Fellow:            Amanda Jackson
                        Senior Project Officer
                        WA Country Health Service Pilbara & Gascoyne

Year:                2005

Title:                 Enhancing the capacity of the MMR Speech Pathology service to provide more accessible services for Aboriginal families residing in the Geraldton Region

Summary

In 2005, the MMR Speech Pathology department embarked on a project to enhance its capacity to provide meaningful and accessible services for Indigenous clients. The objectives were to:

• establish a baseline measurement and to quantify current utilisation of the service;
• explore Speech Pathologists and Audiologists reflections on current principles of service delivery and practice, as well as their perceptions on the barriers and possible solutions for enhancing service provision and access;
• engage with Aboriginal professionals employed in the Education, Health and Disability sector and community groups to understand their experiences and knowledge of the speech pathology service as well as their perceptions of the barriers and possible solutions;
• improve networks between Indigenous groups/ individuals and the speech pathology department; and
• establish a set of clinical guidelines to assist practitioners when providing services to Aboriginal and Torres Strait Islander clients from information obtained through the interviews, networking and literature.

An initial literature review and networking with Allied Health professionals across Australia was conducted to identify the factors important in providing meaningful and appropriate services. Local data collection methods included a review of occasions of service data, semi-structured interviews with speech pathologists and audiologists, and focus groups and semi-structured interviews with Aboriginal professionals.

Some of the key findings and recommendations are:

• It is imperative that more Aboriginal Health workers are employed by MMR to work with Allied Health, advocate and shape service provision.
• Two-way training for Aboriginal Health Workers and Speech Pathologists is required to clarify roles and working relationships.
• Speech Pathologists are aware that they need to enhance services and require support within the health structure in the form of policies and procedures. Importantly, they require ongoing training in how to provide services to Indigenous clients.
• Speech Pathologists felt that there needs to be increased undergraduate training.
• Clinical services need to be offered in the community and at the local Aboriginal Medical Service.
• The Speech Pathology service needs to be promoted within the community in a user friendly way. At the point of referral, more time needs to be taken in order to explain the service, what it can offer and why it is important to families.
• There are specific behaviours and strategies to enhance communication, rapport and effectiveness of services, which Speech Pathologists need to be aware of. These include, dress code, location of service, communication, the time it takes and so on. A specific example is that it is best not to single individual children out for an assessment as this induces shame. Rather, work in pairs or in small groups with the assistance of an Indigenous education or health worker.