Indigenous depression tool tested
There has been significant success so far for a culturally-appropriate depression screening tool for Aboriginal and Torres Strait Islander peoples.
The screening tool is an adapted version of the existing 9-item patient health questionnaire (PHQ-9) used across Australia and globally accepted as an effective screening method for depression.
The adapted tool (aPHQ-9) contains culturally-appropriate questions asking about mood, appetite, sleep patterns, energy and concentration levels.
For example, the original (PHQ-9) questionnaire asks:
- Over the last two weeks, how often have you been bothered by any of the following problems: Little interest or pleasure in doing things?
- Feeling down, depressed or hopeless
The adapted (aPHQ-9) tool instead asks:
- Over the last two weeks have you been feeling slack, not wanted to do anything?
- Have you been feeling unhappy, depressed, really no good, that your spirit was sad?
Mental health problems for Aboriginal and Torres Strait Islander peoples have been overlooked, dismissed and marginalised for too long, according to researcher Professor Maree Hackett, of the George Institute for Global Health.
“This tool, which was developed in conjunction with Aboriginal communities and researchers, will help us address easily treated problems that often go undiagnosed,” Professor Hackett said.
“It will also help us to assess the scale of mental health problems in communities. Up until now, we couldn’t reliably ascertain this in a culturally appropriate way, which has remained a huge concern.
“We need better resources and funding for mental health across Australia, but particularly for Aboriginal and Torres Strait Islander people and within under-resourced health services. We hope this tool will be a turning point.”
The aPHQ-9 is freely available in a culturally-appropriate English version, and can be readily used by translators when working with First Nation communities where English is not the patients first language.
Researchers in partnership with key Aboriginal and Torres Strait primary care providers conducted a validation study in 10 urban, rural and remote primary health services across Australia.
Professor Alex Brown, of the South Australian Health and Medical Research Institute, who was co-investigator on the study, said the studies show the importance of using culturally appropriate language with First Nations people.
“In Australia, as with many countries around the world, everything is framed around Western understandings, language and methods. Our research recognises the importance of an Aboriginal voice and giving that a privileged position in how we respond to matters of most importance to Aboriginal people themselves,” Professor Brown said.
“What we found during this study was that many questions were being lost in translation. Instead of a person scoring highly for being at risk of depression, they were actually scoring themselves much lower and missing out on potential opportunities for treatment.
“It was essential that we got this right and that we took our time speaking with Aboriginal people and ascertaining how the wording needed to be changed so we can begin to tackle the burden of depression.”
The new tool will soon be made available for use at primary health centres across Australia.