Is there a role for prevention in Aboriginal mental health?

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Abstract

Primary prevention is consistently identified as a priority in mental health and Aboriginal health planning. In both areas it has proved to be elusive. Aboriginal mental health therefore presents substantial challenges, particularly in remote Australia. In this paper, two brief case histories are used to demonstrate the limits of conventional psychiatric engagement in such settings and explore the dimensions of social disadvantage that compound psychiatric vulnerability. There are difficulties of primary prevention in mental health generally, and access to mental health services for those most at risk, including indigenous Australians, is unacceptably poor. Proceeding to primary prevention in Aboriginal mental health will, of necessity, include rectifying that situation and addressing the social precursors of mental disorders and distress. Such initiatives will require wide and sustained commitment toward long-term goals, with a focus on children and families, and must include effective substance-abuse strategies.

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Anthropology and Psychiatry

Arthur Kleinman (1987)

To illustrate the contribution anthropology can make to cross-cultural and international research in psychiatry, four questions have been put to the cross-cultural research literature and discussed from an anthropological point of view: ‘To what extent do psychiatric disorders differ in different societies?’ ‘Does the tacit model of pathogenicity/pathoplasticity exaggerate the biological aspects of cross-cultural findings and blur their cultural dimensions?’ ‘What is the place of translation in cross-cultural studies?’ and ‘Does the standard format for conducting cross-cultural studies in psychiatry create a category fallacy?’ Anthropology contributes to each of these concerns an insistence that the problem of cross-cultural validity be given the same attention as the question of reliability, that the concept of culture be operationalised as a research variable, and that cultural analysis be applied to psychiatry's own taxonomies and methods rather than just to indigenous illness beliefs of native populations.