I was diagnosed with Major Depression when I was fourteen years old. At nineteen, I was detained against my will in psychiatric hospitals twice. Although I was relieved to find that I wasn’t the only Indigenous person in the psychiatric ward, I was alarmed to learn that many had been in psychiatric hospitals more than once. My experience is confirmed by the statistics that show that Indigenous people are twice as likely to be hospitalised for mental illness as non-Indigenous people.
In 2006 I spent approximately one and a half months in psychiatric hospitals. It changed my life. I will never take my freedom for granted again. Like most Indigenous Australians, I believe that social factors and biological health both contribute to making a healthy person.
Indigenous people are often misdiagnosed, under-diagnosed and under-treated. Indigenous people maintain their physical and mental health through balanced social relationships and correct ritual behaviours, which differs greatly from the western definition. How can psychiatrists diagnose delusions in a person who does not share their cultural beliefs? Hallucinations are an accepted part of Indigenous Australian spirituality – as they are in many parts of the world. How can a western psychiatrist differentiate between ceremonial hallucinations and trancelike states and the symptoms of schizophrenia.
Mix this with institutionalisation and the public stigma of not only people with mental illness but Indigenous people with a mental illness. These factors all contribute to the fact that Indigenous people are twice as likely to be hospitalised for mental health reasons. Many Indigenous people are misdiagnosed as life trauma is not taken into account. The rate of substance induced psychosis has increased 500 percent in the last twenty years.
I understand what causes mental illness and the greater struggle people my community have in finding help. Australian Indigenous people view mental and physical health differently to western medicine. We don’t view them separately. Adnyamathanha people, my people, do not have words in our language to describe mental illness. In our language people who are deaf are described as not being able to hear, people who are disturbed are described as being unable to understand. As they are recognised as having similar causes to physical illness, mental illnesses are prescribed the same treatment. Many services are not culturally appropriate because doctors diagnosing mental illness do not take into account cultural issues such as being sung, sorry business, and homesick for country.
The sorry state of Indigenous health is something that our communities have been shouting about for years. It has simply taken decades for the rest of the country to catch up. The state of our mental health is something that we are only starting to talk about, but deserves just as much attention.
Indigenous people are under-treated because many live in remote communities and do not have access to community mental health services. Of those that live in urban areas many services are not culturally appropriate or accessible. The lack of funding combined with the different views on what mental illness or health is, means that mental health services to Indigenous communities fall woefully short of what is needed and way short of services in urban or regional areas. This gap needs to be closed.
The state of mental health services in Indigenous communities also ignores the constant discrimination that these communities face. No other community in Australia has had military intervention. This situation alone would ‘do your head in’ if you lived in any other community in Australia. It goes without saying that we have a lot of trauma and grief to deal with in our community. Indigenous people have a lot to be angry about and the woeful provision of mental health treatment isn’t helping.
Rebecca Richards is currently studying psychology and anthropology at the University of Adelaide. She hopes to specialise in psychotherapy related to mood disorders and grief.
The article was published in The Adelaide Advertiser on 10 October 2007.