Diverse Groups

Youth

Dickson, M.J., Cruise, K., McCall, A.C., Taylor, J.P. (2019). A systematic review of the antecedents and prevalence of suicide, self-harm and suicide ideation in Australian Aboriginal and Torres Strait Islander youth. International Journal of Environmental Research and Public Health, 16(17).

Suicide and self-harm represent serious global health problems and appear to be especially elevated amongst indigenous minority groups, and particularly amongst young people (aged 24 years or younger). This systematic review investigates for the first time the antecedents and prevalence of suicide, self-harm and suicide ideation among Australian Aboriginal and Torres Strait Islander youth. Web of Science, PubMed, PsychINFO, CINAHL databases and grey literature were searched from earliest records to April 2019 for eligible articles. Twenty-two empirical articles met the inclusion criteria. The data confirmed that indigenous youth in Australia have elevated rates of suicide, self-harm and suicidal ideation relative to the nonindigenous population. Risk factors included being incarcerated, substance use and greater social and emotional distress. Notably, though, information on predictors of suicide and self-harm remains scarce. The findings support and justify the increasing implementation of public health programs specifically aimed at tackling this crisis. Based on the review findings, we argued that Aboriginal communities are best positioned to identify and understand the antecedents of youth self-harm, suicide ideation and suicide, and to take the lead in the development of more effective mental health preventive strategies and public policies within their communities.

Isaacs, A., & Sutton, K. (2016). An Aboriginal youth suicide prevention project in rural Victoria. Advances in Mental Health, 14(2), 118-125.

Objective:To describe an Aboriginal youth suicide prevention project developed by Njernda Aboriginal Corporation. Method: This is a descriptive study of an Aboriginal youth suicide prevention project developed by Njernda Aboriginal Corporation based in Echuca, Victoria. Information about the program was obtained from interviewing the project worker and the social and emotional wellbeing worker. Further information was obtained about the program by examining activity registers, program flyers and posters. Results: The Aboriginal youth suicide prevention project was designed and implemented by Njernda Aboriginal Corporation over a period of three years. The main components of the project were building resilience, early intervention response and immediate postvention support. Resilience was built through the Bullroarer program, the Red Dust Healing program and community awareness programs. Another program, the Jekkora group was developed and implemented as an early intervention response. A postvention service is in the planning stage. Conclusions:During a three-year period Njernda Aboriginal Corporation established community resilience building and early intervention programs. Developing and implementing a comprehensive suicide prevention plan at the community level requires adequate time as well as support from mainstream services. These findings therefore have implications for future planning of Aboriginal suicide prevention projects.

Lopez-Carmen, V., McCalman, J., Benveniste, T., Askew, D., Spurling, G., Langham, E., & Bainbridge, R. (2019). Working together to improve the mental health of Indigenous children: A systematic review. Children and Youth Services Review104, 104408.

This systematic review analyses research measuring or evaluating primary health care interventions that focused on improving the mental health of Indigenous children via intersectoral service integration processes and tools.  Of the eleven studies included five were conducted with Indigenous children (aged 4 to 17 years) in Australia, the remaining studies included New Zealand, Canada, Norway and/or the United States. Among thenine key strategies adopted by service integration interventions of note were: Engaging the members of the Indigenous community; Empowerment of families; Adapting interventions and care to the specific socio-cultural circumstances; and Cultural strengthening and empowerment of Indigenous children’s identity.  Six factors enabling effective implementation of service integration included: Including and involving the community and stakeholders, Sensitivity to culture, including to historical background and inter-generational trauma, Multi-disciplinary and collaborative health services and Resourcing factors (e.g. funding, costs, time availability, staff/organisation capacity). The authors conclude that while the research evidence for interventions focused on improving the mental health of Indigenous children via intersectoral service integration is preliminary the findings hold potential. Importantly, the main outcomes where strategies focused on intersectoral integration were: Improvements in children’s psychosocial functioning, stress management, and individual empowerment; Improvements in health service access and use; Empowerment of both families and communities; and Increased links and collaboration between the community and health services. The authors identify the need for further research, particularly to incorporate Indigenous voices in evaluation, help clarify impact, and to evaluate costs.

Macedo, D., Smithers, L., Roberts, R., Haag, D., Paradies, Y., & Jamieson, L. (2019). Does ethnic-racial identity modify the effects of racism on the social and emotional wellbeing of Aboriginal Australian children? PLoS ONE14(8), e0220744.

Objectives: This study investigates the protective role of ethnic-racial identity (ERI) affirmation on the longitudinal association between racism and Aboriginal Australian children’s social and emotional well-being (SEWB). Methods: 408 children from the K-Cohort of the Longitudinal Study of Indigenous Children were included in the analysis. Data were collected through questionnaire-guided interviews at 7–10 and 9–12 years of age. Children’s racism experience, SEWB (Strengths and Difficulties Questionnaire), and confounding were reported by caregivers. ERI was reported by children and dichotomized into high versus low. Generalized linear models with log-Poisson links and robust errors were used to estimate adjusted Risk Ratios (RR) for the effect of racism on SEWB domains. Effect-measure modification analysis was used to verify differences on effect sizes per strata of ERI affirmation. The presence of modification was indicated by the Relative Excess Risk due to Interaction (RERI). Results: Slightly above half (51.4%) of the children presented high ERI affirmation. Children exposed to racism and with low ERI affirmation were at increased risk of hyperactive behavior (RR 2.53, 95% CI 1.17, 5.48), conduct problems (RR 2.35, 95% CI 1.07, 5.15), and total difficulties (RR 1.73, 95% CI 0.84, 3.55). Positive RERIs indicated the joint effects of racism and low ERI affirmation surpassed the sum of their separate effects in these domains. Children with high ERI affirmation were at increased risk of peer problems (RR 1.66, 95% CI 0.78, 3.52). Conclusions: These findings suggest that ERI may mitigate the risk of poor SEWB due to racism. Fostering affirmative ERI can be an important strategy in promoting resilience in Aboriginal Australian children.

Macedo, D., Smithers, L., Roberts, R., Paradies, Y., & Jamieson, L. (2019). Effects of racism on the socio-emotional wellbeing of Aboriginal Australian children. International Journal for Equity in Health18(1), 132.

Background: Racism is a pervasive experience in the life of Aboriginal Australians that begins in childhood. As a psychosocial stressor, racism compromises wellbeing and impacts developmental trajectories. The purpose of the present study was to estimate the effect of racism on indicators of Australian Aboriginal child socio-emotional wellbeing (SEWB) at one to two years after exposure. Age-related differences in the onset of symptoms were explored. Methods: Data from the B- and K-cohorts of the Longitudinal Study of Indigenous Children were used (aged 6 to 12 years). Racism, confounding variables, and the Strengths and Difficulties Questionnaire (a measure of SEWB) were collected by questionnaires and guided interviews with each child’s main caregiver. Adjusted Poisson regression was used to estimate the relative risk (RR) effects of racism on SEWB for both cohorts separately. RR were pooled in a random effects meta-analysis. Results: Exposure to racism was associated with an adjusted point estimate indicating a 41% increased risk for total emotional and behavioural difficulties, although the confidence intervals were wide (pooled RR 1.41, 95% CI 0.75, 2.07). Analyses by cohort showed younger children had higher RR for total difficulties (RR 1.72, 95% CI 1.16, 2.54), whilst older children had higher RR for hyperactive behaviour (RR 1.66, 95% CI 1.01, 2.73). Conclusions: The effects observed contributes to our understanding of the impact of racism on Aboriginal Australian children. Support for emotional and behavioural difficulties, and hyperactive behaviour, for Aboriginal children might help counteract the effects of racism. Future longitudinal research and policies aimed at reducing racism in Australian society are necessary.

Moss, M. & Duwun Lee, A. (2019). TeaH (turn ‘em around healing): A therapeutic model for working with traumatised children on Aboriginal communities. Children Australia, 44(2), 55-59.

Aboriginal children in Australia are over-represented in both the child protection and juvenile justice systems. Using Western therapeutic models of practice with Aboriginal people who live in remote communities can be highly problematic. Moreover, the historical legacy of past and present legislation, government interventions and racist service provision needs to be acknowledged and addressed prior to any service implementation. This paper presents a therapeutic model of practice that incorporates Aboriginal concepts of healing and spirit within a creative therapeutic framework. It will demonstrate how the model works through principles of community engagement and capacity building, enabling the provision of a culturally derived therapeutic intervention that involves a synergy of both Aboriginal- and Western-based healing practices. The findings from the implementation of the TeaH model affirm the need to incorporate Aboriginal concepts of healing, spirit and creative therapies into mainstream practice with Aboriginal people.

Skerrett, D. M. Gibson, M., Darwin, L., Lewis, S., Rallah, R., & Diego, D. L. (2017). Closing the gap in Aboriginal and Torres Strait Islander youth suicide: A social–emotional wellbeing service innovation project. Australian Psychologist, 53(1), 13-22.

Objective:The suicide rate for Queensland’s Aboriginal and Torres Strait Islander young people is over four times that of their non- Indigenous counterparts, with Aboriginal and Torres Strait Islander children (under 15) dying by suicide at 12 times the non-Indigenous rate. There is a need for interventions that are culturally validated and community-endorsed. The aim of this article is to describe the design and implementation of a group-based intervention, as well to report the results of the various qualitative and quantitative measures. Method:Sixty-one Aboriginal and Torres Strait Islander persons aged 11–21 years completed a social–emotional wellbeing (SEWB) program at headspace Inala. Data were available through to 2-month follow-up for 49 participants. The program was designed and delivered in collaboration with the local Aboriginal and Torres Strait Islander community. Results:There was a statistically significant decrease in suicidal ideation experienced by the participants after completing the program. Qualitative measures indicated that participants experienced improved understanding of holistic health and an increased number of coping skills. Conclusions:Not only was this the first evaluated intervention in Aboriginal and Torres Strait Islander youth to ever report a decrease in individual suicidality, the program was carefully designed and implemented in consultation with community in a culturally sensitive manner and thus provides an invaluable framework for future SEWB work.

Wright, M., Culbong, T., Crisp, N., Biedermann, B., & Lin, A. (2019). “If you don’t speak from the heart, the young mob aren’t going to listen at all”: An invitation for youth mental health services to engage in new ways of working. Early Intervention in Psychiatry, 1-7.

Aim: Aboriginal and Torres Strait Islander young people are more likely to experience mental health issues or end their life by suicide than non-Aboriginal youth, but are less likely to access mental health services for support. Systemic change is required if mainstream youth mental health services are to be relevant and culturally secure for Aboriginal and Torres Strait Islander young people. Methods: Building Bridges (2017-2019) is a three-year participatory action research project being conducted in partnership with the Nyoongar community and three main-stream youth mental health services in Perth, Western Australia. The project involves Nyoongar Elders and Aboriginal and Torres Strait Islander young people working directly with senior management and key staff of youth mental health services to co-design, implement and evaluate a framework for systems change. The aim of the project is to increase Aboriginal and Torres Strait Islander young people’s engagement with services and improve mental health outcomes for young people and their families. Results: This paper outlines the engagement process that underpinned the first phase of the project. Our research methods are premised by an investment in establishing safe spaces for the Elders, young people and service staff to engage in open, honest dialogue. We present two key activities that illustrate this process of building trust and deepening understanding, namely: spending time “On Country” and engaging in a “storying” process. Conclusions: Building Bridges demonstrates the centrality of trusting relationships for systemic change and the way in which meaningful engagement is at the core of both the process and the outcome.

Aarnja Ltd (2019).2019 Kimberley empowered young leaders report. Kimberley Aboriginal Suicide Prevention Trial, Alice and Kicking Goals, Headspace Broome, Kimberley Aboriginal Medial Service, Primary Health Network Country WA, WA Primary Health Alliance.

Dudgeon, P., Walker, R., Scrine, C., Shepherd, C.C., Calma, T., & Ring, I. (2014). Effective strategies to strengthen Aboriginal and Torres Strait Islander mental health and wellbeing.Issues paper no. 12. Closing the Gap Clearinghouse, Australian Institute of Health and Welfare, Australian Institute of Family Studies.

Fogliani, R.V.C.. (2019). Inquest into the deaths of thirteen children and young persons in the Kimberley region, Western Australia. Coroner’s Court of Western Australia.

The State Coroner conducted an inquest hearing into the deaths of thirteen children and young persons in the Kimberley Region of Western Australia. These deaths were investigated during one Inquest because there were similar circumstances, life events, developmental experiences and behaviours that appear to have contributed to making them vulnerable to suicide. As part of the Inquest process, the State Coroner made forty-two recommendations across a range of areas including:

  • Fetal alcohol spectrum disorder (FASD)
  • Alcohol restrictions
  • Housing
  • Mental health support
  • Employment
  • Cultural healing

Hall, S., Fildes, J., Perrens, B., Plummer, J.,Carlisle, E., Cockayne, N., & Werner-Seidler, A. (2019). Can we talk? Seven year youth mental health report – 2012-2018. Mission Australia.

The Can we talk? Seven year youth mental health report – 2012-2018 Youth Survey findings of the past seven years – is co-authored with Black Dog Institute experts – to ascertain and investigate rates of psychological distress experienced by young people in Australia who are aged 15-19. The report further examines the concerns, general wellbeing and help-seeking behaviours of the close to 27,000 participants of the 2018 Youth Survey aged 15-19, including those who are experiencing psychological distress – highlighting the vital role that friends, parents, services, schools and the internet play as sources of help for young people who are struggling with their mental health. Part 2 is about meeting the diversity of young people’s need  : Dedicated focus on Aboriginal and Torres Strait Islander young people.

SNAICC: National Voice for our Children. (2020). SNAICC submission to the productivity commission’s draft report into expenditure on children in the Northern Territory.

Douglas, J. (2015). Kin and knowledge: the meaning and acquisition of Indigenous ecological knowledge in the lives of young Aboriginal people in Central Australia. Charles Darwin University, Darwin.

This is an ethnographic study about young Aboriginal people in Central Australia. The voices and opinions of more than 150 Aboriginal youth were analysed. My findings show that Indigenous Ecological Knowledge (IEK) is an active part of their lives. This knowledge and practice contributes to the identity and pride of youth from Central Australia. Young Aboriginal people are commonly portrayed in the media as problems. Negative stereotypes and deficit narratives imply they occupy a failed space within and between Aboriginal and non-Aboriginal worlds. Youth are said to be lacking in culture and disinterested in cultural practices. My findings contradict such stereotypes and deficiencies. The lived experiences of Aboriginal people are often invisible to mainstream Australian society. Rarely do we hear from young Aboriginal people themselves. Their role as players in a system of knowledge is simultaneously ignored and assumed. IEK is characterised as the domain of the older generation but not younger generations. This thesis goes beyond academic attention to IEK in environmental programs, developmental theories or the nexus between Indigenous and Western or scientific knowledge. The study explores the social lives of young Aboriginal adults. Mixed methods were used to examine the learning practices, learning contexts and cultural acquisition processes that underpin IEK. Qualitative results from interviews, surveys and observations are presented. I look at how IEK is made to happen, how knowledge and practice is realised in contemporary contexts. The study shows that people’s everyday lived experience integrates IEK. Cultural knowledge is vulnerable to the stresses and forces of modern life; yet it persists. Factors that enable IEK to persevere are examined. I have found that hunting, bush food and medicine harvesting, and natural resource use contribute to IEK. Practices and beliefs are enriched through ceremonial life, health and healing, and in observances in bereavement and funerals. Amongst younger people there is an ongoing belief in the sentience of country. This research revealed that IEK is a vital part of youth values and beliefs. Beliefs inform youth practice. IEK is expressed through relationship to families and people’s connections to each other. Young people demonstrate their care for older and younger generations through the collection, preparation and use of natural resources. ‘Relatedness’ continues to be the currency of knowledge transmission. Feelings of love, duty and care motivate young people to listen, learn and do things for their older and younger loved ones. Deep and powerful feelings for family members call young people to action. Young people are integral to the future of Indigenous Ecological Knowledge and practice in Central Australia.

 

Anang, P., Naujaat Elder, E. H., Gordon, E., Gottlieb, N., & Bronson, M. (2019). Building on strengths in Naujaat: The process of engaging Inuit youth in suicide preventionInternational Journal of Circumpolar Health78(2), 1508321.

Death by suicide and attempted suicide among Inuit youth is now considered a public health emergency of epidemic proportion, with rates among the highest worldwide. A strong sense of cultural identity and pride, as well as social capital, has been identified as being protective against suicide. The Canadian Institute for Health Research (CIHR) Guidelines for Health Research Involving Aboriginal People call for communities to be included in the conception, planning and implementation of research. The authors took first steps towards sharing the responsibility of designing a community initiative with the youth of Naujaat, Nunavut, a community located directly on the Arctic Circle. With the objectives of promoting open listening and exploration of community needs and enhancing self-determination and sustainability, we postulated a youth resiliency project that will be co-authored by the community. This paper describes the joint work process. We recount how Inuit youth take ownership of the project with the guidance of Ms. Elizabeth Haqpi, a Naujaat Elder. The article will particularly reflect on the process of balancing the different perspectives and expectations while enjoying the richness of mutual learning through keeping each other accountable.

Hibbert, A., Fletcher, F., Hammer, B. (2018). Life skills journey: Measuring the impact of a resilience-based intervention for Métis children in Alberta. Journal of Indigenous Wellbeing Te Mauri – Pimatisiwin, 3(1), 18-29.

Métis peoples are descendants of unions between French or Scottish fur traders and First Nations women in Canada. Alberta is the only province in Canada with land-based Métis who live in self-governing communities known as Métis Settlements. University of Alberta’s Faculty of Extension and four Métis Settlements partnered in a community based participatory research project aimed at increasing children’s resilience through inner strength and support from peers and mentors. While working with community members, the learning needs of children were identified, prioritised, and included in a summer day-camp program for children (7 – 14 years). Pre- and post-program surveys with children used an adaption of the Youth Resiliency: Assessing Developmental Strengths Questionnaire. Results are presented using descriptive statistics and were tested for significance using the non-parametric Wilcoxon rank sum test. Positive change occurred in several areas of internal strength, including self-esteem, drug resistance, and planning and decision making. Risk factors also saw positive change, as did the area of external family support. Significant areas of positive change are encouraging given that they demonstrate success in major goals of the summer camp program. Significant areas of negative change require further analysis in order to understand the complexity of Métis youth resiliency.

Isbister-Bear, O., Hatala, A. R., & Sjoblom, E. (2017). Strengthening Âhkamêyimo among Indigenous youth: The social determinants of health, justice, and resilience in Canada’s north. Journal of Indigenous Wellbeing Te Mauri – Pimatisiwin, 2(3), 76-89.

The wellbeing of Indigenous youth living in Canada’s northern communities continues to lag behind the rest of the Canadian population. To a large extent, these health inequities are perpetuated by processes of colonisation that significantly impact the social determinants of health in Canada’s Indigenous north. The purpose of this article is to review the history of colonisation and its impacts on the wellbeing of Indigenous youth in Canada’s north, as well as processes of resilience that have helped Indigenous youth live healthy lives despite social challenges. Academic articles published between 2000 and 2016 outlining resilience from Indigenous perspectives are reviewed in the contexts of Canada’s Indigenous north. Analysis focuses on what insights about resilience emerge from Indigenous communities, particularly as they related to the health inequities of circumpolar regions. The concept of Âhkamêyimo is discussed and how systems of Indigenous knowledge offer important insights into resilience in general, and can be utilised in health promotion, education, and prevention programs targeting Indigenous youth in northern Canada. We conclude that attention should be turned toward issues of social justice and health equity that are desperately needed in order to create healthy environments whereby Indigenous youth within northern Canadian communities can be assisted to flourish.

Kral, M. J. (2016). Suicide and suicide prevention among Inuit in CanadaCanadian Journal of Psychiatry. Revue canadienne de psychiatrie61(11), 688–695.

Inuit in Canada have among the highest suicide rates in the world, and it is primarily among their youth. Risk factors include known ones such as depression, substance use, a history of abuse, and knowing others who have made attempts or have killed themselves, however of importance are the negative effects of colonialism. This took place for Inuit primarily during the government era starting in the 1950s, when Inuit were moved from their family-based land camps to crowded settlements run by white men, and children were removed from their parents and placed into residential or day schools. This caused more disorganization than reorganization. The most negative effect of this colonialism/imperialism for Inuit has been on their family and sexual relationships. Many Inuit youth feel alone and rejected. Suicide prevention has been taking place, the most successful being community-driven programs developed and run by Inuit. Mental health factors for Indigenous peoples are often cultural. It is recommended that practitioners work with the community and with Inuit organizations. Empowered communities can be healing.

Slesnick, N., Zhang, J., & Walsh, L. (2020). Youth experiencing homelessness with suicidal ideation: Understanding risk associated with peer and family social networks. Community Mental Health Journal.

Suicide is the leading cause of death among youth experiencing homelessness, and these youth report high rates of suicide attempts. Research suggests that the interpersonal factors of perceived burdensomeness and thwarted belongingness are proximal causes of suicide, but little is known about factors associated with these risks. The current study examined the relationship of social network characteristics, perceived social network support, and interpersonal risks for suicide among a sample of 150 youth experiencing homelessness who reported severe suicide ideation. Findings indicate that characteristics of the social network, including engagement in crime and alcohol use, interrupted the potentially protective effects of high perceived social network support for interpersonal risk factors of suicide. Findings imply that increasing perceived social network support as a protection against suicide will not be uniformly successful, and consideration of the social network characteristics is necessary. Future work needs to continue to uncover the complexity of modifiable intervention targets to prevent future suicide attempts among this high-risk group.

Trout, L., Mceachern, D., Mullany, A., White, L., Wexler, L., & Trout, L. (2018). Decoloniality as a framework for Indigenous youth suicide prevention pedagogy: Promoting community conversations about research to end suicide. American Journal of Community Psychology62(3-4), 396–405.

Indigenous youth suicide remains a substantial health disparity in circumpolar communities, despite prevention efforts through primary health care, public health campaigns, school systems, and social services. Innovations in prevention practice move away from expert‐driven approaches to emphasize local control through processes that utilize research evidence, but privilege self‐ determined action based on local and personal contexts, meanings, and frameworks for action. “Promoting Community Conversations About Research to End Suicide” is a community health intervention that draws on networks of Indigenous health educators in rural Alaska, who host learning circles in which research evidence is used to spark conversations and empower community members to consider individual and collective action to support vulnerable people and create health‐promoting conditions that reduce suicide risk. The first of nine learning circles focuses on narratives of local people who link the contemporary youth suicide epidemic to 20th century American colonialism, and situates prevention within this context. We describe the theoretical framework and feasibility and acceptability outcomes for this learning circle, and elucidate how the educational model engages community members in decolonial approaches to suicide prevention education and practice, thus serving as a bridge between Western and Indigenous traditions to generate collective knowledge and catalyze community healing.

Elders

Armstrong, G., Spittal, M.J., & Jorm, A.F. (2018). Are we underestimating the suicide rate of middle and older‐aged Indigenous Australians? An interaction between ‘unknown’ Indigenous status and ageAustralian and New Zealand Journal of Public Health42(4), 412-413.

High rates of Indigenous suicide are a distressing phenomenon that plague several postcolonial countries. In Australia, suicide is a leading cause of mortality for Aboriginal and Torres Strait Islander people. In the period 2012 to 2016, the suicide rate for Indigenous Australians was estimated to be 23.7 per 100,000, twice the rate (11.6 per 100,000) for non-Indigenous Australians. Data presented by the National Coronial Information System highlights a major disparity in suicide rates between Indigenous and non-Indigenous Australians in younger age groups; the Indigenous suicide rate was 31.5 per 100,000 among those aged 15–44 years, compared to 11.1 per 100,000 for non-Indigenous people. Meanwhile, among those aged 45 years and older, there appeared to be no or minimal disparity in suicide rates by Indigenous identification. This paper explores the interaction between age and ‘unknown’ Indigenous status in regards to deaths by suicide.

Gibson, C., Crockett, J., Dudgeon, P., Bernoth, M., & Lincoln, M. (2018). Sharing and valuing older Aboriginal people’s voices about social and emotional wellbeing services: A strength-based approach for service providersAging and Mental Health24(3), 481–488.

Objective: Over the last decade, the literature relating to older Aboriginal and Torres Strait Islander people’s preferences for social and emotional wellbeing services has grown. However, little evidence exists in relation to older Aboriginal and Torres Strait Islander people’s experiences of services relating to social and emotional wellbeing. This paper highlights older Aboriginal and Torres Strait Islander people’s experiences of social and emotional wellbeing services in Australia and then uses these key findings of the research, along with the literature, to develop a strength-based approach for service providers. Methods: Yarning was the preferred research method for the older Aboriginal community. In total, 16 older Aboriginal people, including eight women and eight men participated in the research yarning sessions. A modified version of an existing thematic analysis process supported yarning members to participate in each stage of the research, including data analysis. Results: The themes emerging from the voices of the yarning members are they couldn’t give a damn about them, You’ve got to get the right one and ticking the box. The themes focus on negative, positive and preferred experiences of social and emotional wellbeing service provision. Conclusion: The key findings and related literature contribute to the development of a strength-based approach, which supports the implementation of responsive and effective services that address Elders, older peoples and their communities’ social and emotional wellbeing issues and aspirations.

Love, P., Moore, M., & Warburton, J. (2017). Nurturing spiritual well-being among older people in Australia: Drawing on Indigenous and non-Indigenous way of knowingAustralasian Journal on Ageing36(3), 179-185.

Aim: The meaning of spiritual well‐being as a health dimension is often contested and neglected in policy and practice. This paper explores spiritual well‐being from both an Indigenous and a non‐Indigenous perspective. Method: We drew on Indigenous and non‐Indigenous methodologies to explore the existing knowledge around spiritual well‐being and its relationship with health. Results: The Indigenous perspective proposed that spiritual well‐being is founded in The Dreaming, informs everyday relationships and can impact on health. The non‐Indigenous perspective suggested that spiritual well‐being is shaped by culture and religion, is of increased importance as one ages, and can improve coping and resilience stressors. Conclusions: Situating these perspectives side by side allows us to learn from both, and understand the importance of spirituality in people’s lives. Further research is required to better address the spiritual well‐being/health connection in policy and practice.

 Shen, Y.T., Radford, K. , Daylight, G. , Cumming, R. , Broe, T.G.A. , Draper, B. (2018). Depression, suicidal behaviour, and mental disorders in older Aboriginal Australians. International Journal of Environmental Research and Public Health15(3), 1-14.

Aboriginal Australians experience higher levels of psychological distress, which may develop from the long-term sequelae of social determinants and adversities in early and mid-life. There is little evidence available on the impact of these on the mental health of older Aboriginal Australians. This study enrolled 336 Aboriginal Australian participants over 60 years from 5 major urban and regional areas in NSW, utilizing a structured interview on social determinants, and life-time history of physical and mental conditions; current psychosocial determinants and mental health. Univariate and multivariate analyses were utilized to examine the link between these determinants and current depressive scores and suicidality. There was a high rate of life-time depression (33.3%), current late-life depression (18.1%), and suicidal ideation (11.1%). Risk factors strongly associated with late-life depression included sleep disturbances, a history of suicidal behaviour, suicidal ideation in late-life and living in a regional location. This study supports certain historical and psychosocial factors predicting later depression in old age, and highlights areas to target for prevention strategies.

Niu, L., Ma, Z., Jia, C., & Zhou, L. (2020). Gender-specific risk for late-life suicide in rural China: A case-control psychological autopsy studyAge and Ageing, 1-5.

Background:despite unique gender patterns of suicide among older people in rural China, research addressing this issue is scarce.  is study aims to clarify the gender-specific risk factors of late-life suicide in rural China. Methods:the study included 242 persons (51% male) aged 60 and above who had committed suicide between June 2014 and September 2015 in the rural areas of three provinces of China. Using 1:1 matched case-control design, 242 living controls matched in age, gender and neighbourhood were randomly selected. Psychological autopsy interviews and psychological assessments were conducted with two informants for each suicide and living control, respectively. Results:men used alcohol before suicide more than women (12.6 versus 4.7%, P < 0.05).  ere was no gender difference in suicide method, suicide intent and previous attempts. Univariate analysis showed that married status, mental disorder, depressive symptoms, hopelessness, impulsivity, loneliness, social support, family function and quality of life were associated with suicide in both genders. For men, other risk factors were chronic physical illness and functions of daily living. Variables remaining in the multivariable model for both men and women were depressive symptoms and hopelessness. Discussion: depression and hopelessness are the two major risk factors for suicide among both older men and woman in rural China. Suicide prevention programmes focusing on depression and hopelessness in this population are indicated. Also needed are continued efforts to develop and refined gender-specialised strategies to identify high-risk individuals or groups and to enhance targeted support in the rural community.

Yip, P. S. F., Cheung, Y. T., Chau, P. H., & Law, Y. W. (2010). The impact of epidemic outbreak the case of severe acute respiratory syndrome (SARS) and suicide among older adults in Hong Kong. Crisis, 31(2), 86–92.

Background: Previous studies revealed that there was a significant increase in suicide deaths among those aged 65 and over in 2003. The peak coincided with the majority of SARS cases being reported in April 2003. Aims: In this paper we examine the mechanism of how the SARS outbreak resulted in a higher completed suicide rate especially among older adults in Hong Kong. Methods: We used Qualitative data analysis to uncover the association between the occurrence of SARS and older adult suicide. Furthermore, we used a qualitative study based on the Coroner Court reports to provide empirical evidence about the relationship between SARS and the excessive number of suicide deaths among the elderly. Results: SARS-related older adult suicide victims were more likely to be afraid of contracting the disease and had fears of disconnection. The suicide motives among SARS-related suicide deaths were more closely associated with stress over fears of being a burden to their families during the negative impact of the epidemic. Social disengagement, mental stress, and anxiety at the time of the SARS epidemic among a certain group of older adults resulted in an exceptionally high rate of suicide deaths. Conclusions: We recommend that the mental and psychological well-being of the community, in particular older adults, be taken into careful account when developing epidemic control measures to combat the future outbreak of diseases in the community. In addition, it is important to alert family members to vulnerable individuals who are at potential risk because of their illnesses or anxieties.

People Involved in the Justice System

Johnson, J. E., Jones, R., Miller, T., Miller, I., Stanley, B., Brown, G., Arias, S. A., Cerbo, L., Rexroth, J., Fitting, H., Russell, D., Kubiak, S., Stein, M., Matkovic, C., Yen, S., Gaudiano, B., & Weinstock, L. M. (2020). Study protocol: A randomized controlled trial of suicide risk reduction in the year following jail release (the SPIRIT trial)Contemporary Clinical Trials94, 106003.

Purpose:This article describes the protocol for a randomized effectiveness and cost-effectiveness trial of Stanley and Brown’s Safety Planning Intervention (SPI) during pretrial jail detention to reduce post-release suicide events (suicide attempts, suicide behaviors, and suicide-related hospitalizations). Background:With 10 million admissions per year and short stays (often days), U.S. jails touch many individuals at risk for suicide, providing an important opportunity for suicide prevention that is currently being missed. This study (N = 800) is the first randomized evaluation of an intervention to reduce suicide risk in the vulnerable year after jail release. Given that roughly 10% of all suicides in the U.S. with known circumstances occur in the context of a criminal legal stressor, reducing suicide risk in the year after arrest and jail detention could have a noticeable impact on national suicide rates. Design:Pretrial jail detainees at risk for suicide were randomized to SPI during jail detention plus post-release phone follow-up or to enhanced Standard Care. Outcomes assessed through 12 months post-release include suicide events, suicide attempts, weeks of active suicide ideation, severity of suicide ideation, time to first event, psychiatric symptoms, functioning, and cost-effectiveness. Methods accommodate short jail stays and maximize trial safety and follow-up in a large sample with severe suicide risk, access to lethal means including substances and firearms, high rates of psychiatric illness, and unstable circumstances. Conclusion:Adequate funding was important to create the infrastructure needed to run this large trial cleanly. We encourage funders to provide adequate resources to ensure clean, well-run trials.

Lau, P., Marion, C., Blow, R., & Thomson, Z. (2012). Healing for Aboriginal and Torres Strait Islander Australians at risk with the justice system: A programme with wider implications? Criminal Behaviour and Mental Health22(5), 297-302.

Malvaso, C., Day, A., Casey, S., Corrado, R. (2017). Young offenders, maltreatment, and trauma: A pilot studyPsychiatry, Psychology and Law24(3), 458-469.

Although a large number of studies offer consistent and persuasive evidence that exposure to childhood maltreatment and subsequent juvenile offending behaviours are related, relatively few studies have investigated the mechanisms by which maltreatment might increase risk in young offender populations. The aim of this pilot study was to collate data on the key areas of need from 28 young male offenders in secure care in an Australian jurisdiction, with a specific focus on the inter-relationship between scores on self-report measures of maltreatment, trauma, and mental health. The findings provide preliminary evidence that these key constructs are linked to other proximal risk factors for juvenile offending, such as poor anger regulation and antisocial thinking patterns. They offer a rationale for considering the sequelae of maltreatment in the development of service delivery frameworks for young offenders.

Shepherd, S.M., Spivak, B., Arabena, K., Paradies, Y. (2018). Identifying the prevalence and predictors of suicidal behaviours for Indigenous males in custody. BMC Public Health, 18, 1159.

Background: High rates of suicidal behaviours among Indigenous Australians have been documented. Justice- involved individuals are also at a higher risk for engaging in suicidal behaviours. This study sought to ascertain the prevalence and correlates of suicidal behaviours for 107 Indigenous adult males in custody in Victoria, Australia. Methods: Participants undertook a structured interview comprising a psychiatric assessment. Information on suicidal behaviours (ideation and attempts), socio-demographics, environmental stressors, negative life events and mental health was obtained. Results: A high proportion of Indigenous males in custody experienced lifetime suicidal ideation (63.7%) and over one- half had attempted suicide (54.5%). A smaller, yet significant number of participants experienced ideation over the past 12 months (27.9%). Having a loved one pass away within the past 12 months predicted recent ideation; lifetime ideation and a diagnosis of Post-Traumatic Stress Disorder predicted a lifetime suicide attempt. Conclusions: The prevalence of suicidal behaviours among Indigenous people in custody is remarkably high. Correlates of suicidal behaviours for Indigenous people in custody in this study likely manifest in the community, denoting an urgent public health response. Prevention must begin in communities at-risk for suicidal behaviours. The development of low intensity mental health service infrastructure in communities to promote awareness and provide accessible, least restrictive support and treatment is necessary. Correctional institutions must also continue to improve custodial suicide prevention and management initiatives.

Stewart, A.C., Cossar, R., Dietze, P., Armstrong, G., Curtis, M., Kinner, S.A., Ogloff, J.R.P., Kirwan, A., Stoove, M. (2018). Lifetime prevalence and correlates of self-harm and suicide attempts among male prisoners with histories of injecting drug useHealth and Justice, 6(19).

Background: Histories of self-harm and suicide attempts are common among people in prison in Australia, and substance dependence is an established risk factor for these lifetime experiences. We describe the prevalence of self-reported history of non-suicidal self-injury (NSSI) and suicide attempts in a cohort of men with recent histories of injecting drug use (IDU) imprisoned in Victoria, Australia. Baseline interviews from the Prison and Transition Health (PATH) prospective cohort study were conducted in the weeks prior to release from prison among 400 incarcerated men who reported regular IDU in the six months prior to incarceration. Results: Participants completed a researcher-administered structured questionnaire that collected information on socio-demographics, substance use patterns, and physical and mental health indicators. More than one third (37%) reported a history of NSSI and almost half of participants (47%) reported a history of suicide attempts. In multivariable Poisson regression models, a history of NSSI was associated with: being aged 30–39 years; moving accommodation three or more times in the year prior to current sentence; self-reporting a history of mental illness diagnosis; current poor psychiatric well-being; and self-reporting three or more previous drug overdoses. History of suicide attempts was significantly associated with: self-reporting a history of mental illness diagnosis; current poor psychiatric well-being; and self-reporting a history of 1–2 and > 3 drug overdoses. Conclusion: We observed a disconcertingly high lifetime prevalence of non-suicidal self-injury and suicide attempts among incarcerated males with a history of recent regular injecting drug use. Significant associations with indicators of mental illness and drug related harms support the need to prioritise in-prison screening and early intervention to reduce the risk of future harms for this population.

 

Women

Carlin, E.; Atkinson, D.; Marley, J.V. ‘Having a quiet word’: Yarning with Aboriginal women in the Pilbara region of Western Australia about mental health and mental health screening during the perinatal period. International Journal of Environmental Research and Public Health, 16(21), 4253.

Despite high rates of perinatal depression and anxiety, little is known about how Aboriginal women in Australia experience these disorders and the acceptability of current clinical screening tools. In a 2014 study, the Kimberley Mum’s Mood Scale (KMMS) was validated as an acceptable perinatal depression and anxiety screening tool for Aboriginal women in the Kimberley region of Western Australia. In the current study, we explored if it was appropriate to trial and validate the KMMS with Aboriginal women in the Pilbara. Yarning as a methodology was used to guide interviews with 15 Aboriginal women in the Pilbara who had received maternal and child health care within the last three years. Data were analysed thematically, the results revealing that this cohort of participants shared similar experiences of stress and hardship during the perinatal period. Participants valued the KMMS for its narrative-based approach to screening that explored the individual’s risk and protective factors. While support for the KMMS was apparent, particular qualities of the administering health care professional were viewed as critical to the tool being well received and culturally safe. Building on these findings, we will work with our partner health services in the Pilbara to validate the KMMS with Pilbara Aboriginal women.

Dudgeon, P., Bray, A. (2017). Indigenous healing practices in AustraliaWomen & Therapy41(1-2), 97-113.

Indigenous Australian women are among the most disadvantaged women in the world. Over two centuries of colonization have had a damaging impact on perceptions of their gender roles and status as well as many other consequential oppressions. These experiences have affected the social and emotional wellbeing of Indigenous women of all ages, resulting in socio-economic ghettoization, higher suicide rates, psycho- logical distress, illness, and poverty. Generations of women have experienced the forced removal of their children, resulting in complex forms of historical trauma. Despite this, Indigenous women have also maintained strong leadership roles and have kept families and communities intact. In the last few decades, the Australian Indigenous mental health movement has emerged within the context of a broader self-determination movement, restoring and strengthening women’s traditional therapeutic practices. This article offers an overview of the social and emotional wellbeing of Indigenous women within neocolonial Australia and explores women’s relationship to traditional therapeutic practices. Future directions and key issues for the capacity building of Indigenous women’s healing are explored.

Saunders, M.A.E.E. (2014). Yarning with Minjungbal women: testimonial narratives of transgenerational trauma and healing explored through relationships with country and culture, community and family. University of Sydney.

 Yarning with Minjungbal women incorporates the testimonial narratives of five women from the Minjungbal community of Tweed Heads in far northern New South Wales. Our combined metanarrative explores how we have been able to interrupt transgenerational trauma, which is the process that explains how the impacts of historical suffering are inherited by successive generations. Minjungbal women’s experiences of transgenerational trauma are discussed firstly through our ties to country and culture, secondly within the relationships in our community, and finally inside the dynamics of our families. Minjungbal women explain how we have experienced transgressions, resisted oppression, engendered healing and spread strength within each of these spheres. Minjungbal women’s relationships to country and culture, community and family have been influenced by the legacies of the past, and Minjungbal women still experience ongoing injustices from government policies and the attitudes of the dominant society. Nevertheless, this thesis contends that Minjungbal women have always been actors in resisting oppression, agents in interrupting the cycle of transgenerational trauma and instrumental in facilitating positive changes. Yarning with Minjungbal Women proposes that the key to resistance, resilience and healing lies within the teaching and learning that occurs within the context of relationships. Yarning with Minjungbal Women is therefore an embodiment of activism research as it is informed by the sharing of stories and the strengthening of relationships. Yarning with Minjungbal Women is a contribution to the field of research about the history of Minjungbal country. It contributes to existing research that explains the mechanisms by which the transgenerational transfer of trauma is inherited and passed on. This research is focussed though an Indigenous feminist heuristic perspective as the most culturally appropriate and immersive methodology for me to employ as a Minjungbal woman who has been shaped by transgenerational trauma, as I am perfectly suited to elucidate sensitive information from women in my community. The testimonial narratives were recorded using yarning as a communication method. Yarning facilitated the release of information in a way that Minjungbal women were comfortable with, giving them agency in the research process, as well as retaining the integrity of Minjungbal communication practises.

 

McGuire-Adams, T. (2017). Anishinaabeg women’s stories of wellbeing: Physical activity, restoring wellbeing, and confronting the settler colonial deficit analysis. Journal of Indigenous Wellbeing Te Mauri – Pimatisiwin, 2(3), 90-104.

The settler colonial lens deficit approach to Indigenous peoples’ health constructs us as ill, which sets the stage for our eventual erasure. In contrast to this deficit-based approach, in this paper I employed an Anishinaabeg research paradigm and followed Anishinaabeg protocols to understand how Anishinaabeg women are creating wellbeing for themselves, their families, and communities through engaging in physical activity. Based on seven interviews with Anishinaabeg women who are engaged in decolonized physicality, the Anishinaabeg women participants promote gwesayjitodoon indo bimaadiziiwin, which means to transform oneself into a better life. The participants showed how if one can apply the concept of gwesayjitodoon indo bimaadiziiwin to his or her physical activity, it has potential to enact broader community wellbeing that can confront the settler colonial deficit lens that requires Indigenous peoples’ erasure, and through which Aboriginal health research has for too long been examined.