The need for culturally valid psychological assessment tools in Indigenous mental health

ABSTRACT

A clear understanding of the nature and extent of suicidal behaviour and other mental health issues in Aboriginal and Torres Strait Islander populations has been limited by the national failure to develop clinically and culturally valid assessments and to ensure the cultural competence of practitioners. The default position for Australian mental health researchers is to continue to adapt existing mainstream assessments. The problem with this approach is it doesn’t enable researchers to determine culture-specific symptoms or phenomena that are critical to establishing true cultural validity. The mental health field needs culturally co-designed psychometric tools to capture culture-specific expression and manifestation of symptoms, and to capture culture-specific symptoms. Two such tools exist: the WASC-Y and WASC-A. However, there are few data on their psychometric properties beyond the initial developmental research reported in the test manuals. This needs to be a focus for future research.

Key Points

What is already known about this topic:

1. Aboriginal and Torres Strait Islander people in Australia have suicide rates that are at least twice that of non-Indigenous Australians.

2. Research into Aboriginal and Torres Strait Islander people’s mental health is limited by the continued failure to use culturally valid, psychometrically sound, and clinically valid screening tools.

3. For decades researchers have been drawing attention to the need for screening tools and other psychological assessments to be specifically validated for use with Aboriginal and Torres Strait Islander people.

What this paper adds:

1. Some attempts have been made to develop culturally valid tools or to validate mainstream instruments for use with Aboriginal and Torres Strait Islander people, but these tools are significantly limited.

2. Attempting to validate mainstream instruments with Aboriginal and Torres Strait Islander people fails to determine unique aetiologies and explain the over-representation of Indigenous people in suicide deaths.

3. The Westerman Aboriginal Symptom Checklists are culturally and clinically valid screening tools that warrant further exploration of their value in addressing the unacceptable gaps in understanding the nature and extent of mental health problems and suicidal behaviour among Aboriginal people.

KEYWORDS:

• Aboriginal and Torres Strait Islander
• Aboriginal-specific symptoms
• cultural validity
• co-design
• psychological assessment
• psychometric

Disclosure statement

No potential conflict of interest was reported by the author(s).