Lip service: Public mental health services and the care of Aboriginal and Torres Strait Islander peoples

Abstract

The failure of public mental services in Australia to provide care deemed culturally safe for Aboriginal and Torres Strait Islander people has persisted despite several national reports and policies that have attempted to promote positive service change. Nurses represent the largest professional group practising within these services. This article reports on a multisited ethnography of mental health nursing practice as it relates to this group of mental health service users. It explores the beliefs and ideas that nurses identified about public mental health services and the services they provided to Aboriginal and Torres Strait Islander people. During the fieldwork, mental health nurses described the constricting effect of the biomedical paradigm of mental illness on their abilities to provide authentic holistic care focused on social and emotional well-being. Despite being the most numerous professional group in mental health services, the speciality of mental health nursing appears unable to change this situation and in many cases maintain this status quo to the potential detriment of their Aboriginal and Torres Strait Islander service users.

Mental health-related emergency department presentations and hospital admissions in a cohort of urban Aboriginal children and adolescents in New South Wales, Australia: findings from SEARCH

“… 24 Further research is required to determine whether this shorter length of stay is consistent with patterns of inpatient mental healthcare for Aboriginal children and adolescents more broadly and, if so, what the factors driving this relatively short length of stay may be. Previous research has highlighted the inadequacies of the biomedical approach to inpatient mental healthcare for Aboriginal people 50 and the discomfort many Aboriginal people report in hospital settings due to racism and a lack of cultural safety. 51 52 Indeed, Aboriginal patients in NSW have been found to report lower levels of satisfaction with several aspects of hospital care.…”

Encounters with difference: Mental health nurses and Indigenous Australian users of mental health services

“…The first paper presented findings related to public mental health service provision and Aboriginal and Torres Strait Islander peoples (Molloy et al . ). In these findings, mental health nurses described their experiences of biomedical hegemony.…”

“…The other themes, ‘biomedical creep’ and ‘lip service’ and ‘a specialist practice’ have been explored in two previous papers (Molloy et al . ,b). The names used for all interviewees are pseudonyms.…”

‘First tonight, the contentious new code telling nurses to say, ‘sorry for being white’: Mental health nurses’ beliefs about their Code of Conduct and cultural safety for Aboriginal and Torres Strait Islander Peoples

“…Despite the increased need for mental healthcare, mental health services have been criticized for not being culturally appropriate (Hunter, 2020;McGough et al, 2018;Molloy et al, 2018;State of Victoria, 2021). Inappropriate models of service delivery and minimal levels of cultural awareness among staff have been identified as barriers for Indigenous service users for over 30 years (Molloy et al, 2019a(Molloy et al, ,2019bWalker et al, 2014).…”