Mental Health and Indigenous Connection to Land and Community

Mental Health and Indigenous Connection to Land and Community

Background: Although rates of common mental disorders
(CMD) are acknowledged to be high among community-living Indigenous Australians, the data are derived from self-report. Rates among remote residents are half of those
living elsewhere. Community-based prevalence rates of CMD
derived from diagnostic interviews have not been available.

Objectives: To determine whether Indigenous Australians
living as majorities on traditional lands (‘Reserve’
populations) or in remote areas have lower rates of
current CMD than those living as minorities in mainstream
communities.

Methods: Cross-sectional study (July 2014 to November
2016) involving Aboriginal Medical Service (AMS) clients
(n = 420), community residents (n = 54) and Reserve
residents (n =70). Psychologists conducted a Structured
Clinical Interview for Diagnostic and Statistical Manual of
Mental Disorders, fourth edition (DSM-IV) assessments.

Findings: The standardized rates (95% confidence interval
(CI)) of current CMD were 45.9% (38.8, 47.7) among AMS
clients and 37.5% (32.2, 42.8) among community residents,
4.6-fold and 3.7-fold higher, respectively, than those of the
Australian population (2007 National Survey of Mental
Health and Well Being). Among Reserve residents, the
rate was 25.4% (20.7, 30.2). Only 5.5% (3.0, 8.0) of Reserve
residents had a mood disorder, one-third the rate of the
other two groups. Among a small subgroup (n = 25) of the
n = 544 cohort who resided in remote areas, the rate of
current CMD was 7.5% (4.6, 10.3).

Conclusions: The prevalence of current mental disorders
in this Indigenous population is substantially higher than
previous estimates. The much lower rates among reserve
and remote residents point to the importance of Indigenous
peoples’ connection to their traditional lands and culture
and a potentially important protective factor.

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