Richard Akbar: Mental Health Support Worker, Derbarl Yerrigan Health Service, WA

email Richard

Introduction

My name is Richard Akbar an Aboriginal descendent from the Wongi people of the Laverton, Leonora district in WA.

I am employed by the Derbarl Yerrigan Health Service and work as a support worker in the mental health program.

Before I begin I would like to acknowledge the following.

Firstly to the elders and the traditional owners of this land for allowing me to be here. To the organisers who made this conference possible and to my team mates from the Mental Health Support program who have given me the opportunity to be here today.

Also I would like us all to reflect and give a thought for those Australians who have gone to the aid of the East Timor people. May they return safely to their families when their task is completed.

Today I would like to talk to you about mental health and how it effects Aboriginal men and their masculinity. Also I would like to explore some of the problems they encounter. In the second part of my presentation I will talk about the work I do and about the Derbarl Yerrigan Mental Health Support program. Finally I would like to give a personal view about the future and how we can work towards giving better health to Aboriginal men.

The problem

Mental Health is fast becoming the growing epidemic that will test the resources and resolve of health professionals as we approach the beginning of a new century.

For Aboriginal an Torres Strait Islander people its continued rise as a major health problem could if not addressed put us on a path that may see us disappear as a people within 150 years.

Masculinity: the meaning

Let us first look at the meaning of masculine.

In the Australian Oxford Dictionary it describes the word masculine as 1. Of or characteristic of men. 2 Manly vigorous.

These words in themselves do not describe what we may see as masculine qualities or how we perceive masculinity.

I would like to offer some words that could reflect what society might see as ideally masculine.

Strong

Protective

Confident

Kind

A worker

A provider.

Now some words that are associated with how the men I see present themselves.

Fearful 

Confused

 Ashamed

 Angry

 Lost

Not qualities we could describe as ideally male or masculine.

To understand where these words come from we need to look at the clinical aspects of the problem and then some of the underlying and historical and current social issues that effect Aboriginal men.

The most common or major diagnosis of mental illness fall into three areas these are.

Schizophrenia – Major Depression – Bipolar disorders.

Mental disorders due to a general medical condition.

Examples

Sexual dysfunction – Sleep disorder – Mood disorder

Psychotic disorder – Amnestic disorder

Dementia – Delirium.

Substance related disorder.

Examples

Alcohol – Amphetamines – Caffeine

Cannabis – Hallucinogens – Inhalants

Nicotine – Phencyclidine ( Angel Dust )

Sedatives, hypnotics or Anxiolytics

Poly Substances.

Looking at the clinical problems the ones that are more prevalent to the men I work with are Schizophrenia, Major depression, Sexual dysfunction, Sleep disorder, Mood disorder, Psychotic disorder, and Substance related disorders.

Lets now look at the other underlying factors social and historical that effect Aboriginal men with a mental illness.

Historically the effects of colonisation and the repercussions to us as the first people of this land can only be described in terms of a psychological trauma that we are still suffering.

In relation to health of Aboriginal men we are still dying twenty years earlier than our non-aboriginal brothers. Smoking and related disease are our number killer. In my view I see suicide and deaths in custody as the other factors that are effecting our health and our role as men in our own families and the Aboriginal community.

There are social factors that also influence how Aboriginal men view their masculinity. The removal from traditional land, removal from biological parents and family, forced urbanisation and marginalisation. Loss of political voice is also something to be considered when we look at the social issues that Aboriginal men are trying to come to terms with.

In many instances Aboriginal men no longer see themselves as the warrior, providers for their families or role models in their own community. Rather as welfare dependents with no voice and if suffering from mental illness no real future.

The work

Having looked at the problem I would like to speak a little about the work I do and the program I am involved in.

I am a team member of the Derbarl Yerrigan Health Service – Mental Health Support Program. The program began in 1995 as a joint initiative between Ruah Inreach and the Derbarl Yerrigan Health Service. For some you may know Derbarl Yerrigan Health Service by its old name the Perth Aboriginal Medical Service.

In 1998 the team then known as ACSS or Aboriginal Community Support Service moved from Ruah to the Derbarl Yerrigan Health Service’s new premises and took on our current name.

We have two separate teams with a total of nine personnel. The teams are a mix of non-–aboriginal and aboriginal workers. A more detailed picture of our structure can be found in our handbook.

Ours is an Inreach support service working with Aboriginal people who have a diagnosed mental illness.

As a worker I have both female and male clients for whom I provide support in helping them to cope with the medical psychosocial and social issues associated with their illness.

As an aboriginal man I also have a vested interest in helping other aboriginal men in need of help to heal themselves.

The work I do is one on one intensive support but also may require me working in partnership with other family members. Both the clinical and social problems these men present with are complex.

There is no definitive answer as to how I address these problems, as each case is different. Probably the most effective tool I have is being able to develop a relationship based on trust. Also because we are able to work longterm with the client continuity of contact has an advantage. Another distinct feature in being able to assist these men is the ability in our program to cross boundaries not only geographically but also across the different services.

Which means we are not restricted to a purely medical focus but can use a broader range of skills allowing us a more holistic approach to our work.

The Future

Future work in my area and its continued success will ultimately be something that our clients determine.

It is hard for me as a worker to predict what outcomes will emerge but I remain optimistic.

Ideally continued partnerships and a cooperative approach between aboriginal an non-aboriginal agencies needs to continue.

In regards to Aboriginal men and those men I work with there is a need for more of our men to become involved in their care.

Currently there is a move amongst us to reclaim our sense of masculinity in the form of men’s meetings. The most recent being the 1st National Indigenous Male Health Convention held at Ross River Homestead. Unfortunately I was unable to except the offer to speak because of work commitments.

However I was able to attend the first men’s business meeting held with men from the Derbarl Yerrigan Health Service last month. To my knowledge this was the first time that a group of Indigenous men working within one aboriginal health organisation in Perth has been given that chance. For that I thank those with the vision to make it happen and for the support of the women who maintained the service while we were away.

In conclusion the future health of Aboriginal men lies within.

We cannot do it alone but given the tools and the time we can improve our own health.

When that time arrives and we achieve the health status of our non-indigenous brothers then we will stand together united. Giving us the confidence to strengthen our culture, our families, the community and ourselves.

email Richard

---------------------------------------------------------

Aboriginal Population Perth Mandurah Region

Census ATSI figures suggests that there were 16,966 Aboriginal people living in the Perth Mandurah region.

This was 33.4% of WA total indigenous population.

Finance

21% of house holds in Perth and Mandurah received less than $300.00 as there weekly income. This figure is for total population but a significant percentage of Aboriginal families living in the Perth Mandurah area would be included in that 21%.

Deaths in Custody

In 1990 there were 11 black deaths in custody. In 1995 there were 22 deaths

Rate per hundred thousand in 1990 7.1

In 1995 it was 11.6

Ref: Indigenous Deaths in Custody Published Oct1996.

Suicide

A Report On Men’s Health 1996 by the School of Public Health Curtin University said the following.

Young aboriginal males have a higher rate of suicide than that of non-aboriginal males.

Figures suggest this to be twice as high probability of suicide in aboriginal males.