Introduction
Mental illnesses constitute one of serious health problems worldwide. They are characterized by decline in cognitive functions and behavior which ultimately affects their social dealings. In certain instances, these problems are more confined to particular section of the society which in the present context is indigenous population of Australia.
The existing problem is that indigenous people are more prone to be neglected or fail to receive proper attention of the health care workers. This is because of interference of poorly available data and analytic tools. It was of concern that such a drawback in extreme cases may also possibly contribute to rise in death cases from suicides. Clelland, Gould, and Parker (2007) described that the usefulness of indigenous mental health promotion interventions could not be determined if there is an inadequate evidence.
Main body
It may indicate that there is a need of concrete data to gain enough knowledge to render effective mental health services to indigenous population. Further, another problem is that these people fear that Western treatment models do not value their general views and cultural beliefs regarding mental health. However, it was believed that cross-cultural psychiatry was significant in contributing to the development of mental health services to minority cultural groups over the past 30 years. Although this approach has a constructive sign, it was giving an impression that many indigenous people were remaining mute or undisturbed to these advancements.
The study article thus purposely focused on exploring the indigenous people to gain better insights on their cultural beliefs and lived experiences connected with mental health and mental health problems by reviewing qualitative empirical research. In the recent years, evidence based medicine has drawn the attention of many researchers with a hope that it would provide valuable information regarding care and effective management of the health concerns.
For this purpose there is a need to review the available qualitative literature. Existing databases namely, CINAHL and Pre-CINHAL, Health source: nursing/academic edition, Pubmed /Medline, Proquest health and medical complete, Psyc Info, Science Direct, Synergy and Health InfoNet etc, were searched using the key words indigenous, indigenous mental health perceptions, understandings, beliefs, research and Australia.
Reports that were not based on empirical research, expert commentaries, opinion pieces and community consultation were excluded from the literature selection criteria. Prior importance was given to the year 1995 due to Ways Forward report in influencing subsequent approaches to mental health research. The quality of the articles was finally evaluated to determine whether they are focusing on mental health including social and emotional well-being.
Here, the concept of meta-synthesis was used to analyse the selected articles. Metasynthesis involves thorough understanding of related descriptions from various articles regarding a particular topic. It is aimed at transferring ideas and concepts across individual studies and with that information one could easily determine whether the data is comparable (reciprocal translational) or conflicting (refutational synthesis) or presenting (combination of both) an argument. The present description is based on the reciprocal translational metasynthesis used in the article.
So, the sample size comprised of five articles from four recognized studies and the total participants were 313.The study conducted by Vicary and Bishop extracted data by conducting interviews with all informants and the data analysis involved thematic analysis of text and mainly focused on aboriginal traditional frameworks of healing and western psychotherapeutic treatments. Study conducted by Emden et al. was mainly focused on investigating medication use by indigenous people with mental health disorders. Data was extracted by employing field notes and steering committee discussions.
The data was analyzed by regional analysis and meta-analysis. O’Brien conducted qualitative study in an aboriginal community and employed field notes and in –depth interviews for data collection and verbatim transcripts for data analysis. Their study focused on considering the problems faced by indigenous youth for developing greater cultural recognition.
Study conducted by McLennan and Khavarpour focused on exploring the connection between well being and spirituality. Qualitative methods and semistructural interviews were used to collect data but with no analysis. It was understood from these reports that various aspects of culture, spirituality, identity, family and community, land/country, socioeconomic status and socio economic status were strongly interlinked. It indicates that the important facets of indigenous persons’ life circumstance would not exist in isolation from other areas of life. Culture and spirituality mainly reflected story telling, ceremonies, ancestors, sacred sites and tribal areas.
Mental illnesses connected with culture and spirituality arise when people become unwell due to wrong marriages and earlier transgressions. These might increase the chances of illness and make people believe malevolent spirits. The remedy would be to apply diverse traditional routes and creating resistance against spirits to increase well ness. Family and community relationships may be fundamental aspects of culture and are essential for unity and remedy.
The problems believed to alter them are connected with alcohol misuse which is held responsible for domestic violence, unemployment, depression, sexual assault and early deaths of relatives and friends. Socioeconomic reasons mainly stem from employment, overcrowding, family violence, poor physical health, substance misuse and financial difficulties. Very often some people face mental distress when they are socially neglected or deprived of basic amenities that would led to low self esteem and feelings of worthlessness.
Conclusion
Further, the indigenous people are worried about Western mental health services because of shame or stigma associated with the mental illness. They fear that they are being hospitalized away from the country and therefore appear to rely on families to manage themselves by avoiding western treatment until a serious condition is met. In addition, there is a scarcity of appropriate mental health information indicating that there is a need of education to ensure support and thorough knowledge for counteracting the shame ness.
Finally, loss is considered to operate in all cases like spiritual, cultural, social, economic and emotional domains. Mostly family tensions and violence, alcohol, and substance abuses are believed to contribute to the loss of traditional family and community values. Therefore, it may indicate that all these factors may act as risk factors for mental illnesses in indigenous persons. In view of the above, it was concluded that there is an urgent need to concentrate on the mental health problems of indigenous people who are in constant suffering. Their own misconceptions regarding western treatment are keeping them remote and undiscovered.
Hence, cross-cultural psychiatry may have good implications if adopted at the appropriate situation. Metasynthetic approaches may enable better understanding of indigenous people with mental illnesses by emphasizing on thematic concepts, improved methods of data collection and analysis. There is a need to bridge the gap between the traditional indigenous understandings and Western constructs of mental health and mental disorders.
It was also concluded that spirituality acts as a resolving agent for development of promotion and prevention objects. Similarly, the dogmas surrounding indigenous culture and learning should not be underestimated and need to be recognized and modified through careful analysis. However, this study has the sample limitation and needs to further depend on large pool of data for knowing the indigenous people perceptions regarding mental health management and western models of treatment.
References:
Clelland, N., Gould, T., Parker, E. (2007). Searching for evidence: what works in indigenous mental health promotion? Health Promot J Austr, 18, 208-16.
Denise F.Polit and Cheryl Tarano Beck. (2008). Developing an approach for a qualitative study. In. (8 Ed), Nursing Research: Generating and assessing evidence for nurse practice. (pp. 219-220).Philadelphia.Lippincot Williams &Wilkins Book Company.
Valmae A. Ypinazar, Stephen A. Margolis, Melissa Haswell-Elkins, Komla Tsey. (2007). Indigenous Australians’ understandings regarding mental health and disorders. Aust N Z J Psychiatry, 41, 467 – 478.