Social and Emotional Wellbeing of Aboriginal Australians - Literature review Example

Running Title: Social and Emotional Wellbeing of Aboriginal Australians Student’s Name: Instructor’s Name: Course and Course Code: University: Date Assignment is due: Social and Emotional Wellbeing of Aboriginal Australians Introduction Social and emotional wellbeing as a concept of health care underpins the attainment of mental health in the society for a particular group of people within an identified jurisdiction. For the purposes of this short essay, the focus is placed on the Aboriginal Australians whose holistic healthcare has gained an increasing significance in the debate platforms of Australian national and regional health care provision (AIHW, 2009). This group raises interest because of having significant levels of marginalization and having not shared from the improved health programs that Australia in general has effected in the last two decades (AIHW, 2009). Important to this essay is the informed assumption that mental health is a product or is the outcome of many other social factors impacting on the social and emotional dynamics of an individual, with factors like life stressors, discrimination, family structure harmony, cultural identification and access to public health care facilities, etc, having a profound impact on the outcomes of social and emotional wellbeing of the Aboriginals. Aboriginal and Islander Australians today constitute over 2.5% of the general Australian population. Being a minority, the aboriginals today continue to live a life of discrimination, marginalization and suffering, with disproportionate consequences originating from the European settlement that forever invaded their traditional social setup (SCRGSP, 2007). The Indigenous Australians have a life expectancy that is ten years lower than the national average life expectancy level of Australians. Death rate for aboriginals is twice as high in all the age groups as compared to other Australians. Although any definitive data on incidences and or prevalence of any mental health disorders existing or noted with Aboriginal Australians is as yet limited, the health care outcomes and surveys of the enormous disparities in the level of mental health outcomes for aboriginals is apparent. The author is particularly interested in the social and emotional health of the Aboriginal Australians because, until recently, majority of the national data available on the social/emotional wellbeing of the Aboriginal Australians has been primarily centred on mental health services and practices. Some pertinent domains of social health and emotional well being that are interlinked with mental health include life stressors, psychological distress, economic wellbeing, life stressors, anger, discrimination and national identity, sense of belonging, cultural identification and stability of the natural family unit. All these factors need to be included in contemporary research as part of any analysis to the social and emotional wellbeing of the aboriginal Australians, since they determine, influence and impact on the mental health of the individuals to a very large extent. This essay explores concerns and attempts to contextualize the dynamics of social and emotional health of the Aboriginals in this community to the mental health practices intent on recommending the best critical social work approach that can work better with this community in future. Mental Health Issues in Context The dispersed and small population size of Aboriginal Australians and the undeveloped communities, in which they are to be found, are important consideration (SCRGSP, 2007). The fact that they are a minute part of the population and that they are located in isolated locations perhaps explains why their health in general is not at par with that of the average Australian. For one, the areas in which they live lack even the basic infrastructure that is required so as to establish, provide and maintain proper healthcare (SCRGSP, 2007). Consequently, the health and well-being of the remote communities is therefore left to unprofessional and non-conventional methods, nurturing the extra-ordinarily high level of both mortality and morbidity. Even where heath care can be accessed by the aboriginals, the costs involved means that their extreme poverty and ignorance become a major challenge to the delivery of mental health services. The literature suggests that aboriginal Australians prefer the euphemistic term ‘social and emotional wellbeing’ over ‘mental health/illness’ both to avoid the high level of stigma associated with a mental illness and by ‘social and emotional wellbeing’, Aboriginals denote a concept that largely and importantly differs with the concepts of conventional ‘mental health’. The National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Well Being (2004–2009) discussed in the foregoing section, also drew this distinction (OATSIH, (2007). The report noted that the mental health concept has its origins in illnesses and clinical perspectives that focus on an individual’s ability to function in his or her environment (SHRG, 2004, pp. 9). On the other, ‘social and emotional wellbeing has broader recognition of the important connection existing across land, spirituality, culture, family, ancestry and community, and each of these as well as their connectivity affects the individual’ (SHRG, 2004, pp. 9). The National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Well Being (2004–2009) developed by the National Aboriginal and Torres Strait Islander Health Council and National Mental Health Working Group identified some key findings (OATSIH, (2007). These included the fact that 27% of the Indigenous adults have very high levels of psychological distress and that indigenous Australians are twice as susceptible to very high psychological distress levels as the non-Indigenous Australian population (OATSIH, (2007). One in ten Aboriginal Australians visit a health professional or a doctor in a month after feeling psychological distress (OATSIH, (2007). Four in ten Aboriginal adults indicate that their families have experienced death of a member or a friend in the year (OATSIH, (2007). Over 28% patients with distress have serious illness, disability, and instability in their families, with 20% having alcohol-related issues (OATSIH, (2007). The study indicated that the Aboriginal and Islander populations have poorer emotional and social wellbeing than the non-Indigenous Australians (OATSIH, (2007). This means that the rate of contact in community mental health services for the Aboriginals is more than twice as much as that for the non-Indigenous population. Aboriginals and Islanders are twice as likely to have suicidal tendencies and to have violent mental illnesses as the non-Indigenous population (Swan & Raphael, 1995). Social Health Workers Response There has been an extensive set of national enquiries, consultations and surveys beginning 1987 up to the year 2005 accompanying ongoing reforms in the Australian healthcare, especially in mental health. These studies have had a considerable consensus on the fact that Aboriginal people in Australia are a special minority needing a different approach of healthcare services if they are to be brought up to par with the rest of the Australian population (OATSIH, (2007). In specific, the aboriginals are served by mental health professionals with little understanding of the Indigenous Australian culture, history and society (OATSIH, (2007). The result is frequent patient misdiagnosis and consequent inappropriate treatment (OATSIH, (2007). Secondly, there is a very high level of poorly met or totally unmet social, psychological and emotional health support. The fact that the rest of the Australian population is better off, served by health professionals who understand them and their social context better, makes Aboriginal and Islander peoples to perceive the mainstream/conventional mental health services as having failed them. It therefore follows that for social workers responsible for offering mental health services in the rest of Australia are poorly suited to administrate the same help to the aboriginals. For proper effective and adequate social and emotional wellbeing of the aboriginals, the social workers should be increased and offered freely or cheaply by the government in health centres near the people (community centres) and even at homes for those patients who still do not seek for help from the healthcare institutions (outreach programs). This will eliminate the disadvantage of poverty, access and ignorance among the aboriginals. Further, the social workers should further be fetched from the aboriginal communities or at least be selected on the basis of their conversance with the aboriginal culture and history. Being aware of the social and cultural context in which the aboriginal communities lives will help understand and cater for their problems, to the extent that the aboriginals will not feel as having been left behind by the Australian health care services (Swan & Raphael, 1995). Social and Practice Concerns of Mental Health Social and emotional wellbeing is not an element of healthcare that can be conceived as to be in isolation. It is hard to ensure that a person has perfect emotional and psychological health by addressing his emotions and mind alone. In fact, social and emotional health is a product of other situations in an individual’s life and symptoms of other conditions. For instance, an individual living in a chaotic family, having a stressful job and experiencing traumatic relationships will be susceptible to poor psychological and emotional health than one in a good, stable and happy family, job and relationship. It therefore follows that, social and emotional wellbeing accrue from other contextual facts of a community’s life and not from the mind or emotions themselves. Contemporary practice and understanding of social and emotional well-being among the aboriginals has roots in the colonial history of the peoples and the ongoing disadvantage they still live under such as widespread racism, grief, loss, discrimination, isolation, adversity and trans-generational aftermath/effects of the government policies that up until 1970, supported forcible abduction of thousands and thousands of Aboriginal children to be taken away from their parents (HREOC, 1997). As such, the Aboriginal peoples are today products of unresolved loss, grief, recurrent trauma, social disadvantage, family breakdown, abuse, cultural dislocation, family separation, domestic violence, racism, discrimination and substance misuse (Swan & Raphael, 1995). There are reasons why social and emotional wellbeing is preferred by the Aboriginals as proved by the following discussion. SHRG (2004, pp.10) notes that the Aboriginals health needs to be viewed from the ‘holistic context encompassing physical, mental, cultural and spiritual health’. In this context, SHRG (2004, pp. 10) land, family, ancestry, community and spirituality must be construed to be ‘central to the achievement of well being’. If therefore the social health workers who provide services to the aboriginals have no understanding of socio-cultural dynamic, the effectiveness of the services will be marginal. Most studies conducted among the ‘Aboriginal and Islander communities agree on the fact that these peoples possess great endurance, strengths, creativity, tolerance and a deep appreciation/understanding of the crucial relationship holding between human beings and the environment’ (SHRG (2004, pp. 10). Further, SHRG (2004, pp. 10) notes that the centrality of the Aboriginal kinship and family must be ‘recognized in their ability to invoke broader concepts of the family such as the reciprocal affection bonds, sense of responsibility and duty to be caring. This means that the mental health of an aborigine will in mostly be determined by his ability to live a life tied together with that of his family and kin. Any variance in that will be dangerous to his or her mental health. Central to the health care service provision for aboriginals is their self-determination (SHRG, 2004, pp. 10) that perhaps stops them from seeking for help in health care institutions. Critical Perspective SHRG (2004, pp. 10) rightly concludes that the provision of health services to Aboriginal communities should be culturally valid and based on an understanding of the people. This, the essay believes will help shape the services programs, care management protocols and assessment criteria used for the better. Indeed, community based care will best serve the Aboriginals in attaining social and emotional wellbeing since it will in so doing accommodate their belief and feeling of connection to their land, culture, family, kinship, spirituality and community. Rather than adopting a singular health care policy for the Australian nation, a special program designed to care for the aboriginals could help them achieve equal care as non-indigenous Australians (Swan & Raphael, 1995). Further, the community based social care will have a unique ability to tap into the reservoir of their resilience. Such an approach would be best suited in helping the Aboriginals recover through their past and recurrent adversity as in moderating the impact of their stressful circumstances on the social and emotional wellbeing of the individuals, families and community at large. Adopting a critical perspective for Aboriginals mental health services, such as facilitating domesticated community-based health care social workers (conversant with the culture and history of the Aboriginals) to intermingle with the community will help modify the host of social determinants therein which usually lead to the noted high levels of psychological distress (SCRGSP, 2007). The results would ultimately be beneficial health outcomes for the Aboriginals. Two principles can be used in the delivery of such social and emotional well-being initiative. One of the requirements; that all services are initiated and controlled by the Aboriginal communities themselves and mental health services to facilitate culturally appropriate as well as responsive service delivery (Littlefield & Dudgeon, 2010). This will allow advance self-determination, culturally proficient, reflective of recommendations in national reports, flexible in to community’s needs, involving community members in designing, delivering and evaluating the services, raising accountability of the community, providing social and emotional health care holistically and in integrating other health specialist services as a support referral care (Littlefield & Dudgeon, 2010). Secondly, the mental health practitioners themselves must necessarily be culturally competent to serve the aboriginals (Littlefield & Dudgeon, 2010). References Australian Institute of Health and Welfare. (2009). Measuring the social and emotional well- being of Aboriginal and Torres Strait Islander peoples. Cat. no. IHW 24. Canberra: AIHW. Human Rights and Equal Opportunity Commission (HREOC) (1997). Bringing Them Home: Report on the National Inquiry into the Separation of Aboriginal Torres Strait Islander Children from Their Families. Sydney: Spinney. Littlefield, L. & Dudgeon, P. (2010). Australia's First People - Their Social and Emotional Well-being. UN Chronicle Online. Available at http://www.un.org/wcm/content/site/chronicle/cache/bypass/lang/en/home/archive/issues2010/achieving_global_health/australiasfirstpeople?pagination=true&ctnscroll_articleContainerList=1_0&ctnlistpagination_articleContainerList=true Office for Aboriginal and Torres Strait Islander Health (OATSIH) (2007). National Strategic Framework for Aboriginal and Torres Strait Islander Health 2003-2013. Australian Government implementation plan, 2007-2013. Canberra: Department of Health and Ageing. Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/6CA5DC4BF04D8F6ACA25735300807403/$File/nsfatsihimp2.pdf Social Health Reference Group (SHRG) (2004). National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Well Being 2004-2009. Canberra: Australian Department of Health and Ageing. Steering Committee for the Review of Government Service Provision (SCRGSP). (2007). Overcoming Indigenous Disadvantage: Key Indicators 2007. Canberra: Productivity Commission. Swan, P. & Raphael, B. (1995). Ways Forward-National Aboriginal and Torres Strait Islander Mental Health Policy: National Consultancy Report. Canberra: Australian Government Publishing Service. Read More

Mental Health Issues in Context The dispersed and small population size of Aboriginal Australians and the undeveloped communities, in which they are to be found, are important consideration (SCRGSP, 2007). The fact that they are a minute part of the population and that they are located in isolated locations perhaps explains why their health in general is not at par with that of the average Australian. For one, the areas in which they live lack even the basic infrastructure that is required so as to establish, provide and maintain proper healthcare (SCRGSP, 2007).

Consequently, the health and well-being of the remote communities is therefore left to unprofessional and non-conventional methods, nurturing the extra-ordinarily high level of both mortality and morbidity. Even where heath care can be accessed by the aboriginals, the costs involved means that their extreme poverty and ignorance become a major challenge to the delivery of mental health services. The literature suggests that aboriginal Australians prefer the euphemistic term ‘social and emotional wellbeing’ over ‘mental health/illness’ both to avoid the high level of stigma associated with a mental illness and by ‘social and emotional wellbeing’, Aboriginals denote a concept that largely and importantly differs with the concepts of conventional ‘mental health’.

The National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Well Being (2004–2009) discussed in the foregoing section, also drew this distinction (OATSIH, (2007). The report noted that the mental health concept has its origins in illnesses and clinical perspectives that focus on an individual’s ability to function in his or her environment (SHRG, 2004, pp. 9). On the other, ‘social and emotional wellbeing has broader recognition of the important connection existing across land, spirituality, culture, family, ancestry and community, and each of these as well as their connectivity affects the individual’ (SHRG, 2004, pp. 9). The National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Well Being (2004–2009) developed by the National Aboriginal and Torres Strait Islander Health Council and National Mental Health Working Group identified some key findings (OATSIH, (2007).

These included the fact that 27% of the Indigenous adults have very high levels of psychological distress and that indigenous Australians are twice as susceptible to very high psychological distress levels as the non-Indigenous Australian population (OATSIH, (2007). One in ten Aboriginal Australians visit a health professional or a doctor in a month after feeling psychological distress (OATSIH, (2007). Four in ten Aboriginal adults indicate that their families have experienced death of a member or a friend in the year (OATSIH, (2007).

Over 28% patients with distress have serious illness, disability, and instability in their families, with 20% having alcohol-related issues (OATSIH, (2007). The study indicated that the Aboriginal and Islander populations have poorer emotional and social wellbeing than the non-Indigenous Australians (OATSIH, (2007). This means that the rate of contact in community mental health services for the Aboriginals is more than twice as much as that for the non-Indigenous population. Aboriginals and Islanders are twice as likely to have suicidal tendencies and to have violent mental illnesses as the non-Indigenous population (Swan & Raphael, 1995).

Social Health Workers Response There has been an extensive set of national enquiries, consultations and surveys beginning 1987 up to the year 2005 accompanying ongoing reforms in the Australian healthcare, especially in mental health. These studies have had a considerable consensus on the fact that Aboriginal people in Australia are a special minority needing a different approach of healthcare services if they are to be brought up to par with the rest of the Australian population (OATSIH, (2007).

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