The National Mental Health Consumer and Carer Forum acknowledges the Traditional Owners of lands and waters throughout Australia and pays respect to Elders both past and present. We recognise the importance of continued connection to culture, country and community to the health and social and emotional wellbeing of Aboriginal and Torres Strait Islander people.
We also acknowledge that Aboriginal and Torres Strait Island people come from a number of language groups across Australia. This paper addresses the ideas about mental health that Aboriginal and Torres Strait Island people have in common across the country.
Aboriginal and Torres Strait Island people and their communities prefer the term social and emotional wellbeing to mental health, as it reflects a more positive and holistic approach. This is because Aboriginal and Torres Strait Island people have traditionally viewed health as including not only the physical and mental health of the individual, but also the social, emotional and spiritual wellbeing of the whole community.
Research has shown that the social and emotional wellbeing of Aboriginal and Torres Strait Islander people has been severely impacted by a number of historical events arising from colonisation. These include relocation of Indigenous people to missions and reserves, loss of country, cultural practice and language and the grief and trauma resulting from the removal of children. Trauma has been shown, in many cases, to affect many generations. Combined with a
European-centric mainstream culture, ongoing racism and continued socioeconomic disadvantage, it is not difficult to understand that ‘there is a significant and growing gap between mental health and related outcomes reported for Aboriginal and Torres Strait Island peoples and non-Indigenous people in Australia.”
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Community-based approaches to mental health care are required, which are culturally appropriate and that prioritise prevention and health promotion.
In their paper, Six Steps to Closing the Indigenous Mental Health Gap, the National Aboriginal and Torres Strait Islander Leadership in Mental Health (NATSILMH)” has stated that closing the mental health gap requires the re-thinking of conventional models and assumptions across the mental health system pointing out two main areas of importance:
- Identity and culture, and culturally determined relationships to land, family, kin and community are great sources of mental health and resilience to Indigenous Australians (referred to as `social and emotional wellbeing’ or SEWB).
- Disempowerment, cultural losses, racism, and the continuing, stressful impact of entrenched poverty and disadvantage adversely impact on Indigenous social and emotional wellbeing.
Recommendations made by Aboriginal and Torres Strait Island people should inform further actions. The Gayaa Dhuwi (Proud Spirit) Declaration on Aboriginal and Torres Strait Islander leadership” across all parts of the Australian mental health system provides guidance to achieve the highest attainable standard of mental health and suicide prevention outcomes for Aboriginal and Torres Strait Island peoples. It includes position statements to guide the work of mental health services providers. These include:
- A focus on the strength and resilience of Aboriginal and Torres Strait Islander young people, and their families and communities, is essential. There are critical strengths in Aboriginal and Torres Strait Islander communities that should be acknowledged and supported; these include kinship, family and community, spirituality, and culture and cultural identity.
- Young people from Aboriginal and Torres Strait Islander backgrounds are a growing demographic in Australia and their needs should be recognised and prioritised.
- Racism, marginalisation, social disadvantage, and physical and social isolation are all determinants of social exclusion for Aboriginal and Torres Strait Islander Australians. Those that are socially excluded are at a greater risk of developing mental health problems and disorders, substance misuse and suicide.
- Cultural awareness, competence and safety are essential skills for health service providers.
- Community-based approaches to mental health care are required, which are culturally appropriate and that prioritise prevention and health promotion.
- Ongoing partnerships between Aboriginal and Torres Strait Islander Australians and their communities, health and mental health services, and federal and state governments are required to develop a collaborative and coordinated responsive mental health system that is inclusive, equitable and effective.
- Greater collaborative and participatory research effort is needed to better understand the social and emotional wellbeing of Aboriginal and Torres Strait Islander young Australians and the factors that impact on this.
As mental health consumer and carer advocates in Australia we should also as individuals make sure that we are aware of the perspectives and understandings of Aboriginal and Torres Strait Island people, recognising that we all have much to learn from each other.
This document has been developed in consultation with Richard Fejo, Chairman, Larrakia Nation Aboriginal Corporation, Co-Chair, National Cultural Educators and Cultural Mentors Network.
i Pat Dudgeon, Tom Calma Christopher Holland (2015), Future Directions in Aboriginal and Torres Strait Islander Social and Emotional Wellbeing, Mental Health and Related Areas Policy, p. 1, http://natsilmh.org.au/resources
ii National Aboriginal and Torres Strait Islander Leadership in Mental Health (NATSILMH), Six Steps to Closing the Indigenous Mental Health Gap, p. 1, http://www.indigenouspsychology.com.au/Assets/Files/6steps.pdf
iii The Gayaa Dhuwi (Proud Spirit) Declaration http://natsilmh.org.au./sites/default/files/WEB_gayaa_dhuwi_declaration_A4-2.pdf
This paper was originally published in the National Mental Health Consumer & Carer Forum and is republished here with their permission.