"You didn't just consult community, you involved us": transformation of a 'top-down' Aboriginal mental health project into a 'bottom-up' community-driven process

Australas Psychiatry. 2015 Dec;23(6):614-9. doi: 10.1177/1039856215614985. Epub 2015 Nov 3.


Objective: Recently, there has been a consistent call for Indigenous health research to be community-driven. However, for a variety of reasons, many projects, such as the one featured here, start as 'top-down'. Using ten accepted principles for Aboriginal health research, the present article illustrates how a top-down project can be transformed into a 'bottom-up' community-driven project.

Method: A table of examples is provided to show how the ten principles were translated into practice to create a bottom-up process.

Results: We suggest that key elements for creating a bottom-up process are iterative conversations and community involvement that goes beyond notional engagement. A feature of community involvement is generating and sustaining ongoing conversations with multiple levels of community (organisations, health professionals, Elders, community members, project-specific groups) in a variety of different forums across the entire duration of a project. Local research teams, a commitment to building capacity in the local Indigenous workforce, and adequate timelines and funding are other factors that we hypothesise may contribute to successful outcomes.

Conclusion: The article contributes to a much-needed evidence base demonstrating how appropriate structures and strategies may create bottom-up processes leading to successful outcomes.

Keywords: Aboriginal health; Community engagement; Community involvement; Community-based participatory research; Indigenous mental health.

MeSH terms

  • Australia / epidemiology
  • Community-Based Participatory Research* / methods
  • Community-Based Participatory Research* / organization & administration
  • Cultural Competency
  • Evidence-Based Practice* / methods
  • Evidence-Based Practice* / organization & administration
  • Health Services, Indigenous* / organization & administration
  • Health Services, Indigenous* / trends
  • Humans
  • Mental Health / ethnology*
  • Mental Health Services* / organization & administration
  • Mental Health Services* / trends
  • Models, Organizational
  • Native Hawaiian or Other Pacific Islander / psychology*
  • Organizational Innovation