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Page 7 of 7
Working with individuals Diagnosis and Management
At the end of your interview, make sure an adequate explanation is given and treatment negotiated and planned appropriately with the patient and/or family. If the process has been adequate, make sure follow up occurs. Too often Aboriginal or Torres Strait Islander clients are lost in the system due to geographical isolation, demarcation between service providers and failed communication.
Partnerships and collaboration are necessary and your expertise may be invaluable, even if you feel overwhelmed by the enormity of what is required. In general it is easier to divide up problems to see what help can be provided. Separate acute trauma from long standing loss and grief, look at underlying substance abuse, consider the effects of poverty and disadvantage, physical health status, institutionalised racism, and despite all this don't miss significant psychiatric illness, especially anxiety, PTSD, depression and psychosis. Treating psychiatric illness appropriately can relieve significant burden from the family.
It is important to be aware that current diagnostic classification systems do not take into account transgenerational trauma from genocide and ongoing discrimination, nor many culturally related symptoms. There are also few psychological, psychiatric or family therapies or treatments with any proven efficacy for Aboriginal or Torres Strait Islander clients and families. Hence it may be necessary to explore local solutions, consider traditional healing methods and modify existing treatments to be culturally sensitive.
Be aware of symptoms worsening due to the stress of being away from community and feeling further traumatised by the system of care. Finally consider the following questions: - Has the team you are working with, or other providers working with your client, received cross-cultural education and the meaning of mental health for Aboriginal and Torres Strait Islander Australians?
- Has the presentation of illness been understood in the context of the patients own culture and history?
- Has there been consideration of the impact of trauma, grief and loss?
- Is the treatment appropriate to the person's cultural belief system and does it include a broad based assessment of all needs?
- Have alternative treatments been considered or used in conjunction with mainstream practices?
- Has a second opinion been sought from an Aboriginal Mental Health Worker or cultural consultant?
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Guidelines
