Learning From Decolonising Practice: What Mental Health Professionals Can Do Differently
Listening to Indigenous leadership and reshaping care beyond Western frameworks.
Across the world, Indigenous communities continue to face the consequences of colonisation in every layer of life, including mental health care. A recent article in Psychiatric Times by social worker and researcher Dr Jennifer Gereda invites the profession to look inward and ask an uncomfortable but necessary question: what if the ways we define good practice are still rooted in colonial assumptions?
Her piece, Beyond Compliance: Addressing Indigenous Mental Health and What Is Missing in Clinical Practice, argues that progress requires more than adding cultural awareness to existing systems. It asks clinicians, supervisors, and educators to rethink the foundations of mental health work itself: whose knowledge is valued, whose ways of healing are legitimised, and who gets to decide what safety looks like.
What Western frameworks miss
Mainstream psychiatry often separates distress from its social and historical context. It interprets behaviour through an individual lens, rather than through family, kinship, and community. As Gereda notes, this leads to misdiagnosis and harm. A family relying on collective caregiving may be labelled enmeshed. A teenager working to support their household may be judged neglected. These assumptions can invite punitive interventions such as child protection involvement or forced compliance with Eurocentric parenting norms.
The outcome is predictable: families lose trust, culture is sidelined, and the system reproduces the very inequities it was meant to address.
What culturally grounded practice looks like
Gereda offers a clear alternative. Decolonising practice does not reject clinical knowledge. It reframes it through respect for community knowledge, shared decision-making, and historical understanding.
Neurodecolonisation and cultural mindfulness
Healing practices already exist within Indigenous traditions. Grounding, ceremony, storytelling, and land-based rituals are not cultural add-ons; they are evidence of centuries of psychological wisdom. When clinicians make space for these, regulation and safety follow naturally.
Parenting support that reflects real life
Services should fit families, not the other way around. Meeting parents at their literacy level, using their preferred communication style, or shifting appointment times to match their work hours are not small adjustments. They are acts of respect. Reframing survival strategies as strengths helps families see themselves as resourceful rather than deficient.
Community healing structures
Tools such as cultural genograms and talking circles allow families to name both trauma and resilience. Talking circles, used in many Indigenous and migrant communities, have been shown to strengthen cultural identity and reduce stress while restoring collective care.
Rethinking supervision
Gereda’s call extends to those who lead and teach. Supervision, she argues, often replicates colonial hierarchies by valuing neutrality over relationship and control over reflection. Decolonising supervision means slowing down, naming positionality, and acknowledging that multiple truths and knowledge systems can coexist.
Authentic supervision models, like those adapted from South African social work scholar Leon Engelbrecht, emphasise humility, collaboration, and accountability to the communities being served. When supervisors create space for this kind of reflexivity, frontline practitioners gain permission to integrate culture without fear of being seen as unprofessional.
What practitioners can start doing now
Begin every assessment with context: land, language, family, migration, and history.
Ask what healing means to the person or community, not just what symptoms they want to reduce.
Include cultural mentors or Elders in care planning and pay them for their expertise.
Use visual or narrative tools to map intergenerational experience, not just pathology.
Add decolonising reflection to supervision agendas: what power dynamics show up in our sessions, whose comfort is centred.
Challenge policies that treat risk as a reason for separation rather than support.
Working in solidarity, not interpretation
For those of us who are not Indigenous, decolonising practice begins with recognising our own location in these systems. It asks us to listen more than we speak, to cite and compensate Indigenous knowledge holders, and to treat cultural guidance as expertise, not consultation.
At PTC, we understand that allyship is ongoing work. Decolonising care is not a single initiative. It is a long process of unlearning and rebuilding, guided by those who have been doing this work for generations.
Healing, as Gereda reminds us, is not just clinical. It is historical, cultural, and political. The most ethical thing any practitioner can do is to stand beside Indigenous communities, not above them, and to help restore the relationships that colonisation tried to sever.
Reference:
Gereda, J. (2025, August 22). Beyond Compliance: Addressing Indigenous Mental Health and What Is Missing in Clinical Practice. Psychiatric Times.