In this chapter, we briefly examine harmful substance use and mental health among Aboriginal Australians. We explore a range of issues including current substance use and related harms, social and emotional wellbeing and comorbidity, and the social determinants of mental health and harmful substance use. We examine the range of services that have been developed to address these issues, through the National Drug Strategy’s demand, supply and harm reduction framework. We argue that a multi-systemic strategy is required that addresses issues of cultural security, evidence-based practice to enhance treatment outcomes, better service coordination, and attention to the development of the Aboriginal substance use and mental health workforce. Some evidence-based treatments to help with mental illness and harmful substance use are adaptable to work with or along-side local, culturally appropriate, interventions. However, we reiterate that until the social and structural determinants of good mental health are addressed, the comorbidity of harmful substance use and mental health among Aboriginal Australians will linger.
This chapter will explore these issues in more detail and focus specifically on four important areas of concern. What are the problems? What are the underlying issues? What is, and can be done, to address harmful substance use among Aboriginal people? What else needs to be done?