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expectations of two different cultures – about finding a sense of place (South AustralianGovernment final submission page 54).The complexity of the causes of mental health problems for Indigenous people andtheir entrenched nature need to be recognised in the development of responses andtreatments.The National Mental Health Strategy is a joint Commonwealth-State fundingprogram which includes a component for Indigenous people as a special needs group.This joint initiative is a five year program (1992-93 to 1997-98) with a broad objective ofspurring mental health reforms (Commonwealth Government submission page 11).Indigenous health generally was the focus of the 1990 National Aboriginal HealthStrategy. This Strategy was developed by the National Aboriginal Health StrategyWorking Party which reported in 1989. On mental health the Working Party concludedthat,Mental distress is a common and crippling problem for many Aboriginal people and appropriateservices are a pressing need. Advances in the understanding and treatment for mental healthproblems have been impressive since World War II; this progress has yet to benefit Aboriginalpeople. Culturally appropriate services for Aboriginal people are virtually non-existent. Mentalhealth services are designed and controlled by the dominant society for the dominant society. Thehealth system does not recognise or adapt programs to Aboriginal beliefs and law, causing a hugegap between service provider and user. As a result, mental distress in the Aboriginal communitygoes unnoticed, undiagnosed and untreated (pages 171-172).Indigenous use of servicesIndigenous people are generally under-represented as clients of mental healthservices, especially primary and secondary services (NSW Government interimsubmission page 106, Adams 1996 page 1, Dr Jane McKendrick submission 310 page 32,Swan and Fagan 1991 page 24). However all governments now accept that proportionallyat least as many Indigenous people suffer mental health problems but that mainstreamservices have not been accessible or appropriate. The Queensland Government hasadditionally recognised that ‘because of the conditions of life for many Aboriginal andTorres Strait Islander people, other disorders appear to have higher rates. These includeanxiety and adjustment disorders, substance induced psychotic disorders, cognitiveimpairment in older people, and conduct disorders in children’ (Mental Health PolicyStatement 1996 page 10).The reasons for Indigenous under-representation as clients were analysed for theInquiry in a number of submissions.There is an enormous amount of ignorance, lack of understanding, lack of tolerance andunfounded beliefs associated with Aboriginal and Torres Strait Islander people’s mental healthissues among mainstream services. Mainstream services lacked knowledge and/or wereinsensitive to cultural issues of history, culture, spirituality, trauma, loss and grief. These featureswere virtually universal to all Aboriginal people who experienced mental distress. Otherproblems relevant to poor acceptability and accessibility of the mainstream services related also