How an Aboriginal approach to mental health is helping farmers deal with drought

Food insecurity is now a real threat in parts of the country as livestock and wildlife are dying in inner New South Wales (NSW). Farmers are struggling; rates of depression and anxiety are increasing among those who stay.

“I was sleeping for 15 hours a day,” says Richard, a cattle farmer living near White Cliffs in western NSW. “I felt so sick and tired I thought I had cancer. But it was depression.”

His depression hit just before this drought, and was brought on, he thinks, by extreme stress and family issues. But drought only adds to farmers’ stress: it degrades the land, which makes it harder to earn a living.

In 2018, a study from the University of Newcastle in NSW found that farmers in rural parts of the state experienced “significant stress about the effects of drought on themselves, their families and their communities”. Other research suggests that income insecurity related to drought increases the risk of suicide among farmers.

Psychologist Pat Dudgeon at the University of Western Australia is used to people suffering in response to extreme stress. She was Australia’s first Aboriginal psychologist, and specialised in suicide prevention because of the mental health issues in her community in the Kimberley, a region of north-west Australia.

Throughout Australia, rates of suicide have increased dramatically for Aboriginal and Torres Strait Islander people over the past 30 years. The rise is due to ongoing issues of racism, poverty and intergenerational pain, the legacy of centuries of colonisation and mistreatment by British and Australian governments. For instance, many Aboriginal people have had their land taken from them and been forcibly removed to live in missions or be fostered by non-Aboriginal people.

Dudgeon believes many lessons can be learned about grief and trauma from the loss of land and culture that Aboriginal people have experienced. She says psychology can move away from the Western tradition of expert and patient, towards a more narrative form based on Aboriginal traditions and reconnecting with the land. And as more psychologists begin to incorporate these Aboriginal concepts into their practice, such a combined approach might help farmers dealing with drought to reconnect with the land and improve their mental health, too.

“If the land is sick, you are sick,” says Fiona Livingstone, who manages a suicide prevention programme at the University of Newcastle’s Centre for Rural and Remote Mental Health.

She explains that the traditional Aboriginal concept of health is much broader than that of conventional Western medicine. Aboriginal people, she says, are deeply connected to “country”, the place with which they have spiritual ties. The personal, social and ecological are closely interconnected: “health” is the state in which they are all in balance.

The traditional expert–patient relationship of psychological treatment has often been seen by Aboriginal people as being based on that of the colonial master and the colonised. That’s a problem if, as Dudgeon believes, colonisation is also the primary source of Aboriginal people’s distress and often the underlying cause of depression and suicidal feelings.

Prolonged drought affects Aboriginal communities in farming regions economically, because it leads to a lack of work. There’s also grief at the loss of nature from the deaths of wild animals and plants. These experiences of not being able to take care of the land during long periods of drought increase stress, leading to an increase in antisocial and risk-taking behaviour such as drug dependence and drinking. People begin to “mistrust each other, gossip maliciously and turn against each other,” say the authors of one report. Droughts can have the effect of “exacerbating underlying grief and trauma”.

Dealing with feelings of despair can be complicated. The traditional expert–patient relationship of psychological treatment has often been seen by Aboriginal people as being based on that of the colonial master and the colonised. That’s a problem if, as Dudgeon believes, colonisation is also the primary source of Aboriginal people’s distress and often the underlying cause of depression and suicidal feelings.

“It is this lack of self-determination that continues to cause a higher incidence of suicide in Aboriginal people. It is a sense of hopelessness passed from one generation to another,” she explains.

Dudgeon says that medical clinics are sometimes the answer, at least for people at immediate risk of suicide. But for those who want to build their emotional resilience, the use of ancient rituals, reminding people of their history and creating a sense of belonging, can be powerful. “Strengthening culture and a strong sense of self is certainly an important part of Aboriginal wellbeing,” she adds.

In Canada, a model called cultural continuity has proved useful in supporting young First Nations people to strengthen cultural identity and resilience. This approach is about helping people feel pride in their culture, making them custodians of knowledge and asking them to teach others to look after the environment we all depend on. This emphasis on self-determination and valuing cultural ways can help at-risk adolescents by giving them coping strategies. It can also be useful for families coping with trauma and loss.

Studies have suggested that cultural continuity can reduce suicide rates as people begin to feel they are no longer in a cultural no man’s land, belonging to neither Western nor indigenous culture.

It’s an approach that works in Australia, too.

A strong sense of responsibility to the land, of being “custodians of the land we live on”, is intrinsic to Australian Aboriginal culture. It means looking after the water and the land for the next generation. But climate change has made the weather chaotic, with drier winters and erratic or failing rains, especially in the south and east. No one can remember it being so dry, so little water in the dams and creeks. Many of Australia’s iconic gum trees have failed to flower.

Water is a symbol of knowledge in at least one Aboriginal culture. In languages of the Northern Territory, the word ‘ganma’ means a place where salt water and fresh water meet. It is used as a metaphor for different people coming together to share knowledge and reach mutual understanding. It’s also the basis of what Aboriginal people call ‘yarning’ – sitting in a circle on the ground, sharing stories.

These old ways of thinking are being used by some psychologists to counter the colonial connotations of the Western style of psychology. Consultations based on yarning involve history, storytelling and finding common ground through skin ties, a complex system of inter-family connections. It can take weeks or months – the comparative directness of a Western-style consultation is seen as rude in Aboriginal culture.

“Yarning is about cultural awareness,” says Ivan Lin from the University of Western Australia. He works primarily with Aboriginal communities in pain management, and says poor communication can be a barrier to effective treatment: “It’s often the doctor who interrupts too quickly and prevents the patient actually saying what they want to say. I use clinical yarning in my practice for this reason.

“It creates a relationship and it’s about problem solving. I would ask, for example, if the patient is from a place where water is really important. As a doctor, can you use water to keep the discussion moving, keep them talking? Ask about fishing, going out with their son. Could activities on the water be useful in helping the patient in some way?”

Yarning has become the basis of many remote health programmes. A programme based on listening to the voices of Aboriginal Elders started more than 15 years ago for the management of chronic health conditions. It’s now run in several NSW health districts, where Elders are asked to help some health programmes pinpoint why certain initiatives are not working for Aboriginal people, and what could be more effective.

Mental health workers are building on this idea, yarning with older Aboriginal people in remote areas to understand their specific health needs, with the effects of the drought now foremost in everyone’s minds. But could it also work with non-Aboriginal people feeling helplessness and despair in response to the drought?