What is Indigenous cultural health and wellbeing? A narrative review

Moreover, the adaptation of mainstream primary care services provides but one avenue to addressing the existing burden of mental health issues among Indigenous populations . Such difficulties involved the establishment of relationships with the ACCHS (due to ACCHS staff turnover, or mistrust of non-Indigenous organisations), uncertainties of primary healthcare reforms, failure to co-locate the service within a GP clinic, GP turnover, and relationships with state mental health or district health services (due to heavy service workload, a silo mentality, or lacking role clarity). The 31 study participants included 18 ATAPS administering agency staff (16 from Medicare Locals and two from sub-contracted provider agencies; collectively referred to as ‘agency staff’ in the following), five ATAPS referrers (four GPs and one mental health professional), and eight mental health professionals delivering Indigenous ATAPS services (referred to as ‘professionals’ for brevity).

Indigenous peoples’ involvement in conducting research activities and implementing the intervention

To quantify the service demand for the Indigenous population and develop specialized mental health service accessibility measures, it is https://www.cswe.org/centers-initiatives/minority-fellowship-program/news/march-2020/ essential to fully comprehend the obstacles that impede their access to mental health services. Types of mental health services can be distinguished by service contents, levels of healthcare corresponding to mental health conditions, and funding resources from public or private sectors, particularly with regards to service locations and availability . Limited attempts have been made to use spatial interaction methods to measure geographical accessibility to mental health services , to quantify the potential for mental health services (e.g., using pertinent workforce data) in accessibility assessment , and to differentiate geographical accessibility measures for some sub-groups in the population such as age and income groups 25, 73.

This led to the loss of language and cultural resources and is an ongoing source of intergenerational trauma. The trauma experienced by these children was brought back to communities, often resulting in an ongoing legacy of grief, depression, and substance use that crossed generations. Indigenous communities experienced a loss of lands and imposition of the reservation system. A 2020 study outlined the complicated link between contributing factors and depression and anxiety among AIANs. There are also important protective factors that are unique to these communities that may reduce this likelihood.

Suicide prevention in Indigenous communities

• The site offers an “Ask Your Relative” portal, where users can submit questions to a team of educators, public health professionals, and caring adults with an AI/AN background.
• This process of access to mental health services is specified for Indigenous groups by considering individual characteristics such as socio-demographics 40, 42 and marginalised groups (e.g., gender minority) 45, 46, which highlights Indigenous people’s different situations for accessing mental health services .
• Five studies used Indigenous-specific measures or measures validated for use in Indigenous peoples (Brave Heart et al., 2020; Dickerson et al., 2014; Hatcher et al., 2011, 2016; Pearson et al., 2019; Sun and Buys, 2013b) (Supplemental Table S6).
• Furthermore, including traditional knowledge in the delivery of mental health services was deemed necessary for supporting culturally appropriate care.
• It has further been argued that attempts at fostering the cultural appropriateness of services and cultural competency of providers may inadvertently run the risk of reifying cultural stereotypes and producing racialized accounts of health .

The COVID‐19 pandemic has also highlighted vulnerabilities in local workforces that are highly dependent on staff from out of community. This call to action highlights the need for self-determination in use of traditional knowledge and healing practices which have persevered despite systemic oppression and colonial policies. Family engagement and mentorship, the inclusion of parents and families in the school and children’s learning as well as the involvement of Elders and peers as mentors were identified as key elements of healthy families and the holistic model of health and well-being . Participants also described that the justice sector has a role to play, with the suggestion for promoting restorative justice that is more in line with traditional Indigenous views of healing and rehabilitative justice. Moving away from the medical model of sickness and instead including Indigenous knowledge frameworks, such as the Medicine Wheel, was recommended for a holistic approach to healing that is focused on the ‘whole person’.

Through the cultural assessment, we learned that six interventions trained community members (Beckstead et al., 2015; Brave Heart et al., 2020; Gray et al., 2010; Tosa et al., 2018; Varcoe et al., 2017, 2021) (where applicable, given some were retrospective or observational), extending the impact of the intervention beyond the study period. First, mental health is also encompassed by and conceptualized through the term ‘social and emotional wellbeing (SEWB)’ in Australia. We have developed an exploratory table (Supplemental Table S8) which should be reviewed cautiously given that future studies should conduct in-depth investigations into the level and duration of Indigenous involvement for example, as well as other yet to be identified factors that may be more meaningful to Indigenous peoples and communities. Trained Indigenous persons living in the community may integrate intervention activities and skills acquired into programming or services.

Mental Health and Indigenous People

There is a need to ensure Indigenous health workers are supported to provide the best care for communities, especially in areas with pre-existing staff shortages. Additionally, participants voiced that Indigenous-led health partnerships and services need to be grounded in traditional Indigenous knowledge — upheld by community Elders— rather than being grounded in western medicine, structures, and knowledge. When considering existing gaps in the mental health system, participants noted that there is a lack of specialized care and supports for children and youth.