Australia's First People - Their Social and Emotional Well-being
July 31st 2010 04:40
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Aboriginal and Torres Strait Islander Australians make up 2.5 per cent of the Australian population and continue to suffer disproportionately from the consequences of European settlement. The life expectancy for Indigenous Australians is 10 years lower than that of other Australians; the death rates for Indigenous people are twice as high across all age groups; and intentional self-harm was the leading cause of death from external causes for Indigenous males between 2001 and 2005.1 Although definitive national data about the incidence and prevalence of mental health disorders among Aboriginal and Torres Strait Islander Australians is not available, it is clear there are enormous disparities in mental health outcomes for Indigenous people.
The small, dispersed nature of Aboriginal and Torres Strait Islander populations and communities, the lack of infrastructure required to establish and maintain health and well-being in remote communities, the extra-ordinarily high levels of morbidity and mortality, the extreme poverty and disadvantage all pose major challenges to mental health service delivery.
A series of extensive and expensive national enquiries and consultations between 1987 and 1995 reported considerable consensus among a range of Aboriginal and Torres Strait Islander people and organizations on several core issues. One is that many mental health professionals have little understanding of Indigenous Australian history, culture, and society, resulting in frequent misdiagnosis and inappropriate treatment. Another is that there is a high level of unmet need for social, emotional, and mental health support. Also Aboriginal and Torres Strait Islander people perceived mainstream mental health services to be failing them.2
INDIGENOUS CONCEPTS OF SOCIAL AND EMOTIONAL WELL-BEING
Aboriginal and Torres Strait Islander people have drawn an important distinction between the concepts of social and emotional well-being, and non-Indigenous concepts of mental health. According to the Social Health Reference Group, convened by the Australian Government:
“The concept of mental health comes more from an illness or clinical perspective and its focus is more on the individual and their level of functioning in their environment. The social and emotional well-being concept is broader than this and recognizes the importance of connection to land, culture, spirituality, ancestry, family and community, and how these affect the individual.” 3
Mental health and mental illness are seen to come under the umbrella of the broader concept of social and emotional well-being in Indigenous contexts—just one part of a more holistic view of health and well-being. Aboriginal and Torres Strait Islander people maintain that the determinants of contemporary social and emotional well-being have their roots in colonial history and an ongoing disadvantage involving widespread grief, loss, racism, discrimination, adversity, and the transgenerational aftermath of government policies which supported the forcible removal of thousands of Aboriginal children from their parents up until 1970.4
The need to find a way to measure the social and emotional well-being of Indigenous Australians resulted in the development of an interim module of social and emotional well-being, used for the first time in the 2004/05 National Aboriginal and Torres Strait Islander Health Survey. The results indicated that 27 per cent of Indigenous respondents reported serious psychological distress, and were twice as likely as non-Indigenous Australians to report this.5 As well as being an indicator of poor social and emotional well-being, an emerging body of evidence suggests that serious psychological distress forms part of the causal pathway to the proportion of sickness in an Indigenous locality and mortality risk.6 Modifying the social determinants that lead to serious psychological distress should therefore result in a range of beneficial health outcomes
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