“COVID-19 has put many more Indigenous Australians at risk of severe psychological distress,” Professor Dudgeon said.

Prior to the pandemic, Aboriginal and Torres Strait Islander people already faced health and mental health disadvantages and inadequate and inequitable access to mental health care.

Now modelling shows that a severe increase in suicide rates could be expected, and Indigenous people are already over-represented in suicide rates in Australia, especially youth.

It is important for the government to respond to the clear findings in the report with equitable investment to support Indigenous-led initiatives to protect health and wellbeing.

Culturally safe, trauma-informed, lived-experience solutions that respond to the health and wellbeing needs have been established, but are under-resourced,” 

The national pandemic response for Aboriginal and Torres Strait Islanders and communities must be a priority, led, developed and delivered by Aboriginal and Torres Strait Islander organisations, communities and people.”

Professor Pat Dudgeon Director of the Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention and the Transforming Indigenous Mental Health and Wellbeing  and from UWA’s School of Indigenous Studies, who led the working group, said Aboriginal and Torres Strait Islanders were already more than twice as likely as other Australians to die by suicide.

Indigenous communities must be empowered to address the social and emotional wellbeing needs of Aboriginals and Torres Strait Islanders, with COVID-19 putting an additional strain on mental health, a national consensus report led by The University of Western Australia has revealed.

The National COVID-19 Pandemic Issues Paper on Mental Health and Wellbeing For Aboriginal & Torres Strait Islander Peoples summarises the perspectives of a working group of more than 30 Indigenous leaders Australia-wide.

It lists five priorities to mitigate the impact of the pandemic on the psychological wellbeing of Indigenous people as restrictions ease.

These include the right to self-determination, health and mental health of the workforce, social and cultural determinants of health, digital and telehealth inclusion with immediate attention to an Indigenous helpline and evaluation that includes Indigenous data sovereignty.

Within each key recommendation, several key actions are outlined.

Key Issues.

• Prior to COVID-19, Aboriginal and Torres Strait Islander peoples already faced health and mental health disadvantages and inadequate and inequitable access to mental health
• Globally, Indigenous peoples are disproportionately impacted by The Australian Government’s COVID-19 mental health response must address the existing social inequities that make Indigenous peoples more vulnerable to and heavily impacted by pandemics.
• Suicide rates among Aboriginal and Torres Strait people are double those of other An increase in suicide rates is now predicted. The impacts of the COVID-19 pandemic and health response on mental health will be devastating if not managed appropriately.
• In response to COVID-19, the Government has provided extra investment in mental health support. Yet, despite known risks, funding has been largely directed to mainstream services that will not meet the specific needs of Aboriginal and Torres Strait Islander peoples and communities alone.
• Culturally safe, trauma-informed, lived-experience solutions that respond to the health and wellbeing needs and diversity of Aboriginal and Torres Strait Islander peoples and communities have been established, but are chronically under-resourced.
• The national pandemic response for Aboriginal and Torres Strait Islander peoples and communities must be a priority and led, developed, and delivered by Aboriginal and Torres Strait Islander organisations, communities, and

Key Recommendations.

1.Self-determination – Support Aboriginal and Torres Strait Islander leaders and organisations to lead the pandemic mental health responses for their peoples and communities. This calls for direct funding to Indigenous organisations to fund Indigenous-led actions which will best meet the needs of Indigenous peoples, families and

2. Health and Mental Health Workforce – Improve the accessibility of culturally safe care that meets the needs of families and communities. It is critical to support and appropriately utilise the existing local workforce, and to create and grow a longer-term, place-based, multidisciplinary Indigenous social and emotional wellbeing (SEWB)

3.Social and Cultural Determinants – Implement the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017-2023 to enable culturally safe and sustainable approaches to improved mental health. Social determinants of health must be addressed and SEWB programs that are designed, delivered and culturally informed by Indigenous peoples must be supported.

4.Digital and Telehealth – Provide accessible and affordable Internet access and ensure digital and tele-health services to Indigenous communities are culturally safe and trauma-informed. An Indigenous-led helpline to be made available immediately.

5.Evaluation – Implement a comprehensive quantitative and qualitative national research and evaluation program that covers urban, regional, and remote communities, promotes accountability of funding models, and enables Indigenous data

The COVID-19 pandemic is far from over. The responses to this pandemic will shape our future. Government actions taken now will determine the severity of the mental health impacts and subsequent recovery for Aboriginal and Torres Strait Islander peoples, who have already been disadvantaged by historical and intergenerational trauma, economic inequity, and inadequate access to health services and a culturally safe and responsive workforce.

This disadvantage results in higher risk of trauma, mental illness, economic injury, and burnout during the fourth wave of a pandemic (pictured above ).

Structural change is needed. The current pandemic mental health plan and system is not sufficient5,6 to prevent the worst-case scenario for Aboriginal and Torres Strait Islander peoples in the predicted new mental health7 and suicide8 epidemic. Immediate action is needed to ensure culturally safe services9 are accessible and sufficiently resourced to support the psychosocial recovery from lockdown, restricted practices, and the inevitable economic recession to follow.

At the time of writing, under 60 cases of COVID-19 have been notified among Aboriginal and Torres Strait Islander peoples, representing 0.8% of all Australian cases.

Our communities have been kept physically safe through a highly successful COVID-19 health response due to the innovation, leadership, and management of the Aboriginal community-controlled health sector (ACCHO), led by National Aboriginal Community Controlled Health Organisation (NACCHO) and peak organisations that:

• were prepared to respond independently and early in the pandemic,
• united diverse sectors (health, education, land councils, government agencies),
• protected and prepared communities for lockdown, and
• developed effective local communication

These Indigenous-led actions have demonstrated the importance and impact of self-determination in promoting the health and wellbeing of Indigenous peoples in contemporary Australia11.