Background: Although mental illness among Indigenous Australians is generally accepted to be a major health problem, there is little evidence to show whether a clinical diagnostic tool is culturally appropriate for this population.
Objectives: To determine the cultural appropriateness of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) (SCID-I) in the diagnosis of mental illness among Indigenous Australians.
Methods: SCID-I, a semi-structured clinical interview that uses the clinical judgement of the psychologist as well as the information collected by the SCID-I tool itself, was administered by culturally trained psychologists to 544 Indigenous adults living in Southern Queensland and Northern New South Wales.
Findings: The feedback questionnaire was completed by 498 (91.5%) participants. Administrating psychologists provided qualitative feedback for 502 (92.3%) interviews. Most (95.6%) participants were totally comfortable or mostly comfortable during the interview: 96.2% felt that they psychologist understood their responses during the interview; and 83% said that there were no culturally inappropriate questions. For psychologists, 72.5% of interviews did not encounter any cultural challenges to reach a clinical diagnosis; and 40.4% developed an excellent rapport with the participant. Sections of the interview where cultural aspects did need to be considered included those of psychosis (n = 99, 19.7%), anxiety (n = 4, 0.8%) and trauma sections (n = 4, 0.8%).
Conclusions: Cultural nuances need to be considered when SCID-I is used for Indigenous Australians. When administered by a culturally trained psychologist, SCID-I is considered culturally appropriate in this group.

Background: To determine the acceptance and effectiveness of a community-led Indigenous suicide-intervention training program, it is essential to identify which people or organizations are being used to seek support or help for an Indigenous person at-risk of suicide.
Objectives: To identify existing social networks among volunteer suicide intervention trainees.
Methods: We conducted social network surveys to identify existing networks between trainees and at-risk youth, communities and support agencies, before they commenced our suicide intervention training program. Qualitative feedback about the training program was also collected.
Findings: Preliminary findings from 50 participants indicate that 44% were Aboriginal, 28% worked for government organizations, 74% had previous personal suicide experiences, 72% had provided support or help to an Indigenous person in the community who was at-risk of suicide and 48% had no previous prevention training. Most frequent contacts used were non-government agencies and mental health professionals: Both were contacted more than six times in the past 6 months by 16% of the participants. Friends (12%) or parents/guardians (12%) contacted participants for help or support more than six times in the last 6 months. Most-likely contact for future support or help were parents/guardians (44%), emergency services (40%) or doctors (40%). Feedback indicated a strong need for a tailored, community-developed approach to suicide prevention training.
Conclusions: Preliminary findings indicate that our community-led program will be beneficial in developing connectedness within communities. Future research will evaluate the effectiveness of the training program after a period of time and will determine the change in connectedness and information flow within participants' social networks.

Background Although there have been many small studies of mental health in specific Indigenous Australian communities, reliable data on mental illness is mostly lacking. Studies that evaluated a range of mental illnesses using structured diagnostic assessments have not attempted to culturally validate these assessments. Therefore, it is not known whether structured diagnostic tools employed in the literature provide accurate prevalence data of mental illness in Indigenous Australians.

Objectives To determine, in Indigenous Australians, the cultural appropriateness of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR Axis I Disorders (SCID-I) and to provide insight into the prevalence of mental illness in this population.

Background: Although rates of common mental disorders (CMD) are acknowledged to be high among community-living Indigenous Australians, the data are derived from self-report. Rates among remote residents are half of those living elsewhere. Community-based prevalence rates of CMD derived from diagnostic interviews have not been available.
Objectives: To determine whether Indigenous Australians living as majorities on traditional lands (‘Reserve’ populations) or in remote areas have lower rates of current CMD than those living as minorities in mainstream communities.
Methods: Cross-sectional study (July 2014 to November 2016) involving Aboriginal Medical Service (AMS) clients (n = 420), community residents (n = 54) and Reserve residents (n =70). Psychologists conducted a Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) assessments.
Findings: The standardized rates (95% confidence interval (CI)) of current CMD were 45.9% (38.8, 47.7) among AMS clients and 37.5% (32.2, 42.8) among community residents, 4.6-fold and 3.7-fold higher, respectively, than those of the Australian population (2007 National Survey of Mental Health and Well Being). Among Reserve residents, the rate was 25.4% (20.7, 30.2). Only 5.5% (3.0, 8.0) of Reserve residents had a mood disorder, one-third the rate of the other two groups. Among a small subgroup (n = 25) of the n = 544 cohort who resided in remote areas, the rate of current CMD was 7.5% (4.6, 10.3).
Conclusions: The prevalence of current mental disorders in this Indigenous population is substantially higher than previous estimates. The much lower rates among reserve and remote residents point to the importance of Indigenous peoples’ connection to their traditional lands and culture and a potentially important protective factor.