Brains of the Desert
Improving Indigenous mental health motivates the work, and the growing cult, of Central Australia’s Dr Kylie Dingwall.
It’s 5pm sharp at the Centre for Remote Health in Alice Springs. Neat lines of wine glasses, four rows deep, are arranged on a table like a mini military march – parading its way towards Christmas.
Green and red decorations dot the room. Undisturbed snack plates, fanned with crackers and cheese, announce the time: party o’clock.
Slowly, researchers start to emerge from their burrows, greeting each other with nods. Fifteen minutes later the Centre hums with keen chatter and the chinking of glasses.
But there’s someone missing.
"Where’s, Kylie?” I’m asked at least a dozen times. “Oh, she’s on her way,” I reply. Partygoers peep over my shoulder, waiting for her entrance.
The year is 2011. That November I’d worked as a volunteer research assistant with the Menzies School Health Research’s Dr Kylie Dingwall, a mental health and neuroscience specialist.
It didn’t take long for me to pick up on the fact she’s somewhat of a celebrity among the Alice Springs health fraternity.
Some of this attention owes to her approachable, gentle and unassuming manner. With her bobbing head of ringlets, dark-rimmed specs and colourful skirts, I’d guess she’s an ABC Triple JJJ presenter before placing her as an Indigenous mental health researcher.
But it’s this very specialty that has gained her the respect and attention of others in her town, and indeed in her field.
Central Australia is a region in which mental health problems have a high profile – owing to a legacy of substance abuse and associated brain damage.
A quarter of its population is Indigenous, and according to 2008 figures from the Australian Bureau of Statistics, this group is between three and five times more likely to be hospitalised for a substance abuse-related mental disorders than are non-Indigenous people.
Further, a national report suggests that mental health disorders are the second largest contributor to total disease burden for Indigenous Australians.
“We urgently need mental health strategies and therapies tailored for our Indigenous population,” a remote area nurse tells me. “We have vastly different cultural and health challenges than those experienced by the rest of Australia.”
As Kylie makes an appearance at the party, I notice a local psychologist make a beeline towards the young academic.
The psychologist asks about Kylie’s latest study, an investigation into brain function assessment tools for Indigenous people in the Northern Territory.
“Finally! We need culturally-relevant tests,” she says, echoing the nurse’s sentiments. “Language is a huge barrier for our clients, for one.” The women talk animatedly.
I later catch up with the psychologist myself.
“We’re often required to make official judgments on the extent to which an Indigenous patient has cognitive damage – whether the diagnosis is for Centrelink or for the courts,” she says.
“But we don’t have adequate tools. Most brain damage tests have been developed with the mainstream population in mind.
“These assume proficiency in English, as well as a whole host of other abilities. They don’t take into account the different ways in which Indigenous people communicate and interact with the world.
She continues: “That’s why Kylie’s research is so important. She’s looking into how fair the current tests are, and she’s recording ways in which health workers and psychologists adapt their testing techniques to make them more suitable for Indigenous people.”
As the party progresses, I see more researchers and health workers approach Kylie, inquiring about her work and when the results will be available.
Later, she explains why she views this research as critical.
“I want to make inroads in this area to ensure that Indigenous people with cognitive impairments are not further disadvantaged through misdiagnosis; through inability to recognise impairment; or through inability to access appropriate services because they’ve received a poor assessment of brain function.”
Fast forward to 2013 and Dr Dingwall has since finished phase one of her study. The results were published in the January edition of BMC Psychiatry.
Having now captured ideas on how to improve cognitive assessment tools, she’s looking to develop a new, culturally-appropriate brain function test.
This body of works links back to her PhD studies, completed through Menzies in 2010, supervised by neuroscientist, Dr Sheree Cairney.
Based on Cairney’s earlier work, Kylie’s PhD involved an examination into petrol sniffing and its effects on the brain.
Conveniently, in 2005 she had already relocated to Alice Springs – where her petrol sniffing research would be based – for a role with the Northern Territory Government’s Family and Community Services Department.
“The experience opened my eyes to the extent of the disadvantage some of our population endure. I wanted to learn more and hopefully contribute to making a difference in people’s wellbeing.”
Once she’d become an Central Australian local, it didn’t take long for her to fall in love with the surrounds.
“When the sun sets on the ranges it’s just beautiful how the colours change. I admire the view every time I walk or drive past. I love the big blue skies and how the place just springs to life after a bit of rain.”
She doesn’t mind getting her hands dirty either, last year Dr Dingwall joined her partner as a navigator in the Finke Desert Race, an off-road, multi-terrain two day race for buggies, cars and quads through the desert country south of Alice Springs.
“Unfortunately, we didn’t get to finish the race. We broke a shocky shaft 15km out of Alice on the way down to Finke; and fixed that but then we had fuel issues, followed by problems with our diff so we were out of time. It was very fun while it was going and was very dusty and bumpy, but I can’t wait to do it again.”
Though she misses the beach, and her family who live in Brisbane, Dr Dingwall remains passionate about her work with Menzies.
As well as her cognitive assessment project, she’s investigating whether replenishing the nutrient thiamine (Vitamin B1) can aid the brain’s repair process among thiamine deficient, alcohol-dependent patients.
Similarly, she’s working with Associate Professor Tricia Nagel – as well with Aboriginal and Torres Strait Islander people – to develop iPad-based mental health and substance abuse interventions.
She says the interventions are aimed specifically at Indigenous people and will offer a cost effective way to deliver evidence-based mental health treatments in remote locations.
“Kylie’s a different kind of researcher,” I recall the local psychologist telling me, as coloured light from Alice Springs’ famous sunsets streamed through the windows, marking the tail-end of the party.
“She listens to what we, the people who are working in the mental health field, have to say, and she crafts research based on the solutions we’re crying out for. She’s a real collaborator.”
It’s then that I better understand the buzz surrounding the researcher – the reason why her presence is so keenly anticipated at this Alice Springs gathering.
It comes from the trust and belief that what people say to her is truly listened to; and beyond that, that sharing ideas with her adds to a swell of genuine action.
“Service providers often don’t have time to do research. But they often have great ideas and a desire for research and evidence upon which to base their practice,” Dr Dingwall says.
“By working together, mental health researchers can help develop the most effective services offered to people at risk.
“My ambition is to pool together these insights and use them to enhance treatments, and in turn, improve lives.”