“ AMSANT understands that social determinants of health are critical to improving health outcomes for Aboriginal Communities and recognises the role that these determinants play in the development of mental health and harmful substance use issues within communities.
AMSANT therefore recognises that a crucial component of providing support to the delivery of AOD and Mental Health programs and services through the Community Controlled Sector is to continue to advocate and lobby for the improvement of the social determinants of health and mental health for Aboriginal people.
We understand that these determinants extend beyond issues relating to, for example, housing, education, and employment, to more fundamental issues relating to the importance of control, culture and country and the legacy of a history of trauma and loss.
Strong and empowered community governance is the backbone to community resilience and Self-Determination and leads to better health outcomes
We have great challenges and great opportunities here in the Territory and with your commitment to self-determination, Aboriginal Governance, policies and practices that do not re-traumatise, we can achieve strong outcomes together
But first we need to recognise and acknowledge the past to inform our future journey and the sometimes difficult paths we will need to take.
We as Aboriginal people understand the inter-connectivity of all things;
Our call to action is what part will you play, where are you positioned within this connectivity to ensure health and wellbeing is strong for Gayaa Dhuwi our Proud Spirit. “
John Paterson CEO AMSANT ( Pictured above with Kerry Arabena ) Keynote speech see Part 2 Below
Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander people see part 3 below #HaveYourSay about #closingthegap
Part 1 Help close the Aboriginal and Torres Strait Islander mental health gap by pledging support for the Gayaa Dhuwi (Proud Spirit) Declaration.
” The mental health of Aboriginal and Torres Strait Islander peoples is significantly worse than that of other Australians across many indicators. In particular, the suicide rates are twice as high.
The reasons for the gap are many but include the lack of culturally competent and safe services within the mental health system, that balance clinical responses with culturally-informed responses including access to cultural healing.
To rectify this, Aboriginal and Torres Strait Islander leadership is needed in those parts of the mental health system that work with Aboriginal and Torres Strait Islander populations.
Pledging your organisation’s or personal support for the Gayaa Dhuwi (Proud Spirit) Declaration is a first step in supporting Aboriginal and Torres Strait Islander leadership in appropriate parts of the mental health system to improve our mental health and reduce suicide.”
Or Download the 6 Page Brochure HERE
Gayaa-Dhuwi-Declaration_Proud-Spirit
Part 2
The Aboriginal Medical Services of the NT is the peak body for the community controlled Aboriginal primary health care (PHC) sector in the Northern Territory (NT). We have 25 members providing Aboriginal comprehensive primary health care (CPHC) right across the NT from Darwin to the most remote regions.
AMSANT has been established for 25 years and just recently celebrated our 25 year anniversary in Alice Springs. AMSANT has a major policy and advocacy role at the NT and national levels, including as a partner with the Commonwealth and NT governments in the Northern Territory Aboriginal Health Forum (NTAHF).
The ACCHSs sector in the NT is comparatively more significant than in other jurisdictions, being the largest provider of primary health care services to Aboriginal people in the NT. Over half of all the episodes of care approximately 60% and contacts 65% in the Aboriginal PHC sector in the Northern Territory are provided by ACCHSs. Moreover, ACCHS deliver comprehensive primary health care that incorporates social and emotional wellbeing, mental health and AOD services, family support services and early childhood services, delivered by multidisciplinary teams within a holistic service model.
Aboriginal people experience a disproportionate morbidity and mortality burden from mental health and alcohol and other drug (AOD) problems. Nationally, mental health conditions are estimated to account for 12% of the life expectancy gap between Indigenous and non-Indigenous Australians, with suicide contributing another 6% and alcohol another 4% (Vos et al. 2007). Tragically, from 2011-15, the Indigenous suicide rate was twice that of the non-Indigenous population (AHMAC 2017).
At AMSANT, we have come to believe that encouraging an understanding of trauma and its impact and facilitating trauma informed perspectives and ways of working – for all staff throughout our health services – can enhance service delivery and outcomes for the communities in which these services are based.
Some of the most challenging, complex and life threatening issues faced within our health services can be better understood in the context of historical and ongoing experiences of trauma. But as we understand these difficulties in relation to the stories of trauma that communities have lived through since colonisation, it is vital that we also see and understand the strengths and resilience of Aboriginal and Torres Strait Islander peoples and communities – and that we recognise the central role of connection to culture, cultural identity and cultural continuity in maintaining these strengths and keeping people well.
Many Aboriginal people in the NT are happy, engaged with their families and culture, and prepared to make a positive contribution to their communities. The physical and mental health of Aboriginal people have been maintained through beliefs, practices and ways of life that supported their social and emotional wellbeing across generations and thousands of years.
However, factors unique to the Aboriginal experience—including the historical and ongoing process of colonisation that has seen loss of land, suppression of language and culture, forcible removal of children from families, and experiences of racism—have all contributed to profound feelings of loss and grief and exposure to unresolved trauma, which continues disadvantage, poor health and poor social outcomes for far too many Aboriginal people.
This process has directly involved the disruption and severing of the many connections that are protective in maintaining strong mental health and wellbeing – Our connections to a strong spirit
Identifying the extent and impacts of poor mental health among Aboriginal people must be founded on an understanding of this context and the reality that Aboriginal understandings and experiences of mental health and wellbeing are in many ways very different to that of mainstream society.
Also in relation to health and mental health, there is an acknowledgement of the significance of the social determinants of health. There is an understanding of how ongoing marginalisation, disempowerment, discrimination and stress contribute to poor health and mental health outcomes.
AMSANT understands that social determinants of health are critical to improving health outcomes for Aboriginal Communities and recognises the role that these determinants play in the development of mental health and harmful substance use issues within communities.
AMSANT therefore recognises that a crucial component of providing support to the delivery of AOD and Mental Health programs and services through the Community Controlled Sector is to continue to advocate and lobby for the improvement of the social determinants of health and mental health for Aboriginal people.
We understand that these determinants extend beyond issues relating to, for example, housing, education, and employment, to more fundamental issues relating to the importance of control, culture and country and the legacy of a history of trauma and loss.
Strong and empowered community governance is the backbone to community resilience and Self-Determination and leads to better health outcomes. For this reason APONT’s Partnership Principles have been developed to improve collaboration and coordination between service providers with the aim of strengthening and rebuilding an Aboriginal controlled development and service sector in the NT.
It is widely understood that mental illness carries a certain amount of social stigma. The impact of this is magnified however for Aboriginal people, who are often subject to systemic racism and discrimination in their everyday lives. This is demonstrated in the overrepresentation of Aboriginal young people in justice and child protection systems
Census data from June 2017 revealed that among the 964 young people in detention on an average night in Australia, 53% were Aboriginal or Torres Strait Islander and 64% had not been sentenced. In the Northern Territory, these rates were as high as 95% for Aboriginal or Torres Strait Islander children, with 70% not sentenced.
It is now well known that unresolved traumatic experience impacts the developing brain, causing an over-developed fear response leading to increased stress sensitivity and related symptoms can include isolation, aggression, lack of empathy and impulsive behaviour.
Often children in the youth justice system may appear to be violent, aggressive, oppositional, unreachable or disturbed, however, underlying these behaviours is the grief of a child who has had to live through experiences that no human being should ever experience especially a child who does not have the agency to repair, respond and heal, resulting in feelings of powerlessness, anxiousness, and depression.
For these reasons, having a youth justice system that incorporates punishment as a form of behavioural management will only perpetuate the child’s belief that their world is unsafe, and further compound and escalate complex and violent behaviours. If the emotional and psychological wounds do not get appropriately addressed then there is risk of a lifelong pattern of anger, aggression, self-destructive behaviours, academic and employment failures, and rejection, conflict, and isolation in every key relationship. This cycle of trauma and violence can continue across generations.
AMSANT believes that a youth justice system that is trauma informed and sits within a social emotional wellbeing (SEWB) framework would be a positive way forward in redirecting youth away from the justice system, supporting social and emotional health and aiding in community re-entry.
It is also necessary to understand and confront the cumulative impacts of institutional racialism and discriminative policies. For example, the Intervention in the Northern Territory involved the imposition of a series of punitive measures against 73 Aboriginal communities and denied opportunities for community leaders to govern their own communities. The effects of the Intervention on Indigenous people throughout the NT and the fundamental disempowerment that it represented, can hardly be overstated and is demonstrated in our continuing unacceptable disparity in health outcomes.
However Aboriginal Territorian are working together and in collaboration to overcome these disparities. For example, here in the Territory we have the Aboriginal Health Forum which provides high-level guidance and decision-making. The Forum enables joint planning and information sharing, where partners work together in a spirit of partnership and collaboration.
Nationally AMSANT is involved through the Coalition of Peaks in developing agreed policy positions to negotiate a new National Agreement on Closing the Gap with the Council of Australian Governments or COAG. For a long time, Aboriginal and Torres Strait Islander peoples have been calling to have a much greater say in how programs and services are delivered to our peoples.
See Part 3 below to have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander people #HaveYourSay about #closingthegap
As a result of the work of the Coalition of Peaks, we are now formally represented on the Joint Council on Closing the Gap – which is the first time an external non-government partner has been included within a COAG structure.
Finally we are seeing a change in the policy conversation on Closing the Gap, with our mob at the decision-making table.
And regionally, leadership exists throughout all of our communities. Even without the resources and empowerment that would allow for leadership and governance to thrive, it is intrinsically there, understood and followed by the protocols of community life and our kinship systems.
Our ACCHS in the Northern Territory recognise social emotional wellbeing as holistic and interconnected which includes our cultural knowledge and practices as well as mental health and the social determinants of health.
Having control and governance over our service delivery has paved the way for innovation and best practice within our SEWB programs.
We have great challenges and great opportunities here in the Territory and with your commitment to self-determination, Aboriginal Governance, policies and practices that do not re-traumatise, we can achieve strong outcomes together
But first we need to recognise and acknowledge the past to inform our future journey and the sometimes difficult paths we will need to take.
We as Aboriginal people understand the inter-connectivity of all things;
Our call to action is what part will you play, where are you positioned within this connectivity to ensure health and wellbeing is strong for Gayaa Dhuwi our Proud Spirit.
Part 3 Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander people #HaveYourSay about #closingthegap
There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.
The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.
To help you prepare your answers, you can look at a full copy here
The survey is open to everyone and can be accessed here:
https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/