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Mental Health

[ Mental Health ] [ Mental Disorders ] [ Alcohol and Other Drug Use ] [ Children and Young People ]

A Quick Reference Card with summary information about social and emotional well being for use by Indigenous Media is available from the Downloads page of this website.

Data on mental health for Aboriginal and Torres Strait Islander communities in Australia are limited in quality. Discussion in the field draws both on available Australian research and limited data from surveys and hospitalisation rates. Caution must be exercised in examining information and data on patterns of mental illness in these communities due to the unavailability of accurate statistics and population estimates. The following information is presented to progress the development of an understanding of the factors that influence and impact on the mental health and wellbeing of Aboriginal and Torres Strait Islander communities in Australia.

Mental Health

  • Some people, including Aboriginal and Torres Strait Islander Australians prefer the term "social and emotional wellbeing", rather than "mental health" because of its more positive and holistic connotations1.
  • Aboriginal and Torres Strait Islander people have traditionally viewed health as including not only the physical health of the person, but also the social, emotional and spiritual wellbeing of the whole community. Traditional cultures also featured a strong bond with the land and a personal connection to the lands of one's own people.
  • Any consideration of mental health of Aboriginal and Torres Strait Islander people must be set within the context of Australian history and social change. Aboriginal and Torres Strait Islander individuals and communities continue to be affected by the effects of European colonisation in terms of the loss of traditional lands, the forced separation of families and the loss of cultural identity.
  • Trauma and grief have been identified as significant issues for Aboriginal and Torres Strait Islander communities and for individuals. Many Aboriginal and Torres Strait Islander people carry a significant burden of loss and bereavement from an early age, due in part to the high rates of mortality, illness, incarceration, deaths in custody and involuntary hospitalisation among people in their communities.

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Mental Disorders

  • At present, there isn't any definitive national data about the incidence or prevalence of mental disorders among Aboriginal and Torres Strait Islander people. However, some limited available research has supported the conclusion that serious mental disorders occur in these populations, and such disorders are at least as common as among other Australians.
  • Data on hospitalisation and mortality due to serious mental disorders and illnesses are currently the main sources of information about mental disorders among Aboriginal and Torres Strait Islander people.
  • The chance of an Aboriginal or Torres Strait Islander person being involuntarily admitted to psychiatric care are 3 to 5 times higher than for other Australians.
  • In 2001-02, Aboriginal and Torres Strait Islander people were hospitalised for conditions classified as 'mental and behavioural disorders' at a higher rate than the general population2.
  • In 2005, Indigenous Australians experienced high or very high levels of psychological distress, with Indigenous females significantly more likely than Indigenous males to report such levels. These patterns were observed to be higher than those of non-Indigenous adults across every age group3.
  • In 2005, 21% of Indigenous adults were unable to work or carry out their normal activities because of their psychological distress for atleast 1 day in a 4 week period and around 12% had seen a health professional at least once for this reason over the same period4.
  • The rate of hospitalisation for Aboriginal and Torres Strait Islander people diagnosed with mental disorders due to psychoactive substance use was four to five times higher than the rate for other Australians5.
  • The death rate associated with mental disorders among Aboriginal and Torres Strait Islander males was over three times the rate for males in the general population, but for females the rates were the same. The majority of these deaths in the Aboriginal and Torres Strait Islander population (74%) were attributed to mental disorders due to psychoactive substance use6.
  • Depression has been identified as one of the six most frequent problems managed by GPs for Aboriginal and Torres Strait Islander patients7.
  • The 2002 NATSISS8 (National Aboriginal and Torres Strait Islander Social Survey) did not include questions relating specifically to mental health, but it did ask about stressors experienced in the past 12 months. Overall, Aboriginal and Torres Strait Islander people aged 18 years and older were more likely to report experiencing at least one stressor (82%) than other Australians of this age group (57% - as reported in the 2002 ABS General Social Survey).
  • The admission rates of Aboriginal and Torres Strait Islander people for mental and behavioural disorders due to psychoactive substance use in 2000-2001 were 4.8 times higher for males and 3.6 times higher for females than those for other Australians9.
  • Rates for Aboriginal and Torres Strait Islander males and females for 'schizophrenia, schizotypal and delusional disorders were more than double those for males and females generally, and rates for mood and neurotic disorders were slightly higher10.
  • Aboriginal and Torres Strait Islander persons receive proportionately less specialised care for mental disorders and behavioural disorders. In 2000-2001, Aboriginal and Torres Strait Islander males received specialised care in 53% of admissions for mental and behavioural disorders compared with 67% for other Australians. Aboriginal and Torres Strait Islander females were admitted to specialised care for 46% of mental health admissions, compared with 69% for other Australian females.
  • In 2004-2005, the number of community mental health service contacts for Indigenous Australians was 2.3 times the rate of other Australians11.
  • The National Inquiry into the Human Rights of People with Mental Illness12 found that anti-social and self-destructive behaviour, often the result of undiagnosed mental and social distress, brought Aboriginal and Torres Strait Islander people into frequent contact with the criminal justice system.

 Alcohol and Other Drug Use

  • Several surveys have shown that Aboriginal and Torres Strait Islander people are less likely than other Australian people to drink alcohol, but those who do drink are more likely to consume it at hazardous levels13.
  • Alcohol is frequently a contributing factor in injuries, accidents, assaults and self-harm14.
  • The most recent national data on alcohol consumption among Aboriginal and Torres Strait Islander people comes from the 2001 National Health Survey. It found that in the week before the survey, 29% of adult Aboriginal and Torres Strait Islander drinkers were in the risky or high-risk category for alcohol consumption, compared with 17% of other Australian drinkers15.
  • Aboriginal and Torres Strait Islander people are also at risk of ill health through the use of illicit substances such as marijuana, heroin, amphetamines and inhalants (for example petrol, glue or aerosols).
  • The most recent source of national data on the use of illicit drugs among Aboriginal and Torres Strait Islander people is the 2001 National Drug Strategy Household Survey. Approximately 57% of Aboriginal and Torres Strait Islander respondents in urban areas aged 14 years and older reported having tried at least one illicit drug in the past 12 months and 32% were currently using an illicit drug. This compares with 37% of the general urban population who had ever used an illicit drug, and 17% who currently used an illicit drug16.
  • There are no reliable national data on petrol sniffing, but case studies indicate that the practice continues to be a major problem in some Aboriginal and Torres Strait Islander communities. Petrol sniffing causes confusion, aggression, lack of coordination, hallucinations, respiratory problems and chronic disability, including mental impairment17.

    Mental Health First Aid
    Guidelines for Australian Aboriginal and Torres Strait Islander Peoples - Problem Drinking

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Indigenous Children and Young People

  • A 2005 survey in Western Australia looked at the social and emotional wellbeing of Aboriginal children and young people aged 4 to 17 years18.The survey revealed that:

    • Almost one quarter (24%) of Aboriginal children were rated by their parents as being at high risk of clinically significant emotional or behavioural difficulties. This compares with 15% of children in the non-Aboriginal population.
    • Growing up in areas of extreme isolation, where adherence to traditional culture and ways of life is strongest, may be protective against emotional and behavioural difficulties in Aboriginal children.
    • Living in households with high occupancy may also be protective against emotional and behavioural difficulties, as compared to low occupancy households.
    • Males were twice as likely as females to be at high risk of clinically significant emotional or behavioural difficulties.
    • Children were more likely to be at high risk of clinically significant emotional or behavioural difficulties in families that had experienced more life stress events.
    • Associations exist between the social and emotional wellbeing of Aboriginal carers and their children and the past policies and practices of forced separation of Aboriginal people from their natural families.
    • Just over one quarter of young Aboriginal people (27%) drink alcohol, while 30% of young people have used marijuana at some time in their lives. In areas of extreme isolation, only 8% of young Aboriginal people drink alcohol compared with 31% of young people in the metropolitan area.

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References

1. Australian Health Ministers. (2003). National Mental Health Plan 2003-2008. Canberra, ACT: Australian Government.
2. Australian Bureau of Statistics & Australian Institute of Health and Welfare. (2003). The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples, 2003. ABS Cat. No. 4704.0.; AIHW Cat. No. IHW 11. 
3. AIHW. (2008). Australia's Health 2008. Canberra: AIHW.
4 Ibid
5. ABS, & AIHW. (2003). Op cit
6. Australian Institute of Health and Welfare. (2004). Australia's Health 2004. AIHW Cat. No. AUS 4.
7. AIHW. (2004). Ibid
8. ABS. (2004). The National Aboriginal and Torres Strait Islander Social Survey 2002. Cat. No. 4714.0. 
9. ABS, & AIHW. (2003). Op cit
10. ABS, & AIHW. (2003). Op cit
11. AIHW. (2008). Op cit
12. Human Rights and Equal Opportunity Commission. (1993). Human Rights and Mental Illness: Report of the inquiry into the human rights of people with mental illness. Canberra, ACT: Australian Government.
13. ABS, & AIHW. (2003). Op cit
14. Unwin, E., Thomson, N. & Gracey, M. (1994). The Impact of Tobacco Smoking and Alcohol Consumption on Aboriginal Mortality and Hospitalisation in Western Australia, 1983-1991. Perth, WA: Health Department of Western Australia.
15. Australian Bureau of Statistics. (2002b). National Health Survey: A summary of results, 2001. ABS Cat. No. 4364.0.
16. Australian Institute of Health and Welfare. (2002). National Drug Strategy Household Survey: First results. AIHW Cat. No. PHE 35.
17. d'Abbs, P., & MacLean, S. (2000). Petrol Sniffing in Aboriginal Communities: A review of interventions. Darwin, NT: Cooperative Research Centre for Aboriginal and Tropical Health.
18. Zubrick, S. R., Silburn, S. R., Lawrence, D. M., Mitrou, F. G., Dalby, R. B., Blair, E. M., Griffin, J., Milroy, H., De Maio, J. A., Cox, A., & Li, J. (2005). The Western Australian Aboriginal Child Health Survey: The social and emotional wellbeing of Aboriginal children and young people. Perth, WA: Curtin University of Technology and Telethon Institute for Child Health Research.

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