Integrating Healthcare Services for Indigenous Australian Students at Boarding Schools: A Mixed-Methods Sequential Explanatory Study

Abstract

Introduction: Many Aboriginal and Torres Strait Islander Australian adolescents from remote communities attend boarding schools, requiring integrated healthcare between home and schools. This study explored students' health status, healthcare service use and satisfaction. Methodology: A two-phased mixed-methods explanatory design was implemented. 32 Indigenous primary and 188 secondary boarding school students were asked their health status, psychological distress, use of healthcare services in community and boarding school, and service satisfaction. Results were fed back to students, parents and community members, and education and healthcare staff to elicit further explanation and interpretation. Results: In the previous year, 75% of primary and 81% of secondary boarding school students had visited a doctor. More than 90% were satisfied with healthcare services used. Despite 27.1% reporting high psychological distress, students did not perceive distress as reducing their overall health, nor was distress associated with mental healthcare service use. Discussion: Despite high levels of service use and satisfaction, this study highlighted the need for improved healthcare integration for Indigenous adolescents between school-based and remote community services. Further research is needed to identify students' expectations and models for healthcare integration. Conclusion: With resourcing, schools could play a greater role in facilitating access to healthcare.

Systems integration to promote the mental health of Aboriginal and Torres Strait Islander children: protocol for a community-driven continuous quality improvement approach

“…Instead, the system failure to intervene early leads to a continued heavy reliance on crisis and acute services, including hospitalisation [9,16].Hospitalisation costs $16,676 per admitted patient [30] and serious mental illness is associated with lifetime adverse outcomes. In schools, staff (including guidance counsellors and psychologists) provide counselling, case management and referral for social, emotional, and behavioural difficulties including mental illnesses, but little is known about Indigenous students' use of mental health services through schools [31]. Research from the United States suggests that schools may function as a de facto mental health service; a North Carolina study found that 70-80% of children who received services for a mental health problem were seen by education sector providers, and for most children receiving mental healthcare, this was the sole source of care [32].…”