Frameworks for understanding Aboriginal approaches to health

Emerging Minds, Australia, 2019

Resource Summary

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.

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.

Vimeo video: https://vimeo.com/327656419

Aboriginal and Torres Strait Islander Whole Child Video

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.
- Bamblett, Frederico, Harrison, Jackson and Lewis (2012)

Self-determination

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.

Consider

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.

- Capocchi-Hunter, 2018

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.

Consider

  • 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.)?

Case Study

“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)

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.

Vimeo video: https://vimeo.com/337209242

Intergenerational trauma animation

Consider

  • 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?
Vimeo video: https://vimeo.com/337209215

Helen Milroy talks intergenerational trauma

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

 

Human rights

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.

Consider

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

 

 

 

Racism, stigma, environmental adversity and social disadvantage

6. Racism, stigma, environmental adversity and social disadvantage constitute ongoing stressors and have negative impacts on Aboriginal and Torres Strait Islander peoples’ mental health and wellbeing

Watch the Beyond Blue Invisible Discriminator video below, then consider the following questions:

  • What are the different faces of racism?
  • Do you see it when your co-workers, friends or family speak?
  • Are you aware of the dynamics of power and how these are embedded in systems?
Vimeo video: https://vimeo.com/337209234

beyond blue Invisible Discriminator video

Case study

The following is just one story illustrating the ongoing racism faced by First Nations people daily:

‘My brother and I were in a store and we were looking at a laptop computer. Now me and my brother happen to be dark ones. And there in the store there are school kids walking around the store with bags over their shoulders and everything. I happened to have my brief case with me, and this manager of the store said over the PA system: “You two blackfellas looking at the laptop, please move back to the front of the store where we can remove your bag.” I just left the store mate and never been back.’ “Get a life cobber!” (Australian Human Rights Commission, 2005, p49).

Reflect

  • When was the last time you experienced racism?
  • How did you experience racism?
  • How could these experiences affect your interactions with families?

Further information and resources

Unpacking the invisible knapsack by Peggy McIntosh

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)

 Consider

  • 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

Australians Together website – 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.

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.

 

This map attempts to represent the language, social or nation groups of Aboriginal Australia. It shows only the general locations of larger groupings of people which may include clans, dialects or individual languages in a group. It used published resources from 1988-1994 and is not intended to be exact, nor the boundaries fixed. It is not suitable for native title or other land claims. David R Horton (creator), © AIATSIS, 1996. No reproduction without permission. To purchase a print version visit: www.aiatsis.ashop.com.au/

Further information and resources

Creative Spirits website – Aboriginal land councils

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.

Consider

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?

Ku Arts
Tal-Kin-Jeri

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?

Australian Indigenous Governance Institute – Our Vision & Strategic Agenda

Leaders & celebrities

Can you name any Aboriginal and Torres Strait Islander scientists? Meet some in the NITV interview below:

Science Week: NITV talk to Indigenous scientists about their work and inspiration

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?

 

 

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