Positive partnerships: Working alongside Aboriginal Community Controlled Health Organisations to support Aboriginal and Torres Strait Islander social and emotional wellbeing

Key messages

• Aboriginal and Torres Strait Islander health organisations are established across the country and offer culturally secure and empowered ways of working with their communities.
• Aboriginal concepts of health, mental health, and wellbeing are holistic. They account for the social, cultural and political determinants of health at the individual, family and community level, and are often referred to as ‘social and emotional wellbeing’.
• Working in culturally secure and strengths-based ways with Aboriginal and Torres Strait Islander children, young people and their families is optimised by an understanding of Aboriginal concepts of health and wellbeing and partnerships with Aboriginal Community Controlled health services.

Who is this resource for?

This fact sheet is designed to support non-Indigenous practitioners who work with Aboriginal and Torres Strait Islander children, parents and families. While it is suitable for all practitioners, it may be especially helpful in building the cultural competency of psychologists and other mental health professionals.

Across Australia, there are over 140 Aboriginal Community Controlled Health Organisations (ACCHOs) – primary health care services initiated and operated by the Aboriginal and Torres Strait Islander community. ACCHOs are governed by a locally elected Aboriginal Board of Management and reflect Aboriginal and Torres Strait Islander peoples’ understanding of health:

‘Health is not just the physical wellbeing of an individual but refers to the social, emotional and cultural wellbeing of the whole Community, in which each individual is able to achieve their full potential as a human being, thereby bringing about the total wellbeing of their Community. It is a whole-of-life view and includes the cyclical concept of life-death-life.’ (National Aboriginal Community Controlled Health Organisation, n.d.)

Over the decades, ACCHOs have been recognised as providing better health outcomes for Aboriginal and Torres Strait Islander people than mainstream health services (Panaretto et al., 2014). This demonstrates the importance of holistic and culturally secure care for Aboriginal and Torres Strait Islander people.

Many ACCHOS have designated Social and Emotional Wellbeing teams. These teams work closely with clinical staff to support the holistic needs of Aboriginal and Torres Strait Islander people.

The following image from the national leadership body for Aboriginal and Torres Strait Islander health in Australia, National Aboriginal Community Controlled Health Organisation (NACCHO), highlights the distribution of Aboriginal Community Controlled Health Organisations across Australia.

Watch as Zac Cox, Senior Manager SEWB and Mental Health at Kimberley Aboriginal Mental Services (KAMS) describes what social and emotional wellbeing means for Aboriginal and Torres Strait Islander people (1 minute, 14 seconds).

Social and emotional wellbeing is the term given to the historical, political, social and cultural determinants that affect the Self, in addition to connections with seven core domains that support Aboriginal peoples’ wellbeing. The seven domains include connections with one’s:

• body and behaviours
• mind and emotions
• family and kinship
• community
• culture
• Country and land; and
• spirituality

Social and emotional wellbeing is a multi-dimensional concept based on the interconnectedness across the seven domains. The following diagram illustrates how the self; the domains of wellbeing; the social, historical, political and cultural determinants of health; and a person’s experiences and expressions are all connected.

Ensuring that Aboriginal and Torres Strait Islander peoples enjoy high levels of social and emotional wellbeing is a national priority of the Australian Government. This is outlined in Target 14 of the National Agreement on Closing the Gap (2020):

• Target 14 – Significant and sustained reduction in suicide of Aboriginal and Torres Strait Islander people towards zero.
• Outcome 14 – Aboriginal and Torres Strait Islander people enjoy high levels of social and emotional wellbeing.

Exposure to major stressors in the early stages of life can be harmful to the developing brain and to psychological health in childhood. At the population level, Aboriginal and Torres Strait Islander children are exposed to high levels of intergenerational trauma, poverty, racism and violence (Twizeyemariya et al., 2017).

In the following video (1 minute, 43 seconds), Zac provides an example of the systemic disadvantages faced by Aboriginal and Torres Strait Islander children.

Aboriginal and Torres Strait Islander children and young people are over-represented in the child protection system and correctional services. They report higher levels of psychological distress than non-Indigenous people of the same age, and are overrepresented in suicide and self-harm statistics (Leckning et al., 2021; Zubrick et al., 2004; McPhee et al., 2021).

Aboriginal and Torres Strait Islander children and their families face complex and unique barriers in accessing services and receiving appropriate support to heal from trauma and improve their social determinants of health.

Understanding the Aboriginal and Torres Strait Islander model of social and emotional wellbeing will help you to identify some of the culturally specific risk and protective factors that Aboriginal and Torres Strait Islander children and their families may be experiencing. The social and emotional wellbeing framework also helps you to understand the importance of holistic and integrated care for Aboriginal and Torres Strait Islander children.

The following table (Table 1; Cox et al., 2022) explores the risk and protective factors related to Aboriginal and Torres Strait Islander social and emotional wellbeing in more detail.

Table 1: Understanding risk and protective factors related to Aboriginal and Torres Strait Islander social and emotional wellbeing

If you are working with Aboriginal and/or Torres Strait Islander clients and are not already connected to your local ACCHO, please reach out. NACCHO has a free online directory of Aboriginal Community Controlled Health Organisations you can use to find the nearest service.

Your local ACCHO may have a social and emotional wellbeing team that can support Aboriginal and Torres Strait Islander children and their families. Social and emotional wellbeing teams are experienced in working with a broad range of service providers to ensure the interdisciplinary care needs of clients are met. Many ACCHO social and emotional wellbeing teams operate in a family systems approach and can support parents and caregivers alongside children, to optimise the impact of healing interventions and support work. Social and emotional wellbeing teams also operate at the community level, facilitating better connections with service providers and building community members’ literacy around mental health and social and emotional wellbeing.

Strong partnerships between ACCHOs and other providers can strengthen the health and wellbeing of Aboriginal and Torres Strait Islander children and young people and their families.

Watch as Dr Emma Carlin, Senior Research Officer at KAMS discusses the importance of connecting to your local Aboriginal and Torres Strait Islander Health organisations (31 seconds).

Thank you for being an ally and supporting the next generation of strong, deadly, and self-determined Aboriginal and Torres Strait Islander people.

Recommended citation: Carlin E. & Cox Z. (2023). Positive partnerships: Working alongside Aboriginal Community Controlled Health Organisations to support Aboriginal and Torres Strait Islander social and emotional wellbeing. Adelaide: Emerging Minds. DOI: 10.5281/zenodo.10208116.

You can learn more about social and emotional wellbeing service delivery by visiting Kimberley Aboriginal Medical Services’ website or checking out the Transforming Indigenous Mental Health and Wellbeing research project. You can also download a free PDF copy of KAMS’ Social and Emotional Wellbeing Welcome Guide for the Aboriginal Workforce.

We also recommend exploring the following Emerging Minds resources:

• Working with Aboriginal and Torres Strait Islander families and children toolkit
• Positive partnerships with Aboriginal and Torres Strait Islander organisations (podcast episode)
• Working with Aboriginal and Torres Strait Islander families and children: A framework for understanding (online course)

Cox, Z., Carlin, E., Derry, K., Cox, A-R., Ansey, L., Cox, D., & Dudgeon, P. (2022). Social and emotional wellbeing: A welcome guide for the Aboriginal workforce. Kimberley Aboriginal Medical Service.

Gee, G., Dudgeon, P., Schultz, C., Hart, A., & Kelly, K. (2014). Aboriginal and Torres Strait Islander social and emotional wellbeing. In P. Dudgeon, H. Milroy, & R. Walker (Eds.), Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice (pp. 55-68). Department of Prime Minister and Cabinet.

Leckning, B., He, V. Y., Condon, J. R., Hirvonen, T., Milroy, H., & Guthridge, S. (2021). Patterns of child protection service involvement by Aboriginal children associated with a higher risk of self-harm in adolescence: A retrospective population cohort study using linked administrative data. Child Abuse & Neglect, 113, 104931.

McPhee, R., Carlin, E., Seear, K., Carrington-Jones, P., Sheil, B., Lawrence, D., & Dudgeon, P. (2021). Unacceptably high: An audit of Kimberley self-harm data 2014–2018. Australasian Psychiatry. Advance online publication. doi:10.1177/10398562211010790.

National Aboriginal Community Controlled Health Organisation. (n.d.) Aboriginal definitions of health [Web page]. NACCHO.

Panaretto, K. S., Wenitong, M., Button, S., & Ring, I. T. (2014). Aboriginal community controlled health services: Leading the way in primary care. Medical Journal of Australia, 200, 649-652.

Twizeyemariya, A., Guy, S., Furber, G., & Segal, L. (2017). Risks for mental illness in Indigenous Australian children: A descriptive study demonstrating high levels of vulnerability. Milbank Quarterly, 95, 319-357. doi:10.1111/1468-0009.12263

Zubrick, S., Lawrence, D., Silburn, S., Blair, E., Milroy, H., Wilkes, E., … Ishiguchi, P. (2004). The Western Australian Aboriginal child health survey: The health of Aboriginal children and young people. Telethon Institute for Child Health Research.