Over this semester I found the whole process of this unit of study to be very interesting and highly educational, but overall the two themes that I found the most compelling and seem to have shone above the rest me were themes of Social exclusion and the discriminatory nature of western practices. It is to this point that I am providing a holistic approach to unpacking the social perspectives about the themes of social exclusion and the discriminatory nature of Western mental health practices are interwoven with the link between diagnosis and trauma.
For me, we must consider the two main factors that are contributing to said social exclusion in the mental health system. The first is that there is a level of interwoven discrimination within the mental health system that is embedded institutionally when dealing with Aboriginal and Torres Strait Islander people and women from other Culturally and linguistically diverse backgrounds. The second main factor is social exclusion through the existence of profoundly negative instances of stigmatization and discrimination that occur within some ethnic communities regarding the language and labeling used through the depiction of mental illness that happens when trying to interact with the topic of mental health as a whole and especially to the people who are experiencing symptoms that match a diagnosis within those communities which highlights the negative effects in which diagnosis imposes which ultimately further connects to the overarching effects of trauma.
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Initially, I began to center my reflection on assessing the level of disparity that exists within the mental health system and how it particularly affects indigenous and culturally and linguistically diverse people, not only confronting but truly alarming, so we must recognize and assess conversely how social exclusion relates to the nature of western practices and the history behind it, particularly in the wake of European settler-colonialism and the long-lasting effects which have trickled down.
Equally, I have recognized that this is explained by delving into Australia's history of colonization through the considerable amount of trauma which has profoundly affected Aboriginal and Torres Strait Islander people in the form of dispossession of land, removal of children, family separation and displacement, and loss of culture. Resulting in increased levels of stress and anxiety (Human Rights and Equal Opportunity Commission Report, 1997, p.324).
Having analyzed the historical, cultural, social, and economic contexts of Guerin & Guerin (2012, p.555) of First Nations people It is clear that with that comes the need and importance of acknowledging the existence of a racialized social structure “where health care providers ‘willingly and unwillingly, knowingly and unknowingly’ subjugate Indigenous knowledge (epistemology), beliefs (ontology) and values (axiology) to the hegemonic western biomedical model at the level of policy and practice” (Durey, 2011, p. 2). This not only serves in being another tool that erodes First Nations people of their autonomy but also can the hegemonic nature of the Western biomedical model as it ignores the fact that connection to land, culture, spirituality, family, and community are important to First Nations people's mental health.
Furthermore, I when shifting back to the crux of my first main argument which will highlight how the disparity and the interwoven discrimination in the mental health system are linked to social exclusion, particularly regarding indigeneity. It is clear that both historically and currently Aboriginal children are often current victims of past policies and practices this is blatantly displayed by the child removal rates of Indigenous children from their families which has continued to have long-lasting effects such as depression and anxiety due to the separation process from their family it creates a sense of alienation and isolation.
It is to this point that is my understanding that not only is this a contemporary form of colonialism through which it evidently strips the remnants of agency from Indigenous people and their communities respectively. However, it conversely serves to echo Ferdinand et al. (2015) point that experiencing discrimination & social exclusion through isolation can lead to the risk of psychological distress it also allows for one to consider that 'some behaviors and mental illness (e.g. depression and anxiety) may be reactions to racism, dispossession, and disadvantage' (Vicary & Westermen, 2004, p.3).
But as a future social worker ultimately it is my job to understand the intersectionality between the discriminatory nature of the mental health system and recognize it as a by-product of the recurring theme that is social exclusion and the trickle-down effects of colonial history and its overarching impact on Aboriginal and Torres Strait Islander people is evident through recorded trauma and diagnosis.
Subsequently when looking at the social exclusion and the discriminatory nature of Western mental health practices women from Culturally and linguistically diverse backgrounds. Drawing upon the knowledge and understanding I have gained from both Brown (2019) and Ferdinand et al. (2015) it is apparent that large racial disparities in the mental health treatment system exist, as by taking into account the theoretical framework between the intersectionality of race and gender regarding the dominant socially constructed discourses of depression, self-management, and gender via the use of African American women and depression.
Something that I have also noticed is the existence of dominant and racialized socially constructed discourses of depression, self-management, and gender. This exists through the enforcement of traditional gender roles, leading to women’s entrenchment into the notion of “the good woman” by focusing on passiveness and reliance through the obligation to assume the care of others and unpaid domestic labor.
This is problematic as it can lead to social exclusion through a discriminatory assumption that women are expected to be resilient when feeling distressed and this is particularly important when looking at the disparity within the mental health system and how it matters toward women of certain ethnic backgrounds as being more resilient. I find this alarming as the presumptive nature of the discourse within the mental health system goes without recognizing the chain of effects it can cause, which include the experience of negative life events, insecure housing tenure, more chronic stressors, and reduced social support networks.
When assessing the socially exclusionary nature that diagnosis can impose and its connection to the overarching effects of trauma. I have recognized that by using the example of women experiencing postpartum depression being seen as 'lacking a connection with their child, cold, disinterested” or other negative views due to a societal expectation of women based upon attachment theory, which may in turn cause women already experiencing ‘emotional distress’ and ‘emotional difficulties’ to feel worse due to social impacts and the stigma placed on said, “lack of connection” (Brown, 2019, p. 151 -155).
As a future social worker in my practice, I would strive to shift the focus on women's depression from the context of pathology as it decontextualizes the person and allows for progress beyond the rigidity of the bio-medical outlook. By making the recommendation of implementing a feministic framework to approach making efforts to strive for societal gains in gender development through social policy amendment, along with the advocacy for women's rights and governmental investment in programs focusing on women. That aims to tackle the issue of social exclusion and disparity within the mental health system.
Equally, as a person of color and a social work student, upon reflection, I found that the theme of social exclusion can occur through the existence of profoundly negative instances of stigmatization and discrimination that occur within some ethnic communities to be compelling as well I have seen it happen first hand within my community that both the person dealing with mental health issues can
This could include both internal and external forms of stigmatization, as such by acknowledging that varying attitudes towards mental illness exist and how factors such as cultural and religious teachings can shape and influence individuals, families, ethnicities, and countries in regards to the source and nature of the mental illness, this can lead to the formation of attitudes towards people who may be mentally ill. This can create this us v them mentality and promote notions of extreme othering thus leading to social exclusion through alienation/ and solation created due to fear.
Alternatively, I have recognized that “through the process involving the contributions of others, that being the social environment & society “ (Topor, et al 2011, p. 90), I may be able to strategically combat the ways in which social exclusion due to mental health can be difficult however an example could be as a social worker engaging in developing community programs that serve in educating and promoting discourse surrounding mental health as people from ethnic minority communities may be facing cultural barriers as well as perceived normative understandings.
Ultimately as a social worker as Topor et al. (2011) highlight that is our role to help clients, build Relationships, by providing adequate material conditions & responsive services and support systems.
Reference List:
- Brown, C. (2019). Speaking of Women’s Depression and the Politics of Emotion. (Viewpoint essay). Affilia Journal of Women and Social Work, 34(2), 151–169.
- Commonwealth of Australia. (1997). Bringing them home: Report of the national inquiry into the separation of Aboriginal and Torres Strait Islander children from their families. https://www.humanrights.gov.au/our-work/education/bringing-them-home-community-guide-2007-update
- Durey, A., & Thompson, S. C. (2012). Reducing the health disparities of Indigenous Australians: time to change focus. BMC health services research, 12(1), 151.
- Ferdinand, A., Paradies, Y., & Kelaher, M. (2015). Mental health impacts of racial discrimination in Australian culturally and linguistically diverse communities: a cross-sectional survey. (Survey). BMC Public Health, 15(1), 401. https://doi.org/10.1186/s12889-015-1661-1
- Guerin, B., & Guerin, P. (2012). Re-thinking mental health for indigenous Australian communities: communities as a context for mental health. Community Development Journal, 47(4), 555–570. https://doi.org/10.1093/cdj/bss030
- Topor, A., Borg, M., Di Girolamo, S., & Davidson, L. (2011). Not Just an Individual Journey: Social Aspects of Recovery. International Journal of Social Psychiatry, 57(1), 90–99. https://doi.org/10.1177/0020764009345062
- Vicary, D., & Westerman, T. (2004). That’s just the way he is: Some implications of Aboriginal mental health beliefs. Australian e-Journal for the advancement of mental health, 3(3), 103-112.
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