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Meldrum K, Andersson E, Webb T, Quigley R, Strivens E, Russell S. Screening depression and anxiety in Indigenous peoples: A global scoping review. Transcult Psychiatry 2023:13634615231187257. [PMID: 37490720 DOI: 10.1177/13634615231187257] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Indigenous peoples' worldviews are intricately interconnected and interrelated with their communities and the environments in which they live. Their worldviews also manifest in a holistic view of health and well-being, which contrasts with those of the dominant western biomedical model. However, screening depression and/or anxiety in Indigenous peoples often occurs using standard western tools. Understandably, the cultural appropriateness of these tools has been questioned. The purpose of this scoping review was to map the literature that used any type of tool to screen depression or anxiety in Indigenous adults globally. A systematic scoping review method was used to search databases including, but not limited to, CINAHL, PubMed, Scopus and Google. Database-specific search terms associated with Indigenous peoples, depression and anxiety, and screening tools were used to identify literature. In addition, citation searches of related systematic reviews and relevant websites were conducted. The data set was limited to English language publications since database inception. Fifty-four publications met the review's inclusion criteria. Most studies were completed in community settings using standard western depression and anxiety screening tools. Thirty-three different tools were identified, with the Patient Health Questionnaire-9 being the most frequently used. The review's findings are concerning given repeated calls for culturally appropriate screening tools to be used with Indigenous peoples. Although there has been some work to cross-culturally adapt depression screening tools for specific Indigenous populations, clearly more clinicians and researchers need to be aware of, and use, culturally appropriate approaches to screening.
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Affiliation(s)
| | | | | | | | - Edward Strivens
- James Cook University
- Queensland Health, Cairns and Hinterland Hospital and Health Service
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Heris C, Thurber KA, Wright D, Thomas D, Chamberlain C, Gubhaju L, Sherriff S, McNamara B, Banks E, Smith N, Eades S. Staying smoke-free: Factors associated with nonsmoking among urban Aboriginal adolescents in the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). Health Promot J Austr 2020; 32 Suppl 2:185-196. [PMID: 33034057 DOI: 10.1002/hpja.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 10/04/2020] [Indexed: 11/07/2022] Open
Abstract
ISSUE ADDRESSED To examine the factors associated with preventing regular smoking among Aboriginal adolescents. METHODS Cross-sectional analysis of data from 106 Aboriginal adolescents aged 12-17 years, and their caregivers, from four Aboriginal Community Controlled Health Services in urban New South Wales, 2008-2012. The relation of individual, social, environmental and cultural factors to having 'never' smoked tobacco regularly was examined using Poisson regression. RESULTS Overall, 83% of adolescents had never smoked regularly; 13 reported current and five past smoking. Most lived in smoke-free homes (60%) despite 75% reporting at least one current smoker caregiver. Participants were significantly more likely to have never smoked regularly if they had good mental health (PR = 1.4, 95% CI: 1.1-1.9), their mother as their primary caregiver (1.3, 1.0-1.6), good family relationships (1.2, 1.0-1.5), stable housing (1.3, 1.1-1.7), had never used alcohol (1.8, 1.3-2.4), were not sexually active (3.1, 1.3- 7.2) and had no criminal justice interactions (1.8, 1.2-2.8). CONCLUSIONS Most participants lived in smoke-free homes and the vast majority had never smoked regularly. Promoting good mental health and strengthening social connections may be protective against smoking as those experiencing less social disruption were more likely to have never smoked regularly. Smoking may be an indicator of psychosocial conditions and a prompt for screening and simultaneous treatment. SO WHAT?: Organisations should be resourced to deliver holistic adolescent health promotion programs. Programs and policies should support positive family relationships and stable housing as this may protect against the uptake of regular smoking.
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Affiliation(s)
| | | | - Darryl Wright
- Tharawal Aboriginal Corporation, Campbelltown, NSW, Australia
| | - David Thomas
- Menzies School of Health Research, Darwin, NT, Australia
| | | | - Lina Gubhaju
- University of Melbourne, Melbourne, VIC, Australia
| | | | | | - Emily Banks
- Australian National University, Canberra, ACT, Australia
| | - Natalie Smith
- Sax Institute, Sydney, NSW, Australia.,Riverina Medical and Dental Aboriginal Corporation, Wagga Wagga, NSW, Australia
| | - Sandra Eades
- University of Melbourne, Melbourne, VIC, Australia
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Williamson A, Skinner A, Falster K, Clapham K, Eades SJ, Banks E. Mental health-related emergency department presentations and hospital admissions in a cohort of urban Aboriginal children and adolescents in New South Wales, Australia: findings from SEARCH. BMJ Open 2018; 8:e023544. [PMID: 30498044 PMCID: PMC6278810 DOI: 10.1136/bmjopen-2018-023544] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES The aim of the current study is to quantify mental health-related emergency department (ED) presentations and hospitalisations, and associated child and family characteristics, in children recruited through four Aboriginal Community Controlled Health Organisations. SETTING Four Aboriginal Community Controlled Health Services that deliver primary care. All services were located in urban or large regional centres in New South Wales, Australia. PARTICIPANTS 1476 Aboriginal children aged 0-17 years at recruitment to the Study of Environment on Aboriginal Resilience and Child Health. PRIMARY OUTCOME MEASURES ED presentations and hospital admissions with a primary mental health diagnosis obtained via linkage to population health datasets. RESULTS Over a median of 6-year follow-up, there were 96 ED presentations affecting 62 children (10.7/1000 person-years) and 49 hospitalisations affecting 34 children (5.5/1000 person-years) for mental health conditions. Presentations/admissions increased with age. ED presentation was increased with: living in foster versus parental care (adjusted rate ratio (RR)=3.97, 95% CrI 1.26 to 11.80); high versus low baseline child emotional/behavioural problems (adjusted RR=2.93, 95% CrI 1.50 to 6.10); and caregiver chronic health conditions versus none (adjusted RR=2.81, 95% CrI 1.31 to 6.63). Hospitalisations were significantly increased with caregiver unemployment versus home duties (adjusted RR=4.48, 95% CrI 1.26 to 17.94) and caregiver chronic health problems versus none (adjusted RR=3.83, 95% CrI 1.33 to 12.12). CONCLUSIONS Tertiary care for mental health issues was relatively common among participating Aboriginal children, with risk elevated for those living in foster care, with prior mental health and behavioural problems and with carers with chronic illness and/or unemployment. While this study suggests high rates of serious mental health events among children from participating communities, the optimum means for reducing these rates, and the need for tertiary care, has not yet been determined. Such information is urgently required to inform policy and programmes to support Aboriginal child and adolescent mental health.
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Affiliation(s)
- Anna Williamson
- The Sax Institute, Sydney, NSW, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | | | - Kathleen Falster
- The Centre for Big Data Research in Health, University of New South Wales, Kensington, New South Wales, Australia
- The National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, New South Wales, Australia
| | - Sandra J Eades
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Acton, Australian Capital Territory, Australia
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Young C, Craig JC, Clapham K, Williams S, Williamson A. Stressful life events and resilience among carers of Aboriginal children in urban New South Wales: cross-sectional findings from the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). BMJ Open 2018; 8:e021687. [PMID: 29880570 PMCID: PMC6009629 DOI: 10.1136/bmjopen-2018-021687] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/19/2018] [Accepted: 04/19/2018] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE In caregivers of urban Aboriginal children, to determine the frequency of major stressful life events, the proportion who meet criteria for resilience, and factors that are associated with resilience. DESIGN Cross-sectional survey. SETTING Four Aboriginal Community Controlled Health Services located in urban or regional areas in New South Wales, Australia. PARTICIPANTS 574 caregivers of Aboriginal children participating in the Study of Environment on Aboriginal Resilience and Child Health. PRIMARY OUTCOME MEASURE Resilience, defined as having experienced three or more stressful life events in the last 12 months, and having scores of ≤21 on the Kessler 10 Psychological Distress scale. RESULTS Over half (315, 55%) of the caregivers reported three or more stressful life events-the most common being a close family member who was hospitalised with a serious medical problem (259, 45%). Of the participants who experienced three or more stressful life events, almost three-quarters (227, 72%) met the criteria for resilience. Using multivariable analysis, two factors were independently associated with resilience: not having a physical health problem that limited normal activities (adjusted OR (aOR) 4.3; 95% CI 2.0 to 9.0), and not having problems caused by alcohol within the home (aOR 5.3; 95% CI 2.2 to 12.8). Having a child whose behaviour placed a great deal of burden on the family was associated with less resilience (aOR 0.25; 95% CI 0.09 to 0.68). CONCLUSIONS Caregivers of urban Aboriginal children experienced a large number of stressful events, the most common being the poor health of close family members, but most exhibited resilience. Resilience was associated with stable family environments and good physical health. The high number of stressful life events that caregivers experience is reflective of broader inequalities that Aboriginal communities face. The availability of easily accessible and long-term health and support services may go some way to reducing this inequality and improving social and emotional well-being for Aboriginal families.
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Affiliation(s)
- Christian Young
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, The Children's Hospital, Westmead, New South Wales, Australia
| | - Jonathan C Craig
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, The Children's Hospital, Westmead, New South Wales, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute, The University of Wollongong, Wollongong, New South Wales, Australia
| | - Sandra Williams
- Tharawal Aboriginal Corporation, Sydney, New South Wales, Australia
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Twizeyemariya A, Guy S, Furber G, Segal L. Risks for Mental Illness in Indigenous Australian Children: A Descriptive Study Demonstrating High Levels of Vulnerability. Milbank Q 2018; 95:319-357. [PMID: 28589608 PMCID: PMC5461394 DOI: 10.1111/1468-0009.12263] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
| | - Sophie Guy
- School of Health Sciences, University of South Australia
| | - Gareth Furber
- School of Health Sciences, University of South Australia
| | - Leonie Segal
- School of Health Sciences, University of South Australia
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Chih HJ, Liang W. Effect of unaffordable medical need on distress level of family member: analyses of 1997-2013 United States National Health Interview Surveys. BMC Psychiatry 2017; 17:323. [PMID: 28865419 PMCID: PMC5581444 DOI: 10.1186/s12888-017-1483-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 08/23/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Reduced funding to public health care systems during economic downturns is a common phenomenon around the world. The effect of health care cost on family members of the patients has not been established. This paper aims to explore the relationship between affordability of health care and vulnerability of family members to distress levels. METHODS Data of a total of 262,843 participants were obtained from 17 waves (1997-2013) of the United States National Health Interview Survey. Multinomial logistic regression was used to investigate psychological distress level as a result of having family members who experienced unmet medical needs due to cost. RESULTS Among participants without family members who experienced unmet needs for medical care due to cost, risks of having 'moderate' (score of 5-12) or 'serious' (score of 13 or above) level of psychological distress were 1.0% and 11.5%, respectively. Risks of having 'moderate' or 'serious' level of psychological distress were 3.1% and 23.4%, respectively among participants with family members who experienced unmet needs. The adjusted relative risk ratio of 'moderate' and 'serious', as compared to 'normal' level of psychological distress, were 1.58 (95% confidence interval: 1.47-1.69) and 2.09 (95% confidence interval: 1.78-2.45) if one's family members experienced unmet medical needs. CONCLUSIONS Unmet medical needs due to cost increases risk of distress levels experienced by family members. Careful planning and adequate funding to public health care system could be implemented to prevent any unnecessary detrimental effect on mental health among family members of the unwell and any further increment of the prevalence of mental illnesses. This recommendation aligns with the World Health Organization Mental Health Action Plan 2013-2020.
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Affiliation(s)
- Hui Jun Chih
- School of Public Health, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
| | - Wenbin Liang
- 0000 0004 0375 4078grid.1032.0National Drug Research Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
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Mah B, Rae KM. Carers of Indigenous children: services and systems failure? Where to next? Med J Aust 2016; 205:19-20. [DOI: 10.5694/mja16.00551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 05/10/2016] [Indexed: 11/17/2022]
Affiliation(s)
- Beth Mah
- University of Newcastle, Newcastle, NSW
| | - Kym M Rae
- University of Newcastle, Tamworth, NSW
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