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The role of an Indigenous Health Worker in contributing to equity of access to a mental health and substance abuse service for Indigenous young people in a youth detention centre

Abstract Indigenous youth in detention have been identified as a priority category in national and state policies in relation to their mental health and drug and alcohol service needs. This article describes the development of the role of Indigenous Health Worker in the Mental Health Alcohol Tobacco and Other Drugs Service (MHATODS) at a youth detention centre. It provides an account of the process as well the outcomes achieved to date. A retrospective and descriptive account is given of the development of the role, and of strategies aimed at improving access to MHATODS for Indigenous young people. Over a one-year period, data were compiled on all young people admitted to a Queensland youth detention centre, which was then cross referenced with MHATODS’ own service records to determine the proportion of Indigenous young people who had been referred and subsequently received a service. The Indigenous Health Worker has decreased barriers to access for Indigenous young people who require treatment for mental health or substance abuse problems while in detention. There was no significant difference in referral or service provision rates for Indigenous compared to non-Indigenous youth. Indigenous young people were statistically more likely to refuse an assessment by MHATODS, though given the low rates of refusal the clinical significance was small. MHATODS’ use of an Indigenous Health Worker significantly contributes to the needs of Indigenous young people in youth detention by reducing barriers to access for the assessment of mental health problems and substance misuse. MHATODS has achieved equity in referral and service provision between Indigenous and non-Indigenous youth admitted into detention. Clinical and cultural supervision play an important part in the development and maintenance of the Indigenous Health Worker role.