Purro Birik - 11

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Purro Birik - (Healthy Spirit)



5.3 Culturally Appropriate Service Provision


The consultations highlighted the many problems that arise when mental health services do not consult with Koori health services when assessing, admitting and planning treatment for Koori people. Questionable diagnosis and prescribing practices, insensitive lines of questioning from clinical staff (particularly doctors), inadequate provision of information about illness, and a sense of feeling vulnerable in an unfamiliar environment are all issues that are believed to impact on service outcomes.


The unwillingness of some mental health services to see Koori people at home or at a Koori health service, poor understanding of the significance of gender and family issues, and the absence of culturally defined healing places were also issues frequently raised throughout the consultation process.


5.4 Service Development Issues


Service development issues were raised consistently throughout the consultations. In the main, these issues related to the need for the development of social, emotional and cultural wellbeing services provided by Koori health services.


The main concerns were that:

  • mental illness carries a heavy stigma within Koori communities;

  • there is no clear Statewide vision for the delivery of social, emotional and cultural wellbeing services;

  • there are a number of serious Social, emotional and cultural wellbeing issues that communities are struggling to respond to, even where strong relationships have been formed with mainstream services (such as suicide and substance abuse);

  • there is an absence of culturally defined healing places which could play an important role in resolving emotional distress;

  • there are insufficient opportunities for Koori health workers to meet and develop effective ways of addressing social, emotional and cultural wellbeing issues;

  • Koori health service general practitioners need to be recognised as having a role in addressing social, emotional and cultural wellbeing issues and in the ongoing management of mental illness medications;

  • the relationship between social, emotional and cultural wellbeing issues and overall community participation in the job market, sport, recreation, housing and so on, needs to be recognised and acted on to promote long term well being;

  • there does not seem to be a clear strategy for providing social, emotional and cultural wellbeing support to Koori people in prison.

Significantly, the perceived need for a distinction between general health workers and social, emotional and cultural wellbeing workers within Koori health services varied between community controlled services. Generally, it was agreed that each Koori health service needs to be able to determine how it will structure its workforce, and that dynamics such as the size of the community, availability of workers with particular skills, and overall funding will affect the level of specialisation that a service undertakes.


The metropolitan consultation clearly endorsed the existing level of service specialisation in place at the Victorian Aboriginal Health Service Mental Health Network. The service is seen as a State, wide specialist mental health service consisting of adult, youth and children's programs with a combination of clinical mental health approaches and social, emotional and cultural wellbeing approaches.



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