Frameworks for understanding Aboriginal approaches to health
Emerging Minds, Australia, 2019
The nine principles of the National Strategic Framework for Aboriginal and Torres Strait Islander People’s Mental Health and Social and Emotional Wellbeing (2017).
The skills and knowledge required by non-Aboriginal practitioners to work with Aboriginal children, families and communities should be supported by a framework of genuine curiosity, an appreciation of the richness and nuance of Aboriginal cultures and a willingness to hear and understand the lived experience of Aboriginal children, families and communities.
- The context of health
- Culturally valid understandings
- Understanding the experiences of trauma and loss
- Human rights
- Racism, stigma, environmental adversity and social disadvantage
- Family and kinship
- There is no single Aboriginal or Torres Strait Islander culture or group, but numerous groupings, languages, kinships, and tribes, as well as ways of living.
- It must be recognised that Aboriginal and Torres Strait Islander people have great strengths, creativity and endurance and a deep understanding of the relationships between human beings and their environment.
Non-Aboriginal practitioners who embrace these elements are more likely to develop the knowledge they need to form genuine partnerships with Aboriginal children, families and communities.
‘This work requires an insight into the complex historical, cultural and social determinants of health as well as skills in providing culturally sensitive interventions, including responses to the dislocation and trauma of Stolen Generations, grief, loss, trauma, and anger, substance misuse, family and parenting problems, suicide and mental health crisis. But more importantly practitioners need to know about the protective factors that have supported families and communities to remain strong and resilient despite the discourse of disadvantage.’ (AYFN, 2009)
The National Strategic Framework for Aboriginal and Torres Strait Islander People’s Mental Health and Social and Emotional Wellbeing (2017) provides a set of principles to emphasise the holistic and whole-of-life definition of health held by Aboriginal and Torres Strait Islander peoples. The following principles provide considerations that invite us to build and strengthen our knowledge and will assist practitioners in developing respectful engagement strategies that are transferable across Communities.
The context of health
1. Aboriginal and Torres Strait Islander health is viewed in a holistic context that encompasses mental, physical, cultural and spiritual health. Land is central to wellbeing. Crucially, it must be understood that when the harmony of these interrelations is disrupted, Aboriginal and Torres Strait Islander ill health will persist.
What may be different for Aboriginal and Torres Strait Islander children’s social and emotional wellbeing? Watch the Emerging Minds: National Workforce Centre for Child Mental Health’s ‘Whole Aboriginal and Torres Strait Islander Child’ video below and consider the following points.
Aboriginal perspectives are holistic and community based. They believe in:
- the whole child, not just the child’s educational, physical or spiritual needs in isolation
- the child’s relationship to the whole family, not just mum or dad
- the child’s relationship to the whole community, not just the family
- the child’s relationship to the land and the spirit beings which determine law, politics and meaning; and
- the reciprocity of social obligations between the child and others.
2. Self-determination is central to the provision of Aboriginal and Torres Strait Islander health services.
What is self-determination?
Self-determination is defined by the Australian Human Rights Commission (2019) as the right for all people to freely determine their political status and freely pursue their economic, social and cultural development. Self-determination should be present in everyday life and at the heart of one’s practice. It means knowing that Aboriginal and Torres Strait Islanders have the right and are best placed to have the answers to their economic, social and cultural wellbeing needs. In practice this is the honour and value given to Aboriginal experience and narratives, and knowing the place non-Aboriginal practitioners and organisations have in interactions with First Nations families and communities as supporters of story and advocates of experience, not makers of decisions.
When working with First Nations families, how would you support parents/carers in self-determination on an individual level? Would you help them to:
- connect to their own knowledge and skills?
- support empowerment in self-advocacy?
- lead the decisions that affect them?
- create opportunities to problem solve?
To me, self-determination is about complete and total control over my life and all aspects of it. Having control over my present and my future allows me to feel not only independent but also respected. To others, I am someone who can be trusted to make the right decisions for me. No one knows me better than myself, so it only makes sense that I should be the one to make decisions that concern my life and my future – in whatever aspect that may be.
Culturally valid understandings
3. Culturally valid understandings must shape the provision of services and must guide assessment, care and management of Aboriginal and Torres Strait Islander people’s health problems generally, and mental health problems in particular.
When working with Aboriginal and Torres Strait Islander children and families, cultural practices need to be included. This can be through culturally based interventions such as programs, through supervision, and through the ways you conduct assessments.
- How could you work with families to bring out stories of culture and heritage?
- Who are the cultural leaders you could connect with in your region to support your learning in this?
- Natural spaces are important when working with Aboriginal and Torres Strait Islander families. Could you meet outside your office at a park perhaps, or at a local Aboriginal organisation?
- Is there a culturally specific assessment you may integrate into you work?
- How can you bring culture into your work space (e.g. through displaying Aboriginal artwork, ordering catering from an Aboriginal business, etc.)?
“I supported a boys’ group once, who were serving meals to the elders at a local health service luncheon. This group of boys came from varying disadvantage: families experiencing family violence, AOD misuse and social and emotional wellbeing problems. Most of the boys had matters before the court and they struggled through life as best they could with what skills they had every day.
“This gathering was a weekly event within the community and many members from community participated. It was a place to connect, and to yarn, to meet with health services and practitioners in a place that felt welcoming and inclusive. Local artwork was displayed on each wall and there was someone saying, “my nephew did that artwork.” It was a place of comfort and safety.
“While one of the elders was receiving her meal, she asked one of the boys, “who’s your mob?” I saw the boys transform into young men before my eyes; I saw them stand tall with pride, when they each spoke of who their family was and where they came from. The elders then made connections; “I’m your aunty through your grandfather’s side”, “your mum is my first cousin” and so on and so on. I saw the boys beam when they had found their connections and place.
“This was an experience I look back on about how important cultural inclusion and connections are to Aboriginal Community and ways of working. In that space there was safety and connections and an opportunity to explore learning in an inclusive way.” (Youth Worker)
Further information and resources
Mental Health Assessment:
Understanding the experiences of trauma and loss
4. It must be recognised that the experiences of trauma and loss, present since European invasion, are a direct outcome of the disruption to cultural wellbeing. Trauma and loss of this magnitude continues to have inter-generational effects.
The Healing Foundation has developed resources which explain where intergenerational trauma comes from and how it is impacting on Aboriginal and Torres Strait Islander communities. This animation is a deeply touching story of the lived experiences and history of Aboriginal and Torres Strait Islander families. You can find fact sheets to accompany this video in the ‘further resources’ section below.
Please note: This animation is not to be shown to children or young people but is only to be used as a resource for practitioners.
- What are your thoughts after watching this story?
- Does it match your own knowledge of history?
- What will you take with you from this video?
- In what ways may this affect people you are working with?
Further information and resources
Healing Foundation fact sheet – Working with Aboriginal and Torres Strait Islander young people and their families
Australians Together website – Intergenerational trauma
5. The human rights of Aboriginal and Torres Strait Islander people must be recognised and respected. Failure to respect these human rights constitutes continuous disruption to mental health. Human rights relevant to mental illness must be specifically addressed.
What are the human rights factors that would affect First Nations people?
- Is there an adequate standard of living, including adequate food, clothing and housing?
- What is the standard of physical and mental health?
- Is there adequate safety from violence?
- Is the self-determination of families integrated in practice?
- Are the basic human needs a contributing factor to the overall social and emotional wellbeing?
Further information and resources
Australian Human Rights Commission fact sheet – Human rights and Aboriginal and Torres Strait Islander peoples
Australian Human Rights Commission guide – The Community Guide to the UN Declaration on the Rights of Indigenous Peoples
Australian Human Rights Commission – UN Declaration on the Rights of Indigenous People’s, YouTube video
Family and kinship
7. The centrality of Aboriginal and Torres Strait Islander family and kinship must be recognised, as well as the broader concepts of family and the bonds of reciprocal affection, responsibility and sharing.
First Nations children have a much broader support system than the typical non-Aboriginal family structure. The complex connections and extensive kinship structures that surround Aboriginal and Torres Strait islander children may not be seen in a practitioner’s limited sessions or interactions with parents and families.
‘Our children are the youngest people from the longest living culture in the world, with rich traditions, lore and customs that have been passed down from generation to generation. Our children are growing up strong with connection to family, Community and Country. Our children are the center of our families and the heart of our communities. They are our future and the carriers of our story.’ (SNAICC, 2017)
- Who could you contact to learn more about your local area?
- Is there a local Aboriginal organisation or health service you could get in touch with?
Further information and resources
There is no single Aboriginal or Torres Strait Islander culture or group, but numerous groupings, languages, kinships, and tribes, as well as ways of living.
8. There is no single Aboriginal or Torres Strait Islander culture or group, but numerous groupings, languages, kinships, and tribes, as well as ways of living. Furthermore, Aboriginal and Torres Strait Islander people may currently live in urban, rural or remote settings, in traditional or other lifestyles, and frequently move between these ways of living.
Below is a map of Indigenous Australia, with each colour representing a different nation/language group. Nations/Language groups are very diverse with each having unique traditions, customs and ways of doing things. Seek guidance about your local communities’ protocols from local Lands Councils or Aboriginal Community Organisations.
Further information and resources
It must be recognised that Aboriginal and Torres Strait Islander people have great strengths, creativity and endurance and a deep understanding of the relationships between human beings and their environment.
What do these strengths and understandings look like? If you explore the media and speak to First Nations people, what do they tell you? Some examples you may want to explore:
Building & sustaining culture
Explore the following websites. How are these organisations working to build and sustain culture? How are they doing this in similar or different ways?
Building leadership & self-determination
Explore the Australian Indigenous Governance Institute website, starting with the ‘Vision’ statement on the page linked below, then consider the following question:
What is the thinking being discussed in bringing together western views of governance and Aboriginal ways of being and doing?
Leaders & celebrities
Can you name any Aboriginal and Torres Strait Islander scientists? Meet some in the NITV interview below:
Make a list of any other Aboriginal and Torres Strait Islander politicians, academics, actors and sports people you can name. How many were you able to recall?