# Ngalaiya Boorai Gabara Budbut: A Qualitative Study With Primary Care Providers to Understand Perceived Needs, Enablers, Barriers and Opportunities to Strengthen Care

## TL;DR

This study explores how primary care providers perceive the needs and challenges in delivering care to Aboriginal and Torres Strait Islander children and adolescents, emphasizing mental health and cultural safety.

## Contribution

The study identifies specific barriers and enablers to care, offering insights into improving mental health and culturally safe services for Indigenous youth.

## Key findings

- Mental health is a critical need for Aboriginal and Torres Strait Islander children and adolescents.
- Barriers include lack of cultural safety, financial concerns, and privacy issues.
- Training and tailored services are essential to improve care delivery.

## Abstract

To explore primary care providers' perspectives on (i) healthcare needs and barriers to care for Aboriginal and Torres Strait Islander children and adolescents; and (ii) enablers and opportunities to strengthen care.

A qualitative study; interviews and open‐ended survey responses.

Primary care providers who work with Aboriginal and Torres Strait Islander children and young people in health and education settings in New South Wales and the Australian Capital Territory. Data were collected between 23 March 2022 and 13 October 2023.

Sixteen interviews and 33 open‐ended survey responses were analysed using reflexive thematic analysis with a hybrid inductive/deductive approach.

Participants reported that some of the most important health needs for children and young people related to mental health. They recognised that the presenting complaint was not always the underlying or only concern, demonstrated an understanding of trauma‐informed care and acknowledged the importance of collaborative services that engaged support networks. Barriers to care included a lack of cultural safety in mainstream services, challenging social circumstances, financial concerns, being unaware of available services and privacy and confidentiality concerns. To improve care, staff identified several areas needing change including having a package of services tailored for young people; additional training for providers in child and adolescent health, particularly for mental healthcare, trauma‐informed care and communication with young people; providing a safe and engaging environment; support for staff self‐care; and additional resources.

Supporting mental health needs is a key aspect of caring for children and adolescents. To provide optimal primary healthcare, service providers require specialist skills. To support adolescents and children, participants identified a need for ongoing training, professional development and organisational support to ensure best practice care is sustained. This work has informed the development of training and other resources for partner health services.

The known: Childhood and adolescence are key developmental windows during which distinct, though often under‐recognised, healthcare needs can emerge. For Aboriginal and Torres Strait Islander children and young people, many health needs are not met by existing policies and services.

The new: Primary healthcare service providers have identified roadblocks in the way care is delivered to children and adolescents, and the importance of improving the way key priorities, such as mental health, are addressed.

The implications: Improving primary healthcare for Aboriginal and Torres Strait Islander children and adolescents has implications for health now and into the future. Focussing service improvements around social and emotional well‐being, cultural safety and trauma‐informed care remains the key priority.