NACCHO Aboriginal Health and #BlackLivesMatter : Former President  shares advice on how to make George Floyd protests ‘a turning point : Plus Australia must look in the mirror to see our own deaths in custody

” I recognize that these past few months have been hard and dispiriting – that the fear, sorrow, uncertainty, and hardship of a pandemic have been compounded by tragic reminders that prejudice and inequality still shape so much of American life.

But watching the heightened activism of young people in recent weeks, of every race and every station, makes me hopeful.

If, going forward, we can channel our justifiable anger into peaceful, sustained, and effective action, then this moment can be a real turning point in our nation’s long journey to live up to our highest ideals.

Let’s get to work.

Barack Obama former US President Facebook post : In full part 1 below

 ” I can’t breathe, please! Let me up, please! I can’t breathe! I can’t breathe!

These words are not the words of George Floyd or Eric Garner. They weren’t uttered on the streets of Minneapolis or New York.

These are the final words of a 26-year-old Dunghutti man who died in a prison in south-eastern Sydney.

The deaths in custody of First Nations Australians are not hidden. As a nation, we are choosing not to look at them. In 1991, the Royal Commission into Aboriginal Deaths in Custody documented 99 deaths in custody.

Since then, 432 Indigenous Australians have died in custody, according to Guardian Australia’s Deaths Inside project.

Read full article in The Conversation

Part 1

 

As millions of people across the country take to the streets and raise their voices in response to the killing of George Floyd and the ongoing problem of unequal justice, many people have reached out asking how we can sustain momentum to bring about real change.

Ultimately, it’s going to be up to a new generation of activists to shape strategies that best fit the times. But I believe there are some basic lessons to draw from past efforts that are worth remembering.

First, the waves of protests across the country represent a genuine and legitimate frustration over a decades-long failure to reform police practices and the broader criminal justice system in the United States.

The overwhelming majority of participants have been peaceful, courageous, responsible, and inspiring. They deserve our respect and support, not condemnation – something that police in cities like Camden and Flint have commendably understood.

On the other hand, the small minority of folks who’ve resorted to violence in various forms, whether out of genuine anger or mere opportunism, are putting innocent people at risk, compounding the destruction of neighborhoods that are often already short on services and investment and detracting from the larger cause.

I saw an elderly black woman being interviewed today in tears because the only grocery store in her neighborhood had been trashed. If history is any guide, that store may take years to come back. So let’s not excuse violence, or rationalize it, or participate in it. If we want our criminal justice system, and American society at large, to operate on a higher ethical code, then we have to model that code ourselves.

Second, I’ve heard some suggest that the recurrent problem of racial bias in our criminal justice system proves that only protests and direct action can bring about change, and that voting and participation in electoral politics is a waste of time. I couldn’t disagree more.

The point of protest is to raise public awareness, to put a spotlight on injustice, and to make the powers that be uncomfortable; in fact, throughout American history, it’s often only been in response to protests and civil disobedience that the political system has even paid attention to marginalized communities.

But eventually, aspirations have to be translated into specific laws and institutional practices – and in a democracy, that only happens when we elect government officials who are responsive to our demands.

Moreover, it’s important for us to understand which levels of government have the biggest impact on our criminal justice system and police practices. When we think about politics, a lot of us focus only on the presidency and the federal government.

And yes, we should be fighting to make sure that we have a president, a Congress, a U.S. Justice Department, and a federal judiciary that actually recognize the ongoing, corrosive role that racism plays in our society and want to do something about it. But the elected officials who matter most in reforming police departments and the criminal justice system work at the state and local levels.

It’s mayors and county executives that appoint most police chiefs and negotiate collective bargaining agreements with police unions. It’s district attorneys and state’s attorneys that decide whether or not to investigate and ultimately charge those involved in police misconduct.

Those are all elected positions. In some places, police review boards with the power to monitor police conduct are elected as well. Unfortunately, voter turnout in these local races is usually pitifully low, especially among young people – which makes no sense given the direct impact these offices have on social justice issues, not to mention the fact that who wins and who loses those seats is often determined by just a few thousand, or even a few hundred, votes.

So the bottom line is this: if we want to bring about real change, then the choice isn’t between protest and politics. We have to do both. We have to mobilize to raise awareness, and we have to organize and cast our ballots to make sure that we elect candidates who will act on reform.

Finally, the more specific we can make demands for criminal justice and police reform, the harder it will be for elected officials to just offer lip service to the cause and then fall back into business as usual once protests have gone away. The content of that reform agenda will be different for various communities. A big city may need one set of reforms; a rural community may need another.

Some agencies will require wholesale rehabilitation; others should make minor improvements. Every law enforcement agency should have clear policies, including an independent body that conducts investigations of alleged misconduct. Tailoring reforms for each community will require local activists and organizations to do their research and educate fellow citizens in their community on what strategies work best.

But as a starting point, I’ve included two links below. One leads to a report and toolkit developed by the Leadership Conference on Civil and Human Rights and based on the work of the Task Force on 21st Century Policing that I formed when I was in the White House.

And if you’re interested in taking concrete action, we’ve also created a dedicated site at the Obama Foundation to aggregate and direct you to useful resources and organizations who’ve been fighting the good fight at the local and national levels for years.

Let’s get to work.

obama.org/policing-civil-rights-org-toolkit

obama.org/anguish-and-action

 

 

 

 

NACCHO Aboriginal Health and Youth News Alerts : Download @AIHW Youth Justice Report “ Indigenous young people aged 10–17 were 16 times as likely to be under supervision as non-Indigenous young people in 2018–19 “

The rate of Indigenous young people aged 10–17 under supervision on an average day fell from 176 to 172 per 10,000. The rate of non-Indigenous young people fell from 12 to 11 per 10,000.

Although only about 6% of young people aged 10–17 in Australia are Aboriginal or Torres Strait Islander, half (2,448) of the young people under supervision on an average day in 2018–19 were Indigenous.’

Indigenous young people aged 10–17 were 16 times as likely to be under supervision as non-Indigenous young people in 2018–19.”

From AIHW Youth Justice report : Download here or see summary Part 2 below

Youth Justice aihw-

“After the Northern Territory Royal Commission and all the evidence that diversion is much more effective, it’s hard to believe Indigenous kids make up 50% of those under youth justice supervision, but just 5.9% of the population of Australian children

What this tells us is that the need to raise the age of criminal responsibility is more urgent than ever. Until this happens, there must be a moratorium on arrests for children under the age of fourteen.”

Key findings of the latest report include that on average, Indigenous young people entered youth justice supervision at a younger age than non-Indigenous young people; 15.5% of kids in detention on an average day were 14 or under and that 24.7% of kids in detention overall were 14 or under.

It’s particularly alarming that of those in detention, 63% were unsentenced.

Amnesty International Australia Strategic Campaigns Advisor, Joel Clark : Download press release

Indigenous Kids In Prison Amnesty

 

Part 1 AIHW Press Release

The rate of young Aboriginal and Torres Strait Islander people under youth justice supervision has fallen over the past five years, a report from the Australian Institute of Health and Welfare (AIHW) has shown.

The report, Youth justice in Australia 2018–19, presents information on young people aged between 10 and 17 years under youth justice supervision both in the community and in detention.

On an average day in 2018–19, there were 5,694 (1 in 490) young people under youth justice supervision due to their involvement, or alleged involvement, in crime. Throughout the year, a total of 10,820 young people were under supervision.

‘Between 2014–15 and 2018–19, the level of Indigenous over-representation in youth justice supervision stabilised,’ said AIHW spokesperson Ms. Anna Ritson.

The report also shows that, on an average day in 2018–19, young males were about 4 times as likely to be under youth justice supervision as young females. Young females under supervision were more likely to be younger than males, with the most common age being 16 for young females and 17 for young males.

‘Being under youth justice supervision doesn’t always mean a young person is in detention. Around four in five young people (4,767) received community-based supervision such as home detention, bail, parole and probation,’ Ms. Ritson said.

‘The remaining 1 in 5 (956) were in detention, most of whom were remanded in custody awaiting the outcome of their charges.’

Part 2 Summary

This report looks at young people who were under youth justice supervision in Australia during 2018–19 because of their involvement or alleged involvement in crime. It explores the key aspects of supervision, both in the community and in detention, as well as recent trends.

About 1 in 490 young people aged 10–17 were under supervision on an average day

A total of 5,694 young people aged 10 and over were under youth justice supervision on an average day in 2018–19 and 10,820 young people were supervised at some time during the year.

Among those aged 10–17, this equates to a rate of 20 per 10,000, or 1 in every 489 young people on an average day.

Most young people were supervised in the community

More than 4 in 5 (84% or 4,767) young people under supervision on an average day were supervised in the community, and almost 1 in 5 (17% or 956) were in detention (some were supervised in both community and detention on the same day).

The majority of young people in detention were unsentenced

About 3 in 5 (63%) young people in detention on an average day were unsentenced—that is, awaiting the outcome of their legal matter or sentencing.

Young people spent an average of 6 months under supervision

Individual periods of supervision that were completed during 2018–19 lasted for a median of 132 days or about 4 months (this includes time under supervision before 1 July 2018 if the period started before that date).

When all the time spent under supervision during 2018–19 is considered (including multiple periods and periods that were not yet completed), young people who were supervised during the year spent an average of 192 days (about 6 months) under supervision.

Supervision rates varied among the states and territories

Rates of youth justice supervision varied among the states and territories, reflecting, in part, the fact that each state and territory has its own legislation, policies, and practices.

In 2018–19, the rate of young people aged 10–17 under supervision on an average day ranged from 11 per 10,000 in Victoria to 61 per 10,000 in the Northern Territory.

Rates of supervision have fallen slightly over the past 5 years

Over the 5 years from 2014–15 to 2018–19, the number of young people aged 10 and over who were under supervision on an average day saw a small decrease of 1%, while the rate of young people aged 10–17 dropped from 22 to 20 per 10,000.

The rate fell for community-based supervision (from 19 to 17 per 10,000), and fluctuated at 3–4 per 10,000 for detention.

Aboriginal and Torres Strait Islander rates have fallen

Although only about 6% of young people aged 10–17 in Australia are Aboriginal or Torres Strait Islander, half (50%) of those under supervision on an average day in 2018–19 were Indigenous.

Between 2014–15 and 2018–19, the rate of Indigenous young people aged 10–17 under supervision on an average day fell from 176 to 172 per 10,000. The rate of non-Indigenous young people under supervision also fell over the period, from 12 to 11 per 10,000.

Rates of Indigenous (33–35 per 10,000) and non-Indigenous (1–2 per 10,000) young people in detention fluctuated over the same period.

Young people in remote areas were more likely to be under supervision

Although most young people under supervision had come from cities and regional areas, those from geographically remote areas had the highest rates of supervision.

On an average day in 2018–19, young people aged 10–17 who were from Remote areas were 6 times as likely to be under supervision as those from Major cities, while those from Very remote areas were   9 times as likely. This reflects the higher proportions of Indigenous Australians living in these areas.

Young people from lower socioeconomic areas were more likely to be under supervision

More than 1 in 3 young people (35%) under supervision on an average day in 2018–19 were from the lowest socioeconomic areas, compared with 6% from the highest socioeconomic areas.

More than 1 in 3 young people were new to supervision

More than one-third (35%) of young people under youth justice supervision in 2018–19 were new to supervision in that year. The rest (65%) had been supervised in a previous year.

Young Indigenous Australians (71%) were more likely than young non-Indigenous young people (62%) to have been under supervision in a previous year.

Young Indigenous Australians were younger when they entered supervision than their non-Indigenous counterparts

On average, Indigenous young people entered youth justice supervision at a younger age than non-Indigenous young people.

About 2 in 5 (38%) Indigenous young people under supervision in 2018–19 were first supervised when aged 10–13, compared with about 1 in 7 (15%) non-Indigenous young people.

A higher proportion of young people experience community-based supervision in their supervision history than detention

More than 9 in 10 (92%) young people who were supervised during 2018–19 had been under community-based supervision at some time during their supervision history (either during 2018–19 or in a previous year). More than 6 in 10 (65%) had spent time in detention. For Indigenous young people these proportions were 94% and 70% respectively

 

NACCHO Aboriginal Mental Health News : Download @MenziesResearch and @orygen_aus A practice guide for ‘Improving the Social and Emotional Wellbeing of Young Aboriginal and Torres Strait Islander people

 ” Menzies Research and Orygen Australia have developed & just published a practice guide for ‘Improving the Social and Emotional Wellbeing of Young Aboriginal and Torres Strait Islander people’.

Little is known about how best to practically meet the social and emotional wellbeing (SEWB) needs of young Aboriginal and Torres Strait Islander people, particularly those with severe and complex mental health needs.

Yet, there is an urgent need for health programs and services to be more responsive to the mental health needs of this population.

Based on recent statistics, 67 per cent of Aboriginal and Torres Strait Islander young people aged 4-14 years have experienced one or more of the following stressors:

  • death of family/friend;
  • being scared or upset by an argument or someone’s behaviour; and
  • keeping up with school work. “

Download the Report HERE ( See PDF for all research references )

orygen-Practice-Guide-to-improve-the-social-and-emotional-wellbeing-of-young-Aboriginal-and-Torres-Strait-Islander-people

Read over 250 Aboriginal Mental Health articles published by NACCHO over past 8 Years

It is well documented that there are:

  • high rates of psychological distress, mental health conditions, and suicide noted among Aboriginal and Torres Strait Islander young people when compared to non-Aboriginal young people;
  • a lack of evidence-based and culturally informed resources to educate and assist health professionals to work with this population; and
  • notable gaps between knowledge and practice, which limits opportunities to improve the SEWB of young Aboriginal and Torres Strait Islander people.

This promising practice guide draws on an emerging, yet disparate, evidence-base about promising practices aimed at improving the SEWB of Aboriginal and Torres Strait Islander young people. It aims to support service providers, commissioners, and policy-makers to adopt strengths-based, equitable and culturally responsive approaches that better meet the SEWB needs of this high-risk population.

Rationale

The Australian Government appointed Orygen to provide Australia’s 31 Primary Health Networks (PHNs) with expert leadership and support in commissioning youth mental health initiatives.

Orygen has subsequently commissioned Menzies School of Health Research to identify and document promising practice service approaches in improving SEWB among young Aboriginal and Torres Strait Islander people with severe and complex mental health needs. This promising practice guide is an output of that work.

What do we know about the social and emotional wellbeing of Aboriginal and Torres Strait Islander young people?

It is recognised that Aboriginal and Torres Strait Islander societies provided the optimal condition for their community members’ mental health and social and emotional wellbeing before European settlement.

However, the Australian Psychological Society has acknowledged that these optimal conditions have been continuously eroded through colonisation in parallel with an increase in mental health concerns.2

There is clear evidence about the disproportionate burden of SEWB and mental health concerns experienced among Aboriginal and Torres Strait Islander people. The key contributors to the disease burden among Aboriginal and Torres Strait Islander young people aged 10-24 years are:1 suicide and self-inflicted injuries (13 per cent), anxiety disorder (eight per cent) and alcohol use disorders (seven per cent).3

Based on recent statistics, 67 per cent of Aboriginal and Torres Strait Islander young people aged 4-14 years have experienced one or more of the following stressors:

  • death of family/friend;
  • being scared or upset by an argument or someone’s behaviour; and
  • keeping up with school work.4

The stressors have a cumulative impact as these children transition into adolescence and early adulthood. Another study has shown that Aboriginal and Torres Strait Islander young people are at higher risk of emotional and behavioural difficulties.5

This is linked to major life stress events such as family dysfunction; being in the care of a sole parent or other carers; having lived in a lot of different homes; being subjected to racism; physical ill-health of young people and/or carers; carer access to mental health services; and substance use disorders. These factors are all closely intertwined.

Relevant national frameworks and action plans

The Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023 (2015) was developed by the Australian Government Department of Health in close consultation with the National Health Leadership Forum. It has a strong emphasis on a whole-of-government approach to addressing the key priorities identified throughout the plan.

The overarching vision is to ensure that the strategies and actions of the plan respond to the health and wellbeing needs of Aboriginal and Torres Strait Islander people across their life course. This includes a focus on young people.6

The National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017-2023 provides more specific direction by highlighting the importance of preventive actions that focus on children and young people.7 This includes:

  • strengthening the foundation;
  • promoting wellness;
  • building capacity and resilience in people and groups at risk;
  • provide care for people who are mildly or moderately ill; and
  • care for people living with severe mental illness.

In addition, the National Action Plan for the Health of Children and Young People 2020-2030 identifies building health equity, including principles of proportionate universalism, as a key action area and identifies Aboriginal and Torres Strait Islander children and young people as a priority population.8

Social and emotional wellbeing frameworks relating to Aboriginal and Torres Strait Islander people

 

Over the past decades, multiple frameworks have been developed to support the SEWB of Aboriginal and Torres Strait Islander people in Australia.4-8 These have identified some common elements, domains, principles, action areas and methods.7, 9-12

One of the most comprehensive frameworks is the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017-2023, which has a foundation of development over many years.13

It has nine guiding principles:

  1. Health as a holistic concept: Aboriginal and Torres Strait Islander health is viewed in a holistic context that encompasses mental health and physical, cultural and spiritual health. Land is central to wellbeing. Crucially, it must be understood that while the harmony of these interrelations is disrupted, Aboriginal and Torres Strait Islander ill-health will persist.
  2. The right to self-determination: Self-determination is central to the provision of Aboriginal and Torres Strait Islander health services and considered a fundamental human right.
  3. The need for cultural understanding: Culturally valid understandings must shape the provision of services and must guide assessment, care and management of Aboriginal and Torres Strait Islander peoples’ health problems generally and mental health concerns more specifically. This necessitates a culturally safe and responsive approach through health program and service delivery.
  4. The impact of history in trauma and loss: It must be recognised that the experiences of trauma and loss, a direct result of colonialism, are an outcome of the disruption to cultural wellbeing. Trauma and loss of this magnitude continue to have intergenerational impacts.
  5. Recognition of human rights: The human rights of Aboriginal and Torres Strait Islander peoples must be recognised and respected. Failure to respect these human rights constitutes continuous disruption to mental health (in contrast to mental illness/ill health). Human rights specifically relevant to mental illness must be addressed.
  6. The impact of racism and stigma: Racism, stigma, environmental adversity and social disadvantage constitute ongoing stressors and have negative impacts on Aboriginal and Torres Strait Islander peoples’ mental health and wellbeing.
  7. Recognition of the centrality of kinship: The centrality of Aboriginal and Torres Strait Islander family and kinship must be recognised as well as the broader concepts of family and the bonds of reciprocal affection, responsibility and sharing.
  8. Recognition of cultural diversity: There is no single Aboriginal or Torres Strait Islander culture or group, but numerous groupings, languages, kinship systems and tribes. Furthermore, Aboriginal and Torres Strait Islander people live in a range of urban, rural or remote settings where expressions of culture and identity may differ.
  9. Recognition of Aboriginal strengths: Aboriginal and Torres Strait Islander people have great strengths, creativity and endurance and a deep understanding of the relationships between human beings and their environment.13

While the principles outlined above are not specific to young Aboriginal and Torres Strait Islander people, they are considered to be appropriate within the context of adopting a holistic life-course approach.

What’s happening in practice?

This promising practice guide attempts to collate disparate strands of evidence that relate to enhancing youth mental health; improving Aboriginal and Torres Strait Islander SEWB; and strategies for addressing severe and complex mental health needs.

It has been well documented that there are significant limitations in the evaluation of Aboriginal and Torres Strait Islander health programs and services across Australia.22-24 The Australian Governments’ Productivity Commission Inquiry into

Mental Health and the Lowitja Institute are, at the time of producing this document, looking at ways to strengthen work in this space.24, 25

In the absence of high-quality evaluation reports, the term ‘promising practice’ is used throughout this guide.

This is consistent with the terminology used by the Australian Psychological Society through its project about SEWB and mental health services in Australia (http://www.sewbmh.org.au/).

It adopts a strengths-based approach26 which acknowledges and celebrates efforts made to advance work in this space in the absence of strong practice-based evidence.

This is achieved through the presentation of five active case studies.

These reflect organizational, systems and practice focused service model examples. The principles included in the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017-2023 have been mapped against each case study to illustrate how these privilege Aboriginal and Torres Strait Islander ways of knowing, doing and being.

Each case study includes generic background information to provide important contextual information; key messages or lessons learned, and reflections from staff involved in the project.

They have been developed in consultation with both the commissioning PHN and the service/organisation funded to develop and/or deliver the framework, program and service. Where possible, Aboriginal and Torres Strait Islander stakeholders were consulted during the development of the case studies.

Need help ?

Contact your nearest ACCHO or

If the situation is an emergency please call 000
If you wish to speak to someone immediately who can help call:

Kids Help Line

1800 55 1800
www.kidshelpline.com.au

Lifeline Australia

13 11 14
www.lifeline.org.au

NACCHO Aboriginal Health #AODConnect Resources Alert : Download an app to improve access to #alcohol and other #drugs AOD service information for Aboriginal and Torres Strait Islander communities

The AODconnect app has been developed by the Australian Indigenous HealthInfoNet Alcohol and Other Drugs Knowledge Centre to help alcohol and other drug (AOD) workers, community members and health professionals working in the AOD sector to locate culturally appropriate services.

The app aims to support efforts to reduce harmful substance use among Aboriginal and Torres Strait Islander people.

Read over 200 Aboriginal Health Alcohol and other Drugs articles published by NACCHO over past 8 years 

Aboriginal and Torres Strait Islander people are increasingly using online platforms to share and access information about different health topics.

The ownership and use of mobile phones in rural and remote Aboriginal and Torres Strait Islander communities is widespread and increasing, making apps a viable way to provide people living in these regions with access to health information.

AODconnect provides an Australia-wide directory of over 270 Aboriginal and Torres Strait Islander AOD treatment services.

It delivers a portable way to easily access information about service providers such as contact details and program descriptions, helping to facilitate initial contact and referral.

App

Once the app has been downloaded, users can search for AOD services even when their internet connection is unstable or not available.

This is especially useful in rural and remote areas of Australia where the Internet coverage is not always extensive or reliable.

The app enables users to search for services by state, territory, region and postcode via either an interactive map of Australia or by alphabetical listing.

Services can be filtered by the type of treatment they provide: counselling and referral, harm reduction and support groups, outreach, mobile patrols and sobering up shelters, residential rehab, withdrawal management and young people.

The services listed on the app are also available through the Alcohol and Other Drugs Knowledge Centre website.

The app is free to download on both iOS and Android devices.

If you would like to have your service added to the app or would like more information about the AODconnect app, please contact the Alcohol and Other Drugs Knowledge Centre email: aodknowledgecentre@healthinfonet.org.au or Ph: (08) 9370 6336.

Alcohol and other drugs GP education program


NACCHO Aboriginal Health News Alert  : How you can watch and support new documentary @InMyBloodItRuns in Australian cinemas Feb 20. Follow ten-year-old Dujuan as he discovers the resilience and resistance of many generations

” Werte. That means “hello” in my first language, Arrernte.

My name is Dujuan, I am 12 years old. I am from Arrernte and Garrwa Country. I came here to speak with you because our government is not listening. Adults never listen to kids – especially kids like me. But we have important things to say.

I grew up at Sandy Bore outstation and at Hidden Valley Town Camp in Alice Springs. Now I live in Borroloola.

Something special about me is that I am an Angangkere, which means I am a traditional healer. It is my job to look after my family with my healing powers.

I am the star in a new documentary, In My Blood It Runs. “

Dujuan Hoosan : From speech given to the Human Rights Council at the United Nations in Geneva on 11 September : See Part 1 below : 

Meet ten-year-old Dujuan, a child-healer, a good hunter and speaks three languages, as he discovers the resilience and resistance of many generations of his people and faces the history that runs straight into him.

Check out the In My Blood It Runs Website 

How you can share promote In My Blood it Runs  : See Part 3 below

From director Maya Newell (Gayby Baby), in collaboration with Arrernte and Garrwa families onscreen, you won’t want to miss this essential story about the strength and resilience of First Nations communities.

Where can you see the film national from February 20

” We begin to realize that Dujuan’s world does not exist in a vacuum, but is a microcosm of a much larger political and historical battle being waged in Australia. This event offers a stark insight into a potential future for Dujuan. How will his family and community rise above?

In My Blood It Runs looks beyond the ‘problem’ to see the people. Instead of seeing this Aboriginal boy as a ‘criminal’, we see a child who has experienced systematic abuse; instead of ‘bad parents’, we see a family who has been systematically stripped of all agency yet undeniably love their kids; instead of a ‘failure’ at school, we see a child whose talents have been completely overlooked.

And crucially, this child observes the inequality of the world he is presented with.”

Read full synopsis Part 2 below

Our children have to leave their identity at the school gate”

Felicity Hayes, Senior Traditional Owner of Mparntwe, Alice Springs and Executive Producer

Part 1 : Edited speech given to the Human Rights Council at the United Nations in Geneva on 11 September

It was filmed when I was 10 years old. It shows what it feels like to be an Aboriginal kid in Australia and how we are treated every day.

Many things happen to me in this film.

In school, they told me Captain Cook was a hero and discovered Australia. It made me confused. It’s not true because before cars, buildings and houses there were just Aboriginal people.

I want Australia to tell the truth that Aboriginal people were the first people who had the land.

My school report cards said that I was a failure.

Every mark was in the worst box.

I thought “is there something wrong with me?”.

I felt like a problem.

The film shows me working to learn Arrernte and about being an Angangkere.

I say, “If you go out bush each week you learn how to control your anger and control your life.”

I feel strong when I am learning my culture from my Elders and my land.

I think schools should be run by Aboriginal people.

Let our families choose what is best for us.

Let us speak our languages in school.

I think this would have helped me from getting in trouble.

The film shows Aboriginal kids tortured in juvenile detention. I know lots of kids that have been locked up. Police is cruel to kids like me. They treat us like they treat their enemies. I am cheeky, but no kid should be in jail.

I want adults to stop being cruel to 10-year-old kids in jail.

Welfare also needs to be changed. My great-grandmother was taken from her family in the stolen generation. My other great-grandmother was hidden away. That story runs through my blood pipes all the way up to my brain.

But I was lucky because of my family. They know I am smart. They love me.

They found a way to keep me safe. I am alright now, but lots of kids aren’t so lucky.

I think they should stop taking Aboriginal kids away from their parents – that’s wrong.

What I want is a normal life of just being me. I want to be allowed to be an Aboriginal person, living on my land with my family and having a good life.

My film is for all Aboriginal kids. It is about our dreams, our hopes and our rights.

I hope you think of me when you are telling the Australian government how to treat us better.

Thank you for listening to my story.

Baddiwa – that’s goodbye in my other language, Garrwa.

Dujuan Hoosan is 12 years old. This is an edited speech given to the Human Rights Council at the United Nationsin Geneva on 11 September

Part 2 Synopsis

Ten-year-old Dujuan is a child-healer, a good hunter and speaks three languages. As he shares his wisdom of history and the complex world around him we see his spark and intelligence. Yet Dujuan is ‘failing’ in school and facing increasing scrutiny from welfare and the police.

As he travels perilously close to incarceration, his family fight to give him a strong Arrernte education alongside his western education lest he becomes another statistic. We walk with him as he grapples with these pressures, shares his truths and somewhere in-between finds space to dream, imagine and hope for his future self.

Director Maya Newell’s first feature Gayby Baby (Hot Docs, Good Pitch Aus, London BFI), sparked a national debate in Australia when it was banned in schools. Told through the lens of four children in same-sex families during the fight for Marriage Equality, the film offered the voice of those being ignored. Made in collaboration with Dujuan and his family My Blood It Runs tackles another heated topic, First Nations education and juvenile justice and places the missing voice of children front and centre.

Filmed candidly and intimately, we experience this world on the fringes of Alice Springs through Dujuan’s eyes. Dujuan’s family light candles when the power card runs out, often rely on extended family to drop around food and live alongside the ingrained effects of colonization and dispossession.

Every day in the classroom, Dujuan’s strength as a child-healer and Arrernte language speaker goes unnoticed. While he likes school, his report card shows a stream of ‘E’s, which make him feel stupid. Education is universally understood as a ticket to success, but school becomes a site of displacement and Dujuan starts running away from the classroom.

In stark contrast to his school behaviour, on his ancestral homeland surrounded by is family, Dujuan is focused, engaged and learning.

We begin to see Country as a classroom and a place where the resilience can grow and revolution is alive.

But the pressures on Dujuan in Alice Springs are ever encroaching – educational failure, domestic violence, child removal and police. In May 2016, images of children being tortured at the Northern Territory’s Don Dale Youth Detention Centre are leaked and spike global uproar. In fact, 100% of children detained in the Northern Territory are Indigenous.

We begin to realize that Dujuan’s world does not exist in a vacuum, but is a microcosm of a much larger political and historical battle being waged in Australia. This event offers a stark insight into a potential future for Dujuan. How will his family and community rise above?

In My Blood It Runs looks beyond the ‘problem’ to see the people. Instead of seeing this Aboriginal boy as a ‘criminal’, we see a child who has experienced systematic abuse; instead of ‘bad parents’, we see a family who has been systematically stripped of all agency yet undeniably love their kids; instead of a ‘failure’ at school, we see a child whose talents have been completely overlooked. And crucially, this child observes the inequality of the world he is presented with.

In the end, when Dujuan cannot run nor fight alone, he faces the history that runs straight into him and realises that not only has he inherited the trauma and dispossession of his land, but also the strength, resilience and resistance of many generations of his people which holds the key to his future.

Part 3 How you can share promote In My Blood it Runs

Here are links to some assets below and sample copy that you can use – but please tweak as you see fit for your audience.

SAMPLE SOCIAL COPY

In My Blood It Runs hits Australian cinemas Feb 20!

Meet ten-year-old Dujuan, a child-healer, a good hunter and speaks three languages, as he discovers the resilience and resistance of many generations of his people and faces the history that runs straight into him. From director Maya Newell (Gayby Baby), in collaboration with Arrernte and Garrwa families onscreen, you won’t want to miss this essential story about the strength and resilience of First Nations communities.

In My Blood It Runs: a personal and moving film that should inspire us all.

Book your tickets now >>https://bit.ly/39TpM2j

Please don’t forget to follow/tag  on socials @inmyblooditruns

Aboriginal Heath News : NACCHO supports #OchreRibbonWeek #saveFVPLS: 12th – 19th February and call for action to end the violence against Aboriginal and Torres Strait Islander people – particularly our women and children.

 

” This week is Ochre Ribbon Week. It’s a week to raise awareness of the devastating impacts of family violence against Aboriginal and Torres Strait Islander communities and call for action to end the violence against Aboriginal and Torres Strait Islander people – particularly our women and children.

Violence against Aboriginal and Torres Strait Islander women is a national emergency. Aboriginal and Torres Strait Islander women are 34 times more likely to be hospitalised because of family violence and 10 times more likely to die from a violent assault than other women.

Every single Aboriginal and Torres Strait Islander man, woman and child deserves to live a life free of violence and fear, and thrive in culture and identity. ‘

The National Convenor of the Forum is Antoinette Braybrook (CEO, FVPLS Victoria), and the Deputy Convenor is Phynea Clarke (CEO, CAAFLU).

 

Prevention is the key to ensuring safety for our children and mothers, keeping families connected and strong in culture. The holistic, wrap-around response that FVPLSs provide is essential to ending family violence against Aboriginal and Torres Strait Islander women and their children.

The goal of the Forum is to work in collaboration across Family Violence Prevention Legal Services (FVPLSs) and increase access to justice for Aboriginal and Torres Strait Islander victim/survivors of family violence. The Forum provides advice and input to Government and ensures a unified FVPLS response to addressing Aboriginal and Torres Strait Islander family violence.

The Forum has worked with members to develop tools for capacity building, good governance, professional development, training, data collection and evaluation.

The Forum is supported by a Secretariat, and Forum members are represented by their CEO/Co-ordinator (or delegate) at meetings and activities.

Family Violence Prevention Legal Services

FVPLSs are Aboriginal and Torres Strait Islander community controlled organisations – our communities know and trust our staff and services. We are unique, experienced and specialist service providers delivering culturally safe legal and non-legal services within which Aboriginal and Torres Strait Islander culture is acknowledged and celebrated.

FVPLSs provide legal assistance, casework, counselling and court support to Aboriginal and Torres Strait Islander adults and children who are victim/survivors of family violence. Legal services are provided to victim/survivors in matters related to:

  • Family violence (i.e. VRO, AVO different terminology across jurisdictions);
  • Victims of crime compensation;
  • Family law; and
  • Child protection.

FVPLSs also provide an important community legal education and early intervention and prevention function. FVPLSs have adopted a holistic, wrap-around service delivery model that prioritise legal service delivery while recognising and addressing the multitude of interrelated issues that our clients face. Nationally 90% of our clients are Aboriginal and Torres Strait Islander women and children.

FVPLSs are expected to ensure that the services offered are culturally inclusive and accessible to Aboriginal and Torres Strait Islander adults and children in the specified service region, regardless of gender, sexual preference, family relationship, location, disability, literacy or language.

Objectives of the National FVPLS Forum

The objectives of the Forum are to:

  1. Support and enhance the capacity of FVPLSs to provide high quality services that deliver results for clients and communities;
  2. Coordinate and facilitate communication, information sharing and relationship building between FVPLS units;
  3. Develop policy positions that identify areas of FVPLS work in need of reform and make recommendations for change;
  4. Provide advice and input to Government on issues relevant to the FVPLS program and its operation;
  5. Engage with key stakeholders including through participation in activities and national meetings that will benefit and promote National Forum positions;
  6. Promote the existence of the National Convenor/Secretariat role and FVPLSs in the appropriate forums and media; and
  7. Facilitate a co-ordinated approach to building a secure and sustainable resource base that meets the needs of FVPLSs and their clients.

Further information on some of our members’ services is available here.

This Ochre Ribbon Week, show your support in the following ways:

  1. Add the Ochre Ribbon Week 2020 frame to your Facebook profile picture here: https://www.facebook.com/profilepicframes
  2. Follow the National Family Violence Prevention and Legal Services Forum on Twitter and Facebook
  3. Donate to our Aboriginal and Torres Strait Islander controlled FVPLSs across the country
  4. Spread the word! Forward this email to your contacts

To find out more about Ochre Ribbon Week, head to https://www.nationalfvpls.org/

NACCHO Aboriginal Children’s Health #BacktoSchool : What our kids eat can affect not only their physical health but also their mood, mental health and learning

“When kids eat a healthy diet with a wide variety of fruit and vegetables in that diet, they actually perform better in the classroom.​     

They’re going to have better stamina with their work, and at the end of the day it means we’ll get better learning results which will impact on them in the long term.”

Marlborough Primary School principal

We know that fuelling children with the appropriate foods helps support their growth and development.

But there is a growing body of research showing that what children eat can affect not only their physical health but also their mood, mental health and learning.

The research suggests that eating a healthy and nutritious diet can improve mental health¹, enhance cognitive skills like concentration and memory²‚³ and improve academic performance⁴.

In fact, young people that have the unhealthiest diets are nearly 80% more likely to have depression than those with the healthiest diets

Continued Part 1 Below

Aboriginal and Torres Strait Islander people suffer increased risk of chronic disease such as type 2 diabetes and heart disease.

Eating healthy food and being physically active lowers your risk of getting kidney disease and type 2 diabetes, and of dying young from heart disease and some cancers.

Being a healthy weight can also makes it easier for you to keep up with your family and look after the kids, nieces, nephews and grandkids. “

Continued Part 2 Below

Part 1

Children should be eating plenty of nutritious, minimally processed foods from the five food groups:

  1. fruit
  2. vegetables and legumes/beans
  3. grains (cereal foods)
  4. lean meat and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans
  5. milk, yoghurt, cheese and/or their alternatives.

Consuming too many nutritionally-poor foods and drinks that are high in added fats, sugars and salt, such as lollies, chips and fried foods has been connected to emotional and behavioural problems in children and adolescents⁵.

In fact, young people that have the unhealthiest diets are nearly 80% more likely to have depression than those with the healthiest diets¹.

Children learn from their parents and carers. If you want your children to eat well, set a good example. If you help them form healthy eating habits early, they’re more likely to stick with them for life.

So here are some good habits to start them on the right path.

Eat with your kids, as a family, without the distraction of the television. Children benefit from routines, so try to eat meals at regular times.

Make sure your kids eat breakfast too – it’s a good source of energy and nutrients to help them start the day. Good choices are high-fibre, low-sugar cereals or wholegrain toast. It’s also a good idea to prepare healthy snacks in advance for them to eat in between meals.

Encourage children to drink water or milk rather than soft drinks, cordial, sports drinks or fruit juice drinks – don’t keep these in the fridge or pantry.

Children over the age of two years can be given reduced fat milk, but children under the age of two years should be given full cream milk.

Why are schools an important place to make changes?

Schools can play a key role in influencing healthy eating habits, as students can consume on average 37% of their energy intake for the day during school hours alone!6

A New South Wales survey found that up to 72% of primary school students purchase foods and drinks from the canteen at least once a week7. Also, in Victoria, while around three-quarters (77%) of children meet the guidelines for recommended daily serves of fruit, only one in 25 (4%) meet the guidelines for recommended daily serves of vegetables8; and discretionary foods account for nearly 40 per cent of energy intake for Victorian children9.

It’s never too late to encourage healthier eating habits – childhood and adolescence is a key time to build lifelong habits and learn how to enjoy healthy eating.

Get started today

You can start to improve students’ learning outcomes and mental wellbeing by promoting healthy eating throughout your school environment.

Some ideas to get you started:

This blog article was originally published on Healthy Eating Advisory Service . 

Part 2

Aboriginal and Torres Strait Islander people suffer increased risk of chronic disease such as type 2 diabetes and heart disease.

Eating healthy food and being physically active lowers your risk of getting kidney disease and type 2 diabetes, and of dying young from heart disease and some cancers.

Being a healthy weight can also makes it easier for you to keep up with your family and look after the kids, nieces, nephews and grandkids.

Aboriginal and Torres Strait Islander people may find it useful to chose store foods that are most like traditional animal and plant bush foods – that is, low in saturated fat, added sugar and salt – and use traditional bush foods whenever possible.

The Healthy Weight Guide provides information about maintaining and achieving a healthy weight.

It tells you how to work out if you’re a healthy weight. It lets you know up-to-date information about what foods to eat and what foods to avoid and what and how much physical activity to do. It gives you tips on setting goalsmonitoring what you dogetting support and managing the challenges.

There are also tips on how to eat well if you live in rural and remote areas.

The national Live Longer! Local Community Campaigns Grants Program supports Indigenous communities to help their people to work towards and maintain healthy weights and lifestyles. For more information, see Live Longer!.

Part 3 Parents may not always realise that their children are not a healthy weight.

If you think your child is underweight, the following information will not apply to your situation and you should seek advice from a health professional for an assessment.

If you think your child is overweight you should see your health professional for an assessment. However, if you’re not sure whether your child is overweight, see if you recognise some of the signs below. If you are still not sure, see your health professional for advice.

Overweight children may experience some or all of the following:

  • Having to wear clothes that are too big for their age
  • Having rolls or skin folds around the waist
  • Snoring when they sleep
  • Saying they get teased about their weight
  • Difficulty participating in some physically active games and activities
  • Avoiding taking part in games at school
  • Avoiding going out with other children

Signs that a child is at risk of becoming overweight, if they are not already, include:

  • Eating lots of foods high in saturated fats such as pies, pasties, sausage rolls, hot chips, potato crisps and other snacks, and cakes, biscuits and high-sugar muesli bars
  • Eating take away or fast food meals more than once a week
  • Eating lots of foods high in added sugar such as cakes, biscuits, muffins, ice-cream and deserts
  • Drinking sugar-sweetened soft drinks, sports drinks or cordials
  • Eating lots of snacks high in salt and fat such as hot chips, potato crisps and other similar snacks
  • Skipping meals, including breakfast, regularly
  • Watching TV and/or playing video games or on social networks for more than two hours each day
  • Not being physically active on a daily basis.

For more information:

References for Part 1

1 Jacka FN, et al. Associations between diet quality and depressed mood in adolescents: results from the Australian Healthy Neighbourhoods Study. Aust N Z J Psychiatry. 2010 May;44(5):435-42. https://doi.org/10.3109/00048670903571598571598
2 Gómez-Pinilla, F. (2008). Brain foods: The effects of nutrients on brain function. Nature Reviews Neuroscience, 9(7), 568-578. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2805706/
3 Bellisle, F. (2004). Effects of diet on behaviour and cognition in children. British Journal of Nutrition, 92(2), S227–S232
4 Burrows, T., Goldman, S., Pursey, K., Lim, R. (2017) Is there an association between dietary intake and academic achievement: a systematic review. J Hum Nutr Diet. 30, 117– 140 doi: 10.1111/jhn.12407. https://onlinelibrary.wiley.com/doi/pdf/10.1111/jhn.12407
5 Jacka FN, Kremer PJ, Berk M, de Silva-Sanigorski AM, Moodie M, Leslie ER, et al. (2011) A Prospective Study of Diet Quality and Mental Health in Adolescents. PLoS ONE 6(9): e24805. https://doi.org/10.1371/journal.pone.0024805
6 Bell AC, Swinburn BA. What are the key food groups to target for preventing obesity and improving nutrition in schools? Eur J Clin Nutr2004;58:258–63
7 Hardy L, King L, Espinel P, et al. NSW Schools Physical Activity and Nutrition Survey (SPANS) 2010: Full Report (pg 97). Sydney: NSW Ministry of Health, 2011
8 Department of Education and Training 2019, Child Health and Wellbeing Survey – Summary Findings 2017, State Government of Victoria, Melbourne.
9 Department of Health and Human Services 2016, Victoria’s Health; the Chief Health Officer’s report 2014, State Government of Victoria, Melbourne.

 

 

NACCHO Aboriginal Health News Alerts : Indigenous culture not to blame for alcohol abuse, violence says NT MP Yingiya Guyula

” To tackle the problems that (Jancita ) Price and myself and all of us want to see fixed requires a more mature conversation.

This should start with focusing on the behaviour and not pointing the finger at “culture “.

The idea that abandonment of culture is the great hope for Aboriginal people is false, offensive, and dangerous.

We must connect our past, present, and future as we look to address these ­issues.”

Yingiya Guyula is a senior leader for the Liya-Dhalinymirr clan of the Djambarrpungu people within the Yolngu Nation.

He is an independent member of the Northern Territory parliament.

Published in todays AUSTRALIAN

The efforts by Jacinta Price and others to blame Aboriginal culture for violence and abuse serve no one and achieve nothing positive.

The argument that Aboriginal culture is to blame for Aboriginal people being over-represented in cases of domestic and other forms of violence is wrong.

Our culture is who we are. We are inextricably part of our culture, our language, our customs, our spirituality, our worldview. Our law maintains our culture. To take these things away is to remove our identity.

It is a dangerous discussion because it is about the systematic dehumanisation of a group that might have catastrophic consequences.

Price wrote on this page about Yolngu law, but she is not a member of the Yolngu nation and she is not from Yolngu country. She has referred to an article titled Ngarra Law that has no authority.

It was written in English by one Yolngu elder and edited by a non-indigenous man who has no connection to, or authority, under Yolngu law, and was published in a journal no longer in print.

It was not supported by any other Yolngu leader or elder and was challenged by Yolngu leaders in meetings in Galiwin’ku, Ramingining and Maningrida in 2017 to dispute much of the content. We are disappointed about what has been written of our law.

I am not relying on anyone else for my understanding of my law. I am a djirrikaymirr (senior leader) and djungaya (manager) and djagamirr (caretaker) for many Yolngu law ceremonies, including a custodian of Ngarra rom (an institution of law). Our law is not merely a collection of crimes and punishments, it is a whole system of education, discipline and leadership that starts at a young age and continues for a lifetime.

I know this not from reading an article but because I have been trained in this all my life. I was taught by my elders to keep true to the law. When I went away to school I was warned there would be many outside temptations (like alcohol, drugs, greed) and that I must hear the sound of clapsticks and feel the painting on my skin, that signifies living by discipline and a pathway to leadership.

This law system has kept alive and made strong a society that has existed since time began. But these are modern-day issues, they are new to us, and just as Western law has adjusted, we need the opportunity for our elders — men and women — to apply a modern Yolngu response. It’s up to us to do that. It must come from us.

It is clear that foreign solutions are not working for our people. Billions of dollars are spent each year trying to solve what others call the “Aboriginal problem”, but as the Intervention continues to evidence, this pathway is failing everyone.

It is a very sad thing that these days visitors to our communities see all of the outward signs of poverty and disadvantage. These should never be confused with our system of law and culture. Alcohol and drugs are not our culture; overcrowding is not our culture; unemployment and bored kids are not our culture; high rates of imprisonment are not our culture; poor health and suicide are not our culture; and family violence is not our culture. These are not a product of our culture, they are all the side-effects found in every society around the world that is affected by poverty, disadvantage, and colonisation.

As a senior leader, I need to be clear: the family violence that we are seeing in our communities is not lawful — it is breaking the law.

But we are also facing issues of alcohol and drug addictions, gambling addictions, high levels of unemployment, high levels of welfare dependency, and low levels of self-worth, and we must solve these issues too if we are to be successful.

If a visitor to our communities is fortunate enough to attend our ceremonies or live with us, they will see elders leading and organising and educating. They will see young men, fit and confident, humble and dedicated. They will see young women proud and strong. They will see small children everywhere learning and observing. This is our culture, it is full of healthy and vibrant life. At one point not so long ago, this was our everyday — where our communities were governed without outside influence.

To tackle the problems that Price and myself and all of us want to see fixed requires a more mature conversation. This should start with focusing on the behaviour and not pointing the finger at “culture”. The idea that abandonment of culture is the great hope for Aboriginal people is false, offensive, and dangerous. We must connect our past, present, and future as we look to address these ­issues.

Yingiya Guyula is a senior leader for the Liya-Dhalinymirr clan of the Djambarrpungu people within the Yolngu Nation. He is an independent member of the Northern Territory parliament.

NACCHO Aboriginal Health and #Nutrition News : @CAACongress and @Apunipima ACCHO’s partner with Queensland Uni @UQ_NEWs in 3 year study to fight food insecurity in our Indigenous communities

“We have high rates of iron deficiency anaemia in women and young children and we know this is caused by inadequate iron in the diet.

Iron-rich foods are very expensive in remote communities, and it is believed this is a key factor in causing the deficiency.

The study will enable key foods to be reduced in price and determine the impact this has on their consumption and subsequent health concerns. It will also enable the issue of food security to be more widely discussed.”

Congress chief executive Donna Ah Chee (And NACCHO board member ) said the organisation was pleased to be partnering with Apunipima Health Service and the UQ “in this really important study, the first of its kind in Central Australia”.

Download also Congress obesity submission 

Congress-Submission-to-the-National-Obesity-Strategy-Dec-2019

You can read all Aboriginal Health and Nutrition articles published by NACCHO 2012 to 2019 HERE

Working with communities to improve food security for Aboriginal and Torres Strait Islander children will be the focus of a significant University of Queensland study.

The three-year research project, designed in conjunction with the Apunipima Cape York Health Council and the Central Australian Aboriginal Congress, will be funded by a $2 million-plus National Health and Medical Research Council grant to UQ’s School of Public Health.

The study’s phase one will analyse how price discounts, offered via loyalty cards, impact on affordability of a healthy diet.

Phase two will capture participants’ experiences through photos, and use these to develop a framework of solutions that can be translated to health policy.

Dr Megan Ferguson said growing poverty and high food costs were key causes of food insecurity for 31 per cent of Aboriginal and Torres Strait Islander people living in remote communities, although research suggests this may be as high as 62 per cent.

“Food insecurity leads to hunger, anxiety, poor health, including under-nutrition, obesity and disease, and inter-generational poverty,” Dr Ferguson said.

“We will be working with communities to identify effective mechanisms to improve food security and enable healthy diets in remote Australia.”

This would be done through a community-led framework and knowledge-sharing solutions.

“Pregnant and breastfeeding women, and carers of children aged under five, will be involved in the study in Central Australia and Cape York,” Dr Ferguson said.

“Improving food security for the whole family, especially women and children, will improve diet quality and health, and give children the best start in life for generations to come.”

Clare Brown, Apunipima’s Nutrition Advisor, said the organisation was pleased to co-lead “this important project”.

“It has come together through a very positive co-design process between researchers and Aboriginal community controlled health service providers,” Ms Brown said.

“The project’s community-led focus supports our way of working respectfully with Cape York communities, and is reflected in the Food Security Position Statement of Apunipima’s board,” Ms Brown said.

Menzies School of Health Research, Monash University, James Cook University and Canada’s Dalhousie University are also involved in the study.

 

NACCHO Aboriginal Health and #Smoking : Download the @RACGP Supporting #smokingcessation Guide : Smoking daily is three times as high in the lowest socioeconomic areas of Australia compared to the highest.

“The likelihood of smoking daily is three times as high in the lowest socioeconomic areas of Australia compared to the highest.

What this means is that smoking-related health problems disproportionately affect those least able to afford the medicines that are essential to helping them quit.

We have made massive inroads, now it’s time for the final, decisive push to reduce daily smoking levels.

These medicines work, we just need to do more to help get them into the hands of people who need them most and removing restrictions on prescribing will do just that.”

RACGP President Dr Harry Nespolon said that the Government should act to assist those who struggle to afford the medicines that are proven to help people quit smoking.

Aboriginal and Torres Strait Islander people

 ” Indigenous Australians are still more than twice as likely as non-Indigenous Australians to be current daily smokers.2 However, there has been a progressive decrease in daily smoking rates for Aboriginal and Torres Strait Islander people, declining from 49% in 2002 to 45% in 2008, and then to 41% in 2012–13.3

People who identify as Aboriginal or Torres Strait Islander qualify for PBS authority listing that provides up to two courses per year of nicotine patches, each of a maximum of 12 weeks. Under this listing, participation in a support and counselling program is recommended but not mandatory. Access t nicotine patches for Aboriginal and Torres Strait Islander people can be facilitated through the Closing the Gap PBS co-payment measure (see page 45).”

Extracts from GUIDE

Download the RACGP Supporting smoking cessation: A guide for health professionals (2nd edition) smoking-cessation

Read over 130 Aboriginal Health and Smoking articles published by NACCHO over past 8 years

Read Aboriginal Health and our partnership with RACGP articles published by NACCHO over past 8 years

The Royal Australian College of General Practitioners (RACGP) has today recommended allowing greater flexibility in prescribing for smoking cessation pharmacotherapy.

The bold proposal, contained in the RACGP’s newly released Supporting smoking cessation: A guide for health professionals (2nd edition) (“the guide”), could prove a game-changer for reducing smoking rates.

Pharmacotherapy options available in Australia include nicotine replacement therapy (NRT, e.g. a transdermal patch or acute forms such as an oral spray, gum, inhaler or lozenge), varenicline (a drug that blocks the pleasure and reward response to smoking) and bupropion hydrochloride (which reduces the urge to smoke and helps with nicotine withdrawal).

Oral forms of NRT subsidised on the Pharmaceutical Benefits Scheme (PBS) are gum and lozenges for use as the sole PBS-subsidised therapy. This means that combination NRT (i.e. using two forms of NRT together such as a patch and gum) is not currently PBS-subsidised.

Under PBS rules, a maximum 12 weeks of PBS-subsidised NRT is available per 12-month period.

Australia has made commendable inroads in tobacco control and smoking rates with daily smoking nearly halved from 24% in 1991 to 12.8% in 2013. However, the job is not complete and there has been a slowing in the rate of decline with little change in prevalence from 2013 to 2016 (12.2%).

The latest National Tobacco Strategy aims to reduce the national adult daily smoking rate to 10% of the population and halve the Aboriginal and Torres Strait Islander adult daily smoking rate.

RACGP President Dr Harry Nespolon said that the Government should act to assist those who struggle to afford the medicines that are proven to help people quit smoking.

“Some people can quit unassisted; however, those who take advantage of behavioural support and vital medicines including combination NRT, varenicline and bupropion will substantially increase their chances of quitting.

“The science is in – a host of randomised clinical trials tell us that these medicines work. Varenicline or combination NRT almost triples the odds of quitting and bupropion and NRT alone almost double the odds of quitting versus a placebo at six months. The evidence is also clear that combination NRT is most effective.

“However, as things stand we have fixed PBS rules that don’t reflect best-practice medical assistance. As a result, people trying to quit smoking miss out on PBS subsidies that could make a real difference.

“We need to improve flexibility in prescribing to cut costs for patients using pharmacotherapy so that people who could really benefit from these medicines can access them.

“It’s vital to allow for PBS-subsidised combination NRT, which is proven to be the most effective form of NRT.

“We should also allow GPs to prescribe a second round of PBS-subsidised NRT within a 12-month period because it will help reduce relapse in people who have stopped smoking at the end of a standard course of NRT. This is a public health policy no-brainer, pure and simple.”

Dr Nespolon noted that the inflexibility in PBS prescribing was particularly troubling given that smoking rates are inverse to socioeconomic status.

Chair of the Expert Advisory Group behind the guide, Professor Nicholas Zwar, said that health professionals including GPs should also be encouraged to embrace the “brief intervention” approach to smoking cessation.

“One of the most often cited barriers to providing smoking cessation advice is that it can prove time consuming.

“Up until now health professionals have used a ‘5A’s approach’ which involves identifying patients who smoke, assessing nicotine dependence and barriers to quitting, advising patients to quit, offering assistance and arranging a follow up. It is sound practice but it does take time.”

Professor Zwar said that under the three-step model developed by Quit Victoria, advice and help for patients trying to quit smoking could be easier to provide and more frequently offered by a range of health professionals.

“This three-step model offers patients best practice smoking cessation treatment by linking into multi-session behavioural interventions such as Quitline and encouraging the use of pharmacotherapy.

“It can be summarised as ask, advise and help. Ask and record a patient’s smoking status, advise people who smoke to quit and on the most effective methods for doing so and help them by offering to arrange referral, encourage use of behavioural intervention and the use of evidence-based pharmacotherapy.”

The guide update was funded by VicHealth and the Australian Government Department of Health.