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Approach to treatment of mental illness and substance dependence in remote Indigenous communities: Results of a mixed methods study

Nagel, Tricia M., Robinson, Gary W., Condon, John R. and Trauer, Tom (2009). Approach to treatment of mental illness and substance dependence in remote Indigenous communities: Results of a mixed methods study. Australian Journal of Rural Health,17(4):174-182.

Document type: Journal Article

IRMA ID 10201xPUB11
Title Approach to treatment of mental illness and substance dependence in remote Indigenous communities: Results of a mixed methods study
Author Nagel, Tricia M.
Robinson, Gary W.
Condon, John R.
Trauer, Tom
Journal Name Australian Journal of Rural Health
Publication Date 2009
Volume Number 17
Issue Number 4
ISSN 1038-5282   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-68149180570
Start Page 174
End Page 182
Total Pages 9
Place of Publication Australia
Publisher Wiley-Blackwell Publishing Asia
HERDC Category C1 - Journal Article (DEST)
Abstract Objective: To develop and evaluate a culturally adapted brief intervention for Indigenous people with chronic mental illness. Design: A mixed methods design in which an exploratory phase of qualitative research was followed by a nested randomised controlled trial. Setting: Psycho-education resources and a brief intervention, motivational care planning (MCP), were developed and tested in collaboration with aboriginal mental health workers in three remote communities in northern Australia. Participants: A total of 49 patients with mental illness and 37 carers were recruited to a randomised controlled trial that compared MCP (n=24) with a clinical control condition (treatment as usual, n=25). Intervention:  The early treatment group received MCP at baseline and the late treatment group received delayed treatment at six months. Main outcome measures: The primary outcome was mental health problem severity as measured by the health of the nation outcome scales. Secondary measures of well-being (Kessler 10), life skills, self-management and substance dependence were chosen. Outcome assessments were performed at baseline, six-month, 12-month and 18-month follow up. Results: Random effects regression analyses showed significant advantage for the treatment condition in terms of well-being with changes in health of the nation outcome scales (P<0.001) and Kessler 10 (P=0.001), which were sustained over time. There was also significant advantage for treatment for alcohol dependence (P=0.05), with response also evident in cannabis dependence (P=0.064) and with changes in substance dependence sustained over time. Conclusions: These results suggest that MCP is an effective treatment for Indigenous people with mental illness and provide insight into the experience of mental illness in remote communities.
DOI http://dx.doi.org/10.1111/j.1440-1584.2009.01060.x   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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Created: Thu, 25 Mar 2010, 14:42:57 CST by Sarena Wegener