Mental Health Disability in Indigenous People in Australia: An Essay

This essay examines the mental health challenges faced by Indigenous Australians, highlighting the prevalence of issues like depression, anxiety, and suicide. It explores the ecological factors at micro (individual and family), meso (social and cultural), and macro (governmental policies and infr...Read More

Running Head: Mental Health Disability in Indigenous People
Mental Disability in Indigenous People in Australia
Essay
System04104
9/22/2019

Mental Health Disability in Indigenous People
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Introduction
The Aboriginal or Torres Strait Islanders (ATSI) people are the various indigenous people
lives in Australian mainland, Tasmania, and often the Tiwi Islands. The indigenous people
spread all over the country and they have very old culture and civilisation. However, the
numbers of indigenous people are increasing in Australian every day but their living style and
poor income also causes some serious health issues for them in the country. It can be said that
the issues related to indigenous health is a big issue for Australia because it is matter of
national shame for the country where large number of people in indigenous area are
struggling for food and employment and that causes several mental and physical health issues
in the people. There are large numbers of indigenous people in Australian are suffering from
mental health issues like depression, stress, anxiety and several other psychological health
problems. The purpose of this report is to highlight those ecological factors (micro, meso, and
macro) which are responsible for their mental issues. This report also discussed the identified
health inequalities on each ecological level. However, overall the report includes all those
factors, which are responsible for the mental health issues in indigenous people in Australia
and recommend how these problems can be removed from the initiative of government and
society so they can live a healthy and happy life in the country.
Mental health Issues in Indigenous People
Indigenous people are 3.3% of total Australian population [2]. The population of Australian
indigenous people in 2011 was 3% and it has been raised from last few years. The estimated
population of indigenous people in Australia was about 798,400 in 2016, which was 3.3% of
total Australian population [2]. However, Australian indigenous population was 669,900 in
2011 and it was increased by 19% by 2018. These people spread all over the country. In
Australian Capital Territory, the number of indigenous population is 1.9% while in South
Australia indigenous population is 2.5% [3]. In other parts of Australia, the number of
Indigenous people is very low, but in the Northern Territory, 30.3% indigenous people are
living. The current situation of Australian Indigenous people in the country is not good [5].
There are large number of people are suffering from mental health disability in the country.
For example, more than 30% of indigenous people are suffering from the psychological
distress in the country while the same is only 20% in common Australian population. The
percentage number of people who are suffering from dementia above the age of years is

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12.4% in indigenous people while the same is only 2.6% in non-indigenous people in the
country [1]. These fact of show the current poor mental health situation in indigenous people
in indigenous people and a dramatic increase in the numbers of indigenous people who are
suffering from mental health disabilities in the country. Mental health issues in Indigenous
population is seriously a major concern for the Australian government because the large
numbers of people are reported to suicide, anxiety, and depression in the Australian
indigenous areas, especially in northern territory of Australian where large numbers of
indigenous people are living in the country [4].
The indigenous population is tie up with 50,000 old civilisation and culture. The colonization
of Australia was done in 1788 [5]. Colonisation of Australia led to significant adversities for
the ATSI population with loss of traditional way of life, land, and resources. However, these
changes in Australian societies affect the life style of indigenous people and bring poverty,
unemployment, and racism type of social issues that affect the health mental health of
indigenous people in the country [6]. The increasing number of population in indigenous
people is also a major cause of their unemployment in the country that further leads to mental
health issues like depression, anxiety, and stress. The population of indigenous people was
increased by 19% from 2011 to 2018 and it was really a serious concern for the Australia
government from the mental health perspective of these people [5]. The major issues for the
indigenous people about their mental disabilities are unavailability of proper health care
facilities in indigenous areas. Apart from this, the living style and way of communication of
indigenous are is different from Australian common people. In such a scenario the chances of
miscommunication and ineffective patient and doctor communication is the major cause of
the increasing mental health disabilities in the community. English is not the first language of
indigenous people in Australian rural areas and it might be the fifth or sixth language.
Therefore, the miscommunication between doctor and indigenous people possible and it leads
to several other health issues among them like allergy of medicines, inappropriate doses of
medicines, or poor health concerns [7]. Mental disabilities is the indigenous people is really a
serious concern for the Australian government because its shows a national shame for the
country where large number of people are avoided by the national health programs of the
country and facing extreme issues of unemployment, poverty, and healthy life style.
However, the unavailability of medical health experts and psychiatrist or mental health
specialist in the indigenous areas is a serious problem that raises the issues of mental health
disabilities in the indigenous population in the country [20].

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It has been found that factors cause racism, discrimination, and inequality are the major cause
of mental disability in the indigenous people and it leads to suicide tendency and self-harm
problems in the indigenous people. However, the indigenous people strongly fighting against
these social issues in the country to protect and preserve their culture, ethnicity, and artistic
tradition in the country. However, poor conditions of indigenous people in rural areas leads to
10 times more like to develop mental health issues like dementia than those people who lives
in India, Indonesia, or Africa [12]. However, the mental disability conditions in indigenous
area also show the failure of government and its health programs and mission in rural areas to
protect the indigenous and aboriginal people from the mental health issues [8].
Key Factors at Micro, Meso, and Macro Levels
Mental health issue (13%) is a big burden of disease in Australia after the cancer (16%),
cardiovascular disease (14%), and musculoskeletal disorder (15%) [4]. Mental health issue in
indigenous people is a serious issue for the country where large number of people facing
extreme mental pressure because of social, economic, and governmental pressure [18]. The
country spend almost AUD$85 million for indigenous areas for Aboriginal and Torres
Islander people’s mental health services in 2016 to 2019 period. However, the government
tried every time to close the gap between indigenous and non-indigenous people in
employment sector, education sector, and health sector. The main objective behind spending
this huge amount on the mental health of indigenous people is to provide them
comprehensive and culturally appropriate primary healthcare facilities across the country in
all indigenous areas. However, the primary health care services operate its operations at
number of levels in the context of Australia’s system of government and broader health
system [9]. These levels are generally divided in three categories, which are as follow:

Mental Health Disability in Indigenous People
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Micro (practice) level:
The micro level is related to age, sex, and hereditary factors. However, at this level, the
families, culture, and relationship of people with other people play a crucial role in
determining the mental health issues among indigenous people. At this level, the individual
and group of people or agencies are looking to find out people and provide them individual
unitary support for the mental health disabilities. Although this level also considers small
factors like individual life style, their perception, thinking, and living style. It has been seen
that indigenous people are more cautious about their culture and living style [11]. Even they
use some old tradition of treatment for some of the serious health issues like infectious
disease etc.
Meso (middle) Level:
Meso level is generally related with the social and political influences on the health sector.
This is the middle level of ecological map where large numbers of factors considered for the
mental health issues in indigenous people. The major factor that is related with mental health
disabilities of indigenous people is related to their social and cultural environment [20].
However, the meso factors generally positioned between the macro and micro level.
However, connect the healthcare programs and agencies with the local people and determine

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the success of all the primary health services in the indigenous areas. The social and
community influences play a major role in determining the health status of indigenous people
as they can cooperate, coordinate the various health programs, and ensure the success of the
programs in the society [10].
Macro (system) level:
Micro level is a broader level in the ecological health map that includes various macro factors
that have direct influence on the health of indigenous people. The macro level factors show
the system of governmental influence on the mental health disabilities of indigenous people.
At this level, the national or state level policies, funding strategies of government and the
infrastructure from the government to provide better mental health care to the indigenous
people can be considered [21]. At this level, the political influence, socio-cultural influence,
and environmental challenges play a crucial role in determining the mental health of
indigenous people. However, many organisations and agencies at both state and federal level,
which are playing crucial role in determining the mental health of people, are also considered
at this level.
These three levels of ecological map show the influence of various external factors at mini,
micro, and meso level on the mental health of people. These factors have a huge impact on
the mental health of people in indigenous areas [13]. The attitude and old culture at the micro
level is a serious problem for the indigenous people about their mental health issues. The

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Australian government spend a huge amount the individual development of people in the
indigenous areas and provide them job opportunities to avoid stress of unemployment of
young adult people in indigenous group [23]. At individual level, it is necessary for the
Australian government to provide education and employment to the people, so the mental
stress and depression of people in indigenous area can easily be removed. According to a
report, every three out of five young people between 18 years to 35 years age are facing
extreme mental health issues because of unemployment and poverty. Poverty in rural areas of
Australia (especially in northern region where large number of indigenous people are living)
is a serious cause of mental health disabilities in the people [12].
At the meso level, the reach of healthcare agencies in the rural areas is very limited. Large
numbers of indigenous of people are living in the rural areas where medical help cannot be
available for the people. The support of indigenous people to the national and state medical
health agencies is marvellous but the major problem is related to understand the mental health
issues of indigenous people because of their language difference [22]. Misunderstanding of
people is the real concern for the government and community people that plays a role of
obstacle in the healthcare services. However, the political support and funding for the health
of Australian indigenous people is always a concern for the government [14]. The state and
federal government is spending huge fund on the mental health disabilities of people and
trying to provide better healthcare experts and psychiatrist for the people who are suffering
from mental disabilities in the area. However, the major concern in the rural and indigenous

Mental Health Disability in Indigenous People
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areas is that people are suffering from heavy alcoholism issues, depression, and anxiety
problem because of poverty, illiteracy, and unemployment situation. If government wants to
reduce the number of cases related to mental health issues in indigenous areas, then both state
and federal government should care about these social determinants factors and must reduce
the gap between indigenous people and non-indigenous people in the country [17].
Discussion about how identified health inequalities for this group could be addressed at
each level
To encounter the mental health disabilities in indigenous people government should
addressed this issue at each level of ecological map. The government should plan for the
health programs and should determine that how effectiveness of the health issue can be
ensured in those indigenous areas where people are facing extreme issues of mental
disabilities. It is essential for the government and local bodies to identify the mental health
disabilities issues and addressed it at each level of the ecological map. To resolve the mental
health issues at the micro, meso and macro level, government should take initiatives for the
indigenous people, which should be effective and appropriate [15].
At Micro Level
At the micro level, government can consider the individual needs and preferences of people.
To improve the mental health situation of indigenous people the government can improve the
individual life style and their behaviour by providing them education. The factors, which can
be considered under this level, are as follow:
1. Individual life style and culture: The government can provide education and
employment opportunities to indigenous people to improve their life style. Once the
poverty in indigenous area will be eliminated, most of the health related issues could
be removed from the society of indigenous people. It is really important for the people
to know about the consequences of various social issues like unemployment and
poverty and its effect on their mental health. Once the Australian government identify
these issues and persuade people to take the facilities of primary healthcare in their
areas, most of the mental disabilities issues can easily be removed [18].

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2. Families and Relationship: Indigenous people are more committed towards their
family members and they are very protective about their culture and life style.
However, the population of these types of people are increasing with rapid speed in
last 6 to 7 years. Increasing population causes heavy unemployment situation in the
indigenous area because large number of people are unemployment and homeless
because of their large number of family members. This is the cause of mental health
issues in indigenous people. The government should educate the people because
education is the only way that helps them to reduce their population and prevent the
mental health issues [16].
At Meso Level
On the meso level, government can deploy numbers of agencies or group of people in each
indigenous area to provide mental health care and treatment to indigenous people. The
approach of government should be based on the involvement of large number of indigenous
people in the mental health care programs conducted through various agencies or local
mental health hospitals [17]. However, the major factors at this level are as follow that can
play a crucial role in determining the mental health of indigenous people:
1. Social and Community Influences: The influence of social and community cannot
be ignored at the operational level of mental health programs. It is really essential for
indigenous people to cooperate the government approach and health programs which
is conducted for their mental health and physical health. It has been found that most of
the indigenous people have registered themselves under the national health program
of Australia but very few of them take the advantage of medical health care facilities
to avoid mental health issues [18]. Apart from this, the number of psychiatrist and
mental health experts in the indigenous area is very few and the government should
increase these numbers to provide better services to the indigenous community.
Although, it can be said that role of society and community members is very essential
to remove the mental disability from the community and their participation in the
health program ensures the success of Australian mental health initiatives for the
indigenous people.
2. Living and Working Conditions: The people in indigenous areas are living in very
dirty and unhygienic environment. Even the people are not aware about the
importance of cleanliness that is one of the crucial aspects of mental and physical

Mental Health Disability in Indigenous People
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health of indigenous people. However, people in indigenous area are well cooperative
and supportive to medical staffs and experts who arrived in the areas to provide them
better mental health awareness. The government should also focus on developing a
culture in the indigenous area where children and young adults are socialised with the
society and other people that will help them to develop their psychological wellbeing
[19]. It is crucial to understand that the mental health issues are directly associated
with the relationship of people with the outer community and social, cultural and
natural environment. However, the isolation of indigenous people from the society or
common Australian people is the major cause of mental disability in people that
should be prevented.
At Macro
At the macro level, the major factors are considered for the mental health issues indigenous
people. These factors have a great impact on the mental health of indigenous people. The
government should focus on the socio-economic factors for the overall development of
indigenous people and avoid the mental health illness.
1. General Socio-economic Factors: Socio economic factors like employment, income,
and education are directly related to the mental disability in indigenous people. The
government should focus on providing better education and employment
opportunities to indigenous people that will improve the situation of indigenous
community in the country and avoid the mental health issues among them [20].
2. Cultural Factors: The cultural factors related to those traditional views and norms of
indigenous people which the follow from centuries. The government should respect
their culture while they provided mental healthcare facilities. Apart from this, the non-
indigenous people should not discriminate these indigenous people in the society.
Every human has common right and freedom and they should be respected in
dignified ways for protecting their culture. It will make them mentally strong and they
will face any challenges of life with mental fitness and strengths [24].
3. Environmental Conditions: The most of indigenous people depends on the
agriculture and other agro-business work. The government should protect them with
adequate funds and technical supports from natural calamities like floods and draught
because these are some of the major reasons behind their poverty that is the major
cause of mental health problems in indigenous people.

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Conclusion
In conclusion, the numbers of indigenous people are increasing in Australian every year with
growing speed but their living style, culture, social issues like discrimination, inequalities,
racism, and socio economic issues like education, employment, and low incomes are the
major cause of their mental health disability. If government will focus on these factors, which
is related to three levels of ecological map, then the mental disability in indigenous people
can easily be removed. However, the government should utilised the national health funds in
right direction and in effective manner so these indigenous people can get maximum
advantages of healthcare facilities provided by the government and prevent the mental
disability in their community. The government should focus on the socio economic factor that
is the major cause of mental disability at macro level of ecological map. If the living style and
income of the people will be increased by providing them employment opportunities and
education, most of the health issues in the indigenous community automatically will be
eliminated from their community.

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References
1. Azzopardi PS, Sawyer SM, Carlin JB, Degenhardt L, Brown N, Brown AD, Patton GC.
Health and wellbeing of Indigenous adolescents in Australia: a systematic synthesis of
population data. The Lancet. 2018 Feb 24;391(10122):766-82.
2. Whalen DH, Moss M, Baldwin D. Healing through language: Positive physical health
effects of indigenous language use. F1000Research. 2016 May 9;5.
3. Bodkin-Andrews G, Carlson B. The legacy of racism and Indigenous Australian identity
within education. Race Ethnicity and Education. 2016 Jul 3;19(4):784-807.
4. Townsend C, White P, Cullen J, Wright CJ, Zeeman H. Making every Australian count:
challenges for the National Disability Insurance Scheme (NDIS) and the equal inclusion of
homeless Aboriginal and Torres Strait Islander Peoples with neurocognitive disability.
Australian Health Review. 2018 Apr 27;42(2):227-9.
5. Paradies Y. Colonisation, racism and indigenous health. Journal of Population Research.
2016 Mar 1;33(1):83-96.
6. Sarnyai Z, Berger M, Jawan I. Allostatic load mediates the impact of stress and trauma on
physical and mental health in Indigenous Australians. Australasian Psychiatry. 2016
Feb;24(1):72-5.
7. Kisely S, Alichniewicz KK, Black EB, Siskind D, Spurling G, Toombs M. The prevalence
of depression and anxiety disorders in indigenous people of the Americas: A systematic
review and meta-analysis. Journal of Psychiatric Research. 2017 Jan 1;84:137-52.
8. Anderson I, Robson B, Connolly M, Al-Yaman F, Bjertness E, King A, Tynan M, Madden
R, Bang A, Coimbra Jr CE, Pesantes MA. Indigenous and tribal peoples' health (The Lancet–
Lowitja Institute Global Collaboration): a population study. The Lancet. 2016 Jul
9;388(10040):131-57.
9. Waterworth P, Dimmock J, Pescud M, Braham R, Rosenberg M. Factors affecting
indigenous west Australians’ health behavior: Indigenous perspectives. Qualitative Health
Research. 2016 Jan;26(1):55-68.

Mental Health Disability in Indigenous People
12
10. Dalton B, Wilson R, Evans JR, Cochrane S. Australian Indigenous youth's participation
in sport and associated health outcomes: Empirical analysis and implications. Sport
Management Review. 2015 Feb 1;18(1):57-68.
11. Clifford A, McCalman J, Bainbridge R, Tsey K. Interventions to improve cultural
competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the
USA: a systematic review. International Journal for Quality in Health Care. 2015 Mar
10;27(2):89-98.
12. McQuaid RJ, Bombay A, McInnis OA, Humeny C, Matheson K, Anisman H. Suicide
ideation and attempts among First Nations peoples living on-reserve in Canada: The
intergenerational and cumulative effects of Indian residential schools. The Canadian Journal
of Psychiatry. 2017 Jun;62(6):422-30.
13. Griffiths K, Coleman C, Lee V, Madden R. How colonisation determines social justice
and Indigenous health—a review of the literature. Journal of Population Research. 2016 Mar
1;33(1):9-30.
14. Gilroy J, Donelly M. Australian indigenous people with disability: Ethics and standpoint
theory. InDisability in the Global South 2016 (pp. 545-566). Springer, Cham.
15. Kinchin I, Mccalman J, Bainbridge R, Tsey K, Lui FW. Does Indigenous health research
have impact? A systematic review of reviews. International journal for equity in health. 2017
Dec;16(1):52.
16. Browne AJ, Varcoe C, Lavoie J, Smye V, Wong ST, Krause M, Tu D, Godwin O, Khan
K, Fridkin A. Enhancing health care equity with Indigenous populations: evidence-based
strategies from an ethnographic study. BMC Health Services Research. 2016 Dec;16(1):544.
17. Spicer B, Smith DI, Conroy E, Flatau PR, Burns L. Mental illness and housing outcomes
among a sample of homeless men in an Australian urban centre. Australian & New Zealand
Journal of Psychiatry. 2015 May;49(5):471-80.
18. Holloway EM, Rickwood D, Rehm IC, Meyer D, Griffiths S, Telford N. Non-
participation in education, employment, and training among young people accessing youth
mental health services: demographic and clinical correlates. Advances in Mental Health.
2018 Jan 2;16(1):19-32.

Mental Health Disability in Indigenous People
13
19. Black E, Kisely S, Alichniewicz K, Toombs M. Mood and anxiety disorders in Australia
and New Zealand's indigenous populations: A systematic review and meta-analysis.
Psychiatry research. 2017 Sep 1;255:128-38.
20. Ridani R, Shand FL, Christensen H, McKay K, Tighe J, Burns J, Hunter E. Suicide
prevention in Australian Aboriginal communities: a review of past and present programs.
Suicide and Life‐Threatening Behavior. 2015 Feb;45(1):111-40.
21. White R. Indigenous young people and hyperincarceration in Australia. Youth Justice.
2015 Dec;15(3):256-70.
22. Pockett R, Beddoe L. Social work in health care: An international perspective.
International Social Work. 2017 Jan;60(1):126-39.
23. Malla A, Shah J, Iyer S, Boksa P, Joober R, Andersson N, Lal S, Fuhrer R. Youth mental
health should be a top priority for health care in Canada. The Canadian Journal of Psychiatry.
2018 Apr;63(4):216-22.
24. Stanley LR, Swaim RC, Kaholokula JK, Kelly KJ, Belcourt A, Allen J. The imperative
for research to promote health equity in indigenous communities. Prevention Science.
2017:1-9.
25. Christensen J. Indigenous housing and health in the Canadian North: Revisiting cultural
safety. Health & place. 2016 Jul 1;40:83-90.