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Objective: To describe demographic features and well-being of carers of Aboriginal Australians aged ≥45 years in remote Western Australia. Method: Carer burden, empowerment, and depression were assessed in 124 Aboriginal carers in four remote Aboriginal communities. Results: Carers were aged 38.8 ± 15.0 years, 73.4% were female, and 75.8% were children or grandchildren of the person cared for. The mean Zarit-6 score was 3.7 ± 3.6. Attending high school (odds ratio [OR] = 0.3; 95% confidence interval [CI] = [0.1, 0.7]) and feeling empowered (OR = 0.2; 95% CI = [0.1, 0.8]) were inversely associated with carer burden; female carers were less likely to feel empowered (OR = 0.4; 95% CI = [0.2, 0.9]); and empowerment was inversely associated with depression (OR = 0.3; 95% CI = [0.1, 0.7]). Discussion: Aboriginal carers in remote communities are relatively young and most are children or grandchildren. Carer burden was lower than anticipated. However, existing tools may not adequately measure Aboriginal perspectives. Education and empowerment are key factors which support programs must consider.

BackgroundReliable cognitive assessment for non-western cultures is difficult given that mainstream tests typically rely on western concepts, content and values. Despite recognition of the scarcity of appropriate tests for Aboriginal people over many years, limited practical development has occurred. This study aimed to identify barriers to assessment for clinicians working with Aboriginal people in a remote context, and evaluate characteristics of assessments that clinicians considered to be more or less appropriate and thereby identify potential ways forward.MethodsSemi-structured interviews with 22 health professionals working with Aboriginal clients in central and northern Australia enquired about cognitive assessment practices for Aboriginal people. Themes related to common barriers, useful approaches and areas of need are reported.ResultsResults demonstrated that engagement, diversity and the lack of appropriate resources were seen as the most significant barriers to effective assessment. Appropriate tools should be visually engaging, brief, portable, relevant, focus on identifying strengths and cater to diversity whilst also being standardised and scientifically valid.ConclusionsDespite the obvious challenges, further development is required to increase available resources and evidence base. Specifically, assessments suitable for younger populations and measuring substance misuse related impairments and change over time in a clinical setting were highlighted as important areas of need. A comprehensive assessment should include collection of data from multiple sources with clear interpretation guidelines.

Suicide is now a significant contributor towards Indigenous premature mortality in Australia. There have also been an increasing number of anecdotal reports of child and youth suicides and suicide attempts across Central Australia. However, no systematic protocol or database exists to collect  information on attempted suicides in the region. As a result, suicide attempt data are collected in an ad hoc manner and methods and classifications vary between organisations. Suicide and other suicidal behaviour among Aboriginal peoples is often the outcome of complex and multilayered  factors, and suicide responses have often focused on crisis response or postvention activities. It  is essential that evidence based approaches to Aboriginal youth suicide are developed. Capturing accurate data on suicide and suicide attempts will provide a better understanding of the issue and enable the development of targeted interventions.The aims of this project were to develop a systematic data collection system for Indigenous youth suicide and suicide attempts, and suggest appropriate referral pathways between agencies in Central  Australia when a young person is assessed at risk of suicide. The latter aim was to achieve a more systematic approach to the provision of preventative interventions to individuals and their families. This project has been undertaken with the support of an Aboriginal Advisory Group, and ethics approval from two Ethics Committees. Twenty-two in-depth interviews were conducted with a range of practitioners from related areas (such as primary health, community support, youth services). Data were analysed using cross-case and thematic methods involving four researchers.In this paper we report on the issues raised by individuals in achieving the stated aims, including:• diversity of client data systems across agencies and within government departments; and    inconsistent definitions of ‘Indigenous’, ‘y

BackgroundAchieving culturally fair assessments of cognitive functioning for Aboriginal people is difficult due to a scarcity of appropriately validated tools for use with this group. As a result, some Aboriginal people with cognitive impairments may lack fair and equitable access to services. The objective of this study was to examine current clinical practice in the Northern Territory regarding cognitive assessment for Aboriginal people thereby providing some guidance for clinicians new to this practice setting. MethodQualitative enquiry was used to describe practice context, reasons for assessment, and current practices in assessing cognition for Aboriginal Australians. Semi-structured interviews were conducted with 22 clinicians working with Aboriginal clients in central and northern Australia. Results pertaining to assessment methods are reported. ResultsA range of standardised tests were utilised with little consistency across clinical practice. Nevertheless, it was recognised that such tests bear severe limitations, requiring some modification and significant caution in their interpretation. Clinicians relied heavily on informal assessment or observations, contextual information and clinical judgement. ConclusionsCognitive tests developed specifically for Aboriginal people are urgently needed. In the absence of appropriate, validated tests, clinicians have relied on and modified a range of standardised and informal assessments, whilst recognising the severe limitations of these. Past clinical training has not prepared clinicians adequately for assessing Aboriginal clients, and experience and clinical judgment were considered crucial for fair interpretation of test scores. Interpretation guidelines may assist inexperienced clinicians to consider whether they are achieving fair assessments of cognition for Aboriginal clients.