Our People to Live Stronger & Longer

Aboriginal Social and Emotional Wellbeing in an Australian Urban Community

The mental health and wellbeing of Indigenous people across the globe is an area of great focus, no more so than in Australia currently as Indigenous health is set to be a key issue in the upcoming Federal Election.

The social and emotional wellbeing of Australia’s Indigenous people (Aboriginal and Torres Strait Islander people) is an area of disadvantage and inequity that the Australian Government and nation as a whole continues to grapple with. The release of the recent Closing the Gap – Our Choices Our Voices Report (The Lowitja Institute, 2019; Prime Minister and Cabinet, 2019) highlights limited gains in the health and wellbeing of Indigenous Australians.

The gap in life expectancy is widening not closing with Indigenous people continuing to die early due to preventable chronic health diseases. The incidence of mental distress and disorder and the incarceration rate of Indigenous Australians is disproportionately high when compared to non-Indigenous Australians.

Tharawal Aboriginal Medical Service (AMS) is based in Airds, NSW and celebrated its 35th year of operation in 2018. Tharawal AMS provides healthcare, social and cultural support services to Indigenous Australians across South West Sydney. Tharawal AMS is an Aboriginal Community Controlled Health Organisation (ACCHO), independent of the Government, Primary Health Networks (PHNs) and independent of but aligned in principle to other AMSs across Australia.

The Byala team, Byala meaning ‘lets talk’ in the local Dhawaral People’s dialect, is a multi-disciplinary team made up of 7 staff. The team is led by a Mental Health Nurse Practitioner (MHNP) and includes an Aboriginal Mental Health Worker, Aboriginal Drug and Alcohol Worker, Aboriginal Youth Worker and a Psychologist. Access to a second Psychologist for 2 days of the week and a Child Psychologist 1 day a week. The Byala team provides direct service to Indigenous Australians aged 5 years and older.  Services are delivered in a number of modes including individual and group, office-based and outreach (including hospital visits, home visits, school visits and other service visits). To meet the needs of our target community both appointment-based and walk-in clinics are offered. 71% of the Byala team are Aboriginal.

The Byala team sits within Tharawal’s Social and Emotional Wellbeing (SEWB) team supporting a Manager, Social Support Worker, 2 Housing Support Workers, Home Support Worker and a Bringing Them Home Worker (reconnecting the Stolen Generation) to provide broad SEWB support to the Community.

The Byala team is a partnership between clinical and cultural staff. Our PHN funds the staff through mental health stream funding or drug health stream funding. Our MHNP is funded jointly through both mental health and drug health streams. Our MHNP coordinates and provides service across both mental health and drug health areas, comorbidity is overwhelmingly the rule, not the exception. The extended roles, broad education and competence of the MHNP is a key element that allows the team to manage a wide spectrum of presentations and levels of acuity.

The Byala team works from the belief that connection to land, culture, spirituality, family, and community are important to people and impact their wellbeing.

The practice of this belief is reflected in the mix of clinical, social and cultural services and programs run by the team’s staff – from twice weekly Nurse Practitioner mental health / drug health walk-in clinics, psychology sessions, cultural art groups, fortnightly psychiatry clinic, twice-weekly youth cultural dance groups and regular community wake / memorial events.

The success of the Byala team is grounded in the fact that Tharawal AMS is a community controlled and run organisation for the local Aboriginal Community by the local Aboriginal Community that places equal importance on the complementary role of clinical and cultural staff. We are a service run by the Community we serve and accountable to the Community we serve.

Matthew James – Tharawal Aboriginal Corporation