Best Practice Research
The aim of the Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention (CBPATSISP) Clearing House for best practice research is to provide a central resource point that collects, organises and disseminates information about valuable research in the field of Aboriginal and Torres Strait Islander suicide prevention.
Research and a strong evidence base can enable communities, consumers and policy makers to readily distinguish programs and policies that are successful and are also in keeping with the aspirations of Aboriginal and Torres Strait Islander peoples.
The Clearing House for best practice research provides high quality and culturally relevant research, publications, resources to inform the work of Aboriginal and Torres Strait Islander communities, organisations, mental health practitioners, policy makers and program providers. This includes:
• Peer reviewed studies
• Other relevant publications
• Community project reports
Guidelines for Ethical Conduct
The CBPATSISP is informed by the principles contained in the NHMRC values and ethics. The NHMRC guidelines acknowledge that historically research has not always benefited Indigenous peoples. The NHMRC guidelines state that ethical research with Aboriginal and Torres Strait Islander peoples and communities should:
- Improve the way all researchers work with Aboriginal and Torres Strait Islander people and their communities
- Develop and/or strengthen research capabilities of Aboriginal and Torres Strait Islander people and their communities
- Enhance the rights of Aboriginal and Torres Strait Islander people as researchers, research partners, collaborators and participants in research (NHMRC, 2018, p.1)
The NHMRC guidelines have six core values:
An underlying assumption in our work is Aboriginal and Torres Strait Islander disadvantage, high rates of ill health and poor mental health, in particular, high rates of suicide can be attributed to the impacts of colonisation. For the Indigenous peoples of Australia colonisation was, and continues to be, a destructive process that displaces people from their country and their culture. The impacts of colonisation continue to influence Indigenous lives as seen in social exclusion and lack of recognition of cultural difference. Further, there needs to be recognition that Aboriginal and Torres Strait Islander peoples and communities have great strengths and capacity. This focus on strengths and capacity needs to be highlighted and enacted in any research. Processes need to strengthen direction and inclusion, enact self-determination and value culture in order to bring about meaningful outcomes and positive social change. Until recent times, research into Aboriginal and Torres Strait Islander issues was largely exploitative and oppressive, serving the agendas and the priorities of the researcher rather than the people and communities.
Our approach, as seen in the National Empowerment Project, the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project and other initiatives, takes a decolonising approach prioritising a holistic and whole-of-life view of health and mental health. This approach encompasses the social, emotional and cultural wellbeing of the whole community, and acknowledges those distinctive cultural and spiritual relationships, such as connection to land, culture, spirituality, ancestry, family and community, which are of utmost importance. It has a focus on strength and resilience for Aboriginal and Torres Strait Islander peoples. Outcomes will be translated into strength-based preventative mental health policies and strategies.
Aboriginal and Torres Strait Islander researchers lead our work at the CBPATSISP and they come with considerable experience and commitment to social justice. The shared values between researchers and our research group not only ensure a partnership, but also a commitment to personal or community level action to renew and protect identity, culture and life.
The work of the CBPATSISP will contribute to strengthening and improving suicide prevention strategies and services for Aboriginal and Torres Strait Islander peoples nationally. Aboriginal and Torres Strait Islander communities must determine appropriate responses to suicide prevention themselves. As such, self–determination and community ownership of the integral roles of culture and lived experience must be explored with Indigenous communities.
Our work is concerned with safe guarding against discrimination and devaluing of Aboriginal and Torres Strait Islander peoples and cultures by engaging in ongoing consultation and feedback from Indigenous experts. This process further supports the critical role of culture within effective and appropriate suicide prevention strategies and ensures that Aboriginal and Torres Strait Islander peoples’ unique cultural distinctiveness (and associated service provision requirements) are respected and upheld. Further, Aboriginal and Torres Strait Islander values and perspectives will continue to underpin all recommendations, developed frameworks and outcomes to ensure appropriateness and maintenance of Aboriginal and Torres Strait Islander identity.
Equity is at the heart of our work that intends to advance Aboriginal and Torres Strait Islander lived experience understandings as well as suicide prevention strategies. Our work strongly connects to community, regional, state and national Indigenous health priorities and responds to ongoing and consistent needs articulated by Aboriginal and Torres Strait Islander peoples and communities nationally regarding culturally responsive suicide prevention. The work of the CBPATSISP will provide a clear benefit for Indigenous communities.
An acknowledgement of the diversity of Aboriginal and Torres Strait Islander peoples across the country and within communities is reflected through engagements undertaken by the CBPATSISP in recruiting participants for past research projects, such as the National Empowerment Project and the Aboriginal and Torres Strait Islander Lived Experience Project. Further, the CBPATSISP is committed to establishing equitable partnerships between researchers, participants and communities. This commitment is demonstrated through the active inclusion of participants and communities in the research process. For example, whenever possible and appropriate, participants are invited to be co-authors of reports and papers.
The School of Indigenous Studies and Poche Centre for Indigenous Health at UWA has a long-established record of full and proper engagement with Aboriginal and Torres Strait Islander communities. This continues with the work of the CBPATSISP. Where possible, Participatory Action Research (PAR) processes will be utilised. In a PAR process, the connections between the Aboriginal researcher and Aboriginal community are inseparable and as such, any work is being driven by clear, well documented, and self-determined community needs.
Research findings concerning Aboriginal and Torres Strait Islander suicide demonstrate a significant and disproportionate rate of suicide and self–harm when compared to the non-Indigenous Australian population, with a clear need for culturally responsive service provision. Further, a holistic approach that encompasses all facets of Aboriginal and Torres Strait Islander social and emotional wellbeing including cultural and whole of community (collective) wellbeing, as well as spirituality, connection to ancestry, land and culture are integral to appropriate responses to Aboriginal and Torres Strait Islander suicide prevention.
Consequently, research outcomes and recommendations formulated from Aboriginal and Torres Strait Islander participation in the work of the CBPATSISP will contribute to decreasing a gap in existing knowledge regarding Aboriginal and Torres Strait Islander suicide prevention. Such knowledge will assist in culturally responsive and appropriate service provision for suicide prevention strategies, programs and evaluation measures that can be utilised by key stakeholders and service providers to the benefit of Aboriginal and Torres Strait Islander peoples.
The work of the CBPATSISP is predicated upon respectful partnerships with Aboriginal and Torres Strait Islander communities. The CBPATSISP work process encourages the generation of genuine partnerships with Indigenous experts across a number of different areas. The CBPATSISP respects Aboriginal understandings of culture and cultural safety, social and emotional wellbeing, suicide prevention and mental health, and facilitates the inclusion of Aboriginal and Torres Strait Islander knowledges. The researchers at the CBPATSISP have considerable experience working in research that is community based, capacity building and empowering. For example, the National Empowerment Project worked with 11 communities across the country, in partnerships with community-controlled organisations in each site and with two local co-researchers in each site.
Further, the CBPATSISP actively involves Aboriginal and Torres Strait Islander peoples in decision-making processes through engagement with the National Governance Committee (NGC) and the Expert Advisory Panel.
The NGC has been established to provide expert guidance, advice, and coordination regarding the work of the CBPATSISP. The NGC coordinates activities across the consortium and provides high level advice to support suicide prevention initiatives for Aboriginal and Torres Strait Islander peoples and communities. The NGC is made up of members representing the national consortium and partners associated with the CBPATSISP. The NCG also includes relevant stakeholders and organisations in the field of Aboriginal and Torres Strait Islander suicide prevention.
An Expert Advisory Panel (EAP) was convened to establish a culturally appropriate best practice framework for the evaluation of suicide prevention programs and services and to identify relevant suicide prevention research in Aboriginal and Torres Strait Islander communities. The EAP also provides expert advice with respect to reviewing and promoting best practice Aboriginal and Torres Strait Islander suicide prevention programs, services and initiatives that will be part of the CBPATSISP Clearing House Website. The EAP is made up of experts in the fields of culturally appropriate healing, mental health and suicide prevention and program evaluation in Aboriginal and Torres Strait Islander communities.
The CBPATSISP will examine factors involved in appropriate and culturally responsive suicide prevention from the perspectives of Indigenous peoples themselves.
In all various projects, ongoing consultation with Aboriginal and Torres Strait Islander peoples nationally will be adhered to ensure appropriate review and community participation. This ongoing feedback process with Indigenous experts ensures the integrity of all CBPATSISP work processes and outcomes.
Reports and papers as outcomes will also acknowledge the significant cultural and intellectual contributions of Aboriginal and Torres Strait Islander communities and individuals in every instance and, whenever possible and appropriate, participants are invited to be co-authors of reports and papers.
Currently, the CBPATSISP has collected literature and information in accordance with four categories:
- Peer Reviewed Literature
- Other Literature
- Community programs and projects of interest
The Alliance for Suicide Prevention Sunshine Coast – Collective action for the Indigenous community
In 2019 Sunshine Coast’s Aboriginal, Torres Strait Islander and non-Indigenous communities and key organisations came together for a much-needed conversation about suicide prevention at the Triballink Activity Centre in Mapleton. Key findings from the Indigenous Community Consultation event, held to gain valuable perspectives on local Aboriginal and Torres Strait Islander suicide prevention efforts can be found here.
Getting It Right: The Validation Study (commenced in 2014 – ongoing)
Investigators – Maree Hackett, Sara Farnbach, Graham Gee, Alan Cass Timothy Skinner, Alex Brown Deborah Askew, Amrmando Teixeira–Pinto
Aims – The primary aim of Getting it right: The Validation Study is to validate an extensively adapted and culturally appropriate, free to use, tool for use with Indigenous people attending primary care services, the adapted nine-item Patient Health Questionnaire (aPHQ-9), against a gold standard (criterion standard) the MINI International Neuropsychiatric Interview (MINI) 6.0.0., as a screening instrument for depression. The secondary aim is to evaluate the level of contribution of seven additional questions to the aPHQ-9 to the diagnosis of depression, as compared to the aPHQ-9.
Publications – Getting it Right: validating a culturally specific screening tool for depression (aPHQ-9) in Aboriginal and Torres Strait Islander Australians https://www.ncbi.nlm.nih.gov/pubmed/31165642 (Ongoing work)
More information: The George Institute for Mental Health
Trial and validate the KMMS with Aboriginal women in the Pilbara
Aims – The aim of this study is to trial and evaluate the Kimberley Mum’s Mood Scale (KMMS) which was developed and later validated as an effective and acceptable perinatal depression and anxiety screening tool for use with perinatal Aboriginal and Torres Strait Islander women in the Kimberley region under research conditions.
This study will document the process of implementation and establishing the ‘real world’ validity and acceptability of the KMMS in the Kimberley, Pilbara and Far North Queensland in northern Australia.
This project aims to contribute to the important public health priority of screening Aboriginal and Torres Strait Islander women for perinatal depression and anxiety with tools that are meaningful and culturally responsive to cultural and clinical needs. Identifying and addressing barriers to implementation contributes to our understanding of the complexity of improving routine clinical practice.
Investigators – Emma Carlin, Sarah J. Blondell, Yvonne Cadet-James, Sandra Campbell, Melissa Williams, Catherine Engelke, Des Taverner, Rhonda Marriott, Karen Edmonds, David Atkinson & Julia V. Marley (approved by Pilbara Aboriginal Health Planning Forum)
Publications – Carlin, E., Blondell, SJ., Cadet-James, Y., Campbell, S. Williams, M., et al. 2019 Study protocol: a clinical trial for improving mental health screening for Aboriginal and Torres Strait Islander pregnant women and mothers of young children using the Kimberley Mum’s Mood Scale
Carlin E, Atkinson D, Marley JV. 2019 ‘Having a Quiet Word’: Yarning with Aboriginal Women in the Pilbara Region of Western Australia about Mental Health and Mental Health Screening during the Perinatal Period. Int J Environ Res Public Health. 2019 Nov 1;16(21). pii: E4253. doi: 10.3390/ijerph16214253.
Marley, J. V., Kotz, J., Engelke, C., Williams, M., Stephen, D., Coutinho, S., and Trust, S. K. (2017). Validity and acceptability of Kimberley mum’s mood scale to screen for perinatal anxiety and depression in remote aboriginal health care settings. PLoS One. 2017; 12(1): e0168969. Published online 2017 Jan 30. doi: 10.1371/journal.pone.0168969
Validation of the EPDS with Aboriginal Australian mothers and healthcare professionals.
Investigators – Ai Wen Chan, Peta Skerrington, Corinne Reid & Rhonda Marriott
Aim – To establish whether this tool has the potential to be an acceptable, valid and reliable indicator of depression for mothers and mothers-to-be. This mixed-methods research protocol seeks to explore the views and experiences of Aboriginal mothers and healthcare professionals in relation to the Edinburgh Postnatal Depression Scale (EPDS), and is intended to highlight potential barriers in perinatal mental health
Publications – Ai Wen Chan, Peta Skerrington, Corinne Reid & Rhonda Marriott. Research protocol for the exploration of experiences of Aboriginal Australian mothers and healthcare professionals when using the Edinburgh Postnatal Depression Scale: a process-oriented validation study using triangulated participatory mixed methods.
Cultural validation of the structured clinical interview for diagnostic and statistical manual of mental disorders in Indigenous Australians
Investigators – Maree Toombs, Bushra Nasir
Aim – To determine the cultural appropriateness of the Structured Clinical Interview for the DSM-IV Axis I Disorders (SCID-I) as an acceptable tool for diagnosing mental illness among Indigenous people.
Publications – Maree Toombs et al. (2019) – Cultural validation of the structured clinical interview for diagnostic and statistical manual of mental disorders in Indigenous Australians. https://www.ncbi.nlm.nih.gov/pubmed/31165642
The CBPATSISP Clearing House includes a wide range of peer reviewed articles and other publications that are relevant to research in Suicide Prevention, Wellbeing and Healing, Screening and Assessment Tools and Measures, Social Determinants, Systems Approaches, Diverse Groups, Indigenous Governance & Cultural Safety and Evaluations.