Nurse-led multidisciplinary team providing care to Aboriginal patients living in an urban area

Case Study Submitted by: Matthew James
Country: Australia

A nurse practitioner-led healthcare service is providing timely social and emotional support and education to some of Australia’s most culturally diverse urban communities.

To reach Aboriginal and Torres Strait Islander Australians is essential to provide services away from the office in an environment that is accessible, safe and appropriate for the needs of the consumer.

The Byala team is the first nurse practitioner-led specialist Aboriginal healthcare team in Australia.

It aims to support and improve the social and emotional wellbeing of their Aboriginal clients who have a drug health and or mental health need. The Byala objective is to provide safe, accessible, evidence based, culturally safe clinical and social interventions and support to our clients.

The Byala team offers a range of clinical and social support services led by a nurse practitioner, including mental health assessment, drug health assessment, drug health/ mental health interventions, hospital support, pharmacological management, crisis support, social advocacy and cultural support. It also offers specialist referral in a range of settings, including office based, schools, jails, outreach clinics, local parks and anywhere our target population resides.

Together with the clinical and social services the Byala team delivers education and community awareness programmes throughout the district it serves with the aim of increasing the community’s awareness of our specialist team, the services we offer and the disadvantaged community we target for support.

The model works from a ‘no wrong door’ policy of referral and access to services, which ensures engagement with the team and the commencement of service at the earliest point and with the least possible delay.

The Byala team model is nurse practitioner-led, offering a high level of clinical supervision, expertise and guidance to all team members and consumers. A nurse practitioner can deliver advanced and autonomous services to the consumer, including diagnosis, ordering of pathology and investigations, and medication prescription, services that are usually delivered by doctors in Australia.

A significant factor for the Byala team’s success is the fact it has an equal partnership between clinical and cultural expertise, offering specialist clinical support and interventions in a culturally safe environment and in a culturally competent way.

Feedback to date from the community is that the Byala team has improved access to specialist drug health/mental health services and the model is cost effective. The Byala team provides the option of home visits/outreach services to clients who cannot access the clinics. The local hospital and crisis team have said that the Byala team has helped to reduce the length of stay for clients who require an acute admission, and reduced the time delay in accessing acute inpatient services for Aboriginal clients. Local criminal courts have commented that the Byala team staff have improved the support available to Aboriginal people who are before the court with drug health/mental health disorders.

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