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Introduction: Mental Health Nursing

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Mental health among Torres islanders is one of the significant well-being a factor. This creates more than a 10% of health gap between Australia's indigenous and non-indigenous people. A higher rate of mental illness is observed among the Torres islanders compared to no\n indigenous, including diseases such as depression, anxiety, and substance abuse. They are directly linked with overall well-being, physical health, spiritual health and cultural conditions. The mental health factors among women of certain backgrounds are more adverse, as it is impacted by poverty, low level of education and other cultural factors.

As per the record, nearly 33% of women are suffering from depression and associated mental health conditions in this population (, 2021). While considering the mental health conditions of first nation people, analysis on the basis of cultural, historical and other community factors is necessary. For this purpose, Bronfenbrenner's (1979) ecological model has been aimed to be used in this study. As per this model, the complex interconnection and relationship of an individual with their social entities can be described. Hence interaction with the environment and its direct and indirect impact on mental health and personality can be identified through this process. While treatment and intervention planning for depression among Torres island people, a proper analysis of their background is considered important. Culture and its impact on personality and mental health conditions are important for the assessment. 

Evaluation : Case details

Mental health condition is observed to have a direct influence on sociocultural factors. The indigenous people of Australia are observed to be suffering from mental health conditions with higher severity in comparison to the non-indigenous population. This case is mainly based on a patient who visited the clinic last month. She was a middle-aged woman, a mother of three, and from Torres Island. While considering her background, she is from the Boigu group, the top western colonised group of Torres Island. Along with other health complications, such as obesity, and hypertension, she has also been diagnosed with clinical depression. The major symptoms observed include a sudden burst of emotions, such as anger, irritation and tearfulness. Also, it has been difficult to tackle her other health complications as she shows no interest in continuing her medications.

Trust issues and disrespect for western medications and treatment procedure has been observed for the patient. The family members also reported her sleeplessness, as most of the time at night she spent sitting on her couch, smoking. His son and husband work as a labour and do not support the western procedure of treatment. While considering the case, proper analysis and consideration for the cultural impact on mental health are necessary for planning intervention. Communication plays a major role in certain interventions, and the social and ecological aspects of patients play a major role in the process, which is necessary to observe (, (2021). Hence thorough consideration of social background is necessary for this case.

Bronfenbrenner (1979) ecological model

The Bronfenbrenner model is a major recognised framework for describing social and ecological influences. This help to identify the mentality and personality of people from a certain background based on interaction with the environmental elements.

This model is mainly evolved around four basic systems, including the microsystem, mesosystem, exosystem and macrosystem. As suggested by Bronfenbrenner, child development and their personalities are directly impacted by the interconnections and contributions of the environment that they are directly or indirectly linked with (Guy-Evans, 2020). The major cultural aspects include the family, and society that he lives in, the norms, regulation and background history is also a major factor in this process. The micro system refers to the direct connection with which the person has been in contact. The immediate environment is necessary to identify for understanding the quality of interactions and their impact on the development of belief systems. On the other hand, the impacts are largely associated with behaviours and actions. This is considered a bi-directional relationship. The mesosystem help to determine the quality of interaction between a person and their micro system. It includes the relationship, manner or behavioural approaches between the elements of the microsystem, such as the relationship status between parents and siblings.                                       

Exosystem refers to the indirect environment, such as society and the structure to which a person is exposed. This is also considered a major factor to determine the relationship status between a person and the microsystem. A major example of this process includes the mass media. The macrosystem cultural component of the development system is for a person. It helps to describe the impacts of cultural factors on personalities, such as poverty, ethnicity and socio-economic status. Lastly, the chronosystem refers to changes that occur in a lifetime for a person, such as major incidents and transitions in life and events that influence behavioural factors and considerations. While applying this model to the indigenous people, the historical and cultural aspects are considered as the major element for the socio-ecological development. They are considered the major strength factor to initiate their cultural integrity and relationship (Gone & Kirmayer, 2020). Hence they are considered micro and mesosystem for the model. Apart from that, mass media has been selected as a macrosystem whereas organisational approaches, such as values and norms of the indigenous people as the macrosystem for the person.

Application of the model

Historical context

The historical context is referred to as the core dimension of the indigenous model of ecology. The privileged history of the indigenous people is considered a major factor affecting spiritual health and well-being. As per the historical context of the Torres islanders, colonisation and land importance is the major factor. The impacts of British colonisation and their land disown still play a major role in their cultural development. The historical factors are largely associated with their nature consisting of perseverance and resilience (Russell et al. 2022). The colonialism history also helps to understand their importance for lands. This can be considered as the chronosystem as per the Bronfenbrenner model, which has been changed over time, though it still impacts their behaviour. The traditional knowledge and connection between the youth and elders are largely dependent on this factor. Also, this observational learning and cultural values, life ways and activities are largely impacted by this aspect (Brinckley et al. 2021). As mental health conditions, such as depression are largely associated with the behaviour, they are largely associated with the contextual approach to the history of the Torres islanders. This is also mandatory to provide an effective understanding of daily living, education and creative exploration. As this is considered the major differential aspect for the indigenous people that help to maintain their identity, this can be considered as a core ecological aspect for this community.

Cultural context

While following the indigenous model for ecology, culture can be considered an effective factor for promoting learning and its impact on lifestyle. As per Bronfenbrenner's model, this can be considered the mesosystem for this culture. In this aspect, the norms beliefs practices, and unique customs are considered effective factors for development (Carlin et al. 2019). The cultural aspects are considered an effective outgrown factor for historical aspects, and hence they are shaped and modelled through historical events. The experiences such as violent dispossession and disruption of the existing community, agriculture and industry led to the development of the beliefs and behaviours of the indigenous people. The norms and regulations observed among the people are majorly developed from the basic experiences of historical events. The cultural activities and their transition procedure are observed to have an effective impact on mental health conditions, in the development of self-perception and identity, self-esteem and confidence (Gall et al. 2021). This can leads to developing overall management and control over the procedures related to holistic approaches, direct connections with the ancestors and their cultures help to promote good moos and practise cultural skills and knowledge. Hence incorporation of traditional skills for practising wellness, feelings related to belongingness and positive moods are mandatory for healthy engagement and personality development.Mass media aspect

This is referred to as the exosystem for Bronfenbrenner’s model and as the last step for the indigenous model. It helps to describe the social and other factors related to the external environment and their impact on the lifestyle of the indigenous people. In terms of mass media utilisation, theft is not always directly involved in the process. Torres islanders are mostly excluded from the mainstream media of Australia. The major cause depicted for the society includes lack of adaptation and functionality, differences in language and inactivity. As media is considered an entity and reflection of a nation, excluding the indigenous people may indicate the overpowering views and non-indigenous people. It may also send a message of superiority to non-indigenous people in Australia, which impacts on self-esteem and respect of the indigenous people. On the other hand, non-indigenous people may also not get the proper idea and perspectives of indigenous people and their contribution to the nation (Kennedy, 2021). Reflection of racism can be observed in the normal population leads to an impact on the overall cultural diversification of the indigenous people. Health and well-being are largely contributed by availability, contribution and acknowledgement of the current situation, perception and suggestion for a purpose, and are considered basic human rights. 

Organisational aspects

The organisational factor for the indigenous people refers to the macrosystem, which is involved with the economical aspects, cultural development, and status. While following the history of the Indigenous population, the value of land can be observed. The land is considered the major factory for economical development, such as agriculture, industry development and community growth (Kennedy, 2021). Disowning of the lands leads to cause economical deprivation among the people that lead to impacts their overall well-being. It also factors in their tribal structure and they tend to be dependent on the western culture for development and growth, affecting their pride and self-independence. With the increased demand for economical deprivation, the population is prone to perform labour-based jobs due to a lack of education and knowledge of modern society, and hence they tend to lose their norms and communal relations and values. This impacts their mental health and overall well-being in large aspects, leading to depression and anxiety.

Justification for theoretical application

The historical factors and cultural aspects are considered the core ecological factors for the Torres islanders and their overall well-being. While considering the historical context, community development, such as clans, or living places is highly reflected by the historical situations. This help to describe the concept of extended family, the larger community in tribes, relatives and their relationship and connection with the natural environment can be described (Fish et al. 2022). While assessing the well-being factors, they are needed to be considered for mental health intervention. The learning, living ways, communal responsibilities and holistic approaches are integrated within the lifestyle, and hence the healthy practice of the culture is necessary for these aspects. On the other hand, culture is considered an effective factor that influences the knowledge and values and communicable practices of beliefs. On this basis interventions and preventions are mainly needed to be developed (Eriksson et al. 2018). The daily practices are directly considered an outgrown aspect of mass media development and their management is necessary. Along with development and growth, justification and evaluation of the norms along with environmental factors are necessary. Language also plays a major role in effective communication, exposure to western methods and adaptation to the culture can be stressful for the indigenous families working in this situation.

While considering the impacts of mass media on well-being, the exclusion does not the indigenous people to feel welcome among the white people. Discrimination on the basis of origin and culture leads to an impact on the self-perception and esteem of the population (Bryant et al. 2021). This provides a message that they are not a part of the modern society and mainland population of Australia, hence the acceptance is least. While they tend to find support among white people, their contributions are not acknowledged. This also sends a sense of overpowering and dominance of the non-indigenous, which is against the pride of Torres islanders and they also feel humiliated. Along with it, the organisational aspect, such as education, community norms and regulations are not similar to the non-indigenous Australians. This leads impact on their lifestyles and adaptation to modern society. Also, it impacts the socioeconomic background of certain people. Poverty and lack of occupational resources lead to increase difficulties leading to adverse impacts on well-being.

While discussing the ecological concept for social development in Torres islanders, their basic concept of the western population and their society is needed to be judged on the basis of history and experiences. The importance of such experiences is largely associated with the culture and norms that impact their lifestyle (, 2021). Also, a lack of understanding and differentiation mentality of non-indigenous people on the basis of racism and origin is needed to be considered while handling certain cases. Hence to understand the basics of depression and mental health adversity among certain people, their experiences and perceptions are needed to be considered. The mass media has been considered the exosystem, as they have less involvement in the process, though it also has major impacts on the people that are trying to adapt to modern culture (Berger et al. 2020). The organisational aspect is considered a macrosystem effective for understanding the impact of the larger culture and occupational aspects. Cultural factors along with the economy affect their lifestyle and overall factors. Hence considering the larger society as a macrosystem can be effective for analysing the mental health aspects.


Mental health is largely associated with the cultural aspects that impact the development and personality of a population. Hence consideration of the overall factors is necessary for the process. While handling patients in mental health nursing, considering their origin and cultural aspects is mandatory. As per the case study, the patient is from Torres islander and her mental health condition is somehow majorly linked to historical as well as cultural factors. The lack of adaptation and acknowledgement of people in modern society is considered the major barrier in this case. The historical factors and cultural aspects are considered major aspects of societal development, as described in Bronfenbrenner's ecological model.

Based on the importance of overall lifestyle, and holistic approaches, the factors are considered. Apart from that, socio-economic factors, such as occupational options, and choices, poverty and social acknowledgement are also a major factor. The mass media has the least impact, though they are considered as potential future challenges for adaptation, due to increased discrimination factors. Considering all the essential factors for this aspect are mandatory for the intervention planning this leads to the effect a result of treatment through developing a potential relationship between the patient and nurse through effective communication aspects. Also, the understanding may lead to change in the personal concept of modern society and improve attachment to the primal community through improvised self-esteem and confidence of the person.

Reference list

Berger, M., Taylor, S., Harriss, L., Campbell, S., Thompson, F., Jones, S., ... & McDermott, R. (2020). Cross-sectional association of seafood consumption, polyunsaturated fatty acids and depressive symptoms in two Torres Strait communities. Nutritional neuroscience23(5), 353-362.

Brinckley, M. M., Calabria, B., Walker, J., Thurber, K. A., & Lovett, R. (2021). Reliability, validity, and clinical utility of a culturally modified Kessler scale (MK-K5) in the Aboriginal and Torres Strait Islander population. BMC public health21(1), 1-15.

Bryant, J., Bolt, R., Botfield, J. R., Martin, K., Doyle, M., Murphy, D., ... & Aggleton, P. (2021). Beyond deficit:‘strengths?based approaches’ in Indigenous health research. Sociology of Health & Illness43(6), 1405-1421.

Carlin, E., Blondell, S. J., Cadet-James, Y., Campbell, S., Williams, M., Engelke, C., ... & Marley, J. V. (2019). Study protocol: a clinical trial for improving mental health screening for Aboriginal and Torres Strait Islander pregnant women and mothers of young children using the Kimberley Mum's Mood Scale. BMC public health19(1), 1-10.;

Eriksson, M., Ghazinour, M., & Hammarström, A. (2018). Different uses of Bronfenbrenner’s ecological theory in public mental health research: what is their value for guiding public mental health policy and practice?. Social Theory & Health16(4), 414-433.

Fish, J., Counts, P. K., Ruzzicone, D. J., Ogbeide, I. E., & Syed, M. (2022). “… Inside of my Home, I was Getting a Full Dose of Culture”: Exploring the Ecology of Native Peoples’ Development Through Stories.

Gall, A., Diaz, A., Garvey, G., Anderson, K., Lindsay, D., & Howard, K. (2021). An exploration of the sociodemographic and health conditions associated with self-rated wellbeing for Aboriginal and Torres Strait Islander adults. BMC research notes14(1), 1-8.

Gone, J. P., & Kirmayer, L. J. (2020). Advancing Indigenous mental health research: Ethical, conceptual and methodological challenges. Transcultural Psychiatry57(2), 235-249.

O’Keefe, V. M., Fish, J., Maudrie, T. L., Hunter, A. M., Tai Rakena, H. G., Ullrich, J. S., ... & Barlow, A. (2022). Centering Indigenous Knowledges and Worldviews: Applying the Indigenist Ecological Systems Model to Youth Mental Health and Wellness Research and Programs. International Journal of Environmental Research and Public Health19(10), 6271.

Russell, S. G., Quigley, R., Thompson, F., Sagigi, B., Miller, G., LoGiudice, D., ... & Pachana, N. A. (2022). Culturally appropriate assessment of depression and anxiety in older Torres Strait Islanders: limitations and recommendations. Clinical gerontologist, 1-13.

Websites , (2017). 4714.0 - National Aboriginal and Torres Strait Islander Social Survey, 2014-15 . Retrieved from: Retrieved on 28.10.2022 , (2021). Aboriginal and Torres Strait Islander mental health program. Retrieved from: Retrieved on 28.10.2022, (2020). ABOUT THE TORRES STRAIT. Retrieved from: Retrieved on 28.10.2022, (2021). Culture, protocols & heritage. Retrieved from: Retrieved on 28.10.2022

Guy-Evans, O., (2020). Bronfenbrenner's Ecological Systems Theory. Retrieved from: Retrieved on 28.10.2022

Kennedy, T., (2021). Media inclusion of Indigenous peoples is increasing but there is still room for improvement. Retrieved from: Retrieved on 28.10.2022

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