谈时建立信任、融洽关系、互惠和遵循适当的关系流程的重要性。结论:精神健康服务中缺乏文化安全很可能会导致土著居民和托雷斯海峡岛民与非土著澳大利亚人之间的结果差异。将文化安全纳入研究设计可实现真正的社区参与,并促进围绕如何改善心理健康服务中的文化安全的知识共享。
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