Psychological distress in carers of Aboriginal children in urban New South Wales: findings from SEARCH (phase one)

Williamson, Anna; DʼEste, Catherine; Clapham, Kathleen; Eades, Sandra; Redman, Sally; Raphael, Beverley

doi:10.5694/mja16.00111

Cited by 7 publications

(5 citation statements)

References 62 publications

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“…Building a family support service system that can genuinely cater for complexity is a requirement for all vulnerable families, but nowhere is this most urgent than for Indigenous Australian families, whose greater exposure to adversity is not limited to the social determinants reported here, but includes ongoing and historical traumas related to colonization, separation from families, removal from country, intergenerational trauma, language and culture loss, loss of connection with land, systemic racism, disempowerment, marginalization, and discrimination. A recent paper from the Study of Environment on Aboriginal Resilience and Child Health finds psychological distress to be common in carers of Aboriginal children in Australia and calls for increased funding to Aboriginal Community Controlled Health Services for delivery of mental health services and a focus on social connectedness …”

Section: Discussionmentioning

confidence: 99%

Risks for Mental Illness in Indigenous Australian Children: A Descriptive Study Demonstrating High Levels of Vulnerability

et al. 2017

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Policy Points: The developmental origins understanding of mental illness suggests the possibility of prevention, through addressing childhood adversities.More than 43% of Indigenous Australian children aged 6 to 10 years have 6 or more risk factors for mental illness in adulthood, and 23% are experiencing current psychological distress.Substantial risk is already present in infancy (eg, 67% exposed to 3 or more stressful family life events, and 42.5% are not living with both birth parents).An integrated service system response that can both offer high‐level therapeutic services and address associated multiple adversities, from conception to late adolescence, is urgently needed to address current psychological distress in Indigenous Australian children and to reduce the future burden of mental illness. ContextMental illness is a high source of disease burden across the globe. Mental illness is now understood as largely developmental, with its genesis at least in part in adverse childhood experiences. We sought to estimate the prevalence of childhood risks for poor mental health in Indigenous Australian children, noting that Indigenous Australians by virtue of their history of traumatic colonization and dispossession, child removal, and racism are potentially at greater risk.MethodsWe conducted a descriptive study of the modifiable risks and adversities associated with mental illness in Australian Indigenous children (infancy to 10 years), using data from the Longitudinal Study of Indigenous Children (LSIC), a cohort of 1,671 infants enrolled in 2008 and followed up annually. Risk factors of interest were identified from a comprehensive literature review of childhood determinants of adult mental illness by Fryers and Brugha (2013). The age‐category prevalence of individual risks and a multiple‐risk score were computed using data extracted from 6 waves of LSIC.FindingsThe analytic data comprised 8,378 person‐observations from the first 6 waves. Children in LSIC experience high rates of adversities. In utero, nearly 50% were exposed to smoking and 22% to alcohol. As infants, 42.5% were not living with both birth parents. Over two‐thirds of survey children were in households that had experienced, in the previous 12 months, 3 or more major life events; 22% to 26% lived in households with a drug or alcohol problem; and 18% were exposed to domestic violence (41% were ever‐exposed to age 10). At school, nearly 40% of children were bullied. Over 45% of children aged 6 to 10 years were exposed to 6 or more risks for mental illness. Few children (< 2%) were exposed to low parental warmth and, despite the high exposure to adversities, less than 5% of children report low self‐confidence. This suggests considerable resilience. More than 1 in 4 children had conduct problems in the clinical range and more than 1 in 5 were experiencing high psychological distress.ConclusionsIndigenous children in Australia face extreme levels of multiple disadvantage, exposing many to current psychological distress and high risk of developing me...

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Section: Discussionmentioning

confidence: 99%

Risks for Mental Illness in Indigenous Australian Children: A Descriptive Study Demonstrating High Levels of Vulnerability

et al. 2017

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“…Positive family and community connections are identified protective factors providing emotional strength and resilience, and the absence of these connections has been associated with smoking in other studies and with poor mental health in previous SEARCH analyses. 5,6,9,18,30,31,[39][40][41] In our study, a larger proportion of adolescents who had never smoked regularly lived in places their caregivers described as having a sense of community. Although this was not a statistically significant relationship, its likely importance is indicated by the existing literature and the related measure of housing stability.…”

Section: Discussionmentioning

confidence: 54%

Staying smoke‐free: Factors associated with nonsmoking among urban Aboriginal adolescents in the Study of Environment on Aboriginal Resilience and Child Health (SEARCH)

Heris

Thurber

Wright

et al. 2020

Health Prom J of Aust

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The relation of individual, social, environmental and cultural factors to having 'never' smoked tobacco regularly was examined using Poisson regression.Results: Overall, 83% of adolescents had never smoked regularly; 13 reported current and five past smoking. Most lived in smoke-free homes (60%) despite 75% reporting at least one current smoker caregiver. Participants were significantly more likely to have never smoked regularly if they had good mental health (PR = 1.4, 95% CI: 1.1-1.9), their mother as their primary caregiver (1.3, 1.0-1.6), good family relationships (1.2, 1.0-1.5), stable housing (1.3, 1.1-1.7), had never used alcohol (1.8, 1.3-2.4), were not sexually active (3.1, 1.3-7.2) and had no criminal justice interactions (1.8, 1.2-2.8). Conclusions:Most participants lived in smoke-free homes and the vast majority had never smoked regularly. Promoting good mental health and strengthening social connections may be protective against smoking as those experiencing less social disruption were more likely to have never smoked regularly. Smoking may be an indicator of psychosocial conditions and a prompt for screening and simultaneous treatment.So what?: Organisations should be resourced to deliver holistic adolescent health promotion programs. Programs and policies should support positive family relationships and stable housing as this may protect against the uptake of regular smoking.

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“…Adequate resources can maintain if not prevent ill health outcome [ 20 ]. Effective preventative approaches such as implementing mental health first aid program at rural or urban communities, including but not limited to workplaces or learning environment for general public, teachers and future health professionals [ 21 – 24 ] can be applied in various settings as an early preventative strategy.…”

Section: Discussionmentioning

confidence: 99%

Effect of unaffordable medical need on distress level of family member: analyses of 1997–2013 United States National Health Interview Surveys

Chih

Liang

2017

BMC Psychiatry

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BackgroundReduced funding to public health care systems during economic downturns is a common phenomenon around the world. The effect of health care cost on family members of the patients has not been established. This paper aims to explore the relationship between affordability of health care and vulnerability of family members to distress levels.MethodsData of a total of 262,843 participants were obtained from 17 waves (1997–2013) of the United States National Health Interview Survey. Multinomial logistic regression was used to investigate psychological distress level as a result of having family members who experienced unmet medical needs due to cost.ResultsAmong participants without family members who experienced unmet needs for medical care due to cost, risks of having ‘moderate’ (score of 5–12) or ‘serious’ (score of 13 or above) level of psychological distress were 1.0% and 11.5%, respectively. Risks of having ‘moderate’ or ‘serious’ level of psychological distress were 3.1% and 23.4%, respectively among participants with family members who experienced unmet needs. The adjusted relative risk ratio of ‘moderate’ and ‘serious’, as compared to ‘normal’ level of psychological distress, were 1.58 (95% confidence interval: 1.47–1.69) and 2.09 (95% confidence interval: 1.78–2.45) if one’s family members experienced unmet medical needs.ConclusionsUnmet medical needs due to cost increases risk of distress levels experienced by family members. Careful planning and adequate funding to public health care system could be implemented to prevent any unnecessary detrimental effect on mental health among family members of the unwell and any further increment of the prevalence of mental illnesses. This recommendation aligns with the World Health Organization Mental Health Action Plan 2013–2020.

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Psychological distress in carers of Aboriginal children in urban New South Wales: findings from SEARCH (phase one)

Cited by 7 publications

References 62 publications

Risks for Mental Illness in Indigenous Australian Children: A Descriptive Study Demonstrating High Levels of Vulnerability

Risks for Mental Illness in Indigenous Australian Children: A Descriptive Study Demonstrating High Levels of Vulnerability

Staying smoke‐free: Factors associated with nonsmoking among urban Aboriginal adolescents in the Study of Environment on Aboriginal Resilience and Child Health (SEARCH)

Effect of unaffordable medical need on distress level of family member: analyses of 1997–2013 United States National Health Interview Surveys

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