Transcript Slide 1

12-14
15-17
18
Painkillers for non
medical purposes
18.9
35.6
42.2
Tranquillisers for nonmedical purposes
5.0
9.1
17.2
Steroids
2.3
2.3
3.3
Heroin
3.5
3.3
5.6
Methamphetamine
4.1
9.5
24.4
Natural Occurring
Hallucinogens
3.8
5.2
11.1
Synthetic Hallucinogens
3.1
4.8
13.9
Ecstasy
3.7
9.4
27.8
Inhalants
4.7
6.9
8.3
Kava
2.9
3.1
9.4
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higher levels of boredom were associated with
worse levels of alcohol use [r=-.052, n=1472,
p<0.05]
There was no association with other drug use
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higher levels of stress were associated with
worse levels of alcohol use [r=-.082, n=1469,
p<0.001]
higher levels of stress were associated with
worse levels of inhalant use [r=-.055, n=1466,
p<0.05]
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A negative correlation existed between a felt
sense of connectedness to friends and tobacco
[r=-.057, n=1480, p<0.05]
similarly, a negative correlation existed
between connectedness to friends and
marijuana use [r=-.075, n=1477, p<0.01]
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lower levels of connectedness to family were
associated with higher levels of inhalant use
use [r=-.058, n=1471, p<0.05]
lower levels of connectedness to family were
also associated with higher level of ecstasy use
[r=-.069, n=1476, p<0.01]
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Increased resilience and connectedness to the
school led to reduction in suicidal thinking
Resnick, Blum et al, 1997
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School connectedness alone accounts for 49%
of the variance in depressive symptoms,
whereas together with parental attachment
they account for 53%.
Shochet, Homel et al, 2008

Indigenous suicides appear to have their roots
in ‘collective despair’, related to persisting
social disadvantage, cultural and social
exclusion and destruction of cultural continuity
and identity. Clearly these core themes must
inform our understanding, as well as
preventive practice in Australia.
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“The social, emotional, spiritual and cultural
wellbeing of the whole community is
paramount and essential for the health and
wellbeing of the individuals that comprise it.”
“…ruptures to significant relationships and
markers of identity including access to
culturally significant sites and socially
significant persons can serve to compromise
the quality of an individual’s or a community’s
SEWB.”
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According to Kunitz (1994), the particularly
bad mortality and morbidity status of
Aboriginal Australians can be traced back to
two factors concerning how governments have
dealt with Native peoples across history:
signing of treaties and the level of
responsibility for Indigenous affairs
Cultural genocide
Stolen children
Marginalisation from
white society, poor
communication and
discrimination
COLONISATION
Loss of hunter-gatherer
Lifestyle, loss of culture
Poor nutrition
Poor housing,
Poor hygiene,
Overcrowding and
Infectious disease
Unemployment,
Poverty,
Poor education
Alcohol and
Substance abuse
Domestic violence,
Accidents, deaths
in custody
Fixed settlements
Fringe camps
Urban ghettoes
Low birthweight,
Diabetes mellitus
Hypertension
Cardiovasc. disease
Respiratory disease,
Ear disease,
Rheumatic heart dis.
Renal disease
From Matthews 1997
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Non-suicidal patients can all defend notions of
continuity of the self
80% of suicidal patients can mount no
argument about continuity (self or other)
Failures in ‘self’ continuity ‘predict’ suicide risk
(Ball & Chandler, 1989; Lalonde & Ferris, 2001)
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Euro-American culture & Essentialism
 Self & knowledge are individualistic
Aboriginal culture & Narrative
 Self is relational
 Knowledge is communal/cultural product
 Identity is defined by Place (on the land), and
is fashioned out of materials made available
by culture
Lalonde 2006
Courtesy: Michael Chandler University of British Columbia
Courtesy: Michael Chandler University of British Columbia
An authoritative review* of peer-reviewed
qualitative empirical research regarding
Indigenous people’s understandings of mental
health suggested five essential themes:
culture and spirituality;
 family and community kinships;
 historical, social and economic factors;
 fear and education, and
 loss.

Ypinazar et al., (2007) Indigenous Australians’
understandings regarding mental health and disorders.
Australian and New Zealand Journal of Psychiatry;41(6):467-478
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29 Studies: 126,000 patients
Significantly greater Survival for people scoring
higher on measures of religious involvement and
spirituality
McCullough et al., 2000 Health Psychology 19: 211-222
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Decreased Stress and increased well-being
Decreased depressive symptoms
Decreased substance abuse
Faster recovery from medical illness and surgery
Enhanced Immune system function
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Our view is that considerable affirmative action
is required to enable Indigenous Australians to
reach equity with all other Australians.
‘We’ must engage Indigenous communities in
identifying the cultural, historical and spiritual
factors which may influence suicide and
suicidal behaviour;
‘We’ must
 Promote approaches to enhance self‐esteem
and capacity to enable individuals and
communities to connect with a value system
based on identity, place, people and land;
 Develop partnership approaches with
communities to strengthen local responses to
complex issues, including drug and alcohol
use, interpersonal conflict, violence, and grief
and loss
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Despite wide recognition and acknowledgment
of the importance of Indigenous holistic
concepts of self, health, and social and
emotional wellbeing, there is a lack of
consensus regarding its operationalisation and
measurement (Kowal et al., 2007).
There is a paucity of studies and program
evaluations across Australia to indicate which
initiatives and frameworks are effective in
development of social and emotional wellbeing
in Indigenous Australians.
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There is clearly an urgent need for increased
training of Indigenous Australians at all levels
of the Mental Health workforce to ensure a
critical mass of workers steeped in local culture
and acceptable to local communities.
We recommend the recently published
National Aboriginal and Torres Strait Islander
Health Council document ‘A blueprint for
action: Pathways into the health workforce for
Aboriginal and Torres Strait Islander people’
(Commonwealth of Australia, 2008).
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Based on our research and discussions with key
informants, there remains a need for careful
mapping of suicide prevention and Social and
Emotional Wellbeing development programs in
communities to clarify who funds what for whom,
in which communities, who coordinates the
programs, and where capacity needs to be
enhanced?
This is a crucial exercise to prioritise values, clarify
duplication, and identify gaps where additional
funding might be appropriate and lead to solid
outcomes.

The apology to members of the Stolen Generation
on behalf of the Parliament of Australia
(Kevin Rudd, Prime Minister of Australia, February 13, 2008)
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…”an act of hope, dignity and respect” *
(* Tom Calma, Aboriginal and Torres Strait Islander Social Justice Commissioner)
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“reinstating belonging for Indigenous people
otherwise disconnected from family and country
by prior policy and action”
(Darren Garvey, A review of the social and emotional wellbeing of Indigenous
Australian peoples: considerations, challenges and opportunities.
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No! After all the other recommendations we
have made I think the evidence suggests one
more.
We recommend development of an Indigenous
Australian Suicide Prevention Policy
This should be developed by Indigenous
Australians for Indigenous Australians
Sufficient national funding should be made
available to turn the rhetoric of a policy into the
reality of reduced suicide rates.
(a) Males
60
50
50
40
40
30
30
20
20
10
10
0
0
(b) Females
No. of years pre-strategy
54
51
48
45
42
39
36
33
30
27
24
21
18
15
12
9
6
3
0
3
6
9
12
15
18
21
54
51
48
45
42
39
36
33
30
27
24
21
18
15
12
9
6
3
0
3
6
9
12
15
18
21
Rate per 100,000
.
60
No. of years pre-strategy
No. of years post-strategy
All ages
15-24 years
No. of years post-strategy