Co-designing research with Aboriginal and Torres Strait Islander consumers of mental health services, mental health workers, elders and cultural healers

Introduction: The disparity in mental health outcomes compared with non- Indigenous Australians means that there is an urgent need to develop an evi-dence base around how services can better support Aboriginal and Torres Strait Islander communities. A critical first step is to embed cultural safety into research methodologies.

Objective: Here, we aim to establish the foundation of a research project through co- designing a qualitative interview with Aboriginal and Torres Strait Islander consumers and community members about experiences of cultural safety with mainstream mental health services.

Design: Voices of Aboriginal and Torres Strait Islander peoples must be empow-ered across all stages of research. An Aboriginal- led research team conducted focus groups to understand clear, sensitive, and culturally appropriate ways of asking about experiences in mental health care, to co- design an interview on this topic. Participants were Aboriginal and Torres Strait Islander consumers of mental health services, carers, mental health workers, Elders and Cultural Healers, living in Metropolitan and Regional Western Australia.

Findings: Results suggest that Indigenous governance, together with investing in ongoing, and meaningful cultural awareness and cultural safety training (cultural awareness being a first step towards safety) for non- Indigenous researchers, together with taking the time to build respectful partnerships with communities through ongoing consultation, were appropriate and comprehensive methods of co- designing an interview.

Discussion: The process of working with Aboriginal and Torres Strait Islander peoples in research is as important as the outcome. Aboriginal and Torres Strait Islander leadership, self- determination, and relationship building with communities are essential. Conclusion: Empowering co- design methodologies are flexible, iterative, and ensure that the experiences and views of participants are valued, leading to more meaningful results.

What is already known on this subject:

• Research with Aboriginal and Torres Strait Islander peoples should be conducted according to the NHMRC guidelines for ethical research

• Research with Aboriginal and Torres Strait Islander peoples should be done in an empow-ering, decolonising, and culturally safe way

What this paper adds:

• This paper provides a detailed example of how a culturally safe research process was applied to working with Aboriginal and Torres Strait Islander peoples

• We describe and reflect on the process of how an Aboriginal Participatory Action Research approach was used to co- design a qualitative interview, including through partnership build-ing, and under Aboriginal governance

• We describe and reflect on how non- Indigenous research team members began their training to work in culturally safe ways

Aboriginal health, clinical psychology, community psychology, Indigenous health