Diversity

Rural/Remote

Mitchell, J. (1999). From telehealth to e-health: The unstoppable rise of e-Health. Canberra: Commonwealth Department of Communications, Information Technology and the Arts. http://archive.dcita.gov.au/1999/09/rise

Useful summary of the development of e-health in Australia and the importance of this for providing health support to diverse and widely located communities.

Procter, Nicholas (2005). Beyond Words: Lessons on translation, trust and meaning. Aust. Govt. Dept. of health and Aging, under the National Mental Health Strategy. http://www.mmha.org.au/find/resources/library/beyondwords

A valuable resource that provides a model for delivery on promoting mental health issues and learning from culturally diverse communities. It is based on the successful “No more ‘mualagh” project which worked with the Afghani community to help Afghani people living in rural Australia learn more about depression, how it is treated and how to safely use medicine their doctors prescribe them.

Quinn, K. (2003). “Rural suicide and same-sex attracted youth: Issues, interventions and implications for rural counsellors”. International Electronic Journal of Rural and Remote Health Research, Education, Practice and Policy, 3, pp. 1-6.

Outlines how living in remote locations impacts upon same-sex attracted youth. Considers issues that arise from lack of access to resources, mistrust of health care professionals in regards to anonymity and confidentiality, and availability of information about safer sex. The paper proposes that the internet may be an important tool for accessing information and support, but that this will obviously be mediated by the cost and availability of internet access, and also the issues of privacy and familial support involved.

Rajkumar, S. & Hoolahan, B. (2004). “Remoteness and issues in mental health care: Experience from rural Australia”. Epidemiologia e Psichiatria Sociale, 13, pp. 78-82.

Explores the issues that arise for accessing services for those in remote communities. Pays particular attention to the ways in which race and class intersect in remote communities, and outlines some of the specific issues that face those living in remote areas that may lead to suicide. Explores how issues, risk and crises may be compounded in remote communities, with little attendant access to multiple types of health service. Suggests that higher rates of suicide in remote areas also results from the changing face/success of farms in regards to economics.

Ethnicity

Burman, E., Chantler, K. & Batsleer, J. (2002). “Service responses to South Asian women who attempt suicide or self-harm: Challenges for service commissioning and delivery”. Critical Social Policy, 22, pp. 641-668.

Excellent paper that outlines how gender, race and racism impact upon service provision to at risk South Asian women living in Manchester, UK. The paper draws attention to the need for examining intersections of race and gender, and outlines how this often results in ‘functional neglect’ within the health care system. The paper challenges the assumption that ‘minority women’ should be cared for solely by ‘minority women’, thus questioning the marginalisation of certain cultural groups within the health care system. This focus on culture also demonstrates how abuse is often ignored when it is attributed to ‘cultural difference’. Usefully outlines the difference between ‘normalised absence’ and ‘pathologised presence’ in the representation of non-white people in health care services. Suggests that we need to further examine how the dominance of white health care models (which see culture as an ‘add-on’) fails to meet the needs of minority group members: thus need to examine the normative status of whiteness in health care.

Burvill, P.W. (1995). “Suicide in the multiethnic elderly population in Australia, 1979-1990”. International Psychogeriatrics, 7, pp. 319-333.

Outlines the relationship that may exist in relation to immigrant suicide as resulting from conflicts between traditional sociocultural values and those promoted in the new country. Suggests that suicide rates and means may change as a result of length of time living in new country, though also suggests that traditional values still predominate. Suggests focus on polyethnic status of society rather than promoting rhetoric of multiculturalism. Elaborates some of the problems with cross-cultural comparison as a result of differing meanings of suicide and different methods of reporting.

Campbell, D., Moore, G., & Small, D. (2000). “Death and Australian cultural diversity”. In A. Kellehear (Ed). Death and dying in Australia. Oxford: Oxford University Press.

Important chapter that highlights the normative status of white culture within the Australian health care system, and examines the implications of this for working with people from non-white cultures. Draws attention to the culturally specific meanings surrounding death and dying, and challenges white practitioners and workers to explore their own cultural location. Challenges the notion that the answer to working with culturally diverse communities is to simply employ bicultural workers or to engage in cultural awareness training. Explores how cultural issues may impact both on patients and on their families.

* Davis, Martha, Paleg, Kim & Fanning, Patrick (2004). The messages workbook: Powerful strategies for effective communication at work and home. Oakland, CA: New Harbinger Publications Inc.

“The workbook guides you through challenging communication situations like talking through a power dynamic with a boss or a subordinate, or communicating with elders or people of different cultures.”

* Fernando, Suman (2003). Cultural diversity, mental health and psychiatry: The struggle against racism. Hove & New York: Brunner-Routledge.

“[The author] weaves together themes of immense importance for the future of psychiatry and mental health services in a multi-cultural setting, exploring:

  • the nature of racism and its permeation into mental health services
  • the inside story of the struggle against racism in statutory and voluntary sectors of the mental health system
  • the history of psychiatry and the role of spirituality, holistic thinking, psychotherapy and Asian traditions of medicine.”
* Holiday, Adrian, Hyde, Martin & Kullman, John (2004).

Intercultural communication: An advanced resource book. London: Routledge.

Indigenous

Chandler, M.J. & Lalonde, C.E. (2004). “Transferring whose knowledge? Exchanging whose best practice?: On knowing about Indigenous knowledge and Aboriginal suicide”. In D. Beavan & J. White (Eds). Aboriginal Policy Research. London: Althouse Press.

Explores the relationship between non-indigenous knowledge production and the knowledge of Indigenous communities. Critiques homogenous constructions of non-white cultures and questions the utility of statistics that subsume multiple groups. Questions the imposition of non-indigenous knowledge about suicide onto Indigenous communities and outlines how access to sovereignty rights may mediate suicide rates in Indigenous communities.

Steenkamp, M. & Harrison, J.E. (2000). Suicide and hospitalised self-harm in Australia. Injury Research and Statistics Series. Adelaide: AIHW (AIHW cat no. INJCAT 30). http://www.nisu.flinders.edu.au/pubs/reports/2001/suicide_injcat30.pdf

“This is a statistical report on suicide and hospitalised self-harm in Australia. It includes data on age and sex distribution and methods used, and presents trends for suicide deaths. The report also includes information on suicide among Indigenous Australians and describes the shortcomings of the data and the implications for interpreting the information. It will be relevant to those interested in data on suicide or those working in the field, including community practitioners, health planners and administrators, academic researchers and the public.”

* Tatz, C. (2001). Aboriginal Suicide is Different. Canberra: Aboriginal Studies Press.

An important text that outlines some of the different forms, contexts and motivations within which suicide may occur in Indigenous communities. Draws attention to the role that cultural factors play, and in particular those that are imposed upon Indigenous communities by non-indigenous people. Does this in part by examining the moral values that are associated with suicide in Western societies. Questions the scientific method for examining suicide and the predominant association that is presumed to exist between suicide and mental health problems, and outlines an anthropology of suicide.

* Vicary, David (2000). “Developing a Culturally Appropriate Psychotherapeutic Approach with Indigenous Australians”. Australian Psychologist, 35, 3.

Many Australian psychologists have little information about how to perform culturally appropriate assessment and therapy with Aboriginal clients. This article explores relevant history that affects the psychological health of Aboriginals, and contrasts the western perspective on mental health with Aboriginal beliefs. A case study is used to illustrate a process that might be used by non-Aboriginal therapists when working with Aboriginal clientele. The case study contrasts a culturally sensitive approach with common western psychotherapeutic processes. Recommendations for the enhancement of culturally appropriate therapeutic interventions are discussed.

Sexuality

Fergusson, D.M., Horwood, L.J. & Beautrais, A.L. (1999). “Is sexual orientation related to mental health problems and suicidality in young people?”. Archives of General Psychiatry, 56, pp. 876-880.

Outlines some of the debates over [lesbian, gay, bisexual] LGB suicide, and provides research that whilst demonstrating a relationship between identification as LGB and suicide behaviour, continues to point towards the importance of examining multiple factors involved in suicide. Acknowledges that results and apparent relationship between sexuality and suicide may be mediated by poor measures.

Peel, E. (2001). “Mundane heterosexism: Understanding incidents of the everyday”. Women’s Studies International Forum, 24, pp. 541-554.

An excellent elaboration of how discrimination operates in society in very subtle ways in regards to sexuality. Demonstrates how discrimination may often be very implicit, but no less dangerous for those who experience it.

Quinn, K. (2003). “Rural suicide and same-sex attracted youth: Issues, interventions and implications for rural counsellors”. International Electronic Journal of Rural and Remote Health Research, Education, Practice and Policy, 3, pp. 1-6.

Outlines how living in remote locations impacts upon same-sex attracted youth. Considers issues that arise from lack of access to resources, mistrust of health care professionals in regards to anonymity and confidentiality, and availability of information about safer sex. The paper proposes that the internet may be an important tool for accessing information and support, but that this will obviously be mediated by the cost and availability of internet access, and also the issues of privacy and familial support involved.

Skegg, K., Nada-Raja, S., Dickson, N., Paul, S. & Williams, S. (2003). “Sexual orientation and self-harm in men and women”. American Journal of Psychiatry, 160, pp. 541-546.

Whilst this paper does acknowledge the potentially important gender differences in regards to suicide amongst same-sex attracted populations, and despite its claim to clearly define and operationalise its terms of reference, the paper fails to explore the subjective meanings of both same-sex attraction and suicide. This leaves the paper open to being potentially used to legitimate pathological understandings of same-sex attraction, as it focuses on an individualised relationship between same-sex attraction and mental health problems or suicidal behaviours, rather than paying adequate attention to issues of social discrimination and oppression as they impact upon same-sex attracted men and women.

Gender

Langhinrichsen-Rohling, J., Lewinsohn, P., Rohde, P., Seeley, J., Monson, C.M., Meyer, K.A. & Langford, R. (1998). “Gender differences in the suicide-related behaviours of adolescents and young adults”. Sex Roles, 39, pp. 839-854.

Discusses the types of risky behaviours and suicide behaviours that are engaged in by young adults, and outlines the gender specificity of these behaviours.

Frank, E. & Dingle, A.D. (1999). “Self-reported depression and suicide attempts among US women physicians”. American Journal of Psychiatry, 156, pp. 1887-1894.

Gender differences in suicide behaviour among physicians: female physicians may have higher rates than the general population of females, whilst men may be relatively the same. Lists some of the factors that may underlie this phenomenon, and highlights the role that increased access to lethal means may play.

Age

Burvill, P.W. (1995). “Suicide in the multiethnic elderly population in Australia, 1979-1990”. International Psychogeriatrics. 7, pp. 319-333.

Outlines the relationship that may exist in relation to immigrant suicide as resulting from conflicts between traditional sociocultural values and those promoted in the new country. Suggests that suicide rates and means may change as a result of length of time living in new country, though also suggests that traditional values still predominate. Suggests focus on polyethnic status of society rather than promoting rhetoric of multiculturalism. Elaborates some of the problems with cross-cultural comparison as a result of differing meanings of suicide and different methods of reporting.

* Davis, Martha, Paleg, Kim & Fanning, Patrick (2004). The messages workbook: Powerful strategies for effective communication at work and home. Oakland, CA: New Harbinger Publications Inc.

“The workbook guides you through challenging communication situations like talking through a power dynamic with a boss or a subordinate, or communicating with elders or people of different cultures.”

De Leo, D., Hickey, P.A., Neulinger, K. & Cantor, C.H. (2001). Ageing and Suicide. Canberra: Commonwealth Department of Health and Aged Care. Provides extensive statistics and summaries of suicide rates and means in Australia.

Outlines the key motivations that underpin suicide in aged communities, and draws attention to providing support for those bereaved by aged suicide.

Kennedy, M.A., Parhar, K.K., Samra, J. & Gorzalka, B. (2005). “Suicide ideation in different generations of immigrants”. Canadian Journal of Psychiatry, 50, pp. 353-356.

Questions the assumption that acculturalism mediates suicide rates amongst immigrant communities. Explores the impact that culture clash (between younger people and older people who have immigrated) may have on suicide rates.

Lawrence, D., Almeida, O., Hulse, G., Jablensky, A.V., Holman, C.D.J. (2000). “Suicide and attempted suicide amongst older adults in Western Australia”. Psychological Medicine, 30, pp. 813-821.

Investigates the relationship between mental health concerns and suicide amongst older adults. Findings suggest that older adults who commit suicide have an increased likelihood to have been in contact with mental health services prior to their death. Elaborates some of the other factors involved in suicide among older adults.

War Veterans

Australian Institute of Health and Welfare (2000). Morbidity of Vietnam veterans: A study of the health of Australia’s Vietnam veteran community. Suicide in Vietnam veterans’ children: Supplementary Report no. 1. AIHW cat. no. PHE 25. Canberra: AIHW.

Useful summary of the role that war service may play in the lives of children of veterans. Highlights the increased risk that exists within this community and explores some of the reasons for this.

Bullman, T.A. & Kang, H.K. (1996). “The risk of suicide among wounded Vietnam veterans”. American Journal of Public Health, 86, pp. 662-667.

Outlines some of the factors that may be involved in higher suicide rates amongst Vietnam veterans. Discusses implications for developing prevention programmes aimed specifically at this population.

O’Brien, K. (2004). “The intergenerational transference of Post-Traumatic Stress Disorder amongst children and grandchildren of Vietnam veterans in Australia: An argument for a genetic origin: Review of current literature”. Paper presented to the Social Change in the 21st Century Conference, Centre for Social Change Research, Queensland University of Technology, 29 October.

Interesting examination of the effects of PTSD from war veterans upon their children. Elaborates the increased risks of poor health and suicide amongst children of war veterans and highlights some of the reasons for this.

Thoresen, S., Mehlum, L. & Moller, B. (2003). “Suicide in peacekeepers”. Social Psychiatry and Psychiatric Epidemiology. 38, pp. 605-610.

Interesting study of the rates of suicide amongst peacekeepers. Findings shown that suicide rates are still higher than the general population even when peacekeeping work is voluntarily chosen. Elaborates some of the factors that may relate to increased suicide risk amongst this population.

Refugees

Dudley, M. (2003). “Contradictory Australian national policies on self-harm and suicide: The case of refugees in mandatory detention”. Australasian Psychiatry, 11, pp. 103-108.

Very insightful paper on the conflict between government suicide prevention programmes and the policy of mandatory detention. Elaborates the extremely high rates of suicide and suicidal behaviour within detention centres, and explores some of the causes for this.