Case story

Developing a Mental Health Research Team, Community Resources and Training

The Australian Integrated Mental Health Initiative (AIMhi) Northern Territory project was a five-year multi-site project that aimed to improve outcomes for Indigenous clients of mental health services in remote Top End communities. The project developed mental health promotion resources for health professionals, clients and carers, and new approaches to service delivery. It aimed to build capacity at several levels:

• training Indigenous mental health researchers
• developing the capacity of residents and service providers to manage mental illness
• improving the mental health literacy of community residents and service providers.

The program has continued as the Aboriginal and Islander Mental Health Initiative.

Research leader Tricia Nagel talks about capacity-building approaches:

When training the Indigenous team members, we started at the beginning point and said: ‘What is an Indigenous researcher? What are the tasks and capacities and the competencies that you want to build?’ From there, we’ve developed a framework that helps us to know what the components are. Data collection and a range of things around interviewing people is one component. Developing an ethics proposal is another component, which we broke down into steps such as getting support letters from community organisations, negotiating with community, and so on. Presenting findings is another - feeling confident to get up and to speak well, to engage an audience and get the message gets across when they have an important story to tell. We’ve made about eight conference presentations a year and many workshop presentations. We’ve learnt that it’s really important to gently walk with people to a stage where they are telling the story themselves and not to throw them in too soon. A supervision journal keeps track of learning.

In the AIMhi program we have developed a number of resources and we had a wonderful collaborator with health promotion expertise; Jenni Judd placed a health promotion framework around the work that we were doing and highlighted the importance of not putting resources out without training people around them. We realised that people in communities wanted training.  That’s why we moved from flip charts that said ‘this is what you do here, this is what you do there’, to a workshop program in mental health, alcohol and other drugs, chronic disease and perinatal mental health. It meant that we needed to develop training skills in the research team, and that’s another component of an academic life. We’re developing lecturers and trainers - people who not only data collect, not only present their findings, but also adapt those findings to their stakeholders– to clinicians, people who are working in night patrols, community members who are groups of families who recognise they wanted to know and understand more about mental health… So we have a broad population that we deliver training to, and we go TO people to deliver flexible training over one, two or three days. We plan to develop accredited modules mapped from certificate level through to masters levels courses, supported by training materials and facilitators guides.

Whatever research wants doing, I strongly recommend that a way of building capacity is to have those different components and to have researchers run a training and education and research transfer process, all the way through. It enables team members to develop a broad range of skills - research skills, writing skills, clinician skills, education and presentation skills, workshop development and facilitation skills. It opens up a range of career paths and opportunities within and beyond the field of research.

Indigenous researcher Carolyn Griffin talks about developing resources for mental health literacy:

The mental health storyteller mob consulted with a range of non-government and government organisations in the first 12 months of the AIMhi project, including health boards and land councils. We visited remote communities hundreds of kilometres from our base in Darwin – Kalano, Nguiu, Groote Eylandt, Yirrkala, Numbulwar, and a wide range of urban services.

We were advised by stakeholders to use pictures instead of words, to use slow, plain English instead of complex English, and to use Aboriginal and Torres Strait Islander voices and language. We were shown examples for different styles of presentation which people found easier to understand.

We worked with local Aboriginal Mental Health Workers to develop mental health stories which focussed on personal strengths and family support, highlighting the importance of culture and traditional activities and of developing a two-way approach to treatment - Indigenous way and non-Indigenous way working together at the same time.

The eventual outline of the story we wanted to tell was in four parts: ‘what keeps me strong’, ‘what takes my strength away’, ‘what happens to me when I am sick’, and ‘what helps to get me well’. The storytelling resources use local artwork and images, local language, metaphors and music.

AIMhi has produced a wealth of resources for talking about and treating Indigenous mental health issues. See http://menzies.edu.au/AIMHI