Purro Birik - 7

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Purro Birik - (Healthy Spirit)



4.3 Two Service Systems - Koori Health and Mental Health


The aims and objectives of the services which mental health and Koori health organisations set out to provide, and the context those services are provided in, are essential elements that need to be taken into account to establish well targeted protocol and partnership arrangements.


The mental health service system (in the main provided through public hospitals) and the Aboriginal (Koori) health system (generally provided through Aboriginal community controlled organisations) operate from significantly different service models.


The mental health system was primarily set up to respond to the needs of people experiencing serious mental illness and/or a severe level of associated disability. The Koori health system was developed to respond to the primary health care needs of Koori communities on an open door basis. Its service model is based on a holistic definition of health. The definition of health endorsed by VACCHO states:


Health does not simply mean the physical wellbeing of an individual but refers to the social, emotional and cultural wellbeing of the whole community. For Aboriginal people this is seen in terms of the whole of life view incorporating the cyclical concept of life-death-and the relationship to the land. Health care services should strive to achieve the state where every individual is able to achieve their full potential as a human being of their community. (NACCHO 1996)


Community controlled Koori health services provide a centre for the provision of a diverse range of health services within a holistic philosophy. The range of programs varies from one service to another, and may include social and emotional support, health information, basic counselling, transport and other practical support, dental and general practitionaer services, home and community care (HACC) services, referral and advocacy to mainstream services, crises support, carer support and in some instances, case management and/or activity-based programs for particular issues. Given that the service philosophy is holistic, people are not excluded from receiving support on the basis of fitting a program criteria.


Mental health is defined within the holistic context of Koori health as encompassing issues of social, emotional and cultural wellbeing. Consequently, the Koori working definition of mental health includes working with the emotional distress and the social and cultural dislocation which arose out of previous Government policies. In practice this means that community need relating to alcohol and drug problems, mental health problems, youth suicide, domestic violence, and homelessness (to name a few issues) are responded to within a holistic framework through the provision of social, emotional and cultural wellbeing services. This model takes into account that on some occasions referral to mainstream specialist services will be necessary, and that large Koori health services serving large communities may develop some areas of specialisation.


The Koori health system and the mental health system clearly have different approaches to service provision. In effect, mental health services are a specialist mainstream service which occasionally need to be accessed by Koori people to address specific mental illness/psychiatric disability issues, while Koori Health Services set out to provide a holistic primary and preventative healthcare service based on the VACCHO endorsed definition of health. (see above)



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