Guidelines for treating Aboriginal mental illness

A group of Aboriginal mental health experts have helped shape guidelines on culturally appropriate ways of treating indigenous people with mental illness. Laura Hart (Orygen Youth Health Research Centre) and colleagues worked with a panel of experts in Aboriginal mental health using the Delphi method – which involves expert consensus opinion gathering – to choose between different statements about possible first aid actions. Statements were accepted for inclusion in a guideline if they were endorsed by more than 90% of panellists as essential or important, and 5 separate guidelines were produced that covered depression, psychosis, suicidal thoughts and behaviours, deliberate self-injury and trauma and loss. Writing in BMC Psychiatry, Hart said the panel identified that a particularly important concern of culturally sensitive first aid should be to check or understand the cultural norms of a community before assuming that an Indigenous person is displaying symptoms of mental illness. For example, a “first aider” should be aware that ritualistic culturally accepted Aboriginal ceremonial or grieving practice is fundamentally different to pathological self-injury such as cutting and burning. Furthermore, first aiders should be careful not to misinterpret culturally appropriate behaviours such as limited eye contact as symptoms of psychosis. However, the panel also identified that, while they endorsed the idea of culturally appropriate first aid, individuals providing first aid should not get so caught up in the idea that they lose sight of the individual needs of the person they are assessing. “It is actually counter-productive to think that one has to be an anthropologist across the minutiae of all Australian indigenous cultures,” one panel member said. BMC Psychiatry 2009, 9:47...