A culturally safe research process in mental health

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Aboriginal and Torres Strait Islander peoples should be aware that this resource may contain images, voices or names of people who have passed away.

This fact sheet is an executive summary of the article, Co-designing research with Aboriginal and Torres Strait Islander consumers of mental health services, mental health workers, Elders and Cultural Healers (Milroy et al., 2022). In this fact sheet, we describe how culturally safe research can be conducted to learn about the state of cultural safety in mental health services, with Aboriginal and Torres Strait Islander community members, mental health service users, Elders, mental health workers, and Cultural Healers.

• Aboriginal and Torres Strait Islander peoples and cultures have thrived for over 60,000 years. Social and cultural structures ensured every person was supported, and wellbeing thrived (Dudgeon, Milroy, & Walker, 2014).
• Colonisation, genocide and discriminatory policies have created a context of ongoing trauma and high rates of mental health concerns in Aboriginal and Torres Strait Islander communities (Milroy, Dudgeon, & Walker, 2014).
• Colonisation also occurred in mental health research where Aboriginal and Torres Strait Islander knowledges of health and wellbeing were excluded (Dudgeon, Rickwood, Garvey, & Gridley, 2014; Australian Psychological Society, 2016), and where research continues to occur ‘on’ rather than ‘with’ Aboriginal and Torres Strait Islander peoples.
• Furthermore, Indigenous peoples globally have been prevented from maintaining sovereignty over data collected about them. It is therefore important that Aboriginal and Torres Strait Islander peoples have the right to ‘…autonomously decide what, how, and why Indigenous data are collected, accessed and used. It ensures that data on or about Indigenous peoples reflects our priorities, values, cultures, worldviews and diversity.’ (Maiam nayri Wingara Indigenous Data Sovereignty Collective, 2024, p. 5)
• To ensure that any research with Aboriginal and Torres Strait Islander peoples is ethical rather than harmful, it is important that the process of conducting the research is culturally safe.
• Cultural safety requires an understanding of the historical, social and political determinants of social and emotional wellbeing among Aboriginal and Torres Strait Islander peoples, and the dynamics of power relations in and between cultural groups (e.g. between non-Indigenous Australians and Aboriginal and Torres Strait Islander peoples).
• Culturally safe research empowers Aboriginal and Torres Strait Islander communities by working in line with Indigenous knowledges and ways of knowing, being and doing. For example, it is about understanding that the process of conducting research is as important as the outcome (Lindeman & Togni, 2022).
• Overall, for the results of any research involving Aboriginal and Torres Strait Islander peoples to be meaningful, the process of conducting the research needs to be culturally safe.

The following table outlines some of the principles of culturally safe research which we have considered in our investigation, and provides examples of what this looks like in practice. For more details on culturally safe research more broadly, please see this fact sheet on working with Aboriginal and Torres Strait Islander peoples in research.

In the following video (1 minute, 27 seconds), Professor Helen Milroy describes a culturally informed way of understanding what a research outcome can be.

Project aims

Situated within the wider Transforming Indigenous Mental Health and Wellbeing program, this project aims to improve the cultural safety of mainstream mental health services, to better support Aboriginal and Torres Strait Islander consumers, carers, families and communities. We reflect here on the process of the research itself, to understand how to embed cultural safety in this practice.

This project follows a decolonising, Aboriginal Participatory Action Research methodology (Dudgeon, Bray, Darlaston-Jones, & Walker, 2020). It was designed using a phased, iterative approach.

Phase 1 involved consulting with Aboriginal and Torres Strait Islander community members through yarning sessions, to co-design a qualitative interview to be used in the second phase of the project.  For example, we wanted to understand whether Aboriginal consumers, carers and community members would be open to talking about their experiences of engaging with mainstream mental health services, and how to best to yarn about these issues. Through the qualitative interview (Phase 2), we hope to learn about the current state of cultural safety in mainstream mental health services, and how it can be improved.

Phase 1: Yarning sessions

Six yarning sessions were conducted across one metro and two rural areas. We consulted with Aboriginal community members, consumers of mental health services, carers, mental health workers, Elders and Cultural Healers. During the sessions, participants discussed their interpretations of cultural safety and mental health and advised on how to design the qualitative interview for the next phase of the project.

In the following video (54 seconds), Professor Helen Milroy describes some strategies that could improve cultural safety in practice.

Process as the outcome

At every stage of the project, we followed the principles of culturally safe research. In the following table, we provide some examples and associated positive outcomes.

Thank you for being an ally and supporting the next generation of strong, deadly, and self-determined Aboriginal and Torres Strait Islander people.

Recommended citation: Milroy, H., Prichard, L., Collova, J., & Kashyap, S. (2024) A culturally safe research process in mental health. Adelaide: Transforming Indigenous Mental Health and Wellbeing & Emerging Minds. DOI: 10.5281/zenodo.10828298     

Australian Psychological Society. (2016). The APS apology to Aboriginal and Torres Strait Islander people [Web page].

Dudgeon, P., Bray, A., Darlaston-Jones, D., & Walker, R. (2020). Aboriginal Participatory Action Research: An Indigenous research methodology strengthening decolonisation and social and emotional wellbeing. Melbourne: The Lowitja Institute.

Dudgeon, P., Milroy, H., & Walker, R. (Eds.). (2014). Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice (second edition). Canberra: Commonwealth of Australia.

Dudgeon, P., Rickwood, D., Garvey, D., & Gridley, H. (2014). A history of Indigenous psychology. In P. Dudgeon, H. Milroy, & R. Walker (Eds.), Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice (pp. 39-54). Canberra: Commonwealth of Australia.

Lindeman, M. A., & Togni, S. J. (2022). Improving services for Aboriginal women experiencing sexual violence: Working at the knowledge interface. Australian Social Work, 75(3), 1-13.

Maiam nayri Wingara Indigenous Data Sovereignty Collective. (2024). Taking control of our data: A discussion paper on Indigenous data governance for Aboriginal and Torres Strait Islander people and communities. Melbourne: Lowitja Institute. DOI: 10.48455/rtvd-7782

Milroy, H., Dudgeon, P., & Walker, R. (2014). Community life and development programs – pathways to healing. In P. Dudgeon, H. Milroy, & R. Walker (Eds.), Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice (pp. 419-436). Canberra: Commonwealth of Australia.

Milroy, H., Kashyap, S., Collova, J., Mitchell, M., Derry, K. L., Alexi, J., Chang, E. P., & Dudgeon, P. (2022). Co-designing research with Aboriginal and Torres Strait Islander consumers of mental health services, mental health workers, elders and cultural healers. Australian Journal of Rural Health, 30(6), 772-781.

Milroy, H., Kashyap, S., Collova, J., Mitchell, M., Ryder, A., Cox, Z., Coleman, M., Taran, M., Cuesta Briand, B., & Gee, G. (2024). Walking together in friendship: learning about cultural safety in mainstream mental health services through Aboriginal Participatory Action Research. Australian and New Zealand Journal of Psychiatry.