Context: Indigenous Australians experience higher rates of mental illness than the wider Australian population. Indigenous Australians also have the unique experience of dispossession which contributes to the pathogenesis and prognosis of illnesses. In addition to the stress of being an Indigenous member of society, there is the further stress associated with having a mental illness. With disorders such as psychosis, treatment itself can have serious consequences; of particular concern is the use of atypical antipsychotics and hence possible metabolic syndrome in a population that already experiences significantly higher rates of cardiac disease, diabetes and lower life expectancy. The extension of the therapeutic paradigm to include culture is also important as the maintenance of culture can itself be healing. Maintaining cultural integrity through reconnection with family and country can facilitate cultural rehabilitation of the people enabling them to better function as community members and better cope with illness.
Objective: To outline and highlight important medical and cultural issues in addressing the treatment of psychotic disorders in Indigenous Australians.
Key Messages: The multiple determinants of Indigenous health – physical, psychological, social and cultural – warrant due consideration in understanding and treating psychosis in Indigenous Australians. The importance of including an appropriate cultural history and utilising a team approach in management will be discussed.
Conclusion: Indigenous Australians are a high risk population in terms of mental illness and in dealing with disorders such as psychosis there are both medical and cultural considerations that need to be addressed in order to assist with prevention of complications and relapse prevention.
