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Gibson M, Leske S, Ward R, Weir B, Russell K, Kolves K. Aboriginal and Torres Strait Islander youth suicide mortality and previous mental health, suicidality and service use in Queensland, Australia, from 2001 to 2021. J Affect Disord 2024; 354:55-61. [PMID: 38484672 DOI: 10.1016/j.jad.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 02/25/2024] [Accepted: 03/04/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND The current study aimed to compare current suicide rates, trends, previous treatment, suicidality and mental health diagnoses for First Nations and non-Indigenous young people who died by suicide. METHODS Age-specific suicide rates (ASSRs) were calculated per 100,000 persons/year using suicides aged 10-19 years in the Queensland Suicide Register. Rate Ratios (RRs) and 95 % CIs compared ASSRs for First Nations and non-Indigenous youth dying by suicide in Queensland, Australia, from 2001 to 2018. Risk ratios (RiskR) with 95 % CIs compared characteristics between First Nations and non-Indigenous youth suicides. Joinpoint regression was used to identify any changes in trends and annual percentage change (APC) in suicides with 95 % CIs. RESULTS The First Nations youth ASSR was 24.71 deaths per 100,000 persons/year, 4.5 times the non-Indigenous ASSR (95 % CI = 3.74-5.38, p < 0.001). Both non-Indigenous and First Nations suicide trends were stable with no joinpoints (APC: 0.3 %, 95 % CI: -1.6-2.2, p = 0.78; APC: 0.9 %, 95 % CI: -0.2-2.1, p = 0.11). Less than a quarter (23.9 %) of First Nations young people had ever received mental health treatment, significantly fewer than non-Indigenous youth (RiskR = 0.80, 95 % CI = 0.71-0.90, p < 0.001). Similarly, in the three months preceding their death, only 14.5 % of First Nations young people had received mental health treatment (RiskR = 0.89, 95 % CI = 0.83-97, p = 0.015). LIMITATIONS Reported mental illness, suicidality and help-seeking could be underreported due to concealment from family or police. CONCLUSIONS The current study finds no change in the gap between the First Nations and Non-Indigenous youth suicide rates nor evidence of decrease in the First Nations youth suicide rate. There is a need for alternative approaches to Indigenous youth suicide prevention, such as assertive outreach models outside of traditional triage and mental health systems to proactively build trusting relationships with young people in communities to identify young people needing support.
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Affiliation(s)
- M Gibson
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia.
| | - S Leske
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia; UQ Poche Centre for Indigenous Health, The University of Queensland, Toowong, Queensland, Australia
| | - R Ward
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia; Institute for Resilient Regions, Knowledge Broker First Nations Engagement Southern Queensland & Northern NSW Drought Resilience Adoption & Innovation Hub, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - B Weir
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - K Russell
- Beyond the Pale Aboriginal and Torres Strait youth mental health support services, Australia
| | - K Kolves
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
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Fitts MS, Condon T, Gilroy J, Bird K, Bleakley E, Matheson L, Fleming J, Clough AR, Esterman A, Maruff P, Bohanna I. Indigenous traumatic brain injury research: responding to recruitment challenges in the hospital environment. BMC Med Res Methodol 2019; 19:172. [PMID: 31390984 PMCID: PMC6686395 DOI: 10.1186/s12874-019-0813-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 07/30/2019] [Indexed: 11/13/2022] Open
Abstract
Background Hospitals are common recruitment sites for injury and disability studies. However, the clinical and rehabilitation environment can create unique challenges for researchers to recruit participant populations. While there is growing injury and disability focused research involving Indigenous people to understand the types of services and supports required by this population to enhance their recovery experiences, there is limited knowledge of researchers’ experiences implementing recruitment processes in the tertiary hospital environment. This paper reflects on the specific challenges of recruiting Indigenous patients following a traumatic brain injury from two tertiary hospitals in Northern Australia. Methods Between July 2016 and April 2018, research staff recruited eligible patients from one hospital in Queensland and one hospital in the Northern Territory. Qualitative records summarising research staff contact with patients, family members and clinical hospital staff were documented. These qualitative records, in addition to field trip notes and researcher reflections were reviewed to summarise the main challenges in gaining access to patients who fit the eligibility criteria. Results During the recruitment process, there were five main challenges encountered: (1) Patients discharging against medical advice from hospital; (2) Discharge prior to formal emergence from Post Traumatic Amnesia as per the Westmead Post Trauma Amnesia Scale; (3) Patients under adult guardianship orders; (4) Narrow participant eligibility criteria and (5) Coordinating around patient commitments and treatment. Details of how the recruitment processes were modified throughout the recruitment phase of the study to ensure greater access to patients that met the criteria are described. Conclusion Based on our recruitment experiences, several recommendations are proposed for future TBI studies with Indigenous Australians. In addition to treatment, Indigenous TBI patients have wide range of needs that must be addressed while in hospital. Patient engagement and data collection processes should be flexible to respond to patient needs and the hospital environment. Employment of a centralized recruiter at each hospital site may help to minimise the challenges researchers need to navigate in the hospital environment. To improve recruitment processes in hospitals, it is essential for researchers examining other health or injury outcomes to describe their recruitment experiences.
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Affiliation(s)
- Michelle S Fitts
- College of Public Health, Medical & Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia. .,Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC, Australia.
| | - Taeha Condon
- College of Public Health, Medical & Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
| | - John Gilroy
- Faculty of Health Sciences, Centre for Disability Research and Policy, The University of Sydney, Sydney, Australia
| | - Katrina Bird
- College of Public Health, Medical & Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
| | - Erica Bleakley
- National Critical Care and Trauma Response Centre, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Lauren Matheson
- Occupational Therapy Department, Townsville Hospital and Health Service, Townsville, QLD, Australia
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Alan R Clough
- Community-based Health Promotion and Prevention Studies Group, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
| | - Adrian Esterman
- Sansom Institute for Health Research and School of Nursing and Midwifery, University of South Australia and Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, 4870, Australia
| | - Paul Maruff
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - India Bohanna
- College of Public Health, Medical & Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
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Shepherd SM, Spivak B, Arabena K, Paradies Y. Identifying the prevalence and predictors of suicidal behaviours for indigenous males in custody. BMC Public Health 2018; 18:1159. [PMID: 30286743 PMCID: PMC6172717 DOI: 10.1186/s12889-018-6074-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 09/26/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND High rates of suicidal behaviours among Indigenous Australians have been documented. Justice-involved individuals are also at a higher risk for engaging in suicidal behaviours. This study sought to ascertain the prevalence and correlates of suicidal behaviours for 107 Indigenous adult males in custody in Victoria, Australia. METHODS Participants undertook a structured interview comprising a psychiatric assessment. Information on suicidal behaviours (ideation and attempts), socio-demographics, environmental stressors, negative life events and mental health was obtained. RESULTS A high proportion of Indigenous males in custody experienced lifetime suicidal ideation (63.7%) and over one-half had attempted suicide (54.5%). A smaller, yet significant number of participants experienced ideation over the past 12 months (27.9%). Having a loved one pass away within the past 12 months predicted recent ideation; lifetime ideation and a diagnosis of Post-Traumatic Stress Disorder predicted a lifetime suicide attempt. CONCLUSIONS The prevalence of suicidal behaviours among Indigenous people in custody is remarkably high. Correlates of suicidal behaviours for Indigenous people in custody in this study likely manifest in the community, denoting an urgent public health response. Prevention must begin in communities at-risk for suicidal behaviours. The development of low intensity mental health service infrastructure in communities to promote awareness and provide accessible, least restrictive support and treatment is necessary. Correctional institutions must also continue to improve custodial suicide prevention and management initiatives.
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Affiliation(s)
- Stephane M Shepherd
- Centre for Forensic Behavioural Science, Swinburne University of Technology, 505 Hoddle Street, Clifton Hill 3068, Melbourne, VIC, 9947 2600, Australia. .,National Centre for Cultural Competence, University of Sydney, Sydney, Australia.
| | - Benjamin Spivak
- Centre for Forensic Behavioural Science, Swinburne University of Technology, 505 Hoddle Street, Clifton Hill 3068, Melbourne, VIC, 9947 2600, Australia
| | - Kerry Arabena
- Indigenous Health Equity Unit, Melbourne School of Population Health, University of Melbourne, Melbourne, Australia
| | - Yin Paradies
- Alfred Deakin Research Institute for Citizenship and Globalisation, Deakin University, Geelong, Australia
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West M, Chuter V, Munteanu S, Hawke F. Defining the gap: a systematic review of the difference in rates of diabetes-related foot complications in Aboriginal and Torres Strait Islander Australians and non-Indigenous Australians. J Foot Ankle Res 2017; 10:48. [PMID: 29151893 PMCID: PMC5678749 DOI: 10.1186/s13047-017-0230-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 10/25/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The Aboriginal and Torres Strait Islander community has an increased risk of developing chronic illnesses including diabetes. Among people with diabetes, foot complications are common and make a significant contribution to the morbidity and mortality associated with this disease. The aim of this review was to systematically evaluate the literature comparing the rates of diabetes related foot complications in Aboriginal and Torres Strait Islander Australians to non-Indigenous Australians. METHODS MEDLINE, EMBASE, The Cochrane Library; PUBMED and CINAHL were searched from inception until August 2016. Inclusion criteria were: published cross-sectional or longitudinal studies reporting the prevalence of diabetes related foot complications in both a cohort of Aboriginal and Torres Strait Islander Australians and a cohort of one other Australian population of any age with diabetes. Risk of bias was assessed using the STROBE tool. RESULTS Eleven studies including a total of 157,892 participants were included. Studies were set in Queensland, the Northern Territory and Western Australia, primarily in rural and remote areas. Aboriginal and Torres Strait Islander Australians experienced substantially more diabetes related foot complications with the mean age up to 14 years younger than non-Indigenous Australians. Aboriginality was associated with increased risk of peripheral neuropathy, foot ulceration and amputation. In several studies, Aboriginal and Torres Strait Islander Australians accounted for the vast majority of diabetes related foot complications (up to 91%) while comprising only a small proportion of the regional population. Reporting quality as assessed with the STROBE tool showed underreporting of: methods, sample description and potential sources of bias. There are no data available for some Australian states and for specific types of diabetes related foot complications. CONCLUSIONS Aboriginal and Torres Strait Islander Australians have a 3-6 fold increased likelihood of experiencing a diabetes related foot complication compared to non-Indigenous Australians. Evidence-based, culturally appropriate screening and intervention programs and improved access to effective health care services are required to prevent a widening of the gap in diabetes related foot complications between Aboriginal and Torres Strait Islander and non-Indigenous Australians.
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Affiliation(s)
- Matthew West
- Discipline of Podiatry, Faculty of Health and Medicine, University of Newcastle, Box 127, Ourimbah, PO 2258 Australia
| | - Vivienne Chuter
- Discipline of Podiatry, Faculty of Health and Medicine, University of Newcastle, Box 127, Ourimbah, PO 2258 Australia
| | - Shannon Munteanu
- Discipline of Podiatry, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Fiona Hawke
- Discipline of Podiatry, Faculty of Health and Medicine, University of Newcastle, Box 127, Ourimbah, PO 2258 Australia
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