Expert Consensus to Examine the Cross-Cultural Utility of Substance Use and Mental Health Assessment Instruments for Use with Indigenous Clients
| Author | Anne Stephens,Deborah Graham,India Bohanna |
| DOI | 10.1177/1035719X1701700303 |
| Published date | 01 September 2017 |
| Date | 01 September 2017 |
| Subject Matter | Academic Article |
14 Evaluation Journal of Australasia Vol 17 | No 3 | 2017
ACADEMIC ARTICLE Evaluation Journal of Australasia Vol 17 | No 3 | 2017 | pp. 14–22
ANNE STEPHENS | INDIA BOHANNA | DEBORAH GRAHAM
Expert consensus to examine the cross-
cultural utility of substance use and
mental health assessment instruments for
use with Indigenous clients
Evaluation of minority-culture specic
treatment centres for substance use and
mental health is challenging. The challenge
is compounded by a paucity of validated
instruments for assessing substance use and
mental ill health. In the eld of Australian
Indigenous alcohol and other drug service
provision there are few guidelines to
determine which instruments should be
targets for validation for use with Indigenous
clients. As such, reliable, validated, evaluable
data on the client population is limited,
posing multifaceted concerns for clinicians
and service providers as well as evaluators.
The aim of this study was to pilot the use of
a participatory expert consensus approach
to evaluate, rate and select suitable majority-
culture substance use and mental health
assessment instruments for use with their
clients. Eight practitioners of an Indigenous-
specic substance misuse residential
treatment centre participated. The ndings
reinforce the value of consensus approaches
for stakeholder engagement and to provide
a sense of ownership of the results. In this
setting, consensus on the implementation of
an agreed set of Indigenous-specic and non-
Indigenous specic instruments improved the
ownership of the instruments by clinicians
allowing for the use of valid and/or reliable
instruments that also had good face validity.
This makes it more probable that reliable
client wellbeing data will be collected. This is
crucial to program evaluation at a later point
in time. This study was a novel approach to
generating evidence to inform practice in the
absence of normative practice guidelines.
Introduction
Indigenous populations in Australia, New Zealand,
Canada and the United States of America carry a much
higher burden of disease due to substance abuse and
poor mental health compared with their non-Indigenous
counterparts. With higher rates of both psychological
disorders and alcohol and other drug misuse (Beals
et al., 2005; Lee, Conigrave, Patton & Clough, 2009;
MacMillan, MacMillan, Oord & Dingle, 1996; Mitchell,
Beals, Novins & Spicer, 2003; Swan & Raphael, 1995;
Wells et al., 2006), developing scientifically rigorous ways
to measure and treat substance misuse and the symptoms
of mental ill health in Indigenous individuals worldwide,
should be a priority.
Common recommendations for improved
interventions targeting Indigenous Australians suggest
that to address the social determinants of Indigenous
inequality it is necessary to: include Indigenous people
in all stages of development and implementation;
adequately resource the intervention; and, employ a
holistic, coordinated and inclusive approach to the
involvement of all stakeholders (Gray & Saggers, 2005;
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