The QUO Podcast: Ep 12 - How past policies still affect mental health in remote Aboriginal communities
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Story

The QUO Podcast: Ep 12 - How past policies still affect mental health in remote Aboriginal communities

Stories/801 , Issues/Policy , Issues/Mental Health , Issues/First Nations
Cape York Peninsula, Mapoon QLD 4874
31st May 2021
The QUO Podcast: Ep 12 - How past policies still affect mental health in remote Aboriginal communities

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Dr Ernest Hunter is a psychiatrist who has spent nearly three decades working on the frontlines of mental health in remote Aboriginal communities. For him, examining historical policies is critical in examining contemporary differences in the prevalence of mental health conditions across remote communities in Australia and the Torres Strait.

It is now just over 30 years since the Royal Commission into Aboriginal Deaths in Custody and the overrepresentation of Aboriginal people in custody—one of the key drivers of deaths—has not only continued but increased dramatically. According to Dr Ernest Hunter, a psychiatrist with nearly three decades of experience working in remote Aboriginal communities, the majority of these deaths are suicides.

“If we want to look at increases from deaths from suicide, we have to first understand what the patterns of mortality over time have been,” he says.

His research into death records started over 30 years ago and revealed that there were waves of increased mortality over time that varied between communities. As these are processes embedded in history, one has to ask not just what is happening now, but what preceded it historically.

“We needed to ask questions about the experiences of Aboriginal people across the country and how people who worked in mental health, particularly psychiatrists, have thought about these processes. Paradigms of understanding inform the way you respond,” says Dr Hunter.

The way psychiatrists conceptualised Aboriginal mental health historically cannot be separated from the sociocultural environment and policy framework at the time. It was only in 1967 that First Nations people were able to vote in this country. Therefore, it is not surprising that psychiatrists often approached their work with a sense of exoticism until disturbingly recently. Thankfully, there has been significant progress made in challenging these racists approaches and increased First Nations representation in the medical profession has dramatically altered these paradigms.

“A friend of mine, Professor Helen Milroy, was the first Aboriginal psychiatrist in Australia. She became a psychiatrist 30 years ago,” says Dr Hunter.

In the Cape York region, suicide and severe mental health disorders are significantly more prevalent than in the Torres Strait as well as in other, equally remote Aboriginal communities. According to Doctor Hunter, this is because of the unique historical challenges people living in the Cape York have had to face. Similar to other areas across the country, people in Cape York were subjected to draconian ghettoisation in the form of remote missions situated for bureaucratic expediency. In this region, however, the transition to a sense of quasi-autonomy was particularly frustrating.

“This has significant impacts on the way identity is constructed and there are consequences for substance use and self-harm,” says Dr Hunter.

Some of this is a direct result of specific policies implemented in Cape York. Governments took over missions in the 1960s and they had to face the reality of transitioning these missions to quasi-autonomy, so they created Deeds of Trust. This meant that overnight, communities became theoretically self-governing although they were actually still controlled by the government.

“The government had to fund communities so it diverted commonwealth funds for local purposes by opening alcohol outlets in all of the communities in Cape York and giving the proceeds of the sale of alcohol to community counsels for running costs,” says Dr Hunter.

This case study highlights how communities were made reliant on the sale of alcohol directly because of government policy. When it comes to understanding the unique mental health issues faced by remote Aboriginal communities, historic policy decisions can have huge implications for the ongoing prevalence of specific conditions.

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