Given the high proportion of Indigenous people living in underserved rural areas, remote access to specialists is frequently required. Sujata Gupta is the social sciences writer and is based in Burlington, Vt. The authors of that review of 46 yarning studies sought to understand how researchers have been using the method in health-related studies. “Western psychology doesn’t really give reasons or causes of mental health disorders because the Western biomedical model is about remediating symptoms. “The assumptions made by American psychology are contradictory and reductionist compared to the complex, holistic and inter-relational view of health that has been integral to Indigenous people for thousands of years.”
Indigenous peoples in the design of health policies
Unique challenges have been documented for Indigenous communities across Canada, particularly elders who are most at risk, and northern and remote communities that have limited access to services and other types of supports 78,79,80. Participants at the forum highlighted that the different sectors need to be open and willing to explore different ways or models of delivering mental health services that is inclusive of different knowledge systems on health (i.e., both western and Indigenous knowledge), healing practices, and the preferences of Indigenous clients. Therefore, there is growing evidence towards Indigenous-led healthcare partnerships for improving health outcomes and access to care for Indigenous peoples . Co-creating Indigenous models of care with Indigenous communities has also been recommended to support self-determination, increased community participation in health, and increased community capacity . Championing self-determination is highlighted as an important factor in the development of Indigenous mental health services globally.
While Indigenous Australians use some mental health services at higher rates than non-Indigenous Australians, it is difficult to assess whether this use is as high as the underlying need. Stephanie Montesanti, assistant professor, School of Public Health, shares how culturally-strengthening approaches to mental wellness that are based on cultural strengths improve positive mental health resilience for Indigenous children, youth, adults and families. Similarly, Thunder Bay and District has an Access Network that can link people to culturally sensitive services for Indigenous and non- Indigenous peoples. For example, Indigenous people in Toronto can contact Anishnawbe Health Toronto about health and support services in the city. Some regions in Ontario do have centralized places to find Indigenous services, often including mental health services.
How can policy changes address Indigenous mental health disparities?
Tighe et al.’s (2017) trial delivered educational modules based on acceptance-based therapies delivered through an app (Shand et al., 2013). Another intervention used brief motivational care planning with principles of problem-solving therapy, motivational therapy and self-management (Nagel et al., 2009). Brave Heart et al. (2020) incorporated psychoeducation on trauma and grief, and cultural healing practices with interpersonal group therapy. Supplemental Tables S3 and S4 describe the studies according to the TIDieR checklist and guide (Hoffmann et al., 2014). Only nine studies reported response rates ranging from 9% to 97% and 19 studies had follow-up rates between 16% and 100%.
From July 2017 to June 2019, the hospitalisation rate for mental health-related conditions for Indigenous Australians was highest in South Australia (36 per 1,000 population), followed by the Northern Territory (32 per 1,000 population). From July 2017 to June 2019, there were 47,096 hospitalisations (or 4.3 % of all hospitalisations) for Indigenous Australians with a principal diagnosis of mental health-related conditions. In this period, the most common issues related to social and emotional wellbeing managed in terms of staff time and organisational resources were depression (77%), anxiety and stress (76%), grief and loss issues (64%), family and community violence (60%) and family and relationship issues (57%) (AIHW 2018). These organisations employed 551 full-time equivalent social and emotional wellbeing staff, provided 268,529 client contacts for social and emotional wellbeing, the majority of which were for Indigenous clients (86% or 229,968 people) (AIHW 2022a). In 2020–21, there were 191 Australian Government-funded Indigenous primary health care organisations who reported to the Online Services Report Data Collection.
- (2) Secondary mental health services are designed to provide more specialised and intensive support for individuals with moderate to severe mental health conditions, involving more specialised assessment, treatment, and care.
- Include transportation for residents living in rural and remote communities to access mental health services in urban centres
- Through the cultural assessment, we learned that six interventions trained community members (Beckstead et al., 2015; Brave Heart et al., 2020; Gray et al., 2010; Tosa et al., 2018; Varcoe et al., 2017, 2021) (where applicable, given some were retrospective or observational), extending the impact of the intervention beyond the study period.
- Burgeoning viewpoints assert that if colonialism and intergenerational historical loss are recognized as the identified problem, it follows that interventions with AI/ANs should be focused on cultural reassertion and revitalization at the individual and community level (Brave Heart et al., 2011; Gone & Trimble, 2012; Goodkind et al., 2015).
Three of five studies https://www.bet.com/article/n1rvpe/suicide-and-young-black-men-why-the-brothers-feel-alone examining psychological distress and two of four studies on the impact on stress showed statistically significant improvements. Three of the six studies that assessed PTSD symptoms showed statistically significant improvements. Depression was the most frequently examined outcome and 8 of 14 studies observed statistically significant improvements. Meta-analysis could not be conducted due to the heterogeneity of the study designs. Another pre–post study with comparison showed a statistically significant improvement in positive motivational state immediately post-intervention (Tosa et al., 2018).