Aboriginal mental health at the Northern Area Mental Health Service, Melbourne Health

My name is Sabine Fernbacher. I work at the Northern Area Mental Health Services, project manager for the clinical engagement project aboriginal mental health. As we were beginning to work on the project we formed working relationships with aboriginal colleagues based at the hospital here and also at the Victorian Aboriginal Health Service with Helen Kennedy.

One of the positives is definitely the community have an aboriginal worker here within the mental health unit. I believe that by being here and being present, that I’ve been able to engage with consumers and gather information that otherwise the clinicians were unable to get, and that is around that trust. One of the important parts of my role is that I link our consumers and their families and carers into culturally appropriate ongoing support services post-hospital. I'm a big believer in a good discharge plan will prevent readmissions. When a person has a hospital admission they’re usually in crisis and it's about working on a person's strengths, working on areas where they’re willing and wanting to engage with. If a person is ready to look at employment options, then I will link them into that. However, if a person is only looking at social integration and a bit of isolation, then I can link them into those community supports.

I had a young person come in. They'd heard via community that this role had began, that there was now an aboriginal worker within the psych unit, and this young person presented at ED. I was contacted and I went down and spoke with this person. At the time they were presenting with drug issues and substance abuse, however by having a yarn with this person who obviously trusted me because I am from the same culture and I also was able to build somewhat of a good rapport, they opened up and I was able to peel back the onion layers. Sometimes a person's presentation isn’t what we should be looking at. It’s about peeling back the layers and seeing what's going on for this person. Through speaking with other clinicians we were not going to admit this young person due to the substance abuse. After I had had a yarn with them I had very much learnt that there was a lot going on in community for them. They're actually unsafe within their home. There was a lot of trauma. I was able to link this person into appropriate community services and now I'm seeing this person be proactive for themselves.

The reflective practice or processes really started the moment we started, so part of that was getting cultural advice around how to structure the project, how to develop a position description for the aboriginal mental health liaison officer role, the kind of do's and don't do’s and also engaging with our colleagues around developing a whole range of processes. 

As we've gone forward in the project the places where the reflective practice happens has kind of multiplied but also changed. We have a reference group that we sometimes take issues to internally. We work through issues as they arise. The reflective and continuous improvement processes that we employed include a case study on the AMHLO role that included interviews to reflect back to us how that role is going, what the benefits are, if many improvements needed to or changes needed to be made. We've looked at our data, so how many aboriginal people did we use to have through our in-patient unit and ED, and how that’s changed, and that’s changed quite significantly, and also consultation and cultural consultation provided by our aboriginal colleagues both at Vasan and Northern Hospital of how to set up the project, how to go forward and continues to do that.