Effective strategies to strengthen the mental health and wellbeing of Aboriginal and Torres Strait Islander people
Issues paper no. 12 produced for the Closing the Gap Clearinghouse
Pat Dudgeon, Roz Walker, Clair Scrine, Carrington Shepherd, Tom Calma and Ian Ring November 2014
What doesn’t work
- Programs that fail to take account of Indigenous values, lifestyles, aspirations, family and differing needs and capacities of Indigenous people in diverse, complex economic and social circumstances.
- Programs and services developed with inadequate timeframes, funding and program support that fail to address health in a holistic manner and focus on the individual without regard for the family and community context.
- Provision or adaptation of mainstream programs by mainstream providers for Indigenous people without Indigenous community involvement or consultation.
- Programs that are short-term, inflexible and designed and delivered without consultation, engagement and partnership with the community and the Aboriginal Community Controlled Health Service sector.
- Poor engagement with research evidence by the mainstream sector can lead to systemic racism, lack of cultural understanding and appropriateness, and a reliance on ‘one size fits all’ approaches.
- Performance indicators and reporting requirements, developed in accordance with the values and principles of the mainstream mental health system, that do not always align with Indigenous cultural ways of working and views of social and emotional wellbeing.
There is evidence that programs that are developed or implemented in accordance with the 9 guiding principles underpinning the National Strategic Framework for Aboriginal and Torres Straits Islander Peoples’ Mental Health and Social and Emotional Well Being 2004–2009 (SHRG 2004) are more likely to be effective and have positive outcomes than those that do not.
- Programs that show promising results for Indigenous social and emotional wellbeing are those that encourage self-determination and community governance, reconnection and community life, and restoration and community resilience.
- Important program features include:
– a holistic approach
– a focus on recovery and healing from stress and trauma
– a means of empowering people to regain a sense of control and mastery over their lives
– strategies that are Indigenous-led, family focused, culturally responsive, and context specific
– interdisciplinary approaches that provide outreach services and transport
– partnerships with the Aboriginal Community Controlled Health Services sector and local communities.
- There is evidence that both mainstream and Indigenous-specific programs and services that adhere to the Closing the Gap service-delivery principles of engagement, access, integration and accountability are more effective than those that do not.
- ‘Participatory action research’ approaches provide an effective mechanism for involving Indigenous families and communities in developing, implementing and evaluating programs. Programs that adopt participatory action research tend to be more culturally responsive to local contexts and foster a culturally safe environment for program participants.
- Engaging in cultural activities is an indicator of positive cultural identity that is associated with better mental health among Indigenous Australians.
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