University of Western Australia researchers have developed a first of its kind culturally acceptable screening tool for depression among older First Nations people living in remote areas. It is widely accepted that remote First Nations peoples are not inclined to turn up to health practitioners and describe sadness or depression, and rather any undiagnosed depression needs to be detected by information gathering from the practitioners.
UWA Professor Leon Flicker said the new tool “has been modified from the commonly used depression risk assessment tool Patient Health Questionnaire (PHQ-9).”
“We have adapted this tool by rewording and translating some of the questions to align with Indigenous cultural norms,” said Professor Flicker.
“We then validated the instrument amongst remote living Indigenous communities.”
Professor Flicker said the tool was endorsed by a cross-sectional survey of adults aged 45 years or over from six remote First Nations communities in the Kimberley. Thirty per cent of the respondents are based in Derby. The tool has been named Kimberley Indigenous Cognitive Assessment of Depression (KICA-dep) after the place where it was developed.
The tool was a sub-project of the Kimberley Healthy Ageing Project. The study included 250 men and women aged 46 to 89 years.
Researcher, Professor Osvaldo Almeida said, “The KICA-dep has robust psychometric properties and can be used with confidence as a screening tool for depression among older Indigenous Australians.”
“We anticipate that this tool will be very useful to medical professionals and others who work with remote Aboriginal Australians and have made the tool freely available and at no charge via our website.”
The eleven linguistic and culturally sensitive items of the KICA-dep scale were derived from the signs and symptoms required to establish the diagnosis of a depressive episode according to the commonly used psychiatric assessment tool – and their frequency was rated on a four-point scale ranging from ‘never’ to ‘all the time.’ The diagnosis of depressive order was established after a face to face assessment with a consultant psychiatrist. Other measures included socio-demographic and lifestyle factors and clinical history. A paper on the tool was published today in the journal PLOS ONE
According to the Australian Bureau of Statistics, the Kimberley has one of the nation’s highest homelessness rates of First Nations people – one of the highest arrest and incarceration rates, similarly so with extreme poverty rates and it has the highest youth suicide rate.