” The theme of our 2017 World Health Day campaign is depression

The Gayaa Dhuwi (Proud Spirit) Declaration[4] was developed and launched by the National Aboriginal and Torres Strait Islander Leadership in Mental Health in 2015.

It provides a platform for governments to work collaboratively to embed culturally competent and safe services within the mental health system that are adaptable and accountable to Aboriginal and Torres Strait people.

Nearly one-third of Aboriginal and Torres Strait Islander people aged over 15 years reported having high to very high levels of psychological distress. This was more than twice the levels reported for other Australians.

Aboriginal and Torres Strait Islander women reported these levels of stress more than men.

It is often hard to know how common depression is in the Aboriginal and Torres Strait Islander population, however, because of the way people understand depression and their cultural understanding of mental illness.”

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  ” Depression needs to be seen within the wider scope of the social and emotional wellbeing of Aboriginal and Torres Strait Islander people; this means looking more holistically at health.

The warning signs for depression in Aboriginal and Torres Strait Islander people may vary between communities, so it is vital that the people working in the area of social and emotional wellbeing are aware of the different languages and understandings used by individual communities when talking about depression.

From Healthinfonet :Does the understanding of depression differ between Aboriginal and Torres Strait Islander communities?

” World Health Day, celebrated on 7 April every year to mark the anniversary of the founding of the World Health Organization, provides us with a unique opportunity to mobilize action around a specific health topic of concern to people all over the world.

Depression affects people of all ages, from all walks of life, in all countries. It causes mental anguish and impacts on people’s ability to carry out even the simplest everyday tasks, with sometimes devastating consequences for relationships with family and friends and the ability to earn a living. At worst, depression can lead to suicide, now the second leading cause of death among 15–29-year olds.

Yet, depression can be prevented and treated. A better understanding of what depression is, and how it can be prevented and treated, will help reduce the stigma associated with the condition, and lead to more people seeking help.

WHO World Heath Day

“The release of this much awaited Draft Fifth National Mental Health Plan is another important opportunity to support reform, and it’s now up to the mental health sector including consumers and carers, to help develop a plan that will benefit all.”

A successful plan should help overcome the lack of coordination and the fragmentation between layers of government that have held back our efforts to date.”

NACCHO and Mental Health Australia CEO Frank Quinlan have welcomed the release of the Draft Fifth National Mental Health Plan and is encouraging all ACCHO stakeholders to engage with the plan during the upcoming consultation period.

Download the Draft Fifth National Mental Health Plan at the link below:

PDF Copy fifth-national-mental-health-plan

You can download a copy of the draft plan;or see extracts below

Fifth National Mental Health Plan – PDF 646 KB
Fifth National Mental Health Plan – Word 537 KB

View all NACCHO 127 Mental Health articles here

View all NACCHO 97 Suicide Prevention articles here

Priority Area 4: Aboriginal and Torres Strait Islander mental health and suicide prevention

What we aim to achieve

Culturally competent care through integrating social and emotional wellbeing services with a range of mental health, drug and alcohol, and suicide prevention services.

What it means for consumers and carers?

You will receive culturally appropriate care.

Both your clinical and social and emotional wellbeing needs, and the needs of your community, will be addressed when care is planned and delivered.

Summary of actions

1. Governments will work collaboratively to develop a joined approach to social and emotional wellbeing support, mental health, suicide prevention, and alcohol and other drug services, recognising the importance of what an integrated service offers for Aboriginal and Torres Strait Islander people.
2. Governments will work with Primary Health Networks and Local Hospital Networks to implement integrated planning and service delivery for Aboriginal and Torres Strait Islander people at the regional level.
3. Governments will renew efforts to develop a nationally agreed approach to suicide prevention for Aboriginal and Torres Strait Islander people.
4. Governments will work with service providers, including with Aboriginal Community Controlled Health Organisations, to improve Aboriginal and Torres Strait Islander access to and experience with mental health and wellbeing services.
5. Governments will work together to strengthen the evidence base needed to inform development of improved mental health services and outcomes for Aboriginal and Torres Strait Islander people.

Overview

Mental health and related conditions have been estimated to account for as much as 22 per cent of the health gap between Aboriginal and Torres Strait Islander people and other Australians, as measured in Disability-Adjusted Life Years. Mental health conditions are estimated to contribute to 12 per cent of the gap in the burden of disease, with another four per cent of the gap attributable to suicide and another six per cent to alcohol and other drug misuse.^[1]

The 2012-2013 Australian Aboriginal and Torres Strait Islander Health Survey found that Aboriginal and Torres Strait Islander adults were almost three times more likely to experience high or very high levels of psychological distress than other Australians, are hospitalised for mental health and behavioural disorders at almost twice the rate of non-Aboriginal people, and have twice the rate of suicide than that of other Australians. The breadth and depth of such high levels of distress on individuals, their families, and their communities is profound.

Despite having greater need, Aboriginal and Torres Strait Islander people have limited access to mental health services and professionals. In 2012-2013, the most common Closing the Gap service deficits reported by organisations were around mental health and social and emotional wellbeing services.^[2]

Issues such as rural and remoteness, and the diversity and fractured coordination of government funding, policy frameworks and service systems, play a role in hindering the ability of services to adequately and appropriately address the needs of Aboriginal and Torres Islander people. It is also recognised that many services and programmes designed for the general population are not culturally appropriate within a broader context of social and emotional wellbeing as understood by Aboriginal and Torres Strait Islander people.

Aboriginal and Torres Strait Islander people embrace a holistic concept of health, which inextricably links mental and physical health within a broader concept of social and emotional wellbeing. A whole-of-life view, social and emotional wellbeing recognises the interconnectedness of physical wellbeing with spiritual and cultural factors, especially a fundamental connection to the land, community and traditions, as vital to maintaining a person’s wellbeing.

Disruption to this holistic understanding of social and emotional wellbeing caused by dispossession, dislocation, and trauma over generations has, for some Indigenous Australians, created a legacy of grief and psychological distress.

Most Aboriginal and Torres Strait Islander people want to be able to access services where the best possible mental health and social and emotional wellbeing strategies are integrated into all health service delivery and where health promotion strategies are developed with Aboriginal communities to provide a holistic approach. This approach needs an appropriate balance of clinical and culturally informed mental health system responses, including access to traditional and cultural healing, to address mental health issues for Aboriginal and Torres Strait Islander people.

Many Aboriginal and Torres Strait Islander people also continue to experience high levels of exclusion and victimisation, discrimination and racism at personal, societal, and institutional levels. Racism continues to have a significant impact on Aboriginal and Torres Strait Islander people’s decisions about when and why they seek health services, their acceptance of and adherence to treatment.^[3]

While governments have been committed to supporting Aboriginal and Torres Strait Islander mental health and suicide prevention, Aboriginal and Torres Strait Islander people have regularly informed governments that much more could be done to improve both the way in which services are structured and the range of services available. There is a need to better coordinate efforts and focus on achieving improved integration of culturally appropriate mental health, social and emotional wellbeing, suicide prevention, and alcohol and other drug services for Aboriginal and Torres Strait Islander people.

Leadership will involve better collaboration and coordination across governments, and set the direction for how services and programmes can better work together. It will assist in driving and embedding change towards a better joined up and whole-of-life approach to mental health, social and emotional wellbeing, suicide prevention, and alcohol and other drug services for Aboriginal and Torres Strait Islander people, to drive the actions that are needed to support better mental health and social and emotional wellbeing, and reduced incidence of suicide, for Aboriginal and Torres Strait Islander people.

The Fifth Plan recognises that self-determination is essential to overcoming the disadvantage that Aboriginal and Torres Strait Islander people experience. While governments have a critical role in providing leadership, actions will be developed in partnership with Aboriginal and Torres Strait Islander people and their communities to ensure that appropriate solutions are developed and key challenges are addressed.

Governments will work collaboratively to improve the cultural safety and capability of the mental health and social and emotional wellbeing workforce, including increasing the proportion of Aboriginal and Torres Strait Islander people working in this field, strengthening the Aboriginal and Torres Strait Islander community controlled health sector and developing the cultural competence of mainstream mental health services. An important factor in this collaborative process will be the inclusion of local Aboriginal and Torres Strait Islander communities in the design and implementation of culturally relevant mental health services. Supporting skill development to enable Aboriginal and Torres Strait Islander people to actively participate in, and conduct research relating to, their own cultures is also important.

Governments recognise the need to improve access to information on what has been shown to work in Aboriginal and Torres Strait Islander communities to improve social and emotional wellbeing, reduce the impact of mental illness and harms associated with alcohol and other drug use, and to prevent suicide.

Action 14: Governments will work with service providers, including with Aboriginal Community Controlled Health Organisations, to improve Aboriginal and Torres Strait Islander access to and experience with mental health and wellbeing services by:

• increasing knowledge of social and emotional wellbeing concepts and improving the cultural competence and capability of mainstream providers;
• recognising the importance of Indigenous leadership and supporting implementation of the Gayaa Dhuwi (Proud Spirit) Declaration; and
• training all staff delivering mental health services to Aboriginal and Torres Strait Islander people, particularly those in forensic settings, in trauma-informed care.

The National Aboriginal and Torres Strait Islander Leadership In Mental Health Group launched the Gayaa Dhuwi (Proud Spirit) Declaration in 2015. The Declaration emphasises the importance of Indigenous leadership in addressing the mental health challenges faced by Aboriginal and Torres Strait Islander people

The Gayaa Dhuwi (Proud Spirit) Declaration[4] was developed and launched by the National Aboriginal and Torres Strait Islander Leadership in Mental Health in 2015. It provides a platform for governments to work collaboratively to embed culturally competent and safe services within the mental health system that are adaptable and accountable to Aboriginal and Torres Strait people.

The five themes of the Declaration are:

1. Aboriginal and Torres Strait Islander concepts of social and emotional wellbeing, mental health and health should be recognised across all parts of the Australian mental health system, and in some circumstances support specialised areas of practice.
2. Aboriginal and Torres Strait Islander concepts of social and emotional wellbeing, mental health and healing combined with clinical perspectives will make the greatest contribution to the achievement is the highest attainable standard of mental health and suicide prevention outcomes for Aboriginal and Torres Strait Islander people.
3. Aboriginal and Torres Strait Islander values-based social and emotional wellbeing and mental health outcome measures in combination with clinical outcome measures should guide the assessment of mental health and suicide preventions services and programmes for Aboriginal and Torres Strait Islander people.
4. Aboriginal and Torres Strait Islander presence and leadership is required across all parts of the Australian mental health system for it to adapt to, and be accountable to, Aboriginal and Torres Strait Islander people for the achievement of the highest attainable standard of mental health and suicide prevention outcomes.
5. Aboriginal and Torres Strait Islander leaders should be supported and valued to be visible and influential across all parts of the Australian mental health system.

More info here

What is depression?

Depression is about a person’s state of mood. When a person has depression (often called clinical depression) they feel very low in mood (sad, unhappy, or ‘down in the dumps’) and also lose interest in activities they used to gain happiness from.

It is normal for people to feel sad every once in a while, but clinical depression is very different from the occasional feeling of sadness. There are several ways clinical depression differs from the occasional feeling of sadness, they include:

• severity (how serious it is); clinical depression usually ranges from mild to severe
• persistence (strength of the episode)
• duration (how long it lasts)
• the presence of typical symptoms (see next section).

When people feel sad or ‘down’ for a long time, usually for longer than 2 weeks, they may be depressed. Depression can affect anyone at any age.

What are the signs and symptoms of depression?

There are a number of signs or symptoms people may show when they have depression. People do not have to have all of them to be diagnosed with depression. The signs and symptoms of depression can include any of the following:

• waking up feeling sad and not wanting to get out of bed
• feeling sad for most of the day
• feeling restless
• feeling irritable (short-tempered) and/or angry which may lead to arguments with other people
• not wanting to be around other people (may want to be alone)
• thoughts of dying or hurting oneself
• feeling guilty when not at fault
• crying for no reason
• losing interest in the things one likes
• feeling worthless or hopeless
• not sleeping well (maybe walking around all night), or sleeping too much
• not eating well, or eating too much
• less energy; tiredness
• having problems concentrating, remembering things, or making decisions
• weight loss or gain.

Does the understanding of depression differ between Aboriginal and Torres Strait Islander communities?

Depression needs to be seen within the wider scope of the social and emotional wellbeing of Aboriginal and Torres Strait Islander people; this means looking more holistically at health. The warning signs for depression in Aboriginal and Torres Strait Islander people may vary between communities, so it is vital that the people working in the area of social and emotional wellbeing are aware of the different languages and understandings used by individual communities when talking about depression.

What are the risk factors for depression?

The factors that can contribute to depression include:

• previous mental illness
• poor physical health or long-term illness
• grief, loss, and bereavement (referred to as a psychological cause)
• trauma or stressful events
• recently becoming a parent
• too much alcohol, or gunga, or other drugs
• family history of depression (referred to as a biological or genetic cause)
• stopping any treatment for depression
• breaking the law
• social surroundings (e.g., environmental, housing conditions)
• cultural or spiritual separation from country.

A person’s personality can also be a risk factor for depression. People who are: anxious or worry easily; unassertive (people who do not stand up for themselves); negative and self-critical (people who see themselves in a negative way); or shy and have low self-esteem (lack confidence) are at a higher risk of depression than people who do not have these types of personalities.

How do you treat depression?

There are many different ways to help people suffering from depression. People need to know that they do not have to put up with the feelings of depression. It is important to be supportive and encourage people to seek help from doctors, counsellors, Aboriginal Health Workers, or staff at the local Aboriginal medical service.

Medical treatments for depression can involve:

• a full health check from a doctor to screen for any contributing health conditions (e.g., diabetes or hepatitis)
• getting help from mental health professionals to work through any problems
• medication (usually anti-depressant drugs)
• limiting the intake of alcohol and other drugs.

Other tips for managing depression include:

• talking to someone, for example, friends, family, or an Elder
• getting involved in daily exercise
• getting involved in activities that make you feel happy (e.g., fishing, going back to country)
• trying to sleep and eat well
• learning skills that a person can use when they feel they’re not coping well with a situation.

If the treatment is not working, it is important that people discuss this with their doctor, counsellor, or other mental health professional so that other options can be explored.