Peer-Based Support as an Intervention of Nursing to Address Depression

Culturally safe nursing practices are expected from all nurses and midwives in rendering nursing care related to any kind of disorder or disease (Kellett & Fitton, 2017). They are expected to engage with all their subjects in an environment that fosters respectful and open communication so that honest as well as compassionate professional relationships, can be maintained. Schill & Caxaj (2019) said that the nurses are also expected to maintain honesty and confidentiality while catering to the problems faced by nurses. This essay encompasses a critical analysis of a culturally safe intervention that can be used for treating depression, which is a major disorder belonging to the Aboriginal community. There are four different culturally safe nursing interventions that can be used for the treatment of depressive disorders such as feeling lonely, empty and hopeless (Murray, Sundin & Cope, 2018). These interventions are a cultural brokerage, the building of complex relationships, providing emotional support, encouraging community participation of the people in the form of cultural programs and rendering active listening. In this essay, peer-based support services shall be critically analysed and evaluated as a nursing intervention method that can provide remedy and support to the people of the Aboriginal community suffering from depressive disorders or feeling abandoned by the rest of the society as a result of their social identity.

Elimination of the indigenous and ethnic inequalities of health involves addressing the determinants of the inequalities of health that involve racism, as well as ensuring a system of healthcare to deliver equal and appropriate healthcare (Bedi, 2018). Culture-based interventions focus on cultural knowledge, which is basically an indigenous way of practising and includes storytelling, traditional healing and conducting various ceremonies. For example, the sweat lodge ceremony is a nursing intervention of native American origin which includes sweat therapy along with songs, prayers and communication. According to Jones et al. (2019), a nurse can undertake a number of steps for making a patient feel not worthless, and at the same time, it can lift up the spirits of the individual. For the majority of patients suffering from depression-related disorders, it is advisable to talk to the patients regarding their feelings. It is through sympathy that depression patients are made to realise that they are being heard and valued.

The Aboriginals of Australia are the marginalised population of the community within the society of Australia (Haregu et al., 2021). The Aboriginal community of Australia faces extremely elevated levels of psychological distress and depression, and this develops from the long-term sequelae of various determinants of society along with various adversities in their life. The long-term effects of the experiences of residential school on the family members of the Aboriginal community are one of the profound reasons which lead to depression (Shen et al., 2018). The sadness of losing the cultural heritage and increased amount of alcohol and drug abuse, domestic violence as well as sexual abuse and surviving in poverty are some of the reasons which cause depression in a person belonging to the Aboriginal community. As opined by Haregu et al. (2021), when people in the Aboriginal community opt for availing of health care services, they are often subjected to discrimination on the grounds of race, sex, caste and socioeconomic background. This makes them deprived and thus leads to depression eventually. These beliefs are portrayed by individual people through their attitudes and actions (Grant, Simmons & Davey, 2018). Studies have revealed that indigenous mental health, along with well-being, can be perceived to be multifaceted and can be connected to cultural identity in a number of ways. Studies have also confirmed that there is a huge support for the promotion of pathways to render early intervention (Nasir et al., 2018). These interventions included community-based services along with community-based resources that included cultural programs involving Aboriginal families.

Psychoeducation Therapy for Depression

Aboriginal communities are very adaptive to kinship and family structures which are the cohesive force that binds the people of the community together. Smith & Hunt (2018), opined that the system of kinship, a person establishes their relationship with other people as well as the Universe that prescribes the responsibilities of a person towards others along with the natural resources. It is with the help of kinship that the people in the Aboriginal community understand where they fit in the community (Grant, Simmons & Davey 2018). The people of the Aboriginal community rely highly on the advice and remedial measures provided by their families and peer people from the community rather than the actual healthcare workers from the mainstream community (Haregu et al., 2021). This happens because of the racial and ethnic discrimination they face from the mainstream population on the basis of their identity. Therefore, one of the intervention methods of using that can be used for recovering from depression among the Aboriginals is peer-based support. Social support, along with mutual-help groups, plays an important role in promoting healthy outcomes for patients who are suffering from depression. The peer providers render valuable guidance through the sharing of their own experiences of depressive instances (Bowersox et al., 2021). This helps the people of the Aboriginal community to build various skills while addressing the specific needs of the target individual. Grant, Simmons & Davey (2018) stated that peer-support service improves social connectedness while helping the individual to identify social environments that are positive and new.

According to McDaid, Hewlett & Park (2017), a Liaison Officer can be of help while rendering peer support to the individuals of the Aboriginal community. A liaison office is a communication professional who can act as a bridge between the healthcare staff, such as the nurse and the person seeking support as a remedy or treatment. Effective communication with the staff of the hospital may be difficult for Aboriginal individuals on the grounds of discrimination faced them due to their ethnicity (Bowersox et al., 2021). The terminologies and the process of intervention might often appear to be difficult for them. When the nurse and the patient are unable to communicate properly, it can be a very serious issue. Such serious issues can also give rise to life-threatening situations (Bedi, 2018). In case of providing intervention for depression to a patient of the Aboriginal community, the Liaison officer can belong to the same community, which will enhance communication in a better manner. The patient liaison officer will ensure that all the rights as well as interests of the patient are met, which is inclusive of helping the patients and their families along with the management of the hospital so that they can resolve their complaints in an efficient manner (Karidakis, 2021). It has been found that interpreters such as liaison officers are completely impartial while delivering a service that is confidential. If the liaison officer communicates the remedies suggested by the nurse to the patient as well as his family, the Aboriginal individual, they are more likely to embrace it as they are prone to adopting kinship (Karidakis, 2021). Since peer support brings people together, respecting the cultural differences of the communities, through peer support, which is a community-based service, a nurse can provide effective intervention to an Aboriginal individual in a culturally safe manner to overcome the situation of major depression.

Depression, when it persists for a long time, leads to major depressive disorder. It leads to interference with the maintenance of regular and normal life. When the feeling of sadness, loneliness and emptiness persists for over a long time, it can be considered a major depressive disorder. It is also known as clinical depression, which impacts behaviour and mood disorders along with disruption in the functioning of various physical functions such as appetite as well as sleep. The symptoms of the major depressive disorder occur for more than two years. People lose interest in activities; they have a feeling of sadness or irritability. There is a lack of energy and a feeling of restlessness. The person feels guilty about any action happening in their life unnecessarily (Nasir et al., 2018). The difficulty to concentrate on tasks is another problem associated with depression, and in worst cases, people have suicidal thoughts. Due to the increased prevalence as well as a burden which is associated with major depression, it has been understood that there is a clear requirement for psychoeducational intervention for overcoming depression for a person belonging to the community of Aboriginals.

There are various effective treatments available for the treatment of mental disorders. Despite this fact, it has been seen that only a small group of people affected with depression receive proper treatment for the same. This is usually because the delivery rate of treatment is low. There is usually a very long cue due to the lesser workforce, huge expenses of treatment and the perceived social stigma which restricts individuals from seeking help while continuing to suffer from depression. Psychoeducation therapy is inexpensive as well as effective. Psychoeducation therapy, though not completely effective, may be considered an initial step to help people experiencing depression in the community models or in primary care (Jones et al., 2018). This therapy can range from the delivery of materials such as posters and pamphlets, emails and social media posts to multi-session group-intervention measures that are activities involving the guidance of a therapist.

Group therapy involves a group of psychotherapists working in a group with several people who are beneficiaries at a time. It can be practised in clinics and hospitals as well as in community settings. Sometimes, group therapy may also be used alone, but it is done mostly in the form of an integrated plan of treatment which is also comprehensive and is inclusive of individual therapy. In group therapy involving more than two people, the people should sit in a way by which they can see each other while being able to interact. Group therapy may also include the family of the patient, which helps in increasing the family bond as well (Nasir et al., 2018). Members in group therapy share their feelings, strengths and weaknesses while the therapists help in inculcating socialisation techniques by acquiring trust and confidence along with being supportive. The therapist encourages the patients to go ahead with experiments without the fear of being judged or failures. Sharing feelings or experiences can help a patient relieve guilt and stress (Fonagy, Campbell & Bateman, 2017). In the case of group therapy, the therapist offers guidance as well as support in a safe setting and helps victims realise that the people are responsible for their own existence. It instils a lot of hope within depressive patients that their life can become better.

Conclusion

It can be concluded that a community that is somewhat backward in society and discriminated against on the grounds of ethnicity must be guided culturally and safely so that they can overcome a condition of depression which may hamper the total balance of their life. From the above essay, it can be understood that with the help of a liaison officer working with a nurse and the beneficiary of the Aboriginal community suffering from depression, proper care can be rendered, which would overcome problems of depression effectively. The indigenous community can be helped as they would obtain a setting where their culture shall not be hampered much, and they would receive proper remedy. On the other hand, rendering group therapy as a form of psychoeducation therapy can also help a patient suffering from major depression get back into normal life efficiently. 

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