Exploring the expression of depression and distress in aboriginal men in central Australia: a qualitative study.

Alex Brown,Bernadette Rickards,Ushma Scales,Kevin Rowley,Kerin O'Dea,Warwick Beever

doi:10.1186/1471-244x-12-97

Abstract

BackgroundDespite being at heightened risk of developing mental illness, there has been little research into the experience of depression in Australian Aboriginal populations. This study aimed to outline the expression, experience, manifestations and consequences of emotional distress and depression in Aboriginal men in central Australia.MethodsUtilizing a grounded theory approach, in depth semi-structured interviews were conducted with 22 theoretically sampled young, middle aged and senior Aboriginal men and traditional healers. Analysis was conducted by a single investigator using constant comparison methods.ResultsDepressive symptoms were common and identifiable, and largely consistent with symptom profiles seen in non-Aboriginal groups. For Aboriginal men, depression was expressed and understood as primarily related to weakness or injury of the spirit, with a lack of reference to hopelessness and specific somatic complaints. The primary contributors to depression related to the loss of connection to social and cultural features of Aboriginal life, cumulative stress and marginalisation.ConclusionsDepression and depressive symptomatology clearly exists in Aboriginal men, however its determinants and expression differ from mainstream populations. Emotions were understood within the construction of spirit, Kurunpa, which was vulnerable to repetitive and powerful negative social forces, loss, and stress across the life course, and served to frame the physical and emotional experience and expression of depression.

Highlights

Despite being at heightened risk of developing mental illness, there has been little research into the experience of depression in Australian Aboriginal populations
Disparities in health outcomes experienced by Indigenous Australians are as large as those seen in any other high-income country
Ngangkari Tjuta maintain a critical place within the fabric of contemporary Aboriginal life in Central Australia [29], as essential protectors of the community’s wellbeing at times of trouble, sickness, and sadness

Summary

Introduction

Despite being at heightened risk of developing mental illness, there has been little research into the experience of depression in Australian Aboriginal populations. This study aimed to outline the expression, experience, manifestations and consequences of emotional distress and depression in Aboriginal men in central Australia. Growing international interest has focused attention on the need to overcome health disadvantage experienced by the world’s more than 370 million Indigenous peoples [1]. Among the long and seemingly intractable list of determinants, mental health and social and emotional wellbeing loom as critical priorities. Disparities in health outcomes experienced by Indigenous Australians are as large as those seen in any other high-income country. Life expectancy differentials are between 10 and 20 years [2,3]. Indigenous males experience a disproportionate burden of ill health.

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