https://doi.org/10.1177/1039856218789765 Australasian Psychiatry 1–4 © The Royal Australian and New Zealand College of Psychiatrists 2018 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1039856218789765 journals.sagepub.com/home/apy 1 AUSTRALASIAN PSYCHIATRY O ver two decades ago the Ways Forward report identified major mental health problems, high levels of unmet need, limited resources, poor data collection and significant social disadvantage. 1 Mainstream mental health services were perceived as lacking cultural understanding and as having views of health and wellness at odds with Indigenous views. Ways Forward made recommendations for governments, health services and clinicians. In response to Ways Forward and a number of similar reports on physical health, the Commonwealth Government undertook to ‘close the gap’, leading to initiatives including the Aboriginal and Torres Strait Islanders health performance framework and annual Prime Minister’s progress reports. The most recent sixth report highlighted unmet targets in a number of health domains including chronic disease, significantly increasing Indigenous suicide rates, increasing psycho- logical distress and worsening social determinants of well-being (employment, education, nutrition and housing). 2 Barriers to healthcare continue, as does Advancing social and emotional well-being in Aboriginal and Torres Strait Islander Australians: Clinicians’ reflections Sivasankaran Balaratnasingam Visiting Psychiatrist, Kimberley Mental Health and Drug Service, Broome, WA, Australia; Clinical Director, The Cairns Clinic, Cairns, QLD, Australia. Murray Chapman Medical Director, Abbotsford Psychiatric Hospital, West Leederville, WA, Australia. Derek Chong Institute for Urban Indigenous Health, Southern Queensland Centre of Excellence in Indigenous Primary Healthcare, Windsor, QLD, Australia. Ernest Hunter Adjunct Professor, The Cairns Institute, James Cook University and the School of Population Health, University of Queensland, Cairns, QLD, Australia. Jason Lee Mental Health Service Group, Townsville Hospital and Health Service, Douglas, QLD, Australia. Carolyn Little Top End Mental Health Service, Darwin, Flinders University, Australia; Northern Territory Medical Program, Darwin, NT, Australia. Kim Mulholland Cultural Wellbeing Consultant, IvolveGen, Darwin, NT, Australia. Robert Parker Associate Professor, School of Medicine, Faculty of Medicine, Nursing, and Health Sciences, Flinders University, Adelaide, SA, Northern Territory Medical Program, Casuarina, NT, Australia. Marshall Watson Child and Adolescent Mental Health Service, SA Health, Adelaide, SA, Australia. Aleksandar Janca Winthrop Professor of Psychiatry, Medical School, University of Western Australia, Perth, WA, Australia. Abstract Objective: An expert reference group met on four occasions to consider ways forward in terms of Indigenous mental health. This paper summarises the discussion and recommendations. Conclusion: While the negative effects of colonisation and trans-generational trauma continue, we propose renewed emphasis on improving access, cultural orientation and trauma-informed care, and a focus on the needs of young Indigenous Australians. Keywords: aboriginal, Torres Strait Islander, Indigenous, mental health, social-emotional well-being Corresponding author: Sivasankaran Balaratnasingam, The Cairns Clinic, Cairns, QLD 4870, Australia. Email: siva.bala@health.wa.gov.au 789765APY Australasian PsychiatryBalaratnasingam et al. Regular Article