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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Screening for depression in young Indigenous people: building on a unique community initiative

Linton R. Harriss A C D , Mary Kyle B , Katrina Connolly B , Edward Murgha B , Merton Bulmer B , Darren Miller B , Paul Munn B , Paul Neal B , Kingsley Pearson B , Melanie Walsh B , Sandra Campbell A , Maximus Berger A , Robyn McDermott A C and Malcolm McDonald A B
+ Author Affiliations
- Author Affiliations

A Centre for Chronic Disease Prevention, College of Public Health, Medical and Veterinary Sciences, James Cook University, PO Box 6811, Cairns, Qld 4870, Australia.

B Gurriny Yealamucka Health Service Aboriginal Corporation, 1 Bukki Road, Yarrabah, Qld 4871, Australia.

C School of Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia.

D Corresponding author. Email: linton.harriss@jcu.edu.au

Australian Journal of Primary Health 24(4) 343-349 https://doi.org/10.1071/PY18006
Submitted: 9 January 2018  Accepted: 20 May 2018   Published: 9 August 2018

Abstract

Gurriny Yealamucka Health Service Aboriginal Corporation (GYHSAC) is an Indigenous community-controlled health organisation providing comprehensive primary care to the people of Yarrabah in far north Queensland, Australia. GYHSAC conducts an annual Young Person’s Health Check (YPC) for people aged 15–25 years based on the Medical Benefits Schedule Item 715. However, the YPC is constantly evolving to meet the needs of the community, and in 2016, in response to concerns about psychological risk among Indigenous youth, GYHSAC teamed up with James Cook University to trial an adapted PHQ-9 depression screening tool (aPHQ-9) as part of the YPC. This study describes the 2016 YPC event, reports the prevalence of depressive symptoms, examines local issues related to the use of the screening tool and proposes recommendations for future health screening. Experienced health professionals conducted the aPHQ-9 assessment in a private area of the clinic. One-in-five young people were found to have moderate–severe symptoms or self-harm ideation in the previous 2 weeks; they were referred to the mental health service. The aPHQ-9 screening process was found to be straightforward and well accepted by staff and youth. Importantly, it provided valuable ‘space’ to facilitate communication on sensitive issues and was a conduit for speedy referral and follow up by trained staff. Based on our experience, we recommend dedicated depression screening in future routine community health checks for young people and adults.

Additional keywords: Aboriginal and Torres Strait Islander, health screening, primary health care, recommendations.


References

Allgaier A-K, Allgaier AK, Pietsch K, Frühe B, Sigl‐Glöckner J (2012) Screening for depression in adolescents: validity of the Patient Health Questionnaire in pediatric care. Depression and Anxiety 29, 906–913.
Screening for depression in adolescents: validity of the Patient Health Questionnaire in pediatric care.Crossref | GoogleScholarGoogle Scholar |

Armstrong B, White E, Saracci R (1992) ‘Principles of Exposure Measurement in Epidemiology.’ (Oxford University Press: New York, NY, USA)

Australian Bureau of Statistics (2010) The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples. AIHW, Canberra, ACT, Australia.

Australian Bureau of Statistics (2016) Population estimates by age and sex, regions of Queensland (ASGS 2011), 2010 and 2015. (ABS: Canberra, ACT, Australia) Available at http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/3235.02015?OpenDocument [Verified 4 January 2017]

Australian Government Department of Health (2016) Medicare Health Assessment for Aboriginal and Torres Strait Islander People (MBS Item 715). (DoH: Canberra, ACT, Australia) Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare_ATSI_MBSitem715 [Verified 21 August 2017]

Australian Indigenous Health InfoNet (2017) Overview of Aboriginal and Torres Strait Islander health status, 2016. (Australian Indigenous Health InfoNet: Perth, WA, Australia) Available at http://www.healthinfonet.ecu.edu.au/uploads/docs/2016-overview.pdf [Verified 21 August 2017]

Australian Institute of Health and Welfare (2015) The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples 2015. AIHW, Canberra, ACT, Australia.

Australian Institute of Health and Welfare (2016) Australian Burden of Disease Study: impact and causes of illness and death in Aboriginal and Torres Strait Islander people 2011. AIHW, Canberra, ACT, Australia.

Australian Institute of Health and Welfare (2017) Admitted patient care 2015–16: Australian hospital statistics. AIHW, Canberra, ACT, Australia.

Azzopardi PS, Sawyer SM, Carlin JB, Degenhardt L, Brown N, Brown AD, Patton GC (2018) Health and wellbeing of Indigenous adolescents in Australia: a systematic synthesis of population data. Lancet 391, 766–782.
Health and wellbeing of Indigenous adolescents in Australia: a systematic synthesis of population data.Crossref | GoogleScholarGoogle Scholar | [British edition]

Begg S, Stanley L, Suleman A, Williamson D, Sartori J, Serghi M 2014. ‘The Burden of Disease and Injury in Queensland’s Aboriginal and Torres Strait Islander People, 2014.’ (State of Queensland (Queensland Health): Brisbane, Qld, Australia).

Brown AD, Mentha R, Rowley KG, Skinner T, Davy C, O’Dea K (2013) Depression in Aboriginal men in central Australia: adaptation of the Patient Health Questionnaire 9. BMC Psychiatry 13, 271
Depression in Aboriginal men in central Australia: adaptation of the Patient Health Questionnaire 9.Crossref | GoogleScholarGoogle Scholar |

Brown A, Mentha R, Howard M, Rowley K, Reilly R, Paquet C, O’Dea K (2016) Men, hearts and minds: developing and piloting culturally specific psychometric tools assessing psychosocial stress and depression in central Australian Aboriginal men. Social Psychiatry and Psychiatric Epidemiology 51, 211–223.
Men, hearts and minds: developing and piloting culturally specific psychometric tools assessing psychosocial stress and depression in central Australian Aboriginal men.Crossref | GoogleScholarGoogle Scholar |

Burdzovic Andreas J, Brunborg GS (2017) Depressive symptomatology among Norwegian adolescent boys and girls: the PHQ-9 psychometric properties and correlates. Frontiers in Psychology 8, 887
Depressive symptomatology among Norwegian adolescent boys and girls: the PHQ-9 psychometric properties and correlates.Crossref | GoogleScholarGoogle Scholar |

Büttner P, Muller R (Eds) (2015) ‘Epidemiology.’ (Oxford University Press: South Melbourne, Vic., Australia)

Gelaye B, Williams MA, Lemma S, Deyessa N, Bahretibeb Y, Shibre T, Wondimagegn D, Lemenhe A, Fann J, Stoep AV, Zhou X-HA (2013) Validity of the Patient Health Questionnaire-9 for depression screening and diagnosis in East Africa. Psychiatry Research 210, 653–661.
Validity of the Patient Health Questionnaire-9 for depression screening and diagnosis in East Africa.Crossref | GoogleScholarGoogle Scholar |

Gracey M, King M (2009) Indigenous health part 1: determinants and disease patterns. Lancet 374, 65–75.
Indigenous health part 1: determinants and disease patterns.Crossref | GoogleScholarGoogle Scholar |

Hackett ML, Farnbach S, Glozier N, Skinner T, Teixeira-Pinto A, Askew D, Gee G, Cass A, Brown A (2016) Getting it right: study protocol to determine the diagnostic accuracy of a culturally specific measure to screen for depression in Aboriginal and/or Torres Strait Islander people. BMJ Open 6, e015009
Getting it right: study protocol to determine the diagnostic accuracy of a culturally specific measure to screen for depression in Aboriginal and/or Torres Strait Islander people.Crossref | GoogleScholarGoogle Scholar |

Haswell-Elkins M, Sebasio T, Hunter E, Mar M (2007) Challenges of measuring the mental health of Indigenous Australians: honouring ethical expectations and driving greater accuracy. Australasian Psychiatry 15, S29–S33.
Challenges of measuring the mental health of Indigenous Australians: honouring ethical expectations and driving greater accuracy.Crossref | GoogleScholarGoogle Scholar |

Hunter E, Harvey D (2002) Indigenous suicide in Australia, New Zealand, Canada and the United States. Emergency Medicine 14, 14–23.
Indigenous suicide in Australia, New Zealand, Canada and the United States.Crossref | GoogleScholarGoogle Scholar |

Jennings W, Spurling GK, Askew DA (2014) Yarning about health checks: barriers and enablers in an urban Aboriginal medical service. Australian Journal of Primary Health 20, 151–157.
Yarning about health checks: barriers and enablers in an urban Aboriginal medical service.Crossref | GoogleScholarGoogle Scholar |

Jorm AF, Bourchier SJ, Cvetkovski S, Stewart G (2012) Mental health of Indigenous Australians: a review of findings from community surveys. The Medical Journal of Australia 196, 118–121.
Mental health of Indigenous Australians: a review of findings from community surveys.Crossref | GoogleScholarGoogle Scholar |

Kroenke K, Spitzer RL, Williams JB (2001) The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine 16, 606–613.
The PHQ-9: validity of a brief depression severity measure.Crossref | GoogleScholarGoogle Scholar |

Lee EJ, Hall LA, Moser DK (2014) Psychometric properties of the Patient Health Questionnaire-9 in patients with heart failure and gastrointestinal symptoms. Journal of Nursing Measurement 22, 29–40.
Psychometric properties of the Patient Health Questionnaire-9 in patients with heart failure and gastrointestinal symptoms.Crossref | GoogleScholarGoogle Scholar |

Lemstra ME, Rogers MR, Thompson AT, Redgate L, Garner M, Tempier R, Moraros JS (2011) Prevalence and risk indicators of depressed mood in on-reserve first nations youth. Canadian Journal of Public Health 102, 258–263.

Leonard D, McDermott R, O’Dea K, Rowley KG, Pensio P, Sambo E, Twist A, Toolis R, Lowson S, Best JD (2002) Measuring prevalence: obesity, diabetes and associated cardiovascular risk factors among Torres Strait Islander people. Australian and New Zealand Journal of Public Health 26, 144–149.
Measuring prevalence: obesity, diabetes and associated cardiovascular risk factors among Torres Strait Islander people.Crossref | GoogleScholarGoogle Scholar |

Mayers NR, Couzos S (2004) Towards health equity through an adult health check for Aboriginal and Torres Strait Islander people: an important Australian initiative that sets an international precedent. The Medical Journal of Australia 181, 531–532.

Miller G, McDermott R, McCulloch B, Leonard D, Arabena K, Muller R (2002) The Well Person’s Health Check: a population screening program in indigenous communities in north Queensland. Australian Health Review 25, 136–147.
The Well Person’s Health Check: a population screening program in indigenous communities in north Queensland.Crossref | GoogleScholarGoogle Scholar |

Morgan A, Jorm A (2007) Awareness of beyondblue: the national depression initiative in Australian young people. Australasian Psychiatry 15, 329–333.
Awareness of beyondblue: the national depression initiative in Australian young people.Crossref | GoogleScholarGoogle Scholar |

Shawyer F, Enticott JC, Block AA, Cheng IH, Meadows GN (2017) The mental health status of refugees and asylum seekers attending a refugee health clinic including comparisons with a matched sample of Australian-born residents. BMC Psychiatry 17, 76
The mental health status of refugees and asylum seekers attending a refugee health clinic including comparisons with a matched sample of Australian-born residents.Crossref | GoogleScholarGoogle Scholar |

Swan P, Raphael B (1995) Ways forward: national Aboriginal and Torres Strait Islander mental health policy national consultancy report. Commonwealth of Australia, Canberra, ACT, Australia.

van Steenbergen-Weijenburg KM, de Vroege L, Ploeger RR, Brals JW, Vloedbeld MG, Veneman TF, Hakkaart-van Roijen L, Rutten FFH, Beekman ATF, van der Feltz-Cornelis CM (2010) Validation of the PHQ-9 as a screening instrument for depression in diabetes patients in specialized outpatient clinics. BMC Health Services Research 10, 235
Validation of the PHQ-9 as a screening instrument for depression in diabetes patients in specialized outpatient clinics.Crossref | GoogleScholarGoogle Scholar |