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Background: Access to a coordinated range of strengths-based, culturally appropriate community-led primary mental health and Social and Emotional Wellbeing services is critical to the mental health and wellbeing of young Aboriginal and Torres Strait Islander people, and is a policy commitment of the Australian government. However, complex and fragmented service networks and a lack of standardised service data are barriers in identifying what services are available and what care they provide. Method: A standardised service classification tool was used to assess the availability and characteristics of Social and Emotional Wellbeing services for young Aboriginal and Torres Strait Islander people in two regions in Queensland, Australia. Results: We identified a complex pattern of service availability and gaps in service provision. Non-Indigenous non-governmental organisations provided a significant proportion of services, particularly 'upstream' support, while Aboriginal Community Controlled Organisations were more likely to provide 'downstream' crisis type care. Most services provided by the public sector were through Child Safety and Youth Justice departments. Conclusions: Our findings demonstrate the complexity of current networks, and show that non-Indigenous organisations are disproportionately influential in the care received by young Aboriginal and Torres Strait Islander people, despite community goals of self-determination, and government commitment to increasing capacity of Aboriginal Community Controlled Organisations to support their local communities. These findings can be used to support decision making and planning. [ABSTRACT FROM AUTHOR]

There is now evidence linking antibiotic burden in infancy and subsequent risk factors for cardiometabolic disease. In this study we assessed the metabolic health of a community-based cohort of Aboriginal Australians aged 15–25 years and retrospectively examined their early childhood antibiotic burden to identify a possible link between the two. Metabolic health data were extracted from electronic files of 433 participants in prior Young Persons Checks between 2013 and 2016. More than one-third were overweight or obese. Males had more metabolic syndrome than females (20.6% vs 10%; P = 0.03). Metabolic syndrome was twice as common in the 20- to 25-year age group than in the 15- to 19-year age group (19.8% vs 9.7%; P < 0.001). A subsequent medical chart review focused on childhood infections and the antibiotic burden of participants in the Young Persons Check from birth to 15 years of age. Nearly 75% were prescribed antibiotics during their first 2 years of life and 29% were exposed four or more times. Childhood antibiotic burden decreased with age. This population of Aboriginal adolescents and young adults has high rates of antibiotic exposure in childhood and metabolic abnormalities. We did not find a correlation between the two within the cohort, potentially demonstrating a ceiling effect. [ABSTRACT FROM AUTHOR]

Introduction Sixteen Aboriginal and Torres Strait Islander (hereafter respectfully termed Indigenous) Australian mental health, social and emotional wellbeing and suicide prevention government policy documents (2013 to 2018) have cited an urgent need for new responses to the high and increasing rates of Indigenous children's mental health problems and illnesses. The international literature suggests that such reform efforts are more effective when they engage with the providers and users of such services to co-design improvements. This presentation reports the findings of yarning circles with service providers and Indigenous young people in two communities. Theory/Methods Seven yarning circles were held with 34 service providers and 32 young people in two communities to explore their perceptions of the availability, appropriateness and integration of current mental health supports and services for Indigenous young people, and their suggested improvements. Youth yarning circles were facilitated by facilitators from an Indigenous youth empowerment group. The data were transcribed, analysed in NVIVO 12, and compared using grounded theory methods. Results In contexts of a high ratio of youth to adults in their communities and considerable mental health complexity, Indigenous service providers engaged in the research because they recognised they had ""not been able to get it right in this community... the actual model for our youth"", and were committed to improvement. Young people were not willing to approach mental health supports and services unless they were safe or trustworthy, and had clear suggestions for improvements. Discussions Key improvement suggestions were made at multiple levels. Service providers suggested the centering of a youth voice, increasing youth activities, family education, enhancing service available, appropriateness and coordination, and addressing the social and cultural determinants of youth mental health. Young people suggested information and awareness about mental health, identified and trained community gatekeepers, youth space and activities, online booking systems for services, and more support for recovery from mental illness. Conclusions Engaging local service providers and young people in discussions provided needed support and direction to better respond to locally recognised needs. The suggestions will be fed into local codesign workshops to build Indigenous community-developed models of youth mental health promotion. Lessons learned The youth yarning circles gained momentum over the 18 month period and are likely to be sustained as a youth advisory group in each community primary healthcare service; and to serve as the ongoing core of the research project. Limitations The research is context-specific to two communities and findings may not be generalisable. Suggestions for future research The yarning circles form the first stage of a co-design and evaluation project with the two communities. [ABSTRACT FROM AUTHOR]

This case study provides a detailed analysis of one change process within an Aboriginal community-controlled health organisation. It was based on a process of reflective action research to inform ongoing service-development and quality-improvement through an established working partnership with university researchers. The focus was strengthening the original social and emotional well-being services and striking a balance between biomedical dominance versus the promotion of social and emotional well-being. The result was a model of empowerment processes and outcomes to guide organisational change and a range of benefits for the organisation. The study provides an example for others interested in similar processes and identifies some of the key success factors for community control. [ABSTRACT FROM AUTHOR]

In every credit card transaction, major credit card companies impose a fee on merchants, including suppliers in the B2B space, to process the payment by cardholders. Tracing the convoluted history of the origins of that fee stretches back more than half a century. That history may provide context for a supplier evaluating whether to surcharge, or pass the interchange fee to customers. [ABSTRACT FROM AUTHOR]

Background: The capacity of the Indigenous primary healthcare (PHC) sector to continue playing a crucial role in meeting the health needs of Aboriginal and Torres Strait Islander Australians is in large part reliant on the skills, motivation and experience of its workforce. While exhibiting many workforce strengths, the sector faces significant challenges in building and maintaining a strong and stable workforce. Drawing on data from one Aboriginal Community Controlled Health Service (ACCHS), this study reports what is working well and what could be improved to strengthen the Indigenous PHC sector workforce.Methods: Using grounded theory methods, interviews with 17 ACCHS staff from a range of organisational positions were transcribed, coded and analysed. This paper focuses on the strategies identified that contribute towards strengthening the Indigenous PHC workforce.Results: Four overarching strategies for Indigenous PHC workforce strengthening were identified. These were Strengthening Workforce Stability, Having Strong Leadership, Growing Capacity, and Working Well Together. A range of enabling factors at the macro, community, organisational and individual levels were also identified.Conclusion: Indigenous PHC services are already implementing many important workforce-development strategies that are having a positive impact on the sector. There are also several persistent challenges which need to be addressed through action at organisational and structural levels. Approaches to workforce strengthening in Indigenous PHC should be tailored to local needs to ensure they address the unique workforce challenges experienced in different contexts. [ABSTRACT FROM AUTHOR]

Objectives: This paper provides an example of a mental health research partnership underpinned by empowerment principles that seeks to foster strength among community organizations to support better outcomes for consumers, families and communities. It aims to raise awareness among researchers and service providers that empowerment approaches to assist communities to address mental health problems are not too difficult to be practical but require long-term commitment and appropriate support. Methods: A collaborative research strategy that has become known as the Priority Driven Research (PDR) Partnership emerged through literature review, consultations, Family Wellbeing Program delivery with community groups and activities in two discrete Indigenous communities. Progress to date on three of the four components of the strategy is described. Results: The following key needs were identified in a pilot study and are now being addressed in a research-based implementation phase: (i) gaining two-way understanding of perspectives on mental health and promoting universal awareness; (ii) supporting the empowerment of carers, families, consumers and at-risk groups through existing community organizations to gain greater understanding and control of their situation; (iii) developing pathways of care at the primary health centre level to enable support of social and emotional wellbeing as well as more integrated mental health care; (iv) accessing data to enable an ongoing process of analysis/sharing/planning and monitoring to inform future activity. Conclusion: One of the key learnings to emerge in this project so far is that empowerment through partnership becomes possible when there is a concerted effort to strengthen grassroots community organizations. These include social health teams and men's and women's groups that can engage local people in an action orientation. [ABSTRACT FROM AUTHOR]