Mapping Aboriginal Mental Health Journeys Through Psychiatric Care Systems

Area of Science:

• Indigenous Health
• Mental Healthcare Systems
• Health Disparities

Background:

• Mental health services often lack cultural safety for Aboriginal peoples, exacerbating health inequities.
• Understanding care organization and patient experiences is crucial for service improvement.

Purpose of the Study:

• To analyze Aboriginal mental health care pathways using integrated qualitative and quantitative methods.
• To identify structural factors influencing care delivery and cultural safety.

Main Methods:

• Mixed-methods study (June 2022-December 2023) at a Western Australian mental health service.
• Quantitative analysis of 1108 clinical interactions among 19 Aboriginal adults.
• Qualitative in-depth yarning interviews with 7 Aboriginal adults.
• Network analysis and trajectory clustering of care pathways.

Main Results:

• Aboriginal mental health workers held structurally central positions within the clinical network.
• Patients acted as intermediaries between disconnected service providers.
• Three distinct care pathways were identified, including complex referrals and readmissions.
• Qualitative data highlighted themes of cultural safety, kinship, trauma, and inconsistent support.

Conclusions:

• Aboriginal mental health workers play a pivotal yet vulnerable role in fragmented care.
• Redesigning care pathways with a focus on operational flow and culturally grounded roles is essential.
• Improving care coordination and cultural safety requires systemic changes in multisetting mental health systems.