About this topic
For Aboriginal and Torres Strait Islander people (Indigenous Australians), mental health and wellbeing are enhanced by connection to Country, family and spirit, strong social networks and strong leadership in the community (Gee et al. 2014).
Family support can strengthen wellbeing by providing connections to community and culture and the provision of emotional support, particularly in times of stress (Gee et al. 2014; Milroy et al. 2014). Community participation and contact with friends and family outside the household can enhance a person’s sense of belonging, social resilience and can offer meaning to everyday life (ABS 2016; DoH 2019).
Connection to community, family and kinship
Connection to community and to family and kinship are 2 of the 7 domains of social and emotional wellbeing for Indigenous Australians.
Social and emotional wellbeing is a holistic way of looking at relationships between individuals, family, kin and community in the context of land, culture, spirituality and ancestry. Cultural groups and individuals each have their own interpretation of social and emotional wellbeing (Gee et al. 2014).
Having support networks enhances connection to community. Having a loving, stable, accepting and supportive family improves connection to family and kinship (PM&C 2017).
Strong connections to family and kinship systems are central to the functioning of Indigenous communities. Connection to community provides opportunities for support and collaboration (PM&C 2017). Factors that threaten these strong connections include violence, isolation, and disengagement from community (PM&C 2017).
A safe community is one where people feel protected from harm in their home, workplace and society (AIHW 2019a). The wellbeing and mental health of many Indigenous Australians are affected by the safety of their community.
When a person feels safe:
- they can live a better quality life that is healthy
- they are more likely to engage in the community
- their community as a whole faces a lower incidence of injuries and violence (AIHW & NIAA 2020).
Safe communities are able to provide emotional, physical or financial support during times of crisis (DoH 2019).
Indigenous Australians have experienced violence through colonisation, discrimination and cultural dispossession (Day et al. 2013; Our Watch 2018). This has resulted in ongoing social, economic, physical, psychological and emotional effects (AIHW 2018a; Coles et al. 2015; Loxton et al. 2019; Our Watch 2018).
The effects of colonisation are perpetuated through:
- racialised, structural inequalities of power
- entrenched racism in social norms, attitudes and practices
- racist violence
- condoning of, and insufficient accountability for, violence against Indigenous Australians.
‘Lateral violence’ describes the way people (Indigenous and non-Indigenous) in positions of powerlessness covertly or overtly direct their dissatisfaction inward towards themselves, each other and those less powerful than themselves (AIHW & NIAA 2020).
For Indigenous Australians, the roots of lateral violence are found in colonisation, oppression, intergenerational trauma and experiences of racism (Korff 2015).
A range of Indigenous community initiatives have been implemented to manage community safety. These include family violence prevention programs and community patrols.
Community patrols are night patrols, foot patrols, street patrols, youth or women’s patrols (AIHW & NIAA 2020; Blagg 2007; Willis 2010). They aim to minimise risk of harm, de-escalate tensions, divert people away from the criminal justice system, and connect people with support services such as sobering-up shelters or women’s refuges (AIHW & NIAA 2020). Successful community patrols are part of a holistic approach that features:
- community involvement and ownership
- relationships with a network of community services
- strong collaboration with (but independence from) police
- long-term government support
- endorsement by key community members
- social cohesion (Beacroft et al. 2011; Blagg 2007).
The child protection and criminal justice systems are also used as ways of managing community safety, but interactions with these systems can be traumatic for Indigenous communities. Violence or child abuse can be under-reported by victims due to lack of trust in police (Bailey et al. 2017; Olsen & Lovett 2016; Prentice et al. 2017; Willis 2010).
Improving the level of safety in all communities depends on addressing entrenched inequality and disadvantage and the multiple factors that give rise to violent and criminal behaviour.
Child protection system
Child protection agencies aim to address the safety needs of children. These agencies and services intervene within family settings to support children who are at risk of harm (Titterton 2017). Removing children from their families, culture and communities is a last resort (Productivity Commission 2019).
The reasons for the overrepresentation of Indigenous Australian children in child protection and out-of-home care systems are complex and include the intergenerational effects of previous separations from family and culture and the legacy of past policies of forced removal (AIHW 2019b).
Exposure to abuse, neglect and other traumatic experiences are common drivers of entry into the child protection system (AIHW 2020) and these experiences can continue while they are in the system (PM&C 2017). For some children, increased contact with the child protection system can exacerbate trauma and existing mental health conditions (Green et al. 2019). Indigenous children placed in out-of-home care can experience a disconnection from community, family and culture (Chandler & Lalonde 2018).
Mainstream services are mistrusted because of the legacy of colonisation and a history of mistreatment and separation of Indigenous families (Dudgeon et al. 2014). Government policies such as the National Framework for Protecting Australia’s Children and the Child Placement Principle provide guidance for maintaining culture through the child protection system (AIHW 2020; COAG 2009; Tilbury et al. 2013).
Members of the Stolen Generations and their descendants experience higher levels of incarceration, unemployment and poor health compared to Indigenous Australians in the same age cohort who were not removed (AIHW 2018b).
Criminal justice system
The criminal justice system determines which events are criminal and exercises penalties and compensation (ABS 1997). Indigenous Australians experience contact with the criminal justice system—as both offenders and victims—at much higher rates than non-Indigenous Australians (Productivity Commission 2016; Senate Community Affairs References Committee 2010).
Imprisonment compounds existing social and economic disadvantage and affects family, children and the broader community with intergenerational effects (AIHW & NIAA 2020). Child removals, poverty, higher rates of stressful life events, psychological distress, and mental health issues are linked to the higher rates of contact with the criminal justice system (Australian Medical Association 2015; McCausland et al. 2017; Shepherd et al. 2017). The experience of imprisonment can contribute to poor mental health (Baldry et al. 2015).
Imprisonment removes people from their land, community and family. As a result, it is challenging for services to improve the mental health of Indigenous Australians who have contact with the criminal justice system. The use of culturally immersive programs, Indigenous sentencing courts (for example, Koori court), on-Country programs and parenting programs can result in positive social and emotional wellbeing outcomes for Indigenous people and their communities (Bennett 2016; Marchetti 2009; Palmer 2013).
In 2018–19, 73% of Indigenous adults reported that they get the emotional support and help they need from their family. A similar proportion (74%) of Indigenous adults reported that their family really tries to help them (AIHW & NIAA 2020).
- 90% of Indigenous Australians felt able to have a say with family and friends, some, most or all the time
- 82% of Indigenous Australians had family or friends they could confide in outside the household
- 82% of Indigenous Australians were able to obtain support in a time of crisis from a family member living outside the household
- 97% had participated in sport, social or community activities in the last 12 months (AIHW & NIAA 2020).
In 2014–15, 84% of Indigenous Australians felt safe at home alone after dark. 78% of Indigenous Australians were not a victim of physical or threatened violence in the last 12 months (AIHW & NIAA 2020).
In 2019–20, the most common reasons for substantiated notifications for Indigenous and non-Indigenous children were emotional abuse (6,690 or 47% and 18,999 or 57%, respectively), neglect (4,531 or 32% and 6,015 or 18%, respectively), and physical abuse (2,018 or 14% and 4,687 or 14%, respectively) (AIHW 2021a).
In 2018–19, among the estimated 27,200 members of the Stolen Generations aged 50 and over, 43% had ever been diagnosed with a mental health condition. They were 1.3 times as likely to have been diagnosed with a mental health condition compared to the Indigenous reference group aged 50 and over who were not removed from their families (35%) (AIHW 2021b).
In 2018, one-third (33% or 101 people) of surveyed Indigenous prison entrants aged 18 years and over reported having been diagnosed with a mental health disorder, compared with 44% (211 people) of non-Indigenous entrants. More than 1 in 5 Indigenous prison entrants (21% or 65 people) reported a history of self-harm; the same proportion (21% or 103 people) was reported for non-Indigenous prison entrants. Non-Indigenous dischargees were more likely to report an improvement in their mental health during their time in prison (42%) compared with Indigenous dischargees (35%) (AIHW 2019c).
Between 1991–92 and 2018–19, of the 451 Indigenous adult deaths in custody (police and prison custody), more than a quarter (27% or 124 deaths) were self-inflicted (Doherty & Bricknell 2020).
A notification is contact made to an authorised department by people or other bodies alleging child abuse or neglect, child maltreatment or harm to a child.
When a notification of abuse, neglect, maltreatment or harm to a child is made, it is investigated by the authorised department.
The notification is substantiated if it is concluded that there was reasonable cause to believe that the child had been, was being, or was likely to be, abused, neglected or otherwise harmed.
Substantiation does not require sufficient evidence for a successful prosecution and does not imply that treatment or case management was provided. Substantiations also include cases where there is no suitable caregiver, such as when children have been abandoned or their parents are deceased.
This information was compiled from the following data sources: National Prisoner Health Data Collection (NPHDC) 2018, National Deaths in Custody Program (NDCP), National Aboriginal and Torres Strait Islander Social Survey 2014–15 and National Aboriginal and Torres Strait Islander Health Survey 2018–19. More information about these data sources and their data quality is available in Data sources.
For more information about the health of Australia’s prisoners please see AIHW report: The health of Australia’s prisoners 2018.
Among prison entrants, people in custody and prison dischargees who were approached to participate in the 2018 National Prisoner Health Data Collection (NPHDC), some did not consent to participate. Therefore, information relating to the mental health of prison entrants, people in custody and prison dischargees does not necessarily represent the total prison population. For prison entrants, people in custody and prison dischargees, the data excludes New South Wales, which did not provide data for these items (AIHW 2019c).
Information relating to self-inflicted deaths in custody includes self-harm, whether intentional, unintentional or unknown, and accidental hangings (Doherty & Bricknell 2020).
Care has been taken to ensure that the results of survey data presented above are as accurate as possible. However, the following factors should be considered when interpreting these estimates:
- Data collected from self-report surveys may differ from information available from other sources.
- Accuracy of responses may be affected by the length of time between events experienced and participation in the survey.
- Some people may have provided responses they felt were expected, rather than those that accurately reflect their own situation (ABS 2019).
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