Bringing-Them-Home-Report-Web

• adopt an holistic approach.Health promotion and prevention modelThe desirability of this model is indicated by the prevalence of psychologicaldistress and psychiatric problems affecting Indigenous people.Any approach to Aboriginal mental health based simply on direct treatment programs, is unlikelyto impact significantly on outcomes for Aboriginal communities (Swan and Raphael WaysForward 1995 page 85).Strategies should include Indigenous community education about psychologicaldistress and development of prevention programs for those at risk. The humanitarianbenefit of prevention and early intervention is obvious. Economic benefits can also bedemonstrated. The East Arnhem early intervention strategy achieved a reduction inemergency evacuations of petrol sniffers to hospital in Darwin from 43 in 1991 to justfive in 1993 at a saving per patient of ovef $5,000 for an air evacuation and over $75,000for in-patient treatment for lead toxicity (Mcleod 1995 pages 7 and 9). To date howevermental health interventions for Indigenous people have significantly clustered towardsacute and crisis intervention and away from community health promotion and preventionstrategies.Trauma and grief ‘were identified as amongst the most serious, distressing anddisabling issues faced by Aboriginal people both as a cause of mental health problemsand as major problems in their own right’ (Swan and Raphael Ways Forward 1995 page3). Only the most recent Commonwealth initiative addresses this issue.Ways Forward proposed that priority be accorded to violence and destructivebehaviours (page 5). There is no evidence of any mental health project acknowledgingthat these issues should be incorporated within the definition of mental health (with theobvious exception of self-destructive behaviours) much less of recent initiativesaccording them priority. These matters are, however, the focus of the NSW AboriginalFamily Health Strategy launched in 1996.Indigenous empowerment and self-determinationThe Ways Forward report stated,It is essential in terms of recognition of the needs and wishes of Aboriginal people that theimplementation of policy is managed, coordinated, monitored and evaluated by Aboriginalpeople and organisations (page 21).Indeed ‘self-determination is central to Aboriginal people’s well-being’ and ‘denialof this right contributes significantly to mental ill-health’ (page 21). The 1990 NationalAboriginal Health Strategy also identified self-determination in health care as essential(Swan and Raphael Ways Forward 1995 page 21).