NUR3030: Exploring Indigenous Wellbeing and Primary Health Care

This essay critically analyzes the Indigenous definitions of social and emotional wellbeing, contrasting them with Western perspectives on mental health. It explores how Aboriginal Medical Services (AMS) are underpinned by Primary Health Care principles. The essay highlights the differences in understanding wellbeing, emphasizing the importance of cultural, spiritual, and community connections for Aboriginal and Torres Strait Islander people. It discusses the historical context, including dispossession and the stolen generations, and their ongoing impact on social and emotional wellbeing. The role of Aboriginal Medical Services and Aboriginal Community Controlled Health Services (ACCHS) in providing culturally appropriate and holistic care is examined, emphasizing their alignment with primary healthcare principles and their focus on addressing social determinants of health.

Running head: MENTAL HEALTH AND WELL-BEING
MENTAL HEALTH AND WELL-BEING
Name of the student:
Name of the university:
Author note:

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Introduction:
Social and emotional wellbeing problems of the aboriginal and Torres Islander people are found
to be quite different from the mental illnesses that are considered by the western healthcare approaches.
However, both can interact as well as influence each other. It has been found that even with that of the
good social and emotional wellbeing, individuals can still develop mental illness (Newton et al., 2015).
Again, individuals suffering from long-term mental illness can survive and function at a high degree with
sufficient support. Therefore, the main aim of living a better quality life with high social and emotional
well-being can be only achieved when several important factors in life like spiritual, emotional, physical,
mental as well as financial wellbeing are achieved by individuals. This assignment would show how
different professional bodies working under aboriginal leaderships can help in developing better quality
lives.
Differences of the concept of social and emotional wellbeing of Aboriginals and that of the mental
health concept of the western healthcare system:
Aboriginal and Torres Strait Islander people are mainly seen to use the term of social as well-
being to describe the emotional, social, cultural as well as spiritual well being of a person. They are of the
opinion that connection of the people with that of the family, culture, spirituality, land as well as
community are significant for the people and can thereby impact on their well-being. They have also
stated that different policies and incidents of the past also hold the capability of shaping the social as well
as emotional well-being of a particular person (Hatala et al., 2016). Often the concept of social and
emotional well-being also called SEWB put forward by the Aboriginal and Torres Strait Islander people
are often compared with that of the concept of mental health as believed by the western healthcare
approaches. It has been found that the western healthcare approaches mainly refer the terms of mental
health as the area which described how people think and feel and how they are able to cope with the
different issues in life and take part in everyday activities. Western healthcare professionals consider

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mental health disorders as the conditions when people become unwell in mind and when it affects their
feelings, thinking as well as behavior. People are considered to being mentally healthy when they do not
have any mental illness. Therefore, there remains a stark difference between the concepts of social and
mental health by aboriginals and that of the mental health as proposed by western healthcare.
Many of the Aboriginal and Torres Strait Islander people are of the belief that mental illness and
mental health as considered by the western healthcare centers mainly focus too much on the problems
and do not describe all the factors properly that are considered to be important components of well being.
Therefore, most of the indigenous people are seen to be comfortable by using the term social and
emotional wellbeing as this had been found by them to fit well with the holistic view of health (Langham
et al., 2017). The best ways for understanding the different terms is to think of the different mental health
as well as mental illness as components of the social and emotional wellbeing.
There are different types of factors that can result in negative impacts on the social and emotional
well being of the patient and can range from normal everyday stresses to major life events. Normal
everyday stresses have the ability to impact peaceful emotional conditions of lives in people but such
conditions are not considered to be mental health issues by western healthcare sections unless they impact
the lives of the people in any way. For Aboriginal and Torres Strait Islander people, different types of
events in the past can be seen to have serious ongoing impact on the social and emotional wellbeing.
Some of the incidents are the dispossession from their lands as well as the impact of various policies and
actions that followed like that of the removal of children from their families during stolen generations. All
such incidences have been found to be intricately associated with the social and emotional well-being of
the people (Farnbach et al., 2017). These have humongous impact on the emotional health and mental
condition of the patient as they have put stress on Aboriginal and Torres Strait Islander people making
them go through turmoil condition. Hence not having a mental disorder might not ensure that the person
is having a happy and peaceful living and therefore social and emotional well-being plays an important
life to ensure better quality living.

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Aboriginal medical services and their alignment with that of the primary care principles of
the western healthcare centers:
The gap in health as well as life expectancy between the indigenous and that of the non-
indigenous people has always been a matter of concern that was criticized. The different disparities have
been mainly because of the presence of Aboriginal Medical Services evolved being settled in the remote
areas and about 60% of the gap was found mainly because of a higher burden of disorder of chronic
ailments faced by indigenous people living in both remote as well as the non-remote areas (Whiteside et
al., 2016). It had been always found that the healthcare services that were present for the indigenous
people were not aligned to their cultural preferences and traditions but were rather developed with the
views of the western medical care approach. Hence, language barriers, cultural barriers, geographical
barriers, communication barriers, financial inabilities – all had resulted in poor care services for the
aboriginal people.
In the year 1971, in Redfern, the Aboriginal Medical Service (AMS) had been initiated and
Medicare did not exist. Most of the indigenous people during these times have to travel longer distances
for any emergencies or have to rely on the different goodwill of the different local general healthcare
professionals. Many of the aboriginal and Torres Islanders have experienced racism in healthcare system
and that of the wider community (Shepherd et al., 2017). Poverty was also found to be a major barrier for
attending general practices or purchasing medications. It first started as a shop-front volunteer service and
was mainly staffed by non-indigenous healthcare professionals. Within the first year of the starting, it was
found that it had become quite popular and was not being able to meet the demands for the services
(Skerett et al., 2018). Federal government funding was found to have been made easily available the
following year. From this time onwatds then; AMS has grown into multidisciplinary health services. This
consisted of a different types of clinics as well as services that include medical, public health, dental, and
outreach services. It mainly followed a community-controlled model of health and mainly comprised of
150 aboriginal community controlled health services in urban, regional as well as remote Australia. The

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AMS has always acted as the free service for the Aboriginal and Torres Strait Islander and are mainly
seen to follow the principles of holistic healthcare that align with the expectations of the people of the
nation.
The Sisters of Mercy had donated the property and in this palce, the aboriginal Medical services
had been established in the Redfern Aboriginal community in the year 1978 (Prehn, 2018). The service
now helps in providing medical, dental, aged acre drugs as well as alcohol services to around 55000
patients every years.
It had successfully recognized that education of the healthcare professionals is important part of
the indigenous healthcare when they decided to recruit aboriginal healthcare workers for bridging the
cultural gap in the services. Therefore, the first Aboriginal health workers (AHWs) course had been
started in the year 1984 and then a post graduate program for training in mental healthcare had been
followed (Dobia et al., 2017). From that time onwards, the Aboriginal health worker training had then
moved onto the tertiary settings but many of original class continue to work at AMS and subsequent
graduates were employed in the Indigenous medical and mainstream health services throughout the
nation. In the present times, it has been found that competent aboriginal healthcare professionals work
collaboratively with the local, federal and national governmental organizations and even with western
healthcare professionals ensuring that the care now provided by AMS ensure social and emotional well-
being along with proper physical health.
Their services align with that of the principles of care that are followed by the primary healthcare
services. Just like the primary care services, the AMS professionals focus on collaborative care where
they work with government and non-government sectors for ensuring holistic care services for all people
that align with cultural expectations (Atkinson et al., 2016). Following the guidelines of WHO, they are
now providing which are accessible universally and cover the basic needs of people. The healthcare
professionals ensure that they provide care ensuring health equity and ensure that social justice is

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followed. They also promote community participation in effectively defining as well as implementing
health agendas (Smith et al., 2017). They are also seen to undertake inter-sectoral approaches to health.
Another important aspect of primary healthcare that is also followed by them is educating their clients in
ways by which they learn about the proper lifestyle factors that contribute to quality health and social and
emotional well-being.
ACCHS:
Aboriginal Community Control in Health Services can be explained as the process had been
found to allow the local Aboriginal community to be involved in various types of affairs that work in
accordance with whatever procedures or protocols have been determined by the community. These are the
aboriginal communities that mainly comprises of different types of large multi-functional services which
employ several medical practitioners. Then, they are also found to be providing a wide range of services,
to even different types of small services without medical practitioners (Balaratnasingam et al., 2015).
These services mainly help the Aboriginal healthcare workers or that of nurses for providing the bulk of
primary care services often with that of preventive health education focus. However, they also play
important role in ensuring social and emotional well-being of patients.
While providing care that ensures stable social and emotional well-being of the indigenous
people, it mainly focuses on a number of factors. One of the most important factors that they have
identified correctly is impact of the social determinants of health on the SEWB of the people. Firstly, it
has been found that ACCHS had been successfully contributing to that of the improvement of the socio-
economic contexts in which Aboriginal people live by. This has been mainly done by providing
employment opportunities as well as educational opportunities (Day et al., 2016). Secondly, they have
focused on ensuring that both the non-aboriginal as well as the aboriginal healthcare workers to increase
their understanding of culturally appropriate care.

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Nine guiding principles are mainly followed by the ACCHS so that the Aboriginal and Torres
Strait Islander people can experience the Social and emotional well-being by the people. It can be seen
that the guiding principles although not entirely different but may vary from the governing principles of
the mental healthcare services developed by western healthcare systems. These are considering health as
holistic, right for self-determination as well as the need for the cultural understanding. Therefore, the care
services are seen to ensure that cultural expectations and cultural preferences of the patients are followed
and that they are provided care which ensures holistic wellbeing of people with better physical, mental,
emotional, psychological and spiritual well-being (Ogloff et al., 2017). Other impact of history is trauma
as well as loss, recognition of human rights and also the impact of racism and stigma are well assessed by
the professionals and accordingly their impacts are managed through evidence-based interventions. .
Others important principles of SEWB are recognition of centrality of kinship, as well as recognition of
cultural diversity and aboriginal strengths (Le Grande et al., 2017). Connection to body, mind and
emotions, family and kinship, community, culture, spirit-spiritual-ancestors and similar other factors are
mainly considered for SEWB and therefore, the healthcare interventions that are designed are based on
ensuring that the principles are met successfully.
Inequality in health services and discrimination and injustice while providing care are strongly
condemned by ACCHS. They believe that such aspects in care can prevent SEWB among the aboriginal
people and in order to develop the well being of people, not only mental health but physical, spiritual and
psychological health needs to be ensured. Therefore, the ACCHs are seen to participate in health
screening tests, chronic disorder management, illness prevention, mental health assessment, healthy
lifestyle advice as well as counseling as this might prevent stress due that occur due to ailments and hence
SEWB can be ensured (Kanu et al., 2016). Effective healthcare plans, referrals and adult and child health
check-ups are also ensured that people from different age cohorts like from children to older people can
all enjoy positive social and emotional well-being by being physically fit as well and enjoying resources
required for quality living.

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Conclusion:
It has been found that social and emotional wellbeing of aboriginal people overrides the concept
of being mentally fit and stable. These are governed by many important factors like social determinants of
health, gaps in healthcare status, health inequality and inequity, social injustice and many others. AMS
and ACCHs have thereby tried their best to bridge the gap and prepare healthcare professionals in ways
by which they not only care for mental health of indigenous but also cover other important aspects
affecting their lives as well.

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