The need for relapse prevention strategies in Top End remote indigenous mental health

The Australian Integrated Mental Health Initiative in the Northern Territory (AIMHI NT) is one site of a National Health and Medical Research Council (NHMRC) Strategic Partnership initiative seeking to improve remote indigenous mental health outcomes - in a context of increasing hospital admissions and high readmission rates. Remote indigenous mental health service delivery faces challenges of isolation, staff recruitment and retention, and cultural, language and literacy issues. AIMHI NT explored the challenges of mental health service delivery and relapse prevention in Top End remote Aboriginal communities through semi-structured interviews with general practitioners, nurses, and Aboriginal mental health workers and sought views from a range of practitioners and health centres, representing each of the three Top End regions - Katherine, East Arnhem and Darwin Rural. Remote service providers reported low levels of confidence in indigenous mental health assessment, and little formal training in mental health. They reported high rates of relapse of mental illness and high rates of comorbidity, but few relapse prevention activities and relapse prevention tools. The development of relapse prevention activities in primary care requires support and change at all levels - community, consumers and carers, service providers, health system, and health policy. AIMHI NT is engaged in a range of activities promoting relapse prevention in remote NT health centres, and has developed a care plan and care plan training package for remote service providers.