The Kalumburu project and its focus on mental health
Discuss about the Primary Healthcare in Action for Social Isolation and Exclusion.
The two important social determinants of health that were addressed in these programs are:
- Social Isolation and Exclusion: Several studies supports the adverse effect Social Isolation and Social Exclusion can have on the mental and physical well being of individuals. Holt-Lunstad bet al. (2015) suggested that risks of mortality can increase due to social isolation, while Cacioppo and Cacioppo (2014) also pointed out the effect of social relation on health, and how isolation can have ‘toxic effects’ on the well being. Similarly, Smith and Victor also highlighted the adverse effects of isolation on the mental and physical well being of people. Studies by Miner et al. (2016) also showed that isolation can also be a predictor of child abuse. Workshops were set up to provide support and build cooperation within the community, involving all community members. Studies by McMurray and Clendon, (2015) also supported the concept of community health and wellness programs to ensure the wellbeing of the indigenous Australians.
- Social Support: The project in Kalumburu also aimed to ensure social support to the community. The focus of the project was to collaborate indigenous research centre for learning and educare (CIRCLE), as a safe zone where individuals can share their stories and experiences. It also enables the providence of social support to the communities to encourage them to share their stories. The project set up a journey towards healing, incorporating activities such as painting, dancing and storytelling. Also, the community was educated on the ill effects of drugs and alcohol, enabling the members to make healthier lifestyle choices, identifies how addiction can affect them and their community, and quit the addictive behaviors (2015).
The main Primary Health Principles that guided this project were:
- 1. Health Promotion: This was a significant PHP that was addressed in the Kalumburu project. The health and well being of the individuals of the community members were promoted through the strengthening of the socioeconomic conditions which can foster good health. The activities included building the community, through participation of the community members, educating them, and also encouraging the youth to develop their bonding with their culture. Also, the children were taught the old ways of life, thereby fostering their well being through the development of cultural ties. Such an approach is supported by studies which show education, community partnership and improving cultural bonding as effective strategy for health promotion (Eldredge et al., 2016; Bloch et al., 2014; Varcoe et al., 2017).
- 2. Community Participation: Building of the community through participation of all the members of the community was an essential focus of the project. The project highlighted the motto “it takes a healthy community to raise a healthy child”, to emphasize the importance of a strong and healthy community to foster an environment of safety, which prevents maltreatment and abuse of people, especially the children. This is supported by Lewallen et al. (2015) which highlighted the importance of a safe and healthy environment foe the well being of individuals, and by South (2015) who suggested the importance of community partnership to ensure health and wellbeing of people.
The Kalumburu project addressed the concern of mental health of the members of the community, and how it can be caused due to social exclusion and the lack of social support. The project also emphasizes on how problems related to drug abuse and alcoholism can cause domestic violence or child abuse, and also increase the risk of mental health issues in the members of the community. Such aspect can be supported by evidences from many studies that show community involvement and community building activities which can help to address mental health problems of individuals (Betancourt et al., 2015; Grob, 2014). Furthermore, strengthening the ties of the young members of the communities to their cultural roots can also help to improve their social bonding and address the mental health concerns of the community and individuals. According to Parker and Milroy (2018), the mental wellbeing of the Aboriginal and Torres Island People can be improved through the strengthening the capacities of these communities, and strengthening and supporting their traditional cultures to foster development of their cultural ties.
Cultural competency is an attribute that allows care providers to effectively deliver healthcare services addressing the cultural, social and linguistic needs of the patients (Hpi.georgetown.edu, 2018). The Kalumburu is an indigenous community, who were facing a crisis situation, with an increase in the cases of violence and abuse, community building programs were initiated to encourage the individuals reach out and form strong community ties. One significant example of such an action was the inclusion of a journey to healing, through the implementation of painting, dancing, story-telling, which allowed individuals to share their experiences and stories with others, within a circle of healing. This also incorporated the aboriginal values of community strength and their relation to the land/environment.
Cultural Safety is a competency which allows the identification of the cultural and social differences in the provision of education and health service. It also fosters an environment that is safe for individuals, where there are no risks of assault or abuse or of the denial of their identities, and ensures a shared respect, meaning, knowledge and experience as well as a sense of cohesion in the community (humanrights.gov.au 2018). The importance of ensuring the well being of the children was also aligned to the Aboriginal traditional belief that all children are sacred, and highlighted the necessity of the parents to protect their kids, even in ways in which they themselves might not have been protected before as children. This was significant to ensure a loving and caring environment for the children.
Cultural competency and cultural safety
References:
Betancourt, T. S., Frounfelker, R., Mishra, T., Hussein, A., & Falzarano, R. (2015). Addressing health disparities in the mental health of refugee children and adolescents through community-based participatory research: a study in 2 communities. American journal of public health, 105(S3), S475-S482. DOI: 10.2105/AJPH.2014.302504
Bloch, P., Toft, U., Reinbach, H. C., Clausen, L. T., Mikkelsen, B. E., Poulsen, K., & Jensen, B. B. (2014). Revitalizing the setting approach–supersettings for sustainable impact in community health promotion. International Journal of Behavioral Nutrition and Physical Activity, 11(1), 118. DOI: https://doi.org/10.1186/s12966-014-0118-8
Cacioppo, J. T., & Cacioppo, S. (2014). Social relationships and health: The toxic effects of perceived social isolation. Social and personality psychology compass, 8(2), 58-72. DOI: 10.1111/spc3.12087
Eldredge, L. K. B., Markham, C. M., Ruiter, R. A., Kok, G., & Parcel, G. S. (2016). Planning health promotion programs: an intervention mapping approach. John Wiley & Sons. URL: https://books.google.co.in/books?hl=en&lr=&id=UyrdCQAAQBAJ&oi=fnd&pg=PR11&dq=Planning+health+promotion+programs:+an+intervention+mapping+approach&ots=Od5x1vLMDB&sig=QU2-KCle3vUY6gluQJ1Qe-60iiE#v=onepage&q=Planning%20health%20promotion%20programs%3A%20an%20intervention%20mapping%20approach&f=false
Grob, G. N. (2014). From asylum to community: Mental health policy in modern America. Princeton University Press. URL: https://books.google.co.in/books?hl=en&lr=&id=8DgABAAAQBAJ&oi=fnd&pg=PP1&dq=From+asylum+to+community:+Mental+health+policy+in+modern+America&ots=_ok0BDL4d6&sig=Io_EzPC5HDtPsakMG4zCBed3Xcw#v=onepage&q=From%20asylum%20to%20community%3A%20Mental%20health%20policy%20in%20modern%20America&f=false
Heiman, H. J., & Artiga, S. (2015). Beyond health care: the role of social determinants in promoting health and health equity. Health, 20(10), 1-10. URL: https://www.issuelab.org/resources/22899/22899.pdf
Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspectives on Psychological Science, 10(2), 227-237. URL: https://scholarsarchive.byu.edu/cgi/viewcontent.cgi?article=3024&context=facpub
Hpi.georgetown.edu. (2018). Cultural Competence in Health Care: Is it important for people with chronic conditions?. Hpi.georgetown.edu. Retrieved 20 April 2018, from https://hpi.georgetown.edu/agingsociety/pubhtml/cultural/cultural.html
humanrights.gov.au. (2018). Chapter 4: Cultural safety and security: Tools to address lateral violence – Social Justice Report 2011 | Australian Human Rights Commission. Humanrights.gov.au. Retrieved 20 April 2018, from https://www.humanrights.gov.au/publications/chapter-4-cultural-safety-and-security-tools-address-lateral-violence-social-justice
Lewallen, T. C., Hunt, H., Potts?Datema, W., Zaza, S., & Giles, W. (2015). The Whole School, Whole Community, Whole Child model: a new approach for improving educational attainment and healthy development for students. Journal of School Health, 85(11), 729-739. DOI: https://doi.org/10.1111/josh.12310
McMurray, A., & Clendon, J. (2015). Community Health and Wellness-E-book: Primary Health Care in Practice. Elsevier Health Sciences.
Miner, M. H., Swinburne Romine, R., Robinson, B. B. E., Berg, D., & Knight, R. A. (2016). Anxious attachment, social isolation, and indicators of sex drive and compulsivity: Predictors of child sexual abuse perpetration in adolescent males?. Sexual Abuse, 28(2), 132-153. DOI: 10.1177/1079063214547585
Parker, R., & Milroy, H. (2018). Aboriginal and Torres Strait Islander Mental Health: An Overview. Telethonkids.org.au. Retrieved 20 April 2018, from https://www.telethonkids.org.au/globalassets/media/documents/aboriginal-health/working-together-second-edition/wt-part-1-chapt-2-final.pdf
Smith, K. J., & Victor, C. (2018). Typologies of loneliness, living alone and social isolation, and their associations with physical and mental health. Ageing & Society, 1-22. DOI: https://doi.org/10.1017/S0144686X18000132
South, J. (2015). A guide to community-centred approaches for health and wellbeing. URL: https://eprints.leedsbeckett.ac.uk/1229/11/A%20guide%20to%20community-centred%20approaches%20for%20health%20and%20wellbeing%20(full%20report).pdf
Varcoe, C., Browne, A. J., Ford?Gilboe, M., Dion Stout, M., McKenzie, H., Price, R., … & Khan, K. (2017). Reclaiming Our Spirits: Development and pilot testing of a health promotion intervention for Indigenous women who have experienced intimate partner violence. Research in nursing & health, 40(3), 237-254. DOI: 10.1002/nur.21795
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