Healing among Indigenous people is more crucial now than ever. Here’s a way forward | Pat Dudgeon and Zena Burgess

This year Naidoc week focuses on healing: healing Country and strengthening the social, emotional, spiritual and cultural wellbeing of Aboriginal and Torres Strait Islander peoples.

For many peoples and communities who already experience marginalisation and disadvantage – including Aboriginal and Torres Strait Islander peoples – the Covid-19 pandemic has compounded and highlighted existing issues, such as a lack of housing and access to health care, food insecurity, financial distress, unemployment and poverty.

Due to the higher prevalence of issues associated with social determinants of health, Aboriginal and Torres Strait Islander peoples experience significant ongoing health and mental health challenges.

Aboriginal and Torres Strait Islander peoples are nearly twice as likely to die by suicide and are almost three times more likely to be psychologically distressed than non-Indigenous Australians.

There’s never been a more critical time for healing. But what does that look like?

A more holistic approach

There is a growing body of work dedicated to Aboriginal and Torres Strait Islander social and emotional wellbeing frameworks, research and practices.

The term social and emotional wellbeing is used by many Aboriginal and Torres Strait Islander peoples to describe the social, emotional, spiritual and cultural wellbeing of a person. For Aboriginal and Torres Strait Islander peoples, health and wellbeing is viewed holistically and sense of self includes the individual, their kin (family), community and Country (land, sea, and sky). Mental and physical wellbeing are viewed as important domains that are inextricably linked and of equal value to the other necessary domains of wellbeing.

The term social and emotional wellbeing recognises that a person’s wellbeing is influenced by current policies and past events, such as the effects and aftermath of colonisation and the cultural determinants of health, including systemic racism, dispossession of land, social exclusion and intergenerational trauma.

Protective social and cultural determinants – such as community cohesion and cultural revitalisation, self-determination and connection to Country and spirituality (ancestors) – are also recognised.

But Australia’s mental health system is built on a western viewpoint, where western knowledge and methodologies are the default approach to psychological frameworks. Little recognition is given to Aboriginal and Torres Strait Islander worldviews, wisdom, knowledge and methods, which span more than 60,000 years and represent the resilience of the oldest living culture.

Psychologists know how important it is for people to feel heard and understood. Research shows that better therapeutic relationships with patients lead to better outcomes.

This is especially true within the wider mental health care system. How can a system help you if it doesn’t understand or even acknowledge you, your community and your culture?

Indigenous expertise

For those of us who work in Indigenous mental health spaces, both within Australia and internationally, we are looking at how to decolonise mental health care.

The process and impacts of colonisation are more than physical. They are a cultural and psychological process that determines whose knowledge is dominant. It filters into social, political and health systems, including the mental health system.

Decolonisation seeks to remedy this by listening to the voices of Indigenous peoples. Just as colonisation took time, so will healing our nation.

In Australia, Aboriginal community controlled health organisations (ACCHOs) represent best-practice healthcare for Aboriginal peoples, and embody self-determination. Decolonising mental healthcare means that Aboriginal ways of knowing, being and doing are heard equally and ACCHOs are empowered to provide care for peoples and communities.

Aboriginal and Torres Strait Islander empowerment and self-determination can be powerfully protective against psychological distress.

Culture, while important, alone is not enough. The larger forces and systems need to play their role and become culturally responsive. Maintaining connection to Country, ancestry and kinship networks, as well as cultural continuity, Indigenous governance, self-determination and effective partnerships with government are fundamental to healing and supporting social and emotional wellbeing. Mainstream services need to look at how they can also be part of a solution.

Generational change

Psychologists represent the largest workforce in the mental health sector. If we are going to decolonise the mental health system, we need to start by looking at what we teach the emerging workforce. We need to create an inclusive and respectful curriculum.

Psychology students are often taught about Indigenous issues through a Western, colonial lens, and this monocultural approach produces graduates who later work with Aboriginal and Torres Strait Islander peoples, but know little about how to do so in a culturally safe, responsive and respectful way.

The colonial education model also deters Aboriginal and Torres Strait Islander students through presenting a singular approach to treatment. We are excluding a workforce who are likely to be better equipped to practice with cultural responsiveness and empower their colleagues to do so too.

But there is hope for positive change.

The Australian Indigenous Psychology Education Project (Aipep) was created in 2012 to increase recruitment, retention and graduation of Aboriginal and Torres Strait Islander psychology students, and to integrate Indigenous knowledge and psychologies in psychology courses for all students.

The project has been endorsed by the Australian Psychology Accreditation Council, and in 2019 it issued a statement of support in its new accreditation standards, with new standards requiring psychology schools and departments to incorporate Indigenous knowledges in the curriculum and to include cultural responsiveness as a graduate competency in the training of all psychology students.

Several universities have made strides in meeting the requirements of the new accreditation standards and have formed part of the reference group for the revised Aipep 2 initiative. This new project will be overseen and guided by members of the Australian Indigenous Psychologists’ Association and other senior Aboriginal and Torres Strait Islander scholars and practitioners to ensure Indigenous governance.

The Australian Psychological Society also partnered with the original Aipep team and is a member of the executive reference group for Aipep 2. More than 60% of universities have enthusiastically joined the Aipep 2 reference group and project initiatives.

As psychology students are increasingly emerging with a deeper understanding of social and emotional wellbeing, they need to be met by workplaces and professional bodies that support those policies and practices.

The Australian Psychological Society, the largest peak body for psychologists, has also supported a decolonisation agenda by taking a firm stance against racially motivated violence and the Black Lives Matter movement, as well as issuing a formal and unprecedented apology to Aboriginal and Torres Strait Islander peoples for the profession’s involvement in past policies and practices, including the Stolen Generations.

Next steps

More culturally appropriate ways of providing services for Aboriginal and Torres Strait Islander peoples and communities will emerge only by working in genuine partnership with Aboriginal and Torres Strait Islander communities, supporting self-determination and broadening our understanding of mental health to include a more holistic endeavour of social and emotional wellbeing.

A program I lead, the Transforming Indigenous Mental Health and Wellbeing project, is doing precisely this. The project is a ground-breaking program of research bringing cultural ways and healing into mental health and wellbeing systems to better serve the needs of Aboriginal and Torres Strait Islander peoples and communities, build capacity among the existing workforce, increase Aboriginal and Torres Strait Islander participation in psychology, and empower the next generation to work effectively with Aboriginal and Torres Strait Islander peoples.

We invite you to walk with us on this movement for a better tomorrow for all Australians.

  • Pat Dudgeon is from the Bardi people of the Kimberley in Western Australia. She is a professor at the University of Western Australia and a fellow of the Australian Psychological Society, and has been a commissioner with the Australian National Mental Health Commission and the inaugural chair of the Australian Indigenous Psychologists’ Association

  • Dr Zena Burgess is the CEO of the Australian Psychological Society


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