Bringing-Them-Home-Report-Web

Most States and the Northern Territory now support Aboriginal medical and healthservices. Tasmania, South Australia and the ACT are notable exceptions. Apreponderance of resources, including ‘human resources’ such as Aboriginal mentalhealth workers, are still controlled by government health departments. Thispreponderance in part reflects the fact that most mental health resources are devoted tothe care of the mentally ill rather than to health promotion and the prevention of mentalillness.Holistic approachA holistic approach is one which permits mental health issues to be addressed in the‘general health sector’. Mental health care must be part of primary health care as well asreflecting Aboriginal values and approaches to mental and general well-being (Swan andRaphael Ways Forward 1995 page 26).This approach requires, for example, that Indigenous medical and health services beequipped to deal with mental health issues and that Indigenous general health workers betrained to recognise and deal with mental health problems and mental disorders (page 26).The general reluctance to pursue this strategy wholeheartedly seems to stem fromthe continued emphasis on more acute care. A preventive focus would be more conduciveto facilitating a holistic approach. Similarly the more mental health resources are placedat the disposal of Indigenous organisations implementing self-determination, the moretheir values and needs can be incorporated in the overall approach to Indigenous mentalwell-being.Evaluation – Inquiry criteriaThe Inquiry’s evaluation criteria are largely consistent with the objectives forIndigenous mental health provision set out in Ways Forward.Self-determinationAs noted above, the bulk of mental health resources continue to be controlled bygovernments and non-Indigenous non-government agencies. If effective Indigenouscontrolledprimary and preventive programs were widely available it might well beefficient and appropriate for secondary and tertiary services, for a much smaller minorityof Indigenous patients, to remain under government control. It would still be essential forthe government to work in partnership with local or regional Indigenous communityorganisations in the provision of acute care.Ways Forward proposed the establishment of a National Aboriginal Mental HealthAdvisory Committee to ‘oversee, coordinate and monitor’ national policy and planning(page 23). Consultations in the Northern Territory came to a similar conclusion.The Aboriginal Reference Groups or a Consultative Network of prominent Aboriginal peoplemust be responsible for the provision of high level advice and direction to the Minister …Territory Health Service must make their staff accountable to Aboriginal people and communities… (Adams 1996 pages vi and vii).