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1. Racial microaggressions and interculturality in remote Central Australian Aboriginal healthcare

Author

Mary Wicks, Christine Hampshire, Jeannie Campbell, Louise Maple-Brown, and Renae Kirkham

Subjects
Health Communication, Microaggressions, Interculturality, Discourse Analysis, Aboriginal Australians, Central Australia, Public aspects of medicine, RA1-1270
Abstract

Abstract Background An epidemic of type 2 diabetes in remote Aboriginal people in Central Australia, contributes to high rates of morbidity and mortality. Remote non-Aboriginal Health Care Workers (HCW) and the Aboriginal people they serve inhabit a complex cultural interface. This study aimed to recognise racial microaggressions in the everyday discourse of HCWs. It proposes a model of interculturality for remote HCWs that avoids racialisation and essentialising of Aboriginal people’s identities and cultures. Methods Semi-structured in-depth interviews were undertaken with HCWs from two Primary Health Care services in very remote Central Australia. Fourteen interviews were analysed from seven Remote Area Nurse, five Remote Medical Practitioners and two Aboriginal Health Practitioners. Discourse analysis was employed to explore racial microaggressions and power relations. NVivo software assisted in the thematic organisation of microaggressions according to a predefined taxonomy. Results Seven microaggression themes were identified - racial categorization and sameness, assumptions about intelligence and competence, false colour blindness, criminality and dangerousness, reverse racism and hostility, treatment as second-class citizens and pathologizing culture. A model of interculturality for remote HCWs was based on concepts of the third space, deCentred hybrid identities and small culture formation on-the-go combined with a duty-conscious ethic, cultural safety and humility. Conclusions Racial microaggressions are common in the discourse of remote HCWs. The model of interculturality proposed could improve intercultural communication and relationships between HCWs and Aboriginal people. This improved engagement is required to address the current diabetes epidemic in Central Australia.

Published
2023
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5. A Learning Collaborative of CMHCs and CHCs to Support Integration of Behavioral Health and General Medical Care

Author

Kamaljeet Girn, Charles Ingoglia, Jeannie Campbell, Jürgen Unützer, Steven D. Vannoy, John W. Kern, Laura Galbreath, and Barbara J. Mauer

Subjects
Gerontology, medicine.medical_specialty, business.industry, Public health, Collaborative learning, General medical services, Mental health, Health indicator, Psychiatry and Mental health, Nursing, Workforce, Community health, medicine, Managed care, business
Abstract

Objective: Integration of general medical and mental health services is a growing priority for safety-net providers. The authors describe a project that established a one-year learning collaborative focused on integration of services between community health centers (CHCs) and community mental health centers (CMHCs). Specific targets were treatment for general medical and psychiatric symptoms related to depression, bipolar disorder, alcohol use disorders, and metabolic syndrome. Methods: This observational study used mixed methods. Quantitative measures included 15 patient-level health indicators, practice self-assessment of resources and support for chronic disease self-management, and participant satisfaction. Results: Sixteen CHC-CMHC pairs were selected for the learning collaborative series. One pair dropped out because of personnel turnover. All teams increased capacity on one or more patient health indicators. CHCs scored higher than CMHCs on support for chronic disease self-management. Participation in the learning collaborative increased self-assessment scores for CHCs and CMHCs. Participant satisfaction was high. Observations by faculty indicate that quality improvement challenges included tracking patient-level outcomes, workforce issues, and crossagency communication. Conclusions: Even though numerous systemic barriers were encountered, the findings support existing literature indicating that the learning collaborative is a viable quality improvement approach for enhancing integration of general medical and mental health services between CHCs and CMHCs. Real-world implementation of evidence-based guidelines presents challenges often absent in research. Technical resources and support, a stable workforce with adequate training, and adequate opportunities for collaborator communications are particular challenges for integrating behavioral and general medical services across CHCs and CMHCs. (Psychiatric Services 62:753–758, 2011)

Published
2011

6. Medical Services for Clients in Community Mental Health Centers: Results From a National Survey

Author

Brian J. Cuffel, Barbara J. Mauer, Benjamin G. Druss, Chuck Ingoglia, Steven C. Marcus, Jeannie Campbell, and James Harnett

Subjects
medicine.medical_specialty, Community Mental Health Centers, Referral, business.industry, General medical services, Health Services, Mental health, Medical care, United States, Local community, Medical services, Psychiatry and Mental health, Health Care Surveys, Family medicine, Workforce, Medicine, business, Psychiatry, Reimbursement
Abstract

Objective: This study provides national data on community mental health centers’ (CMHCs’) capacity to screen for and address their clients’ general medical conditions. Methods: A survey was distributed to members of the National Council for Community Behavioral Healthcare, the oldest and largest association of CMHCs. Results: Among the 181 CMHCs responding to the survey, more than two-thirds reported having protocols or procedures to screen for common medical problems (hypertension, obesity, dyslipidemia, and diabetes). However, only one-half could provide treatment or referral for those conditions, and less than one-third could provide general medical services on site. Barriers to providing general medical services included problems in reimbursement, workforce limitations, physical plant constraints (for example, lack of available space or equipment), and lack of options for referrals to local community medical providers. Conclusions: Although most CMHCs had the capacity to screen for common medical conditions, they reported a variety of barriers to providing medical care for those problems either on site or via referral. (Psychiatric Services 59:917–920, 2008)

Published
2008

8. Clinical procedures manual for remote and rural practice: supporting clinical practice in the bush

Author

Sabina Knight, Andrew White, Caitlin Steiner, Chris Del Mar, Christine Connors, Frances Vaughan, Janet Struber, Jo Wright, Kerrie Gell, Nick Williams, George Tripe, Peter McCormack, Rosemary Schmidt, Andrew Lee, Carolyn MacLennan, Gaynor Garstone, Graeme Maguire, Jane Smith, Malcolm Mcdonald, Nathan Ryder, Paul Lawton, Peter May, Rachael Lockley, Rosalie Schultz, Shelley Crowther, Simon Kane, Steve Margolis, Timothy Carey, Ahmed Latif, Alan Cass, Alison Mustapha, Amanda Sanburg, Andrew Bezzina, Andrew Crowhurst, Andrew McCallum, Anne Bromhead, Anne Chang, Anne Davis, Annie Tangey, Anthony Brown, Bart Currie, Belinda Davis, Beth Amega, Bronwyn Silver, Bruce Simmons, Buddhima Lokuge, Phillips, Dr Cameron J., Cherian Sajiv, Dale Edgar, Damien Fagan, Daniel Ewald, Darryl Maybery, David Hockley, Dennis Pashen, Dion Dionysopoulos, Don Boldiston, Elise Beachley, Erik Tikoft, Fiona Wood, Geri Malone, Glenda Gleeson, Gregory Perry, Helen Vaughan, Hugh Taylor, Jason Warnock, Jennifer Alison, Joanna Keily, Joshua Davis, Julia Stewart, Keith Edwards, Lin Davis, Lisa Wallace, Louise Roufeil, Megan Halliday, Lesley Scott, Linda Medlin, Louise Maple-Brown, Lucy Little, Michele Luey, Patrick AhKit, Paul Torzillo, Peter Morris, Pippa Tessmann, Pippa Travers-Mason, Rae-Lin Huang, Ral Antic, Rita Apelt, Robert Parker, Rose Fahy, Rosemary Lee, Sandra Meihubers, Sarah Jackson, Sarah Larkins, Selina Taylor, Sharon Johnson, Rourke, Sharon O., Sheila Kavanagh, Sheryl Alexander, Sridhar Chitturi, Sue Kruske, Sue Orsmond, Sue Roth, Suzanne Connor, Timothy Henderson, Tina Hourigan, Tracy Johns, Warwick Beever, Alison Dawes, Allan Donnelly, Andrew Bisits, Anne Sneddon, Claire Boardman, David Ellwood, Donna Chung, Duncan Reed, Greg McHugh, Hannah Dahlen, Heather Mumme, Helen Land, Jenny May, Jonathon Ball, Judith Gardiner, Kathy Currie, Katie Sullivan, Koen De Decker, Libby Bowell, Lukas Arkapaw, Lyn Byers, Lyndall Young, Brien, Margaret O., Michael Nicholl, Pamela Wood, Peter Markey, Raelene Carroll, Rishi Narasimhan, Shaun Soloman, Shona Sandford, Steve Milanese, Steven Doherty, Susan Gordon, Sue Kildea, Susan Howell, Wendy Bowyer, Zi Li, Adeline Drogemuller, Alanna Watson, Andrew Urquhart, Anna Ralph, Anna Whitehead, Annie Hepner, Anton Drover, Antony Veale, Beverley Hamerton, Breanna Monk, Brycen Brook, Catherine Moody, Charles Douglas, Clare Golding, Colin Watson, Deborah Hales, Denise Sheedy, Diane Griffin, Dy Kelaart, Emslie Lankin, Evonne Thompson, Fabian Schwarz, Fay Clark, Frances Squires, Gayle Woodford, Graham Clegg, Holi Catton, Jacqueline Boyd, Jane Giles, Jeannie Campbell, Jennie McDowall, Jennifer Peters, Jeremy Downes, John Wright, Josephine Appoo, Joy Hussain, Kenneth McNeil, Keppel Schafer, Larissa Meneri, Laura Edwards, Lenaire Keatch, Lesley Woolf, Lynette Flynn, Marcel Campbell, Marjie Middleton, Mark Ramjan, Matthew Steer, Monica Ostigh, Noelene Simmonds, Patricia Woolven, Perry Burstin, Philip Hungerford, Rachael Charles, Rebecca Numina, Ree Dunn, Renita Kantawara, Sally Foxley, Sandra Bell, Sandra McElligott, Sharon Marchant, Stephen Permezel, Suzanne Lenthall, Tanya Gardner, Terrie Ivanhoe, Thea Nungala, Vicki Gordon, Stephanie MacKie-Schneider, Melinda Barlow, Allison Gray, Andrew Lal, Brenda Thornley, Dianne Bell, Erin Emmons, Georgina Brunsdon, Jessica Lopes, Sally Herring, and Sandeep Reddy

9. CARPA Standard Treatment Manual

Author

Sabina Knight, Andrew White, Caitlin Steiner, Chris Del Mar, Christine Connors, Frances Vaughan, Janet Struber, Jo Wright, Kerrie Gell, Nick Williams, George Tripe, Peter McCormack, Rosemary Schmidt, Andrew Lee, Carolyn MacLennan, Gaynor Garstone, Graeme Maguire, Jane Smith, Jeff Brownscombe, Malcolm Mcdonald, Nathan Ryder, Paul Burgess, Paul Lawton, Peter May, Shelley Crowther, Rosalie Schultz, Steve Margolis, Carey, Timothy A., Ahmed Latif, Alan Cass, Alan Ruben, Alison Dawes, Alison Mustapha, Amanda Sanburg, Andrew Bezzina, Andrew Crowhurst, Andrew McCallum, Anne Bromhead, Anne Chang, Anne Davis, Annie Tangey, Annie Villeseche, Anthony Brown, Balan Iyngkaran, Bart Currie, Belinda Davis, Beth Amega, Robert Batey, Bronwyn Silver, Bruce Simmons, Buddhima Lokuge, Phillips, Dr Cameron J., Cherian Sajiv, Clare MacVicar, Dale Edgar, Damien Fagan, Daniel Ewald, Darryl Maybery, David Hockley, Dennis Pashen, Dion Dionysopoulos, Donald Boldiston, Elise Beachley, Erik Tikoft, Fiona Wood, Gavin Wheaton, Geri Malone, Gregory Perry, Helen Vaughan, Hugh Taylor, Jason Warnock, Jennifer Delima, Jennifer Alison, Joanna Keily, Joshua Davis, Julia Stewart, Kathy Currie, Keith Edwards, Lesley Scott, Lin Davis, Linda Medlin, Louise Maple-Brown, Louise Roufeil, Marcus Ilton, Margot Webster, Melissa Cumming, Monique Stone, Annette Flaherty, Patrick AhKit, Paul Torzillo, Peter Morris, Pippa Tessmann, Pippa Travers-Mason, Rae-Lin Huang, Ral Antic, Renee Gwee, Robert Parker, Rose Fahy, Rosemary Lee, Sandra Meihubers, Sarah Jackson, Sarah Larkins, Selina Taylor, Sharon Johnson, Rourke, Sharon O., Sheila Kavanagh, Sridhar Chitturi, Stephen Brady, Sue Kruske, Sue Orsmond, Suzanne Connor, Tina Hourigan, Timothy Henderson, Vivienne Hobson, Warwick Beever, Alan Clough, Andrew Frukacz, Andrew Wilkinson, Antony Veale, Bernadette Rogerson, Chris Johnstone, Christine Quigley, Digby Green, Donna Chung, Duncan Reed, Gary Sinclair, Heather Ferguson, Helen Land, Ian Norton, Jenni Judd, Jenny May, John Whitehall, Jonathon Ball, Julian White, Karen Coss, Karen Edmond, Kimberly Poole, Koen De Decker, Laurencia Grant, Lewis Marshall, Libby Bowell, Lucy Comerford, Lyn Byers, Marianne Cummins, Matthew Wright, Maureen Mitchell, Rosalind Webby, Rosemary Wanganeen, Rowena Ivers, Sally Edmonds, Sheree Cairney, Stephen Gourley, Steve Milanese, Steven Doherty, Susan Gordon, Susan Jacups, Teem-Wing Yip, Treasure McGuire, Victoria Krause, Adeline Drogemuller, Alanna Watson, Alexander Hope, Alexander Gallus, Alice Gilbert, Andrew Urquhart, Anna Whitehead, Anne Patton, Annie Hepner, Anton Drover, Bhavini Patel, Catherine Marshall, Catherine Moody, Charles Douglas, Colin Watson, Dana Dabrowska, David Thomas, Debbie Moon, Deb Spurgeon, Deborah Hales, Emslie Lankin, Evonne Thompson, Fabian Schwarz, Fay Clark, Frances Squires, Gayle Woodford, Graham Clegg, Holi Catton, Jacqueline Boyd, Jan Bowman, Jane Giles, Jane Whitehead, Jayasree Subi, Jeanette Smith, Jeannie Campbell, Jennie McDowall, Jeremy Downes, Jill Pettigrew, John Wright, Josephine Appoo, Joy Hussain, Judi Arthur, Julie Hughes, Kara Milne, Karrina Demasi, Kenneth McNeil, Kerrie Simpson, Lachlan Lock, Laura Edwards, Lea Davidson, Leila Kennett, Lesley Woolf, Louise Dennis, Lynette Flynn, Lynnette Laker, Marea Fittock, Marjie Middleton, Mark Ramjan, Mark Russell, Matthew Steer, Michele Luey, Monica Ostigh, Nat McLean, Nazlin Remtulla, Neale Cohen, Nicholas Antic, Noelene Simmonds, Patricia Woolven, Philip Hungerford, Philip McMahon, Philippa Thomas, Rachael Charles, Ree Dunn, Richard Hosking, Rodney Roulstone, Roslyn Dart, Ruth Soorley, Sharon Marchant, Sharon Weymouth, Shelley Parker, Shirley Bailey, Simon Slota-Kan, Sophie Higgins, Susan Willis, Tanya Gardner, Terrie Ivanhoe, Vanessa Johnston, Stephanie MacKie-Schneider, Melinda Barlow, Allison Gray, Andrew Lal, Brenda Thornley, Dianne Bell, Erin Emmons, Georgina Brunsdon, Jessica Lopes, Sally Herring, and Sandeep Reddy

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