Mental Health (History) Dictionary

There are now 2 major classification systems used for the diagnosis of mental health disorders.

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Westerman suggests that the solution to increasing access to mental health services by Indigenous people lies in the integration of specific cultural and clinical competencies within systems and individual practitioner levels. She describes how a failure to do so creates problems at the clinical level and the broader systems level. At the clinical level, practitioners may have the desire to be culturally appropriate, but are frustrated by the lack of empirically grounded conceptual frameworks that have proven to be effective with Indigenous people. Further, the lack of consistent theoretical frameworks applied to specific presenting issues makes tracking the reasons for successful outcomes difficult.

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A barrier to this outcome rests in the preparation and professional development of mental health practitioners. Bailey suggests that high levels of ignorance and misunderstanding pertaining to Indigenous culture and the intergenerational impacts of past policies on the social and emotional wellbeing of Indigenous people still exist among many non-Indigenous practitioners. In a review of 'traditional' Indigenous health beliefs, Maher argues that Western health professionals often experience difficulties in providing health care to Indigenous people because of the distance between mainstream and Indigenous cultures. The differences in health belief systems exacerbate difficulties experienced in cross-cultural health delivery settings because there is poor compatibility between the underlying values of the Western medical system and traditional Indigenous health beliefs. It is not enough to provide a service. It is also important to understand the reasons why a service may (or may not) be sought. For example, differences in perceptions regarding the cause of illness or disability will affect management, compliance and how the person reacts to their illness. Health professionals should make an effort to understand and link into the belief system of their patients to ensure they have maximum effect. As such, the need for better communication is still stressed as a fundamental requirement underlying investigations of Indigenous mental health .

There may also be conditions for which specialist treatment resides outside a clinic environment. The NSW Mental Health Coordinating Council suggested that Indigenous people exhibiting symptoms of mental illness may be perceived by their community as experiencing a normal reaction to spiritual forces or a curse and, in turn, rely on their community for assistance and spiritual treatment. A challenge for clinical services is how well they are able to act as a conduit for arranging traditional treatments. That is, how do clinical staff act to facilitate a community-based intervention, rather than providing the intervention themselves? Examples of such collaboration exist: Sheldon , for example, observes that Western psychiatric systems were able to work well alongside local resources and that, in fact, the best outcomes for people experiencing problems were when both systems worked together, rather than in competition.

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The repercussions of these imperatives still echo for many Indigenous people in contemporary Australian society - that is, how to gain acknowledgement in contexts that have otherwise excluded them? how to gain access to systems that have otherwise restricted them? and how to promote identity and culture in settings that have otherwise devalued them? If we consider that SEWB is determined and supported by the quality of the nexus of relationships in which Indigenous people locate themselves, then it is unsurprising that instances of poor mental health or compromised SEWB are widespread given the impact of the policies and actions perpetrated upon Indigenous individuals, families and communities. The ongoing effects of such trauma continue to play out for many Indigenous people today, supported and at times allowed by systems that require a critique of the ways in which they construct both the identity of and their relationships with Indigenous people.