Reflecting on a paper published in Australasian Psychiatry one decade ago, the author identifies that in terms of gross indices of morbidity and mortality little has changed despite what appears to be substantial activity and effort. To explain this apparent paradox, the author examines a number of specific areas of change: critical issues, services, language, research, and health ‘players’. These are put in a historical context.Conclusions
Given the enormity of social disadvantage and the deplorable state of health resources available to Indigenous Australians three decades ago, significant preconditions for health advancement have been required, which are themselves intermediate or process outcomes. In relation to a range of these including Indigenous workforce participation and research capacity, there have been very substantial developments in the last decade. This effort will need to be sustained in the long term to realize reductions in health differentials.