Brady, Margaret Ann
Description
This research addresses the ways in which alcohol problems among indigenous
Australians have been conceptualised and acted upon by the people themselves, and by
government policy-makers. The thesis considers two main questions. First, how has it
eventuated that Aborigines have become excluded from national and international
innovation in the management of drug and alcohol problems? Second, are mainstream
models of best practice for alcohol intervention, particularly secondary...[Show more] prevention
activities, acceptable to and feasible for Aboriginal people?
I examine how the growth of the indigenous rights movement came to underpin
assertions of cultural difference from other Australians, which in turn influenced the
growth of separate community-controlled health and other organisations. National policymakers
found it difficult to deal with demands for the recognition of cultural difference
through the provision of special funds and separate services. As a result of this increased
sensitivity, national policies often gave inadequate consideration to indigenous issues.
Alcohol problems in particular received little expert attention, and the division of
community-controlled alcohol programs from health services for Aborigines exacerbated
these shortcomings. Aboriginal approaches to alcohol were influenced by a small group
of charismatic activists who pursued a unitary position and remained insulated from the
changes in policy and practice available to the wider population. While the health
services came to be influenced by an all encompassing 'Aboriginal' definition of health -
associated with the broad WHO definition of health emanating from the Alma-Ata
Declaration of 1978 - alcohol programs maintained a narrow, disease-based focus.
Cultural difference is presented throughout the thesis as being a crucial issue, and it is
analysed as a political construct with continuing salience in the face of the unequal
distribution of resources. The constructions of difference are discussed and contested in
the areas of culture and healing, in health, and in approaches to alcohol problems. I
demonstrate that the politics of difference has masked the fact that many Aboriginal
dependent drinkers manage to give up drinking, either on their own or with the
encouragement of a health professional, just as do others in the population. The politics
of difference is also implicated in the rejection of innovative and varied approaches to
alcohol problems emanating from mainstream treatment research. This has deprived
Aboriginal people experiencing serious alcohol problems of access to a range of
interventions which could assist them much earlier in their drinking careers. Some
relevant approaches include brief and opportunistic interventions delivered by health
professionals, which are found to be relevant and feasible for use with Aboriginal clients
of primary health care services.
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