NUR 3030 Aboriginal And Torres Strait Islander Health Assessment 1 Answer

a) Aboriginal concept of Social and emotional well-being as opposed to term mental health:

Aboriginal and Torres Strait Islander use the term social and emotional wellbeing to indicate the emotional, spiritual, social and cultural well-being of the person. They do not describe health as an objective entity but consider the well-being as the whole entity comprising of family, community., land and culture. All these impacts the health of the individual (Toombs et al., 2020). They also value the significance of past encounters and policies as a part of social and emotional well-being. Contrary to this the western world or non-indigenous people use the word mental health for the individual mental health status. They use the word mental health to describe the feeling of the individual and how they cope and behave in daily activities (Balaratnasingam et al., 2018). The concept deal with either the presence or absence of mental illness. The individual is considered mentally healthy if he does not have any mental illness which might affect his feeling, behaviour, perception and thinking. However, the Aboriginal does not consider it as a parameter for the social and mental well being as it primarily focusses on the illness, problems only and does not give weightage to the concept of well-being and factors that influence it ("Department of Health, 2013).

Factors impacting the social and emotional well being 

For Aboriginal and Torres Strait Islander people several factors influence the emotional social well-being. These factors can be from their day to day routine stress stimulus to major life events. These factors majorly include loss of lands, forced removal from the homelands, poverty, dispossession and impact of policies.  Three crucial factors that have deeply impacted the concept of social and emotional well being for Aboriginal and Torres Strait Islander people are the denial of humanity, denial of existence and denial of identity (Gupta et al., 2020). Also, the importance of social and emotional well-being is due to the disadvantages indigenous people have faced in history and even today. This is evident in the field on employment, education, income and their positioning within the society in Australia (Toombs et al., 2020).

The concept of SEWB 

Social and emotional wellbeing differs from the western concept of mental health in the way of adopting broader and holistic attributes. Social and emotional wellbeing signifies a distinct set of principles and domain and cultural set of practices. The social and mental well-being framework have some essential components and concepts which describes the core understanding and values of Aboriginal and Torres Islander. These key principles include the concept of health as a holistic entity (Williamson et al., 2016). The right of self-determination; cultural understanding and cultural diversity; the human rights, impact of history in terms of trauma, racism, stigma. The social and emotional well being is connected with the domains of body, mind and emotions which are based on the bodily as well as interpersonal experiences. However, the contemporary definition of mental health incorporates the mere absence or presence of predefined mental illness or measurements along the spectrum of positive mental health (Williamson et al., 2016).

b) Aboriginal Medical Services and how they align with the WHO concept of primary healthcare:

The first Aboriginal medical services were established in the year 1971 at Redfern as National Aboriginal and Islander health organisation. This development was part of the urgent requirement for providing an appropriate response to the healthcare need of the indigenous population. The development of Aboriginal medical health services was the reflection of self-determination among the indigenous population of Redfern. In Australia, the health status of the indigenous population was already disadvantaged evident through various health indicators including mortality and morbidity rate (Davy et al., 2016). They are prone to poor health outcomes owing to racism and inaccessibility of services in comparison to non-indigenous counterparts. The Aboriginal medical service was started by the community activist and initially staffed by non-indigenous doctors, nurses and students. Then the National Aboriginal Community Controlled Health Organisation was established in the year 1988. This was followed by NACCHO establishment in the year 1992. In the year 1997 government-funded NACCHO formed secretariat in Canberra for health management and policy development ("NACCHO History", 2020). This was more of a shopfront volunteer service on Regent street in Redfern. Within the year of opening, the services became so popular among the community that funding from the federal government was provided. Then AMS grow into a multidisciplinary service containing medicine clinics, dental, family clinic and public healing outreach services. The model is now well accepted in Australia with approximately one hundred and fifty community-controlled health services across Australia. Aboriginal medical service has fostered the union with several hospitals and organisation including Prince of Wales Hospital, Hearing Australia, Sydney Local Health District. The service has now expanded intending to uplift the health standards and indicators of Indigenous population (Durey et al., 2016).

Aboriginal medical services also known as Aboriginal Community Health services are controlled by the local population and community members. These members are the elected boards of management. The primary health care framework adopted by the Aboriginal health services is resonant with the WHO model of primary health care services and universal health coverage which is aimed at providing effective, affordable and accessible health services for the need of the community population (Campbell et al., 2018). The healthcare services focus on the motto of social justice and disease prevention through health promotion abiding by the alma Alta declaration 1978 of WHO. The WHO's public health agenda describes four gaps that needs to be addressed including social justice, community responsibility, implementation and knowledge. AMS primarily works on the principles of providing comprehensive primary health services in the environment which creates positive impact and people within the community to receive health services as needed (Durey et al., 2016). Based on the principle of primary healthcare services Aboriginal medical services also play a crucial role in correcting the health inequalities within the communities through the various spectrum of activities of health promotion, prevention and early detection, intervention, rehabilitation and treatment. They function to provide health programs that provide treatment and management along with prevention and health promotion through addressing the social determinants (Harfield et al., 2018).

c) How social and emotional well-being is applied in an Aboriginal community-controlled health services

The fundamental aim of Aboriginal Community controlled health services is to provide primary health care to people of indigenous community, that is to not only serving the local community but providing holistic, cultural and comprehensive health opportunities (Finlay & Wenitong, 2020). The concept of self-determination and social and emotional wellbeing plays the central role in Aboriginal Medical service.  The principle discussed in the National “Aboriginal Health strategy” also emphasis on not only serving the physical well -being of the individual through Aboriginal medical services but serving the community for socially and emotionally empowering the individuals of the community to achieve total well-being. It addresses the multi-faceted need and cultural complexities of people. Closing the gap framework” of the Aboriginal community-controlled health service is committed in reducing the disadvantages of the indigenous population such as racism, barriers to healthy living and healthcare services which are contributing factors in the social and emotional health of the Aboriginal people (Sibthorpe et al., 2018). 

The clinical services along with health promotion, community engagement and cultural safety are underpinned through the various model of care, research and planning. They provide various programs including maternity and child health, family centres primary healthcare, substance abuse care through the team-based approach and participation of friends, family and outreach services.  This helps in engaging the resources and time in a better way and creating an environment for individual holistic growth including social and emotional well-being (Harrison et al., 2019). The impact of the medical health services can be reflected in dimensions other than health-related provisions like employment, empowerment and sharing social responsibilities towards the community development.

 By providing culturally competent practices and indigenous leadership and co-development within the community the Aboriginal community-controlled health services can foster the environment which facilitates the implementation of programs which are further directed towards improving the SEWB for the indigenous population in Australia. The strength-based approach adopted help in reducing the risk factors and facilitating protective factors for mental health or social and emotional well-being. This facilitates the movement towards better constructive behaviour and competencies for enhancing life (Mills et al., 2017). 

The impact of social, economic and health issue disturbs the spiritual, spiritual and emotional growth of the Aboriginal people. The Aboriginal community-controlled health service under the funding of the federal government also support in the implementation of the “Quality improvement initiatives” in indigenous healthcare (Sibthorpe et al., 2018). This is done through the “Healthy for life program”. This allows the efforts essential for building a healthier community with the progressive improvement of health and reduced negative impact of persistent differences. This also enhances the SEWB of indigenous people. ACCHSs also provides the training and development to the staff and the workforce for better culturally competent and informed care.  Through its “Patient centred medical home model” and “Community-driven model of care”, they have achieved the comprehensive success in the outcomes in comparison to mainstream mental clinics or primary health centres (Harrison et al., 2019).