title: Sharing stories: indigenous alcohol and other drug workers' well-being, stress and burnout.
abstract: BACKGROUND
  Indigenous alcohol and other drug (AOD) workers' roles are often exhausting, poorly paid and under-recognised. There has been relatively little examination of work-related stressors on their health and well-being. This national study identified Indigenous AOD workers' experiences and perspectives on well-being, stress and burnout along with strategies to improve worker well-being.
  
  
  METHODS
  Focus groups were conducted with 121 participants (70 Indigenous, 20 non-Indigenous, 31 unspecified) from metropolitan, rural and remote locations around Australia, selected via a purposive sampling strategy. Audio files and interview notes were analysed to identify key themes.
  
  
  RESULTS
  Main themes identified included excessive workloads, extensive demands and expectations, workers' proximity to communities, loss and grief issues, lack of recognition, inadequate rewards, stigma and racism, and Indigenous ways of working. Stressors were compounded by workers' complex personal circumstances, profound levels of loss and grief, and lack of culturally safe working environments.
  
  
  CONCLUSIONS
  Indigenous workers' stress was exacerbated by close links and responsibilities to their communities and a 'dual accountability', being constantly on call, playing multiple roles, complex personal and professional lives, and needing to interact with multiple agencies. Many Indigenous AOD workers had developed mechanisms to deal with work-related pressures and received valued support from their communities. The study identified the importance of workforce strategies to improve Indigenous workers' well-being and reduce stress, including: mutual support networks, training in assertiveness and boundary setting, workloads that take account of Indigenous ways of working, adequate remuneration, supervision and mentorship, and cultural sensitivity training for non-Indigenous workers.
authors.affiliation: National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Roche
authors.forename: Vinita
authors.initials: V
authors.lastname: Duraisingam
authors.forename: Allan
authors.initials: A
authors.lastname: Trifonoff
authors.forename: Samantha
authors.initials: S
authors.lastname: Battams
authors.forename: Toby
authors.initials: T
authors.lastname: Freeman
authors.forename: Amanda
authors.initials: A
authors.lastname: Tovell
authors.forename: Donna
authors.initials: D
authors.lastname: Weetra
authors.forename: Nancy
authors.initials: N
authors.lastname: Bates
mesh_terms: D000328:Adult; D002055:Burnout, Professional / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology*; D005260:Female; D017144:Focus Groups / Q000379:methods; D006303:Health Services, Indigenous; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology*; D016320:Substance Abuse Treatment Centers / Q000379:methods; D019966:Substance-Related Disorders / Q000208:ethnology / Q000523:psychology / Q000628:therapy; D016526:Workload / Q000523:psychology; D055815:Young Adult
keywords: Indigenous; alcohol and other drug; well-being