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Guaranteeing the mental health and social and emotional well-being of Aboriginal and Torres Strait Islander peoples

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Earlier this year, the National Mental Health Commission announced a comprehensive review of mental health services and programs across Australia, including in the private, government and non-government sectors.

Although the review is seeking to identify where efficiencies can be made, a major focus is nonetheless to develop measures to support individuals with a mental illness and their families to lead a full life and engage productively in the community.

Aboriginal and Torres Strait Islander peoples are a group identified by the Commission as particularly important in its review.

Aboriginal and Torres Strait Islander peoples are among the most disadvantaged groups in Australia, and experience high levels of mental ill health and low levels of social and emotional wellbeing.

The sources of poor mental health and wellbeing are bound up with the social, economic and cultural circumstances of Aboriginal peoples’ and Torres Strait Islanders’ history and current lives. Suicide rates are high, including among young Aboriginal people and Torres Strait Islanders, and in many communities there are significant levels of substance use, violence and insecurity.

The AMA, through the work of its Taskforce on Indigenous Health, has recognised for some time that the solutions to these problems must incorporate many different factors, including recognition of the importance of a strong cultural identity as a key lever for healing.

However, the momentum around systematic and strategic national measures to improve things has flagged.

The five-year COAG National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes negotiated in 2009 was a significant step forward in closing the health gap, and the AMA believes that it must be renewed, and must include a greater focus on  mental health and harmful alcohol and substance use.

In order to strengthen the services and opportunities available to improve the mental and emotional health of Aboriginal people, the AMA believes that future COAG Closing the Gap agreements should recognise that Aboriginal people benefit most from health care provided by Aboriginal people. This will particularly be the case regarding their mental and social and emotional health.

The AMA believes, and research shows, that Aboriginal community controlled health services (ACCHS) have a strong capacity to provide comprehensive care that can address drivers of poor mental health. That capacity can be enhanced through:

  • setting core funding for the Aboriginal community controlled health sector at a rate which allows existing ACCHSs to attract GPs, health and mental health professionals through appropriate salaries, and to have the infrastructure to accommodate them, particularly in remote locations;
  • the development of a capacity-building plan, in partnership with the National Aboriginal Community-Controlled Health Organisation, for the establishment of further ACCHSs in areas of need; and
  • the development of more services dedicated to mental health and emotional and social wellbeing, according to the ACCHSs model.

Mental health must be tackled in an integrated and strategic way for Aboriginal people and Torres Strait Islanders. This requires that:

  • the National Aboriginal and Torres Strait Islander Suicide Prevention Plan be implemented as soon as possible, with appropriate resourcing;
  • the Social and Emotional Wellbeing Framework for Aboriginal people and Torres Strait Islanders be implemented as soon as possible; and
  • an alcohol and other drugs strategy for Aboriginal peoples and Torres Strait Islanders be developed.

Finally, imprisonment can exacerbate mental health and substance use issues. One in four people in prison today is an Aboriginal person or Torres Strait Islander.

The AMA strongly believes that rates of incarceration of Aboriginal people and Torres Strait Islanders must be significantly decreased, particularly of young offenders. Those in prison should also have ready access to culturally appropriate mental health and substance use treatment.

The AMA believes that the impetus for improving the mental, social and emotional health of Aboriginal and Torres Strait Islander people needs to be re-invigorated.

The AMA’s Taskforce on Indigenous Health will be contributing to the momentum by developing this year’s Aboriginal and Torres Strait Islander Health Report Card on mental health and social and emotional wellbeing, and making detailed and practical recommendations for change.