Integrating healthcare services for Indigenous Australian students at boarding schools: A mixed-methods sequential explanatory study

Introduction: Many Aboriginal and Torres Strait Islander Australian adolescents from remote communities attend boarding schools, and require healthcare to be integrated between home communities and schools. This study explored these students’ health status, healthcare service use and satisfaction. Methods: A two-phased mixed-methods explanatory design was implemented. 32 Indigenous primary and 188 secondary boarding school students were asked their health status, psychological distress, use of healthcare services in community and boarding school, and service satisfaction. Results were fed back to students, parents and community members, and education and healthcare staff to elicit further explanation and interpretation. Results: In the previous year, 75% of primary and 81% of secondary school students visited a doctor, and 12% visited a mental healthcare service. 94% of secondary students were satisfied with community services; 91% with school-based services. Four related themes were: 1) Over or under servicing 2) Continuity of healthcare; 3) “When behaviours are normalised, there’s no acknowledgement”; and 4) Identifying effective healthcare integration models. Discussion and conclusion: Despite high levels of service use and satisfaction, schools could play a greater role in facilitating access to school-based and coordination with community healthcare services. Further research is needed to identify students’ expectations and effective healthcare models.