Nursing in the Australian Context

Introduction to Nursing in the Australian Context

The report aims to understand the social determinants of health (SDOH) with respect to the individuals of Aboriginal and Torres Strait Islander (ATSI) communities. The SDOH are the multifaceted situations in which an individual is born and live his life. It has the potential to affect their health (Markwick et al, 2014). They encompass some vague factors that include social, economic, socioeconomic, political, and cultural constructs, along with locality-based circumstances. This entails some easily approachable healthcare system, education systems, well-designed neighbourhoods, safe environmental conditions, and accessibility of healthy food (Braveman, Egerter, & Williams, 2011). The national priority areas that are going to be discussed in this report are the mental health disorders that have been experienced by the ATSI communities.

Part 1: Social Determinants of Health (SDOH)

The SDOH have been structured by the allocation of resources, wealth, and power at local, national, and global levels. The attributes of SDOH engage environment, educations, housing, admittance to health care, employment, good nutrition, access to clean water, and sanitation (Markwick et al, 2014). The health status of the people of ATSI community is deprived and there are certain social determinants that potentially affect their health status. Some of them include the Socio-economic status, unemployment, poverty, exposure to violence, racial discrimination, trauma, and inadequate access to community resources (Markwick et al, 2014). All these factors eventually affect their health status as socio-economic status results in the rise in environmental health risk, poverty leads to food and nutrition crisis, lack of education leads to redundancy, and poor housing has impact on the well-being of people, exposure to violence, racial discrimination often becomes the reason behind the stress and trauma. All of these factors directly and adversely affect the physical as well as psychological health of an individual who belongs to the ATSI community.

There are certain instant as well as some long term impacts of SDOH are the health-related issues faced by the community and these health-related issues are disability, high rate of perinatal deaths, malnutrition, hypertension, diabetes, renal failure, comorbidity, cardiovascular diseases, injury, and violence (Braveman & Gottlieb, 2014). All these issues are the outcomes of cultural, lifestyle, and environmental variables.

Mental health disorders are one among the national priority areas that have been experienced by the individuals of ATSI communities and discussing about the psychological health fissure of the community is an urgent national priority. SDOH have adversely affected the psychological health of the individuals as well as that of the ATSI communities.

Education and literacy is one of the SDOH that impacts on the psychological health of the community. According to Perry et al (2014), people who do not actively participate in educational and literacy programs leads to the non-participation in employment and their chances of being employed and getting a job also reduces this daunts them continuously and results in mental suffrage. Poor psychological health literacy is the prime barrier of seeking help for psychological health issues. Poor literacy leads to high stigmatization and improved literacy reduces the stigma. It has been seen that organizing educational programs positively affect the literacy among the community (Holloway et al, 2016).

Mental distress that is associated with the factors such as cultural and social networks, racism, disadvantage related with socioeconomic interact to have an adverse effect on the health behaviour of the ATSI in an intricate manner. The longing to retain culturally, isolation influence the health risk behaviour of the people (Williamson et al, 2016). Not only this, even good social connections with friends, family, and relatives that are exaggerated by the compulsions of culture, seems to assert and interrupt the positive health behaviour of the community. However, the barrier between the Indigenous and non-Indigenous social association that came forward to be encouraged by the racism and marginalisation manipulates the impact of social networks on community health behaviour (Maar et al, 2011). Also, communication between non-Indigenous and Indigenous people have chances to get interrupted by the disbelief they have for each other, this also diminishes the persuade of some sources of non-Indigenous on Indigenous community’s health behavior (Waterworth et al, 2015).

According to McLafferty et al (2017) mental disorders are considered to be the most solemn problems affecting the social as well as emotional wellbeing of the individuals that belong to Aboriginal and Torres Strait Islanders community. There is a wide range of mental health disorders that adversely affect the social & psychological wellbeing of the ATSI communities. These psychological health disorders have been categorized collectively depending on their type. The major types of mental health disorders comprise of:

  • Anxiety disorders: Those disorders where individual panics and worry about things a lot and often feels anxious, restless, and nervous (Bystritsky et al, 2013).

Examples of anxiety disorders are: Posttraumatic stress disorder and panic disorders.

  • Psychotic disorders: The disorders that transpire when an individual loses contact with reality. Such people often experience some strange changes in their thoughts, emotions, as well as in their behavior. Such individuals often have baffled thoughts, hear strange voices, and see things that are not seen by others (Arciniegas, 2015).

Example of psychotic disorder is Schizophrenia.

  • Mood disorders: The disorders that adversely affect an individual’s mood. Individuals with mood disorders feel ‘low’ or ‘down’ most of the times and some of them also experiences ‘high’ moods (Bystritsky et al, 2013).

Examples of mood disorders: Bipolar disorders and depressive disorders.

  • Substance use disorders: These disorders arise when an individual’s consumption of alcohol or other addictives substances leads to impair their psychological health (Malick, 2018).

Health Promotion Program

Health promotion is the most common and relevant approach in today’s era for addressing the problems of public health. The health circumstances are sited at an exclusive intersection as the world is dealing with a ‘triple burden of diseases’ (Kaur, Prinja & Kumar, 2015). Health promotion programs for of the welfare Aboriginal and Torres Strait Islander communities haven’t been effectively assessed. Most of the programs entail the expansion of the individual skills and the altering personal attitudes without dealing with some other health promotion exploit areas, this includes generating compassionate environments and reorienting the services offered by healthcare system (Canuto et al, 2019).

Healthcare service engaging the individuals of Aboriginal and Torres Strait Islander communities in scheming and bringing the healthcare is one of the ways to deal with the issue. Community engagement is considered to be one of the health promotion programs that have been implemented for setting up the social determinants into places. It aims to improve the health as well as social outcomes by targeting the modifiable factors. Community engagement is a way of working collaboratively, developing partnerships with indigenous people and communities by engaging them on a regular or annual basis; making commitments and establishing agreements will develop the capacity of the individuals and organizations which will result in increasing the literacy and numeracy, reducing the unemployment rate and improving the housing and nutrition (Durey et al, 2016).

Community engagement has been recognized as having a great impending for the betterment of healthcare services, because of its impending for the widespread community participation (Snijder et al, 2015).

The Aboriginal and Torres Strait Islander communities face many issues while accessing the majority of the services. These services comprise of hostile hospital settings, distrust of ordinary health care, lack of transport, and nonflexible treatment alternatives (Snijder et al, 2015). This has led to an overall disinclination for availing the services. It has been reportedly seen that deprived communication from healthcare professionals’ end along with the shortage of Aboriginal workers to provide healthcare services has aggravated this problem. For overcoming this and resolving the same, healthcare services are required to perpetrate to developing the reverential collaboration with the Aboriginal and Torres Strait Islander communities along with augmenting the service facilities to be more receptive, responsible, and approachable to the Aboriginal people (Durey et al, 2016).

The practice of community engagement seems to be helping in avoiding the stigma, because these practices have been demonstrating in order to capitulate sustainable results that are based on the potency of the community members. All in all, community engagement can be considered as a spectrum that starts from informing, consulting, involving, and collaborating with the community members to empower them (Liaw et al, 2011).

For successfully engaging the individuals of the Aboriginal and Torres Strait Islander community in healthcare studies, it is required to build relationships with communities, being deferential and collaborative, having a community occurrence, utilization of enticement, and employing some methodologies of reasonable length that are adaptive as well as flexible. Such community engagement proposes a point of association between the individuals of Aboriginal communities and the local healthcare services that result in better community depiction and contribution to the local healthcare issues. The procedure of engagement also enables a synchronized response from the healthcare service providers to address the health concerns of the Aboriginal community members (Charania & Tsuji, 2012).

However, Community engagement is also built on trust and integrity between the groups of people that have been working together towards shared goals. This engagement occurs through the cooperating with Aboriginal organizations within an agenda of self-determination and Aboriginal control. Along with this, the strategies used should explicitly address the power inequalities, with looking forward and focusing on the genuine efforts for power-sharing by including the agreements of negotiation. However, the staff members working with Aboriginal community members must understand the social as well as cultural context at each position and up to date social fluidity (Snijder et al, 2015).

The main purpose of community engagement is that it can result in improving the health outcomes of the members of the communities. For providing a more clear justification to this, when an institution is seeking for the objectives, apprehensions, beliefs, and values of a community; and the community share their objectives, apprehensions, beliefs, and values with the institution; and these objectives, apprehensions, beliefs, and values of the community are integrated into the process of decision-making; the institution is able to congregate the requirements of the community in a better way - fundamentally as an outcome of being better conversant. Ascertaining an effectual collaboration between the individuals of Aboriginal community and service systems need a larger sense of possession larger take-up of services, along with the better health outcomes for the community. As a result of approaches and intrusions that have been tailored into the unique objectives, apprehensions, beliefs, and values of that community will result in improved health outcomes for community members. So, for this, all those who have been involved in such a procedure would be conversant by the principles of uprightness, enclosure, reflection, and persuasion (Australian Institute of Family Studies, 2016).

Conclusion on Nursing in the Australian Context

From the report, it can be concluded that community engagement is a health promotion technique that has the potential to improve the release of evidence-based healthcare promotion. This has been done not just by engaging vanguard healthcare practitioners in process of decision-making but also involving the community members regarding designing/redesigning the systems of healthcare s for supporting the execution of best practice involved with the promotion of healthcare. On the other hand, further and persistent progress in healthcare promotion needs broader engagement of senior staff, management, and local community member for addressing the managerial as well as policy level barriers.

References for Nursing in the Australian Context

Arciniegas D. B. (2015). Psychosis. Continuum, 21(3), 715–736.

Australian Institute of Family Studies. (2016). Community engagement: A key strategy for improving outcomes for Australian families. Retrieved from:

Braveman, P., & Gottlieb, L. (2014). The social determinants of health: it's time to consider the causes of the causes. Public Health Reports, 129 (2), 19–31.

Braveman, P., Egerter, S., & Williams, D. R. (2011). The social determinants of health: Coming of age. Annual Review of Public Health, 32, 381-398.

Bystritsky, A., Khalsa, S. S., Cameron, M. E., & Schiffman, J. (2013). Current diagnosis and treatment of anxiety disorders. Pharmacy and Therapeutics, 38(1), 30–57.

Canuto, K. J. et al. (2019). A scoping review of Aboriginal and Torres Strait Islander health promotion programs focused on modifying chronic disease risk factors. Health Promotion Journal of Australia, 1(29).

Charania, N.A., & Tsuji, L.J. (2012). A community-based participatory approach and engagement process creates culturally appropriate and community informed pandemic plans after the 2009 H1N1 influenza pandemic: remote and isolated First Nations communities of sub-arctic Ontario, Canada. BMC Public Health, 12, 268.

Durey, A., McEvoy, S., Swift-Otero, V., Taylor, K., Katzenellenbogen, J., & Bessarab, D. (2016). Improving healthcare for Aboriginal Australians through effective engagement between community and health services. BMC Health Services Research, 16, 224.

Holloway, E. M., Rickwood, D., Rehm, I. C., Meyer, D., Griffiths, S., & Telford, N. (2016). Non-participation in education, employment, and training among young people accessing youth mental health services: demographic and clinical correlates. Advances in Mental Health, 16(1), 19-32.

Kaur, M., Prinja, S., & Kumar, R. (2015). Evaluating the performance of health promotion interventions. The Indian Journal of Medical Research, 142(2), 109–112.

Liaw, S. T., Lau, P., Pyett, P., Furler, J., Burchill, M., Rowley, K., & Kelaher, M. (2011). Successful chronic disease care for Aboriginal Australians requires cultural competence. Australian and New Zealand Journal of Public Health, 35(3), 238-248.

Maar, M. A. et al, (2011). Thinking outside the box: Aboriginal people’s suggestions for conducting health studies with Aboriginal communities. Public Health, 125(11), 747-783.

Malick R. (2018). Prevention of substance use disorders in the community and workplace. Indian journal of Psychiatry, 60(Suppl 4), S559–S563. JPsychiatry_24_18

Markwick, A., Ansari, Z., Sullivan, M., Parsons, L., & McNeil, J. (2014). Inequalities in the social determinants of health of Aboriginal and Torres Strait Islander People: A cross-sectional population-based study in the Australian state of Victoria. International Journal of Equity Health, 13.

Markwick, A., Ansari, Z., Sullivan, M., Parsons, L., & McNeil, J. Inequalities in the social determinants of health of Aboriginal and Torres Strait Islander People: A cross-sectional population-based study in the Australian state of Victoria. International Journal of Equity in Health, 13(91).

McLafferty, M., et al. (2017) Mental health, behavioural problems and treatment seeking among students commencing university in Northern Ireland. PLoS ONE, 12(12), e0188785.

Perry, Y. et al. (2014). Effects of a classroom-based educational resource on adolescent mental health literacy: A cluster randomised controlled trial. Journal of Adolescence, 37(7), 1143-1151.

Snijder, M., Shakeshaft, A., Wagemakers, A., Stephens, A., & Calabria, B. (2015). A systematic review of studies evaluating Australian indigenous community development projects: the extent of community participation, their methodological quality and their outcomes. BMC Public Health, 15, 1154.

Waterworth, P., Pescud, M., Braham, R., Dimmock , J., & Rosenberg, M. (2015) Factors influencing the health behaviour of indigenous australians: Perspectives from support people. PLoS ONE, 10(11), e0142323.

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