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Aboriginal and Torres Strait Islander Suffer Higher Rates of Mental Illness and Suicide Rate Than the Above National Average.

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Submitted By archana7176
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Aboriginal and Torres Strait Islander peoples are significantly exposed to new cultural, social environment and life style in the past few decades. They also affect from a colonisation process that destroyed their culture, tradition, language, politics and economy (Holland, Dudgeon & Milroy, 2013). Their life has been changed suddenly and has devastating effect on their mental and health well-being. This essay will elaborate the reasons including social and cultural factors contributing significantly higher rate of mental illness and suicidal behaviour and mental health plans that the government has adopted to prevent self-harm and increase mental awareness. There have been a few researches conducted about Aboriginal people’s suicidal behaviour and self-harm.
The definition of mental illness has been updated and a few times for the last 50 years on a regular basis (Parker &Milroy, 2014). Mental illness is also known as mental health disorder and it is very common in Australia. Mental disorders as defined by WHO (2016) is “comprise a broad range of problems, with different symptoms. However they are generally characterized by some combination of abnormal thoughts, emotions, behaviour and relationship with others. Examples are schizophrenia, depression, intellectual disabilities and disorders due to drug abuse.” Almost relatively half of the population in Australia suffered affective or substance use disorder and anxiety between the age from 16 to 85 in some stage of their life (The Department of Health, 2014).

According to Australian government (2013), 7% of Aboriginal and Torres Strait Islander people hospitalised due to mental health condition. The leading cause of hospitalisation was schizophrenia, alcohol addiction and severe stress reaction (Holland et al., 2013). Among them the most affected age group was 25-44, who suffered from a number of mental health illness such as physical or intellectual disability, poverty, neglect, abuse, trauma, poor physical health and excluded and isolated from society (Australian government, 2013). Walls, Hautala & Hurley (2014) confirmed that suicidal tendency is most common health related mental illness in young people. Also, Indigenous Australians are more than twice hospitalised for intentional self-harm as non-Indigenous people (Jamieson, Paradise & Gunthorpe et al., 2011). If it has been focused on Aboriginal culture, it is precious and oldest culture in Australia and has been present since 45000 to 50000 years (Parker & Milroy, 2014). The Aboriginal people were relatively healthy, disease free, following their spiritual belief and highly valued their culture and traditions. The data indicate that Aboriginal people would be having good life if they lived like before in their social environment (Department of Health and Aging, 2013) (parker & Milroy, 2014). Suicide is relatively rare in Aboriginal community during pre-colonial times. It has become more prevalent after 1980s with different rates in geographical variation, in term of fluctuation in suicide rate in some remote areas, from year to year (DHA, 2013). Colonisation results in the destruction of Aboriginal population and culture, significant destroy their community and the issues of stolen Generations. In addition, the history of forcibly separated children from parents, anxiety of destroying culture and continuing pressure of disadvantage are greatly impacted on their mental health and well-being (DHA, 2013). The suicide rate was twice of Aboriginal and Torres Strait Islander people between the period of 2001-2010 than non-Indigenous people (Australian government, 2013) (DHA, 2013). Suicide rated for 4.2% of death in Aboriginal People in 2010 which was 2.6 times more than non-Indigenous Australians. Suicide rates were different in Aboriginal male aged from 25 to 29 and female aged from 20 to 24 accounted for 90.8 deaths and 21.8 deaths per 100000 respectively ( DHA, 2013). The main reason for higher rate of suicidal tendency in Aboriginal people is mental health diseases, substance abuse and stressful life events (Clifford, Doran, Tsey, 2013). For example, there has been a link of prolonged use substance and suffered mental disorder before they commit suicide. (DHA, 2013).
Stroud, Lookwood and Abbey (2014) indicated that Indigenous people are more likely not to go to mental health professional to seek advice compare to non-Indigenous people with rated 10.1% and 22.9% respectively. Prandl, Rooney and Bishop (2012) also outlined that Aboriginal women are not likely to seek medical advice such as antenatal services because they believe that it’s culturally inappropriate and unsafe services. Moreover, lack of transportation, cost, gender issue, and lack of trust, stigma, culture clashes and racism, difficulty in disclosing mental health problems are other barriers to seek mental health services in this community (Anton and Berwyn, 2014).
Aboriginal Indigenous and Torres Strait Islander people are experienced highly racial discrimination to some extent. Cunningham and Paradies (2013) outlined that 27% of people discriminated in 2012 and most commonly in public. There are some evidence indicate that Indigenous people assess low level of health care services due to experienced racism (Australian government,2013). The common factors are associated with discriminations are removal from family or community, lack of trust, not working, having a university degree and engaging in community and cultural identity. The others factors related to discrimination are home ownership, living in remote and having a few indigenous friends (Cunningham et al., 2013). In addition, under the Flora and Fauna Act and Protection and Segregation Act, Indigenous people not only lost their land, but also removed from their family (Elder, Evans & Nizette, 2013).
Social inequality is another pivotal social factor making them more vulnerable. Unequal distribution of wealth and access to resources result in social inequality for the development of adult and children. (Zubrick, CJShepherd and Dudgeon et al., 2014). Also, Aboriginal people are greatly disadvantaged in distribution process of wealth and social benefit. Therefore, these people are not getting proper access to health care services and also lack of resources diminished their self-efficacy. This impact on their social and psychological life. The ratios of the problems are generally more in Indigenous people than the non-Indigenous people. As a result, Aboriginal people have highly suffered psychological distress and mental health problems. Hayman (2011) described that the price of the medication is major problem for the Aboriginal people. Also, Aboriginal people tend to live in larger houses with more dependents and have low income. Also, they have a low income compare to non-Indigenous people in Australia. Thus, low income leads to illnesses, disability and diminish opportunity to gain employment. Overall, their poverty is exaggerated.
Australian government implemented a range of programs to promote Aboriginal culture and tradition, legacy and, continuing supporting mental health promotion, early intervention and suicide prevention services to improve social and emotional wellbeing. Australian government has increased fund by 245% on mental health compared to 151% by state and territory governments (The Department of Health, 2013). Aboriginal and Torres Strait Islander peoples running sustained campaign for the last five decades , and the economic position has started to improve significantly and will more effort needs to close the gap until about 2030 (Holland et al., 2013). But, McCalman (2016) argues that Australian suicide prevention strategy is strong but there is a lack of evidence literature regarding interventions for these people

To decrease the incidence of suicide and its impact on individual and community, Australian government convinced to organize Australian’s first National Aboriginal and Torres Strait Islander Suicide prevention Strategy, 2013. This strategy is based on six main goals, and to achieve it, there has been set up six action areas of the strategy. The main objective of this strategy is to decrease the incidents of suicide, provide all necessary resources to promote mental awareness and evaluate them, assess risk factor and determine the outcome on local, regional and national level (DHA, 2013).This strategy is based on respect and recognition of Aboriginal people, their culture and history with high standard of care. In addition, there is a great involvement of government and non-government organisation, all sectors and communities themselves. There has been focused on different groups according to their need and different age group from children to adolescent. Community involvement is key area of this strategy who greatly involved preventing suicide and working within culturally appropriate practise. For example, Indigenous health workers who can guide the clinicians for validate assessment and treatment within Indigenous people’s social, emotional, spiritual, historical and community perspective (Elder et al., 2013).
Also, they have focused on counselling services and engage youth in activities. For example, encouraging them to join in workforce and take further training to get employment, counselling and support services for arrested people or people who are in prison. This is a long term suicide prevention strategy and will look forward for desirable outcome in 5 to 10 years periods of time (DHA, 2013). Australian state and territory has law in legislation for involuntary treatment. However, involuntary treatment order is not best practice to treat the disease. The involvement of family, Indigenous worker and community is better to build good therapeutic relationship, establish rapport and prepare treatment plan. Therapeutic relationship is more strong and effective than enforcing treatment (Elder, 2013).
In conclusion, it has been shown that how culturally and socially Indigenous and Torres Strait Islander people have impacted on higher rates of mental illness and suicide. Anxiety of loss of culture and legacy and their own attitude towards mental health make them to become more vulnerable and the distance between Indigenous and non-Indigenous people become wider than before. Also, this essay indicates that Aboriginal Australians are socially disadvantage to some extent such as unemployment, education, housing and community safety. Australian government has spent extensively a big chunk of money for suicide prevention plan and has adopted different strategies to prevent self-harm and promote mental awareness.

References:
Australian Government (2013), The Department of Health, National Mental Health Report. Retrieved from http://www.health.gov.au/internet/main/publishing.nsf/content/mental-pubs-n-report13

Australian Government (2013), Department of Health and Aging, National Aboriginal & Torres Strait Islander Suicide Prevention Strategy, 2013 retrieved from http://www.health.gov.au/internet/main/publishing.nsf/content/305B8A5E056763D6CA257BF0001A8DD3/$File/Indigenous%20Strategy.pdf

Australian Government (2013)cli, National Aboriginal And Torres strait Islander Health Plan 2013-2023, Closing the Gap, Retrieved from http://www.health.gov.au/internet/main/publishing.nsf/content/B92E980680486C3BCA257BF0001BAF01/$File/health-plan.pdf
Clifford, Anton C., Doran, Christopher M., & Tsey, Komla. (2013). A systematic review of suicide prevention interventions targeting indigenous peoples in Australia, United States, Canada and New Zealand. BMC Public Health, 13, 463. Retrieved from http://unilinc-alma-new.hosted.exlibrisgroup.com/
Cunningham, J., & Paradies, Y. C. (2013). Patterns and correlates of self-reported racial discrimination among Australian Aboriginal and Torres Strait Islander adults, 2008-09: analysis of national survey data. International Journal For Equity In Health, 12(1), 47-61 15p. doi:10.1186/1475-9276-12-47
Hallond, C., Dudgeon, P. & Milroy, H. (2013). The Mental Health and Social and Emotional wellbeing of Aboriginal and Torres Strait Islander Peoples, Family and Communities. Supplementary paper to a contributing life, 2012 National Report Care on Mental Health and Suicide Prevention, National Mental Health Commission. Retrieved from http://www.naccho.org.au/download/aboriginal-health
Hayman, H. (2011) Improving Aboriginal and Torres Strait Islander people’s access to the pharmaceutical benefit scheme. Australian Prescriber, an independent review, 34(2), 34:38-40. Retrieved from http://dx.doi.org/10.18773/austprescr.2011.025

Jamieson, L. M., Paradies, Y. C., Gunthorpe, W., Cairney, S. J., & Sayers, S. M. (2011). Oral health and social and emotional well-being in a birth cohort of Aboriginal Australian young adults. BMC Public Health, 11(1), 656-656 1p. Retrieved from http://web.b.ebscohost.com.ezproxy2.acu.edu.au/ehost/detail/detail?vid=11&sid=830b6719-55ce-4405-9198-c8672c4c4dc1%40sessionmgr111&hid=105&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=104585674&db=ccm
McCalman, J., Bainbridge, R., Russo, S., Rutherford, K., Tsey, K., Wenitong, M., & ... Jacups, S. (2016). Psycho-social resilience, vulnerability and suicide prevention: impact evaluation of a mentoring approach to modify suicide risk for remote Indigenous Australian students at boarding school. BMC Public Health, 161-12 12p. doi:10.1186/s12889-016-2762-1

Parker, R., & Milroy, H. (2014). Aboriginal and Torres Strait Islander mental health: an overview. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice. 2nd ed. Canberra: Department of The Prime Minister and Cabinet, 25-38. Retrieved from http://aboriginal.telethonkids.org.au/media/673972/wt-part-1-chapt-2-final.pdf

Prandl, K., Rooney, R., & Bishop, B. (2012). Mental health of Australian Aboriginal women during pregnancy: identifying the gaps. Archives Of Women's Mental Health, 15(3), 149-154 6p. doi:10.1007/s00737-012-0276-0

Stroud, P., Lookwood, .,Abbey, J.(2014) Obstacles to the take-up of mental health care provision by adult males in rural and remote areas of Australia; The JBI library of systemativ reviews.12(3):166-233,2014 retrieved from http;//www.ovidsp.tx.ovid.com.ezproxy1.acu.edu.au

Walls, M., Hautala, D., & Hurley, J. (n.d.).(2014)
“Rebuilding our Community”: Hearing silenced voices on Aboriginal youth suicide.
Transcultural Psychiatry, 51(1), 47-72. DOI: 10.1177/1363461513506458…...

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