Indigenous Australians' Mental Health Issues - Literature review Example

INDIGENOUS AUSTRALIANS AND MENTAL HEALTH ISSUES [Insert name] September 13, 2013 INDIGENOUS AUSTRALIANS AND MENTAL HEALTH ISSUES Introduction Mental illness was present in indigenous Australians prior to European colonization but it was fairly a rare occurrence. Currently, there is much prevalence of mental illness in the Torres Strait islander and Aboriginal population which is a reflection of the disruption of the indigenous Australians society and has a strong context of emotional and social deprivation. Management of the issues of mental illness in Torres Strait and Aboriginal society needs strong emphasis on cultural safety in addition to recognition of the culture, community and family in the healing process. This report will explore the impact on the individual, population, implications for the role of the nurse and a conclusion. Impact of mental illness on an individual According to Farrell, & Carr (1996, p.77) individuals suffering from mental illness or psychological disorder are at greater risk of not only poverty and lowered productivity but also educational difficulties, social problems, other health problems, vulnerability to abuse and decreased quality of life. It is evident that for the likelihood of education being compromised on the early onset of mental illness is high and as a result affected individuals are unable to either complete their education or successfully pursue their careers. Hunter (1997, p. 820) in his study found that individuals suffering from any form of mental illness were significantly less likely to enter college, receive college degree or complete high school as compared to their peers not suffering from any mental disorder. Consequently, mental illness can contribute to lower productivity as a result of unemployment, reduced work productivity and missed work (Farrell, & Carr, 1996, p.77). A study carried out in 2001 among indigenous Australian indicated that five to six million indigenous Australian workers aged between 15 to 54 years fail to seek or cannot find any form of employment due to mental illness. However, of the mentally ill individuals who were in active employment, the condition reduced their annual income by approximately $ 3000 to $6000. Hence, decreased employment and reduced earning among mentally ill people place them at increased risk of poverty. As Farrell, & Carr (1996, p.78) explain in their study, poverty and mental illness do interact in a negative cycle whereby poverty acts as a risk factor for individual mental illness, at the same time mental illness increasing the risk that individuals will either drift or remain in poverty. Mental illness can also result into other health problems. For example, patients suffering from comorbid depression are most likely to adhere to medical treatment regimens compared to non-depressed patients. Consequently, mentally ill individuals are vulnerable to human rights violation, abuse, low-quality care, especially in low-income areas that have limited mental care resources. Impact on the family The responsibility of caring for mentally ill individuals always falls on the immediate family or relatives. According to Ring & Brown (2003, p. 404) caregivers and families of mentally ill individuals in most cases are unable to work at a full capacity as a result of demands of the mentally ill individual, an aspect that results into reduced household income and decreased economic output. The mentioned makes the family to be at a risk of poverty. Additionally, the family members may experience chronic stress as a result of physical and emotional challenges associated with caring for a mental ill family member. Even though experience of caring for mentally ill individuals among cultures and families varies, Farrell, & Carr (1996, p.77) points out that the biggest challenge families face is provision of assistance on a daily basis such as offering financial assistance, cleaning, transportation, housework, and money management among others. The caregivers further experienced social isolation as caregiving duties deterred them from attending social functions such as parties, church services, funerals and weddings among others. Mentally ill people in most cases are unable to express their needs an aspect that causes emotional and psychological distress to the caregivers. This makes the families to be unable to understand the mentally ill individual particularly when he/she has problems. Caring for mentally ill individuals was found to be associated with a number of social challenges. Caring responsibilities, stigma and social services are some of the areas that affect families. Most parents experience inadequate social services such as hospital care and education for people with mental disorders. Indigenous Australians spent a lot of time looking for schools and colleges which can admit individuals who are mental ill (Farrell, & Carr, 1996, p.79). Impact of mental health on society It is important to note that certain societal impacts of mental illness varies among nations and cultures, untreated mental disorders has significant costs to the society. According to 2001 WHO report, developed countries spend approximately 4% of their gross national product on mental health problems. However, if the loss of productivity and mental illness expenditures are taken into account, then according to WHO, mental health problems cost national economies billions of dollars yearly (WHO, 2002). Additionally, mental illness can exacerbate other public health issues in the society an aspect that is likely to increase burden on impending international health efforts as well as national economies. For instance in 2001, approximately five to ten people all over the worldwide used intravenous drugs and about 10% of new HIV infections were due the drug transmission. Consequently, mental illness is linked to increased risks particularly of non-adherence to medical regimens for other existing health conditions. For infectious diseases, incomplete or improper use of medication can result to drug resistance, an aspect that may have significant public health implications globally. Moreover, mental depression such as maternal depression may put the infants at the risk of childhood health problems, incomplete immunization and low birth weight among others which are high risk factors to childhood mortality (WHO, 2002). Implications for the role of the nurse Due to the fact that nurses have more contact with mentally ill patients compared to other health care providers, they play significant role in detection of not only problem behaviors but also concurrent mental illness. Additionally, nurses do have close relationship with their patients, they are the major source of encouragement for proper physical activity and self-care. The nurses should focus on physical activity, because studies have proven that physical activity is of great necessity, because it lowers the levels of anxiety and depression (Ring & Brown, 2003, p. 407). Changes in the field of mental health have significant effects on the nurses. In handling the impacts of mental health on an individual, it is important for a nurse to provide front-line treatment in addition to negotiating different service providers with an aim of mediating the interests of the families, the patients and the society as a whole (Ring & Brown, 2003, p. 407). Additionally, nurses focus on providing support to the family members and the caregivers who are close to burning out as a result of taking care of a mentally ill person. Additionally, the experience of the nurses enable them to be strong advocates for additional community services for the mentally ill because they are usually the eye witnesses of the existing gaps in the system. Furthermore, nurses working in the public health system may play important role in not only preventing but also identifying individuals with mental illness. Consequently, it is important for nurses to value the lived experiences of the mentally ill people, the caregivers and their families (Pink & Allbon, 2008, p. 50). The mentioned will be essential in dealing with any form of associated stigma. The nurse should also have the dignity for the individual who is mentally ill. It is important for the nurses to establish a network of support for indigenous Australians is a very essential step in assisting them in resolving their mental health problems, particularly if access to mental health or professional services are limited. In order to assist the individual, the nurse should also try to support the family members of the mentally ill person and in doing so, confidentiality need to be maintained. Nurses can also be supportive to the mentally ill individual and their families by building personal relationship with them so that they can develop trust and respect (Ring & Brown, 2003, p. 405). Consequently, Pink & Allbon, (2008, p. 50) the nurse as an educator in dealing with impacts of mental illness on an individual, the family and the society as a whole. Ring & Brown (2003, p. 406) nurses have the role of facilitating empowerment of the indigenous Australian population. Hence, as an educator, the nurse will provide education to the affected families and the society as a whole on mental health issues in a variety of formats for the populations, the families and the individuals. Additionally, the nurses should use the principles of child and adult learning that is appropriate for the indigenous groups in handling mental health issues. According to Ring & Brown (2003, p. 404) there is huge performance particularly in regard to provision of services as well as a legitimate gap in terms of security and performance gap which makes it challenging for nurses to adequately meet the needs of mentally ill people and their families. Similarly, the same situation may face aboriginal and Torres islander people who are mentally ill and live in towns and cities whereby they tend to be more marginalized and poor than their non-indigenous counterparts, an aspect that makes it challenging for them to access quality medical services. Hence, it is essential to have an appropriate clinical response in place for the majority of the indigenous Australians suffering from mental illness particularly in remote Australian and hence nurses need to appreciate the community as they tackle the challenges the community, families and individuals face in dealing with mental illness. Pink & Allbon, (2008, p. 57) in successful management of the individual who is mentally ill, it is important for the nurses and the family of the individual suffering from mental illness to interact within a primary health setting. According to Milroy, Milroy, Parker, & Phillips, (2003, p. 50) it is important to have a variety of ways that nurses can work with the families of the mental ill people. Hence, it is important for the nurses within the primary health care setting should clarify the mutual goals and not force the families to fit in specific models so as to ensure that diversity of the indigenous people social issues and culture is encompassed. Additionally, the nurses as therapists should acknowledge their weaknesses while working with the indigenous people and work with the affected family as a team so that they do not feel the burden of taking care of a mentally ill person as well as pointing out the family strengths. The nurses should also learn to respond to the intense feeling of the family and encourage family enrichment with an aim of fulfilling their own needs in the context of care for the affected person. The nurse should also provide information about the illness as well as the therapies. The nurses should also provide practical advice not only to the affected families but also to the community for example information on the community resources. It is important for the nurses to encourage family involvement in support and advocacy groups so as to avoid social isolation. In handling mental illness among the indigenous people, it is important for the nurses to acknowledge a diversity of beliefs as well as making personal commitment to the issues at hand (Pink & Allbon, 2008, p. 67). However, nurses can play an important role in lowering the burden and the prevalence of mental disorders via broadening the scope of care and ensuring consumer empowerment as well as reducing the stigma and discrimination within the hospital settings. The mentioned will contribute to reducing and addressing the impact of mental illness on individuals, families and the society as a whole. Conclusion From this report it is evident that indigenous Australians suffer from mental illness and this impacts on the lives of individuals, families and the community as a whole. Families and caregivers of the mentally ill suffer from stigma and social isolation in addition to economic setback. On the other hand, individuals who are mentally ill are incapable of completing their education or pursuing their careers. Nurses has a great rule to play in handling mentally ill individuals, their families and the society as a whole within a primary health care setting taking into consideration the social, political, psychological, economic and cultural impacts of mental illness among the indigenous people. References Farrell, G. A. & Carr, J. M. 1996, ‘Who Cares for the Mentally Ill? Theory and Practice Hours with a Mental Health Focus in Nursing Curricula in Australian Universities’, Australian & New Zealand Journal of Mental Health Nursing,5,77-83. Hunter, E. (1997). Double talk: Changing and conflicting constructions of Indigenous mental health. Australian and New Zealand Journal of Psychiatry, 31, 820–27. Milroy, H., Milroy, J., Parker, R., & Phillips, N. (2003). Aboriginal and Torres Strait Islander mental health. Educational Unit for the PCP course offered by the NSW Institute of Psychiatry. Pink, B., & Allbon, P. (2008). The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples. ABS Cat. No. 4704.0. Canberra: Australian Bureau of Statistics. Ring, I., & Brown, N. (2003). The health status of Indigenous peoples and others. BMJ, 327, 404–05. World Health Organization [WHO] 2002.. The world health report 2002: reducing risks, promoting healthy life style. Geneva: World Health Organization. Read More