Better medication management for mental health

Better medication management for Aboriginal people with mental health disorders and their families

Aboriginal people with mental health conditions may have particular needs given the difficult social circumstances both they and their principal carers often find themselves in. Lack of appropriate medication information, poorly integrated services and the impact of other chronic conditions/substance abuse issues mean that this group of people with mental health conditions are more at risk of medication mismanagement than other groups. Using a participatory action-oriented approach, this research project aimed to identify strategies that would improve Aboriginal peoples’ ability to manage their medications. It was also a foundation project of the Centre for Clinical Research Excellence (CCRE) in Aboriginal and Torres Strait Islander Health and led to other projects and courses (see links below).

This project has led to effective collaborations between Aboriginal communities, service providers and researchers to provide staff training, community workshops, practice guidelines and further research into coordinated Aboriginal mental health care and other strategies to improve safe use of medicines. This research informs culturally appropriate policies and practices to enhance quality use of medication for Aboriginal people with mental health and other disorders. It offers a partnership model for ethical research that can produce tangible benefits for participating communities.

This project highlights the complex needs of Aboriginal people with mental health problems and chronic disease co-morbidity, lack of medication education, inadequate services,poorly integrated services, and unsafe practices.

The aims of this project were to:

• Explore the particular needs, experiences and contexts of Aboriginal people with mental health problems (including drug/alcohol), their carers and other family members, focusing on issues relating to management of medications
• Recommend strategies to improve quality use of medicines by this group, informed by the findings
• Implement and evaluate selected recommendations.

The research team used a participatory action-oriented research approach using multiple methods, including: interviews with clients, carers, community leaders and health professionals; a survey of service providers; a review of statistical hospital separation data; and a review of key documents. Recommendations for improving medication management, safety and related issues, and implementation and evaluation of targeted strategies, were developed collaboratively by the team, key informants, workers and local project committees. The project started in 2000 and finished in 2003. Publications See the list at

Related resources:

• de Crespigny, C., Kowanko, I., Murray, H., Wilson, S. & Ah Kit, J. 2007, ‘A Nursing Partnership for Better Outcomes in Aboriginal Alcohol, other Drugs and Mental Health’, Contemporary Nurse (Special Issue: Indigenous Health Care Advances in Nursing), vol. 22(2), pp. 275–87.
• Emden, C., Kowanko, I., de Crespigny, C. & Murray, H. 2005, ‘Better Medication Management for Indigenous Australians: Findings from the field’, Australian Journal of Primary Health, vol 11(1), pp. 80–90.
• Kowanko, I., de Crespigny, C., Murray, H., Emden, C. & Wilson, S. 2005, ‘Improving Indigenous Health through Better Medication Management: An overview’, Australian Journal of Primary Health, vol. 11(1), pp. 17–23.
• de Crespigny, C., Emden, C., Kowanko, I. & Murray, H. 2004, ‘A Partnership Model for Ethical Indigenous Research’, Collegian, vol 11(4), pp. 7–13.
• Kowanko, I., de Crespigny, C., Murray, H., Groenkjaer, M. & Emden, C. 2004, ‘Better Medication Management for Aboriginal People with Mental Health Disorders: A survey of providers’, Australian Journal of Rural Health, vol. 12, pp. 253–7.
• de Crespigny, C., Kowanko, I., Murray, H. & Emden, C. 2004, ‘Implementing Research Outcomes for Better Medication Management for Aboriginal People’, Aboriginal and Islander Health Worker Journal, vol. 28(4), pp. 14–17.
• Kowanko, I., de Crespigny, C., Murray, H., Wilson, S. & Emden, C. 2004, ‘Better Medication Management for Aboriginal People’, Aboriginal and Islander Health Worker Journal, vol 28(2), pp. 11–13.
• Kowanko, I., de Crespigny, C. & Murray, H. 2003, Better Medication Management for Aboriginal People with Mental Health Disorders and their Carers – Final Report 2003 (a collaborative project of the Flinders University School of Nursing and Midwifery and the Aboriginal Drug and Alcohol Council (SA) Inc).
• Kowanko, I., de Crespigny, C., Murray, H. & Groenkjaer, M. 2003, Better Medication Management for Aboriginal People with Mental Health Disorders and their Carers – Survey of Service Providers 2003 (in partnership with the Aboriginal Drug and Alcohol Council (SA) Inc).
• Kowanko, I., de Crespigny, C. & Murray, H. 2003, Better Medication Management for Aboriginal People with Mental Health Disorders and their Carers – Report on Research Conducted in Coober Pedy 2003 (in partnership with the Aboriginal Drug and Alcohol Council (SA) Inc).
• Kowanko, I., de Crespigny, C., Murray, H. & Groenkjaer, M. 2003, Better Medication Management for Aboriginal People with Mental Health Disorders and their Carers – Report on Research Conducted in the Port Augusta Region 2003 (in partnership with the Aboriginal Drug and Alcohol Council (SA) Inc).
• Kowanko, I., de Crespigny, C. & Murray, H. 2003, Better Medication Management for Aboriginal People with Mental Health Disorders and their Carers – Report on Research Conducted in the Port Lincoln Region 2003 (in partnership with the Aboriginal Drug and Alcohol Council (SA) Inc). de Crespigny, C. 2003, Better Medication Management for Aboriginal People: Pilot Study in Northern Metropolitan Adelaide.