‘Having a Quiet Word’: Yarning with Aboriginal Women in the Pilbara Region of Western Australia about Mental Health and Mental Health Screening during the Perinatal Period
Abstract
:1. Introduction
2. Materials and Methods
2.1. Setting the Scene
2.2. Research Approach: Yarning as Methodology
2.3. Recruitment
2.4. Interview Process
2.5. Interview Analysis
2.6. Ethics
3. Results
3.1. Theme One: A lived Experience
‘I was on my own for my pregnancy, I was excited but scared too you know. Her dad [baby’s dad] was in jail for drink driving. I stopped drinking for her but it was still hard, my dad and I don’t talk and my mother passed. I was sometimes stressing out’.(Participant 002)
‘I never heard anyone say they are depressed, I hear them say they are ‘stressing out’, ‘going mad’. Sometimes we might use language words, but those are the ones mostly. We find it hard to talk about pain, I don’t know why, I think as Aboriginal people we like to laugh and talk for the good times but now everyone has a story of pain and we don’t know how to talk [about it]’.(Participant 010)
3.2. Theme Two: Connectedness and Support
‘Since my sister went through this [perinatal depression] we are all a lot more aware. We don’t, like, bang on about it, but I see they [partner and mother] ask me things in a way we never talked about before…. I feel supported, I think whatever happens I will be ok’.(Participant 008)
‘My midwife is in [name of Pilbara town] but she is gone now. She was really good to me. I still call her. She made me feel it is ok to talk even when I didn’t know what I was going to say’.(Participant 001)
‘My children saw all that violence with their father and then when my younger brother died [by suicide] the lights went out for me. I was pregnant and I took myself in to see the [name of service]. No one [in the participant’s family] was talking and I was starting to go mad. My other brothers, everyone is so broken from it and sometimes on the garri [alcohol] they might talk but it turns sour. So I tried it. The whitefella way [laughs]. It was alright, I was a bit thing [shy] but the lady was kind to me and, and, it was good to talk’.(Participant 011)
‘If you want to push through the shame [of going to counselling] you can… I learnt about myself. I got my kids back, I said fuck you to violent relationships. I wasn’t going to be like my mum and spent 20 years getting belted. I wanted to nurture my kids. I don’t think I had that nurture ‘.(Participant 003)
‘I need something else, some other way to heal. Something with my old people and being on my ancestors land. The drugs and the violence get me down. I think the counsellor was good but I don’t know’…(Participant 014)
3.3. Theme Three: Yarning Safely
‘Clinics need to talk these things through [KMMS Part 2], they really do, but they need to build up the friendship and trust… We are coping with so much loss. So much sadness…. You have to be really clear with the mum that this is for mum to help her stay strong and look after bub. It is not for DCP [Department of Child Protection] or anyone else, only the midwife and maybe a doctor’.(Participant 007)
‘Talking about the protective stuff, right, the stuff that keep us going, keeps us strong, that’s something. We are living this life the best way we can and for us to hear that. For clinic, my midwife to hear that. Now that is a powerful thing’.(Participant 009)
‘You talk about things because they are important to talk about not cause they happened one week ago! It is a real whitefella way to start. It’s like you’re in or you’re out. You see that hey? Like what happens if it was a bit longer, then the lady might think oh no, it’s not important I won’t talk about that’.(Participant 015)
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Prince, M.; Patel, V.; Saxena, S.; Maj, M.; Maselko, J.; Phillips, M.R.; Rahman, A. No health without mental health. Lancet 2007, 370, 859–877. [Google Scholar] [CrossRef]
- Lucas, T. The integration of mental and physical health care. Lancet 2014, 384, 1072–1073. [Google Scholar]
- Ohrnberger, J.; Fichera, E.; Sutton, M. The relationship between physical and mental health: A mediation analysis. Soc. Sci. Med. 2017, 195, 42–49. [Google Scholar] [CrossRef] [PubMed]
- Gausia, K.; Thompson, S.; Nagel, T.; Rumbold, A.; Connors, C.; Matthews, V.; Boyle, J.; Schierhout, G.; Bailie, R. Antenatal emotional wellbeing screening in Aboriginal and Torres Strait Islander primary health care services in Australia. Contemp. Nurse 2013, 46, 73–82. [Google Scholar] [CrossRef] [PubMed]
- Kildea, S.; Kruske, S.; Barclay, L.; Tracy, S. ‘Closing the Gap’: How maternity services can contribute to reducing poor maternal infant health outcomes for Aboriginal and Torres Strait Islander women. Rural Remote Health 2010, 10, 1383. [Google Scholar] [PubMed]
- Kildea, S.; Tracy, S.; Sherwood, J.; Magick-Dennis, F.; Barclay, L. Improving maternity services for Indigenous women in Australia: Moving from policy to practice. Med. J. Aust. 2016, 205, 374–379. [Google Scholar] [CrossRef]
- Australian Institute of Health and Welfare. The Health and Welfare of Australia’s Aboriginal and Torres Strait Islander Peoples. 2008. Available online: https://www.aihw.gov.au/reports/indigenous-health-welfare/health-welfare-australias-indigenous-peoples-2008/contents/table-of-contents (accessed on 13 January 2019).
- Marley, J.V.; Kotz, J.; Engelke, C.; Williams, M.; Stephen, D.; Coutinho, S.; Trust, S.K. Validity and Acceptability of Kimberley Mum’s Mood Scale to Screen for Perinatal Anxiety and Depression in Remote Aboriginal Health Care Settings. PLoS ONE 2017, 12, e0168969. [Google Scholar] [CrossRef]
- Prandl, K.J.; Rooney, R.; Bishop, B.J. Mental health of Australian Aboriginal women during pregnancy: Identifying the gaps. Arch. Womens Ment. Health 2012, 15, 149–154. [Google Scholar] [CrossRef]
- Esler, D.M.; Johnston, F.; Thomas, D. The acceptability of a depression screening tool in an urban, Aboriginal community-controlled health service. Aust. N. Z. J. Public Health 2007, 31, 259–263. [Google Scholar] [CrossRef] [Green Version]
- Gausia, K.; Thompson, S.C.; Nagel, T.; Schierhout, G.; Matthews, V.; Bailie, R. Risk of antenatal psychosocial distress in indigenous women and its management at primary health care centres in Australia. Gen. Hosp. Psychiatry 2015, 37, 335–339. [Google Scholar] [CrossRef]
- Stein, A.; Pearson, R.M.; Goodman, S.H.; Rapa, E.; Rahman, A.; McCallum, M.; Howard, L.M.; Pariante, C.M. Effects of perinatal mental disorders on the fetus and child. Lancet 2014, 384, 1800–1819. [Google Scholar] [CrossRef]
- O’Hara, M.W. Postpartum depression: What we know. J. Clin. Psychol. 2009, 65, 1258–1269. [Google Scholar] [CrossRef] [PubMed]
- Sayers, S.; Boyle, J. Indigenous perinatal and neonatal outcomes: A time for preventive strategies. J. Paediatr. Child Health 2010, 46, 475–478. [Google Scholar] [CrossRef] [PubMed]
- Austin, M.-P.; Highet, N. Mental Health Care in the Perinatal Period: Australian Clinical Practice Guideline. Available online: https://www.cope.org.au/health-professionals/health-professionals-3/review-of-new-perinatal-mental-health-guidelines/ (accessed on 12 June 2019).
- Cox, J.L.; Holden, J.M.; Sagovsky, R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br. J. Psychiatry 1987, 150, 782–786. [Google Scholar] [CrossRef] [PubMed]
- Austin, M.-P.; Colton, J.; Priest, S.; Reilly, N.; Hadzi-Pavlovic, D. The antenatal risk questionnaire (ANRQ): Acceptability and use for psychosocial risk assessment in the maternity setting. Women Birth 2013, 26, 17–25. [Google Scholar] [CrossRef]
- Matthey, S.; Phillips, J.; White, T.; Glossop, P.; Hopper, U.; Panasetis, P.; Petridis, A.; Larkin, M.; Barnett, B. Routine psychosocial assessment of women in the antenatal period: Frequency of risk factors and implications for clinical services. Arch. Womens Ment. Health 2004, 7, 223–229. [Google Scholar] [CrossRef]
- Austin, M.-P. Psychosocial assessment and management of depression and anxiety in pregnancy. Key aspects of antenatal care for general practice. Aust. Fam. Phys. 2003, 32, 119. [Google Scholar]
- Kotz, J.; Munns, A.; Marriott, R.; Marley, J.V. Perinatal depression and screening among Aboriginal Australians in the Kimberley. Contemp. Nurse 2016, 52, 42–58. [Google Scholar] [CrossRef]
- Chan, A.W.; Skeffington, P.; Reid, C.; Marriott, R. Research protocol for the exploration of experiences of Aboriginal Australian mothers and healthcare professionals when using the Edinburgh Postnatal Depression Scale: A process-oriented validation study using triangulated participatory mixed methods. BMJ Open 2018, 8, e022273. [Google Scholar] [CrossRef]
- Geia, L.K.; West, R.; Power, T. Editorial—Addressing perinatal mental health issues for Aboriginal and Torres Strait Island parents and their families: Working towards better maternity outcomes. Contemp. Nurse 2013, 46, 70–72. [Google Scholar] [CrossRef]
- San Martin Porter, M.A.; Betts, K.; Kisely, S.; Pecoraro, G.; Alati, R. Screening for perinatal depression and predictors of underscreening: Findings of the Born in Queensland study. Med. J. Aust. 2019, 210, 32–37. [Google Scholar] [CrossRef] [PubMed]
- Kimberley Aboriginal Health Planning Forum. Perinatal Depression and Anxiety Protocol. 2019. Available online: https://kahpf.org.au/clinical-protocols (accessed on 27 August 2019).
- Bessarab, D.; Ng’andu, B. Yarning about yarning as a legitimate method in Indigenous research. Int. J. Crit. Indig. Stud. 2010, 3, 13. [Google Scholar] [CrossRef]
- Barnett, L.; Kendall, E. Culturally appropriate methods for enhancing the participation of Aboriginal Australians in health-promoting programs. Health Promot. J. Aust. 2011, 22, 27–32. [Google Scholar] [CrossRef]
- Geia, L.K.; Hayes, B.; Usher, K. Yarning/Aboriginal storytelling: Towards an understanding of an Indigenous perspective and its implications for research practice. Contemp. Nurse 2013, 46, 13–17. [Google Scholar] [CrossRef] [PubMed]
- New South Wales Department of Health. SAFE START Guidelines: Improving Mental Health Outcomes for Parents and Infants. 2010. Available online: https://www1.health.nsw.gov.au/pds/pages/doc.aspx?dn=GL2010_004 (accessed on 22 April 2019).
- Davydov, D.M.; Stewart, R.; Ritchie, K.; Chaudieu, I. Resilience and mental health. Clin. Psychol. Rev. 2010, 30, 479–495. [Google Scholar] [CrossRef] [Green Version]
- Rapp, C.A. The Strengths Model: Case Management with People Suffering from Severe and Persistent Mental Illness; Oxford University Press: New York, NY, USA, 1998. [Google Scholar]
- Government of Western Australia, WA Country Health Service. Pilbara Health Profile. 2018. Available online: http://www.wacountry.health.wa.gov.au/fileadmin/sections/publications/Publications_by_topic_type/Reports_and_Profiles/Pilbara_Health_Profile_2018.pdf (accessed on 3 March 2019).
- Walker, M.; Fredericks, B.; Mills, K.; Anderson, D. “Yarning” as a Method for Community-Based Health Research with Indigenous Women: The Indigenous Women’s Wellness Research Program. Health Care Women Int. 2014, 35, 1216–1226. [Google Scholar] [CrossRef]
- National Health and Medical Research Council. Values and Ethics—Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research. Canberra: Commonwealth of Australia. 2003. Available online: https://www.nhmrc.gov.au/about-us/publications/national-statement-ethical-conduct-human-research-2007-updated-2018#toc__235 (accessed on 18 October 2019).
- Bowen, A.; Duncan, V.; Peacock, S.; Bowen, R.; Schwartz, L.; Campbell, D.; Muhajarine, N. Mood and anxiety problems in perinatal Indigenous women in Australia, New Zealand, Canada, and the United States: A critical review of the literature. Transcult. Psychiatry 2014, 51, 93–111. [Google Scholar] [CrossRef]
- Campbell, A.; Hayes, B.; Buckby, B. Aboriginal and Torres Strait Islander women’s experience when interacting with the Edinburgh Postnatal Depression Scale: A brief note. Aust. J. Rural Health 2008, 16, 124–131. [Google Scholar] [CrossRef]
- Brown, A.E.; Fereday, J.A.; Middleton, P.F.; Pincombe, J.I. Aboriginal and Torres Strait Islander women’s experiences accessing standard hospital care for birth in South Australia—A phenomenological study. Women Birth 2016, 29, 350–358. [Google Scholar] [CrossRef]
- Jongen, C.; McCalman, J.; Bainbridge, R.; Tsey, K. Aboriginal and Torres Strait Islander maternal and child health and wellbeing: A systematic search of programs and services in Australian primary health care settings. BMC Pregnancy Childb. 2014, 14, 251. [Google Scholar] [CrossRef]
- Kirkham, R.; Hoon, E.; Rumbold, A.; Moore, V. Understanding the role of Australian Aboriginal maternal infant care workers: Bringing a cultural dimension to a critique of the ideal worker concept. Com. Work Fam. 2018, 21, 393–409. [Google Scholar] [CrossRef]
- Clarke, M.; Boyle, J. Antenatal care for Aboriginal and Torres Strait Islander women. Aust. Fam. Phys. 2014, 43, 20. [Google Scholar]
- Homer, C.S.; Foureur, M.J.; Allende, T.; Pekin, F.; Caplice, S.; Catling-Paull, C. ‘It’s more than just having a baby’women’s experiences of a maternity service for Australian Aboriginal and Torres Strait Islander families. Midwifery 2012, 28, e509–e515. [Google Scholar] [CrossRef] [PubMed]
- Ypinazar, V.A.; Margolis, S.A.; Haswell-Elkins, M.; Tsey, K. Indigenous Australians’ understandings regarding mental health and disorders. Aust. N. Z. J. Psychiatry 2007, 41, 467–478. [Google Scholar] [CrossRef]
- Vicary, D.; Westerman, T. That’s just the way he is’: Some implications of Aboriginal mental health beliefs. Adv. Ment. Health 2004, 3, 103–112. [Google Scholar] [CrossRef]
- Vicary, D.; Bishop, B. Western psychotherapeutic practice: Engaging Aboriginal people in culturally appropriate and respectful ways. Aust. Psychol. 2005, 40, 8–19. [Google Scholar] [CrossRef]
- Vicary, D.; Andrews, H. Developing a culturally appropriate psychotherapeutic approach with Indigenous Australians. Aust. Psychol. 2000, 35, 181–185. [Google Scholar] [CrossRef]
- Brown, A.; Scales, U.; Beever, W.; Rickards, B.; Rowley, K.; O’Dea, K. Exploring the expression of depression and distress in aboriginal men in central Australia: A qualitative study. BMC Psychiatry 2012, 12, 97. [Google Scholar] [CrossRef]
- Guerin, B.; Guerin, P. Re-thinking mental health for indigenous Australian communities: Communities as context for mental health. Com. Develop. J. 2012, 47, 555–570. [Google Scholar] [CrossRef]
- Nagel, T.; Hinton, R.; Griffin, C. Yarning about Indigenous mental health: Translation of a recovery paradigm to practice. Adv. Ment. Health 2012, 10, 216–223. [Google Scholar] [CrossRef]
- Westerman, T. Engaging Australian Aboriginal youth in mental health services. Aust. Psychol. 2010, 45, 212–222. [Google Scholar] [CrossRef]
- Freeman, T.; Edwards, T.; Baum, F.; Lawless, A.; Jolley, G.; Javanparast, S.; Francis, T. Cultural respect strategies in Australian Aboriginal primary health care services: Beyond education and training of practitioners. Aust. N. Z. J. Public Health 2014, 38, 355–361. [Google Scholar] [CrossRef] [PubMed]
- Gomersall, J.S.; Gibson, O.; Dwyer, J.; O’Donnell, K.; Stephenson, M.; Carter, D.; Canuto, K.; Munn, Z.; Aromataris, E.; Brown, A. What Indigenous Australian clients value about primary health care: A systematic review of qualitative evidence. Aust. N. Z. J. Public Health 2017, 41, 417–423. [Google Scholar] [CrossRef] [PubMed]
- Australian Government Department of Health. Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023. 2013. Available online: https://www1.health.gov.au/internet/main/publishing.nsf/Content/indigenous-implementation-plan (accessed on 16 February 2019).
- Webb, L. Tools for the job: Why relying on risk assessment tools is still a risky business. J. Psychiatr. Ment. Health Nurs. 2012, 19, 132–139. [Google Scholar] [CrossRef] [PubMed]
Step | Description |
---|---|
1 | Introduction and brokerage of the researcher in the participant’s space |
2 | Deconstructing the research agenda |
3 | Establishing informed consent |
4 | The research topic yarn |
5 | Reviewing the yarn and re-confirming permission for future use of data |
6 | Reflecting, coding and analysis |
7 | Presentation of results to participants, key Aboriginal stakeholders and the Pilbara Aboriginal Health Planning Forum for review, feedback and revision |
8 | Publication of results and dissemination back to key stakeholders and participants |
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Carlin, E.; Atkinson, D.; Marley, J.V. ‘Having a Quiet Word’: Yarning with Aboriginal Women in the Pilbara Region of Western Australia about Mental Health and Mental Health Screening during the Perinatal Period. Int. J. Environ. Res. Public Health 2019, 16, 4253. https://doi.org/10.3390/ijerph16214253
Carlin E, Atkinson D, Marley JV. ‘Having a Quiet Word’: Yarning with Aboriginal Women in the Pilbara Region of Western Australia about Mental Health and Mental Health Screening during the Perinatal Period. International Journal of Environmental Research and Public Health. 2019; 16(21):4253. https://doi.org/10.3390/ijerph16214253
Chicago/Turabian StyleCarlin, Emma, David Atkinson, and Julia V Marley. 2019. "‘Having a Quiet Word’: Yarning with Aboriginal Women in the Pilbara Region of Western Australia about Mental Health and Mental Health Screening during the Perinatal Period" International Journal of Environmental Research and Public Health 16, no. 21: 4253. https://doi.org/10.3390/ijerph16214253
APA StyleCarlin, E., Atkinson, D., & Marley, J. V. (2019). ‘Having a Quiet Word’: Yarning with Aboriginal Women in the Pilbara Region of Western Australia about Mental Health and Mental Health Screening during the Perinatal Period. International Journal of Environmental Research and Public Health, 16(21), 4253. https://doi.org/10.3390/ijerph16214253