Ways forward: national Aboriginal and Torres Strait Islander mental health policy
This plan provides an overview of Mental Health Services in the Northern Territory. This is constituted by a network of services organised into seven districts. Districts are responsible for identifying and meeting service needs and supervising staff. While the Centre Program Directorate is responsible for formulating goals and objectives, developing policies and procedures and monitoring goal achievements.
Community based services are provided in all districts and encompass assessment, treatment and continuing care. Services include consultation, liaison, community outreach, and accommodation services. In smaller Districts (Darwin Rural, Alice Springs Rural, Katherine, East Arnhem and Barkly) services are provided by Community Psychiatric Nurses, and in some Districts, Aboriginal Health Workers. The community staff provide visiting services to remote communities in their Districts. Districts are visited on a regular (4-6 weekly) basis by a Psychiatrist from either Darwin or Alice Springs. Darwin and Alice Springs have full Community based multidisciplinary teams for assessment, treatment and ongoing management of people with mental health problems and mental disorders. Living skills, social skills training and other day rehabilitation programs are provided. In Darwin there is also a specialist Child, Adolescent and Family Therapy Team. This provides both direct service and consultation and Liaison to hospitals and other agencies. There is also a Forensic Team in Darwin, and limited Child and Forensic services are provided by the community team in Alice Springs. There is no psychiatric hospital but there are 12 acute, 10 rehabilitation and 10 secure beds in Darwin, and 7 acute, 5 rehabilitation, and 0 secure beds in Alice Springs. There are also 8 transitional beds in Darwin. There is no stand alone psychiatric hospital in the Territory. Current Services vary substantially across districts and are both mainstreamed and integrated.
Services are distributed as far as possible to the population areas delineated below.
Table 5: Estimated prevalence of mental disorder in the NT
ABS Statistical Subdivision
Aboriginal and Torres Strait Islander population
Total population Northern Territory
Number of people with a mental disorder
|Lower Top End NT|
It is estimated, in general, that this service treats about one percent of the population (see 1992–93 Mental Health Act report) and using Andrews' conservative estimate of the treated prevalence rate of 3% this suggests that only one of the population who would be receiving treatment is so doing.
With respect to the Aboriginal people 68.9% reside in rural areas. The 1992-93 report indicates that a total of 172 Aboriginal people were admitted to hospital with 91 into Royal Darwin and 80 into Alice Springs. This was one third of the total numbers in Alice Springs and 16% of those in Darwin. There appears to be no other data available on other utilisations.
It is intended that the plan will continue to fulfil the 1992 National Mental Health Policy principles that notes several issues relevant to Aboriginal Mental Health. The need to address cross cultural issues is emphasised, both for Aboriginal people and the significant numbers of people from ethnic backgrounds.
A key Territory objective is to increase the participation of Aboriginal people in the delivery of Mental Health Services. The draft discussion paper on "Aboriginal Mental Health Training: Identifying the Need' proposes that a mental health curriculum should be developed in conjunction with educational institutions. Pilot training programs in Aboriginal Mental Health, and Aboriginal Mental Health Worker positions will be further developed. As well cultural training for Department staff will be actively developed. In terms of workforce development Aboriginal Mental Health workers will be identified as a new category of Clinical Staff.
Research developments in terms of Aboriginal Mental Health Research are also seen as a priority with the Northern Territory being ideally placed to research this field. There is currently underway a project to develop a measure to assess depression in Aboriginal people (Dr Kyaw, Rural Psychiatrist).
Future directionIt is proposed that the service will continue to provide "a comprehensive, accessible Mental Health Service that encapsulates the concepts of primary, secondary and tertiary prevention, and which is provided in the least restrictive way" (p25).
The relatively recent establishment of this service means that the emphasis is on development rather than reform.
It is proposed that a resource allocation model will be developed to ensure the equitable distribution of mental health resources across the Territory. It is believed that the establishment of Aboriginal Mental Health Workers positions will enhance access. Community services will be enhanced through formalising case management and supplying additional staff, particularly to refine outreach and accommodation services. Community education will also be enhanced.
A specific Objective and Strategy was proposed by the Northern Territory Report with respect to Aboriginal Mental Health as well as other strategies which will be relevant.
Objective 14: Increase participation of Aboriginal people in service delivery
Strategy: To negotiate for Aboriginal Health Workers and Aboriginal Mental Health Workers and to develop and implement pilot training programs and packages and to establish positions by the end of 1995.
Indicators would be the number of positions.