Social and Emotional Wellbeing

The term social and emotional wellbeing is used by many Aboriginal and Torres Strait Islander people to describe the social, emotional, spiritual, and cultural wellbeing of a person. The term recognises that connection to land, culture, spirituality, family, and community are important to people and can impact on their wellbeing. It also recognises that a person’s social and emotional wellbeing is influenced by policies and past events.

Another term that is often used when discussing wellbeing is mental health. Mental health is a term that has been used a lot, mainly by non-Indigenous people, to describe how people think and feel, and how they cope with and take part in everyday life. People are often thought of as being mentally healthy when they don’t have a mental illness (when people become unwell in the mind and it affects their thinking, feelings, and behaviour).

Many Aboriginal and Torres Strait Islander people believe that mental health and mental illness focus too much on problems and don’t properly describe all the factors that make up and influence wellbeing. Because of this, most Aboriginal and Torres Strait Islander people prefer the term social and emotional wellbeing as it fits well with a holistic view of health. The best way to understand these different terms is to think of mental health and mental illness as part of a person’s social and emotional wellbeing.

What are the factors impacting on the social and emotional wellbeing of Aboriginal and Torres Strait Islander people?

There are many different factors that can impact on a person’s social and emotional wellbeing. These can range from normal everyday stresses to major life events.

For Aboriginal and Torres Strait Islander people, a number of events in the past have had a serious ongoing impact on their social and emotional wellbeing. These include dispossession from their lands (loss of lands), and the impact of the policies and actions that followed, such as the forced removal of Aboriginal and Torres Strait Islander children from their families and homelands.

Professor Helen Milroy, an Indigenous psychiatrist, describes three important themes to come from an analysis of Aboriginal and Torres Strait Islander history. They include: ‘the denial of humanity, the denial of existence and the denial of identity’ (see Zubrick et al., 2005).

Also of importance to the social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples are the general disadvantages experienced by Aboriginal and Torres Strait Islander children and adults in the areas of education, employment, income, and their overall position in Australian society. These areas, which are some of the important ‘social determinants of health’, are linked with many other external stresses. These stresses include serious illnesses and disability, higher levels of death in the family/community, overcrowded houses, substance use problems, violence, discrimination and racism, trouble with police, and being sent to jail and/or having a family member who has been sent to jail.

What are the mental health problems impacting on the social and emotional wellbeing of Aboriginal and Torres Strait Islander people?

The most serious mental health problems impacting on the social and emotional wellbeing of Aboriginal and Torres Strait Islander people are mental illnesses (also called mental disorders). There are many different mental illnesses that can affect a person’s social and emotional wellbeing. These mental illnesses have been grouped together depending on their type. The main types of mental illnesses include:

  • anxiety disorders – these are disorders where people worry a lot or often feel edgy and nervous. Examples include panic disorders and posttraumatic stress disorder
  • mood disorders – these are disorders that affect a person’s mood. People will often feel ‘down’ or ‘low’ in mood and some people also experience very ‘high’ moods. Depressive disorders and bipolar disorders are types of mood disorders
  • psychotic disorders – these disorders occur when a person loses touch with reality and experiences unusual changes in their thinking, emotions, and behaviour. The person may have confused thoughts, hear voices, or see things that others can’t. Schizophrenia is a type of psychotic disorder
  • substance use disorders – these disorders occur when a person’s use of alcohol and/or other substances causes them problems but they continue to take the substance anyway.

Only a trained and qualified health professional can confirm whether someone has a mental illness. This decision is based on the person meeting a strict set of criteria (the person must show a certain number of signs/symptoms for a certain period of time). It is common for people to show some signs of a mental illness but not enough for them to have a mental illness. It is important that these people are also offered help and support because the signs/symptoms could get worse and really affect their social and emotional wellbeing.

In addition to mental illnesses/disorders, there are other problems that can impact on the social and emotional wellbeing of Aboriginal and Torres Strait Islander people. These include:

  • grief and loss
  • trauma
  • self-harm
  • suicidal thoughts and behaviours.

While these problems are not mental illnesses, they can be a sign or symptom of a mental illness and have a serious impact on a person’s social and emotional wellbeing.

How do you measure social and emotional wellbeing?

As with health generally, it is very difficult to provide an overall ‘measure’ of social and emotional wellbeing. Because of this, measurement tends to focus on the reasons why people are not mentally healthy, and the factors contributing to the reasons why their mental health is not so good.

Mental health problems – and the factors contributing to mental health problems – relate to individuals, but they are often measured by looking at their occurrence in a population. These measures attempt to give an overall picture of:

  • how common various mental health problems and stressors are
  • how mental health problems are managed in terms of primary health care and hospitalisation
  • the impact of mental health problems, including death.

How common are mental health problems among Aboriginal and Torres Strait Islander people?

The exact extent of mental health problems among Aboriginal and Torres Strait Islander people is not known, but there is evidence that:

according to the 2012-13 Australian Aboriginal and Torres Strait islander Health Survey (AATSIHS), almost one-third of Aboriginal and Torres Strait Islander adults  reported feeling high or very high levels of psychological distress in the previous year ref=26817.

The 2014-15 National Aboriginal and Torres Strait Islander Social Survey (NATSISS) found that the most common causes of stress for Aboriginal and Torres Strait Islander people were ref=32429:

  • death of a family member or close friend (28% of people surveyed)
  • not being able to get a job (19%)
  • serious illness (12%)
  • other work-related stressors (11%)
  • mental illness (10%).

Education level, employment status and high levels of stress can affect a person’s social and emotional wellbeing ref=29665:

  • Aboriginal and Torres Strait Islander people who had only a year 9 education were more likely to experience high or very high levels of psychological distress compared with those who were educated to year 12 (34% compared with 26%).
  • Aboriginal and Torres Strait Islander people who were unemployed were more likely to experience high or very high levels of psychological distress compared with those who were employed (42% compared with 22%).

Positive feelings, like feeling calm and peaceful, happy, full of life, and having energy, have a positive impact on a person’s SEWB:

  • 91% of Aboriginal and Torres Strait Islander people reported feeling happy either some, most, or all of the time ref=28644
  • around half of Aboriginal and Torres Strait Islander people rated their satisfaction with life as at least 8 out of 10 (Derived from ref=32430).

‘Mental and behavioural disorders’ is the term used to classify different types of mental illnesses. ‘Mental and behavioural disorders’ were responsible for almost 20,000 hospital admissions of Aboriginal and Torres Strait Islander people in 2015-16 (around 4% of all hospital admissions of Aboriginal and Torres Strait Islander people) ref=33073. Hospital admissions for ‘mental and behavioural disorders’ were almost two times higher for Aboriginal and Torres Strait Islander people than for non-Indigenous people.

There are sub-categories for ‘mental and behavioural disorders,’ and Aboriginal and Torres Strait Islander people are admitted to hospital more often because of some of these sub-categories than non-Indigenous people ref=33152:

  • hospital admissions for ‘psychoactive substance use disorders’ were almost four times higher for Aboriginal and Torres Strait Islander people than non-Indigenous people during 2013-15
  • hospital admissions for ‘schizophrenia, schizotypal and delusional disorders’ were almost three times higher for Aboriginal and Torres Strait Islander people than non-Indigenous people during 2013-15.

Mental illnesses contribute to the deaths of some Aboriginal and Torres Strait Islander people. The most recent statistics show that 385 Aboriginal and Torres Strait Islander people died from these conditions between 2011 and 2015  ref=33152. (See our webpages on self-harm and suicide for specific information about these conditions.)

Please note the term ‘mental illness’ has been used in place of ‘mental disorder’ and ‘psychological disorder’ because it is a more common term.

References and further reading

References

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Untitled by Donna Lei Rioli

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