Better medication management for Aboriginal people with mental health disorders: a survey of providers

Objective: To explore the experiences and training needs of service providers in relation to medication management for Aboriginal people with mental health disorders. Design: Survey. Setting: Aboriginal and mainstream health and human service organisations in metropolitan, rural and remote South Australia. Subjects: Aboriginal health workers, nurses, mental health workers, substance misuse workers, managers, liaison officers, social workers, police, pharmacists, general practitioners, community workers, counsellors, paramedics, educators, family support workers and others. Results: The major health service issues for Aboriginal people with mental health disorders and their carers are related to access to, and availability and appropriateness of services. Quality use of medications by Aboriginal clients is influenced by drug and alcohol misuse, cost, compliance, feelings about the value of medicines, sharing of medications and unwanted side-effects. Many workers providing services to Aboriginal people with mental health disorders lack adequate training and/or resources on mental health and safe medication management; yet, are required to provide advice or assistance on these matters. Conclusions: The survey provides new, reliable evidence relevant to mental health services and medication management for South Australian Aboriginal people. It highlights the major issues impacting on quality of care and service provision, demonstrates the wide range of health and allied workers providing medication advice and assistance to Aboriginal people, and reveals workforce development needs. What is already known: Statistics show the general health status and life expectancy of Australian Aboriginal people are markedly lower than the non-Aboriginal population. Mental health disorders are pervasive, especially related to alcohol and other drugs. Despite numerous health-related studies, very little has been documented about medication management for Aboriginal people with mental health disorders. What this study adds: Health and social service workers revealed major issues impacting on medication management for Aboriginal people with mental health disorders in urban, rural and remote regions of South Australia. These included racism, problems with alcohol and other drug use, money and transport issues, availability and access to a range of specialist services, and confidentiality and suitability of services. The wide range of backgrounds and occupations of people involved with medicines has been revealed, together with their urgent need for education on cultural safety, mental health, and the safe handling, transport, storage and administration of medicines.Inge Kowanko, Charlotte de Crespigny, Helen Murray, Mette Groenkjaer and Carolyn Emde