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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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