NUR329 Assessing Mental Health Status Of Indigenous Population Of Australia Assessment 2 Answer

ASSESSING THE MENTAL HEALTH STATUS OF ABORIGINAL AND TORRES ISLANDER PEOPLE OF AUSTRALIA

ABSTRACT

Background:  Aboriginal and Torres Islander people in Australia have been at higher risk of poor health and overall well-being. There is an immediate need for assessing the current mental health status of the indigenous people and identifying the gap in evidence-based interventions and services.

Aim:  To conduct the review of the literature evaluating the qualitative and quantitative literature on the mental health status of the indigenous population of Australia.

Method:  A detailed analysis of the peer-reviewed journal articles were taken from the year 2012-2020. The literature study included the article from Scopus, Google Scholar, PubMed and PsycINFO, and National Library of Australia. Out of 26 extracted papers, 12 were studied in detail. Papers selected for review consists of surveys, cross-sectional studies and systemic review with meta-analysis. The focus was given to the survey articles that considered the evaluation of the mental health of the chosen population group through direct questioner. Article focusing on the comparative analysis of the indigenous and non-indigenous population were given preference. 

Results:  There is marked inequality in mental health between the indigenous and non-indigenous Australian people. This disparity as well as mental distress can be observed from a very early age. This needs to be addressed through the priority for services and preventive steps. The Prevalence rates for mental health disorder were high for depression followed by mood disorders and post-traumatic stress disorder followed by anxiety disorders and substance dependence.

Conclusion:  There is evident inequality between the health status of the Aboriginal and Torres Islander people in comparison to the non-indigenous population group. Several studies have highlighted the factors influencing the mental status of the Indigenous people however there are no evident researches done on the mental health status of the indigenous population in Australia

Keywords: Indigenous Population, Aboriginal and Torres Strait Islander people in Australia, mental health 

INTRODUCTION

The disease burden among the Indigenous population attributed to the mental health disparities is almost 16%. His can be also considered as a concern due to the prevalence of the vast disparity among the indigenous and non-indigenous population as well as the underestimation of the accurate data the underestimated (Azzopardi et al., 2018). Several studies have indicated that the presence of mental disorders among the indigenous population is four times higher as compared to the non-indigenous counterparts in Australia (Black et al., 2015). The gap in the mental conditions of both these population has reduced in the past few years however the reflection in the data is still worrisome as it indicates the lack of mental health service accessibility for Aboriginal and Strait Islander people. The standardized rate of prevalence of mood disorders was 17%, total 2.2 times higher than those of generalised population of Australia (Black et al., 2015). 

Several factors have resulted in the disproportionate status of the mental health or the services that among the indigenous people which includes colonisation, slavery, lack of service accessibility with services available are either not culturally appropriate in supporting the goals and need of the indigenous people (Black et al., 2017). Despite the compromised mental health of the indigenous people lesser efforts and trials has been conducted to analyse the current mental health status of the indigenous people; hence it requires for the immediate need for addressing the mental health issues and develop the framework that could address the barrier including cultural, economic and geographical barriers existing in the utilization of the resources. 

For Indigenous people in Australia, the role of health and well-being revolve around the concepts of social and emotional well-being (Beckers et al., 2020). Mental health is a crucial part of the holistic concepts of health. As per the National Aboriginal and Torres Strait Islander Social Survey, the essential components that define the mental health within indigenous people are the cultural attachment, language, social identity, self-identity, participation, spirituality and traditional activities. Hence incorporation of social and emotional well-being along with the spiritual and cultural dimension is a necessary way of reducing the mental health burden among the indigenous people (Cunningham, 2018). 

The health statistics

The disparity among the indigenous people and non-indigenous is well known and established. The concern over the health status sand disparity has been even raised by the world health organisation as a concerned human right issue. The indigenous people suffer from higher rates of the chronic illness which may include respiratory illness, circulatory disease and lifestyle disorder. Menta health illness has also the concerning statistics along with substance abuse. As per the statistics released by the Australian Institute of Health and Welfare the aboriginal and Torres islander experience higher distress experiences as much a two and a half times more than the non-indigenous population (Heffernan et al., 2012). They are often admitted to the healthcare centres for the menta; health issues and disorders around twice in rate in comparison to their counterparts.  

The distress may lead to serious consequences among the indigenous people which are reported in form of self-harm having twice prevalence as compared to non-indigenous people. Even the hospitalisation rates of the Aboriginal and Torres Islander secondary to substance abuse are higher. The suicide was the second commonest reported cause of mortality. In the year 2016, the rate of death as per the Aboriginal and Torres Islander survey there were 24 deaths per 1,00,000 persons. These statistics were almost double in comparison to non-indigenous people where the rate of suicide was 11 deaths per 1,00,000 individuals (Hunter, 2019). Since years there has been a lack of evident data reporting for the mental health condition of the Aboriginal and Torres Islander people especially complex mental illnesses like schizophrenia and psychosis. In Australia, there has been underreported epidemiological data for the Aboriginal and Torres Islander suffering from mental conditions. In a study conducted on the indigenous population have found that the prevalence of the psychosis is twice in comparison meanwhile the rate of the mental condition among males is higher than females (Black et al., 2015).

There have been several initiatives that have been employed by the government to address the mental health condition among Indigenous people. These innovative strategies by the state and federal government are focused on reducing the occurrence of the mental illness and improving the outcome of the services. These are intended to develop education-based therapies in a culturally competent manner. This will help in reducing the stress and depression with long terms positive effects such as reducing the suicidal ideations among the indigenous adults and adolescents.

OBJECTIVE

 To Assess the mental health condition among Aboriginal Strait Islander people in Australia.

To compare the mental health disparity among the indigenous and non-indigenous people of Australia.

INCLUSION AND EXCLUSION CRITERIA

The systemic review was based on certain criteria considering the studies were identified on eligibility criteria only if they have taken the Australian Aboriginal or Torres Strait Islander people as the sample of the study. Only studies published in context to Australian population menta health status or government statistics were discussed. The data must be from 2010 onwards. Also, studies that have various metal health comparative discussion. Research articles published before 2012 were not considered for the review. Articles published in the past five years with the relevant study on the indigenous population were considered.

METHOD AND DESIGN

Detailed systemic research was conducted on the available literature in the cyberspace. The articles from 2015-2020 were considered on the data source on Google scholar, PubMed, PsycINFO, and National Library of Australia. The keyword used for the selection of the research paper was Aboriginal and Torres Islander, Australian indigenous people, mental health, social well-being, anxiety, depression or distress.  

Studies were initially excluded if they do not have abstract meeting the eligibility of the exclusion and inclusion criteria. The assessment for the mental health among Aboriginal and Torres islander was concluded through surveys that include the identification of the population and sampling and measurement of the mental health.  Multiple aspects of almost 26 articles were considered and out of which 12 comprising of current mental health conditions, factors influencing it and prevalence of mental illness among the indigenous population were considered. The data was extracted from the 6 surveys which include the measurement of the health status of the indigenous population in Australia. These articles were studied further for the appropriateness of the literature review topic. 

RESULTS

Out of the 12 studies selected eight have found to be reporting the higher prevalence of the psychological distress among the Aboriginal and Torres Islander people in Australia. These studies mostly include adults and adolescents. Four studies have indicated that most of the mental illnesses are underreported either due to limited asses to the primary health centres or lack of awareness, five studies have provided the comparative analysis of the population between the non-indigenous and indigenous people.  6 Surveys have concluded that there is a significant observable difference between the mental health status of the indigenous and non-indigenous people. Higher prevalence of mental distress was observed in the females in five studies. The studies have indicated the distress among the population in almost 50% of studies.

 In one study that has done surveys from the adolescent group have found no difference between the indigenous and non-indigenous population in comparison. The overall prevalence of mental distress among the indigenous population was 11% higher. Two studies have marked the mental distress among school students through the teacher report based on Strength and difficulty Questionnaire which indicates higher behavioural disorder among students. Peer problem, hyperactivity disorder and some emotional disturbances were some of the common reported mental distress. Among adults, some of the commonest reported mental health issues were anxiety in 22% followed by depression in 18% adults. Two studies have encountered a higher prevalence of mental health disorder among the indigenous people in the prison.

DISCUSSION

The review reflected on the higher presence of mental distress among the Aboriginal and Torres Islander people (Black et al., 2015). The rate of prevalence of the mental illness including depression and anxiety is 50% higher or three times more in comparison to the non-indigenous population (Cunningham, 2018). In studies which were based on self or parent, interview have reported the higher prevalence of emotional or mental distress as compared to teacher interview. In two studies the self-reported questioner does not found any difference among adult’s mental status of the two groups selected. However, studies conducted in the indigenous children have found some external problems like hyperactivity but have not found significant internal issues like emotional distress (Shepherd et al., 2012). The factors that were affecting the mental status of the Aboriginal and Torres Islander were found to be education, unemployment and lower-income (Nasir et al., 2018). 

These things lead to an adverse impact on the mental health condition of indigenous people and many of them end up being into substance abuse like smoking, alcohol and drug use (Jorm et al., 2012). One of the commonest factors that came out in most of the studies as mental distress is the social disadvantages associated with most of the behavioural issues right from childhood. There are ample of literature that describes the symptomatology and presentation of mental condition however there is still lacking substantial search done on the field of mental status rather than reporting of the mental illness among Aboriginal and Torres Islander people.  The crucial role of social wellbeing, tradition model of health, cultural competencies and social worker is also not studied well. The inclusion of the recovery approach had not been well studied among the indigenous people in term of mental illness. There is a need for the development of guidelines for the management of mental distress in the Indigenous population. These guidelines may include prescribing and diagnosing the condition (Molloy et al., 2019).

LIMITATION

The review has not considered the long-term effect of the social and governmental initiative on the Aboriginal and Torres Islander people mental status. 

CONCLUSION 

The review illustrated marked psychological impact of the colonisation on the Aboriginal and Torres Islander population. The evident impact can be observed due to the historical events leading to disparities. There also have been noticeable mental health problems within indigenous people who have reached a worrisome stage and require immediate attention and intervention. Although there are multiple government initiatives to address the issues however the need for further researches in the area should be prioritized to address the core issue causing imbalanced mental health status.