Viewpoint: Evidence and practice in Indigenous mental health

A decade ago the author published a commentary on the content relating to Aboriginal and Torres Strait Islander populations in the RANZCP clinical practice guidelines for the treatment of schizophrenia and related disorders. The recently released ANZJP guidelines bring a fresh framework – the GRADE approach – but, in relation to consideration of Indigenous Australians, not much else. The author reflects on considerations a decade ago and now, and what has changed in relation to the social determinants of Indigenous vulnerability over that time. A decade ago I wrote a commentary (Hunter, 2016) on the Indigenous content of the (then) recently published guidelines for the management of schizophrenia (Galletly et al., 2016). The updated guidelines (Suetani et al., 2026) bring a fresh orientation, being informed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. That shift is consequential for consideration of Aboriginal and Torres Strait Islander populations which are consigned – with Māori – to a brief section – ‘special populations’ – the salient recommendation being: ‘we advocate for universal cultural safety in mental health systems’.