Indigenous Mental Health and Role of Mental Health Nurse

This presentation discusses the relevance of indigenous mental health to mental health nursing, the role of mental health nurse, gaps in indigenous mental health service, and risk and protective factors for indigenous mental health. Mental health problems are regarded as direct manifestation of disharmony or imbalance. High rates of mental health issues are experienced by the Aboriginal and Torres Islanders. Most common issues include high mortality rates, behavioral disorders, intentional self-harm, and psychological distress. Mental health nurses are required to work with several individuals belonging to a wide range of age groups and coming from all walks of life. The primary role of these nurses are based on utilizing advanced behavioral therapies that will help in facilitating physical and mental recuperation. Racism and discrimination has been found to create significant negative impacts on the mental and physical health of indigenous people, due to fear, stress and other adverse emotions accompanying it. The indigenous people can most often internalize stereotypes and negative comments they are being subjected to. Mental health professionals should respond to the clinical and social needs of the indigenous people and adopt a perspective that recognizes their historical and social context.

Running head: PRESENTATION
Indigenous mental health and role of mental health nurse
Name of the Student
Name of the University
Author Note

1PRESENTATION
Slide 1
Indigenous mental health and role of mental health nurse
Slide 2
Introduction-
• Mental health problems are regarded as direct manifestation of disharmony or imbalance.
• High rates of mental health issues are experienced by the Aboriginal and Torres Islanders
(Reiss, 2013).
• Most common issues include high mortality rates, behavioral disorders, intentional self-
harm, and psychological distress (Sveticic, Milner & De Leo, 2012)
Speaker notes- A mental disorder, or mental illness refers to presence of mental or behavioural
patterns, which lead to significant impairment or distress of basic personal functioning. These
mental abnormalities are generally relapsing, persistent, and remitting. Moreover, they can also
get manifested in the form of single episode. A healthcare professional is responsible for
diagnosing range of such disorders presented by an individual or community. Indigenous
Australians refer to the Aboriginal and Torres Strait Islander individuals of Australia, who are
considered to have descended from several groups that were present in Australia and other
islands before British colonisation. Such indigenous Australians are twice as likely to get
affected by poor health conditions and are 1.5 times more likely to suffer from disabilities or
long-term adverse health conditions (Kelaher, 2014).
Slide 3

2PRESENTATION
Relevance of indigenous mental health to mental health nursing-
• Indigenous communities underwent rapid social changes that led to changes in patterns of
mental health problems faced by them.
• Indigenous people suffering from mental problems have high unemployment rates.
• Mental health is therefore not considered separate from spirituality or physical health.
Aboriginals and Torres Islanders have also demonstrated specific mental health needs
(Rickwood, Telford, Parker, Tanti & McGorry, 2014)
Speaker notes- There exist special strengths in the Aboriginal culture that considers mental
health to be an essential part of the continuum, which pertains to the individuals, families or
entire communities. These are generally attributed to a combination of discrimination and
disadvantage that combined with the devastating trauma and grief. These are direct manifestation
or consequence of previous removal of their children, colonization of their land and destruction
of their communities. Furthermore, premature death of loved ones or family members and loss
from incarceration significantly contributed to poor mental condition
Slide 4
Role of mental health nurse-
• Evaluating and assessing the health needs of a patient
• Devising or formulating specific treatment plans
• Providing a range of psychotherapy related services

3PRESENTATION
• Delivering patient centered care
• Administering therapeutic interventions
Speaker notes- Mental health nurses are required to work with several individuals belonging to a
wide range of age groups and coming from all walks of life. The primary role of these nurses are
based on utilizing advanced behavioral therapies that will help in facilitating physical and mental
recuperation. These nurses are expected to care for all patients, suffering from a range of mental
dysfunctions or disorders, regardless of their cultural and ethnic backgrounds (Happell & Gaskin,
2013). The job of providing appropriate mental care services to all patients is challenging and
creates an emotional drain on the professionals. Thus, they are required to assess patients who
are mentally ill, help them participate in several activities and assist in adherence to behavior
modification programs, in addition to implementing pharmacological interventions.
Slide 5
Relevance of indigenous mental health-
• Mental illness are commonly associated with high levels of disability
• Regional isolation, financial costs and waiting lists are major barriers to low utilization of
mental health services (Jorm, Bourchier, Cvetkovski & Stewart, 2012)
• Inability to identify mental illness and holding opinions and attitudes that do not favor
mental health care increase mental illness among indigenous people
Speaker notes- Even when the indigenous people are recently being valued by the wider society,
they still feel marginalized due to existence of power imbalance between the non-Aboriginal
Australians. Indigenous people have reported significantly lower levels of usage of benefits that

4PRESENTATION
pertain to Medicare and other pharmaceuticals (Parker & Milroy, 2014). Levels of expenditure
for the indigenous people, as decided by the government are way below that other communities.
Low access to primary healthcare facilities often contribute to their increased likelihood of
presenting major mental health issues. Late presentation of symptoms and low levels of health
literacy result in higher rates of mental disorders among the people living in rural regions. This
leads to poorer health outcomes.
Slide 6
Importance of culture-
• Indigenous culture is complex and multidynamic
• Ethnic groups are often under-represented in mental health services
• Poor mental health literacy contributes to impediments in use of mental service
• Healthcare provider might not know about history of colonization and racism
Speaker notes- Attitudes that the indigenous people hold towards prevalence of mental illness are
found to vary considerably among individuals, ethnicities, families, cultures, or countries.
Religious and cultural teachings also play a role in influencing the beliefs that the indigenous
people hold about the nature and origin of mental disorder (Eggington, 2012). Moreover, culture
also shapes the attitudes of the mental health providers towards the mentally ill. In addition,
culture makes mentally distressed people experience discrimination, social stigma, and false
beliefs about mental disorders. This affects their willingness and readiness to adhere to and seek
treatment. Thus, gaining a deeper understanding of cultural beliefs about mental illness is
imperative for implementing appropriate approaches to mental health care.

5PRESENTATION
Slide 7
Gaps in indigenous mental health service-
• Lack of provision of the services
• Security gaps that lead to high level of violence among the indigenous people
• Legitimacy gaps related to deficient standards of government (Heffernan, Andersen, Dev
& Kinner, 2012)
• Marginalization of the target population compared to non-Aboriginal counterparts
• Reduced access to quality care services
Speaker notes- Long histories related to discrimination and colonization of the Aboriginals and
Torres Islanders have led to marginalization of these indigenous peoples, from the dominant
sections of their society. Most statistical data that elaborate on poverty, health, and education
demonstrate that indigenous peoples are poor, least healthy, and do not have access to formal
healthcare service and education. This significantly contributes to higher rates of addiction and
substance abuse, thereby worsening mental health (Shepherd, Li, Mitrou & Zubrick, 2012).
Indigenous people also face systemic exclusion and discrimination from major economic and
political power, thereby leading to their over-representation among the illiterate, poor, and
destitute.
Slide 8
Risk and protective factors for indigenous mental health-
• Stolen children

6PRESENTATION
• Widespread grief and loss related to land invasion and cultural loss
• Unresolved trauma
• Racism and discrimination
• Loss of self-identity (Parker, 2012)
• Poor economic opportunities
• Poor physical health
• Substance abuse
• Incarceration
Speaker notes- Racism and discrimination has been found to create significant negative impacts
on the mental and physical health of indigenous people, due to fear, stress and other adverse
emotions accompanying it. The indigenous people can most often internalize stereotypes and
negative comments they are being subjected to (Ferdinand, Paradies & Kelaher, 2013).
Eventually, these detrimental effects related to discrimination gets passed down to next
generation. Before British settlement, 500 indigenous groups were found to inhabit Australia,
which resulted in approximately 750,000 people. Colonization of Australia created devastating
impacts on the indigenous people. Stolen generations refer to the children of the indigenous
people who were forcefully removed from their families by the federal and state government,
under the act of the parliaments (Short, 2012). This also resulted in significant adverse effects on
mental health.
Slide 9

7PRESENTATION
Major mental illness-
• Depression- It was reported by nearly 33% indigenous people, aged above years
• Dementia- Indigenous people living in rural regions have a ten times increased likelihood
of developing this condition
• Worse mental health reported among 93% Aboriginal prisoners
• Schizophrenia- This abnormal social behavior is reported in equal rates as seen in white
Australians
Speaker notes- The National Aboriginal and Torres Strait Islander Social Survey (NATSISS)
conducted in 2014-2015 states that 29% indigenous people, aged above 15 years self-reported
symptoms of anxiety, depression, emotional or behavioral problems, and drug or alcohol
dependence. One-quarter (23%) of these people reported presence of mental health condition, in
combination with long-term health conditions. Mental health conditions were found less likely
among younger people (22%) than those belonging to older age groups (30%-35%) (Abs.gov.au,
2018).
Slide 10
Duties of a mental health nurse in indigenous mental health-
• Not allow prejudice and stereotyping to influence their thinking or behavior towards the
indigenous communities
• Forming a partnership, negotiating and demonstrating willingness to provide care

8PRESENTATION
• Recognizing the rights of indigenous people access to optimal mental health services
(Bradshaw & Pedley, 2012)
• Respecting dignity and human rights of the patients
• Recognizing importance of their land, culture and spirituality
• Providing culturally safe and appropriate environment
Speaker notes- Mental health nurses should promote the emotional and mental wellbeing of all
indigenous people and work to increase their understanding of their traditions and cultures. The
indige nous people should always be treated with respect and dignity to allow for identification
of major difficulties that are faced while dealing with them. The nurses are also required to
contribute significantly to improve courtesy and increase the awareness of the indigenous people
on the mainstream mental health services that can be utilized by them. Every possible efforts
must be taken to ensure elimination of all forms of language barriers while providing care
services. They should also take into account all existing cultural differences while evaluating the
patients.
Slide 11
Conclusion-
• Aboriginal and Torres Strait islanders suffer from high rates of morbidity and mortality
due to prevalence of mental health disorders
• Historical legacy related to colonization and economic disadvantage

9PRESENTATION
• Mental health professionals should respond to the clinical and social needs of the
indigenous people and adopt a perspective that recognizes their historical and social
context.
Slide 12
References-
Abs.gov.au. (2018). 4714.0 - National Aboriginal and Torres Strait Islander Social Survey,
2014-15. Retrieved 10 April 2018, from
http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4714.0~2014-
15~Feature%20Article~Aboriginal%20and%20Torres%20Strait%20Islander%20people
%20with%20a%20ment
Bradshaw, T., & Pedley, R. (2012). Evolving role of mental health nurses in the physical health
care of people with serious mental health illness. International Journal of Mental Health
Nursing, 21(3), 266-273. https://doi.org/10.1111/j.1447-0349.2012.00818.x
Eggington, D. (2012). Aboriginal health equity: the key is culture. Australian and New Zealand
journal of public health, 36(6), 516-516. https://doi.org/10.1111/j.1753-
6405.2012.00950.x
Ferdinand, A., Paradies, Y., & Kelaher, M. (2013). Mental health impacts of racial
discrimination in Victorian Aboriginal communities. Lowitja Institute.
http://dro.deakin.edu.au/eserv/DU:30058482/paradies-mentalhealthimpacts-2013.pdf

10PRESENTATION
Happell, B., & Gaskin, C. J. (2013). The attitudes of undergraduate nursing students towards
mental health nursing: a systematic review. Journal of clinical nursing, 22(1-2), 148-158.
https://doi.org/10.1111/jocn.12022
Heffernan, E. B., Andersen, K. C., Dev, A., & Kinner, S. (2012). Prevalence of mental illness
among Aboriginal and Torres Strait Islander people in Queensland prisons. Medical
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Jorm, A. F., Bourchier, S. J., Cvetkovski, S., & Stewart, G. (2012). Mental health of Indigenous
Australians: a review of findings from community surveys. Medical Journal of
Australia, 196(2), 118. doi: 10.5694/mja11.10041
Kelaher, M. A. (2014). Experiencing racism in health care: the mental health impacts for
Victorian Aboriginal communities. Education, 55(56), 8-3. doi: 10.5694/mja13.10503
Parker, R. M. (2012). Aboriginal and Torres Strait Islander mental health: paradise
lost?. Medical Journal of Australia, 196, 89-90. doi: 10.5694/mja11.11561
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, 2, 25-38. Retrieved from-
https://www.researchgate.net/profile/Roz_Walker/publication/259715124_Working_Tog
ether_Aboriginal_and_Torres_Strait_Islander_Mental_Health_and_Wellbeing_Principle_
and_Practice/links/59c3abb20f7e9b21a82fd663/Working-Together-Aboriginal-and-
Torres-Strait-Islander-Mental-Health-and-Wellbeing-Principles-and-
Practice.pdf#page=54

11PRESENTATION
Pmc.gov.au. (2018). 3.10 Access to mental health services | Aboriginal and Torres Strait
Islander Health Performance Framework 2014 Report. Retrieved 10 April 2018, from
https://www.pmc.gov.au/sites/default/files/publications/indigenous/Health-Performance-
Framework-2014/tier-3-health-system-performance/310-access-mental-health-
services.html
Reiss, F. (2013). Socioeconomic inequalities and mental health problems in children and
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—Australia’s innovation in youth mental health: who are the clients and why are they
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Shepherd, C. C., Li, J., Mitrou, F., & Zubrick, S. R. (2012). Socioeconomic disparities in the
mental health of Indigenous children in Western Australia. BMC public health, 12(1),
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Short, D. (2012). When sorry isn’t good enough: Official remembrance and reconciliation in
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suicide: a comparison of Indigenous with non-Indigenous Australians. General hospital
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Slide 13
Thank you!