Measuring cultural appropriateness of mental health services for Australian Aboriginal peoples in rural and remote Western Australia : a client/clinician's journey

Aboriginal and Torres Strait Islander people in Australia suffer from poorer mental health than non-Aboriginal people, especially in remote and rural settings. Even with the ongoing adoption of the World Health Organisation's 'Closing the Gap' recommendations, the determinants of mental health, including suicide rates, hospitalisation rates and access to healthcare are not noticeably improving. One of the issues for this gap is the poor cultural proficiently of mental health services, creating a cultural security threat to the workers and service users. In my work as a senior Aboriginal Mental Health worker, I have observed incidents of ongoing cultural incompetence across the spectrum of healthcare. This embeds institutionalised racism that in turn fosters poor mental health. I offer examples of operational cultural proficiency and make recommendations to increase the appropriateness of services for Aboriginal people.