Aboriginal Mental Health and Economic Rationalism: The Great Misunderstanding

© Michael Kidd, 1998

Faculty of Social Inquiry
University of Western Sydney Hawkesbury

This paper was presented to the Social Justice, Social Judgement Conference, University of Western SSydney in April 1998

Synopsis

Despite the implementation of many of the recommendations of the Aboriginal Deaths in Custody Commission, Aboriginal incarceration around Australia continues to rise and with it deaths in custody.

In the light of general cuts to ATSIC (Aboriginal & Torres Strait Islander Commission) funding, this rise is linked to restructuring of the work force which has affected many traditional Aboriginal jobs leading to increased dislocation and the rise of symptoms of mental illnesses in Aboriginal communities. Most importantly in treatment of mental illness inappropriate “white” concepts of mental illness still prevail. Economic rationalism by seeking efficiency and uniformity at the expense of cultural sensitivity has impacted on Aboriginal well being.

How does economic rationalism compare with the Dreamtime? It is not surprising that the 200 year old law of Adam Smith does not sit well with 40,000 years of Aboriginal Dreamtime.

Compare: Economic rationalisation and main streaming promoting “efficiency and market force” as ends in themselves; and Aboriginal mental health based on acknowledgment of Dreamtime, and suicide prevention and the reduction of depression as ends in themselves.

There is a need to define a caring system for Aborigines based on the latter rather than the former; to develop a specialised Aboriginal mental health system based on traditional concepts.

Definitions:

Mainstreaming : involves two levels a) treating everyone the same regardless of the needs of ethnicity; b) the take over of responsibility for Aboriginal health by non Aboriginal organisations from ATSIC, whether private contractors or State and Federal bodies.

Dreamtime : a term used by and based on the works of Spencer and Gillen and since adopted by Aborigines as some parameter and description of their religion and cultural practices. Spencer and Gillen did not call it a religion because of their own ethnocentrism. (Morphy 1996:163)

Introduction

To borrow from some submissions made last year to the Australian Senate on the proposed ten point Wik legislation:

“The problem confronting us is that of two very different cultures...for Aborigines the meaning of life is based on their relationship to the land..for white people land is generally seen as a means of livelihood to be developed and appropriated for economic gain..for Aborigines (this is) continuous theft of their livelihood, their health..all that is sacred to them”¹.

My experience as a Criminal and Family Lawyer in Aboriginal Legal Services for a total of six years in NSW and Tasmania leads me to detail the case for and make a plea for an Indigenous based mental health service.

1. I make the anecdotal connection underlying many criminal cases (based on my experience of conducting thousands of criminal cases from the outback to the cities of NSW, from the towns of the Northern Tasmania to the islands of the Furneaux Group in Tasmania) between the high incidence of trauma and grief with Aboriginal people being associated with loss of identity.
2. Secondly and more pertinent to the thesis of this paper I frequently found to my astonishment that Freudian, Jungian and other western psychological concepts were being applied to Aboriginal behaviour by doctors, probation officers and psychologists. An indigenous based perspective using Aboriginal Dreamtime concepts to explain and deal with offending was entirely lacking; it had not been taught, and there were almost no Aborigines working in the field.
3. I also met resistance from the Bench particularly in Tasmania when I attempted in making submissions on sentencing to move away from stereotypes into actual rehabilitation based on self respect and dignity. This was in part due to lack of resource for an indigenous based perspective into offending, lack of cultural awareness on the part of lower rank Judicial officers, lack of alternative psychological models other than western based forensic based theories.

Bringing Them Home

Bringing them Home, amongst other recommendations suggest that the States institute Indigenous mental health worker training through Indigenous run programs to ensure cultural and social appropriateness. (Rec 35: 1997 : 397) This was one of the main planks of Ways Forward² some three years previously and it appears according to the Inquiry little has changed in that time.

The Coalition was elected partly on making the health and housing needs of Aborigines a greater priority, and specifically exempted these areas in the Budget cuts of 1996 by telling ATSIC which programs it could preserve. The cost was of the lessening of autonomy for ATSIC, but even so since then Government still has not addressed the fundamental issues.

Firstly, the reason is that the debate is centred on giving Aborigines better European style medicine: the prevailing idea being that if everyone in Australia got the same medical treatment we would be all better off; and frequently the question is not asked what is the most appropriate type of treatment. Secondly mental health has always been the poor cousin of medical service provision generally, and more so since the advent of “community based” treatment in the 1980s.

It is my contention that Aboriginal health is a holistic practice and can not be divorced from culture. Mental health is part of that, and has a broader meaning than that associated by white practitioners and Western psychological theory. It takes in many issues not usually associated with mental health and for Aborigines must be part of primary (preventative) health care run by Aborigines (Bringing Them Home 1997:396 rec 33 a,b,c).

Underlying these health issues is the underlying philosophy of the society that provides the health services: whether there is true commitment to Reconciliation which involves seeing the “other” in a new light and also seeing how the other sees us, and taking responsibility for the conditions which shape the dominant European ways of seeing. It is important to start a process of the questioning of how the dominant culture sees things (Berger 1972:6). Some of these issues will be touched on below.

Suicide and Depression

Suicide prevention and the reduction of depression are the cutting edges of any mental health policy. (Swan & Raphael 1995:II:69) In my opinion, these two areas are where any underlying ill at ease in any society manifests most visibly. In Australia in 1994 before Swan & Raphael's report, approximately 2,400 people suicided an increase of 17% over the year before³. Of these the majority did not want to die but could not see a way out of a particular painful situation:

" Suicide is a process, not only a final act...what they want most is for the pain to go away" ⁴.

How does economic rationalism cost suicide? The point is it does not! ; even though the community might have paid for schooling, health care, housing up to the death of the person. The social effects of economic rationalism have an economic determinant, but this is frequently ignored.

Aboriginal communities have gone through a cycle of dispossession, powerlessness, having their language and culture destroyed since the white man and woman came to Australia. It is not surprising that suicide figures prominently in the equation for some Aboriginal communities in Australia.

Suicide did not figure prominently in Aboriginal communities in the past. Research commissioned by The Royal commission into Aboriginal Deaths in Custody reported :

a) Suicide in Aboriginal populations was most uncommon in the traditional past;
b) Non custodial suicide/attempts are now endemic in some Aboriginal communities;
c) Aborigines in custody are no more likely to suicide/attempt than white people;
d) The high rate of Aboriginal deaths in custody was a reflection of the over-representation of Aborigines in custody.
e) The reason for this over-representation had a lot to do with police and court policy but was also connected to social breakdown in Aboriginal communities due to many reasons⁵.

High demoralisation leads to depression and mental illness. Detailed studies (Swan & Raphael 1995)⁶ have shown a link in Aboriginal communities between childhood disruption, separation from biological parents, employment difficulties and despair:

Clayer et al found that 31% of an urban Aboriginal population had been separated from their parents by age 14; absence of a father and traditional teachings correlated significantly with suicide attempts; 35% were distressed to the level equivalent to a psychiatric case; 35% used non-prescribed drugs; 76% used alcohol (not necessarily to excess); the sample scored highly on the Brief Symptom Inventory of depression.

Radford studied 88 heads of Aboriginal households, and it was remarkable that 90% of whom were women, 50% of whom had been assaulted or bashed, two thirds of these on many occasions; 31% were depressed enough to have serious thoughts of suicide; 18% had serious alcohol problems.

The 1991 NSW Aboriginal Mental Health Report surveyed 1500 Aborigines for the presence of mental health problems and found 23 % resided in the inner city, 19 % resided in a large country town and of these 25% presented with mental health problems associated with stressful life situations⁷.

The above studies were also commented on and adopted in Bringing them Home (1997:193ff).

It is not to say that depression has various causes, but Bringing Them Home⁸ ties it to Aboriginal societal factors such as environmental, upbringing, socialisation and loss of culture through Genocide. According to the classic Freudian view depression is caused by the inability to deal with a certain emotion such as anger, grief, sadness, love or lack of intimacy⁹, but the idea that depression can be caused by loss of culture is an idea that does not readily commend itself to reflection by Europeans from my observations.

From Dreamtime to Nightmare

Family violence is widespread in our Communities. In fact it is one of the major causes of family breakdown..(due to) coping with the loss of their families and the deterioration of their traditional roles..consider how our ancestors lived prior to and after the invasion of 1788, and the violent history of the establishment of Australia, which have contributed to the breakdown of our family life, and our low socio-economic status today¹⁰.

Drawing on the Victorian study in Through Black Eyes¹¹ the following selection of data has bearing on the these above points in the discussion of Aboriginal mental health issues:

70% of assaults on Aboriginal women are in the domestic violence context;
the Victorian Aboriginal Child Care Agency reports over 2,000 cases on file, 75 % of these being related to family violence and child abuse;
50% of Aboriginal children are victims of family violence and child abuse;
in Tasmania 99% of family violence in Aboriginal families is directly related to alcohol¹².

Trauma and grief within the family were identified by respondents in the survey as the most distressing and disabling issues faced by Aboriginal people¹³. As a result suicide , self harming behaviours and risk taking behaviours associated with alcohol and mental disorders are high and rising. Risk taking behaviours particularly among young people, are considered to be as follows:

taking on the police in hide and seek;
engaging in car theft, high speed chases with police;
burglaries;
not wearing seats belts;
drink driving¹⁴.

Alcohol is usually blamed as being a major factor in this apparent breakdown of community cohesiveness, but is only a symptom not the cause. Some misconceptions must be dispelled:

Aborigines do not have a genetic inability to handle alcohol. And are no more liable to get drunk than a Caucasian, everything being equal, with general health, body weight and gender. There is more likelihood of binge drinking and drinking in open spaces. With regard to management of alcohol problems, motivational issues lie at the heart of treatment, which supports Aboriginal drug and alcohol workers being more likely to achieve results than non Aboriginal. (Greeley in Biles:1992:338)

Economic Rationalism

Aboriginal community is not unique with the rising dis-ease in their midst, there has been a general rise in depression drug and alcohol abuse in the Western World. Australia has one of the highest suicide rates for young men (Kidd 1997):

Rates of depression have been doubling in some industrial countries roughly every ten years. Suicide is the second most common cause of death among young adults in North America after car wrecks. 15% of Americans have a clinical anxiety disorder¹⁵.

In Australia the use of anti-depressant medication has doubled in the last few years (ABC Compass 5/4/1998). I postulate that there is correlation between this phenomena and the rise of economic rationalism in the last fifteen years.

The continuing rise in Black incarceration (despite a raft of counter measures and increased spending on Aborigines) is linked to the rise of economic rationalism which has impacted on Aboriginal well being, in a number of ways:

1. After a decade or so of economic reform, the gap between rich and poor has increased and our suicide rate has crept up as well. "Economic rationalism is a disease rampant in the Anglophone countries, distinctly linked with a version of primitive capitalist machismo..this is promoted as the natural state of man and therefore the market mechanism is natural law"¹⁶
2. Despite the implementation of many of the recommendations of the Aboriginal Deaths in Custody Commission, Aboriginal incarceration around Australia continues to rise and with it deaths in custody¹⁷. There is a more fundamental reason for the continued rise of incarceration and associated distress, and that is the continued breakdown of Aboriginal society in the face of economic rationalism. The rise of mental dis-ease, alcoholism and violence.
3. The history of Aboriginal employment participation has been mixed with exploitation by unscrupulous employers and unemployment four times the rate for non-Aborigines¹⁸. The few jobs that are available in Aboriginal communities are associated with community funded government programs which pay little more than the dole.(CDEP). (Norris 1998) Aborigines have been working for the dole long before Europeans. Though these positions teach skills which can be used to compete in the wider Labor market, and provide valuable self esteem so important to mental health and self determination, however, the underlying problem is the loss of traditional ways which can not be addressed by cash economy type jobs even as a precursor to wider job training and job market participation. If these jobs disappear due to Budget cuts the results will show eventually in the incarceration rate. Jobs need to translate into small economic scale enterprises to bring back connection to self and well being. (Schumacher 1974:145)

Aboriginal Psychology v Economic Rationalism

Aboriginal health is intrinsic with Aboriginal Spirituality or Dreamtime. Economic rationalism is synonymous with what I term the cult of the individual. A definition of Dreamtime is not going to be attempted here, as it is very much in the eyes of the beholders and practitioners, but its characteristics compared with Western concepts out of which economic rationalism has grown amongst others are:

1. A framework of myth for the Creation where everyone has a “place”; this idea has largely been discarded in the West, by the idea people have to “earn” a living to get a place. Also we have a form of social Darwinism which eschews “creationism”.
2. A system of black law regulating black society and clans which internalises a) above; whereas it is not clear what motivates Western culture apart from wealth creation; the nuclear family has declined and not been replaced with anything else (Kidd 1988/97).
3. Initiation rituals governing men and women's entry into adult responsibilities; in the West we have some ceremonies¹⁹ for this transition but these are largely ignored.
4. The individual is subject to the group and deviation is punished by various means expulsion (but not destruction of the individual) being the most draconian. In the West it is good thing to succeed preferably on your own and wealth is “kept”. Punishment is formally carried out by an adversarial legal process, which usually favours the rich. Imprisonment is increasingly moving away from rehabilitation to punishment.

The Dreamtime emphasises co-operation, community, sharing of resources; the health of the individual can not be distinguished from the health of the group. How you get to a decision is as important as the decision itself. The means to the end is as important as the end itself.

Economic rationalism essentially shifts resources to the individuals with most economic power under the pretences of greater efficiency belying the fact that these same individuals come in the end to dominate the “free market”. The ends and means become diffuse. “Greed is good” to quote Gordon Gecko²⁰.

As family violence in Aboriginal Australia seems to have become a major mental health issue, economic rationalism is unable to cost this into the balance sheet of reform, as it unable to quantify such things as group cohesion. Under economic rationalism it is important to mine Jabiluka to create jobs and enhance export income particularly after the economic rationalist/market engineered collapse of the Asian economies.

The Dreamtime overrides such far away concepts as the market by emphasising the particular Dreaming of the site, group cohesiveness, perhaps even being against the purpose of uranium mining which is to produce end products which can not be disposed of without a massive impact on the environment and the food chain.

Aboriginal coping mechanisms are different. It is therefore apparent that Western psychological models can not be imposed on Aboriginal mental health issues. In the traditional ( and not so traditional) oriented culture there is strong interplay between bush medicine like witchcraft and taboos and modern psychiatric practice.

Aboriginal coping strategies rely more on expression and communication of feeling and a reliance on a collective coping response. Alcohol facilitates this coping²¹.

" Relatedness " influences the construction of "self ", as in the Aboriginal way self is seen to incorporate ones family and extended clan group. Loss and fragmentation of the group will lead to mental ill health in the individual. Those who were removed as children from their families have a greater susceptibility to mental illness ( Bringing Them Home 1997:193) Alcohol and other forms of abuse of self and others will follow. Self and Aboriginal society are an organic whole. European societies' market mechanism is by comparison a construct²² depending where you happen to be in the mechanism, or for an increasing numbers of Australians outside of the market.

And the young

With respect to the young people (under 15) who constitute 40% of the Aboriginal population there are no mental health programs designed for Aboriginal children and, little or no funding or mental health programs in the Aboriginal Health Services or Children's services²³. This was not however the subject of a specific recommendation of Bringing Them Home, but it is in the juvenile justice area, where in my experience as a lawyer, the major amount of damage is being done to young Aboriginal men (Kidd:1994).

This is an indictment on all levels of Government, but particularly the Federal Government which under our Constitution has primary responsibility for the welfare of Aborigines. It is shameful that it is now seeking to get around self determination (24/3/98 Australian) by out sourcing health funds from ATSIC; but is it an indictment on ATSIC which for the last eight years out of 210 years of European occupation has been charged with Aboriginal health care? I think not. Aboriginal mental health seems to have been always totally neglected, except in acute admissions (Bringing Them Home).

The Great Misunderstanding

I would term this the “Great Misunderstanding” which pervades Government-Aboriginal relations in Australia: of the cultural causes and basis for the phenomena of a Dreamtime at odds with the effects of economic rationalism in Aboriginal communities across Australia. In many ways, economic rationalism is another name (and an inheritor) for various economic and social exigencies forced on Aboriginal people since the invasion.

In summary:

1. Aboriginal health is holistic, and more so mental health. Land and cultural traditional beliefs form the basis of this well being.
2. The history of Aboriginal exploitation can not be divorced from health care.
3. Self determination : the provision of mental health services, must be by Aboriginal workers or health professionals trained in Aboriginal cultural sensitivities.
4. There must be recognition and development of an approach to psychology that is particularly Aboriginal, emphasising reconnection to the Spiritual.
5. Trauma and grief arising from family breakdown, racism, loss of children, high custodial incidence should be specially recognised and appropriate counselling developed.
6. A psychology relating to Aborigines must be developed and fostered as Aboriginal culture has inherent strengths which can be drawn upon.
7. Western models influenced by economic rationalism, or narrow forensic psychology are not helpful.
8. Attempts by the Federal and State governments to take Aboriginal health away from Aboriginal organisations is misconceived and in my opinion is inherently racist for the reasons given above.

In the final analysis the path to healing must be by the individual's recognition of his/her own personal power and responsibility, which can be facilitated by culturally appropriate counselling²⁴.

Notes

(click on this arrow to return to your place in the text)

1) A Statement From Harbour to Hawkesbury Australians For Reconciliation, J. de Voogd, 10 September 1997

2) “Ways Forward” the 1995 Commonwealth Government funded report by P. Swan B. Raphael on Aboriginal mental health was based on widespread consultation and forms the basis for many of the comments in the paper. It emphasises that self determination is the ultimate path to achieving better Aboriginal mental health.

3) Australian 30/11/95, Australian 29/11/95

4) See proceedings of the First Tasmanian Suicide Prevention Conference, September 1995. ( Unfortunately the organisers, Train For Life Enterprises, went broke because of promised funding not eventuating, attended by 300 people from all round Australia).

5) Greeley in Biles, Aboriginal Deaths in Custody Research Paper No14.

6) “Ways Forward” Part ii, P 40.

7) Ibid

8) National Inquiry Into The Separation Of Aboriginal Children “Bringing Them Home”, Human Rights & Equal Opportunity Commission, Australian Government Printers, Canberra.

9) “Analysis of a Case Of Hysteria” by Sigmund Freud in Young-Bruehl.

10) “From Bush Tucker to Poison: Rations” in C. Mattingley (Ed) (1992) Survival In Our Own Land

11) M. Sam (1992) Through Black Eyes: A Handbook of Family Violence in Aboriginal and Torres Strait Islander Communities, SNAICC Victoria.

12) Ibid

13) Ibid

14) Cooling, N. Dr

15) Time Magazine, “The Evolution Of Despair”, September 11 1995

16) Eva Cox in "Beyond The Market"

17) Aboriginal Deaths In Custody Watch Group Annual Report 1997

18) Norris

19) Bar Mitzvah (Jewish) Confirmation (Catholic)

20) The Michael Douglas character in Warner Bros Film “Wall Street”

21) Greeley in Biles : Research Paper No14, P 321.

22) See Hawkins in S H Riggins.

23) P4 “ Ways Forward” Part i and p 39 part ii Ways Forward, also commented on the high(est) detention rate for Aboriginal juveniles Chapter 24 “Bringing Them Home”.

24) "Ways Forward" Part i p10-11.

Some specific models of counselling are suggested as appropriate to Aboriginal families.
a) "Just talking" Training in effective communication emphasising: "I" messages rather than blame, silence, listening, relevance, clarity, delivery, direction, summary. This extends into counselling and contributes in terms of basic skills.
b) " Narrative Therapy" This takes advantage of the oral, story telling tradition of Aboriginal culture. It is based on Narrative Psychotherapy and is a good example of what the two cultures have to offer each other. Carl Jung and the anthropologist Joseph Campbell both emphasised cultural archetypes in story telling as the path to psychological recovery.
c) " Counselling training" for Aboriginal health care workers was initiated at Curtin University in 1993 and needs to be extended and promoted into every State, particularly (my comment) using a basis of clinical as well as theoretical approaches.

Bringing Them Home (p19) refers to the necessity for follow up funding for this program which has been affected by general University cut backs. ("Ways Forward" Part i & ii)

References

Campbell, J (1959) The Masks of God : Primitive Mythology Viking Press

Biles , B & D McDonald Editors (1992) Research Papers: Aboriginal Deaths in Custody 1980-89 Australian Institute of Criminology, Canberra

Berger, John (1972) Ways of Seeing, Penguin Books London

Morphy H, (1996) “Empricism to Metaphysics: In Defence of the Concept of the Dreamtime” in Bonyhady, Tim & Tom Griffiths, Ed. (1996) Mulvanny A Public Intellectual Prehistory to Politics, Melbourne University Press

Cooling, N. Dr:(1994) “The Dangerous Edge- Male Risk taking Behaviours.” in proceedings of the First Tasmanian Men's Health Conference, Burnie Tasmania November 1994 (PO Box 338 Devonport Tasmania 7310).

Human Rights & Equal Opportunity Commission (1997) Guide to Bringing them Home Australian Government Printer, Canberra

Kidd, Michael J (1994): "Juvenile Justice in Northern Tasmania", Internal paper for Aboriginal Legal Service Hobart, paper written for but not presented Juvenile Justice Conference Australian Institute of Criminology (13th April 1994)

Kidd, M.J (1997) “Suicide and gender issues in Young Men” Manhood, Chatswood http://www.manhood.com.au

Kidd, M.J. (1988/97)“Centrepoint An Experiment In Community Living” Centrepoint Magazine Vol 15 November 1997, (PO Box 35 Albany Auckland New Zealand).

Mattingley, C Ed (1992) Survival In Our Own Land: Aboriginal Experiences in South Australia since 1836 as told by Nungas and others, Hodder & Stoughton, Sydney.

National Inquiry Into The Separation Of Aboriginal Children Bringing Them Home, Human Rights & Equal Opportunity Commission Australian Government Printers Canberra.

Norris, Rae “Human rights and Wrongs: Indigenous Employment Past Present and Future” Social Alternatives Vol 17 No2 April 1998 Department of Education University of Queensland.

Rees, S & G Rodley, F Stilwell: (1993) Beyond the Market : Alternatives to Economic Rationalism Pluto Press Sydney.

Riggins, S H (ed) (1990) Beyond Goffman: Studies on Communication, New York: De Gruyter.

Sam, M (1992) Through Black Eyes: A Handbook of Family Violence in Aboriginal and Torres Strait Islander Communities, SNAICC :Secretariat National Aboriginal Islander Child Care, Victoria.

Sanders , MR Ed: (1995) Healthy Families Healthy Nation, Australian Academic Press

Schumacher, E.F. (1974) Small Is Beautiful, Abacus Press, London.

Swan P & B Raphael,(1995) Ways Forward : National Consultancy Report : Aboriginal and Torres Strait Islander Mental Health, Commonwealth Department of Human Services and Health , Canberra,

Young-Bruehl, Elisabeth(1990) Freud On Women Hogarth Press London

The Author

Michael Kidd is a Kiwi, Quaker, Lawyer and PhD candidate who teaches in the University of South Pacific, Fiji. 

This article may be cited as:
Kidd, M.  (1998) 'Aboriginal Mental Health and Economic Rationalism: The Great Misunderstanding' in BEHS2115 Health & Human Behaviour II: Readings, University of Sydney, http://www.behs.cchs.usyd.edu.au/behs2115/kidd98.htm

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