In the lead up to World Suicide Prevention Day (Sep 10th 2023) and the 2023 Australian Indigenous Voice referendum, I’ve been reflecting on what we can learn from First Nations as a people.
As part of my Master of Public Health, we have been learning about First Nation’s Epistemologies and Cultural Determinants of health and wellness. It had me reflecting on a public health issue close to my heart, suicide prevention, and how we can learn from First Nation’s knowledges and practices to improve current practices.
The facts
Currently, suicide is the leading cause of death for Australians aged 15-44.(1-3) The rates are rising, and Australians are over two times more likely to die by suicide than be killed in a motor vehicle accident.(4)
The numbers scream out to us that what we are currently doing isn’t enough. It also tells me that we cannot afford to view mental health and suicide as anything other than a public health issue.
All humans have the right to the enjoyment of the highest attainable standard of physical and mental health.(5 p. 8) Suicide is a life prematurely lost and leaves lasting effects that ripple onto the family, friends and community of the individual.
Western views of suicide
Traditionally, we have viewed mental health, distress and suicide as an individual problem.(6) This seems to be rooted in Western views of health and wellbeing, that focus on the responsibility of the individual to control their personal health fate.(7)
Western views of health and wellbeing are also often limited to the connection between thought and behaviour. Cognitive behavioural therapy (CBT) is an example of this. While CBT is an important tool in improving mental health, it doesn’t always address the individual as a whole. Another example is the teaching of resilience in health professionals, the logic being that people just need more toughness to get through any difficulty. In actual fact, mental health is often a symptom of our environment, where we are born, grow, live, work, and age. Who we are surrounded with, and the generations before us.(6,8)
First Nations Knowledge
First Nation’s definition of health and wellbeing is more holistic, beyond the socio-economic status, it includes issues like kinship, connection to Country, traditional knowledge, reciprocity, identity, accountability and physical, social, spiritual and emotional wellbeing.(9)
Beyond the individual, First Nation’s knowledge and practices emphasise the importance of relationships and how the individual is part of a greater whole.(9-10) This is evident through the spiritual connection to Country and their relational nature to spirit, spirituality and community.(9-10).
Moving forward
The numbers of Australia show that our current suicide prevention practice isn’t working. I think we could learn from First Nation’s knowledge and practices to implement meaningful change to the way we as a nation approach mental health and suicide prevention. Moving away from placing responsibility on the individual, to strengthening bonds as a community, addressing health inequities and supporting individuals to achieve truly holistic wellbeing.
As we head towards a referendum about The Voice, I hope we can listen to the voice of First Nations and learn.
What do you think?
References
- Dawson A, Verweij MF, editors. The meaning of “public” in “public health.”In: Ethics, prevention, and public health. Oxford: Clarendon Press; 2007. p. 13–29.
- Australian Institute of Health and Welfare. Deaths in Australia [Internet]. Canberra: Australian Institute of Health and Welfare, 2022 [cited 2023 Sep. 1]. Available from: https://www.aihw.gov.au/reports/life-expectancy-death/deaths-in-australia
- Australian Institute of Health and Welfare. Suicide & self-harm [Internet]. Canberra: Australian Institute of Health and Welfare, 2022 [cited 2023 Sep. 1]. Available from: https://www.aihw.gov.au/suicide-self-harm-monitoring/data/populations-age-groups/suicide-among-young-people
- Australian Bureau of Statistics. Causes of Death, Australia [Internet]. Canberra: ABS; 2021 [cited 2023 Sep. 1]. Available from: https://www.abs.gov.au/statistics/health/causes-death/causes-death-australia/latest-release
- United Nations General Assembly. International Covenant on Economic, Social and Cultural Rights. United Nations, Treaty Series, vol. 993, p. 3 [Internet]. 1966 [cited 2023 Sep. 1]. Available from: https://www.ohchr.org/en/instruments-mechanisms/instruments/international-covenant-economic-social-and-cultural-rights
- Fitzpatrick SJ. Reshaping the Ethics of Suicide Prevention: Responsibility, Inequality and Action on the Social Determinants of Suicide. Public health ethics. 2018;11(2):179–90.
- Sherwood J. Colonisation–It’s bad for your health: The context of Aboriginal health. Contemporary nurse. 2013 Dec 1;46(1):28-40.
- Compton MT, Shim RS, editors. The Social Determinants of Mental Health. Washington, D.C.: American Psychiatric Publishing; 2014.
- Kingsley J, Townsend M, Henderson-Wilson C, Bolam B. Developing an exploratory framework linking Australian Aboriginal peoples’ connection to country and concepts of wellbeing. International journal of environmental research and public health. 2013 Feb;10(2):678-98.
- Hart MA. Indigenous worldviews, knowledge, and research: The development of an Indigenous research paradigm. Journal of Indigenous Social Development. 2010 Feb 1;1(1A).