First Nations people need mental health services but it’s the right type of services that are making a difference.
Research has shown that First Nations people are more likely to suffer from poorer health outcomes than non-First Nations people in Australia. Poor mental health can contribute to poor physical health and sometimes, a shortened life expectancy. Poor physical health can also have an adverse impact on mental health. Providing a holistic perspective on mental and physical health is important to improving these outcomes within our community.
Mental Health Statistics of First Nations People
First Nations people are more likely to suffer from poor mental health than non-First Nations people in Australia. They’re more likely to be impacted by trauma, grief, stress related to housing, physical illness and cultural disconnection.
A self-reported survey in 2018-19 found an estimated 24% of First Nations people reported a diagnosed mental health or behavioural condition. Almost three in 10 (31%) indicated a ‘high’ or ‘very high’ level of psychological distress.
Mental health is responsible for 10% of the health gap between r people and non-Indigenous people. In 2015, the suicide rate for First Nations people was double that of the general population in Australia.
The Australian Burden of Disease Study: impact and causes of illness and death in Aboriginal and Torres Strait Islander people 2018 found that for every 1,000 people, 289 years of healthy life were lost due to ill-health and premature death. One of the leading five disease groups contributing to the loss is mental and substance use disorders which include anxiety, depression and drug use.
While social and mental well-being isn’t the same as mental health, the two interact and influence each other, especially within First Nations people.
How to Improve Mental Health for First Nations People
It’s important that the organisations and individuals that deliver mental health services to First Nations people understand that their patients’ complex needs require a holistic approach to service delivery.
Culturally appropriate
Mental health services that are designed for the general population don’t meet the requirements of First Nations people.
Mental health services can’t be the same for everyone. Views of mental health and social and emotional well-being amongst First Nations people are different to non-First Nations people. In some First Nations cultures, aunties, uncles and grandmothers care for individuals who are sick or in need of care. For example, in this case, it may be more important to talk to a patient’s grandmother or aunty rather than their mother.
Programs that show promising results are those that encourage reconnection with country, culture, community life and self-determination. It’s not enough to just focus on the individual without taking into account their family, culture and community. The mental health service needs to take into account the values, lifestyle, and complex economic and social circumstances some First Nations people find themselves in.
This may mean taking individuals outside, and being on country outdoors. It also means thinking outside the box, self-disclosing more than usual, doing cultural games or promoting a yarning style of communication.
Mental health services may need to start taking authority anxiety into consideration. A newly developing concept, authority anxiety is described as a fear of those in a perceived state of power. This is thought to have stemmed from the intergenerational trauma experienced by First Nations people and it may cause barriers when accessing services and developing therapeutic alliances.
Accessibility to Services
Many First Nations people live in rural and remote areas where there are no mental health services. Even gaining a referral and a mental health treatment plan from a GP is difficult due to a lack of doctors. Mental health services may be provided via a regular fly-in fly-out provider or via a telehealth video appointment. A long-term view is needed, not a short-term fix. Sustainable services are required to ensure patients have ongoing care.
When a care provider arrives in a First Nations community, they need a local person to provide introductions and help break down cultural barriers. First Nations organisations and service providers are often small organisations. They have the cultural connection and understanding of their patients but lack the resources of a large organisation. By partnering with Altius Group, we’ve been able to provide the support the service providers need to provide the best level of care to their patients. At Altius, we are also fortunate to have First Nations staff that promote accessibility for our First Nations clients, with many clients commenting on how much more beneficial sessions with a First Nations psychologist have been.
Access to Technology
Young First Nations people may not be able to access web-based or telephone helpline services as readily as a non-First Nations person may. Making services available to First Nations people is one of the first considerations. For example, a radio ad about mental health during the pandemic was translated into 15 First Nations languages.
Referrals
Individuals providing mental health support need to be able to provide referrals to other services for the needed holistic approach. Other services may include substance abuse, housing support, domestic violence and suicide prevention. Access to these services will complement and support the mental health service.
Lifestages
Mental health services are required for First Nations children younger than non-First Nations children, as they often experience trauma and grief at a much younger age.
The median age at death for suicide amongst First Nations people was 29.5 years in 2017 compared to 45.4 years in the non-First Nations population in 2017. Suicide is the leading cause of death for First Nations children aged between five and 17. The same resources and advice can’t be used for both populations because they are at different life stages. Life in Mind is an online knowledge exchange portal connecting Australian suicide prevention sectors with evidence, policy, data and resources to advance suicide prevention practice in Australia.
While there are many areas of concern when it comes to mental health throughout First Nations communities, Altius Group is committed to working with First Nations organisations and services to provide access to a range of psychological programs and make a difference to lives all over Australia. Contact us online or call 1800 258 487 for more information.
Author: Rebecca Caratti
Proud Yamatji Woman | Provisional Psychologist
