• Subject Name : Mental health

Introduction to Mental Health

The chosen health issue for the Indigenous people of Australia is mental health. The mental health of the Indigenous people is affected and there exists a significant health gap in the current status of these people as compared to non-indigenous people of Australia (Stone & Waldron, 2019). The current status of the Indigenous people of Australia is discussed in relevance to the mental health issue as there exists a health disparity among the Aboriginal and non- Aboriginal people of Australia. This essay describes the extent of mental health issue experienced by Indigenous Australians in the terms of epidemiology, health status indicators and the measures. It also aims to discuss the historic and contemporary reasons for this mental health issue gap between the Indigenous and non- indigenous population of Australia. The current health status of the “Aboriginal and Torres Strait Islander people” is analyzed in the context of their mental health which is addressed using literature. This essay will then identify Government/ non- Government health interventions that work towards closing the health gap in terms of mental health. The governmental interventions will describe the policies and rules for closing the gap and non- governmental interventions like the interventions from health care professionals such as health promotion strategies will be discussed.

Indigenous People and Their Mental Health

The Indigenous people of Australia are one amongst the world's primeval groups of highly disadvantaged people. They have their own culture and language that is significantly different from the non- Indigenous people of Australia. As compared with the white population of Australia, these people significantly mark health disparities that exist in Australia (Nasir et al., 2018). Mental health is one of the major contributors to the burden of disease in many countries, still, it is not well- addressed in the Indigenous population of Australia. According to the statistical data for year 2014- 2015, one in every three Indigenous people experienced a high level of psychological distress contributing to higher rates of mental health issue in them. Their markedly higher burden of disease is attributed to higher rates of non- communicable disease that includes serious mental disorders. In 2014- 2015, the National Aboriginal and Torres Strait Islander Social Survey was conducted by the Australian Bureau of Statistics which states that 29% of Indigenous people self- reported that they have a mental health complications and some of the common mental health disorders that are suffered by them are depression, panic disorder, specific phobia and generalized anxiety disorder (Armstrong et al., 2018).

They are also the victim of substance abuse at higher levels. There exist health gap that is health disparities in the terms of treatment, health care facilities and services that are available for them. Among the Aboriginal inmates, there are high rates of death by drug overdose and suicide that characterizes severe mental illness in these people. Most of the people among who are studied for the presence of mental health disorder, most of them were diagnosed with at least one mental health disorder that indicates high prevalence of mental health complications among Aboriginal communities (McGough, Wynaden& Wright, 2018). The mental health issue experienced by Aboriginal people is up to a high extent which marks them to be disadvantaged. The main cause of mental health disorder in the Aboriginal people are social determinants of health that are low education, low employment, poor housing and low financial status (McKenzie, Dell &Fornssler, 2016).

As per the study conducted, it was deduced that the Indigenous people who are sick or disabled in particular has a high prevalence of psychological distress that is around 51% of the Indigenous people had higher psychological distress. This can be linked with their disability or sickness in a way that the chronic illness or some other kind of disability draws them back from earning which makes them the victim of psychological disorder. This higher prevalence is also associated with limited physical function capacity in Aboriginal people. The contributor to elevated distress and psychological disorders are various social determinants of health which needs to be addressed by various interventions so that the health gap can be reduced (Black, MacDonald, Chambers & Ospina, 2019).

Historic and Contemporary Reason for Poor Mental Health

The mental health issue has been prevailing for a long time and has been a major health issue in the past also. The Indigenous people who are the first people of Australia have always been the most disadvantaged people from the past and currently, they are at the same level. Many historic and contemporary reasons for them being disadvantaged contribute to their affected mental health. There are social problems that exist in the Aboriginal communities those results in increased concerns with the issues of Aboriginal mental health. One of the main reasons for this low mental health status of Aboriginals is their health practices and the cultural context of their emotional experience (Lima et al., 2019). The existing health disparities between Indigenous population and non- Indigenous population of Australia leads to shorter life expectancy and it is also known that Australians engage themselves in the detrimental health risk behaviours and this is the main reason of them being disadvantaged in the health context. Various factors influence the health behaviour of the Indigenous people of Australia like their perceived behavioural control.

The social disruptions include their smoking and alcohol abuse addiction that causes them the victim of poor mental health. They have stress in daily life that is known to exacerbate the practice of health risk behaviour like tobacco smoking (Cianconi, Lesmana, Ventriglio&Janiri, 2019). The historic reasons also include social networks and their abnormal distinctiveness. There are various health behaviors that are known to affect the health of Indigenous people and these have been affecting their mental health from a very long time like their dietary habits, alcohol consumption and smoking. In history, they have faced a very strong cultural obligation towards their families like they were supposed to be the bread earners for their families which resulted in increased stress. The aspect of cultural preservation like maintaining their cultural identity has also led them to adopt risky health behaviour.

Few health care services are available for the indigenous population of Australia but these people do not have affordable and easy access to these health care services as a result of which their mental illness is not addressed (Tighe et al., 2017). These people also do not access such health care services because they most often face discrimination over there by the medical staff members which draws them back from accessing these services. They face difficulty in maintaining their cultural identity as a result of which they prefer not following their desire for cultural identity and inclusivity. As per the view of support workers who work in close association with the Indigenous people, these people feel the loss of identity, sense of hopelessness and disempowerment which makes them engage in unhealthy coping mechanisms of stress (Isaacs et al., 2017).

The Indigenous people of Australia have also faced traumatic events from the history like colonization and oppression and this continued to have a long-lasting effect on their mental health (Dudgeon, Watson & Holland, 2017). These historic events had a significant impact on the psychological and physical aspects of these people. The psychological effects also happened when they heard their history of suffering and also when they saw the places where events from the past have occurred and this perpetuated the impact of past. The contemporary reason that has continued to affect the psychological health of Indigenous people is racism and this systemic racism at the interpersonal level influences the decisions that are regarding human health behaviour. The health behaviour of not accessing health care services is also influenced by racism and other types of discrimination. There was one event from past which made them follow unhealthy health behaviour was that the non- Indigenous people occasionally used to provide unhealthy options that were made very accessible for them so that they can be influenced to leave the premises (Chmielowska& Fuhr, 2017).

They have always been surrounded by negative socio-economic factors such as economic hardship and unemployment and these are known to have influenced negative health behaviours that contribute to deteriorating mental health.

Thus, the contemporary reasons that cause mental health issue in Aboriginal people are overcrowding in housing, drug and alcohol consumption, tobacco smoking and unemployment (McHugh et al., 2016).

Government/ Non-Government Interventions

The Government of Australia has implemented several interventions to close the gap that is in the context of health disparities between Indigenous Australians and non- Indigenous Australians. “Close the Gap” is an Indigenous health campaign that aims to clear the health disparities in terms of mental health issue differences (Skerrett et al., 2018). Many Governmental actions have proved to be futile because they are not successfully addressed the mental health issues of Indigenous Australians and their emotional well- being. It aims to achieve the improved health status of Indigenous people of Australia by 2030 (Nasir et al., 2017). The Government of Australia has also invested in to deliver National Mental Health Reform which aims to deliver primary care to the Indigenous people of Australia and bring innovations in the mental health services.

It promotes person-centredd approaches to prevent mental illness and also focuses on early detection and interventions so that they can be best treated. These mental health services are made easily accessible for all the people of Australia and also aim to build strength and capacity in Aboriginal and Torres Strait Islander communities. Other Government interventions include implementation of the National Suicide Prevention Program that aims to support the people with mental illness in a way, so that suicide can be prevented (Dudgeon, Calma& Holland, 2017). In 2012- 2014, the Social and Emotional Wellbeing Program was also launched for the emotional well- being of people. The government has taken several interventions to help people with mental health issues. The Government of Australia is also supporting the culture of ATSI community as there is Indigenous Culture Supporting funding, the Indigenous Repatriation Program, and Indigenous Languages Support funding (Thompson, Talley & Kong, 2017).

The non- Government interventions include the interventions from the health care professionals like the GPs and the people who are non- Indigenous who works in association with these people. There is alcohol and substance abuse services that are made available for Indigenous people of Australia, health care services, psychiatrists, health care networks and welfare and housing agencies. These non- governmental agencies are also trying to establish external service partnerships so that the mental health issues of these people can be well addressed (Brady, 2018).The Indigenous people are also given referral of other allied life science professionals for the treatment and cure of their mental health. The mental health professionals are working hard to end the discrimination and also to provide mental health care services at affordable and easily accessible levels so that it can be accessed by them. The medical health professionals are also facing some potential barriers but their main focus in on the facilitators for the implementation of several mental health care services (Wohler &Dantas, 2017).

Conclusion on Mental Health Analysis of Indigenous People of Australia

The conclusion drawn is that the mental health status of Indigenous people of Australia is badly affected and there are many contemporary reasons for it. Some of these contemporary reasons include colonization and oppression which are faced by the Indigenous people. These people face discrimination and racism on a regular basis as a result of which they have stress and they face a lot of difficulty in living a normal life. The Indigenous people must address their mental health concerns along with them maintaining their cultural identity and their cultural preferences so that their dignity is maintained. There are various Governmental actions for “Closing the Gap” that addresses the health disparities that exists between Indigenous people of Australia and non- Indigenous people of Australia. There are some non- governmental interventions also that have been implemented for the favour of Indigenous people of Australia. The mental health issue is a prominent issue among the people of Australia and its prevalence is quite higher among the Indigenous people as compared to no- Indigenous people of Australia.

References for Mental Health Analysis of Indigenous People of Australia

Armstrong, G., Ironfield, N., Kelly, C. M., Dart, K., Arabena, K., Bond, K., &Jorm, A. F. (2018). Re-development of mental health first aid guidelines for supporting Aboriginal and Torres Strait Islanders who are experiencing suicidal thoughts and behaviour. BMC Psychiatry, 18(1), 228.

Black, K. A., MacDonald, I., Chambers, T., & Ospina, M. B. (2019). Postpartum mental health disorders in indigenous women: A systematic review and meta-analysis. Journal of Obstetrics and Gynaecology Canada, 41(10), 1470-1478.

Brady, M. (2018). Indigenous residential treatment programs for drug and alcohol problems: Current status and options for improvement. Canberra, ACT: Centre for Aboriginal Economic Policy Research (CAEPR), the Australian National University.

Chmielowska, M., & Fuhr, D. C. (2017). Intimate partner violence and mental ill-health among global populations of indigenous women: A systematic review. Social Psychiatry and Psychiatric Epidemiology, 52(6), 689-704.

Cianconi, P., Lesmana, C. B. J., Ventriglio, A., &Janiri, L. (2019). Mental health issues among indigenous communities and the role of traditional medicine. International Journal of Social Psychiatry, 65(4), 289-299.

Dudgeon, P., Calma, T., & Holland, C. (2017). The context and causes of the suicide of indigenous people in Australia. Journal of Indigenous Wellbeing, 2(2), 5-15.

Dudgeon, P., Watson, M., & Holland, C. (2017). Trauma in the Aboriginal and Torres Strait Islander Population. Australian Clinical Psychologist, 3(1), 1741.

Isaacs, A. N., Sutton, K., Hearn, S., Wanganeen, G., & Dudgeon, P. (2017). Health workers' views of help-seeking and suicide among aboriginal people in rural Victoria. Australian Journal of Rural Health, 25(3), 169-174.

Lima, F., Shepherd, C., Wong, J., O'Donnell, M., & Marriott, R. (2019). Trends in mental health-related contacts among mothers of Aboriginal children in Western Australia (1990–2013): a linked data population-based cohort study of over 40 000 children. BMJ Open, 9(7), e027733.

McGough, S., Wynaden, D., & Wright, M. (2018). Experience of providing cultural safety in mental health to Aboriginal patients: A grounded theory study. International Journal of Mental Health Nursing, 27(1), 204-213.

McHugh, C., Campbell, A., Chapman, M., &Balaratnasingam, S. (2016). Increasing Indigenous self-harm and suicide in the Kimberley: An audit of the 2005–2014 data. The Medical Journal of Australia, 205(1), 33.

McKenzie, H. A., Dell, C. A., &Fornssler, B. (2016). Understanding addictions among indigenous people through social determinants of health frameworks and strength-based approaches: A review of the research literature from 2013 to 2016. Current Addiction Reports, 3(4), 378-386.

McKenzie, H. A., Dell, C. A., &Fornssler, B. (2016). Understanding addictions among indigenous people through social determinants of health frameworks and strength-based approaches: A review of the research literature from 2013 to 2016. Current Addiction Reports, 3(4), 378-386.

Nasir, B. F., Toombs, M. R., Kondalsamy-Chennakesavan, S., Kisely, S., Gill, N. S., Black, E., ... & Nicholson, G. C. (2018). Common mental disorders among Indigenous people living in regional, remote and metropolitan Australia: a cross-sectional study. BMJ Open, 8(6), e020196.

Nasir, B., Kisely, S., Hides, L., Ranmuthugala, G., Brennan-Olsen, S., Nicholson, G. C., &Toombs, M. (2017). Pathways to prevention: Closing the gap in Indigenous suicide intervention pathways.

Skerrett, D. M., Gibson, M., Darwin, L., Lewis, S., Rallah, R., & De Leo, D. (2018). Closing the gap in Aboriginal and Torres Strait Islander youth suicide: A social-emotional wellbeing service innovation project. Australian Psychologist, 53(1), 13-22.

Stone, L., & Waldron, R. (2019). Great expectations and e-mental health:'The role of literacy in mediating access to mental healthcare'. Australian Journal of General Practice, 48(7), 474.

Thompson, G., Talley, N. J., & Kong, K. M. (2017). The health of Indigenous Australians. The Medical Journal of Australia, 207(1), 19-20.

Tighe, J., Shand, F., Ridani, R., Mackinnon, A., De La Mata, N., & Christensen, H. (2017). Ibobbly mobile health intervention for suicide prevention in Australian Indigenous youth: A pilot randomised controlled trial. BMJ Open, 7(1).

Wohler, Y., &Dantas, J. A. (2017). Barriers accessing mental health services among culturally and linguistically diverse (CALD) immigrant women in Australia: Policy implications. Journal of Immigrant and Minority Health, 19(3), 697-701.

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