‘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

Despite high rates of perinatal depression and anxiety, little is known about how Aboriginal women in Australia experience these disorders and the acceptability of current clinical screening tools. In a 2014 study, the Kimberley Mum’s Mood Scale (KMMS) was validated as an acceptable perinatal depression and anxiety screening tool for Aboriginal women in the Kimberley region of Western Australia. In the current study, we explored if it was appropriate to trial and validate the KMMS with Aboriginal women in the Pilbara. Yarning as a methodology was used to guide interviews with 15 Aboriginal women in the Pilbara who had received maternal and child health care within the last three years. Data were analysed thematically, the results revealing that this cohort of participants shared similar experiences of stress and hardship during the perinatal period. Participants valued the KMMS for its narrative-based approach to screening that explored the individual’s risk and protective factors. While support for the KMMS was apparent, particular qualities of the administering health care professional were viewed as critical to the tool being well received and culturally safe. Building on these findings, we will work with our partner health services in the Pilbara to validate the KMMS with Pilbara Aboriginal women.

Risk and resilience: a mixed methods investigation of Aboriginal Australian women’s perinatal mental health screening assessments

“…This study also demonstrated that the KMMS was acceptable to women and their health professionals [ 13 ]. The KMMS validation study and subsequent consultations with other groups of Aboriginal women have identified that the inclusion of protective factors is central to Aboriginal women identifying the KMMS as acceptable and culturally safe [ 42 , 43 ].…”

A systematic review of EPDS cultural suitability with Indigenous mothers: a global perspective

“…Cultural translations and adaptations Cultural concerns around standard EPDS suitability are implicit in the decision to translate the EPDS into the Townsville Aboriginal and Islanders Health Services (TAIHS) version (Campbell et al 2008;Hayes et al 2005;Hayes et al 2010) and adapt the EPDS to form the Kimberley Mums Mood Scale (KMMS) (Carlin et al 2019a;Kotz et al 2016;Marley et al 2017). Perinatal Aboriginal women in the Pilbara region in WA supported the KMMS and preferred it over the EPDS because of its simplified language and yarning element of KMMS (Carlin et al 2019a). These modifications and translations address perceived wording and formatting limitations (Kotz et al 2016) and reflect more implicit and common usage of words in the local dialect (Hayes et al 2010) as well as the use of face emoticon in place of a numeric Likert scale.…”

“…Culturally relevant research methodology Studies describing the process of tool development (TAIHS, KMMS) outlined the importance of being patient, providing time and space to listen to and seek endorsement from Indigenous women with respect to preferences or suggestions for wording, emerging layout themes, and implementation management and strategies (Campbell et al 2008;Hayes et al 2005;Kotz et al 2016;Marley et al 2017). Allowing Indigenous women and communities to have a voice is necessary in building strong partnerships with Indigenous communities (Campbell et al 2008;Carlin et al 2019a;WAPMHU and WNHS 2011). Possible strategies to enhance community engagement and participation is the use of yarning technique (Carlin et al 2019a;Kotz et al 2017) or the use of Indigenous interviewers (Clarke 2008a).…”

“…Allowing Indigenous women and communities to have a voice is necessary in building strong partnerships with Indigenous communities (Campbell et al 2008;Carlin et al 2019a;WAPMHU and WNHS 2011). Possible strategies to enhance community engagement and participation is the use of yarning technique (Carlin et al 2019a;Kotz et al 2017) or the use of Indigenous interviewers (Clarke 2008a). Yarning, as a research methodology, follows an open-ended and conversational approach that acknowledges Indigenous principles of oral language, story-telling, and shared experiences (Bernardes et al 2020;Walker et al 2014).…”

Why validation is not enough: Setting the scene for the implementation of the Kimberley Mum’s Mood Scale

“…Colonisation, forced removal of Aboriginal people from their cultural homelands and their families, and ongoing policies of discrimination have created conditions for increased stress and mental illness within Aboriginal families [11][12][13]. These conditions are often further amplified by limited mental health literacy and/or cultural norms governing the concept of mental illhealth, [14,15] and issues of equity and access to appropriate healthcare providers [16,17] including mental health specialist services [18].…”