By Graham Davidson FAPS, Director of Social Issues
THE APS (2003) Guidelines for the Provision of Psychological Services for, and the Conduct of Research with, Aboriginal and Torres Strait Islander People of Australia include, amongst their requirements for culturally competent practice, an expectation that members "should be familiar with national health and mental health policies and initiatives which are designed to direct services for indigenous persons and communities."
Members might reasonably ask, therefore, what those policies and initiatives entail.
National health and mental health policies are relatively recent policy initiatives. A National Aboriginal Health Strategy published by the National Aboriginal Health Strategy Working Party (1989) was the first of its kind to address Indigenous health issues on a national level. From the late 1990s onward, the Australian Bureau of Statistics in conjunction with the Australian Institute of Health and Welfare (1999, 2001) has released statistical information on the Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples.
Framework Agreements on Aboriginal and Torres Strait Islander Health now exist between the Commonwealth and all States and Territories, with the first of these appearing in NSW in 1996 and the most recent in Queensland in 2002. During that time some States, such as NSW (1999), have published their own Aboriginal Health Strategic Plan.
Last year, the Standing Committee on Aboriginal and Torres Strait Islander Health (2002) published its Aboriginal and Torres Strait Islander Health Workforce National Strategic Framework, and the National Aboriginal and Torres Strait Islander Health Council (2002) published a National Strategic Framework for Aboriginal and Torres Strait Islander Health: Framework for Action by Governments.
National policy development on mental health services for Indigenous people has been slower to develop, although individual mental health professionals and researchers have shown a keen interest in this aspect of Indigenous people's wellbeing. Joe Reser's chapter on Aboriginal Mental Health in Reid and Trompf's (1991) collection of readings in The Health of Indigenous Australia provides an excellent introduction to, and overview of, Indigenous mental health research, as does Swan and Raphael's (1995) strategic statement, Ways Forward Consultancy Report on Aboriginal and Torres Strait Islander Mental Health.
It is essential to locate one's understanding of Indigenous health and mental health service needs within the socio-political landscape of injurious practices that Indigenous people have had to endure. Bringing Them Home: Report on the National Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from Their Families by Wilson (1997) and the Report of the Royal Commission into Aboriginal Deaths in Custody by Johnson (1991), with follow-up reports on State and Territory implementation of the recommendations of these Royal Commissions provide some context for understanding Indigenous mental health issues.
The most recent policy development initiative is by the Social Health Reference Group (2003) of the Office of Torres Strait Islander Health in the Commonwealth Department of Health and Ageing, which has released a Consultation Paper for Development of the National Strategic Framework for Aboriginal and Torres Strait Islander Mental Health and Social and Emotional Well Being 2004-2009.
The APS has received a copy of the Consultation Paper for comment, and will be represented at future workshops that are planned to facilitate the consultation process. The Consultation Paper builds on an earlier Aboriginal and Torres Strait Islander Emotional and Social Well Being (Mental Health) Action Plan 1996-2000, and on the Second National Mental Health Plan 1998-2003, as well as on general health strategies for Indigenous people catalogued above. The Society, after appropriate consultations, will be making comment on the key priorities and proposed strategies contained in the Consultation Paper.
This catalogue of policy statements might make dry reading; and there is also a view held by some Indigenous people and non-indigenous health professionals that what is needed is less policy and more action. Notwithstanding, it is important that psychologists familiarise themselves with these policies. First, it is important that APS psychologists seek opportunities to influence Indigenous mental health policy, given the Society's commitment to Indigenous health and wellbeing, and to evidence based practice. Its Guidelines for the Provision of Psychological Services for, and the Conduct of Research with, Aboriginal and Torres Strait Islander People of Australia (2003) comprise a comprehensive set of standards for allied health professionals and researchers who are working with Indigenous communities. Second, the national strategies and plans mentioned in this article form the basis for allocation of health and mental health funding. Psychologists run the risk of being further marginalised in Indigenous mental health service delivery unless they actively engage with these national strategic action frameworks. Finally, national strategies and action plans that are based on effective consultation with Indigenous people can inform psychologists about Indigenous people's prioritisation of Indigenous mental health needs.
As mental health professionals it is important that we are not ignorant of those priorities and accompanying opportunities.