Principles and practices of communicating with Aboriginal and Torres Strait Islander peoples accessing mental health services: A systematic review

Purpose Communication between mental health professionals and Aboriginal and Torres Strait Islander peoples is critical for culturally safe care. Although the importance of communication is well recognised, genuinely supporting culturally safe communication necessitates moving beyond challenges to identify solutions. Using a strengths-based approach, this study aimed to identify principles and practices for communicating with Aboriginal and Torres Strait Islander peoples accessing mental health services. Methods This study was conducted at the interface of Indigenous and Western knowledge using theories and tools developed by Aboriginal and Torres Strait Islander scholars and integrating these with systematic review methods. A systematic search for qualitative and quantitative evidence was conducted across databases including peer-reviewed and other (‘grey') literature. Search results were independently screened by an Aboriginal researcher and a non-Indigenous clinician researcher. Following screening, additional searches were conducted (e.g. of reference lists in systematic reviews). The quality of literature sources meeting inclusion criteria was appraised by the same researchers using Aboriginal and Torres Strait Islander and Western tools. Informed by Indigenous research methodology, thematic synthesis was used to identify principles and practices for communication. Main findings The search strategies identified 2,504 unique literature sources. Following screening, 57 sources were deemed to meet inclusion criteria. Critical appraisal identified that most sources were produced by reputable organisations and authors, who provided accurate information based on evidence, although fewer sources incorporated Aboriginal or Torres Strait Islander leadership, governance and authorship. Thematic synthesis identified three high-level principles for communication that could be understood from the standpoints of Aboriginal and Torres Strait Islander Peoples and other people living in Australia: 1) Knowing Our Stories : Professional requirements of knowledge and understanding to support culturally safe communication; 2) Being With Us : Preparing for culturally safe communication; and 3) Doing Things Our Way : Practices for culturally safe communication. Principal conclusions The sizable body of literature synthesised in this review identifies both high-level and detailed principles and practices that mental health professionals should employ to promote culturally safe communication with Aboriginal and Torres Strait Islander peoples accessing mental health services.