The Aboriginal Mental Health Worker Program: The challenge of supporting Aboriginal involvement in mental health care in the remote community context

Abstract

Abstract This paper draws on our experience as evaluators of the Aboriginal Mental Health Worker Program that has been operating in eight remote communities across the Top End of the Northern Territory, Australia, for over four years. The program aimed to fund the placement of Aboriginal Mental Health Workers (AMHWs) in remote community health centres, to work under the clinical leadership of General Practitioners and to contribute to development of a culturally appropriate community based mental health care service for Indigenous people. In this paper, we examine the key features of the AMHW program and the originating partnership, the degree of integration of AMHWs in health centre processes and the provision of support for the development of the AMHW role in community mental health work. While there are many examples in this program of AMHWs providing highly valued services within their communities, the evaluation showed that the program did not achieve clear commitments to develop mental health practice around the AMHWs’ role. In addition there was variability in levels of local managerial support for the AMHWs, vulnerability to staff turnover and other discontinuities, as well as tensions in views about what the role of the AMHWs should be. Should it be culturally informed, clinically-related mental health work or community ‘wellbeing work’, and how should each role be supported? Together these factors undermined the sustainability of positive achievements within the program.