Levels of depression
Discuss About The Aboriginal Torres Strait Islander Health Survey.
Depression is a mental disorder that has negative effect on how people feel, think and act. Its symptom includes loss of pleasure or interest in daily activities, sadness, feeling down, sadness etc. and has negative impact on physical healthcare as well. There are several types of depression with symptoms that ranges from relatively minor to very severe symptoms that may last for short or long periods. There are other several common symptoms of depression that includes weight gain or loss, suicidal thought, trouble making decisions and concentrating, feeling sad, insomnia, tiredness, hopelessness etc. Different types of symptoms include: major depression, bipolar disorder, persistent depression disorder, situational depression, psychotic depression etc. Depression is the second most leading cause of mental health issue world-wide. Globally millions of people of every race, sex, community and age are affected by depression. Now it is considered to be a main contributor to the world-wide disease burden. Female are more likely to be affected by it than male (WHO, 2018). According to the World Health Organization, depression will be the number one health issue worldwide by 2030. In Australia, it has high life time prevalence i.e. one in every seven will suffer from depression in their lifetime. It has the third highest i.e. 13% burden of all illness in the country. Burden of disease can be defined as the total impact of any disease measured by morbidity, mortality, financial cost and other indicator.
Aboriginal and Torres strait islander people are indigenous Australian and represents 2.8% of the total population in Australia according to 2016 data released by Australian Bureau of Statistic. National Aboriginal and Torres Strait Islander Social Survey in 2008 measured psychological distress in these people and found that one-third of them over 15 years old are suffering from high levels of depression or anxiety. Aboriginal people are more vulnerable to mental disorders than non-indigenous Australians (Mental health services in Australia, 2018).
From the national statistics of Australia, it has been found that, the suicide rate, hospitalization rate for diagnosed case of depression and other mental disorder, substance misuse related cases are increasing in aboriginal Australians and indicates a prevalence of twice or thrice times the corresponding non-indigenous population rate (Ryba & Hopko, 2011). Indigenous women and young adult are more affected by depression than men. Unipolar depression is more common in woman because of which they feel constant sadness, lack of interest, outside stimuli, negative thoughts/emotions etc. Elderly indigenous people with disability or illness are also at high risk of depression. Psychology variables are main cause of depression which includes factors like trauma in childhood and frequent victimization, domestic violence, gender role factor i.e. role restrictions, interpersonal orientation and competing social roles e.g. increased vulnerability to emotional trauma and pain of others, differential attributional styles, more prone to rumination, greater reactivity to stress, coping styles and self-concepts.
Social determinants of indigenous mental health
The development and health of people is shaped by several factors over time, place and life experiences. Biology, environmental exposures, genetic history can have significant impact on mental and physical health. There has been an increased impact of social factors in determining health outcomes of people. The qualitative and quantitative evidence base widely supports the concept that the health inequalities between non-indigenous and indigenous Australian are process and result of factors fall outside the traditional health domains. They are influenced by structures of the social conditions and society in which they live, grow, work and age which is also known as social determinants of health.
Social determinants of health include several factors that comprises of material and social environment of their families and communities and psychosocial conditions of their life. These determinants also include employment, poverty, education, income, human rights, demographic factors like age, gender and ethnicity (Social Determinants of Mental Health, 2014).
Gender and sex are recognized as significant determinants of health for men and women. Beyond several biological differences between them, gender roles, behavior and norms have a major influence on how girls, women, boys and men access health care facilities and how these systems respond to their needs (Gender differences in mental health policy, 2016).
According to World Health Organization, gender inequalities lead to both physical and mental health risks for girls and women globally. Unbalanced power relations between women and men affect the risks and health outcomes of people in different social and age groups.
Gender difference is one of the main cause of mental health disorder like depression. Women are more likely to suffer from depression than men because of several social and biological factors. The women of the indigenous community face several problems and challenges which only add to their stress and hence affecting their mental state. They are the victims of sexual assault, family or domestic violence, gender discrimination, inequality etc. which leads to depression and other mental illness. There is an inadequate policy in Australia to protect Aboriginal and Torres Strait Islander women. They are deprived from access to basic economic and social rights, including in particular rights of housing and education.
Despite a strong and effective tradition of protecting political and civil rights in Australia, indigenous people faces human rights issues. They are excessively represented in the criminal justice system even for small offenses like unpaid fine. More than half the prison people has a disability, inmates face neglect, violence and expanded periods of isolation. These people are 13 times more likely to be kept in prison than non-indigenous Australian.
Health promotion intervention to address depression and promote positive mental health for indigenous people
There is an increasing number of indigenous women in the prison as well due to several crimes in Australia. State inquiries have stated that there is a significant number off indigenous child suffering abuses. These people are often mistreated poor socio-economic condition receives low employment opportunities, low paid jobs etc.
There is a great difference in health between aboriginal and other Australian. Indigenous men have 10.6 years lower life expectancy than the other Australians. Similarly, indigenous women have 9.5 years lower life expectancy than other indigenous women (Australia Events of 2017, 2017 ). Even the suicide rate of indigenous people is higher than other Australians. The number of children from indigenous community in prison are 25 times higher than non-indigenous children. The human resource management right abuses faced by indigenous people that leads to psychological distress causing mental illness like depression and anxiety are unemployment, homelessness, domestic violence, lack of basic health services, education etc. Most of indigenous people are unemployed. They even face problem to get jobs to fulfill their basic requirement. According to the data of 2016, the unemployment rate of these people was 16% and only 5% in non-indigenous people. Indigenous women experience more threatened and physical abuses.
Culture of indigenous take a holistic view of health and life so spiritual, social and cultural wellbeing are important to the health of these people. Australian and international studies data shows that the aboriginals who are familiar with their own languages have better mental health and resilience (Sturgeon, 2006). There are only few well-constructed evaluation specific programs for indigenous people whose main aim is to promote positive menta health that are effective in promotion mental health of indigenous people as well.
- The programs like cultural competent health care programs increases the usage of service and results in positive outcomes and higher satisfaction with services.
- The other program is healing programs and cultural continuity which can have positive impact on the health of the individual and can reduce the rate of suicide among youths.
- The parenting program which can improve the interaction between mother and children, so that children are open to share their problems.
It has been observed that human behavior dose not changes easily and that too in an environment that does not favor change. In order to improve the mental health of the people, the focus should not only be on behavioral or habitual choice but also on the factors which influence those question. Social-ecological model helps to find out the opportunities in order to promote mental health by identifying various factors which effects or influences an individual’s behavior (Cramer & Kapusta, 2017).
The probability of changing behavior of an individual is more successful when various levels of influence are noticed at the same time. This model considers both environmental level and individual level interventions to attain major changes in health behaviors. The components of social-ecological model for mental health consists of individual, social environment, physical environment and policy component.
Conclusion
Depression is the second leading cause of disease burden globally affecting millions of people. In Australia indigenous people are more likely to have mental illness. From the above paper it is apparent that the mental health of indigenous people is in vulnerable condition due to various social determinants. There is a great need for improvement of health facilities and policies in Australia for indigenous people to improve mental health condition of these people as large number of indigenous people are suffering from depression.
References
Australia Events of 2017. (2017 ). Retrieved from Human Rights Watch: https://www.hrw.org/world-report/2018/country-chapters/australia
Australian Aboriginal and Torres Strait Islander Health Survey: management, Australia, 2012-13. (2015, December 16). Retrieved from Australian Bureau of Statistics : https://www.abs.gov.au/ausstats/[email protected]/Lookup/9F3C9BDE98B3C5F1CA257C2F00145721?opendocument
Cramer, R. J., & Kapusta, N. D. (2017). A Social-Ecological Framework of Theory, Assessment, and Prevention of Suicide. Frontiers in Psychology, 8, 1756. https://doi.org/10.3389/fpsyg.2017.01756.
Depression. (2018, March 22). Retrieved from World Health Organization: https://www.who.int/news-room/fact-sheets/detail/depression
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Gender differences in mental health policy. (2016). Retrieved from https://www.myvmc.com/news/gender-differences-in-mental-health-policy/
Human rights and Aboriginal and Torres Strait Islander peoples. (n.d.). Retrieved from Australian Human Rights Commission: https://www.humanrights.gov.au/sites/default/files/content/letstalkaboutrights/downloads/HRA_ATSI.pdf
Mental health services in Australia. (2018, May 3). Retrieved from Australian Institute of Health and Welfare: https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-australia/report-contents/summary/prevalence-and-policies
Ryba, M. M., & Hopko, D. R. (2011, December 11). Gender Differences in Depression: Assessing Mediational Effects of Overt Behaviors and Environmental Reward through Daily Diary Monitoring. Retrieved from Depression Research and Treatment: https://www.hindawi.com/journals/drt/2012/865679/
Social Determinants of Mental Health. (2014). Retrieved from World Health operations: https://apps.who.int/iris/bitstream/handle/10665/112828/9789241506809_eng.pdf;jsessionid=1E0F0305F586DB56246151DEF5B5CBD8?sequence=1
Sturgeon, S. (2006). Promoting mental health as an essential aspect of health promotion. Health Promotion International, 21(1), 36-41.