Needs of Aboriginal Australian women with comorbid mental and alcohol and other drug use disorders KS KYLIE LEE 1 , KAYLIE HARRISON 2 , KATHERINE MILLS 3,4 & KATHERINE M. CONIGRAVE 1,5 1 Discipline of Addiction Medicine, Sydney Medical School, University of Sydney, Sydney, Australia, 2 South Coast Medical Service Aboriginal Corporation, Nowra, Australia, 3 National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia, 4 National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, University of New SouthWales, Sydney, Australia, and 5 Drug Health Services, Royal Prince Alfred Hospital, Sydney, Australia Abstract Introduction and Aims. AboriginalAustralian women have an important role in raising strong families.Yet there are many challenges for women with mental health disorders, sometimes following past traumas. This study examines experiences of Aboriginal women engaging with treatment services for co-occurring mental health and substance use disorders (SUD), and the experiences of their family, and of health staff seeking to support them. Design and Methods. The study was implemented by four Aboriginal Community Controlled Health Services in urban and regional New South Wales to inform improvements to local health service delivery. All Aboriginal female clients with a diagnosed comorbid mental health and SUD were offered study participation by staff of that Aboriginal Medical Service. Semi-structured interviews were conducted by an independent Aboriginal interviewer: 21 with clients, 12 with adult family members of these clients and 11 with Aboriginal health workers from these services. Results. Clients (aged 21–60) experienced a range of mental health and SUD, attributed by them to negative events early in life. Clients and family members reported that the disorders have severe impacts on the women and their families, including children. Considerable barriers to accessing relevant services were described. Suggested service improvements included more local inpatient treatment options, more friendly and flexible services, better service promotion and improved staff professional development opportunities. Discussion and Conclusion. Barriers to accessing mental health and SUD treatment (Aboriginal and mainstream) need addressing. Research is needed to optimise treatment to meet the complex needs of Aboriginal Australians with co-occurring mental health and SUD. [Lee KSK, Harrison K, Mills K, Conigrave KM. Needs of Aboriginal Australian women with comorbid mental and alcohol and other drug use disorders. Drug Alcohol Rev 2014;33:473–81] Key words: Indigenous, drug, mental disorder, comorbidity. Introduction Women have an important role in raising strong and healthy families. For Aboriginal and Torres Strait Islander (Aboriginal - In this document the term ‘Aboriginal’ is used to denote both groups.) women, this is critically important due to a need to break the cycle of transgenerational trauma [1]. Yet the chal- lenges for women who experience co-occurring mental health and substance use disorders (SUDs) are keenly felt [2]. These disorders impact not only on women who are affected but also on their families [2]. In the general Australian population, more women than men (44% vs. 31%) with an SUD have at least one co-occurring affective or anxiety disorder. Among Abo- riginal Australians, no large-scale national surveys describe co-occurring mental health and SUDs [1]; however, the available evidence suggests high preva- lence and impact of both [3]. Among Aboriginal KS Kylie Lee PhD, BMus(Hons), Senior Lecturer and NHMRC Postdoctoral Fellow in Aboriginal and Torres Strait Health, Kaylie Harrison BHlthSc(IndigHlth), Project Officer, Katherine Mills PhD, BHlthSc(Hons), Associate Professor and NHMRC Career Development Fellow, Katherine M. Conigrave FAChAM, FAFPHM, PhD, Addiction Medicine Specialist and Professor. Correspondence to Dr KS Kylie Lee, Discipline of Addiction Medicine, Central Clinical School, University of Sydney, Based at: Drug Health Services, Royal Prince Alfred Hospital, 83–117 Missenden Road, Camperdown, NSW 2050 Australia.Tel: +61 2 9515 7314; Fax: +61 2 9515 5779; E-mail: kylie.lee@sydney.edu.au Received 25 September 2013; accepted for publication 9 February 2014. REVIEW Drug and Alcohol Review (September 2014), 33, 473–481 DOI: 10.1111/dar.12127 © 2014 Australasian Professional Society on Alcohol and other Drugs