Social And Emotional Wellbeing Research Articles

Building on the Definition of Social and Emotional Wellbeing: An Indigenous (Australian, Canadian, and New Zealand) Viewpoint

AbstractThis article will build on the definition of social and emotional wellbeing (SEWB) used within an Indigenous health framework. We intend to distance it from its current discipline of mental health, the Eurocentric term commonly used in social science literature. This is to emphasize that, within Aboriginal (Rudder and Grant, 2005) and Torres Strait Islander, Maori, and First Nations (Canadian) languages, there is no specific word for “health.” Indigenous peoples from within these countries have a holistic view of health that encompasses the physical, mental, emotional, and environmental spectrum of wellbeing. This article therefore uses “social and emotional wellbeing” rather than the generic Eurocentric terms of “health” or “mental health” to give this a stronger Indigenous voice. The elements of social and emotional wellbeing are discussed from an Indigenous viewpoint and from extracts compiled in work undertaken by Sutherland (2017). The elements explored may offer new perspectives to others. Similarly, this article offers an explanation as to why elements are siloed within the context of mental and physical health. This has led to some parts of SEWB gaining advantages over others within policy and funding models.

Does ethnic-racial identity modify the effects of racism on the social and emotional wellbeing of Aboriginal Australian children?

ObjectivesThis study investigates the protective role of ethnic-racial identity (ERI) affirmation on the longitudinal association between racism and Aboriginal Australian children’s social and emotional well-being (SEWB).Methods408 children from the K-Cohort of the Longitudinal Study of Indigenous Children were included in the analysis. Data were collected through questionnaire-guided interviews at 7–10 and 9–12 years of age. Children’s racism experience, SEWB (Strengths and Difficulties Questionnaire), and confounding were reported by caregivers. ERI was reported by children and dichotomized into high versus low. Generalized linear models with log-Poisson links and robust errors were used to estimate adjusted Risk Ratios (RRa) for the effect of racism on SEWB domains. Effect-measure modification analysis was used to verify differences on effect sizes per strata of ERI affirmation. The presence of modification was indicated by the Relative Excess Risk due to Interaction (RERI).ResultsSlightly above half (51.4%) of the children presented high ERI affirmation. Children exposed to racism and with low ERI affirmation were at increased risk of hyperactive behavior (RRa 2.53, 95% CI 1.17, 5.48), conduct problems (RRa 2.35, 95% CI 1.07, 5.15), and total difficulties (RRa 1.73, 95% CI 0.84, 3.55). Positive RERIs indicated the joint effects of racism and low ERI affirmation surpassed the sum of their separate effects in these domains. Children with high ERI affirmation were at increased risk of peer problems (RRa 1.66, 95% CI 0.78, 3.52).ConclusionsThese findings suggest that ERI may mitigate the risk of poor SEWB due to racism. Fostering affirmative ERI can be an important strategy in promoting resilience in Aboriginal Australian children.

Holistic Conceptualizations of Health by Incarcerated Aboriginal Women in New South Wales, Australia.

While there has been extensive research on the health and social and emotional well-being (SEWB) of Aboriginal women in prison, there are few qualitative studies where incarcerated Aboriginal women have been directly asked about their health, SEWB, and health care experiences. Using an Indigenous research methodology and SEWB framework, this article presents the findings of 43 interviews with incarcerated Aboriginal women in New South Wales, Australia. Drawing on the interviews, we found that Aboriginal women have holistic conceptualizations of their health and SEWB that intersect with the SEWB of family and community. Women experience clusters of health problems that intersect with intergenerational trauma, perpetuated and compounded by ongoing colonial trauma including removal of children. Women are pro-active about their health but encounter numerous challenges in accessing appropriate health care. These rarely explored perspectives can inform a reframing of health and social support needs of incarcerated Aboriginal women establishing pathways for healing.

‘Baby Coming – You Ready?’ An audacious innovation to perinatal social and emotional wellbeing assessment screening and supportive management for vulnerable parents-to-be

This study explored the risk of antenatal psychosocial distress (APD) and associated potential factors and examined management aspects of risk of APD in women attending Aboriginal primary health care services in Australia.Audits of medical records of 797 pregnant women from 36 primary health centres in five jurisdictions (NSW, QLD, SA, WA and NT) were undertaken as part of a quality improvement programme. Information collected included mental health assessed by a standard screening tools, enquiry regarding social and emotional well-being (SEWB), depression management (including antidepressant medications) and referral.Around 18% (n= 141) of women were at risk of APD based on assessment using a standard screening tool or by SEWB enquiry. There was a significant association between risk of distress and women’s life style behaviours (e.g., alcohol, illicit drug use) and health centre characteristics. Of the 141 women, 16% (n= 22) were prescribed antidepressant drugs during pregnancy. A range of nonpharmaceutical mental health interventions were also recorded, including brief intervention of 61% (n= 86), counselling of 57% (n= 80) and cognitive behaviour therapy of 5% (n= 7). About 39% (n= 55) of women with APD were referred to external services for consultations with a psychiatrist, psychologist or social worker or to a women’s refuge centre.The higher risk of APD associated with women’s life style behaviour indicates that the better understanding of mental health in its cultural context is essential.

The conduct of Australian Indigenous primary health care research focusing on social and emotional wellbeing: a systematic review.

Systematic review in accordance with PRISMA Guidelines and MOOSE Guidelines for Meta-Analyses and Systematic Reviews of Observational Studies. We searched four databases and one Indigenous-specific website for qualitative, quantitative and mixed-method studies published since Values and ethics was implemented (2003). Included studies were conducted in primary health care services, focused on Indigenous SEWB and were conducted by research teams. Using standard data extraction forms, we identified actions taken (reported by authors or identified by us) relating to Values and ethics and local protocols. A total of 25 studies were included. Authors of two studies explicitly mentioned the Values and ethics document, but neither reported how their actions related to the document's values. In more than half the studies, we identified at least three actions relating to the values. Some actions related to multiple values, including use of culturally sensitive research processes and involving Indigenous representatives in the research team. Local protocols were rarely reported. Addressing Values and ethics appears to improve research projects. The academic community should focus on culturally sensitive research processes, relationship building and developing the Indigenous research workforce, to facilitate acceptable research that affects health outcomes. For Values and ethics to achieve its full impact and to improve learning between research teams, authors should be encouraged to report how the principles are addressed during research, including barriers and enablers that are encountered.

Assessing the Mental Health, Substance Abuse, Cognitive Functioning, and Social/Emotional Well-Being Needs of Aboriginal Prisoners in Australia.

This study sought to identify the incidence of mental illness, substance misuse, and cognitive impairment among a representative cohort of 123 Aboriginal people in custody in Australia. In addition, the study measured levels of social and emotional well-being (SEWB) and considered the interrelationship of mental health issues, SEWB, and unmet needs. Both male and female Aboriginal prisoners were found to have high rates of mental health, substance abuse, and cognitive functioning needs that were heavily contextualized within perceptions of their own SEWB. Findings provide important information with regard to the specific needs of Aboriginal people in custody. Implications for the development and implementation of effective, culturally themed best practice programming for this population are discussed.

Narratives of Twitter as a Platform for Professional Development, Innovation, and Advocacy

ObjectiveTo explore why and how Twitter engagement may be useful for health professionals with an interest in decolonising practice and for supporting the social and emotional wellbeing (SEWB) of Aboriginal and Torres Strait Islander people.MethodA narrative methodology is used to explore innovative uses of Twitter with relevance to the SEWB of Aboriginal and Torres Strait Islander people. The authors present their personal and professional stories of engagement with Twitter as three inter‐related case studies.ResultsThematic analysis of these narratives found that Twitter is enabling Aboriginal and Torres Strait Islander people to share their stories and experiences, and to develop new connections and collaborations for change. It provides a platform for reflexivity, reciprocity, relationship‐building, strengths‐based learning and practice, advocacy, and other elements of decolonising practice.ConclusionEngaging with Twitter offers psychologists and other health professionals an opportunity for improving their understanding of the complexity of factors affecting the SEWB of Aboriginal and Torres Strait Islander people, and for developing their professional practice into new spheres.

Decolonising Psychology: Validating Social and Emotional Wellbeing

ObjectiveAustralian Aboriginal and Torres Strait Islander social and emotional wellbeing (SEWB) is a multifaceted concept that acknowledges that a person's wellbeing is determined by a range of inter‐related domains: body, mind and emotions, family and kinship, community, culture, Country, and spirituality. This paper explores the meaning of these seven domains of SEWB.MethodA thematic analysis of qualitative data obtained from the National Empowerment Project (NEP) was conducted, along with a literature review of each domain.ResultsFindings from the NEP, together with relevant literature, indicate that implementing strategies that focus on strengthening SEWB is important for individual, family, and community wellbeing. Addressing the social determinants of Indigenous disadvantage is also shown to have an important role in strengthening the SEWB of individuals, families, and communities.ConclusionIt is important for all practitioners and policymakers involved with improving Indigenous health to recognise the seven inter‐related domains of SEWB and to acknowledge and support people in addressing the social determinants of wellbeing.

Social and Emotional Wellbeing Screening for Aboriginal and Torres Strait Islanders within Primary Health Care: A Series of Missed Opportunities?

Social and emotional wellbeing (SEWB) is a critical determinant of health outcomes for Indigenous Australians. This study examined the extent to which primary healthcare services (PHSs) undertake SEWB screening and management of Aboriginal and Torres Strait Islander clients, and the variation in SEWB screening and management across Indigenous PHS. Cross-sectional analysis between 2012 and 2014 of 3,407 Indigenous client records from a non-representative sample of 100 PHSs in 4 Australian states/territory was undertaken to examine variation in the documentation of: (1) SEWB screening using identified measurement instruments, (2) concern regarding SEWB, (3) actions in response to concern, and (4) follow up actions. Binary logistic regression was used to determine the factors associated with screening. The largest variation in SEWB screening occurred at the state/territory level. The mean rate of screening across the sample was 26.6%, ranging from 13.7 to 37.1%. Variation was also related to PHS characteristics. A mean prevalence of identified SEWB concern was 13% across the sample, ranging from 9 to 45.1%. For the clients where SEWB concern was noted, 25.4% had no referral or PHS action recorded. Subsequent internal PHS follow up after 1 month occurred in 54.7% of cases; and six-monthly follow up of referrals to external services occurred in 50.9% of cases. Our findings suggest that the lack of a clear model or set of guidelines on best practice for screening for SEWB in Indigenous health may contribute to the wide variation in SEWB service provision. The results tell a story of missed opportunities: 73.4% of clients were not screened and no further action was taken for 25.4% for whom an SEWB concern was identified. There was no follow up for just under half of those for whom action was taken. There is a need for the development of national best practice guidelines for SEWB screening and management, accompanied by dedicated SEWB funding, and training for health service providers as well as ongoing monitoring of adherence with the guidelines. Further research on barriers to screening and follow up actions is also warranted.

Ecological Levels of Social and Emotional Wellbeing of Young People

This paper reports on the social and emotional well-being (SEWB) of 66,767 young people (grades 2–12) in Australia enrolled in 404 government/state, independent and Catholic schools who completed the ACER Social-Emotional Well-Being Surveys between 2003 and 2014. Based on the Rasch measurement methodology, an ecological model of SEWB was described on a continuum on which five qualitatively distinct SEWB levels were identified: Low, Emerging, Developing, Highly Developed and Very Highly Developed. Details of the different aspects of the external (school, home and community) and internal strengths (social, emotional, learning skills; values) as well as the feelings and behaviors that characterize each level of SEWB are described. Implications of these findings for program planning for young people with mental health problems and recommendations for future research conclude the paper.

Aboriginal prisoners and cognitive impairment: the impact of dual disadvantage on Social and Emotional Wellbeing.

Negligible information is available regarding the Social and Emotional Wellbeing (SEWB) needs of Aboriginal Australian individuals in custody with cognitive impairment. This is problematic given that Aboriginal people with cognitive impairment often experience dual disadvantage in the context of the justice system. This study sought to ascertain the relationship between cognitive impairment and mental health/cultural needs (SEWB) Aboriginal and Torres Strait Islander people in custody. A sample of 122 Aboriginal and Torres Strait Islander people were administered a culturally themed semi-structured questionnaire in custodial settings in Victoria, Australia. The questionnaire included measures of cognitive impairment, SEWB and forensic needs. Analyses were performed to determine differences in the presence of SEWB and unmet custodial needs by level of cognitive impairment. Findings revealed a diminished level of wellbeing for cognitively impaired participants across several factors. Cognitive impairment was associated with poorer coping mechanisms, additional experiences of racism, difficulties handling emotions, discomfort around non-Aboriginal people and reduced access to meaningful activities in custody. All participants regardless of their level of impairment recognised the importance of cultural engagement; however, cognitively impaired participants had greater difficulty accessing/practicing cultural activities. Culturally responsive disability assistance should be available at all phases of the justice system for Indigenous people with cognitive impairment to ensure that equitable care is accessible and needs are addressed.

Ngara Dyin

The marginalised position and unequal health status of Aboriginal people in Australia are a direct consequence of the trauma and dispossession of colonisation. Aboriginal women experience even greater levels of distress and ill health than Aboriginal men, and are more disadvantaged than any other group of women in Australia. While strength of cultural identity leads to increased social and emotional wellbeing (SEWB) and reduced socioeconomic hardship, Aboriginal people in urban and regional areas suffer greater discrimination and resultant psychological stress than those in remote areas; they are additionally subjected to accusations of inauthenticity. Improving Aboriginal women’s SEWB is pivotal in advancing Aboriginal SEWB overall. This research has explored nine regional Aboriginal women’s experiences of culture and identity by a process of deeply listening to each woman: Ngara Dyin (Dharawal language). The aim was to discern means to strengthen cultural attachment and enhance positive cultural identity for this group of women, and consequently their community. Through the process of interpretive phenomenological analysis, seven interdependent overarching themes were developed: walking and talking black; it’s not easy growing up in a white society; we sit down and listen; connection to Country; strong black women; the way forward; and, wanting that magic. Decolonising approaches to increasing Aboriginal women’s SEWB dictate that understandings of culture and identity must be informed and guided by the very people whose experience is being sought, and these women clearly indicate the need for strengthened cultural connection through funded gatherings and connections with senior women from remote areas.

Editorial

The articles in this edition again attest to the broad range of scholarly concerns that signify the growing disciplinary maturity of critical Indigenous studies. The first article, by Mary Goslett and Vanessa Beavan, draws on empirical research concerning improving the social and emotional well being (SEWB) of Aboriginal women through listening to their experiences of identity and culture. Deploying interpretive phenomenology in their analysis of the women's accounts, they discerned interdependent themes that captured their experiences. They conclude by reiterating the need for decolonising approaches to SEWB, informed by the very people whose experiences are being canvassed in our efforts at amelioration. The second article, by Valmaine Toki, notes the optimism that greeted the United Nations Declaration on the Rights of Indigenous Peoples. However, Toki further illuminates the routine violations and breaches that followed, particularly those by extractive industries and business activity generally. The article examines the fraught relationship between Indigenous rights, the state and business imperatives.

Connecting and Strengthening Young Aboriginal Men: A Family Wellbeing Pilot Study

ABSTRACTA significant proportion of young people in Australia are currently not being engaged in school and other social systems. This article presents the results of a mixed-methods study of a pilot Family Wellbeing intervention designed to enhance the social and emotional wellbeing (SEWB) of young Aboriginal men and improve engagement in education, employment, and other social participation. A questionnaire incorporating the Kessler Psychological Distress Scale and respondent self-assessment SEWB questions was administered to program participants pre and post intervention (N = 30) and qualitative data were collected from program organisers (N = 6). The results suggest that the Family Wellbeing intervention has the capacity to make a marked contribution to the SEWB of young Aboriginal men; participants experienced strong improvement in capacity to manage relationships, engagement in education and employment, and mental and physical health. The factors that enabled the program to be adapted to the target group and setting are documented.

Here and Now Aboriginal Assessment: background, development and preliminary evaluation of a culturally appropriate screening tool.

Assessment of Aboriginal social and emotional wellbeing (SEWB) is a complex and challenging task, in part due to a lack of suitable assessment tools. This paper reports the development and evaluation of a culturally appropriate screening tool called the Here and Now Aboriginal Assessment (HANAA). The initial phase included development of a glossary of Aboriginal terms and concepts relating to SEWB. The glossary was used to identify 10 key HANAA domains, which included physical health, sleep, mood, suicide risk and self harm, substance use, memory, unusual experiences, functioning, life stressors and resilience. Evaluation of the HANAA included exploration of its cultural applicability, feasibility, reliability and validity. The HANAA was well accepted by study participants and easily implemented by assessors. Reliability was good, with inter-rater agreements between Aboriginal and non-Aboriginal assessors measured by Kappa statistics ranging from 0.5 to 1.0. There was also a good agreement between assessors and treating clinicians in identifying the main presenting problem and recommended course of action. The HANAA is a culturally appropriate and useful tool for the screening of SEWB among Aboriginal adults. It can also be used for teaching and training purposes of mental health and other professionals working with Aboriginal people.

Risk of antenatal psychosocial distress in indigenous women and its management at primary health care centres in Australia

ObjectiveThis study explored the risk of antenatal psychosocial distress (APD) and associated potential factors and examined management aspects of risk of APD in women attending Aboriginal primary health care services in Australia. MethodAudits of medical records of 797 pregnant women from 36 primary health centres in five jurisdictions (NSW, QLD, SA, WA and NT) were undertaken as part of a quality improvement programme. Information collected included mental health assessed by a standard screening tools, enquiry regarding social and emotional well-being (SEWB), depression management (including antidepressant medications) and referral. ResultsAround 18% (n=141) of women were at risk of APD based on assessment using a standard screening tool or by SEWB enquiry. There was a significant association between risk of distress and women’s life style behaviours (e.g., alcohol, illicit drug use) and health centre characteristics. Of the 141 women, 16% (n= 22) were prescribed antidepressant drugs during pregnancy. A range of nonpharmaceutical mental health interventions were also recorded, including brief intervention of 61% (n=86), counselling of 57% (n=80) and cognitive behaviour therapy of 5% (n=7). About 39% (n=55) of women with APD were referred to external services for consultations with a psychiatrist, psychologist or social worker or to a women’s refuge centre. ConclusionsThe higher risk of APD associated with women’s life style behaviour indicates that the better understanding of mental health in its cultural context is essential.

Social and emotional wellbeing in Indigenous Australians: identifying promising interventions

To review the empirical evidence that exists to support the delivery of the range of psycho-social interventions that have been implemented to improve social and emotional wellbeing (SEWB) in Aboriginal and Torres Strait Islander individuals and communities. A systematic review of the available literature, with relevant evaluations classified using the Maryland Scientific Methods Scale. Despite a substantial literature on topics relevant to SEWB being identified, only a small number of program evaluations have been published that meet the criteria for inclusion in a systematic review, making it impossible to articulate what might be considered evidence-based practice in this area. Examples of those programs with the strongest empirical support are outlined. The results are discussed in terms of the need to develop key indicators of improvement in SEWB, such that more robust evidence about program outcomes can be gathered. The diversity of the identified programs further suggests the need to develop a broader and over-arching framework from which to approach low levels of SEWB, drawing on the concepts of 'grief and loss' and 'healing' and how high levels of social disadvantage have an impact on service utilisation and outcomes. From a public health perspective, the pressing need to implement programs that have positive impacts on low levels of social and emotional well-being in Aboriginal and Torres Strait Islander communities in Australia seems clear.

How Can Country, Spirituality, Music and Arts Contribute to Indigenous Mental Health and Wellbeing?

Mental health and social and emotional wellbeing (SEWB) have been linked as outcomes of attachment to country, spirituality, and engagement in music and arts, particularly for Indigenous Australians. It is not clear how this occurs, even though the links seem substantial. We explore how mental health and SEWB may be linked to attachment to country, spirituality, and engagement in music and arts by reviewing literature and presenting examples from our research with Indigenous communities. Rather than abstracting, our goal is to describe specific examples encompassing the rich contextual details needed to understand the factors contributing to mental health and SEWB. While engagement in music is often seen as benefiting mental health because thoughts and feelings can be expressed in less public ways, it can also lead to employment and access to economic and social resources. Attachment to country also shows a plethora of positive outcomes which can contribute to mental health and SEWB even when not explicitly aimed at doing so, such as reducing conflictual situations. We conclude that more detailed, contextual research is required to fully explore the links between creative enterprises and mental health and SEWB outcomes.

Strong Souls: Development and Validation of a Culturally Appropriate Tool for Assessment of Social and Emotional Well-Being in Indigenous Youth

The aim of the present study was to develop and validate an appropriate tool to assess the social and emotional well-being (SEWB) of Indigenous adolescents participating in the longitudinal Aboriginal Birth Cohort (ABC) Study. A range of tools was assessed as to the suitability of each for use in the ABC Study. Two existing tools and a newly developed one called 'Strong Souls' were piloted in a representative group (n = 67). Strong Souls was selected as the most appropriate for use in the ABC Study, and was completed by 361 participants. Exploratory factor analysis was used to explore construct validity. Cronbach alpha was used to assess the reliability of the latent constructs and the tool overall. Factor analysis produced a 25-item, four-factor model accounting for 34.5% of the variance. This model demonstrated sound construct validity and reliability. Factor structure was consistent with the epidemiological literature, identifying constructs of anxiety, resilience, depression and suicide risk. While these align with observations in mainstream populations, different relationships between distinct factors, and differences in symptomatology were found in this population. For example, two key findings were: feelings of sadness and low mood were linked with anxiety and not depression; and the expression of anger was verified as a unique symptom of depression for Indigenous people. Strong Souls demonstrated validity, reliability and cultural appropriateness as a tool for screening for SEWB among Indigenous young people in the Northern Territory.