The Aboriginals of Australia have recorded high levels of depression than the non-indigenous groups. Depression is a mental complication that makes the patient experience recurrent sadness episodes (Brown et al., 2016). The psychiatric disorder affects how an individual behaves, thinks, and feel. Furthermore, depressive disorder leads to numerous physical and emotional problems. Depressed individuals encounter difficulties in conducting their daily chores. Some of the symptoms of the condition include hopelessness, insomnia, and recurrent suicidal thoughts. Recent research has indicated that most women encounter unipolar depression than their male counterparts. The levels of depression among the aboriginals are higher than that of the majority tribes due to social inequalities. However, an efficient health promotional strategy can promote positive mental health among the Aboriginals. This paper will explore the levels of depression among the indigenous group and the social determinants. It will also discuss the health promotion strategies and socio-ecological model towards depressive disorders.
Almost one in three indigenous Australians has depressive disorders. Out of the total number of Aboriginals with depression, women dominate men. Indigenous individuals are twice as more depressed than the non-indigenous Australians. According to the 2008 statistics, 31% of the indigenous individuals had a depressive disorder (Black et al., 2015). The 31% of the Aboriginals and the Torres Islanders were complaining of anxiety and depression. Violence victims recorded high rates of depression in comparison to violence-free individuals. 46% of the victims complained of depressive disorders. Aboriginals with long-term health issues like disability recorded 43% depression. 44 % of the individuals who had encountered discrimination had a psychiatric disorder. Additionally, individuals separated from their families documented 39% depressive disorder. Despite the elevated amounts of depressive disorders, a majority of the individuals indicated that they were happy. Research also shows that those living in non-remote areas experience less depression than those inhabiting the rural settings. The depression values for the aboriginals living in urban areas stand at 71% (McGrath et al., 2015). On the other hand, the depressive disorder values for those living in remote areas are 78%.
Violence
The aboriginals and Torres Islanders experienced numerous forms of violence hence resulting in elevated amounts of depression. A majority of the indigenous individuals migrated from their original land due to violence (Spence, Wells, Graham, & George, 2016). Additionally, the European settlers grabbed the lands of the Aboriginals violently. Any form of violence affects the mental health of an individual thereby resulting in psychiatric disorders like depression.
According to a health survey, 16% of the Aboriginals stated that their received undesirable treatment due to their race and cultural beliefs (Spence et al., 2016). 40% of the majority tribes avoid associating with the indigenous individuals when the two kinds of individuals are using public transport. A section of the indigenous individuals has also stated that they are victims of verbal abuse from the majority white tribes. 31% of the aboriginals have witnessed employment discrimination due to their race. However, some Aboriginals avoid seeking formal employment due to fear of racial discrimination.
Racial discrimination is a significant determinant of depression (Spence et al., 2016). The high levels of depression among the Aboriginals are due to bias. 56% of the Aboriginals believe that the vice is one of the reasons hindering their success in life since a depressed individual cannot conduct daily chores. 21% of non-indigenous individuals have admitted that they avoid places where the aboriginals are shopping or eating their meals. Therefore, discrimination makes the Aboriginals to develop depressive disorders.
Migration from their original homelands into Australia separates the Aboriginals from their communities. The separation leads to loneliness and the progression of depressive disorder (Salmon et al., 2018). After moving to Australia, the indigenous individuals lose touch with their family members. The separation from loved ones is another source of the psychiatric disorder. The aboriginals are also forced to abandon their culture and embrace the non-indigenous ways of life. Additionally, the indigenous individuals have to learn English language and quit their traditional modes of communication. Separation from an individual’s culture and language causes depression.
Research has shown that most Aboriginals have low levels of education in comparison to their non-indigenous counterparts. Additionally, discrimination has made only a few aboriginals to assess gainful employment and a decent income. Less educated indigenous individuals are profoundly depressed since they cannot get gainful employment (Markwick, Ansari, Sullivan, Parsons, & McNeil, 2014). Unemployment prevents indigenous individuals from meeting their daily needs like adequate food. Therefore, the three social determinants cause high depression among the indigenous communities.
Section Aboriginal women have complained about unfair treatment regarding assessing health services. Apart from health care, some women have also noted inequality in job provision where employers show preference to men. The disparity explains the high level of discrimination in women as compared to men. The Australian service providers should ensure gender equality in the provision of services (WHO, 2013).
The first intervention involves creating a physical and social environment that prevents individuals from anxiety and depression. Prevention mechanisms towards racial discrimination and violence lower the high levels of depression. The Australian government should improve the physical environment of the Aboriginals by constructing psychiatric centers at the rural areas to cater for depression patients (Carey, & McDermott, 2017). Secondly, the psychiatrists should encourage indigenous individuals to seek medical attention for depressive disorders. The indigenous individuals should also understand the essence of early diagnosis and care. The caregivers should help individuals to identify the symptoms of anxiety and depression (Jorm, & Ross, 2018). The health agencies should urge depressed individuals to seek appropriate assistance. Health facilities should also conduct awareness campaigns on the causes, symptoms, and treatment options for depression.
Thirdly, the government should enhance the ability of health specialists to conduct proper diagnosis and treatment for depression patients. The national administration can achieve caregivers’ efficiency by offering them adequate training. Additionally, the health department should equip the psychiatric centers in various health facilities with appropriate medications. Fourthly, the Australian administration should support coordination frameworks between the mental, primary, and public care services. Therefore, health specialists should not neglect mental care in favor of physical attention. Caregivers should conduct additional research on the cause and treatment of depression (Rice et al., 2017). Health agencies should monitor the treatment of depression to ensure that caregivers are providing proper remedies.
The model assists to explain the impacts of the prevention strategies discussed above. The model has four levels which include individual, relationship, community, and societal phase (CDC, 2015). The individual level explores the personal and biological factors that can cause depression. The factors include income, education, and many others. Offering quality education and attractive income to the aboriginals reduces depression. The second level explores the impacts of relationship on depressive disorders. The people close to an individual determine whether the person can acquire depression or otherwise. Aboriginals should share their tribulations with family members and request for a solution. Sharing the status of mental health with an individual’s partner also helps in getting an appropriate solution. Therefore, individuals should rely on relationships to solve their mental illnesses.
The third level looks at social settings like neighborhoods, workplaces, and schools (CDC, 2016). Researchers seek to identify factors at those social settings that can lead to depression. At the community level, the prevention strategies should improve the physical and social environment. Therefore, the Australian government should reduce the social isolation of the aboriginals and improve their economic status to curb depression. The fourth level focuses on societal factors that can prevent or encourage the development of depression among the Aboriginals. The factors include cultural and social norms that can promote the development of mental complications. A majority of the treatment methods in Australia are not in line with the cultural beliefs of the indigenous communities. Therefore, the government should provide care that is in line with the culture of the aboriginals to prevent the onset of depression.
Conclusion
Depression is a mental disorder that makes an individual experience prolonged sadness. Its symptoms include hopelessness, insomnia, suicidal thoughts, among others. The levels of depression are high among the indigenous Australians than their non-indigenous counterparts. Additionally, women are more depressed than men due to gender inequalities. The leading causes of depression among Aboriginals are discrimination, violence, and separation from an individual’s family. Other determinants include education and income. Health promotion intervention assists in reducing the high levels of depression among the aboriginals. The socio-ecological model assists researchers in evaluating the effectiveness of the intervention steps. The model has four standards which include individual, relationship, community, and societal phase.
References
Black, E. B., Ranmuthugala, G., Kondalsamy-Chennakesavan, S., Toombs, M. R., Nicholson, G. C., & Kisely, S. (2015). A systematic review: Identifying the prevalence rates of psychiatric disorder in Australia’s Indigenous populations. Australian & New Zealand Journal of Psychiatry, 49(5), 412-429.
Brown, A., Mentha, R., Howard, M., Rowley, K., Reilly, R., Paquet, C., & O’Dea, K. (2016). Men, hearts, and minds: developing and piloting culturally specific psychometric tools assessing psychosocial stress and depression in central Australian Aboriginal men. Social psychiatry and psychiatric epidemiology, 51(2), 211-223.
Carey, T. A., & McDermott, D. R. (2017). Engaging Indigenous People in Mental Health Services in Australia. The Palgrave Handbook of Sociocultural Perspectives on Global Mental Health (pp. 565-588).
Centers for Disease Control and Prevention. (2015). The social-ecological model: A framework for prevention. Atlanta, GA: CDC. Retrieved from: https://www. cdc. gov/violenceprevention/overview/social-ecologicalmodel.
Centers for Disease Control and Prevention. (2016). The social-ecological model: a framework for prevention. 2015.
Jorm, A. F., & Ross, A. M. (2018). Guidelines for the public on how to provide mental health first aid: a narrative review. BJPsych Open, 4(6), 427-440.
Markwick, A., Ansari, Z., Sullivan, M., Parsons, L., & McNeil, J. (2014). Inequalities in the social determinants of health of Aboriginal and Torres Strait Islander People: a cross-sectional population-based study in the Australian state of Victoria. International journal for equity in health, 13(1), 91.
McGrath, J. J., Saha, S., Al-Hamzawi, A., Alonso, J., Bromet, E. J., Bruffaerts, R., … & Florescu, S. (2015). Psychotic experiences in the general population: a cross-national analysis based on 31 261 respondents from 18 countries. JAMA Psychiatry, 72(7), 697-705.
Rice, S. M., Aucote, H. M., Parker, A. G., Alvarez-Jimenez, M., Filia, K. M., & Amminger, G. P. (2017). Men’s perceived barriers to help-seeking for depression: Longitudinal findings relative to symptom onset and duration. Journal of health psychology, 22(5), 529-536.
Salmon, M., Skelton, F., Thurber, K. A., Kneebone, L. B., Gosling, J., Lovett, R., & Walter, M. (2018). Intergenerational and early life influences on the well-being of Australian Aboriginal and Torres Strait Islander children: overview and selected findings from Footprints in Time, the Longitudinal Study of Indigenous Children. Journal of developmental origins of health and disease, 1-7.
Spence, N. D., Wells, S., Graham, K., & George, J. (2016). Racial discrimination, cultural resilience, and stress. The Canadian Journal of Psychiatry, 61(5), 298-307.
WHO, (2013) Universal Health Coverage and Universal Access, Bulletin of the World Health Organization; 91:546-546A
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