Table 1 PAR methodologies and methods over 4 phases

Phase 1: Look and listen –knowledge sharing using Yarning, Dadirri and Ganma, listening carefully to a diverse range of participants. The participants consist of three groups who were all involved in comorbidity care in the region; Group A- Participants from the local Aboriginal community who would act as consumer advocates, Group B – clinicians and workers from local MH and AOD services (government and non-government), and Group C – Workers from local support services (including emergency departments, ambulance and Aboriginal Health Workers, service coordinators, managers).

Data collection

Meetings with

- Aboriginal community members and groups, formal and informal discussions, building relationships

- local MH-AOD clinicians and workers

- support service staff

a three-step process by HS and ACW with all participants

1. visit and introduce the project

2. in-depth conversation style interview or focus group

3. checking back that the manuscript was correct (member checking)

Phase 2: Think and reflect; stepping back and reflecting on the shared knowledge using critical theory from both a Western and Indigenous understanding, with consideration of colonisation impacts. Deep consideration regarding access to culturally-appropriate MH-AOD services, and research questions such as: How are MH-AOD services structured? Does this benefit Aboriginal consumers? How easy or difficult is it for Aboriginal consumers to get access to these services?

Data analysis – a collaborative process between HS and ACW

- Systematically organised contextual thematic analysis

- Interactive coding and categorising as themes

Identify

- Existing gaps in care, from multiple perspectives

- Strategies and services that are meeting Aboriginal comorbidity needs.

- Suggestions for improvement

Phase 3: Collaborate, consult and plan using Dadirri and Ganma; interpreting and analysing the data together, and including the diverse knowledge, ideas and concepts shared. Concepts of mutual partnership ensured that the needs, perceptions and opinions of each person were considered, and no one person ruled over another, and no one person’s knowledge was considered more important than another’s. This needs to be a carefully negotiated approach that respects the role of senior Elders and Aboriginal consumers, yet also gives space for a range of voices and opinions to be heard. Rather than a step-by-step process following a set systematic (Western) formula, this process is based on mutual partnerships and respectful inclusion, discussion, disagreement and consensus making. This phase uses living knowledge to inform change, inviting participants and key stakeholders to work together to create an advanced, deeper level understanding and a practicable outcome.

Collaborative process led by HS and ACW

Emerging themes discussed with:

- Aboriginal Working Party

- Aboriginal consumer, MH-AOD & support service participants

- Wider CAN research team.

Confirm findings with participants in a CAN Aboriginal workshop involving

all participants and the wider Aboriginal community

Discuss findings with participants and community members in an open public forum for them to confirm, refute or agree upon, in order to come up with the most appropriate solutions to best meet the Aboriginal community’s MH-AOD needs.

Phase 4: Take action; a reflective cycle of consultation and action, which is repeated until a solution is reached [17]. This phase involves carrying out the agreed plan of action in a collaborative, systematic, logical and appropriate way, and critically reflecting on each step. The process of “trustworthy action” arises through participation-mutual consultation, collaboration and collective reflection towards the collaboratively-agreed goal [16].

Community report of findings.

Agreed recommendations for Aboriginal MH-AOD improvements and implementation in the local region