Bringing-Them-Home-Report-Web

to racial prejudice and discrimination, lack of respect, and in many cases poor previousexperience in mainstream services both rural and urban (Sydney Aboriginal Mental Health Unitsubmission 650 page 2).Such services [ie conventional, mainstream, mental health services] are culturally inappropriatefor Aboriginal people and do not meet their needs. Aboriginal people do not feel comfortableusing mainstream health services … It is vital to Aboriginal people that they know and are knownby those they trust to work with them (Dr Jane McKendrick, Victorian Aboriginal Mental HealthNetwork, submission 310 pages 32-33).The national consultancy on Indigenous mental health commissioned by theCommonwealth under the National Mental Health Strategy found widespread agreementwith this assessment.Consumers and families have frequently described the failure to inform them, to explain, toprovide optimal care and there is a pervasive view that diagnosis and treatment are ‘second class’for Aboriginal people with mental illness (Swan and Raphael Ways Forward 1995 page 32).The authors concluded,[There was] extensive evidence of the inadequacy of current mental health services forAboriginal people. In many remote and rural communities these were virtually non-existent.Where there was contact with or use of mainstream mental health services they were frequentlyseen as unhelpful, non responsive, inaccessible or unavailable and totally failing to respond to theneeds of Aboriginal people with mental illness. Misdiagnosis, the inappropriateness of Westernmodels, failure to recognise language differences, ignorance of Aboriginal culture and history,and racism complicated the picture … the overall picture is one of gross inadequacy … (Swanand Raphael Ways Forward 1995 page 38).Misdiagnosis with its consequent inappropriate treatment or even failure to treat is acritical problem.… in a lot of cases from my experience, Aboriginal people are often misdiagnosed as having apersonality disorder when they are in fact depressed. And that will come about becausepsychiatrists might hear that they have been in gaol or that they have been abusing substances andso immediately the diagnosis is closed. The diagnosis of personality disorder – which is actuallymore a moral diagnosis and implies you cannot help the person – is given.There are other cases where a person has very obviously got a very serious psychotic disorder andthey present to a hospital and if they smell of alcohol at all they might be refused admission. Or ifthey have committed a minor offence they might be refused admission. It seems that the obviouspsychotic symptoms are missed and the person is said just to have a personality disorder.