Aboriginal and Torres Strait Islander mental health: paradise lost?

MJA 196 (2) · 6 Febru t may well be that Australian Aboriginal culture, before significant European contact, provided conditions for mental health that the rest of the world would envy. Traditional Aboriginal culture has several factors that strongly reinforce good mental health. Sense of self was seen as being intimately connected to all aspects of life, community, spirituality, culture and country. Material needs were provided for through sharing rules, and relationships and kinship defined social roles. Aboriginal people derived a sense of meaning and understanding of life experience from their connection to country and their Dreaming. Spiritual beliefs offered guidance, comfort, and a sense of connectivity and belonging. Lore, the body of knowledge that defined their culture, and the Elders who contained and interpreted the Lore, were highly valued. Over 200 traditional languages and other methods of communication allowed rich expression, and formal ceremony allowed a method of dealing with life’s transitions through birth, initiation and death. Men and women had defined economic and cultural roles, and children had a range of “aunties” and older siblings to take over child care if a mother was stressed.1 Torres Strait Islander culture also had rituals and societal mechanisms that appeared to reinforce mental health.1 Early reports of Aboriginal and Torres Strait Islander people mention occasions of mental illness, but these were considered to be rare events.2 This is in marked comparison to the high rates of mental illness described by Hunter and colleagues3 and Jorm and colleagues4 in this issue of the Journal. Hunter and colleagues identified rates and correlates of psychosis in a defined Aboriginal and Torres Strait Islander population in Far North Queensland, while Jorm and colleagues identified broader issues with respect to the mental health of Aboriginal and Torres Strait people by reviewing community studies. Jorm and co-workers point to the difficulty of establishing validity in community surveys through the use of formal diagnostic instruments, underscoring concerns about the validity of Western psychiatric diagnoses for non-Western cultural groups. Such concerns include the standards of what constitutes scientific evidence, the meaning and uses of ethnic and racial categories, interpretations of differences of prevalence rates for mental disorders and the tension between universal and group-specific approaches to mental health research and policy.5 ElseAboriginal and Torres Strait Islander mental health: paradise lost?