Healthcare Assignment: Impact of "Transgenerational Trauma" on Aboriginal & Torres Strait Islanders

Question

Task: Your task is to prepare a report on healthcare assignment addressing the following points:
-Brief explanation of "Transgenerational trauma" in relation to Aboriginal and Torres Strait Islander People in the context of the contemporary topic of "Black Lives Matter". The response is supported by relevant evidence-based literature. -Analysis of the impact of “Transgenerational trauma” on Aboriginal and Torres Strait Islander Peoples and how the impact is addressed within the Closing the Gap (CTG) policy. The response refers to the CTG policy and is supported by relevant evidence-based literature.

Discussion of the benefits of an Aboriginal client being registered with CTG and how this may have an impact on them accessing healthcare. Discussion of ONE strategy a RN could implement to improve health outcomes for an Aboriginal & Torres Strait Islander person experiencing Transgenerational trauma. Application of the concept of cultural respect in regards to the discussion of Aboriginal and Torres Strait Islander Peoples throughout the assignment.

Answer

“Aboriginal and Torres Strait Islander” people is seensubjected to “Transgenerational Trauma”. It has been observed through the investigation on healthcare assignmentthat only a few Indigenous children are able to grow up in safe environments with most children experiencing trauma (Duthie et al, 2019). This trauma arises mainly from trauma arising from historical events due to colonization of Indigenous land (O’Neill et al, 2018).Such traumahasled to tremendous ineffectiveness in "Black Lives Matter" efforts undertaken and also in "Closing the Gap” (CTG) policy for the entire population of Indigenous people in order to enhance their health care outcomes.

Research depicts that various children from Indigenous and non-Indigenous Australian have been observed to grow up across safe homes, residing in “safe communities”. Trauma in the context of transgenerational aspects includes events that concerns“psychologically overwhelming” for individuals(Atkinson et al, 2014, p 300). The traumatic events are associated with interpersonal nature which includes psychological neglect, maltreatment, physical or sexual abuse (Sarnyai et al, 2016). These events faced by “Aboriginals and Torres Strait Islander” people might be a direct effect of their own experience or resulting from secondary exposure from their family’s experience (Dudgeon et al, 2017, p 1741). Most children of indigenous origin are the most affected and might also face hospital separation for assault or be under juvenile justice systems (Blakemore et al, 2018). Families and households are further seen as faced with direct risks of traumatization (Lang, and Gartstein, 2018).

Transgenerational trauma mainly arises from the subjective experiences and remembering of events of an individual or of the life of the community. It is generally passed from adults to their children by way of the cyclic process through psychological and cumulative emotional wounding(Ketheesan et al, 2020).Transgenerational types of trauma on“Black Lives Matter” can become normalized within a particular culture or memory of people and transmitted through culture. Each individual reacts in a different manner to these traumas (Chamberlain et al, 2019, p.e028397). While some individuals have a great capacity to adapt some face long-lasting effects from it. With the “Black Lives Matter” movement there is a fight for equality and to close gaps in health, education, and wellness. This highlights generation old inequality that is faced by the indigenous people in the hands of the prevailing justice system (Kim et al, 2014).

Impact of "Transgenerational Trauma" on "Aboriginal and Torres Strait Islander" people had been tremendous and passed on for generations (Seran, 2015). It causes tremendous psychological as well as emotional wounding of the individual. Trauma includes a real or perceived threat to an individual's emotional or physical wellbeing(Sullivan et al, 2019). In response to such even the individual is faced with helplessness, intense fear, or horror leadingto disorganized or agitated behavioral outbreaks (Lehrner, and Yehuda, 2018). Indigenous people are also faced with complex trauma historically that results from an individual's exposure to prolonged traumatic events or in this case from trauma transmitted from across generations, which does not categorically match the psychiatric criteria as detailed in post-traumatic stress disorder(O'Toole et al, 2017). It has emerged as a crucial part of the Indigenous culture and memory that have been passed through generations (Menzies, 2019a, p 1530). The most important effect of such kinds of trauma is seen amongst children where their development is slowed down or impaired for the long-term (Sarnyaiet al, 2016). Such trauma is seen to affect brain development and cause cognitive impairment as well (Sarnyai et al, 2016). Most importantly individuals experiencing such trauma are known to show destructive behaviors to themselves as well as to others (Menzies, 2020). Such behavioral manifestations include drug abuse, sexual promiscuity, alcoholism, physical inactivity, and smoking. There has also been noticed a link amongst childhood trauma with suicide(McQuaid et al, 2017).There are various other challenges arising from unresolved trauma which leads to extreme adversities (McQuaid et al, 2017).

Within the policies of CTG, such traumas are attended to by way of providing culturally safe and protective services (Menzies, 2019b). Further in CTG policy Indigenous people are registered and their individual ailments are recorded with appropriate follow-up treatment(Menzies, 2019b). Long-term consequences of CTG policy will ultimately enable attending to the inequality faced by indigenous people in regards to education, health, and overall wellbeing(Menzies, 2019b).The CTG set-up target to increase life-expectancy by 2030. The policy has been effective in completing targets to 12 years hence attending to child mortality by 2018 (Menzies, 2019b).As depicted by the Australian Bureau of Statistics,it is seen that that between the timeframe 2005-2007 and 2010-2012 there was considerable reduction in life expectancy gap for 0.8 years for males and 0.1 years for females.

Figure 1: Life Expectancy at Birth
Source: (Australian Government, 2020)

By way of undertaking healthcare interventions, there have been tremendous steps adopted in early life nutrition, health as well as in wellbeing. It has been observed that even when the “indigenous people” are protected from traumatic experiences linked to the life of their indigenous children, family by way of directly exposing them to impacts of family violence, accident, and abuse, there has still been witnessed impacts from "Transgenerational Trauma" which can be long-lasting as well as severe, where recovery can be mediated through appropriate interventions. Some of these impacts can be addressed by way of the CTG policy to bring about greater interventions in health amongst the Indigenous people(Medina et al, 2017, p 110). Interventions need to aim at undertaking registering as many people as possible in the CTG policy. RNs also need to undertake specific approaches and strategies such that health outcomes of the “indigenous population” can be enhanced”(Medina et al, 2017, p 110). The below figure depicts significant decline in mortality rates which have continued to decline since 1998 and 2016(Medina et al, 2017, p 110).

Figure 2: Mortality rates by jurisdiction
Source: (Australian Government, 2020)

"Closing the Gap" is a federal government strategy for reducing disadvantages faced by the “Aboriginal and Torres Strait Islander” people in education, health as well as in employment (Medina et al, 2017, p 110). There are various policies developed in consistence with the CTG to attain equality amongst the Indigenous and non-Indigenous Australians (Medina et al, 2017, p 110). There are varied targets outlined with the timeframe in accordance with the policies published (Medina et al, 2017, p 110). There are several benefits that can occur to an Aboriginal client once he is registered with CTG especially in regards to accessing healthcare (Medina et al, 2017, p 110). Firstly, the CTG aims at registering people from the “Aboriginal and Torres Strait Islander” community by increasing awareness such that they can have access to healthcare facilities and can be incentivized for payment(Burke, and Korngiebel, 2015, p.e1004978). There is at least one GP supported by staff for the rendering of a culturally aware practice environment that is welcoming (Burke, and Korngiebel, 2015, p.e1004978). With registration with CTG, it will become easier to identify patients of the Aboriginal and Torres Strait Islander origin (Burke, and Korngiebel, 2015, p.e1004978). The indigenous people are mostly avertingto healthcare practices and their norms, with their registration it will be possible to record their data and gain sufficient information regarding the healthcare issues facing them. Hence with the registration of CTG the “Aboriginal and Torres Strait” people, there can be follow up arrangements made on their health (Burke, and Korngiebel, 2015, p.e1004978). A systematic review approach can be adopted by which the Indigenous people can be rendered culturally safe and effective healthcare (Trueman, 2017). Patients who are eligible need to be registered for Practice Incentive Payment (PIP) and also be registered for co-payments (PBS CTG). Most importantly, clinical guidelines along with programs from the RACGP, PHNs, and Medicare can be implemented and applied to them for enhancement of their access to and overall quality of care(Trueman, 2017).These enhancements include lowering rates of mortality and higher quality of life and so on.

The role of an RN is found to critical and essential in implementing one strategy for improvement of health outcomes for the “Aboriginal and Torres Strait Islander” people, who are experiencing Transgenerationaltrauma (Trueman, 2017). As an RN, my primary focus will be including strategy to promote the safety of individuals as well as families experiencing such trauma (Trueman, 2017). They will need to be provided with spaces that make them feel emotionally and physically safe especially advising children on topics that make them feel safe (Trueman, 2017). I need to identify measures (such as cultural competence) consistently, as well as predictably and then deliver my practicerespectfully(Trueman, 2017). An example of providing such a safe environment includes creating safe physical space for children by having child-friendly areas, through engaging them with play materials (Trueman, 2017). Also, they need to be provided with a safe emotional environment that makes the children feel welcome by way of tours and staff introduction in the healthcare space. There needs to be full information provided for the service processes at the healthcare center in their preferred language along with being respectful and responsive to their needs (Trueman, 2017). It has been noticed that the promotion of safety in healthcare spaces enables the indigenous people to disclosedetails regarding their health and also the issues they are facing (Vallesi et al, 2018). It becomes easier to deal with their health problems and provide interventions that are most suitable to them (Vallesi et al, 2018). Also in case, they feel safe in close contact with the RN, it becomes possible to apply healthcare intervention strategies, as indigenous people are generally averting to medical treatment that is provided to them from outside their communities(Browne et al, 2016). They generally feel that the RN or other healthcare staffs are not able to understand their cultural demands and hence they are unable to express themselves fully (Browne et al, 2016). Once an RN is able to develop a patient-centric relationship by the promotion of safety, not only the indigenous people are able to disclose themselves but also engage in a practice that promotes their health and overall wellbeing (Browne et al, 2016). In conclusion, indigenous people are faced with "transgenerational trauma" for a prolonged period of time. The CTG policy is bringing about tremendous benefits in health, education, and in providing wellbeing to these Indigenous populations and in meeting targets set by them. The policy can bring about significant changes to the "Black Lives Matter" by enhancing healthcare benefits to the Indigenous people.

Reference
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