Journal Article

Socio-spatial inequalities in accessibility of Indigenous community-controlled mental health services in South East Queensland, Australia

Liu, Yan, Jin, Lu, Zhou, Xiaoyun, Suetani, Shuichi, Zhang, Lihong, Diminic, Sandra, Bainbridge, Roxanne, Hou, Xiang-Yu, Nelson, Carmel

2025

Overview

Background Mental disorders significantly burden Indigenous communities, worsened by limited culturally appropriate services. Spatial inequalities in access further disadvantage Indigenous peoples, especially in socio-economically challenged areas. This paper measures the spatial accessibility of Indigenous community-controlled mental health services in South East Queensland, Australia and examines its social inequalities across the region. Methods We considered both population and health service providers’ capacity to maximise service coverage in measuring potential access to the services. Using Geographical Information Systems (GIS) technologies, a Gaussian-based two-step floating catchment area (G2SFCA) method was applied to quantify accessibility under four driving time thresholds ranging from 15 to 60 minutes. Bivariate global and local Moran’s I statistics were used to analyse social inequalities in accessibility across various geographical areas. Results Accessibility was higher in urban areas than those towards the peri-urban and rural areas; the overall spatial coverage was relatively limited for service access within the 15- or 30-minute driving time threshold, compared with the 45- or 60-minute driving time threshold. Lower levels of accessibility were identified in areas with a concentration of Indigenous and socio-economically disadvantaged populations. Conclusions This study advances a socially informed spatial inequality assessment framework. Unlike previous research exploring accessibility qualitatively, our framework innovatively integrates spatial analysis, Indigenous-specific population data and culturally sensitive provider capacity metrics within an advanced G2SFCA model. This approach uniquely exposes the compounded socio-spatial barriers to mental health services for Indigenous populations across South East Queensland’s urban-rural continuum. The resulting accessibility and inequality maps, combined with a summary of focus areas and their associated socio-demographic profiles, provide a direct policy lever to prioritise intervention for Indigenous communities experiencing the greatest disadvantage. By bridging spatial analysis with Indigenous cultural contexts, this work offers a replicable model for equitable, community-driven healthcare resource allocation for Indigenous peoples globally.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Accessibility / At risk populations / Australian aborigines / Bivariate analysis / Catchment areas / Community Mental Health Services - statistics & numerical data / Community psychiatric services / Demographic aspects / Distribution / Epidemiology / Geographic Information Systems / Health aspects / Health care access / Health care disparities / Health disparities / Health Informatics / Health Promotion and Disease Prevention / Health services / Health Services Accessibility - economics / Health Services Accessibility - statistics & numerical data / Health Services, Indigenous / Healthcare Disparities - ethnology / Human Geography / Humans / Indigenous health / Indigenous peoples / Low income groups / Male / Medical Geography / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Mental disorders / Mental health / Mental health care / Mental Health Services / Native peoples / Older people / Population / Population studies / Populations / Psychological aspects / Public Health / Queensland - epidemiology / Queensland - ethnology / Remote sensing / Resource allocation / Rural areas / Social aspects / Socio-spatial inequality / Socioeconomic Factors / South East Queensland / Spatial analysis / Statistical analysis / Urban areas / Workforce planning