Explorations of understandings of mental health in an urban Aboriginal and Torres Strait Islander sample

Kilcullen, Meegan Lesley (2011) Explorations of understandings of mental health in an urban Aboriginal and Torres Strait Islander sample. PhD thesis, James Cook University.

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Abstract

It has been acknowledged that the mental health of Aboriginal and Torres Strait Islander people has been 'bedevilled' by the inappropriate application of non- Indigenous models of mental health. Given the poor health outcomes of Indigenous people, another approach to mental health practice is perhaps required. In order to enhance Indigenous health and wellbeing, it is necessary for non-Indigenous practitioners to find a culturally safe way in which to enter the negotiated space of cross-cultural mental health. Such practice can be facilitated through understanding both the points of similarity and divergence in perspectives of mental health across cultures. While the majority of Indigenous people live in urban areas, understandings of Indigenous mental health have primarily been derived from research in rural and remote communities. It is unclear whether findings from rural and remote research are applicable in urban Indigenous communities. The aim of the current research is to address this gap and to explore understandings of mental health in an urban Indigenous sample. This study provided a voice for urban Aboriginal and Torres Strait Islander people to convey their understandings of mental health so that an accurate representation may be available for those who are engaged in health promotion and mental health treatment.

Using a positive psychology framework, a strengths-based approach was taken in this study in order to explore understandings of mental health. A qualitative research investigation was conducted with a sample of 19 Australian Aboriginal and Torres Strait Islander participants. Data was collected via individual semi-structured interviews and focus groups. Qualitative analysis was conducted using thematic analysis. A model of Indigenous mental health was developed taking an holistic perspective. Four themes emerged as reflecting health and wellbeing and are presented in a model of Indigenous mental health:-

• Coping Skills: emotional, behavioural and cognitive;

• Knowledge: regarding physical health and access to mental health care;

• Social Support: personal resources and help-seeking behaviours; and

• Connectedness: cultural, social and family and kinship.

The theme of connectedness emerged as reflecting a unique contribution to Indigenous health and wellbeing. The role of connectedness to country, family and kinship, knowledge and social networks was highlighted. Further, the theme of connectedness also emerged as central to supporting cultural identity. Not only did connectedness promote and protect mental health and cultural identity, factors that diminished cultural identity also negatively impacted upon mental health. The striking similarity between mental health and cultural identity, as seen in the common theme of connectedness, highlights the necessity of attending to cultural factors to facilitate positive health outcomes.

This model of Indigenous mental health begins to fill in the boundaries of the negotiated space that is cross-cultural psychology - the space where both Indigenous and non-Indigenous knowledge offers a path or guidelines to enhance health and wellbeing. It is essential to address those factors that are similar across cultures – coping skills, social support and knowledge, but also to engage at the cultural interface of connectedness to culture, kinship and social networks.

This information has implications for cross-cultural clinical practice, through providing a map for non-Indigenous practitioners to engage in culturally safe practice. Further, this information will support the development of culturally safe health and wellbeing programs that sustain and nurture the cultural identity and mental health of Indigenous people. In this way, meaningful contributions may be made by health professionals to 'close the gap' in health and mental health outcomes for Indigenous people.

Item ID: 29143
Item Type: Thesis (PhD)
Keywords: mental health; well being; Aboriginal and Torres Strait Islanders; health outcomes; cross-cultural mental health; connectedness; cross-cultural clinical practice
Date Deposited: 05 Sep 2013 22:21
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111701 Aboriginal and Torres Strait Islander Health @ 34%
17 PSYCHOLOGY AND COGNITIVE SCIENCES > 1701 Psychology > 170106 Health, Clinical and Counselling Psychology @ 33%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111714 Mental Health @ 33%
SEO Codes: 92 HEALTH > 9203 Indigenous Health > 920302 Aboriginal and Torres Strait Islander Health - Health Status and Outcomes @ 50%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920410 Mental Health @ 50%
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