Walking together in friendship: Learning about cultural safety in mainstream mental health services through Aboriginal Participatory Action Research.

OBJECTIVE: Culturally safe service provision is essential to improving social and emotional wellbeing among Aboriginal and Torres Strait Islander communities, and to eliminating health inequities. Cultural safety is about ensuring that all people have a safe and healing journey through services, regardless of their cultural background. In this project, we aim to (1) understand how Aboriginal and Torres Strait Islander peoples conceptualise cultural safety, and (2) co-design a qualitative interview for the next phase of this project, where we plan to learn about experiences of cultural safety within mental health services. METHODS: We conducted six focus groups (in one metro and two regional areas, Western Australia). Following an Aboriginal Participatory Action Research methodology, we yarned with Aboriginal and Torres Strait Islander mental health service users, carers, community members, mental health professionals and Cultural Healers about cultural safety. RESULTS: Participants described a culturally safe service as one where Aboriginal cultural knowledges, life experiences, issues and protocols are understood and acknowledged, and reported that mainstream mental health services are not currently culturally safe. Participants emphasised the importance of building trust, rapport, reciprocity and following appropriate relational processes when designing a qualitative interview for the next phase. CONCLUSIONS: A lack of cultural safety in mental health services is likely to contribute to the disparity in outcomes between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Embedding cultural safety into research design allows for authentic community engagement and facilitates knowledge sharing around ways to improve cultural safety in mental health services.

GP perspectives on a psychiatry phone line in Western Australia's Great Southern region: implications for addressing rural GP workload.

BACKGROUND: Mental illness is a public health challenge disproportionately affecting rural Australians. GPs provide most of the mental health care, and they report increasing levels of burnout and unsustainable workload in the context of increased patient complexity. This may be more salient in rural settings characterised by resource constraints. In this paper, we use evaluation data from a GP psychiatry phone line established in Western Australia's Great Southern region in 2021 to describe GPs' perspectives on the service and reflect on how it may help alleviate rural GP workload. METHODS: The sample was recruited among GPs practicing in the region. Data were collected through an online survey and semistructured interviews. Descriptive statistics were used to analyse the survey data. Interview data were subjected to thematic analysis; qualitative survey data were used for triangulation. RESULTS: A total of 45GPs completed the survey and 14 were interviewed. Interview data yielded three themes: the criticality of timeliness; the building blocks of confidence; and trust. GPs were highly satisfied with the service, and timeliness and trust were the characteristics underpinning its effectiveness. The service built GPs' confidence in managing mental health and alcohol and other drug use issues through strengthening knowledge and providing reassurance. CONCLUSIONS: Our results suggest that a telephone line operated by trusted, local psychiatrists with knowledge of the local mental health ecosystem of support can reduce rural GP workload through building confidence and strengthening personal agency, helping GPs navigate the ethical and clinical labyrinth of managing patient complexity in rural settings.

A rural ecosystem of recovery: Lessons from substance users' experiences of accessing services in Western Australia's South West.

INTRODUCTION: Substance use is a public health issue with a greater burden in rural areas. Barriers to accessing services are exacerbated for rural substance users, with confidentiality concerns, longer travel distances, workforce issues and limited availability of services. This paper presents results from a study exploring substance users' experiences of accessing services in Western Australia's South West. METHODS: This qualitative study was informed by phenomenology, and drew from social determinants and socio-ecological theories. Data were collected through 22 semi-structured telephone interviews with current and past substance users residing in the South West. Interviews were audio-recorded and transcripts were subjected to thematic analysis. RESULTS: Two themes were identified: readiness to engage as a three-way street; and building an ecosystem of recovery networks. Effective engagement with services required multi-level readiness. Individual readiness was strongly influenced by the social environment, while service readiness required trustworthiness and responsiveness. A number of local access barriers were identified that hindered broader system readiness. Participants experienced recovery as on-going and require an ecosystem of support with peer support at the centre and a network of healthy relationships established through meaningful connections. DISCUSSION AND CONCLUSIONS: An effective ecosystem of support for alcohol and other drugs users in the South West should include expanded access to health, community and welfare services, with an emphasis on peer-led support programs, and strong cross-sector collaboration to mitigate the access barriers operating at the broader community level. Lessons from our study can inform the development of rural ecosystems of support for alcohol and other drugs users.

Responding to rural adversity: a qualitative study of alcohol and other drug service users' experiences of service response to COVID-19 in Western Australia's Southwest.

OBJECTIVE: This study reports on the impact of the COVID-19 pandemic on the lived experiences of people with substance use problems in accessing services in the Southwest region of Western Australia, and its implications for preparedness in a context of rural adversity. METHOD: This was a qualitative study informed by the principles of phenomenology. Data were collected through semi-structured interviews and subjected to thematic analysis. RESULTS: Twenty-two participants were interviewed. Two main themes were identified: disruption to supportive connections; and bridging the connection gap: local service response to the COVID-19 pandemic. CONCLUSIONS: The COVID-19 pandemic restrictions exacerbated social isolation and mental health issues, and disrupted services and treatment in the Southwest. Our results demonstrate that local alcohol and other drug services in rural areas can successfully respond to crises by assertively and flexibly adapting their service provision.

Three-dimensional microwave tomography: initial experimental imaging of animals.

The purpose of this study was to construct a microwave tomographic system capable of conducting experiments with whole scale biological objects and to demonstrate the feasibility of microwave tomography for imaging such objects using a canine model. Experiments were conducted using a three-dimensional (3-D) microwave tomographic system with working chamber dimensions of 120 cm in diameter and 135 cm in height. The operating frequency was 0.9 GHz. The object under study was located in the central area of the tomographic chamber filled with a salt solution. Experimentally measured attenuation of the electromagnetic field through the thorax was about -120 dB. To obtain images, we used various two-dimensional and 3-D reconstruction schemes. Images of the canine were obtained. In spite of imperfections, the images represent a significant milestone in the development of microwave tomography for whole body imaging and demonstrate its feasibility.