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  • Cultural competence training for mental health practitioners

    Author: Karen Keast

Mental health issues are one of the leading causes of the Indigenous health gap. A group of Indigenous psychologists are stepping into the gap, developing essential resources to improve the cultural competence of Australia’s mental health workforce.

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Indigenous psychologist Tania Jones is adding an Aboriginal voice to mental health care provision for Indigenous Australians.

A descendant of the Gunditjmara and Wathaurong peoples of Victoria, Ms Jones is based in Warrnambool, where she works with Indigenous communities and stakeholders as an Indigenous family violence regional coordinator.

Ms Jones is also chair of the Australian Indigenous Psychologists Association (AIPA), an affiliate of the Australian Psychological Society (APS), which is committed to advancing the social and emotional wellbeing and mental health of Indigenous Australians.

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“I’m passionate about working with my own Aboriginal people and also about ensuring a viable choice for people to get good service provision and to have good outcomes when they do seek mental health and allied health services,” she says.

“When people have really good outcomes, that impacts on their entire life.

“I suppose that’s what got me into this area was that driving, burning need to have some input into that.”

Statistics show Aboriginal and Torres Strait Islander people have the highest rates of psychological distress in Australia while the suicide rates are at least two to three times higher for Aboriginal people than for non-Indigenous Australians.

AIPA is working to improve the mental health of Indigenous Australians through a raft of measures.

One measure is to equip non-Indigenous mental health practitioners, including mental health nurses, psychiatrists, occupational therapists and psychologists, with mental health cultural competence training.

Ms Jones says it’s vital nurses and allied health professionals provide culturally appropriate services that focus on the social and emotional wellbeing framework for Indigenous Australians, rather than mainstream concepts of mental health.

Mental health issues for Aboriginal and Torres Strait Islanders go beyond the individual and are linked to a person’s connection to land and culture, alongside physical, emotional, spiritual and social factors.

Social and emotional wellbeing connections also need to be considered within broader social, cultural, political and historical contexts.

“I think that people are all well-intentioned and they think that by providing the same service to everybody, they are catering to everybody,” Ms Jones says.

“Sometimes that’s not the case because you may not know that an Aboriginal person comes from a collective as a society, and therefore their obligations and their responsibilities can be very different to that of a person in an individualistic culture.

“If you don’t take into account their broad connections to family, kinship groups and community, then you may be missing some of the story or some of the picture when you are dealing with that client and you may not be giving the assistance that is going to help them heal.

“If this misconnection is occurring then people don’t engage.”

AIPA has provided cultural competence workshops to the majority of Medicare Locals nationally and also provides free, online resources for mental health practitioners including the Working Together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice book.

The book, now in its second edition, was edited by leading Indigenous psychologist Professor Pat Dudgeon, of the University of Western Australia, who is also chair of the National Aboriginal and Torres Strait Islander Leadership in Mental Health (NATSILMH) group, and her UWA colleagues Professor Helen Milroy and Associate Professor Roz Walker.

The book details the social determinants of social and emotional wellbeing, mental illness in Aboriginal and Torres Strait Islander people, harmful substance use and mental health, suicide prevention among Aboriginal Australians, and mental disorder and cognitive disability in the criminal justice system.

It also explains cultural competence and outlines assessment and management, working with children, families and communities, as well as healing models and programs.

Significant differences exist in the way that social and emotional wellbeing, mental health and mental health disorders are understood in different Aboriginal and Torres Strait Islander communities across Australia.

As a result, Ms Jones also advises mental health practitioners to seek Aboriginal community support.

“If you’re dealing with Aboriginal people you really should be also talking to somebody who can give you guidance if something comes up around community, obligations and responsibility about the way they perceive mental health issues,” she says.

“Sometimes it is very different to the way that other people can perceive it, depending on where they are from in Australia and what their belief systems and that are.

“It’s very important to have contact with Aboriginal people to say - is this something that is common with people from this part of Australia or not?

“It’s about being able to have that cultural understanding of what you’re dealing with and the presentations can be different because of that.”

AIPA is striving to increase the number of Indigenous psychologists which currently stands at just 50, and the group is working towards Indigenising psychological curriculum in universities, while providing mentoring and professional support for members.

Indigenous psychologists are making a major contribution to Indigenous health, Ms Jones says.

“We are working with a lot of trauma and grief - it can be attached to the closing the gap statistics of lower life expectancy, chronic illness, those sorts of areas, also suicide is three times higher within Aboriginal communities,” she says.

“We also have trauma associated to racism and that sort of thing. It’s about trying to find ways to heal that hurt.”

Ms Jones says cultural competence training for non-Indigenous mental health practitioners will ensure Aboriginal and Torres Strait Islander people receive better mental wellbeing services.

“It means better outcomes for Aboriginal people but also for the practitioner it’s gaining skills in being able to relate to Aboriginal people,” she says.

“If you can be successful and have good outcomes it’s of benefit to everybody.

“Hopefully this is a way to improve and to close the gap in some of these appalling statistics that are impacting on Aboriginal communities.”

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Karen Keast

Karen Keast is a freelance health journalist who writes news and feature articles for HealthTimes.

Karen regularly writes for some of Australia’s leading health news websites and magazines.  In a media career spanning 20 years, Karen has worked as a senior journalist in newspapers and television. She has covered the grind of daily news and worked as a politics reporter at countless state and federal elections.

Since venturing into freelance writing five years ago, Karen has found her niche in writing about the health sector for editors, businesses and corporations.

Karen has interviewed the heads of peak health organisations in Australia and overseas, and written hundreds of news and feature articles covering the dedicated work of health professionals who tread the corridors of hospitals and health services, universities, aged care facilities and practices, day in and day out.

Follow Karen Keast on Twitter @stylemywords