Critical Analysis of Case Management Practice for First Australians

This essay provides a critical analysis of case management practice for First Australians, addressing historical and contemporary issues faced by Aboriginal and Torres Strait Islander people. It discusses the impact of colonization, including genocide, cultural destruction, and health disparities, and examines current challenges such as poorer housing, lower socioeconomic status, and racism. The essay explores case management principles, culturally responsive guidelines, and the intercultural tensions that arise when healthcare is provided by non-indigenous professionals. It also highlights case management models used in Aboriginal healthcare, such as strengths-based and clinical case management, and discusses the benefits and limitations of case management in improving healthcare access and outcomes for First Australians. Desklib offers this essay as a valuable resource for students studying social work and indigenous health issues.

Running Head: CASE MANAGEMENT PRACTICE FOR FIRST AUSTRALIANS 1
Case Management Practice for First Australians
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CASE MANAGEMENT PRACTICE FOR FIRST AUSTRALIANS 2
Case Management Practice for First Australians
Introduction
The people of the European ancestry have occupied Australia for only about 10
generations. Before their arrival in 1788, for possibly more than 2,600 generations (65, 000
years) the land was owned and occupied by various indigenous communities who co-existed
peacefully and harmoniously. Their cohesion was based on their comparable customary values
and laws, as well as similar life experiences and practices such as communal initiation rites and
exchange of women amongst extended families. They were hunters and gatherers who survived
mostly on world foods. However, they were organized in such a way that women dug up and
collected food resources such as edible roots, ants, burrowing animals, grubs, insects, shellfish
and vegetables while the men fished and hunted. (Jalata, 2013). These nations had a rich artistic
heritage and culture and possessed distinctive skills in areas such as forest regeneration and
navigation. They are now referred to as Australia’s first peoples and include the Aboriginal and
Torres Strait Islander people in the country. This essay discusses the historical as well as the
contemporary issues faced by the first Australians. It also deliberates case management practice
for these communities putting emphasis on how it is carried out and the models commonly used.
In addition, the paper brings to light the benefits and limitations of case management in relation
to Australia’s first people and highlights any tensions identified in the practice.
Historical and Contemporary Issues Facing the Aboriginal People
Historical Background
Prior to the arrival of English colonial settlers, the land of Australia was occupied by
indigenous nations with a unique culture. They did not have permanent settlements neither did

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they keep domestic animals, in exception of the dog. Their movements were dependent on the
accessibility of food and water resources in the region (Jalata, 2013). Conversely, they had
property rights in groups as they recognized kinship relations which were vital to their economic
and social practices. Indigenous Australians mostly produced for their subsistence consumption
and only traded within and outside their kin associations to a limited extent which sometimes
brought about episodes of conflict among the groups. These communities also engaged in
activities of leisure, administration and management, education, investment, religion and ritual,
reproduction, order and sometimes warfare. Indigenous Australians were oral communities who
kept their cultural heritage alive by passing their customary laws, knowledge, performances, arts,
rituals, and languages from one generation to the next.
Key Historical Issues
The history of Australia’s first people is marked with the arrival of English, Dutch and
French settlers in the late 18th century, termed as one of the most unexpected and disastrous acts
of colonization in the world’s history. Mariners from Europe started to explore Australia in the
early 17th century. Between 1606 and 1770 approximately 54 ships belonging to European
mariners had arrived in the continent and made contact with the inhabitants. Initially, the
indigenous people were amicable to the foreigners and exchanged artifacts, cloth, food and other
materials with them. Nonetheless, the English settlers, later on, turned this friendliness and
cooperation into conflict, terrorism, and war and started expropriating their lands. This led to
resistance by these communities as the invaders were disrupting their way of life and violating
their rights to the property. The more the colonizers confiscated their lands the more the
communities resisted leading to the loss of the lives of many indigenous populations. The
English colonizers also eradicated the self-governing laws and institutions of the Aboriginal

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people and replaced them with their own rules and regulations. In addition, women were raped
and children kidnaped to become unpaid laborers for the white folks (Jalata, 2013).
Contemporary Issues
This act of colonization introduced genocide, cultural destruction, epidemics, abduction,
displacement, rape, alcoholism, and warfare as many Aboriginal nations were wiped out and the
rest were subjugated. New infections such as influenza, measles, chickenpox, and smallpox were
introduced. Until the late twentieth century with the introduction of the National Sorry Day in
1998, European Australians denied or suppressed most of this horrific history. This is an event
that was introduced to commemorate the mistreatment of the indigenous people for the past two
centuries. Unfortunately, the indigenous Australians have never quite recovered from these
adversities and many still suffer the social, psychological and economic detriments of their
ancestry. An event such as the Stolen Generations adversely affects the mental health of many
aboriginal people (Blignault et al., 2014). In this incident, children of the Aboriginal and Strait
Islander lineage were removed from their families by church missions as well as the agencies of
the state and federal governments under their analogous parliaments. Some indigenous
Australians have reported losing their relatives while a percentage of others have made reports of
being separated from their families (ABS, 2009). The hardships have also affected their
wellbeing, reducing the abundance of their health. Compared to other Australians, indigenous
people have poorer health as more of them suffer from chronic conditions such as heart disease,
diabetes, cancer, trauma, and mental ailments as well. Also, more of them are involved in
excessive drinking and smoking in comparison with non-indigenous Australians (Vos et al.,
2009).

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Indigenous Australians are also faced by issues such as poorer housing conditions and
lower socioeconomic position as compared to other Australians which impacts on their health
and wellbeing. A person’s conditions of living have a huge effect on their health. Many non-
indigenous Australians live in overcrowded households in which they can easily contract
communicable diseases such as TB that in addition to the chronic illnesses affecting them,
adversely impacts their wellbeing (O’Donnell & MacDougall, 2016). Many of Australia’s first
people are from poor backgrounds which impact on their education, their living standards and
consequently their ability to secure good employment opportunities and high levels of incomes.
In turn, this affects their capability to secure quality healthcare and obtain frequent medical
checkups which negatively impacts their wellbeing and expands the life expectancy and health
gap between the indigenous and non-indigenous Australians. This may become an
intergenerational issue as their children may not be able to acquire a decent education or obtain
good jobs as well. Although various attempts such as Closing the Gap and the National
Aboriginal and Torres Strait Islander Health Plan have been made to progress the health of the
indigenous people, aspects such as racism, social and cultural barriers may hinder this
improvement.
Case Management Practice for Australia’s First People
Case management is a coalesced process that entails care coordination, planning,
assessment, evaluation, facilitation, and advocacy for services and options that are intended to
meet the patient’s comprehensive care needs as well as those of the individual’s family. This is
done through effective communication and use of the available resources to enhance the quality
of care, promote the patient’s safety and their health outcomes and reduce healthcare costs
involved. Case management is based on the fundamental premise that everyone benefits when a

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person reaches their optimal level of functional aptitude and wellness. These include the party’s
support systems, the institution’s reimbursement schemes, the healthcare delivery systems and of
course the individual being served. Case management and care coordination are practices
incorporated when the client requires multidisciplinary support often from a range of health
service givers and across different sectors (Lukersmith, Millington & Salvador-Carulla, 2016).
The case manager’s responsibility is to support the client throughout the journey to make sure
that he or she receives continued care that is actively coordinated to meet his or her complex
requirements.
In the case of case management practice for the indigenous Australians, policies and
guidelines have been developed that are culturally responsive, holistic and uphold the
perspectives and values of the Aboriginal people. These principles are intended to:
 inform specified service responses and complete care that meet the unique
requirements and expectations of the indigenous communities as recognized by the
Aboriginal people
 respond to the particular needs of the Aboriginal communities across the
healthcare continuum from prevention of illnesses and early intervention to aftercare
support and child protection (AIHW, 2015)
 apply to all phases of case management involved in the care and support
of the Aboriginal people both within and outside their service environments. These stages
include case planning in consideration to the culture, execution, monitoring as well as
case review (Moore, 2016).
The healthcare for Aboriginal communities is mostly provided by non-Aboriginal people
due to a shortage of medical professionals that are of indigenous descent. In fact, only one

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percent of the healthcare workforce identifies as Aboriginal and/or Torres Strait Islander, despite
the efforts that have been made towards increasing this number (Wilson et al., 2016). Provision
of health care to the Aboriginal people by a specialist from the same group of people enhances
accessibility to culturally appropriate care and improves the health outcomes of the patient hence
addressing the inequality in health faced by the Aboriginal and Torres Strait Islander
communities. On the other hand, there is an intercultural tension when care is provided to the
Aboriginal people by non-indigenous healthcare professionals Moore, 2016). This is caused by
differences in their values, practices, and ways of life as they have disparate views on many
things and the world at large. An intercultural space or interface is created that causes anxiety,
disquiet, and discomfort between the patient and the clinician. However, this interface also
provides an opportunity to learn and better understand both the worlds. Healthcare educators,
students, and professionals can help in closing the life expectancy and health gap that exists
between the indigenous and non-indigenous Australians by working effectively within the
intercultural space (Wilson et al., 2016).
Case Management Models
Some of the case management models used in the healthcare of the Aboriginal people are
the strengths-based clinical case management model and the clinical case management model.
The most commonly used in the latter, whereby the clinician is the case manager. This model
puts into account the fact that many patients face obstacles to services that stretch beyond the
question of access to healthcare. As the clinical care provider, the case manager provides
counseling, information, and education to the patient. This is applicable for the Aboriginal
people as many of them suffer from chronic conditions such as diabetes that require continuous
management even after leaving the hospital. The clinician provides info to the patient on how to

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manage the disease so as to avoid its severity and minimize the pain and symptoms. Chronic
conditions are also associated with various medications for which the healthcare professional
gives directives on usage. In addition, the care provider is able to embolden the client to create
connections with family and friends which is crucial management of chronic illnesses
((Uittenbroek et al., 2018).
Benefits and Limitations of Case Management
In relation to the healthcare of Aboriginal and Torres Strait Islander, case management is
beneficial as it prevents hiccups that could have otherwise occurred during the interactions of the
patient with the healthcare providers and other parties of interest, for example, the insurance. It
thus makes the client’s process of engagement easier and it can encourage those who are less
likely to obtain services due to a lengthy procedure (Stokes et al., 2015). It also enhances the
accessibility of data by the care providers who are then able to strategize on their clinical
decision making. Additionally, clinicians can be able to share data easily leading to safer and
better care across all sectors. Furthermore, case management creates a seamless healthcare
experience which leads to a reduction of cost for both the institution and the client (Hudon et al.,
2016). This is especially helpful to the indigenous Australians who have relatively low socio-
economic status. Case management creates a stronger relationship between the caregiver and
receiver which advances the quality of care as well as patient experience (Uittenbroek et al.,
2018). Nonetheless, case management has its drawbacks such as issues of betraying patient
confidentiality through oversharing of data. The line between the data that can be shared and that
which cannot be made known is thin and can be crossed sometimes. Also, case management
services are successful in situations where there is effective communication. This may however

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not be the case with the healthcare of Australia’s First people due to issues such as language
barrier as well as cultural differences which may lead to misunderstandings.

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References
Australian Bureau of Statistics (2009). National Aboriginal and Torres Strait Islander Social
Survey 2008. ABS cat. no. 4714.0. Canberra: ABS.
Australian Institute of Health and Welfare (AIHW) (2015). Child Protection Australia 2013- 14,
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Blignault, I., Jackson Pulver, L., Fitzpatrick, S., Arkles, R., Williams, M., Haswell, M. R., &
Grand Ortega, M. (2014). A Resource for Collective Healing for Members of the Stolen
Generations: Planning, Implementing and Evaluating Effective Local Responses.
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management interventions for frequent users of healthcare services: a scoping
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O’Donnell, K., & MacDougall, C. (2016). Social determinants of health of Australia’s First
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