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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Using participatory action research to prevent suicide in Aboriginal and Torres Strait Islander communities

Adele Cox A E , Pat Dudgeon A , Christopher Holland B , Kerrie Kelly C , Clair Scrine D and Roz Walker D
+ Author Affiliations
- Author Affiliations

A National Empowerment Project, The University of Western Australia, School of Indigenous Studies, M303 Shenton House, 35 Stirling Highway, Crawley, WA 6009, Australia.

B Independent Consultant, Surry Hills, NSW 2010, Australia.

C PO Box 577, Kyogle, NSW 2474, Australia.

D Telethon Kids Institute, University of Western Australia, 100 Roberts Road, Subiaco, WA 6008, Australia.

E Corresponding author. Email: adelecox@internetexpress.net.au

Australian Journal of Primary Health 20(4) 345-349 https://doi.org/10.1071/PY14043
Submitted: 4 March 2014  Accepted: 8 September 2014   Published: 14 October 2014

Abstract

The National Empowerment Project is an innovative Aboriginal-led community empowerment project that has worked with eight Aboriginal and Torres Strait Islander communities across Australia over the period 2012–13. The aim of the Project was to develop, deliver and evaluate a program to: (1) promote positive social and emotional well-being to increase resilience and reduce the high reported rates of psychological distress and suicide among Aboriginal and Torres Strait Islander people; and (2) empower communities to take action to address the social determinants that contribute to psychological distress, suicide and self-harm. Using a participatory action research approach, the communities were supported to identify the risk factors challenging individuals, families and communities, as well as strategies to strengthen protective factors against these challenges. Data gathered during Stage 1 were used to develop a 12-month program to promote social and emotional well-being and build resilience within each community. A common framework, based on the social and emotional well-being concept, was used to support each community to target community-identified protective factors and strategies to strengthen individual, family and community social and emotional well-being. Strengthening the role of culture is critical to this approach and marks an important difference between Aboriginal and Torres Strait Islander and non-Indigenous mental health promotion and prevention activities, including suicide prevention. It has significant implications for policy makers and service providers and is showing positive impact through the translation of research into practice, for example through the development of a locally run empowerment program that aims to address the social determinants of health and their ongoing negative impact on individuals, families and communities. It also provides a framework in which to develop and strengthen culture, connectedness and foster self-determination, through better-informed policy based on community-level holistic responses and solutions as opposed to an exclusive focus on single-issue deficit approaches.


References

Australian Bureau of Statistics (ABS) (2012) Suicides, Australia, 2010. ABS cat. no. 3309.0. Available at http://www.abs.gov.au/ausstats/abs@.nsf/Products/3309.0~2010~Chapter~Aboriginal+and+Torres+Strait+ Islander+suicide+deaths?OpenDocument [Verified 10 January 2014]

Australian Bureau of Statistics (ABS) (2013) Australian Aboriginal and Torres Strait Islander Health Survey, first results, 2012, ABS cat. no. 4727.0.55.001. Available at http://www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/4727.0.55.001Main%20Features12012-13?opendocument&tabname=Summary&prodno=4727.0.55.001&issue=2012-13&num=&view= [Verified 10 January 2014]

Australian Government (2010) Strategic review of Indigenous expenditure. (Commonwealth of Australia, Canberra). Available at http://www.finance.gov.au/sites/default/files/foi_10-27_strategic_review_indigenous_expenditure.pdf [Verified 20 February 2014]

Biddle N (2011) ‘Physical and mental health’, measures of Indigenous wellbeing and their determinants across the lifecourse, 2011 CAEPR lecture series (lecture 3). ANU, Canberra.

Bulman J, Hayes R (2011) Mibbinbah and spirit healing: fostering safe, friendly spaces for Indigenous males in Australia. International Journal of Men’s Health 10, 6–25.
Mibbinbah and spirit healing: fostering safe, friendly spaces for Indigenous males in Australia.Crossref | GoogleScholarGoogle Scholar |

Burgess CP, Johnston FH, Berry HL, McDonnell J, Yibarbuk D, Gunabarra C, Mileran A, Bailie RS (2009) Healthy country, healthy people: the relationship between Indigenous health status and ‘caring for country’. The Medical Journal of Australia 190, 567–572.

Dockery A (2011) ‘Traditional culture and the wellbeing of Indigenous Australians: an analysis of the 2008 NATSISS’ (Centre for Labour Market Research, Curtin University: Perth)

Dodson M (1997) Reconciliation in crisis. In ‘Our land is our life: Land rights–past present and future’. (Ed. G Yunupingu) p. 137–149. (University of Queensland Press: St Lucia)

Doyle J, Firebrace B, Reilly R, Crumpen T, Rowley K (2013) What makes us different? The role of Rumbalara Football and Netball Club in promoting Indigenous wellbeing. The Australian Community Psychologist 25, 7–15.

Dudgeon P, Cox K, D’Anna D, Dunkley C, Hams K, Kelly K, Scrine C, Walker R (2012) ‘Hear our voices: community consultations for the development of an Empowerment, Healing and Leadership Program for Aboriginal people living in the Kimberley, Western Australia. Final research report.’ Commonwealth of Australia, Canberra.

Dudgeon P, Cox A, Walker R, Scrine C, Kelly K, Blurton D, Bolardaras J, Brennan T, Butorac A, Charles A, Duffin W, Grogan G, Hams K, Hansen C, Holland C, Ingram D, Mascall C, Mia T, Miller D, McGuire V, Murray B, McGrady G, Peckham M, Riley B, Ryder A, Swift S, Taylor N (2014) The voices of our people – National Empowerment Project promoting cultural, social and emotional wellbeing to reduce distress and suicide in Aboriginal and Torres Strait Islander communities: Final report 2013. Perth.

Gee G, Dudgeon P, Schultz C, Hart A, Kelly K (2014) ‘Social and emotional wellbeing and mental health: an Aboriginal perspective’. In ‘Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice’, 2nd edn. (Eds P Dudgeon, H Milroy, R Walker) Chapter 4, pp. 55–68. Available at http://aboriginal.telethonkids.org.au/media/673974/wt-part-1-cht-4-final.pdf [Verified 21 April 2014]

McCoy B (2007) Suicide and desert men: the power and protection of kanyirninpa (holding). Australasian Psychiatry 15, S63–S67.
Suicide and desert men: the power and protection of kanyirninpa (holding).Crossref | GoogleScholarGoogle Scholar | 18027139PubMed |

Mitchell P (2000) ‘Building capacity for life promotion: evaluation of the National Youth Suicide Prevention Strategy: technical report volume 1.’ (Australian Institute of Family Studies: Melbourne)

Osborne K, Baum F, Brown L (2013) ‘What works? A review of actions addressing the social and economic determinants of Indigenous health.’ Issues paper no. 7. (Close the Gap Clearinghouse, Australian Institute of Health and Welfare: Melbourne; Australian Institute of Family Studies: Canberra)

Rowley KG, O’Dea K, Anderson I, McDermott R, Saraswati K, Tilmouth R, Roberts I, Fitz J, Wang Z, Jenkins A, Best JD, Wang Z, Brown A (2008) Lower than expected morbidity and mortality for an Australian Aboriginal population: 10-year follow-up in a decentralised community. The Medical Journal of Australia 188, 283–287.

Social Health Reference Group (2004) National strategic framework for Aboriginal and Torres Strait Islander peoples’ mental health and social and emotional well being (2004–2009). Commonwealth of Australia, Canberra.

Steering Committee for the Review of Government Service Provision (2011) Overcoming indigenous disadvantage: key indicators 2011. (Productivity Commission: Canberra)

Tsey K, Wilson A, Haswell-Elkins M, Whiteside M, McCalman J, Cadet-James Y, Wenitong M (2007) ‘Empowerment-based research methods: a 10-year approach to enhancing Indigenous social and emotional wellbeing’. Australasian Psychiatry 15, S34–S38.
‘Empowerment-based research methods: a 10-year approach to enhancing Indigenous social and emotional wellbeing’.Crossref | GoogleScholarGoogle Scholar | 18027133PubMed |

Wallerstein N (2006) ‘What is the evidence on effectiveness of empowerment to improve health?’ (World Health Organization Regional Office for Europe: Copenhagen)

Zubrick S, Shepherd C, Dudgeon P, Gee G, Paradies Y, Scrine C, Walker R (2014) Social determinants of Aboriginal and Torres Strait Islander social and emotional wellbeing. In ‘Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice’, 2nd edn. (Eds P Dudgeon, H Milroy, R Walker) pp. 94–112. Australian Government Department of the Prime Minister and Cabinet, Canberra. Available at http://aboriginal.telethonkids.org.au/media/698896/wt-part-2-chapt-6-final.pdf [Verified 21 April 2014]