title: Needs of Aboriginal Australian women with comorbid mental and alcohol and other drug use disorders.
abstract: OBJECTIVE
  Aboriginal Australian women have an important role in raising strong families. Yet there are many challenges for women with mental health disorders, sometimes following past traumas. This study examines experiences of Aboriginal women engaging with treatment services for co-occurring mental health and substance use disorders (SUD), and the experiences of their family, and of health staff seeking to support them.
  
  
  METHODS
  The study was implemented by four Aboriginal Community Controlled Health Services in urban and regional New South Wales to inform improvements to local health service delivery. All Aboriginal female clients with a diagnosed comorbid mental health and SUD were offered study participation by staff of that Aboriginal Medical Service. Semi-structured interviews were conducted by an independent Aboriginal interviewer: 21 with clients, 12 with adult family members of these clients and 11 with Aboriginal health workers from these services.
  
  
  RESULTS
  Clients (aged 21-60) experienced a range of mental health and SUD, attributed by them to negative events early in life. Clients and family members reported that the disorders have severe impacts on the women and their families, including children. Considerable barriers to accessing relevant services were described. Suggested service improvements included more local inpatient treatment options, more friendly and flexible services, better service promotion and improved staff professional development opportunities.
  
  
  CONCLUSIONS
  Barriers to accessing mental health and SUD treatment (Aboriginal and mainstream) need addressing. Research is needed to optimise treatment to meet the complex needs of Aboriginal Australians with co-occurring mental health and SUD.
authors.affiliation: Discipline of Addiction Medicine, Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: K S Kylie
authors.initials: KS
authors.lastname: Lee
authors.forename: Kaylie
authors.initials: K
authors.lastname: Harrison
authors.forename: Katherine
authors.initials: K
authors.lastname: Mills
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Conigrave
mesh_terms: D000328:Adult; D019973:Alcohol-Related Disorders / Q000534:rehabilitation*; D003153:Community Health Services / Q000458:organization & administration; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006303:Health Services, Indigenous / Q000458:organization & administration; D006801:Humans; D007407:Interviews as Topic; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D009517:New South Wales; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D055815:Young Adult
keywords: Indigenous; comorbidity; drug; mental disorder