Week 6: Social and Emotional Weelbeing Flashcards
What is the difference between social and emotional wellbeing and mental health and illness?
Social and emotional wellbeing is a holistic view of wellness which incorporates community and social determinants of health
It is a comprehensive concept including service provision, knowledge system and worldview
Recognises the impacts of colonisation, trauma and racism
Mental health and illness is based on the individual and the medical aspect of health
What is the Aboriginal worldview of depression?
Not recognised as depression, seen as struggling to live
Types (medication cannot fix many of these, requires SDH changed): Masked: smiling but feeling sad Vital: somatic Ill-health: chronic disease Alcoholic Ill-use: person has experienced abuse Rage Fearful: anxiety Shameful: out of experience of racism or incarceration Exhaustion: carer burden Loss: grief Social: living in poverty, difficult life circumstances
Where Western worldviews of depression focus on thoughts and ideation, Aboriginal focused on the heart
“a silent heart”: ‘do I want to live?’ heart is unable to answer
Asking about suicidal thoughts is ineffective
Wandering is a powerful healing practice for a silent heart
What is the Aboriginal worldview of anxiety?
“Anxiety” not used in language
“Worry”
Symptoms: feeling frightened unable to sleep spirit of fear stomach fear shaking watchfulness paralysis (spirit of stone)
Nursing response to spirit of stone: swaddle with warm blankets and provide rest, hot tea, no talking
How do you provide cross-cultural care?
‘Being with’ a person, walking alongside them
Begin with acknowledge of their Aboriginality and introduce yourself
Have family present, or if unable to, acknowledge as if they are there
Encourage story telling
Allow for waiting time, give enough time for a sad heart to answer
Be cautious seeking a developmental history: likely to be trauma, concept of time may go in circles
Be cautious of seeking a drug use history: shame
How to Aboriginal people usually present for mental health issues?
Come from concerned family, rather than patient
Late in course of illness
Psychotic disorders more often than anxiety/depression
Substance abuse rarely presented as primary issue
Somatisation common but rarely responded to
Children rarely presented
How can you help healing?
Acknowledgement: pain, stress, trauma Healers, healing places, healing houses Aboriginal health workers ACCHS Mistrust is part of the therapeutic relationship: identify it Respond to somatisation Mindfulness Recognise hostility as anxiety 'Help' is not always trusted, better to say 'trying to make something better'
