Mental health issues have been identified as one of the leading causes of the Indigenous health gap (18% - second only to cardiac disease). When combined with intentional and unintentional injuries (13%) the two issues account for almost one third (31%) of the total health gap (Vos et al, 2007). Nearly one third of the Aboriginal and Torres Strait Islander population report high levels of psychological distress - 2.5 times the rate of others.
The ability to access appropriate services is in itself one of the social determinants of health. Effective primary health care has a documented capacity to offset the effects of disadvantage by detecting illness early and restoring health (Griew, 2008). As well as population level strategies to address the social determinants, immediate health gains can be made by providing culturally appropriate primary mental health care to address the burden of distress, anxiety and depression amongst the Aboriginal and Torres Strait Islander population.
Reforms for mental health services were agreed by COAG in 2006. While Aboriginal and Torres Strait Islander peoples were identified as a priority group in those reforms, few measures accommodated their needs.
The lack of mainstream understandings equivalent to Indigenous concepts of social and emotional wellbeing has served as a barrier to the delivery of culturally competent mental health services to Aboriginal and Torres Strait Islander people.
'The social and emotional wellbeing concept...recognizes the importance of connection to land, culture, spirituality, ancestry, family and community, and how these affect the individual' (SHRG, 2004).
In 2010 members of AIPA collectively pooled their cultural and professional expertise to develop a workshop to overcome this barrier.
The workshop aims to provide participants with the cultural competence they require to deliver mental health services within a social & emotional wellbeing framework when working with Aboriginal and Torres Strait Islander peoples.
The workshop is underpinned by the Guiding Principles from the SEWB Framework that were developed to underpin the delivery of social and emotional wellbeing and mental health services for Aboriginal and Torres Strait Islander people (2004), and supported by the Working Together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice book published by the Department of Health and Ageing (Purdie, Dudgeon & Walker, 2010).
AIPA has now delivered 78 cultural competence workshops to 1109 non-Indigenous mental health practitioners (July 2010 - Oct 2013).
Evaluation outcomes show the workshop has been successful in achieving its aims.
92% of those who have attended a workshop have rated it as excellent (64%) or very good (28%) and 99% (more than a thousand!) would recommend it to others.
All participants have reported gains in their ability to practice within a social and emotional wellbeing framework and to accommodate the historical and social determinants when working with Aboriginal and Torres Strait Islander clients. This includes recognizing and working with risk and protective factors found within Indigenous-specific domains of social and emotional wellbeing.
For more information see: http://www.culturalcompetence.net.au