NACCHO Aboriginal Health and Remote Communities News : I. @SenatorDodson The Need to empower remote Communities 2.@abcnews Empowering Young Leaders’ in the Kimberley call for change to curb suicides

Indigenous people living in remote communities are still betrayed. The truth of this nationally is seen in the government’s “duck, dive” approach to entrenching a voice in the Constitution.

On the first day of parliament sittings next year, the Prime Minister will present the annual Closing the Gap report, an index of the disadvantage experienced by First Nations people.

It will be another recitation of government failures to improve their lives — lives that in remote communities end many years shorter than elsewhere.

Not only do they die younger, their existence also is miserable. It’s not just a matter of poor service delivery, it’s that their lives are not their own. Governments, unwilling to trust First Nations people to take charge of their own lives, continue to intrude and manage.

Patrick Dodson is the Labor senator for Western Australia writing in the Weekend Australian

See Part 1 Below

“The Empowered Young Leaders’ report, released last week, calls for more education for young people around social and emotional wellbeing and increased efforts to embed Indigenous culture in schools.

They also want a permanent forum for young people to voice their concerns.

It comes as the State Government considers a formal response to the WA coroner’s inquest into the suicides of 13 Indigenous young people in the remote region.” 

See Part 2 Below

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Part 1 : The nation’s treatment of remote indigenous communities is an international scandal. We need a Marshall Plan to end the squalor.

Labor MPs Murray Watt, Linda Burney, Warren Snowdon, Sharon Claydon and Patrick Dodson on their indigenous road trip. Picture: supplied

In January 1994, then Labor senator Graham Richardson, health minister in Paul Keating’s government, toured remote Aboriginal communities in Western Australia and the Northern Territory.

Conditions in those communities, he said, were “miserable”. He “saw things … that would barely be tolerated in a war-ravaged African nation”.

In August, with a party of fellow federal Labor parliamentarians, I did a big sweep through remote communities in WA and the Territory. From Port Hedland we dropped in at Marble Bar, Jigalong, Newman, Meekatharra, Wiluna, Leonora,

More than 25 years after Richardson’s expedition, I can attest that conditions for Aboriginal people in those places are still miserable and intolerable.

Last month WA Aboriginal Affairs Minister Ben Wyatt visited remote communities in his jurisdiction and wrote in The Australian of their “institutionalised ghetto status”.

How many inquiries or reports will it take, how often can the UN Special Rapporteur on the Rights of Indigenous Peoples declaim against this tragedy, before Australia confronts the crisis that cripples these communities, and sets about fixing things?

The people out there did not choose to live in those places. By and large, those communities were artificially designed by bureaucrats and Aboriginal people were shepherded there — sometimes for their protection (from Woomera rockets, for example), sometimes as a consequence of assimil­ationist policies. But, having plonked them there, governments have failed to maintain adequate basic services.

Forget the trumped-up national emergency John Howard and Mal Brough declared across the Northern Territory in June 2007 (although Aboriginal people will never forget).

The real emergency was staring them right in the face and they never dealt with it: the parlous plight of thousands of Aboriginal people forced to live in squalor and denied basic rights of citizenship.

It’s interesting to recall that back in 1994 when Richardson pledged to “clear up that mess” he said: “I hope perhaps out of the social justice package we’ve promised for Mabo, there will be scope to address some of these wrongs.”

The Keating government’s response to the High Court’s Mabo decision had three elements: the Native Title Act, the land fund — out of which grew the (now) Indigenous Land and Sea Corporation — and a social justice package.

Robert Tickner, Keating’s Aboriginal and Torres Strait Islander affairs minister, told the 12th session of the UN Working Group on Indigenous Populations in 1994: “The social justice package presents Australia with what is likely to be the last chance this decade to put a policy framework in place to effectively address the human rights of Aboriginal and Torres Strait Islander people as a necessary commitment to the reconciliation process leading to the centenary of Federation in 2001.”

Hollow words. The justice package was doomed: the Keating government did not press its pro­gress and passed to the Aboriginal and Torres Strait Islander Commission the job of consulting with First Nations about what it should embrace.

Keating’s successor, John Howard, rejected ATSIC’s visionary report in 1996 and went off on his own “practical reconciliation” frolic. ATSIC itself was dispatched by Howard a few years later, but it’s worth restating a few words from the ATSIC report on the social justice package because they continue to resonate: “Indigenous people have been too often betrayed over the last two centuries by fine words that have soon withered in the grim drought of inaction and indifference.”

Indigenous people living in remote communities are still betrayed. The truth of this nationally is seen in the government’s “duck, dive” approach to entrenching a voice in the Constitution.

On the first day of parliament sittings next year, the Prime Minister will present the annual Closing the Gap report, an index of the disadvantage experienced by First Nations people. It will be another recitation of government failures to improve their lives — lives that in remote communities end many years shorter than elsewhere.

Not only do they die younger, their existence also is miserable. It’s not just a matter of poor service delivery, it’s that their lives are not their own. Governments, unwilling to trust First Nations people to take charge of their own lives, continue to intrude and manage.

Remote communities, especially those in the desert region straddling the Territory,WA and South Australia, have the foundations of their customary law, kinship relationships and knowledge of country pretty much underpinning their continuing survival. It is the world of art, sport and ceremonial obligations that makes their world partly tolerable.

But, as long as we view these places through the prism of reform­ing public sector outlays, we will continue to contribute to their demise. They must have a real say in their destiny, and governments have a duty to reorder ideological and biased views about their futures.

In the Territory, the federal government wants to foist its cashless debit card on 23,000 people deemed to be “beneficiaries”, who are already subject to income management (a hangover from the intervention). There is no choice being offered here and the policy will impact severely on First Nations people living remotely.

As the Central Land Council has pointed out, the transfer to the CDC will require people to have an email address, access to mobile phone coverage and a smartphone, the skills to navigate online card activation, and access to the internet. But access to the National Broadband Network is limited in remote communities, home computers are rare, and most internet access through mobile phones is intermittent and unreliable. CDC holders will need to receive an activation number by post, but the post in remote communities is slow or non-existent.

The federal government’s plan to introduce the CDC is yet another example of top-down policy, and recipients in remote communities have not been consulted.

So much for the government’s mantra it wants to do things with First Nations people, not to them.

How will this card help build the capacity of people in these remote communities? How will it help them manage their lives?

We need new frameworks that enable people in remote communities to determine their destiny, and for governments to treat them as sovereign peoples.

These remote communities must be helped to lift themselves out of “institutionalised ghetto status”. Relief is beyond the capacity of states and territories. The federal government has the remit to avert disaster — after all, what was the 1967 referendum all about?

It will require a Marshall Plan to correct the decades of neglect.

However, until we grasp that sort of commitment and empower remote Aboriginal communities, the lives of their residents will be further accursed.

Part 2

Aboriginal youth leaders in Western Australia’s far north have made sweeping recommendations to curb the chronic rates of suicide among their peers.

PHOTO: The Empowered Youth Leader delegates have proposed a set of recommendations. (Supplied: WA Primary Health Alliance)

Key points:

  • Suicide remains the leading cause of death for Aboriginal and Torres Strait Islander children
  • The Empowered Young Leaders’ report calls for more education for young people around social and emotional wellbeing
  • It also recommends increased efforts to embed Indigenous culture in schools, and a permanent forum for young people to voice concerns

From Here

The Empowered Young Leaders’ report, released last week, calls for more education for young people around social and emotional wellbeing and increased efforts to embed Indigenous culture in schools.

They also want a permanent forum for young people to voice their concerns.

It comes as the State Government considers a formal response to the WA coroner’s inquest into the suicides of 13 Indigenous young people in the remote region.

Too many lost’

In an impassioned statement, the delegates put policy makers on notice, saying they would no longer accept the “normalisation of suicide”.

“We have lost too many loved ones to suicide,” the statement read.

“Through our own lived experience, we bear witness to the heavy burden our families and communities endure in grappling with the never-ending cycle of grief and loss.

“We no longer choose to be disempowered by the issues that continue to impact on us as a result of intergenerational trauma. The lives of our children and grandchildren are in our hands.”

Jacob Smith, 23, has been working in suicide prevention for two years.

As a member of the Empowered Young Leaders, he spent 12 months working intensely with 10 youth delegates across the Kimberley.

He said the recommendations were the starting point for creating generational change.

“There’s endless possibilities, there’s a lot more focus now on young people stepping up and getting involved,” he said.

“Our hope is to amplify our voice and be at the forefront of these conversations with our leaders.

“If we can better consult with our youth they will be way more inclined to engage in these conversations and initiatives.”

Efforts to meaningfully reduce the amount of Aboriginal youth taking their lives have largely failed, despite dozens of reports, inquests and millions of dollars in funding.

It remains the leading cause of death for Aboriginal and Torres Strait Islander children.

In the Kimberley, the rate of youth suicide is among the highest in the world.

In the aftermath of coroner Ros Fogliani’s 2017 inquest into 13 suicides, young people had been given a bigger role in helping governments at both levels forge a solution.

Mr Smith said the top priority was to ensure youth were permanently involved in the design and delivery of policy.

He said this would be achieved by establishing local Aboriginal youth action committees in each town.

“We need to invest and build the skills of our young people … to build a real peer-to-peer network in the Kimberley,” he said.

“There’s a few of us young people working in this space but we don’t feel like we have a strong network.

“There’s no real structure around that at the moment.”

Calls for better education and resources

Education was another key area in which the group wanted improvement.

They called for more social and emotional wellbeing training for young local people so they could support their peers with mental health difficulties.

There was also a push to better involve youth in developing targeted programs.

Delegates raised concerns about the lack of after-hours services, and proposed to establish 24-hour safe houses and a youth-focused rehabilitation centre.

“Delegates expressed frustration at the lack of local training and employment opportunities for Aboriginal people in the youth services sector,” the report stated.

They also identified the poor “cultural and community connection” between mainstream services and local Aboriginal families.

Government to respond to coroner’s inquest

The report is being considered by the WA Government.

Minister for Aboriginal Affairs Ben Wyatt said the recommendations were valued and would be treated with respect.

“The report will have an important role to play in the Government’s understanding of the perspective of young Aboriginal people in the region,” he said.

Mr Wyatt also outlined the McGowan Labor Government’s efforts to improve education and skills training.

“In 2019, there were 60 WA public schools teaching one or more of 21 Aboriginal languages to 5,611 students,” the Minister said.

“WA public schools are increasingly teaching children local Aboriginal languages, benefiting students and helping to keep the languages alive in our communities.

“The Aboriginal Cultural Standards Framework supports all Department of Education staff to reflect on their approaches to the education of Aboriginal students.”

Mr Wyatt pointed to a “range of regional partnerships” that ensured Aboriginal people received adequate skills training.

“A great success story is one of North Regional TAFE’s alumni, Soleil White, who was named the WA Aboriginal and Torres Strait Islander Student of the Year at the 2018 WA Training Awards.”

The State Government is expected to hand down its formal response to the coroner’s inquest in the coming weeks.

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NACCHO Aboriginal Youth Health : Download 2019 @MissionAust Reports Including 20 pages top 3 issues for Aboriginal and Torres Strait Islander young people – #mentalhealth, #alcohol and drugs and equity and #discrimination. Plus #NACCHOYouth19 Interviews

” Young Aboriginal and Torres Strait Islander people were asked to list the three issues they considered were the most important in Australia today.

In 2019, the top three issues identified by Aboriginal and Torres Strait Islander young people were mental health, alcohol and drugs and equity and discrimination.

  • Nearly three in ten Aboriginal and Torres Strait Islander young people indicated that mental health (28.9%) and alcohol and drugs (28.1%) are important issues in Australia today.
  • Around one in four Aboriginal and Torres Strait Islander respondents reported that equity and discrimination (24.3%) and the environment (23.7%) are important national
  • Since 2018, the proportion of Aboriginal and Torres Strait Islander young people reporting the environment as a key national issue has more than tripled from 8% to 23.7%. Conversely, concerns about mental health and bullying have decreased since 2018.

Extract from Report What issues do young people think are the most important in Australia today? see Pages 37-57 

The Mission Australia Youth Survey is the largest annual survey of young people of its kind in Australia.

It provides a platform for young people aged 15 to 19 to share their values, aspirations and concerns.

The Youth Survey provides a platform for young people to ‘speak up’ about the issues they are concerned about and it offers valuable insights into the experiences, concerns, challenges and ambitions of young people living in Australia.

Mission Australia CEO James Toomey says “Our Youth Survey has come of age this year and we take very seriously our responsibility and commitment to elevating the voices of young people who come from all across Australia.”

The results of the Youth Survey are shared widely with governments, schools, not-for-profit and community organisations, so that NGOs, social commentators, decision-makers and policymakers have access to current evidence on what young people are thinking, feeling and hoping in 2019.

The Youth Survey gives us the vital evidence needed to advocate with young people, and for them, for the services and policy responses that they need.

Young people have a vital role in shaping our tomorrow. If we ensure young people have the right supports and opportunities to be heard, the future will be brighter for everyone. Through this survey, once again, they are speaking to us, speaking to people who need to listen to them and respond to their very real concerns and aspirations.

For more information or to register your interest for the 2020 Youth Survey, please contact: youthsurvey@missionaustralia.com.au.

Download full 2019 Youth Report

Mission Australia Youth Survey FULL Report 2019

Download 2019 Young Aboriginal and Torres Strait Islander people Report

MA Youth Survey 2019 ATSI-Web

Profile of respondents

A total of 1,579 (6.4%) respondents to Mission Australia’s 2019 Youth Survey identified as Aboriginal and/or Torres Strait Islander. Of this total, 1,310 (5.3%) respondents identified as Aboriginal, while 149 (0.6%) identified as Torres Strait Islander (the remaining 0.5% identified as both).

Gender breakdown

Nearly half (49.6%) of Aboriginal and Torres Strait Islander respondents were female and 42.7% were male.

Language background other than English

A total of 173 (11.1%) Aboriginal and Torres  Strait Islander respondents stated that they were born overseas and 298 (19.2%)     Aboriginal and Torres Strait Islander young people reported speaking a language other than English at home. Of the 43 languages other than English spoken at home by Aboriginal and Torres Strait Islander respondents, the most common were (in order of frequency): Indigenous languages, Chinese, Spanish, Kriol and Japanese.

Disability

A total of 216 (13.8%) Aboriginal and Torres Strait Islander respondents identified as living with a disability. Twice the proportion of Aboriginal and Torres Strait Islander males (14.4%) identified they were living with a disability (compared with 7.0% of females). The most frequently cited disabilities for Aboriginal and Torres Strait Islander respondents were (in order of frequency): autism, attention deficit hyperactivity disorder (ADHD), learning disabilities, anxiety disorder and deafness or hearing impairment.

Education

As indicated in Table 2.1, 83.1% of Aboriginal and Torres Strait Islander respondents were studying full-time, which is similar to the 83.3% of Aboriginal and Torres Strait Islander respondents studying full-time in 2018. A slightly higher proportion of Aboriginal and Torres Strait Islander females reported studying full-time (86.8% compared with 82.3% of males). Conversely, a slightly higher proportion of Aboriginal and Torres Strait Islander males reported they were not studying (11.6% compared with 8.1% of females).

Respondents who reported that they were currently studying were asked how satisfied they were with their studies. Responses to this question were rated on a 5-point scale that ranged from very satisfied to very dissatisfied. As in previous years, the majority of

Aboriginal and Torres Strait Islander respondents reported that they were either very satisfied (10.8%) or satisfied (45.7%) with their studies. Around one in ten Aboriginal and Torres Strait Islander respondents indicated they were dissatisfied (5.9%) or very dissatisfied (5.4%). As shown in Table 2.2, a slightly higher proportion of Aboriginal and Torres Strait Islander males reported feeling very satisfied (12.7% compared with 8.6% of females), yet a much higher proportion of Aboriginal and Torres Strait Islander females indicated they felt satisfied (52.2% compared with 41.2% of males).

Of those that were still at school, 89.7% of Aboriginal and Torres  Strait Islander respondents stated that they intended to complete       Year 12 (compared with 96.4% of non-Indigenous respondents). More than twice the proportion of Aboriginal and Torres Strait Islander males indicated that they did not plan to complete Year 12 (14.0% compared with 6.3% of females).

1 of 2 Interviews from our NACCHO Youth Conference Darwin 2019

This years NACCHO youth conference theme was ‘Healthy youth, healthy future’ with sessions follwing sub themes of leadership and resilience.

24 year old Gamilaroi and Dunghutti woman, and co-founder of Tiddas 4 Tiddas, Marlee Silva talked with our youth about the importance of social media among the Aboriginal and Torres Striat Islander population and how to use social media as activists to make a change for the better for our people!

“Tiddas 4 Tiddas is a social media based movement that is all about empowering and giving a voice to our Aboriginal and Torres strait Islander woman and girls.”

What issues are of personal concern to our young people?

Young people were asked to indicate how concerned they were about a number of issues over the past year, as shown in Figure 2.5. Responses were rated on a 5-point scale that ranged from extremely concerned to not at all concerned. The items were ranked in order of personal concern according to the summed responses for extremely concerned and very concerned for each item.

The top three issues of personal concern for Aboriginal and Torres Strait Islander young people were coping with stress, body image and mental health. The next most personally concerning issues were school or study problems and physical health.

  • Coping with stress was the top issue of concern, with nearly four in ten (38.4%) Aboriginal and Torres Strait Islander respondents indicating that they were extremely or very concerned about this
  • Around three in ten Aboriginal and Torres Strait Islander young people were extremely or very concerned about body image (31.7%), mental health (31.5%) and school or study problems (30.5%).
  • Around one quarter of Aboriginal and Torres Strait Islander respondents were extremely or very concerned about physical health (25.6%) and family conflict (23.3%).

2 of 2 Interviews from our NACCHO Youth Conference Darwin 2019

Amanda Sibosado from SAHMRI talks with NACCHO about her experience at the NACCHO Members’ Conference 2019 and tells us a little bit about the Young Deadly Free Project and her role as co-ordinator.

Amanda ran a workshop with our young proffesionals at the NACCHO Youth Conference held on the first day of our Members’ conference. The groups came up with some new ideas and input on how health services can assist young people in the approach to STI testing with shame gremlins and how services can work with young people to over come these.

Have our young people experienced bullying?

For the first time in 2019, young people were asked whether they had experienced bullying over the past twelve months. Three in ten (29.9%) Aboriginal and Torres Strait Islander young people reported that they had experienced bullying in the past twelve months (compared with 20.3% of non-Indigenous respondents).

A much higher proportion of Aboriginal and Torres Strait Islander females reported that they had experienced bullying over the past year (33.4% compared with 22.0% of males).

Young people who reported that they had experienced bullying over the past year were then asked to identify from a list of suggested locations where the bullying took place. Table 2.6 shows that, of the 29.9% of Aboriginal and Torres Strait Islander respondents who had experienced bullying in the past year, nearly three quarters (72.5%) reported that the bullying took place at school/TAFE/university.

Four in ten (40.9%) indicated they had experienced bullying online/on social media, while three in ten (30.1%) stated they had experienced bullying at home. Around one in six reported that they experienced this in my neighbourhood (16.8%) or at work (15.8%).

The proportion of Aboriginal and Torres Strait Islander respondents who reported they had experienced bullying across the majority of locations was much higher than the proportion of non-Indigenous respondents

NACCHO Aboriginal #MentalHealth and #SuicidePrevention @cbpatsisp : Health Minister @GregHuntMP welcomes the #YouCanTalk campaign, encouraging our mob struggling with their mental health to reach out and find support

“ The Federal Government welcomes the #YouCanTalk campaign, which encourages Australians struggling with their mental health to reach out and find support.

The awareness campaign is a collaboration between several organisations, including Beyond Blue, Everymind, headspace, Lifeline, ReachOut, RU OK?, SANE Australia, the Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention, Roses in the Ocean and the Black Dog Institute.

The campaign will take place over the December-January holiday period, in recognition of how difficult this time of year can be for many Australians.

Our Government commends the collaboration of these organisations to raise awareness about the importance of starting a conversation, particularly over the Christmas-New Year period.” 

Health Minister Greg Hunt Press Release continued Part 1 below 

Read over 160 Aboriginal Health and Suicide Prevention articles published by NACCHO over past 7 years 

” Suicide has emerged in the past half century as a major cause of premature mortality and is a contributor to the overall health and life expectancy gap for Aboriginal and Torres Strait Islander peoples.

In 2018 it was the fifth leading cause of death among Aboriginal and Torres Strait Islander peoples, and the age-standardised suicide rate was more than twice as high as the non-Aboriginal and Torres Strait Islander people’s rate.”

What we know about suicide for Aboriginal and Torres Strait Islander people : or see Part 3 Below

Sadly, more than 3,000 Australians choose to end their lives each year – about eight people a day.

Every life lost to suicide is a tragedy, creating a ripple effect that flows through families, friendship groups, schools, workplaces and communities.

That’s why the Federal Government has committed to Towards Zero – working towards reducing the suicide rate to zero.

Towards Zero is a total commitment to the value of each and every life, and recognises the importance of all lives, in all ages, and all groups.

This commitment is backed by our investment of $5.2 billion in mental health and suicide prevention services this financial year, including $63.3 million on suicide prevention activities.

It’s so important for Australians who are struggling to reach out and seek support.

The #YouCanTalk campaign also aims to connect people with tools that can support them through their website

www.lifeinmindaustralia.com.au/youcantalk.

#YouCanTalk exists to encourage all Australians to have a conversation with a friend, family member or work colleague they’re concerned about.

While it can be difficult to talk about suicide, research shows you can have a positive influence on someone who may be considering suicide by initiating a conversation with them and supporting them to seek help.

The main message is you don’t need to be a clinician, a GP, or a nurse to check-in with someone you are worried about.

It is OK to let someone know you have noticed they are struggling and ask them if they are experiencing thoughts of suicide.

It is normal to feel worried or nervous about having a conversation with a friend, family member or work colleague who might be experiencing suicidal thoughts, but there are resources available to help you.

Life in Mind is a national digital gateway providing organisations and communities access to suicide prevention information, programs, services, resources and research.

Part 3

Suicide has emerged in the past half century as a major cause of premature mortality and is a contributor to the overall health and life expectancy gap for Aboriginal and Torres Strait Islanders

In 2018 it was the fifth leading cause of death among Aboriginal and Torres Strait Islander peoples, and the age-standardised suicide rate was more than twice as high as the non-Aboriginal and Torres Strait Islander people’s rate.

The standardised death rate for Aboriginal and Torres Strait Islander peoples (24.1 per 100, 000) was higher than the non-Indigenous rate (12.4 per 100, 000)2.

On average, over 100 Aboriginal and Torres Strait Islander persons end their lives through suicide each year, accounting for 1 in 20 Aboriginal and Torres Strait Islander deaths.

STATISTIC

Further suicide data can be found at the Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention, and from the ATSISPEP report.

Three main issues can be identified:

  1. There is variable quality of Aboriginal and Torres Strait Islander identification at the state and national levels, resulting in an expected under-reporting of Aboriginal and Torres Strait Islander suicides.
  2. Lack of reporting on suicide due to questions regarding intent, especially in the case of childhood suicides. Similarly, it can be demonstrated that there may be a reluctance to classify adult deaths as suicides for a variety of reasons also.
  3. Delays in reporting data, whereby incidences of Aboriginal and Torres Strait Islander suicide might not be known for months and often years after the fact.

NACCHO Aboriginal Youth Health News #OwningFutureChange : Download @AusAAH Report : Health and wellbeing of Aboriginal and Torres Strait Islander young people : Plus The Imagination Declaration 2019 Garma festival’s youth forum

 ” Identity and connection to family and Aboriginal ways of knowing, doing and being are at the core of what it is to be an Aboriginal and/or Torres Strait Islander person.

A large proportion of Australia’s Aboriginal and Torres Strait Islander peoples are young and signify an opportunity for harnessing their energy and ideas to prevent poor health and social conditions.

While many Aboriginal and Torres Strait Islander young people lead healthy and safe lives, there is still a conscious journey required to ensure a strong connection to identity and culture that supports overall health, wellbeing and self-determination.

Identity is also informed by many other factors including gender, sexuality, disabilities, social and emotional wellbeing, location and mobility, and socioeconomic status.

For young people impacted by trauma, systemic racism and inequity, there can be lasting effects on identity, connection to culture, health and wellbeing (Atkinson, 2013).

The impact of intergenerational trauma is often overlooked by mainstream health services attempting to engage Aboriginal and Torres Strait Islander young people.

Intergenerational or historical trauma is a transference of trauma among families and communities, which is ‘the subjective experiencing and remembering of events in the mind of an individual or the life of a community, passed from adults to children in cyclic processes’ (Atkinson, 2013, p. 4).

While there are commonalities in factors important to attaining good health among Aboriginal and Torres Strait Islander young people, it is important to also acknowledge Aboriginal and Torres Strait Islander people in Australia are diverse and represent over 200 nations each with their own history, cultures and norms.

Further, young people have unique talents and strengths, have different social and cultural capital and have had varying experiences with health and the health system. “

Preface to Young persons position paper ” See extracts and recommendations below or 

Download full report

The_Health_and_Wellbeing_of_Aboriginal_and_Torres_Strait_Islander_Young_Peoples_PositionPaper_FINAL

Photo above from AAAH Website

Read over 400 Aboriginal Youth / Children’s articles published by NACCHO over the past 7 years

 ” Following the ‘Uluru Statement From The Heart’, in 2019, a group of young Indigenous people have gathered in East Arnhem Land for the Youth Forum at Garma. The forum has been facilitated by AIME and resulted in a Declaration for the Prime Minister and Education Minister’s across Australia – The Imagination Declaration.” see Part 2 below 

This message was read out by Sienna on August 5, 10:00am at the 2019 Garma festival.

Health and wellbeing of Aboriginal and Torres Strait Islander young people

The Constitution of the National Aboriginal Community Controlled Health Organisation (2011) describes health as “not just the physical well-being of an individual but refers to the social, emotional and cultural well-being of the whole Community in which each individual is able to achieve their full potential as a human being thereby bringing about the total well-being of their Community.

It is a whole of life view and includes the cyclical concept of life-death-life”.

View presentations from the recent NACCHO Youth Conference in Darwin 

Australia’s Aboriginal and Torres Strait Islander population is young, with 241,824 people between the ages of 10-24 years in 2016, which represents 5% of the Australian population of young people (Australian Institute of Health and Welfare, 2018a).

Adolescence, defined in western bio-medical terms as the life stage between age 10 and 24 years, is a period of self-discovery and growth when important biological, social and emotional changes take place which can have a long-lasting impact on future health and well-being. Information and practices to support youth life stage development from an Aboriginal and Torres Strait Islander perspective are not currently in use; these types of cultural knowledges and practices were forbidden under past government policy, which has excluded Aboriginal and Torres Strait Islander peoples from decision making about policies to protect health and bring about health and social equity.

Currently, Aboriginal and Torres Strait Islander young people have disproportionately high rates of largely preventable causes of morbidity and mortality which include: injuries, mental health and sexual and reproductive health (Australian Institute of Health and Welfare, 2018a; Azzopardi et al., 2018).

In 2011, for Aboriginal and Torres Strait Islander young people aged 10–24 years, the leading contributors to the disease burden were suicide and self-inflicted injuries (13%), anxiety disorders (8%), alcohol use disorders (7%) and road traffic injuries (6%) (Australian Institute of Health and Welfare, 2018a).

Incarceration and child removal rates continue to be disproportionately high. Aboriginal and Torres Strait Islander children and young people are over-represented at all stages of the child protection system, out of home care (OOHC) and are under-represented in services that could subvert this (SNAICC, 2018).

The Aboriginal and Torres Strait Islander Child Placement Principle (ACPP) aims to prioritise carers who are from the young person’s family in the first instance, or from the young person’s Aboriginal and Torres Strait Islander Community, or alternatively are Aboriginal and Torres Strait Islander carers, however in practice this is not always enacted (Australian Institute of Family Studies, 2019).

The ‘Family is Culture Review’ cautions that “the ACPP is not simply a hierarchy of options for the physical placement of an Aboriginal child in OOHC. The ACPP is one broad principle made up of five elements that are aimed at enhancing and preserving Aboriginal children’s sense of identity, as well as their connection to their culture, heritage, family and community” (Davis, 2019).

These five elements include prevention, partnership, placement, participation and connection (Davis, 2019).

Further, though it varies by state and territory, Aboriginal and Torres Strait Islander young people are markedly over-represented in the youth justice system and in detention; all children in the Northern Territory juvenile detention system are Aboriginal and Torres Strait Islander people (Australian Institute of Health and Welfare, 2019).

Young people who have been in youth detention are at greater risk of mental health disorders, and are more likely to experience homelessness and substance use issues (Australian Institute of Health and Welfare, 2016). Furthermore, Aboriginal and Torres Strait Islander children and young people who are in OOHC are over-represented in the youth justice system and this is a key driver of adult incarceration (Davis, 2019; Sentencing Advisory Council, 2019).

Forced separation either through OOHC or incarceration of young people (or members of their family) can have lifelong consequences for young peoples’ connection to family, Community, culture and Country. Further, transitions from OOHC as an adult or from detention back to Community can be very difficult for young adults.

In terms of social and emotional wellbeing, a majority (76%) of Aboriginal and Torres Strait Islander young people aged 15-24 years report being happy all or most of the time in the past 4 weeks (Australian Institute of Health and Welfare, 2018a).

However, it is important to note that nationally, one third of Aboriginal and Torres Strait Islander young people aged 15-24 report high to very high levels of psychological distress (Australian Institute of Health and Welfare, 2018a).

Not being able to find a job has been reported as the most common stressor (Australian Institute of Health and Welfare, 2018a). Importantly, it has also been found that having a carer with a greater number of stressful life events was associated with poorer mental health among adolescents (Williamson et al., 2016).

A study in New South Wales found that greater resilience among Aboriginal and Torres Strait Islander young people was associated with: having someone to talk to, family encouragement to attend school and engaging in physical activity (Young, Craig, Clapham, Banks, & Williamson, 2019).

The social determinants of health are the conditions in which people are born, grow, live, learn and work, which have a profound impact on health and wellbeing across the life course1. Aboriginal and Torres Strait Islander young people are diverse in their social, cultural, economic and physical living situations; however the social determinants of health are responsible for approximately 39 % of the health gap between Aboriginal and Torres Strait Islander and non-Indigenous Australians (Australian Institute of Health and Welfare, 2018b).

Housing, education, access to income, economic resources and employment are key determinants that influence the health and wellbeing of Aboriginal and Torres Strait Islander young people during adolescence and their life trajectories thereafter. These social and environmental determinants affect the health of young people living in cities and urban areas as well as those in remote areas (Andersen, Skinner, Williamson, Fernando, & Wright, 2018).

Furthermore, racism is a determinant of health, which has been associated with poor physical and mental health outcomes and increased risk for suicide among Aboriginal and Torres Strait Islanders

While the aforementioned social determinants of health are relevant to Aboriginal and Torres Strait Islander people, it is imperative to consider Aboriginal and Torres Strait Islander positive social determinants of health.

Some positive determinants of health include oral history, cultural survival, family support and connection, emotional wellbeing, community control, self-determination and affirmation of cultural practices (AbSec, 2019; Vickery, Faulkhead, Adams, & Clarke, 2007).

The formative years of adolescence are an important period for reducing inequities, promoting health, wellbeing and better access to health services to improve the current and future health of Aboriginal and Torres Strait Islander people.

The AAAH acknowledges

  1. Aboriginal and Torres Strait Islander young people are the experts in their own health and have agency in their health and health
  2. The importance of cultural, familial and kinship connections between young people today with past, present and emerging generations of Aboriginal and Torres Strait Islander peoples regarding health, wellbeing and
  3. Western pre-conceived notions of family units impact young people’s equitable access to services and culturally safe
  4. The ongoing role of colonisation, dispossession, racial discrimination and marginalisation in creating the economic and social disparity experienced by so many Aboriginal and Torres Strait Islander young
  5. Historical trauma, intergenerational trauma and racism are determinants of health and wellbeing, which are not adequately understood or addressed across multiple sectors, including the health
  6. Positive determinants of Aboriginal and Torres Strait Islander health and wellbeing include oral history, cultural survival, family support and connection, emotional wellbeing, community control, self-determination and affirmation and respect of cultural practices and Aboriginal and Torres Strait Islander ways of knowing and
  7. The social determinants of health are shaped by the distribution of money, power and resources; addressing these determinants requires political will and coordinated action in sectors beyond the health
  8. That the health sector needs to consider:
    1. Many Aboriginal and Torres Strait Islander young people have unmet health needs that reflect issues of inequity and inadequate access to appropriate services; these issues may be compounded for young people with intersecting identities due to greater discrimination and
    2. The importance of health services to be culturally safe, trauma-informed and responsive to the needs of young people and to local histories, needs and
    3. The Aboriginal community-controlled health sector are the leaders in providing culturally safe, holistic, accessible health care for communities, families and young people.
    4. The right of Aboriginal and Torres Strait Islander young people to have access to health-enablers beyond health care, employment and education, including frequently overlooked health enablers like safe and legal transport, and stable, safe and affordable
  9. The impact of forced separation from family and Community through OOHC and incarceration, including disconnection from Country and
  10. The following issues related to research and data:
    1. Aboriginal and Torres Strait Islander people have a right to data sovereignty and self- determination, which is “the right of Indigenous peoples to govern the collection, ownership and application of data about Indigenous communities, peoples, lands, and resources” (Bodkin-Andrews, Walter, Lee, Kukutai, & Lovett, 2019).
    2. Much of the research that drives policy and service provision is grounded in Western notions of empiricism rather than Indigenous knowledge systems and research methods.
    3. Risk and vulnerability are frequently (mis)used to account for health disparities without adequate consideration of social and structural inequalities created by racist policies and
    4. The limitations of existing data and statistical modelling to adequately capture and represent:
      1. Aboriginal and Torres Strait Islander peoples’ experiences of health and wellbeing
      2. The proportion of Aboriginal and Torres Strait Islander people living well and enjoying healthy
    5. The importance of emphasising the National Health and Medical Research Council’s ethical principles in underpinning ways of working with Aboriginal and Torres Strait Islander young peoples: Spirit and integrity, respect, reciprocity, equality, survival and protection, responsibility.

 

The AAAH recommendations

1.Our work with and for young people is guided by The Imagination Declaration written by young people and read at the 2019 Garma festival’s youth forum:

“set an imagination agenda for our classrooms, remove the limited thinking around our disadvantage, stop looking at us as a problem to fix, set us free to be the solution and give us the stage to light up the world.”

2.Principles to be guided by

    1. Connection to culture, Country and family is recognised as a determinant of health and wellbeing in its full
    2. Listening to the solutions that communities, families and young people already have
    3. Young people are recognised as the future leaders in determining priorities, aspirations and directions for their health and
    4. Policy, services, practitioners and researchers centre on young people, their views and their
    5. A rights-based approach to health enabling infrastructure to fulfil the right of young people to safe and legal transport, housing, education and culturally safe services. Health professionals, educators and researchers are in a powerful position to advocate for this and to highlight the costs (human, health, social and financial) of failing to ensure these issues are
    6. Aboriginal and Torres Strait Islander peoples’ experiences and understandings of family are recognised, including the importance of support from extended family and community networks for young people’s health and wellbeing, which should be incorporated into policies, programs and service delivery
    7. Aboriginal and Torres Strait Islander peoples will lead the discourse on Aboriginal and Torres Strait Islander peoples’ health and wellbeing to ensure decolonisation and self- determination.
    8. The responsibility to be informed and enact understanding of Australia’s history, including the legacy of colonisation, must be met by individuals, organisations, communities and governments.
    9. Investment in promoting cultural and historical knowledge to the broader community beyond schools and workplaces across

3.Health sector

      1. There is much that can and should be done to improve the likelihood that Aboriginal and Torres Strait Islander young people will access high quality culturally safe care. This means that both community owned and youth friendly health services are accessible to young
      2. The Aboriginal community-controlled health sector is recognised for leadership and expertise and this is reflected in appropriate indicators that reflect culturally safe and holistic health care
      3. The funding of Aboriginal community-controlled health organisations should be long term and sustainable. Wherever possible, funds for the provision of health care for Aboriginal and Torres Strait Islander peoples should be administered through Aboriginal Community Controlled health
      4. Access to timely, appropriate, high quality, culturally safe care within mainstream services including hospitals, allied health, community health, residential treatment facilities and non-government organisations – this means that services recognise that safety for young people is an ongoing process, and that the workforce is accountable for ensuring that Aboriginal and Torres Strait Islander young people receive the highest quality care that is culturally safe and free from
      5. An intersectoral approach is essential to good health and requires:
        1. Policy that recognises the social determinants of health and shapes investment in incentivised collaborative
        2. Holistic funding models that prioritise community led services and long-term investment.
  • Shared mutual understanding that centres on the needs of young people rather than prioritising competing
  1. Out of Home Care
    1. Addressing over-representation in OOHC is a priority and requires:
      1. Commitment to early intervention and prevention of child
      2. Investing in families through community led, holistic services that strengthen families and connections to
    2. The Aboriginal and Torres Strait Islander Child Placement Principle to be
    3. The AbSec – NSW Child, Family and Community Peak Aboriginal Corporation Plan on a Page for Aboriginal children and young people strategy provides a blueprint for reform to better meet the needs of young people, families and communities and address over-representation in
    4. The Family is Culture: Review Report 2019, provides insight into and recommendations of how to restructure the OOHC system to support Aboriginal and Torres Strait Islander children, families and
  2. Youth justice
    1. Ending over-representation in the youth justice system is a priority and requires:
      1. Investment in youth friendly diversion programs that are community led, including justice reinvestment
      2. Addressing social determinants that are drivers for contact with the youth justice system, including issues of trauma, mental health, early transition from school, unemployment, homelessness and substance
  • Action on inequitable policies that contribute to contact with the youth justice system, including fines enforcement and driver licensing
  1. Research and data
    1. Current conversations around self-determination and data sovereignty should be broadened to specifically include Aboriginal and Torres Strait Islander young people; this is not limited to health and medical data and includes multiple and vast digital footprints as well as lived experience and knowledge of young people and communities.
    2. Move beyond reporting of difference, deficit and disadvantage by developing meaningful indicators of Aboriginal and Torres Strait Islander peoples’ experiences of health and
    3. Research is grounded in First Nations knowledge systems and Indigenous research methods.
  2. Advocating for reforms outlined in the Uluru Statement From the Heart and for a constitutional voice in

Following the ‘Uluru Statement From The Heart’, in 2019, a group of young Indigenous people have gathered in East Arnhem Land for the Youth Forum at Garma. The forum has been facilitated by AIME and resulted in a Declaration for the Prime Minister and Education Minister’s across Australia – The Imagination Declaration.

This message was read out by Sienna on August 5, 10:00am at the 2019 Garma festival.

To the Prime Minister & Education Ministers across Australia,

In 1967, we asked to be counted.

In 2017, we asked for a voice and treaty.

Today, we ask you to imagine what’s possible.

The future of this country lies in all of our hands.

We do not want to inherit a world that is in pain. We do not want to stare down huge inequality feeling powerless to our fate. We do not want to be unarmed as we confront some of the biggest problems faced by the human race, from rising sea levels, which will lead to significant refugee challenges, to droughts and food shortages, and our own challenges around a cycle of perpetuated disadvantaged.

It’s time to think differently.

With 60,000 years of genius and imagination in our hearts and minds, we can be one of the groups of people that transform the future of life on earth, for the good of us all.

We can design the solutions that lift islands up in the face of rising seas, we can work on creative agricultural solutions that are in sync with our natural habitat, we can re-engineer schooling, we can invent new jobs and technologies, and we can unite around kindness.

We are not the problem, we are the solution.

We don’t want to be boxed.

We don’t want ceilings.

We want freedom to be whatever a human mind can dream.

When you think of an Aboriginal or Torres Strait Islander kid, or in fact, any kid, imagine what’s possible. Don’t define us through the lens of disadvantage or label us as limited.

Test us.

Expect the best of us.

Expect the unexpected.

Expect us to continue carrying the custodianship of imagination, entrepreneurial spirit and genius.

Expect us to be complex.

And then let us spread our wings, and soar higher than ever before.

We call on you and the Education Ministers across the nation to establish an imagination agenda for our Indigenous kids and, in fact, for all Australian children.

We urge you to give us the freedom to write a new story.

We want to show the world Aboriginal genius.

We want to show the nation Aboriginal leadership and imagination.

Over the coming months we’ll be sharing the declaration with thousands of Indigenous kids across our nation and together we’ll stand to say, “set an imagination agenda for our classrooms, remove the limited thinking around our disadvantage, stop looking at us as a problem to fix, set us free to be the solution and give us the stage to light up the world.”

We want the Imagination agenda in every school in the nation, from early childhood learning centres through to our most prominent universities.

To our Prime Minister & Education Ministers, we call on you to meet with us and to work on an imagination plan for our country’s education system, for all of us.

We are not the problem, we are the solution.

 

 

NACCHO Aboriginal #SexualHealth @atsihaw Resources and Events : Plus Dawn Casey ” NACCHO recognises the importance of the Aboriginal and Torres Strait Islander #HIVAwarenessWeek #WorldAIDSDay2019 “


“Exposure to STIs differs for Aboriginal and Torres Strait Islander people.

Our women are diagnosed with HIV, STIs and BBVs at a greater rate than other Australian women and are facing infertility, ectopic pregnancy, spontaneous preterm birth or still-birth.

NACCHO believes this requires greater recognition and commitment from all levels of government to work collaboratively across portfolios and mainstream organisations.

A good example is the current partnership between the Commonwealth Department of Health and NACCHO to address the syphilis outbreak, which has been extraordinary!

It highlights innovation in science and the great work done on the ground by Aboriginal health workers.

There is no better way to provide healthcare than through the 145 Aboriginal Community Controlled Health Organisations (ACCHOs), who deliver holistic, culturally safe, comprehensive primary healthcare across Australia, including those living in very remote areas

Studies have shown that ACCHOs are 23% better at attracting and retaining Aboriginal and Torres Strait Islander clients than mainstream providers. 

If funded adequately ACCHOs are the solution to addressing the increasing rates of STIs, BBVs and HIV/AIDS.”

Dr Dawn Casey, Deputy CEO of NACCHO who spoke at the 2019 parliamentary World AIDS Day breakfast this week. See continued NACCHO Press Release Part 1 and speech notes part 2 Below 

“ATSIHAW has grown bigger, with 132 ATSIHAW events to be held by 73 organisations across Australia this year – mostly in ACCHOs. ACCHOs have embraced ATSIHAW wholeheartedly and this has been key to ATSIHAW’s success.

Community engagement has been pivotal to the improvements in Australia’s HIV response and it’s time to focus on getting HIV rates down in our communities.”

South Australian Health and Medical Research Institute (SAHMRI) Head, Aboriginal Health Equity—Sexual Health and Wellbeing, A/Prof James Ward

Download the 30 Page PDF Report 

2019-SAHMRI-ATSIHAW-booklet

ATSIHAW 2019 dates are November 28 to December 5

View the ATSIHAW 2019 registered events on Facebook or below by state.

NSW | QLD | SA | VIC | WA | ACT | NT | TAS

See Web Page

Part 1 NACCHO Press Release continued 

The National Aboriginal Community Controlled Health Organisation (NACCHO) recognises the importance of the Aboriginal and Torres Strait Islander HIV Awareness Week (ATSIHAW) and the 2019 World AIDs Day to draw attention to the increasing impact of sexually transmitted infections (STIs) on Aboriginal and Torres Strait Islander communities.

In Australia, it has been recorded that the cases of new HIV diagnoses amongst Australians represent a decline of 23% in the last five years.

However, the HIV notification rates within the Aboriginal and Torres Strait Islander population in 2018 was more than twice the rate for the Australian-born non-Aboriginal and Torres Strait Islander people. Source: Kirby Institute

Australia is perceived on the global stage as a world leader in HIV prevention and treatment.

But considering the high prevalence of this issue in Aboriginal and Torres Strait Islander communities, NACCHO understands there is still some way to go.

Part 2 Dawn Casey Speaking Notes

World AIDS Day Parliamentary Breakfast – 27 November 2019

Traditional Owners of this land, the Ngunnawal and Ngambri People. I like to acknowledge other Aboriginal and Torres Strait Islander people in the room.

I would like to thank AFAO for inviting me here to speak this morning.

I would like to acknowledge the Hon Greg Hunt, Minister for Health, the Hon Chris Bowen, Shadow Minister for Health and all the Members of Parliament present here. It is just fabulous to see a bipartisan approach taken to this issue.

Exposure to STIs, HIV and BBVs differs for Aboriginal and Torres Strait Islander peoples. Research tells us that it is more likely attributed to heterosexual sex and injection drug use coming into our communities. And we know that Aboriginal and Torres Strait Islander women are diagnosed with HIV, STIs and BBVs at a greater rate than other Australian women.

This is extremely concerning as the next generation of Aboriginal and Torres Strait Islander women living in remote communities are facing infertility, ectopic pregnancy, spontaneous preterm birth or still-birth.

Let me remind you that there is no better way to provide healthcare than through Aboriginal Community Controlled Health Organisations (ACCHOs). They have been around here for many years and are established and operated by local communities, through locally elected Boards of Management, to deliver holistic and culturally safe and comprehensive primary healthcare.

They punch above their weight, with 145 services nationally providing about three million episodes of care each year for Aboriginal and Torres Strait Islander people across Australia, including those living in very remote areas.

ACCHOs provide culturally safe, comprehensive primary health care consistent with our people’s needs, this includes: home and site visits; provision of medical, public health and health promotion services; allied health, nursing services; assistance with making appointments and transport coordination; help to access child care or to deal with the justice system and drug and alcohol services.

Our people trust us with their health. Studies have shown that ACCHOs are 23% better at attracting and retaining Aboriginal and Torres Strait Islander clients than mainstream providers.

If funded adequately ACCHOs are the solutions to addressing the increasing rates of STIs, BBVs and HIV/AIDS. The current partnership between the Department of Health to address the syphilis outbreak has been extraordinary! It highlights innovation in science and the great work done on the ground by Aboriginal health workers.

I would like to leave with one message:

It is only with everyone working together that we will be able to help minimise the impact of STIs, BBVs and HIV/AIDS in the community. Mainstream organisations need to do their part and collaborate and work collectively with us.

Nationally, there is a high-quality network of Aboriginal controlled service providers that get results – understand them, connect with them and identify mutually beneficial areas to work together

Picture above Tim Wilson MP and his quote : At Parliament today, we gathered to remember & honour those lost to HIV/AIDS, redouble our efforts to stop new transmissions and stigma + mark tomorrow’s start of Aboriginal and Torres Strait Islander HIV Awareness Week.

Find out more here: atsihiv.org.au

Part 3 Health Minister Greg Hunt Press Release 

World AIDS Day is held on 1 December each year. It raises awareness across the world and in the community about HIV and AIDS.

It is a day for people to show their support for people living with HIV and to remember and honour those who we have lost.

In the 2019–20 Budget, the Morrison Government invested $45.4 million to implement Australia’s five National Blood-Borne Viruses (BBV) and Sexually Transmissible Infections (STI) Strategies.

These strategies will make a deep and profound difference in reducing the health impacts and stigma of BBV and STI, including HIV.

Today, I am pleased to announce that our Government will provide additional, ongoing support for people with HIV and other BBV and STI’s by extending funding to six national peak organisations, providing almost $3 million for 2020-21.

In addition, from 1 December 2019, Australians living with HIV will save more than $8,500 a year with the listing of a new combination medicine on the Pharmaceutical Benefits Scheme (PBS).

It is estimated that 850 Australians with HIV will benefit from the listing of Dovato® (dolutegravir with lamivudine) on the PBS, which will provide more choice for them in how they can manage their HIV.

Effective once daily treatments such as Dovato and other new medicines can control the virus so that people living with HIV can enjoy long, healthy and productive lives.

With the PBS subsidy, people living with HIV will pay just $40.30 per script, or $6.50 with a concession card for Dovato®.

Australia continues to be a world leader in the response to HIV. The number of new HIV diagnoses today is at its lowest in nearly 20 years.

Our success is built on a model of partnership between government, people living with HIV, community based organisations, health professionals and researchers.

We are seeing more people tested for HIV and initiating treatment for HIV. There are also more people living with a suppressed viral load. In addition, improved access to HIV prevention methods, including the PBS-listed pre exposure prophylaxis (PrEP), helps reduce the number of new HIV diagnoses.

We are also looking to address stigma and discrimination.

The Eighth National HIV Strategy 2018-22, guides our partnership approach over the next four years to virtual elimination of HIV transmission by 2022.

We aim to be one of the first countries in the world to eliminate new HIV transmissions.

NACCHO Aboriginal Women’s Health Resources : #stopitatthestart #respectstartswithus 25 November : Aboriginal and Torres Strait Islander communities are encouraged to join national efforts to help break the cycle of violence against women

We might say things that are harmful to our partners and children, sometimes we say things without even realising the danger it causes.

Most of us, at some time, have heard adults say things to boys like, ‘stop acting like a girl’, or they excuse disrespectful behaviour by saying things to girls such as, ‘it’s just boys being boys’.

I know I have been guilty of this in the past. “

Kuku-Yalanji and Gumbaynggirr man, father and cultural mentor Jeremy Donovan 

Aboriginal and Torres Strait Islander communities are encouraged to join national efforts to help break the cycle of violence against women, coinciding with the International Day for the Elimination of Violence against Women on 25 November.

Culturally appropriate resources have been developed to support communities to talk with young people about respect as part of the Stop it At the Start campaign.

Violence against women and their children is a serious issue in Australia.

One in four women has experienced violence from a current or former partner, boyfriend, girlfriend or date.

For Aboriginal and Torres Strait Islander women, the statistics are even more concerning.

One-third of Indigenous women has experienced physical violence from a partner, twice the level recorded among non-Indigenous women. In addition, Indigenous women in remote and regional areas experience rates of family violence up to 45 times higher and sexual assault 16 to 25 times higher than other women [1].

All members of the community have a role to play as role models for teaching children about respect. Parents, family members, teachers, coaches, employers and community leaders can help break the cycle of violence by reflecting on their own attitudes and talking with young people about respectful relationships and gender equality.

Aboriginal and Torres Strait Islander role models and Stop it at the Start campaign supporters Jeremy Donovan, Lani Brennan and Leila Gurruwiwi have reflected on their own stories and experiences of disrespect to highlight the importance of having these conversations with young people.

Indigenous Support Worker, TV Host and role model Leila Gurruwiwi agrees that people should stop to reflect on the impact of their words.

When I hear people say, ‘he just did it because he likes you’, I think, ‘if he loved and respects you, he wouldn’t hurt you – whether that’s emotionally, physically, spiritually,” says Leila.

Lani Brennan, Nyawaygi woman and domestic violence survivor, says the campaign is important for the community and shaping behaviours built on respect.

The Stop it at the Start campaign is targeting the disrespectful attitudes and behaviours that parents and other role models teach our young people, often without realising it. I think this message is so important, because what we say to our kids and show them by our own actions, shapes their attitudes and beliefs,” Lani says.

The Stop it at the Start campaign is an initiative under the National Plan to Reduce Violence Against Women and their Children 2010-2022.

Visit respect.gov.au for more information and to download free resources.

If you or someone you know is impacted by sexual assault, domestic or family violence, call 1800RESPECT on 1800 737 732 or visit 1800RESPECT.org.au

#stopitatthestart
#respectstartswithus

National #NACCHOYouth19 Conference and Members’ Conference #NACCHOAgm2019 :Because of Them, We Must! Improving health outcomes for 0-to-29-year-olds

For thousands of years, our Elders have shown great resolve thriving on this vast continent and the youth delegates who attended the conference have instilled confidence in us for the continuation of this into the future.

The NACCHO Youth and Members Conference included engaging workshops and enlightening presentations from our members – the Aboriginal Community Controlled Health Organisations (ACCHOs), clinicians, academicians, medical experts and Aboriginal Health Practitioners.”

NACCHO has been commissioned by the Department of Health to produce a ‘Core Services and Outcomes Framework’ by May 2020.

An important project for our sector that will bring together a comprehensive set of core primary health care functions that apply to our services in remote, regional and metropolitan Australia “

NACCHO Acting Chair, Donnella Mills photo 2 above with Minister Greg Hunt  : Photo 1 above Darwin Larrakia-Belyen dancers for the welcome to country

“The biggest thing that we’re all getting from it is that even though they’re really doing some good things in their space, they can actually do more,

More that’s going to not only benefit their communities, but also make things a little bit easier on themselves. I think that’s what these events are all about – being able to come together and share what we’re doing and what we can all gain from it.”

Preston Campbell told NITV  see Part 2

More than 400 Aboriginal and Torres Strait Islander people; youth, health service workers and policy makers gathered at the Darwin Convention Centre from 4 – 7 November to discuss initiatives to improve health outcomes of Aboriginal and Torres Strait Islander people aged 0-to-29-year-old.

Delegates included Professor Tom Calma , Dr Mark Wenitong from Apunipima ACCHO Cape York and James Ward SAHMRI

The National Aboriginal Community Controlled Health Organisation’s (NACCHO) annual Members’ Conference kicked off with the Youth Conference, attended by 60 Aboriginal and Torres Strait Islander emerging leaders from the health sector.

The delegates were inspired by a range of speakers in the areas of self-determination, mental health and wellbeing, resilience, and social media. They engaged in discussions around raising the voices of the youth, undertaking genuine leadership roles and getting a seat at the table in decision making and policy development.

Safe-sex superheroes Condoman and Lubelicious – part of the successful sexual health community education and engagement campaign by Queensland Aids Council with our deadly youth delegates.

The NACCHO Youth Conference set the tone for the Members’ Conference with 40 outstanding speakers and panellists.

Some of the key highlights included:

The Government in partnership with NACCHO and the Australian Medical Association (AMA) has developed a revised funding model for ACCHOs, investing an additional $90 million over three years under the Indigenous Australians’ Health Programme (IAHP). NACCHO welcomes this new funding that will further support the delivery of culturally appropriate, comprehensive primary healthcare.

See full Minister Greg Hunt Press Release HERE

Presentation by Dr Kelvin Kong, an Aboriginal ear, nose and throat (ENT) specialist with great insight around his research on ear issues affecting up to 70% of children in remote communities.

Memorandum of Understanding (MOU) between NACCHO and the Royal Australian College of GPs (RACGP) to a five-year program to champion community control and self-determination; improving cultural competency, eliminating racism in the healthcare system and further developing an Aboriginal and Torres Strait Islander health workforce.

CEO of NACCHO, Ms Pat Turner AM and Co-Chair of the END RHD alliance along with Professor Jonathan Carapetis AM, presented a sneak peek into the soon-to-be launched RHD Endgame Strategy aimed at eliminating rheumatic heart disease (RHD) in Australia by 2031.

They were accompanied by Raychelle and Noeletta McKenzie, who shared their personal experiences of RHD and their work to empower communities as part of RHDAustralia’s Champions4change program.

Hey you mob?! Did you hear that SA took out the Karaoke cup last night – back in its rightful home

Part 2 First Nations youth are at the forefront of this year’s National Aboriginal Community Controlled Health Organisation (NACCHO) Conference

A stellar line-up of inspiring young speakers has focused on mental health at the 2019 National Aboriginal Community Controlled Health Organisation (NACCHO) Youth Conference in Darwin this week.

Themed as ‘healthy youth, healthy future’, about 100 young people from across the country gathered on balmy Larrakia country on Monday to discuss issues important to each of their communities over the next three days.

See Full Report HERE 

Notable speakers included mental health youth worker Brooke Blurton (pictured above with NACCHO Staff Oliver Tye Left and Brendan Dunn Right ) and former NRL champion and mental health advocate Preston Campbell, who shared his own experiences with the young delegates.

“The biggest thing that we’re all getting from it is that even though they’re really doing some good things in their space, they can actually do more,” Mr Campbell told NITV News.

 

“More that’s going to not only benefit their communities, but also make things a little bit easier on themselves. I think that’s what these events are all about – being able to come together and share what we’re doing and what we can all gain from it.”

The attendees are now able to take home the skills, knowledge and inspiration of their peers to their communities to grow themselves and continue their important work

NACCHO Aboriginal Youth Health #ClosingtheGap #HaveYourSayCTG : The #NACCHOYouth19 Conference kicks off today in Darwin with a great line up of inspirational speakers

“Young people make up 54 per cent of the Aboriginal and Torres Strait Islander population and look up to the example set by generations past and present to navigate ever-changing and complex social and health issues.

We are thrilled to announce an illustrious line-up of speakers at the NACCHO Youth Conference and are expecting to host around 100 Aboriginal and Torres Strait Islander youth delegates from across the country.

The conference will provide opportunities to explore and discuss issues of importance to young people, their families and communities, and help shape our youth towards becoming tomorrow’s leader.”

NACCHO Acting Chair, Donnella Mills.

The National Aboriginal Community Controlled Health Organisation (NACCHO) will today host its annual National Youth Conference, Members’ Conference and AGM from 4–7 November 2019 at the Darwin Convention Centre, commencing with the Youth Conference on 4 November.

The 2019 theme for the Members’ Conference is Because of Them, We Must! Improving health outcomes for people aged 0-to-29-year-olds. In line with the theme follows the central focus on building resilience for the NACCHO Youth Conference Healthy youth, healthy future.

NACCHO is thrilled to announce some of the featured speakers for the 2019 Youth Conference which include:

Preston Campbell, Former NRL star, community leader and founder of the Preston Campbell Foundation;

Brooke Blurton, Noongar-Yamatji woman, social media influencer and youth advocate;

Jarlyn Spinks and Katy Crawford of the Kimberley Aboriginal Medical Service (KAMS) team for the campaign ‘Her Rules Her Game’ which celebrates the strength of Aboriginal women playing football in the Kimberley region;

Marlee Silva, Gamilaroi-Dunghutti woman and Co-Founder of #tiddas4tiddas, an Aboriginal and Torres Strait Islander women’s empowerment social media initiative;

Brendan Dunn of the Coalition of Peaks Secretariat in Canberra;

Dr.Mangatjay Mcgregor, Yolgnu man from Milingimbi and intern doctor at the Royal Darwin Hospital;

Oliver Tye, Noongar man based on Ngunnawal Country in the ACT and Policy Officer at NACCHO.

Part 2 Closing the Gap / Have your say about youth issues 

Deadline extended to Friday, 8 November 2019.

 

The engagements are now in full swing across Australia and this is generating more interest than we had anticipated in our survey on Closing the Gap.

The Coalition of Peaks has had requests from a number of organisations across Australia seeking, some Coalition of Peak members and some governments for more time to promote and complete the survey.

We want to make sure everyone has the opportunity to have their say on what should be included in a new agreement on Closing the Gap so it is agreed to extend the deadline for the survey to Friday, 8 November 2019.

This will help build further understanding and support for the new agreement and will not impact our timeframes for negotiating with government as we were advised at the most recent Partnership Working Group meeting that COAG will not meet until early 2020.

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/

NACCHO Aboriginal Prisoner Health #ClosingThe Gap #HaveYourSayCTG : What are the barriers preventing community-controlled health organisations providing care to Aboriginal and Torres Strait Islander people in prison ?

“Findings showed that while most participant ACCHOs had delivered services to people in the community upon release from prison, opportunities to deliver primary health care services to individuals in prisons were very limited.

Two key barriers to implementing holistic and culturally appropriate health care in prisons were lack of access to prisoners due to security protocols and prison staff attitudes, and lack of a sustainable funding model.

A reliable funding model underpinned by consistent access to prisoners and access to certain Medicare items could resolve this conundrum, as has been previously proposed.23

To this end, we encourage the Commonwealth of Australia to engage in appropriate discussions to resolve this matter.

Additionally, custodial and prison health providers need to engage in meaningful discussions with ACCHOs to address prisoner access issues. “

Download the Research Paper Here or READ Online

Barriers prevent ACCHOs from getting care to prisoners

Read all the Aboriginal health and Just Justice articles by NACCHO

How likely are you to go to jail? As an Aboriginal adult you are 16 times more likely to be incarcerated. Juveniles in Western Australia are 52 times more likely to be imprisoned than their white peers [15

Closing the Gap / Have your say about the prison system see Part 3 below

Deadline extended to Friday, 8 November 2019.

Part 1 PHAA Press Release

New research has revealed that Aboriginal Community Controlled Health Organisations (ACCHOs) face barriers to deliver to Aboriginal and Torres Strait Islander prisoners what they do best – holistic primary health care for Aboriginal and Torres Strait Islander people.

Researchers interviewed nineteen staff from four ACCHOs close to prisons across three Australian jurisdictions.

They found that while most ACCHOs deliver post release programs, their capacity to deliver health care to prisoners is limited by security protocols that restrict access to prisoners and funding constraints.

The study results are published today in the Public Health Association of Australia’s journal, the Australian and New Zealand Journal of Public Health.

ACCHOs are universally acknowledged as organisations that are run by Aboriginal and Torres Strait Islander people for Aboriginal and Torres Strait Islander people, delivering holistic primary health care that’s local and community owned.

The authors make several recommendations including reliable funding for ACCHOs and better and consistent access to prisoners.

State governments are encouraged to address prison access issues while the Federal Government is urged to consider changing the rules that prevent ACCHOs from using Medicare to fund work undertaken in the prison setting.

The health of Aboriginal and Torres Strait Islander people is poorer than that of other Australians. They are over-represented in Australian jails. Due to the unique cultural, social and historical factors, specific solutions to address health issues are required.

Part 2 Selected extracts

The offender population is one of the most stigmatised and socially excluded groups in society. Epidemiological studies of prisoners consistently find high levels of physical ill health, psychiatric illness and communicable diseases, and engagement in health risk behaviours such as smoking, alcohol consumption, illicit drug use and violence.12

For Aboriginal and Torres Strait Islander (hereon ‘Indigenous’) offenders, disadvantage is further compounded by poor social determinants of health.

Since colonisation more than 230 years ago, Indigenous Australians have lower levels of political representation, educational attainment and income when compared to the general Australian population, as well as higher rates of social exclusion, unemployment, trauma and ill‐health, and shorter life expectancy.3 Indigenous Australians frequently experience racism and low levels of access in mainstream health services and the legal system.45 These issues underscore the importance of community controlled primary health care for Indigenous offenders that is contextually relevant, holistic and culturally safe.

Aboriginal and Torres Strait Islander Community Controlled Health Organisations (ACCHOs) provide culturally appropriate, autonomous primary health care services that are initiated, planned and governed by local Aboriginal Australian communities through an elected board of directors.6

ACCHOs are represented nationally by the National Aboriginal Community Controlled Organisation (NACCHO), which engages directly with policy makers and funding bodies, links ACCHOs to facilitate health service delivery and research, advises on research, and provides leadership on service delivery principles such as community control.

Community control is vital for culturally appropriate and acceptable health care services in Indigenous communities and enacts articles of the United Nations Declaration on the Rights of Indigenous Peoples, ensuring self‐reliance, self‐determination, appropriate and acceptable health care.6

Since the establishment of the first ACCHO in inner Sydney in 1971, the network of ACCHOs has grown to 143 across Australia, providing more than three million episodes of care each year for approximately 350,000 people.7

Primary health care services provided by ACCHOs embody the Aboriginal definition of health, which is not just about an individual’s physical wellbeing but also the social, emotional and cultural wellbeing of the community, and takes a whole‐of‐life perspective that incorporates a cyclical concept of life–death–life.8

ACCHOs provide comprehensive primary health care that includes health education, health promotion, social and emotional wellbeing support and a range of other community development initiatives.9

Limited access to primary health care services for Indigenous peoples is a major barrier to addressing the overall aim of the Australian Government’s ‘Closing the Gap’ framework.10 Data show that, compared to mainstream services, ACCHOs are frequently accessed by Indigenous people.11

A 9% growth in Indigenous community members accessing their local ACCHO was observed between 2012–13 and 2014–15, with a 23% increase in the total number of episodes of care during this time.7 In a study comparing outcomes and indicators between ACCHOs and mainstream services, ACCHOs performed better in terms of best practice care, monitoring clinical performance, increasing engagement of Indigenous community members, and better leadership in training non‐Indigenous staff in Indigenous health matters.12

Barriers to accessing mainstream services extend also to Indigenous Australians in the criminal justice system. In Australia, Indigenous people comprise 28% of the prisoner population, but only 2% of the general population.13 Australian state and territory legislation states that prisoners must be able to access health care when they require it, and that they have the right to the same level of care as in the wider community14 – a right referred to in the international context as the ‘equivalence of care’ principle.15

Incarceration causes a person to be separated from their community.17 A recommendation (168) by the Royal Commission into Aboriginal Deaths in Custody (RCIADIC) requires that a person be incarcerated as close to their home community as possible.16 Incarceration can also disrupt continuity of holistic health care provided by an ACCHO,17 if that ACCHO has no means of accessing the prisoner.

Other custodial health and safety recommendations made by the RCIADIC state that Corrective Services departments should review the provision of health services to Indigenous prisoners including the level of involvement of ACCHOs (Recommendation 152c) and the exchange of relevant health information between prison medical staff and ACCHOs (Recommendation 152e).16

Australia’s National Indigenous Drug and Alcohol Committee (NIDAC) asserts that improvements in health services for Indigenous prisoners and juvenile detainees may assist in reducing the overall prisoner numbers.18 Areas noted for improvement included health screening on reception, increasing uptake of recommended treatments, and enhancing prisoner throughcare by facilitating access of Indigenous health and other services to Indigenous prisoners.18

NIDAC highlighted that “the provision of a ‘one health service fits all’ model, as in the case for many corrections systems, creates a disjointed and unsuitable approach” for addressing health needs of Indigenous prisoners.18

In response, NIDAC recommended several strategies for involving ACCHOs to improve the health care of prisoners and their ongoing care post‐release.18 However, there is a dearth of literature on external health care provision to Australia’s prisoners from which to plan coordinated actions and resource allocation. Only a small number of reports are available on health care provided by community‐based organisations in prisons.1920

Health care varies greatly in Australia’s state‐ and territory‐based prisons, with government Departments of Health providing health care services to some through agencies such as the Justice and Forensic Mental Health Network in New South Wales (NSW), and Departments of Justice or contracted private companies providing services to others.21

There is no nationally coordinated approach or body whose role it is to monitor prisoners’ health care needs, and no national strategy for assessing or meeting the specific health needs of Indigenous prisoners.22 Australia’s publicly funded universal health care system – the Medicare Benefits Scheme and Pharmaceutical Benefits Scheme, collectively known as Medicare – is suspended for prisoners during incarceration.

This is because other state‐ and territory‐level government departments become responsible for providing health care to prisoners.23 However, this arrangement has been identified as problematic, with concerns that it reduces resources or opportunities for providing comprehensive health care to prisoners that is equivalent to that available in the community.23

This project was designed by a team of Aboriginal and non‐Aboriginal researchers working at the nexus of the justice and health systems, and with specialisations in Indigenous health research, epidemiology, qualitative research and health services research and evaluation. Three of the team members identified as Indigenous Australians.

The primary aim of the research was to explore prisoner health services and programs provided by a selection of ACCHOs, including the challenges and enablers of delivering these, and implications for further research.

Part 3 Closing the Gap / Have your say about the prison system

Deadline extended to Friday, 8 November 2019.

 

The engagements are now in full swing across Australia and this is generating more interest than we had anticipated in our survey on Closing the Gap.

The Coalition of Peaks has had requests from a number of organisations across Australia seeking, some Coalition of Peak members and some governments for more time to promote and complete the survey.

We want to make sure everyone has the opportunity to have their say on what should be included in a new agreement on Closing the Gap so it is agreed to extend the deadline for the survey to Friday, 8 November 2019.

This will help build further understanding and support for the new agreement and will not impact our timeframes for negotiating with government as we were advised at the most recent Partnership Working Group meeting that COAG will not meet until early 2020.

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/

Aboriginal #NACCHOYouth19 #MentalHealth #ClosingTheGap #HaveYourSayCTG : According to new @blackdoginst  @MissionAust report 32 % of Aboriginal and Torres Strait Islander young people met the criteria for psychological distress, compared to 23.9% for non-Indigenous young people

It is essential that Aboriginal and Torres Strait Islander young people have access to culturally and age-appropriate mental health services that are in close proximity to their homes.

The Australian Government should invest in building the capacity of Aboriginal and Torres Strait Islander-led and controlled health organisations to deliver these services in communities.

Why ? A greater proportion of Aboriginal and Torres Strait Islander respondents indicated concerns about suicide (40.2% compared with 6% of non-Indigenous respondents).

Relative to non-Indigenous respondents, a greater proportion of Aboriginal and Torres Strait Islander respondents with psychological distress indicated concerns about gambling (13.8% compared with 4.2%), domestic/family violence (26.3% compared with 16.8%), drugs (20.1% compared with 10.9%), discrimination (26.3% compared with 18.6%) and alcohol (15.2% compared with 8.6%).

See dedicated focus on Aboriginal and Torres Strait Islander young people Part 2 Below

Read Brooke Blurton’s speaker BIO Here 

” Have you seen the brilliant line-up of speakers at the NACCHO Youth Conference, 4 November 2019 at the Darwin Convention Centre? https://www.naccho.org.au/home/naccho-youth-conference-2019/

Are you under 29 years and working in the Aboriginal and Torres Strait Islander health or related sectors?

If so, register NOW for our free NACCHO Youth Conference. Closing 25 October

Places are filling quick! 👉🏾 http://bit.ly/2qALFkH

Part 1 Press Release : A new joint report by Mission Australia and Black Dog Institute indicates that considerably more young people in Australia are experiencing psychological distress than seven years ago.

Almost one in four young people in 2018 say they are experiencing mental health challenges, with young females twice as likely as males to face this issue.

A higher proportion of Aboriginal and Torres Strait Islander young people also met the criteria for psychological distress than their non-Indigenous peers.

The Can we talk? Seven year youth mental health report – 2012-2018 Youth Survey findings of the past seven years – and is co-authored with Black Dog Institute experts – to ascertain and investigate rates of psychological distress experienced by young people in Australia who are aged 15-19.

The report further examines the concerns, general wellbeing and help-seeking behaviours of the close to 27,000 participants of the 2018 Youth Survey aged 15-19, including those who are experiencing psychological distress – highlighting the vital role that friends, parents, services, schools and the internet play as sources of help for young people who are struggling with their mental health.

Key findings include:

  • Close to one in four young people met the criteria for experiencing psychological distress – a substantial increase over the past seven years (rising by 5.5% from 18.7% in 2012 to 24.2% in 2018).
  • In 2018, more than three in ten (31.9%) of Aboriginal and Torres Strait Islander young people met the criteria for psychological distress, compared to 23.9% for non-Indigenous young people.
  • Across seven years, females were twice as likely as males to experience psychological distress. The increase in psychological distress has also been far more marked among females (from 22.5% in 2012 to 30.0% in 2018, compared to a rise from 12.7% to 15.6% for males).
  • Stigma and embarrassment, fear and a lack of support were the three most commonly cited barriers that prevent young people from seeking help.
  • The top issues of personal concern for young Australians experiencing psychological distress were coping with stress, mental health and school or study problems. There was also a notably high level of concern about other issues including body image, suicide, family conflict and bullying/emotional abuse.
  • Almost four times the proportion of young people with psychological distress reported concerns about suicide (35.6% compared with 9.4% of respondents without psychological distress).
  • Young people experiencing psychological distress reported they would go to friend/s, parent/s or guardian/s and the internet as their top three sources of help. This is compared to friend/s, parent/s or guardian/s and a relative/family friend for those without psychological distress.

In response to these findings, Mission Australia’s CEO James Toomey said: “It’s deeply concerning that so many young people are experiencing psychological distress. Youth mental health is a serious national challenge that must be tackled as a priority.

“The sheer volume of young people who are struggling with mental health difficulties shows that there remains urgent need for improved access to timely, accessible and appropriate support. Irrespective of their location, background or gender, young people must have the resources they need to manage their individual mental health journey with access to youth-friendly and evidence-based mental health supports.

“Parents, peers, schools and health professionals are vital sources of support for our young people, so it’s important they are adequately equipped with the skills and knowledge they need to provide effective support when needed. For schools right across Australia, more resourcing is needed to train staff, embed wellbeing personnel and provide evidence-based early intervention and prevention programs.

“In light of these findings, I urge governments to listen to young people’s concerns about mental health and co-design solutions with them.”

With the report confirming that young people experiencing psychological distress are less likely to seek help than those without mental health concerns, Black Dog Institute Director and Chief Scientist, Professor Helen Christensen said: “Global research tells us that over 75% of mental health issues develop before the age of 25, and these can have lifelong consequences.

“We are still in the dark as to why mental health and suicide risk has increased in our current cohort of youth, a finding that is not unique to Australia.

“Adolescence is a critical time in which to intervene, but we also know that young people experiencing psychological distress can be harder to reach. This report shows that young people in distress will seek help directly from the internet. As such, we need to continue to provide online and app-based tools that may be a key part of the solution. We also need to catch the problems upstream by prioritising early intervention and prevention efforts.”

Part 2 Meeting the diversity of young people’s need  : Dedicated focus on Aboriginal and Torres Strait Islander young people

Nearly one third (31.9%) of Aboriginal and Torres Strait Islander young people indicated some form of psychological distress, compared with just under one quarter (23.9%) of non-Indigenous respondents.

Aboriginal and Torres Strait Islander young people experiencing psychological distress were more likely than their non-Indigenous peers to report feeling as though they had no control over their life and to report lower levels of self-esteem. Further, a greater proportion of Aboriginal and Torres Strait Islander young people with psychological distress reported having issues that they did not seek help for, despite thinking they needed to (41.2% compared with 36.2% of non-Indigenous respondents).

Positively the Aboriginal and Torres Strait Islander adolescent and youth health and wellbeing 2018 report found that in 2014–15 over three-quarters of Aboriginal and Torres Strait Islander young people aged 15–24 said, they were happy all or most of the time in the previous 4 weeks.

However, around two-thirds of Aboriginal and Torres Strait Islander people aged 15–24 experienced one or more personal stressors in the previous year, the most common being not being able to get a job, and one in three reported being treated unfairly because they were Indigenous.

This report also showed that most Aboriginal and Torres Strait Islander people aged 15–24 (67%) experienced low to moderate levels of psychological distress in the previous month, while 33% experienced high to very high level.

When responding to the Youth Survey 2018 greater proportions of Aboriginal and Torres Strait Islander respondents with psychological distress also indicated concerns about gambling, domestic/family violence, drugs, discrimination, alcohol, LGBTIQ issues and suicide than non- Indigenous respondents with psychological distress.

It is important to take into account these often compounding concerns, as research shows that the leading causes of hospitalisation for mental and behavioural disorders among Aboriginal and

Torres Strait Islander people aged 10-24 years were due to substance abuse, schizophrenia, and reactions to severe stress.

Aboriginal and Torres Strait Islander communities have endured and survived a traumatic and deeply challenging colonisation period that affected all aspects of their collective lives, and which continues to challenge communities, families and individuals today.

At the population level, higher rates  of mental health  difficulties among Aboriginal and Torres  Strait Islander people are intertwined with entrenched poverty, substandard and overcrowded housing, health conditions and disabilities, intergenerational un/under-employment, stressors and trauma, racism and discrimination, and at-risk behaviours in response to sometimes desperate situations.80 In particular, the members of the Stolen Generations and their descendants are ‘more likely to have had contact with mental health services,’ with children in their care often challenged by higher rates of emotional and behavioural difficulties.81

In many cases, responding to population mental health challenges means addressing their deeper, structural causes. These should be identified and solutions co-designed and co-implemented under Aboriginal and Torres Strait Islander community-leadership, including community-controlled organisations and health services. The needs of young people should be prioritised as directed by Aboriginal and Torres Strait Islander communities and their representative organisations.

Community-led programs that build on cultural determinants of social and emotional wellbeing and cultural strengths should be supported to help provide Aboriginal and Torres Strait Islander young people with protective factors against mental health challenges, and particularly against suicide, by supporting a strong sense of ‘social, cultural and emotional wellbeing’ that includes a positive Indigenous/cultural identity. These cultural determinants vary but can include culturally- shaped connections to family, kin, community, and country.

Yet, in many cases, mainstream health and mental health programs fail to incorporate culturally appropriate practices or awareness when working with or treating Aboriginal and Torres Strait Islander people experiencing challenges to their wellbeing.

Program funding must be flexible enough to provide for differences, tailor services to meet community and individual needs and to support younger age groups where critical issues arise. It is essential that Aboriginal and Torres Strait Islander young people have access to culturally and age-appropriate mental health services that are in close proximity to their homes. The Australian Government should invest in building the capacity of Aboriginal and Torres Strait Islander-led and controlled health organisations to deliver these services in communities.

Sources of support

Friend/s (63.6%), internet (44.3%) and parent/s or guardian/s (43.5%) were the most commonly cited sources of help for Aboriginal and Torres Strait Islander young people with psychological distress. Smaller proportions of Aboriginal and Torres Strait Islander respondents than non-

Indigenous respondents with psychological distress said they would turn to close personal connections for help, such as friend/s, parent/s or guardian/s, a GP or health professional, school counsellor, brother/sister or a relative/family friend.

Aboriginal and Torres Strait Islander communities have identified challenges in relation to mainstream models of health care offered and their affordability. Aboriginal Controlled Health Organisations have a strong role to play and should be appropriately funded.

Conversely, greater proportions of Aboriginal and Torres Strait Islander respondents indicated turning to a community agency, social media or a telephone hotline for help. Community agencies therefore need to be funded to provide culturally appropriate support to Aboriginal and Torres Strait Islander young people experiencing psychological distress.

Suicide prevention

A greater proportion of Aboriginal and Torres Strait Islander respondents indicated concerns about suicide (40.2% compared with 35.6% of non-Indigenous respondents).

The rate of Aboriginal and Torres Strait Islander suicide is a critical public health challenge for Australia. Over the 5 years from 2013 to 2017, one in four Australian children and young people aged 5-17 years who died by suicide were Aboriginal and Torres Strait Islanders.86

Designed to complement the mainstream National Suicide Prevention Strategy, the 2013 National Aboriginal and Torres Strait Islander Suicide Prevention Strategy87 was developed to respond to this public health challenge. It recognises the need for investment in holistic and integrated approaches that helps individuals, families and communities have hope for, and optimism about, the future.

In addition to mainstream integrated approach interventions, the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP) highlighted the need for community- led, locally-based and culturally-appropriate ‘upstream’ preventative activities to address community-level challenges associated with suicide.

Further, ATSISPEP underlined the need for programs that build on cultural determinants of social and emotional wellbeing and its protective factors to have a positive impact against complex mental health challenges, including risks of suicide.88

Recognising the intersectionality between mental health, suicide and substance dependence, the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing requires the integration of mental health, alcohol and other drug, and suicide prevention services in communities.89 However, the Strategy needs a focused implementation plan that is properly costed and operationalised if it is to shape the mental health space.

Part 3 National : Closing the Gap / Have your say CTG deadline extended to Friday, 8 November 2019.

 

The engagements are now in full swing across Australia and this is generating more interest than we had anticipated in our survey on Closing the Gap.

The Coalition of Peaks has had requests from a number of organisations across Australia seeking, some Coalition of Peak members and some governments for more time to promote and complete the survey.

We want to make sure everyone has the opportunity to have their say on what should be included in a new agreement on Closing the Gap so it is agreed to extend the deadline for the survey to Friday, 8 November 2019.

This will help build further understanding and support for the new agreement and will not impact our timeframes for negotiating with government as we were advised at the most recent Partnership Working Group meeting that COAG will not meet until early 2020.

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/