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Life, lifestyle and location: examining the complexities of psychological distress in young adult Indigenous and non-Indigenous Australians

  • B. Davison (a1), T. Nagel (a1) and G. R. Singh (a1) (a2)


Mental health is fundamental to an individual’s health and well-being. Mental health disorders affect a substantial portion of the Australian population, with the most vulnerable time in adolescence and young adulthood. Indigenous Australians fare worse than other Australians on almost every measure of physical and mental health. Cross-sectional data from young adults (21–27 years) participating in the Life Course Program, Northern Territory, Australia, is presented. Rates of psychological distress were high in remote and urban residing Indigenous and urban non-Indigenous young adults. This rate was more pronounced in young women, particularly in Indigenous remote and urban residing women. Young adults with high psychological distress also had lower levels of positive well-being, higher perceived stress levels, experienced a higher number of major life events and were at an increased risk of suicidal ideation and/or self-harm. This study supports the need for a continued focus on early screening and treatment at this vulnerable age. The significant association seen between psychological distress and other markers of emotional well-being, particularly risk of suicidal ideation and/or self-harm, highlights the need for a holistic approach to mental health assessment and treatment. A concerted focus on improving the environs of young adults by lowering levels of stress, improving access to adequate housing, educational and employment opportunity, will assist in improving the emotional health of young adults.


Corresponding author

*Address for correspondence: B. Davison, Menzies School of Health Research, Casuarina 0811, Australia. (Email


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1. Walker, ER, McGee, RE, Druss, BG. Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry. 2015; 72, 334341.
2. Kessler, RC, Matthias, A, Anthony, JC, et al. Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative, 2007.
3. Slade, T, Johnston, A, Teesson, M, et al. The mental health of australians 2. Report on the 2007 National Survey of Mental Health and Wellbeing, Department of Health and Ageing, Canberra. Report No.: 4326.0. Accessed on 10th February 2017.
4. Lavoie, JG. Governed by contracts: the development of Indigenous primary health services in Canada, Australia and New Zealand. Int J Indig Health. 2004; 1, 624.
5. Australian Bureau of Statistics. Life tables for Aboriginal and Torres Strait Islander Australians, 2010–2012 (cat. 3302.0.55. 003), 2013. Retrieved 10th February 2017 from
6. Australian Bureau of Statistics. Australian Aboriginal and Torres Strait Islander Health Survey: first results, Australia, 2012–13 (cat. no. 4727.0.55.001), 2013. Retrieved 1st February 2017 from
7. Bailie, RS, Stevens, M, McDonald, EL. Impact of housing improvement and the socio-physical environment on the mental health of children’s carers: a cohort study in Australian Aboriginal communities. BMC Public Health. 2014; 14, 472.
8. Berry, JG, Harrison, JE, Ryan, P. Hospital admissions of Indigenous and non-Indigenous Australians due to interpersonal violence, July 1999 to June 2004. Aust N Z J Public Health. 2009; 33, 215222.
9. Tovell, A, McKenna, K, Bradley, C, Pointer, S. Hospital separations due to injury and poisoning, Australia 2009–10. Injury research and statistics series no. 69. Cat. no. INJCAT 145. Canberra: Australian Institute of Health and Welfare.
10. Blair, EM, Zubrick, SR, Cox, AH. The Western Australian Aboriginal Child Health Survey: findings to date on adolescents. Med J Aust. 2005; 183, 433435.
11. World Health Organization. World Report on Violence and Health: Summary, 2002. World Health Organization: Geneva.
12. Australian Bureau of Statistics. Suicides, Australia, 2010: Canberra (cat no. 3309.0), 2012. Retrieved 10th February 2017 from
13. Leckning, BA, Li, SQ, Cunningham, T, et al. Trends in hospital admissions involving suicidal behaviour in the Northern Territory, 2001–2013. Australas Psychiatry. 2016; 24.3, 300304.
14. Mościcki, EK. Epidemiology of completed and attempted suicide: toward a framework for prevention. Clin Neurosci Res. 2001; 1, 310323.
15. Fergusson, DM, Woodward, LJ, Horwood, LJ. Risk factors and life processes associated with the onset of suicidal behaviour during adolescence and early adulthood. Psychol Med. 2000; 30, 2339.
16. Dole, N, Savitz, DA, Hertz-Picciotto, I, et al. Maternal stress and preterm birth. Am J Epidemiol. 2003; 157, 1424.
17. Rondo, P, Ferreira, R, Nogueira, F, et al. Maternal psychological stress and distress as predictors of low birth weight, prematurity and intrauterine growth retardation. Eur J Clin Nutr. 2003; 57, 266272.
18. Grote, NK, Bridge, JA, Gavin, AR, et al. A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry. 2010; 67, 10121024.
19. Robinson, M, Mattes, E, Oddy, WH, et al. Prenatal stress and risk of behavioral morbidity from age 2 to 14 years: the influence of the number, type, and timing of stressful life events. Dev Psychopathol. 2011; 23, 507520.
20. Australian Bureau of Statistics. 2011 Census QuickStats: Northern Territory, Code 7 (STE), 2011. Retrieved 1st January 2017 from
21. Lawrance, M, Sayers, SM, Singh, GR. Challenges and strategies for cohort retention and data collection in an Indigenous population: Australian Aboriginal Birth Cohort. BMC Med Res Methodol. 2014; 14, 31.
22. Gruen, RL, Weeramanthri, T, Bailie, R. Outreach and improved access to specialist services for Indigenous people in remote Australia: the requirements for sustainability. J Epidemiol Community Health. 2002; 56, 517521.
23. Hinton, R, Kavanagh, DJ, Barclay, L, Chenhall, R, Nagel, T. Developing a best practice pathway to support improvements in Indigenous Australians’ mental health and well-being: a qualitative study. BMJ Open. 2015; 5, e007938.
24. Sayers, S, Singh, G, Mackerras, D, et al. Australian Aboriginal birth cohort study: follow-up processes at 20 years. BMC Int Health Hum Rights. 2009; 9, 23.
25. Davison, B, Cunningham, T, Singh, G. Engaging adolescents and young adults in a longitudinal health study: experience from the Top End Cohort. Aust N Z J Public Health. 2011; 35, 8687.
26. Sayers, S, Powers, J. Birth size of Australian Aboriginal babies. Med J Aust. 1993; 159, 586591.
27. Sayers, SM, Mackerras, D, Singh, G, et al. An Australian Aboriginal birth cohort: a unique resource for a life course study of an Indigenous population. A study protocol. BMC Int Health Hum Rights. 2003; 3, 1.
28. McNamara, BJ, Banks, E, Gubhaju, L, et al. Measuring psychological distress in older Aboriginal and Torres Strait Islanders Australians: a comparison of the K-10 and K-5. Aust N Z J Public Health. 2014; 38, 567573.
29. Nagel, T, Robinson, G, Condon, J, Trauer, T. Approach to treatment of mental illness and substance dependence in remote Indigenous communities: results of a mixed methods study. Aust J Rural Health. 2009; 17, 174182.
30. Jorm, AF, Bourchier, SJ, Cvetkovski, S, Stewart, G. Mental health of Indigenous Australians: a review of findings from community surveys. Med J Aust. 2012; 196, 118121.
31. Cohen, S, Kamarck, T, Mermelstein, R. A global measure of perceived stress. J Health Soc Behav. 1983; 385396.
32. Wiggers, J, Radvan, D, Clover, K, et al. Public housing, public health: health needs of public housing tenants. Aust N Z J Public Health. 2001; 25, 111114.
33. Bartram, DJ, Sinclair, JM, Baldwin, DS. Further validation of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) in the UK veterinary profession: Rasch analysis. Qual Life Res. 2013; 22, 379391.
34. Clarke, A, Friede, T, Putz, R, et al. Warwick-Edinburgh Mental Well-being Scale (WEMWBS): validated for teenage school students in England and Scotland. A mixed methods assessment. BMC Public Health. 2011; 11, 487.
35. Thomas, A, Cairney, S, Gunthorpe, W, Paradies, Y, Sayers, S. Strong souls: development and validation of a culturally appropriate tool for assessment of social and emotional well-being in Indigenous youth. Aust N Z J Psychiatry. 2010; 44, 4048.
36. Kowal, E, Gunthorpe, W, Bailie, RS. Measuring emotional and social wellbeing in Aboriginal and Torres Strait Islander populations: an analysis of a Negative Life Events Scale. Int J Equity Health. 2007; 6, 18.
37. Australian Bureau of Statistics. Census of population and housing: Socio-Economic Indexes for Areas (SEIFA), Australia (cat no. 2033.0.55.001), 2011.
38. Kessler, RC, Andrews, G, Colpe, LJ, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002; 32, 959976.
39. Jöreskog, KG. A general approach to confirmatory maximum likelihood factor analysis. ETS Res Bull Series. 1967; 1967, 183202.
40. Cunningham, J, Paradies, YC. Socio-demographic factors and psychological distress in Indigenous and non-Indigenous Australian adults aged 18-64 years: analysis of national survey data. BMC Public Health. 2012; 12, 95.
41. Burgess, C, Johnston, F, Bowman, D, Whitehead, P. Healthy country: healthy people? Exploring the health benefits of Indigenous natural resource management. Aust N Z J Public Health. 2005; 29, 117122.
42. Australian Bureau of Statistics. Australian Health Survey: first results, 2011–12-Northern Territory (cat. no. 43640DO001_20112012), 2015. Retrieved 11th January 2017 from
43. Allgulander, C. Psychoactive drug use in a general population sample, Sweden: correlates with perceived health, psychiatric diagnoses, and mortality in an automated record-linkage study. Am J Public Health. 1989; 79, 10061010.
44. Najman, JM, Aird, R, Bor, W, et al. The generational transmission of socioeconomic inequalities in child cognitive development and emotional health. Soc Sci Med. 2004; 58.
45. Lancaster, CA, Gold, KJ, Flynn, HA, et al. Risk factors for depressive symptoms during pregnancy: a systematic review. Am J Obstet Gynecol. 2010; 202, 514.


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