Overview
There are large discrepancies in the mental health and emotional wellbeing of Indigenous Australians compared with non-Indigenous peoples, apparent in the analyses of Indigenous hospitalisations for mental health conditions, Indigenous mortality resulting from mental illness and the incarceration of Indigenous people with a mental health condition.
Traditionally, Aboriginal and Torres Strait Islander people perceive their health not only in terms of the physical health of the individual, but rather in regard to the social, emotional and cultural wellbeing of the whole community (National Aboriginal Health Strategy 1989). Information related to the mental health of Indigenous Australians presented here includes self-reported data from the 2004-05 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS), and hospitalisations and mortality which result from mental illness, assault and incarceration.
Some data are available on self-harm and assault, child abuse and neglect, substance use, and incarceration related to mental health conditions in Aboriginal and Torres Strait Islander people. These factors may be indicators of social and emotional distress, but the data, which are recorded separately in each case, do not provide information about the cause of the patient's mental illness or behavioural problem. Nevertheless, the available data indicate that Indigenous Australians suffer a higher burden of emotional distress and possible mental illness than that experienced by the wider community.
On this page
Available data
The 2004-05 National Aboriginal and Torres Strait Islander Health Survey included a module to assess various aspects of social and emotional wellbeing of Aboriginal and Torres Strait Islander people, for the first time. Information was collected from Indigenous adults using questions from the SF-36 and the Kessler Psychological Distress Scale. Questions were also asked regarding feelings of anger, stressors and cultural identification.
Hospitalisation
Data recorded under the category, 'mental and behavioural disorders' are available for Indigenous people who were hospitalised over the period 2004-05. Although the data are likely to underestimate the number of Aboriginal and Torres Strait Islander people, it is evident that Indigenous Australians were more likely than non-Indigenous people to be hospitalised for these disorders. In 2004-05 there were around two times as many hospital separations of Indigenous Australians for 'mental and behavioural disorders' in Queensland, Western Australia, South Australia and the Northern Territory, than would be expected, based on the rates of other Australians.
Rates of intentional injury, whether self-inflicted or caused by assault, may be an indicator of psychological illness and distress in the community. Hospitalisation data from 2003-04 show that there were about seven times as many hospital separations as expected for assault among Indigenous males, and nearly 31 times as many for Indigenous females, based on all-Australian rates. There were also about twice as many hospital separations as expected for self-harm, for both Indigenous males and females.
Mortality
In 1999-2003, deaths from mental disorders accounted for 2.4% of Indigenous deaths in Queensland, Western Australia, South Australia and the Northern Territory.
For the period 1999-2003 in Queensland, Western Australia, South Australia and the Northern Territory, the mortality rates for mental and behavioural disorders for Indigenous males and females were 5.5 and 2.2 times the rates of non-Indigenous males and females respectively. There were also much higher rates of mortality from assault and intentional self-harm of Aboriginal and Torres Strait Islander people compared to non-Indigenous people.
For the period 1999-2003 the suicide rate for Indigenous males and females was twice that for non-Indigenous males and females. For Indigenous males aged 0-24 and 25-34 years, rates were 3 times those for non-Indigenous males. For Indigenous females aged 0-24 years, rates were 5 times those for non-Indigenous females.
Tatz (1999) found high rates of suicide among Aboriginal youth in New South Wales for the years 1996-98, noting that these were among the highest recorded in the international literature he reviewed. He describes Aboriginal suicide as having 'unique social and political contexts' (p. 10), and stresses that any attempt to identify the causes of and possible remedies for Aboriginal suicide needs an understanding of the differences that distinguish Aboriginal suicide from non-Aboriginal suicide. For more information, see: Mortality, in this site
For more information, see Mortality.
Incarceration
The National Inquiry into the Human Rights of People with Mental Illness (HREOC 1993) found that anti-social and self-destructive behaviour, often the result of undiagnosed mental and social distress, brought Indigenous people into frequent contact with the criminal justice system. In the year 2004, 21% of the total prisoner population were Aboriginal and/or Torres Strait Islanders. Indigenous people aged over 17 years were incarcerated at a rate of 1,417 per 100,000 compared to only 129 per 100,000 non-Indigenous people.
Indigenous Australians aged 10 to 17 were also at high risk of imprisonment. At 30 June 2004, 32% of young people in juvenile detention were identified as Aboriginal and/or Torres Strait Islander.
Incarceration may be both a risk factor for, and a result of, emotional distress and mental illness. The 1991 Royal Commission into Aboriginal Deaths in Custody found that Aboriginal people who were imprisoned 'often experience depressive symptoms and unresolved anger which sometimes leads them to attempt or commit suicide whilst in custody' (HREOC 1993, p. 698). The incarceration of young Indigenous men and juveniles during their formative years left them 'permanently alienated from their communities', so that on release from prison, they were likely to turn to substance abuse and violence (HREOC 1993, p. 698).
Further information
For more general information on mental health services,go to Mental health.