Evidence map›Paper›PMID 42160050›Full record

ArticleJAMA network open2026

Mapping Aboriginal Mental Health Journeys Through Psychiatric Care Systems.

Helen Milroy, Blerida Banushi, Beatriz Cuesta Briand, Dathan Tran, Shraddha Kashyap, Michael Mitchell, Gray Josephine, Toby Price, Michael Taran, Layale Tayba and 5 more

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In one paragraph

Article in JAMA network open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Helen MilroyUWA Medical School, The University of Western Australia, Perth, Western Australia, Australia.
Blerida BanushiSchool of Indigenous Studies, The University of Western Australia, Crawley, Western Australia, Australia.
Beatriz Cuesta BriandRural Clinical School of WA, The University of Western Australia, Crawley, Western Australia, Australia.
Dathan TranComplex Systems Group, Department of Mathematics and Statistics, The University of Western Australia, Crawley, Western Australia, Australia.
Shraddha KashyapSchool of Indigenous Studies, The University of Western Australia, Crawley, Western Australia, Australia.
Michael MitchellSchool of Indigenous Studies, The University of Western Australia, Crawley, Western Australia, Australia.
Gray JosephineWA Country Health Service, Perth, Western Australia, Australia.
Toby PriceGreat Southern Mental Health Service, WA Country Health Service, Albany, Western Australia, Australia.
Michael TaranGreat Southern Mental Health Service, WA Country Health Service, Albany, Western Australia, Australia.
Layale TaybaGreat Southern Mental Health Service, WA Country Health Service, Albany, Western Australia, Australia.
Mathew ColemanGreat Southern Mental Health Service, WA Country Health Service, Albany, Western Australia, Australia.
Jemma CollovaSchool of Indigenous Studies, The University of Western Australia, Crawley, Western Australia, Australia.
Sean HoodDivision of Psychiatry, UWA Medical School, The University of Western Australia, Crawley, Western Australia, Australia.
Patricia DudgeonSchool of Indigenous Studies, The University of Western Australia, Crawley, Western Australia, Australia.
Michael SmallComplex Systems Group, Department of Mathematics and Statistics, The University of Western Australia, Crawley, Western Australia, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: Mental health services fail to provide culturally safe care for Aboriginal peoples, contributing to persistent health disparities. Understanding how psychiatric care is organized, alongside lived experiences of care, may identify leverage points for service redesign. Objective: To examine Aboriginal mental health care pathways using integrated qualitative and quantitative analysis. Design, Setting, and Participants: This mixed-methods study was conducted from June 2022 to December 2023 at the Great Southern Mental Health Service in Western Australia. Twenty Aboriginal adults were recruited; the quantitative component included 19 patients with 1108 documented clinical interactions, and 7 participated in in-depth yarning interviews. Novel analytical methods included a community-preserving surrogate network algorithm and transition-matrix trajectory clustering. Main Outcomes and Measures: Centrality metrics identifying key agents in the clinical interaction network; patient trajectory clustering based on clinical action sequences; qualitative themes from yarning interviews using reflexive thematic analysis. Results: A total of 20 Aboriginal adults were recruited; the quantitative analysis included 19 patients (mean [SD] age, 38.4 [15.9] years; 10 women and 9 men) with 1108 documented interactions, with 7 patients (mean [SD] age, 44.0 [17.8] years; 4 women and 3 men) participating in qualitative yarning interviews. The clinical interaction network had a core-periphery structure in which patients often served as the main link between external agents and hospital staff. Aboriginal mental health workers had closeness centrality above the 99th percentile in surrogate networks, indicating a structurally distinctive central position within the network. Trajectory analysis identified 3 care pathways: predominantly internal care, prolonged internal engagement, and complex external referral with repeated readmissions. Qualitative themes emphasized cultural safety, kinship, and ongoing trauma and showed inconsistent Aboriginal mental health worker presence during crises, while integrated analyses highlighted their pivotal yet vulnerable role within fragmented care pathways, underscoring the need for trauma-informed, culturally safe redesign. Conclusions and Relevance: In this mixed-methods study, Aboriginal mental health workers occupied central bridging positions, and patients were intermediaries between disconnected parts of the system. Strengthening culturally grounded roles and redesigning care pathways based on operational information flow may improve care coordination and cultural safety in multisetting mental health systems.

Indexed as

Health Services, IndigenousMental DisordersMental Health ServicesAdultFemaleHumansMaleMiddle AgedQualitative ResearchWestern Australia

Identifiers

PMID42160050
PMCPMC13191385

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.