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Carers of Indigenous children: services and systems failure? Where to next?

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We need solutions that adequately engage Indigenous carers in mental health care

In this issue of the MJA, Anna Williamson and colleagues report that 18% of a sample of primary carers of Indigenous children in urban New South Wales exhibit high or very high rates of psychological distress.1 This paper raises a number of questions. One in three carers reported that they or a relative had been removed from their primary carer as a child. This figure is astoundingly high, and leads us not only to wonder whether this rate of removal is similar in other populations in Australia, but also why the rate of psychological distress is not higher. Williamson and colleagues found no correlation between the carer having been removed themselves and currently high distress levels. We suggest that the small number involved (28, or 5% of the sample) affected the power of the analysis to detect a difference; the lack of association may reflect a psychological survival strategy of suppression, as has been found by research into the effects of childhood trauma.2

The reported high rates of distress in urban NSW carers of Aboriginal children prompts us to ponder the rates in other parts of Australia. Comparative data about parenting is sparse, with differing outcome measures and sample demographics used, but an Australian study found the rate of depressive symptoms in Indigenous…