Country and community vs poverty and conflict: Teasing apart the key demographic and psychosocial resilience and risk factors for Indigenous clinic-referred children and adolescents

Abstract

Objective: Indigenous young people are known to have adverse demographic and psychosocial factors affecting worse mental health outcomes and some household factors aiding resilience. In Australia, there has been no exploration of these factors in clinically referred Indigenous young people assessed in a culturally appropriate way. Methods: A total of 113 Indigenous children and adolescents, 217 non-Indigenous young people, age, gender, mental disorder symptom severity, symptom-linked distress and impairment matched, and 112 typically developing participants, age- and gender-matched were recruited. Cultural validity and reliability of the impairing symptoms in Indigenous young people were determined. Key demographic and psychosocial factors were compared across the three groups. Results: The Indigenous clinical group differed significantly from the other two groups that did not differ on three possibly protective measures examined. Key demographic and psychosocial risk factors in the Indigenous group differed significantly from the non-Indigenous clinical group which in turn differed from the typically developing participants. The three groups exhibited a progressively increased magnitude of difference. Conclusions: It remains imperative to nurture features that provide protection and enhance resilience for Indigenous young people and their communities. Indigenous status is linked to significant demographic and psychosocial disadvantage over and above that conferred by clinical impairment and its management. It is crucial that these features are managed and/or advocated for with those demographic and psychosocial factors of the greatest magnitude dealt with first. Future systematic investigations of the contribution of these key factors to mental health referral pathways, assessment and management are needed.

Dissonance, Disagreement, Difference: Challenging Thematic Consensus to Decolonise Grounded Theory

“…The team resisted pursuing consensus, allowing these differences to be important findings that shaped the second stage of the project: the development of an adjuvant mental health therapy based on cultural practices within a Western hospital for young people with mental health difficulties. This has been discussed in more detail in another publication (Vance et al, 2023).…”

“…There was also a lack of consensus about whether culture can be integrated into Western care or whether it is wholly different and must stand alone. Consequently, the team has published an overview that presents key shared findings (Vance et al, 2023), but a number of other papers that tease out these variation findings are in press or development.…”

‘Doing culture’ in contemporary south-eastern Australia: how Indigenous people are creating and maintaining strong cultural identities for improved health and wellbeing

“…The project also sits within a broader national research program led by an Indigenous academic and medical doctor. Further details about the study design are available in the research team's earlier publications [9,10,59,[67][68][69][70][71][72][73][74][75][76]. The project was approved by the Royal Children's Hospital Human Ethics Committee (2019.207/56941).…”

“…Aboriginal and Torres Strait Islander people -the Indigenous people of Australia -continue to experience far poorer health than their non-Indigenous counterparts [8][9][10]. While the gap in some areas appears to be narrowing, the most recent data indicate there is still a long way to go before Indigenous Australians achieve health parity with non-Indigenous Australians.…”