Mental health

About this topic

For many Aboriginal and Torres Strait Islander people (Indigenous Australians), good mental health is indicated by feeling a sense of belonging, having strong cultural identity, maintaining positive interpersonal relationships, and feeling that life has purpose and value (Dudgeon & Walker 2015; Dudgeon et al. 2014). Conversely, poor mental health can be affected by major stressors such as removal from family, incarceration, death of a close friend or family member, discrimination and unemployment, as well as stressors from everyday life (PM&C 2017; Gee et al. 2014).

The legacies of colonisation and the ongoing trauma experienced by Indigenous Australians also affect mental health. Dispossession from land, forced removal of Indigenous children from families, and institutionalised racism have enduring effects on social and emotional wellbeing (Dudgeon & Walker 2015).

Connection to mind and emotions

Connection to mind and emotions is 1 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).

Factors that support the connection to mind and emotions are education, agency and strong identity. Conversely, mental illness, development or cognitive impairments and other disability, trauma, racism and unemployment can negatively affect the connection to mind and emotions (PM&C 2017).

Mental health is a positive state of wellbeing in which a person can manage their thoughts and feelings to cope with the normal stressors of life and reach their potential in the context of family, community, culture and broader society. Mental health problems are ‘diminished cognitive, emotional or social abilities but not to the extent that the criteria for a mental illness are met’, such as psychological distress (AIHW & NIAA 2020).

Mental illnesses are diagnosed according to criteria and range from high‑prevalence disorders such as anxiety and depression, through to low‑prevalence disorders such as psychosis, schizophrenia, and bipolar disorder (AIHW & NIAA 2020).

There are cultural differences to be considered by practitioners when identifying and treating mental health conditions in Indigenous Australians. Symptoms such as a weakened spirit and community disconnection may require cultural resolution and healing with culturally appropriate counselling services (Gee et al. 2014). Additionally, expressions and perceptions of mental health conditions such as depression may differ between Indigenous and non-Indigenous Australians (Brown et al. 2012; Vicary & Westerman 2004).

Key statistics

The information presented above is from survey data. Estimates are calculated using a sample selected from a population rather than all members of that population. See the downloadable excel workbook for notes related to this data and for alternative text.

In 2018–19, based on self-reported survey responses, an estimated 24% of Indigenous Australians reported having a diagnosed mental health or behavioural condition with a higher rate among females (25%) than males (23%). More than one in 10 individuals reported having diagnosed anxiety (16.5%) or depression (13.3%) (ABS 2019).

Two-thirds of Indigenous adults reported ‘low or moderate’ levels of psychological distress (66%). The rate was higher among males (70%) than females (63%) (ABS 2019).

From 2004–05 to 2018–19, the proportion of Indigenous adults reporting ‘high or very high’ levels of psychological distress increased from 27% to 31%. Those aged 45 to 54 years were most likely to report ‘high or very high’ levels of psychological distress in 2018–19 (ABS 2019).

The proportion of Indigenous adults reporting high levels of psychological distress was 31% in Non-remote areas (major cities and regional areas) and 28% in Remote areas in 2018–19 (ABS 2019).

In 2018, mental and substance use disorders were the leading cause (23%) of total disease burden for Indigenous Australians. Within this disease group, the leading causes of burden were:

23% anxiety disorders
19% alcohol use disorders
19% depressive disorders
9% drug use disorders (excluding alcohol)
7% schizophrenia (AIHW 2022).

Key terms

Burden of disease or disease burden refers to:

Burden of disease is a measure of the impact of different diseases or injuries on a population. It combines the years of healthy life lost due to living with ill health (non-fatal burden) with the years of life lost due to dying prematurely (fatal burden). Fatal and non-fatal burden combined are referred to as total burden, reported as the disability-adjusted life years (DALYs) measure (AIHW 2020).

Disability-adjusted life years (DALY): Measure (in years) of healthy life lost, either through premature death, defined as dying before the expected life span at the age of death (YLL), or, equivalently, through living with ill health due to illness or injury (YLD). It is often used synonymously with ‘health loss’ (AIHW 2022).

A mental health or behavioural condition refers to the following:

depression (including feeling depressed)
anxiety
harmful use or dependence on alcohol or drugs
behavioural or emotional problems such as attention deficit hyperactivity disorder (ADHD) and conduct disorders in children and adolescents and adults
other mental health conditions such as organic mental problems, other mood (affective) disorders, other anxiety related problems, and psychological development (ABS 2019).

The term Mental and substance use disorders is an international administrative classification that includes mental health and behavioural conditions as well as other conditions such as autism spectrum disorder and cognitive impairment.

Psychological distress refers to how often a person had experienced negative emotional states in the previous four-week period, measured by the Kessler Psychological Distress Scale (K5). The K5 prompts questions such as ‘in the last four weeks, how often did you feel without hope?’. Responses range from ‘all of the time’ to ‘none of the time’. Combined responses produce a score between 1 and 25. The scores were grouped to describe the level of psychological distress as low/moderate (5–11) or high/very high (12–25) (ABS 2019).

Where do I go for more information?

This information was compiled from the following data sources: ABS National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) 2018–19 and the Australian Burden of Disease Study 2018. More information about these data sources and data quality is available in Data sources.

Data quality issues

Survey data presented above are from the Aboriginal and Torres Strait Islander Health Survey (NATSIHS). The following factors should be considered when interpreting these estimates.

Data are collected from a self-report survey, and responses 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.
Results of previous surveys have shown a tendency for people to under-report when asked about certain topics, such as substance use.
Survey participants may report more than one mental or behavioural condition. Total mental and behavioural conditions refers to those who reported at least 1 mental or behavioural condition (ABS 2019).

See ABS NATSIHS 2018–19 Methodology for more information.

All estimates in the Australia Burden of Disease Study 2018 were produced using the best possible data that were available within the scope and timeframe of the study.

Data for Indigenous Australians are subject to several limitations of data quality and availability. These include under-identification of Indigenous Australians in administrative data sets, changes in people’s inclination to identify as Indigenous, and lack of available data on the prevalence of certain diseases in the Indigenous population. For more information about data quality issues, see Australian Burden of Disease Study 2018: methods and supplementary material.

References

ABS (Australian Bureau of Statistics) 2019. National Aboriginal and Torres Strait Islander Health Survey, 2018–19. ABS cat. no. 4715.0. Canberra: ABS.

AIHW (Australian Institute of Health and Welfare) 2020. Indigenous health and wellbeing. Canberra: AIHW. Viewed 17 May 2021.

AIHW 2022. Australian Burden of Disease Study: Impact and causes of illness and death in Aboriginal and Torres Strait Islander people 2018. Australian Burden of Disease Study series no. 26. Cat. no. BOD 32. Canberra: AIHW. Viewed 15 November 2022.

AIHW & NIAA (Australian Institute of Health and Welfare & National Indigenous Australians Agency) 2020. Aboriginal and Torres Strait Islander Health Performance Framework. Canberra: AIHW. Viewed 19 May 2021.

Brown A, Scales U, Beever W, Rickards B, Rowley K & O'Dea K 2012. Exploring the expression of depression and distress in aboriginal men in central Australia: a qualitative study. BMC Psychiatry 12:97. doi:10.1186/1471-244X-12-97

Dudgeon P, Cox A, Walker R, Scrin C, Kelly K, Blurton D et al. 2014. Voices of the peoples: The national empowerment project research report 2015. Perth: National Empowerment Project, University of Western Australia.

Dudgeon P & Walker R 2015. Decolonising psychology: discourses, strategies and practice. Journal of Social and Political Psychology 3(1):276–297.

Gee G, Dudgeon P, Schultz C, Hart A & Kelly K 2014. Aboriginal and Torres Strait Islander social and emotional wellbeing. In: Dudgeon P, Milroy H & Walker R (eds). Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice. 2nd edn. Canberra: Australian Government, pp. 55-68.

PM&C (Department of Prime Minister and Cabinet) 2017. National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing. Canberra: Australian Government.

Vicary D & Westerman T 2004. That’s just the way he is’: Some implications of Aboriginal mental health beliefs. Australian e-Journal for the Advancement of Mental Health 3(3):103–112.