ABORIGINAL MENTAL HEALTH
FORUM
22TH NOVEMBER 2013
NCIE – GEORGE STREET, REDFERN
Community
resilience in mental
health-Aboriginal
Pathways
INDEX
1.
Index
2.
Background
3.
Definitions
4.
Causes and Determinants/housing
5.
Families
a. Women
b. Men
c. Youth
d. Children
6.
Education and Training
7.
Capacity Building for Community organisations
8.
Stakeholders
9.
Recommendations
1
ABORIGINAL MENTAL HEALTH
Background
Members of the Redfern/Waterloo Aboriginal community met to discuss
mental health issues with some of our local stakeholders. It was proposed that
meetings take place on a regular basis to look at what the ongoing and arising
problems are, and how they can be addressed. Another meeting was held
with the Police Aboriginal Consultative Committee (PACC) where the issue
was discussed, particularly in reference to juveniles with substance abuse
problems and other mental health issues.
A further larger meeting with government agencies and community members
was held on Rodd Island on Suicide Prevention Day, 9thSeptember 2013.
At the Rodd Island Forum on 9thSeptember, several workshops were held
where different categories of mental health problems were discussed.
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Definitions of Mental Health
Causes and determinants of mental health problems
Cultural Awareness training
Capacity building for Aboriginal Community organisations
Housing
Education, Employment and Training
Funding
Family
o Men
o Women
o Youth
Stakeholders
Recommendations
Current Available Services
Support for families and carers of people with mental health problems
A working party of volunteers was established to discuss the previous
meetings and to organise a major forum, and to invite the Commissioner for
Mental Health. With awareness of the development of a NSW Mental Health
Strategy it was determined that there should be strong input from the
Aboriginal Community on the needs of the Aboriginal people with mental
health problems that is to be included in the NSW Mental Health Strategy.
2
DEFINITIONS
Discussion was held on the definitions of Mental Health disorders. There can
be confusion when just the broad brush statement of MENTAL HEALTH is
used. It is important that the community people are aware of the diversity of
mental health illnesses. Several have been identified and listed:
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Depression
Post Natal Depression
Schizophrenia
Bi Polar Disorder
Substance Abuse
Intellectual Disorders
Autism
Acquired Brain Injury
Dementia
People and families need to recognise the signs or these disorders and to
seek help. Aboriginal young people have the highest suicide rates in Australia,
five times higher than the non-Aboriginal community.
If the signs are to be recognised earlier and families can seek help, these
statistics can be changed. However there is a great need for funding and
resources to address the Aboriginal Mental Health issues.
People and communities need to be empowered to deal with Mental Health in
the home and in the community.
Many of the MH problems may be caused by the untreated or unresolved
trauma experienced by the stolen generations. Healing programs should be
held in communities by cultural mentors to counsel clients in the specific areas
of concern. Aboriginal mentors can work with clients at a community level
whilst they are also working with the relevant health professionals.
Racism and bullying, relationship breakdowns should be identified if these are
causes of mental health problems for individuals.
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CAUSES AND DETERMINANTS
Family dysfunctions
Child abuse
Substance abuse
Racism
Displacement
Homelessness
Poverty
Unemployment
Trauma and Post Traumatic Stress Disorder (PTSD)
Dual diagnosis with substance misuse
Acquired Brain Injury
Foetal Alcohol Syndrome (FAS)
Chronic Diseases
Undiagnosed Stress
HOUSING
Suitable and affordable housing is vital to the wellbeing of Aboriginal people
suffering from a mental health problem, or who may be at risk of developing a
mental health problem.
Housing should be provided in areas where there are Aboriginal support
service and adequate transport.
Housing in rural and remote areas accommodating Aboriginal people and
families with mental health issues needs to be suitable to their specific needs.
Homelessness is a major issue for people living in the inner city and Kings
Cross area.
Accommodation and homelessness is a major problem for men and women
coming out of prison. Local housing providers should work with community
mental health advocates and community organisations, including AMS’s to
address the issue of homelessness of prisoners on release.
An in prison survey should be carried out with prisoners to assess what their
housing options are, at least six months before their release.
4
FAMILY
Family issues need to be looked to see what contributes to the mental health
issues affecting Aboriginal peoples. Families may experience challenging
issues which may contribute to mental health problems, special attention
should be given to young people within the family unit.
We must also recognise those families who have children who are born with
an intellectual disability.
Youth and Children
In order to prevent mental health problems and support young people,
particularly school aged children, with mental health problems more support
must be given. Young people who live with a family member with a mental
health problem require ongoing support. There could be overcrowding in the
family home and lack of school attendance. Children may be suffering if there
is family disunity and dysfunction. Constant fighting and even bickering can
affect young children quite dramatically. Mental health problems start from an
early age; children with mental health problems are more likely to have poor
mental health as adults (Jorm, Bourchier, Cvetkovski, Stewart 2012).
Men.
Mental health problems among men may be associated with substance
abuse, including drugs and alcohol or prescription drug abuse. Mental health
problems and associated alcohol and drug use can lead to perpetration of
domestic violence within families. Additional problems may include gambling
or health problems not spoken of. Absence of meaningful engagement with
family, community and employment can be a problem for men.
Women
Unresolved trans-generational abuse contributes to mental health problems
for young women. Women may experience substance abuse, domestic
violence, total loss of control over their lives and disempowerment. Aboriginal
women are more likely to be a victim of physical and sexual violence than
non-indigenous women (AIHW 2006). Unemployment, poverty and isolation
can also be a contributing factor. Trying to keep a family together and trying to
pay bills without having money, the ongoing struggle and the constant threat
that their children can be taken away through government intervention are
problems that many women experience.
5
EDUCATION AND TRAINING IN MENTAL HEALTH
Community and families
There should be a training program for families on recognising existing or
developing mental health problems within their family.
There should be training made available in the community for families by an
Accredited Training Organisation for Aboriginal mental health and first aid
training. Families can then gauge an understanding of mental health and to
recognise the signs to look for.
Community workers and organisations
Training in mental health should be a priority for all Aboriginal Health Workers
and other community health workers alongside First Aid and Work Health and
Safety training courses. These workers should be trained to identify risks that
may exist in a family situation that can result in a mental health illness. They
should meet together regularly to share information on problems and solutions
through case studies and counselling proposals with families.
Mental Health Professionals
Cultural Awareness training should be undertaken by all mental health
professionals. Many participants said they had bad experiences with some
mental health professional they were referred to and were reluctant to
continue treatment with them.
Participants in the meetings held voiced their concerns that professional
psychiatrists and psychologists whom they were counselled by were not
aware of the cultural aspects of their problems. Some did not believe the
family should be involved and seemed to make value judgements based on
their own family unit and personal environments and experiences.
Regular contact with community health workers and mental health mentors
and advocates should be available to give cultural advice to mental health
professionals who may need further support if clients are not improving or
responding to their professional services.
6
Capacity Building for Aboriginal Community Organisations
A concentrated effort is to be made to ensure community organisations are
given the support of funding and resources to build their capacity to identify
and deal with mental health at the community level. Workers in community
organisations can give peer support and cultural support before clients are
referred on to mental health professionals.
Aboriginal organisations should develop fair and equitable partnerships with
government and non-government organisations and mental health
professionals for the development and implementation of collaborative
programs and services.
Accredited Training Organisations (ATO’s) should have Aboriginal Cultural
Awareness included in their curriculum as a mandatory syllabus for all
trainees in Mental Health, Aboriginal Community Health Workers.
Communities should establish community based Aboriginal Mental Health
Advocacy Committees to meet and discuss mental health issues at regular
intervals. These committees should include family members of clients with a
Mental Health illness.
Promotional material to be developed and distributed to community based
organisations and individual families on mental health issues and how to
identify and deal with them. These promotional materials should be user
friendly and targeted at the Aboriginal community.
Rural and remotes areas of New South Wales should also be targeted for
capacity building and training for their specific needs to be addressed. Theirs
will differ from the urban areas and should be given special consideration.
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Stakeholders
Aboriginal Community Organisations
Families
Mental Health Professionals
NSW Ministry of Health, Sydney Local Health District – Mental Health
- Community Health
- Drug Health
- Youth Health
Housing NSW
Department of Education – Schools, primary and secondary
Weave
The Salvation Army-Oasis
Aboriginal Medical Service
Aboriginal Health and Medical Research Council
Mission Australia – Greater Sydney Aboriginal Tenancy
Redfern Police
Tranby Community College
Beyond Blue
Lifeline
Kid’s Helpline
Inner-West Sydney Medicare Local
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Funding
There needs to be serious look at sources of funding for communities to
address the issues at a community level before consumers are to be referred
to mental health professionals.
Recommendations
1. Research the links between childhood mental health problems such
as attention deficit hyperactivity disorder and adult mental health
problems within the Aboriginal community
2. Establish community based Mental Health Advocacy Committees
3. Investment in accessible community based mental health training for
workers in Aboriginal community services
4. Funding made available for family mental health mentors in each of
the Aboriginal community organisations
5. Cultural awareness training for all public and private mental health
professionals
6. Research the current prevalence of mental health problems and
suicide amongst Aboriginal people
7. Develop community based Aboriginal Mental Health Interagency for
the Redfern-Waterloo area
8. Aboriginal Community Engagement Officer at Redfern Health Centre
9. Establish a culturally appropriate healing house in the local area for
people to access to culturally appropriate support
10.
Training in mental health to be included in mandatory training for
all organisations alongside WH&S, Child Protection and First Aid
9