Mental Health Stigma in Indigenous Communities

This assignment delves into the challenges of mental health stigma faced by Indigenous communities. It examines cultural perceptions, societal influences, and the impact of historical trauma on attitudes towards mental illness. The task requires students to analyze research findings, explore coping mechanisms employed by individuals and families, and propose strategies for reducing stigma and promoting culturally sensitive mental healthcare.

Running head: CASE STUDY OF JUSTIN O’DOWD
CASE STUDY OF JUSTIN O’DOWD
Name of the Student
Name of the university
Author’s note

1CASE STUDY OF JUSTIN O’DOWD
1. Describe how Justin’ s well-being might be impacted by his recent life events.
It is quite evident from the case study that Justin has been encountering several problems
over the time which has contributed to his mental illness. The adverse conditions have impacted
upon his physical, emotional and the psyche-social well being. It is evident from the case study
that Justin is very uncertain about his career as he had dropped out of the school and he had the
responsibilities of his family, to bear the financial support of his family. Justin had been in grief
since the demise of his beloved uncle Reggie. Justin had faced difficulties for being an aboriginal
with respect to his career, the repeated rejection due to racism and low esteem had cater to the
psychosocial problems (Kelaher, Ferdinand and Paradies 2014). Another factor is that at an early
age he became the victim of Type 2 diabetes mellitus. The adverse effects brought by the chronic
diseases in combination which the psychosocial problems play a significant role in Justin’s
health challenges. Researchers suggest that frustrations and the problem of not being able to
share anything with anyone is a leading cause of depression and anxiety among the adolescents
like Justin (Elliott-Farrell 2004).
2. How might Justin’s cultural interpretation of mental illness be different from your own?
The case study provided us with the idea that Justin was an Australian aboriginal. It is known
from time immemorial that the aboriginals are superstitious and mainly depend upon the home
based treatment (Vicary and Westerma 2004). From the 1:1 assessment it is evident that Justin’s
community doesn’t consider mental illness a serious problem and consider that this can be due to
the influence of some bad omen which only comes to those, who have done something wrong
and cannot be treated (Maher 1999). They find it awkward to approach the non aboriginal health

2CASE STUDY OF JUSTIN O’DOWD
organizations. This may be due to the racism, biasness or dejection. On the other hand I belong
to an Arabic family, and in Arabic culture, mental disorders are considered as serious problems
that needs full attention as it hampers the lifestyle of both the family and the community (Ciftci
et al.2013). In the Arabic community mental illness is considered as a public stigma and hence
forth needs an immediate treatment to come back to the community (Dalky 2012). In the Arabian
perspective the differential act on mental illness to that of the aboriginal is due to the ignorance
and stereotypes.
3. Identify how you own attitudes and values relating to mental illness may influence any
communication with Justin?
It has already been mentioned in the previous answer that my own cultural background in
understanding of mental illness is different than that of Justin’s. In my culture mental illness is
considered as a serious illness and needs to be corrected as soon as possible (Dardas and
Simmons 2015). As we have already noted from the case study that Justin was an aboriginal and
the aboriginals have social stigma regarding the mental illness. Since Justin is a boy of just 20
years old, his young mind is susceptible to any kind of trauma, be it the grief of his uncle’s death
and his feeling of low esteem and uncertainty about his future. As a nurse I should be able to
understand Justin’s culture. I should be able to provide a conducive environment to Justin. As a
nurse I would be able to lead a transformative role in bringing out better outcomes in Justin. It is
very important for a nurse to have an acceptance to all types of culture and traditions
(Chidarikire 2012). Whatever interventions that has to be taken should cope with the patient’s
culture at least to some extent. Any negative attitudes regarding the patient’s culture and the
rituals have to be avoided. As a nurse it is very important to provide the patient with a holistic
care of approach and deal sensitively.

3CASE STUDY OF JUSTIN O’DOWD
4. How can partnerships with Justin and his immediate and extended family be developed
and maintained throughout his journey of care?
As per the case study Justin had withdrawn himself from socialization, he had also stopped
his meals with his families. Therefore it is evident that Justin’s ties with his family were
gradually unwinding due to his mental illness. It is therefore very important to reinforce the
bonding once again. Justin had been suffering from acute depression and anxiety, which is
common among the aboriginal teens. A partnership between Justin and his extended family is
very essential to give a combined care. It is very necessary to provide education to the patient’s
family regarding the clinical condition and a joint venture would help to maintain a conducive
environment at home (Jorm et al. 2012). In order to accomplish this, it is very essential to mix
and understand Justin’s culture. It should be noted that the counseling strategies taken up for
Justin should be able to fit in to Justin’s cultural beliefs. A positive restorative relationship can
be maintained that would make Justin and both his family members absolutely comfortable to the
treatment. Understanding of the culture and the norms of Justin’s family would help to give a
proper palliative home based care in a sensitive way.
5. What are the social and cultural implications for Justin leaving his home and
community for assessment and treatment in the city?
It has already been found from the case study that Justin came from an Aboriginal
background. Even in these years of progressiveness the ill effects of racism could not be
demolished, as result the aboriginals cannot rely on the modes of treatment provided by the non-
aboriginals and manly depend upon the home based treatment. And it has already been known
that Justin’s mother is having a strong bonding with her child. On being influenced by the

4CASE STUDY OF JUSTIN O’DOWD
cultural norms and the stigma, Justin’s mother is worried that on taking Justin for a treatment to
the city would lose ties to the cultural traditions of Aboriginal treatments. The cultural bounds
that had left Justin untreated for so many days, were gradually fading away with the decision of
taking him to the City hospital. At the hospital Justin had to accept the westernized model of care
that directly contradicts with the aboriginal treatment. Justin’s community might not take this in
a very positive way, but the step was required for the well being of Justin. It has been found that
at the hospital Justin let open his grievances and his feelings by untying the traditional norms of
Justin’s culture and the treatment plan henceforth does not remain confined to Aboriginal
culture.
6. What needs to happen to ensure culturally safe care for Justin once he is hospitalized?
Justin is just a boy of 20 years and is having an aboriginal background. He had already
faced the impacts of racist culture. On being bullied, Justin dropped out from the school. This
obviously impacted upon his career and Justin could not get a good career (Parker and Milroy
2014). Apart from that Justin had been suffering from Diabetes mellitus. Justin should be
provided with a friendly and understanding environment that would increase the chance of
adherence to the medications and set aside the culturally dependant mentality. In order to ensure
a culturally safe environment it is very important to take his culture in a positive way even if it
has lots of negative implications. A nurse should be able to accept all types of cultures, when it
comes to assessing of patients. (Dudgeon et al. 2014) has suggested that it is essential to embrace
some aboriginal norms in order to assure that the caregiver is beside him and is well aware of
Justin’s cultural sensitivity. In the assessment report it has been mentioned that Justin positions
the aboriginal perspective that the caregiver attending him should be a male. Again provision of
meals that is culturally fit for him would help to increase Justin’s reliability on the Non

5CASE STUDY OF JUSTIN O’DOWD
aboriginal healthcare.
7. From the information in the Mental Health Assessment and Mental State Examination,
what are the identified areas of concern and the priorities of care planning for Justin
It has been known from the given case study that Justin had reached the acute level of
depression, which Justin had thought of ending his life (Durey et al. 2012). This one is the major
health concern that most of the depressed aboriginal teens opt for. It is evident that Justin has
developed a thought of hopelessness regarding his life. In order to provide Justin with a holistic
care of approach, Justin would be administered proper therapeutics. Then Justin requires a
psychiatric counseling in order to expand his thoughts and slowly look at the world with a whole
new perspective. Furthermore Justin could not accept the death of his uncle Reggie, which is one
of the causes of his depression. Justin also needs a psychiatric support in order to understand the
reality of death, reality of Uncle Reggie’s death. Furthermore Justin lacked self confidant may be
due to his bitter schooldays, maybe he still couldn’t accept the fact of being bullied by his class
mates due to his aboriginal background. A proper mental counseling will be providing
opportunity Justin to open up completely and share, which can be a new ray of hope for him.
8. Read the 1:1 intervention notes and identify the communication skills/strategies that are
allowing the health professional to talk with Justin in a culturally safe manner.
Adoption of a treatment that is culturally safe, which can be
accomplished by (Parker and Milroy 2014)-
 Curative relationship- This involves the nursing interventions like
provision of mental and spiritual support to the patient. A nurse should
be able to sink in with the aboriginal culture but, although the

6CASE STUDY OF JUSTIN O’DOWD
treatment should be absolutely westernized. A proper nurse would be
able to include Justin’s family in the treatment of Justin.
 The way of questioning- the way of questioning to the patient is a big
factor in providing holistic care of support to the patient. It should be
done in a non threatening way. Furthermore it is evident from the case
study that Justin only agreed to give 30 minutes for the conservation to
take place. The health care professional must have avoided long or
sensitive questions that might make Justin to cringe and avoid
answering the questions. It can be difficult for Justin to understand long
questions and give answers accordingly. In this case the doctor might
have asked short and to the point questions and have allowed Justine
to give genuine answers.
 Scope for opening up- At some point of the 1:1 interview the doctor
might have helped Justin to open up and express his feelings.
Throughout the session the doctor have maintained a positive thought
about Justin’s aboriginal culture that has helped Justin to open up and
tell more about his culture and grief. The doctor has not directed any
closed ends question, lest that might deter Justin from expressing his
grievances apart from the basic answer.
9. Review the discharge plan and 3-month review and consider how Justin can be supported
to maintain his well-being when he has returned to his family and community.
The 3- month review provides us with the information that Justin had been showing
improvement and has started to return back to the normal life. Justin is now willing to go home

7CASE STUDY OF JUSTIN O’DOWD
as he is missing his family and friends, and would definitely join a work to support his family.
Even though Justin has been discharged from the hospital, Justin needs a continuous mental and
spiritual support, be it from the community, his peers or from his loved ones. The release plan
emphasizes that Justin needed a daily exercise to get rid of the physical complications brought
about by the diabetes. The discharge plan also asserts that Justin needs enough mental rest, which
is sleep. In the discharge plan it has been mentioned that his family has to look after the factors
that can trigger anxiety and depression in Justin. Family has to be involved in order to take Justin
return to his professional life. Justin can be encouraged to work with the traditional healer if
Justin wishes or can return to his previous job unless he finds something permanent (Parker and
Milroy 2014). Furthermore a routine follow up by an aboriginal health worker is required to see
Justin’s conduct.
10. After considering the issues for Justin, reflect on your own experiences of relating to
people from different cultures. Consider what you have learned from Justin's story and
how your new knowledge might influence your practice
I have often come across teenagers with anxiety problems coming from a different culture
and have successfully dealt with them and have tried my best to bring back peace in their
quality of life. Still I would rightly say that Justin’s case had been an exceptional example to
show how a proper anticipated nursing can bring back some one like Justin to the normal
course of life. I have learn how sensitivity, acceptance to others culture overlooking the
negative cultures can bring about changes in the quality of care. One should be culturally
sensitive to others culture, providing there is a scope for treatment in the concerned culture. It
is very important or a care giver to avoid biasness when it comes to a different culture,
especially the culture that had been the victim to racism. I have learned that how embracing of

8CASE STUDY OF JUSTIN O’DOWD
new culture can bring about trustworthy and open understanding between the patient and that
healthcare professional. I have also come to know how to involve the communities and the
family to provide a palliative care to the patient. I have also learned about how to deliver a
proper therapeutic care and a discharge plan for a patient like Justin. Thus it can be said that,
the following case study and the interventions would help me to deliver a proper physical,
mental and spiritual support to a patient like Justin, coming from a diversified cultural
background.

9CASE STUDY OF JUSTIN O’DOWD
References
Chidarikire, S., 2012. Spirituality: The neglected dimension of holistic mental health
care. Advances in Mental Health, 10(3), pp.298-302.
Ciftci, A., Jones, N. and Corrigan, P.W., 2013. Mental health stigma in the Muslim
community. Journal of Muslim Mental Health, 7(1).
Dalky, H.F., 2012. Perception and coping with stigma of mental illness: Arab families’
perspectives. Issues in mental health nursing, 33(7), pp.486-491.
Dardas, L.A. and Simmons, L.A., 2015. The stigma of mental illness in Arab families: a concept
analysis. Journal of psychiatric and mental health nursing, 22(9), pp.668-679.
Dudgeon, P, Walker, R, S, Scrine, C, Shepherd, C, Calma,T & Ring, I 2014, ‘Effective strategies
to strengthen the mental health and wellbeing of Aboriginal and Torres Strait Islander people’,
Australian Institute of Family Studies, no. 12, viewed 15 August 2016,
http://www.aihw.gov.au/uploadedFiles/ClosingTheGap/Content/Our_publications/2014/
ctgc_ip12.pdf.
Durey, A., Wynaden, D., Thompson, S.C., Davidson, P.M., Bessarab, D. and Katzenellenbogen,
J.M., 2012. Owning solutions: a collaborative model to improve quality in hospital care for
Aboriginal Australians. Nursing inquiry, 19(2), pp.144-152.
Elliott-Farrelly, T., 2004. Australian Aboriginal suicide: The need for an Aboriginal
suicidology?. Australian e-journal for the Advancement of Mental Health, 3(3), pp.138-145.

10CASE STUDY OF JUSTIN O’DOWD
Jorm, A.F., Bourchier, S.J., Cvetkovski, S. and Stewart, G., 2012. Mental health of Indigenous
Australians: a review of findings from community surveys. Medical Journal of Australia, 196(2),
p.118.
Kelaher, M.A., Ferdinand, A.S. and Paradies, Y., 2014. Experiencing racism in health care: the
mental health impacts for Victorian Aboriginal communities. The Medical journal of
Australia, 201(1), pp.44-47.
Maher, P., 1999. A review of ‘traditional’Aboriginal health beliefs. Australian journal of rural
health, 7(4), pp.229-236.
Parker, R. and 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, 2, pp.25-38.
Patel, V., Flisher, A.J., Hetrick, S. and McGorry, P., 2007. Mental health of young people: a
global public-health challenge. The Lancet, 369(9569), pp.1302-1313.
Simons, R.C. and Hughes, C.C. eds., 2012. The culture-bound syndromes: Folk illnesses of
psychiatric and anthropological interest (Vol. 7). Springer Science & Business Media.
Vicary, D. and Westerman, T., 2004. That’s just the way he is’: some implications of Aboriginal
mental health beliefs. Australian e-Journal for the advancement of mental health, 3(3), pp.103-
112.