Aboriginal Health ” managing two worlds ” : How Katherine Hospital, once Australia’s worst for Indigenous health, became one of the best

 

” Katherine Hospital in the Northern Territory has gone from one of the worst facilities in the country when it comes to Indigenous health care to one of the best.

Their secret: engaging with Indigenous patients and supporting doctors.”

Dr Quilty his high level of specialist training has meant that patients who would have had to be evacuated to Royal Darwin Hospital can now receive treatment in Katherine. Full Story below

Photo above : Gaye is a 50 year-old cancer patient from Mataranka in the NT. Supplied: Simon Quilty

NACCHO support INFO

Aboriginal Patient Journey Mapping Tools Project:

Communicating complexity

The Managing Two Worlds Together project aims to add to existing knowledge of what works well and what needs improvement in the system of care for Aboriginal patients from rural and remote areas of South Australia (and parts of the Northern Territory). It explores their complex patient journey.

The relationship between patients and health care providers is the foundation of care and requires communication across cultures, geography and life experiences. As a staff member in one rural Aboriginal Community Controlled Health Service put it: ‘It’s like managing two worlds together, it doesn’t always work’.

Download Stage 3 Study Managing Two World Study Report

NACCHO Aboriginal Health News Alert :

Do we need to close the gap on Aboriginal hospital experiences ?

How Katherine Hospital, once Australia’s worst for Indigenous health, became one of the best

As published ABC NEWS  By Hagar Cohen for Background Briefing

When physician Simon Quilty arrived at the hospital, it was going through a major crisis.

“What had happened in 2010 is that the hospital found itself in a situation where things were falling apart,” he says.

A number of doctors complained to the NT Medical Board about a lack of supervision and the impractical workload. The hospital was on the verge of shutting down.

More than one in four Indigenous patients left Katherine Hospital before completing treatment, often without informing staff, the worst rate in the nation. These “take own leave” cases are complex, but one factor is Indigenous patients’ perception of inadequate treatment.

It’s an issue plaguing the health system nationally: a 2014 Federal Health Department report found that racism contributes to the low rates of access to health services by Aboriginal people.

Similarly, the number of patients who “discharge against medical advice” is recorded and recognised by health departments as a key indicator for the quality of Aboriginal healthcare.

In the NT, 11 per cent of all Indigenous patients discharge themselves against medical advice.

“These people have very complex illnesses,” says Dr Quilty. “Many of them are highly likely, if not treated well, to resolve in significant injury or death. Hospitals in remote locations really need high expertise to deal with the very sick patients that turn up here.

“Thirteen and 15-year-olds are developing type 2 diabetes, they’ve got kidney impairment by the time they’re 22 and they’re on dialysis in their early 30s. It’s a bit terrifying really.”

Back from the brink

The NT Department of Health conducted an investigation into the staffing crisis at the Katherine Hospital. Its findings weren’t released publicly.

Background Briefing can reveal that the final report concluded that there were “significant deficiencies in nearly all the essential dimensions of safe clinical service provision”, adding that the “root cause is that the medical service model is unsustainable and becomes more unsustainable with each passing year”.

Six years ago, a new general manager and a group of new doctors arrived with an ambition to turn things around.

Katherine Hospital

They’ve brought highly trained specialist doctors who are invested in the community, interpreters are used regularly and families of Indigenous patients are consulted on complex treatment plans.

In the past, interpreters were available but rarely used. Families weren’t a part of the consultation process. Many of the doctors were junior, and staff turnover was high.

The new management has made huge inroads in the way the hospital cares for Aboriginal patients.

This year, only 4 per cent of the Indigenous patients “took own leave”, making Katherine one of the best performing hospitals in the nation when it comes to caring for Aboriginal patients.

Systematic use of interpreters

In 2006, when respected Indigenous lawman Peter Limbunya, from the remote community of Kalkarindji, stayed in the hospital for 10 days, he did not have access to an interpreter, despite not speaking English.

At the end of his treatment, Mr Limbunya, who was part of the legendary Wave Hill walk off in the 60s, was flown to a remote airstrip 5 kilometres away from his community.

His family wasn’t told he’d be back that day and nobody was there to meet him. He died of dehydration.

During the inquest into his death, the coroner found that interpreters were not in use at the hospital.

His cousin, lifetime activist and advocate for Aboriginal people Josie Crawshaw, remains outraged. She says her uncle would have known “absolutely nothing” about his treatment and what was going on.

But things have come along way since then. The hospital’s Aboriginal liaison officer, Theresa Haidle, says improving the way doctors communicate is the key to developing Indigenous patients’ trust in their treatment plans.

Regular use of interpreters has been an essential part of Ms Haidle’s work. She says they’ve been key in making sure patients understand their illnesses and treatment options.

“English isn’t their first language. It may not even be their second or third either. If there’s any doubt, we get interpreters in, or even on the phone.”

The systematic use of interpreters is a big change at Katherine Hospital.

Ms Haidle says the hospital has a lot further to go when it comes to providing a culturally safe environment, but overall, the relationship with the Aboriginal community is getting better all the time.

“It’s like a big learning process for everybody,” she says.

“We have to break it down as simple as we can,” she says. “There’s not an Aboriginal word that means cancer, so how do you explain those things?

“I remember one day a lady had this fungus, and there’s no words for those things on women’s bodies, or inside. So I heard the interpreter telling her: ‘You know, like mushrooms growing?’ They got her to stay and get it treated.”

Changing doctors’ attitudes

Pip Tallis, who is training to be a physician at Katherine Hospital, has worked in hospitals in Alice Springs and Darwin, where she says many of her Indigenous patients left before their treatment was complete.

“I found it really hard to understand why,” she says.

“It was frustrating as a doctor, and there was a lot of frustration among the staff and no-one really took the time to understand why people were taking their own leave, or really did anything to change it.

“I think, there was a bit of hands up in the air. ‘Whatever, what can we do about it? It’s their problem.'”

The NT town of Katherine, seen from the air

Dr Tallis says that her perspective has changed since coming to work at Katherine Hospital.

“I’ve spent six months working with the team here and observing how they engage with the patients, and I think that they do significant things to result in people not taking their own leave,” she says.

“Previously I was very inflexible. Now I spend a lot more time appreciating why people take their own leave.

“I’m also picking up the subtle signs on a patient who’s starting to not engage. I’ll sit down with them and explore their issues. And if they say they want to just go for a walk, you just say, ‘Would you like to take some medicine with you just in case you don’t come back?'”

Care plans to lower ‘take own leave’ rates

The introduction of weekly meetings to go over care plans for the Indigenous patients means everyone in the hospital can keep up with what’s happening with individual patients

These meetings are attended by social workers, doctors, nurses and admin staff.

At one such meeting, Dr Tallis mentions Jason, a 30-year-old patient from the remote community of Ngukurr, 330 kilometres south-east of Katherine.

Jason has tuberculosis, and has left the hospital during treatment once before. His family has convinced him to return. Dr Tallis explains at the meeting that Jason doesn’t like the hospital food, and that special food is being provided for him.

“We tried really hard to engage him,” she says. “We even got bacon and eggs for him in the mornings so he doesn’t complain about porridge, he’s got a DVD player, USB drive, he got pizza the other day. So we tried really hard to make it possible.”

But there’s still a cultural divide. At the end of the meeting, Jason explains to another doctor that he thinks “white fella” medicine is too slow.

“I want to go back to bush medicine,” he says. “It’s better and works fast because we learned it from old people.”

More support for staff

The hospital’s general manager, Angela Brannelly, says the 2010 investigation into the staffing crisis recommended major changes to the way the hospital operates, its level of staffing and supervision.

She says supporting the medical staff was one of her first priorities.

“We took it very seriously and made some really serious changes to the way that the medical team was supported here. It was around ensuring that someone’s got their back,” she says.

Dr Quilty, who joined the hospital in 2012, was the first physician to have ever been employed at the hospital. Last year he won the Royal Australian College of Physicians’ medal for clinical service in rural and remote areas.

A dark-skinned doll

His high level of specialist training has meant that patients who would have had to be evacuated to Royal Darwin Hospital can now receive treatment in Katherine. Since 2012, there has been a decrease of 43 per cent in the number of total aeromedical evacuations to Darwin.

Many Indigenous patients who live in remote communities don’t like going to Darwin to receive medical treatment because it’s far from family and the hospital is bigger and less personal.

Gaye, 50, a cancer patient who was transferred to Darwin for chemotherapy says she felt lonely in Darwin. “In Darwin I was always sad and crying a lot,” she says.

No-one in Darwin had realised that Gaye was deaf, which made communication with medical staff virtually impossible. In Katherine her deafness was recognised by the nurses and she was given a hearing aid, which she says made a huge difference to her mental health.

Katherine Hospital now employs two full-time physicians.

Still no Aboriginal doctors

Katherine Hospital employs 24 doctors but none of them are Indigenous.

Ms Brannelly admits the hospital hasn’t done enough to attract Aboriginal doctors.

“That’s good advice for us, and it’s probably where we need to go in that space around seeking out Aboriginal medical officers to come and work for us,” she says.

“I think we have some work to do there, absolutely.”

NACCHO #Aboriginal Health and #Racism #justjustice : The importance of teaching doctors and nurses about unconscious bias

aee

 “Australian universities, medical schools and health systems grappling with how to include Aboriginal and Torres Strait Islander people in their institutions as participants and staff – and how to produce equality of outcomes – need to deal with both overt and systemic factors of racism.

In Australia, the inability to deal with unconscious bias and racism has serious health effects on Aboriginal and Torres Strait Islander people. These include increased stress, mental ill-health and suicide, systemic racism in education, sports, justice and the public sector.

In a national survey of Aboriginal patients, 32.4% reported racial discrimination in medical settings most or all of the time. “

Gregory Phillips, Associate Professor and Research Fellow in Aboriginal Health at the Baker IDI Heart & Diabetes Institute, considers the coroner’s recommendations in light of Australia’s “inability to deal with unconscious bias and racism”, in and out of the health system. He says our responses must go far beyond cultural awareness training and its implicit judgements:

Image above : Equality can only work if everyone starts from the same place, whereas equity is about making sure people get access to the same opportunities. Interaction Institute for Social Change | Artist: Angus Maguire/madewithangus.com, CC BY

NACCHO Resources

Cultural awareness isn’t enough

 ” Teaching health professionals about Indigenous health will effectively require teaching about unconscious bias and racism; one’s own culture, values and motivations. It requires training in “unlearning” preconceptions, regular reflections on one’s own practices; as well as education about Aboriginal and Torres Strait Islander cultures.”  See Below

” The National Cultural Respect Framework for Aboriginal and Torres Strait Islander Health 2016–2026 (the Framework) was recently launched by the Australian Health Ministers’ Advisory Council .

This ten year framework seeks to guide delivery of culturally safe, responsive, and quality health care to Aboriginal and Torres Strait Islander people and communities.

Download the COAG Cultural Respect Framework here :

cultural_respect_framework_1december2016_1

Ms Dhu coronial findings show importance of teaching doctors and nurses about unconscious bias

Originally published at The Conversation and then Croakey /JustJustice

In delivering her findings of the coronial inquest into the death of 22-year-old Ms Dhu during time spent in a Western Australian jail cell, state coroner Ros Fogliani was highly critical of some actions of police and medical staff.

She reportedly said Ms Dhu’s medical care in one instance was “deficient” and both police and hospital staff were influenced by preconceived notions about Aboriginal people.

Ms Dhu died on 4 August 2014 from staphylococcal septicaemia – a severe bacterial infection – and pneumonia, which were complicated by a previously obtained rib fracture. Released CCTV footage showed Ms Dhu moaning from pain, saying it was ten out of ten.

It was reported an emergency doctor considered her pain real but exaggerated for “behavioural gain”. Another doctor also noted Ms Dhu suffered from “behavioural issues” while a constable thought she was “faking” her suffering.

Ms Dhu’s case is not the first instance of mistreatment of an Aboriginal person in custody or a medical setting, nor is it likely the last. And while coroner Fogliani’s recommendations included mandatory, ongoing cultural competency training for police officers, to assist with health issues and other dealings with Aboriginal people, this isn’t enough.

For thirty years, Australian institutions have implemented cultural awareness programs. The thinking was if they taught staff about Aboriginal and Torres Strait Islander cultures, it would result in better lecturers, clinicians and policy-makers – and magically produce equity.

But this assumes Aboriginal culture is the problem. Like a deaf student in an all-hearing classroom, it is not the deaf student or their needs that are the problem, but a system that thinks an all-verbal and all-hearing teaching style is equal. The idea of equality itself entrenches systemic discrimination.

Unconscious bias

Singer Gurrumul Yunupingu has been suffering from chronic Hepatitis B since he was a child. ALAN PORRITT/AAP Image

 

 

 

In April, Darwin Hospital staff were under fire for allegedly leaving Aboriginal singer Gurrumul Yunupingu to bleed internally for eight hours. Media reported hospital staff noted Gurrumul’s liver damage was self-inflicted (a result of repeated heavy alcohol use) rather than being due to his chronic hepatitis B infection he had since he was a child.

We don’t know whether these allegations are true, but we do know unconscious bias exists in Australia. It refers to the instant judgements we make about other people and situations based on our own values, experiences and cultural and gender beliefs.

These judgements impact significantly on hiring and promotion decisions, how medical students make decisions, and in public discourse.

Regardless of merit or facts, research shows black or Indigenous people are more likely to be seen as less trustworthy; women to be risky prospects, and overweight people as irresponsible. Those with power and privilege judge those with less power for their inability to compete on terms set by the powerful.

So how is unconscious bias different to racism? Like an iceberg, unconscious bias is said to represent the beliefs, values and experiences (below water) that give rise to overt expressions of discrimination (above water).

There are two problems with these definitions, however. They don’t reveal how beliefs, values and experiences got into the subconscious in the first place. They may also imply it is not the responsibility of those with unconscious bias to change their implicit beliefs and explicit actions.

In Australia, the inability to deal with unconscious bias and racism has serious health effects on Aboriginal and Torres Strait Islander people. These include increased stress, mental ill-health and suicide, systemic racism in education, sports, justice and the public sector.

In a national survey of Aboriginal patients, 32.4% reported racial discrimination in medical settings most or all of the time. These people felt they had been treated unfairly (which included being treated rudely or with disrespect; being ignored, insulted, harassed, stereotyped or discriminated against) because they were Aboriginal or Torres Strait Islander.

Equality vs Equity

Public discussion about racism in Australia is often met with denial, discomfort and fragility. Some blame AFL player Adam Goodes for calling out racism – shooting the messenger is a common reaction.

Some stand with whistle blowers and defend their right to speak truth to power. Others completely deny racism’s existence, wishing it would go away because “we treat everyone the same”.

But the impulse to treat everyone the same confuses equality of inputs with equality of outcomes. As the below diagram shows, treating everyone with equal inputs (the same boxes) produces an inequality of outcomes (not everyone can access the game).

Alternatively, treating everyone differently, according to their needs and humanity is more likely to produce equality of outcomes where everyone can access the game. Equity deals not only with overt discrimination but the systemic factors that give rise to it.

Australian universities, medical schools and health systems grappling with how to include Aboriginal and Torres Strait Islander people in their institutions as participants and staff – and how to produce equality of outcomes – need to deal with both overt and systemic factors of racism.

Cultural awareness isn’t enough

Teaching health professionals about Indigenous health will effectively require teaching about unconscious bias and racism; one’s own culture, values and motivations. It requires training in “unlearning” preconceptions, regular reflections on one’s own practices; as well as education about Aboriginal and Torres Strait Islander cultures.

Most importantly, if the clinician cannot see themselves, their privilege and power as a potential problem, this will inadvertently re-establish racism and unconscious bias.

People had mixed reactions when Adam Goodes spoke out on racism in Australia. DEAN LEWINS/AAP Image

Educators have found patiently moving Australian medical students who were initially hostile to Aboriginal health curricula through their discomfort to reach the “a-ha” moment, is a key teaching strategy in producing better prepared doctors.

Further, cultural awareness training assumes that even if we could train every individual staff member in a hospital to be perfectly culturally competent, they would then go on to magically produce better health outcomes.

But the systemic factors – workplace culture, policies, power, funding and criteria on which decisions are made – are critical if we want a culturally equitable society.

Improving outcomes for Aboriginal and Torres Strait Islander people includes moving from a goal of equality to equity; teaching about racism and unconscious bias, not just culture; and making explicit the deeper transformational work of institutional decolonisation. We need to ask: how can power be shared? On whose terms are decisions made? Who owns institutions and services? Whose criteria are used to judge effectiveness?

The answer is that Aboriginal and Torres Strait Islander definitions and measurement tools of success are more likely to contribute to producing better outcomes than those where unconscious bias and racism is implicit. The work of admitting and addressing institutional racism remains.

croakey-new

How you can support #JustJustice

• Download, read and share the 2nd edition – HERE.

Buy a hard copy from Gleebooks in Sydney (ask them to order more copies if they run out of stock).

• Send copies of the book to politicians, policy makers and other opinion leaders.

• Encourage journals and other relevant publications to review #JustJustice.

• Encourage your local library to order a copy, whether the free e-version or a hard copy from Gleebooks.

• Follow Guardian Australia’s project, Breaking the Cycle.

Readers may also be interested in these articles:

NACCHO Aboriginal #SUDI Children’s Health : Queensland leads the way with #Pepi-Pods safe co-sleeping spaces

 pepi-pod-baby

” The Pēpi-Pod® Program, comprising a safe sleep enabler, safe sleeping parent education and safety briefing; and family commitment to share safe sleeping messages in social networks, was delivered to Aboriginal and Torres Strait Islander families with identified SUDI risks, recruited through Queensland maternal and child health services (n=10 services, 25 communities) across metropolitan, regional and rural/remote areas.”

From the Pepi-Pod Program Website

 ” Hundreds of Aboriginal and Torres Strait Islander newborns will be tucked safely into bed with funding for more safe co-sleeping spaces. 

Mothers in Aboriginal and Torres Strait Islander communities will be provided with a Pēpi-Pod for their babies to sleep safely in, as well as access to a safe sleeping education program in a bid to cut infant deaths.

The safe sleeping program is a partnership between the Department of Communities, Child Safety and Disability Services, Queensland Health, University of the Sunshine Coast, the Queensland Aboriginal and Islander Health Council, Rural Doctors Association for Queensland Foundation and Red Nose.”

Premier Annastacia Palaszczuk said the Queensland Government would provide $100,000 to continue the roll-out of a safe sleeping program in Indigenous communities, including 600 Pēpi-Pods for young mothers aged 15-25 years.

“Safe sleeping arrangements are absolutely vital and provide a starting point to keep babies and young children safe at home,” she said.

“Sudden Unexpected Death in Infancy (SUDI) is one of the leading causes of death amongst infants and in some cases may be preventable with the right education and support.

“Pēpi-Pods have made a real difference in helping reduce infant mortality in New Zealand by up to 30 per cent over the last four years, so I’m pleased that hundreds of young Indigenous mothers right here in Queensland will be able to use them, in conjunction with education and health support.”

Minister for Child Safety Shannon Fentiman said The Queensland Family and Child Commission 2015-16 report into Queensland child deaths found half of infants who died from sudden unexpected death were sleeping with one or more people at the time of death.

“We know co-sleeping can increase the risk of sudden unexpected death and fatal sleep accidents, especially for babies less than 12 weeks of age,” she said.

“The rates of sudden unexpected death are around four times higher among Indigenous infants than non-Indigenous infants,” she said.

“We know that co-sleeping can be a risk factor associated with sudden unexpected deaths in some circumstances, which is why we’re focusing this trial on the delivery of education and support for high-risk young women.”

Pēpi-Pod’s are a safe sleep enabler, which provides physical protection around a baby when they are asleep in places where the risk of suffocation is heightened, for example, on adult beds, couches or in makeshift beds.

The Pēpi-Pod Program is made up of a portable sleeping space designed for babies up to five months, which includes appropriate bedding, and is embedded in safe sleep education and a family commitment to spreading safe sleep messages within their own social network.

The program was first introduced in Queensland as a research trial led by Professor Jeanine Young from the University of the Sunshine Coast in collaboration with New Zealand’s Change of our Children social innovation organisation and Queensland Health in 2012.

Professor Young said babies thrive when they are kept close to their mothers.

“We have had strong support from health services participating in the study,” she said.

“This program is all about valuing and maintaining the cultural values of keeping babies close, but also ensuring baby has a safe place to sleep, particularly when there are other risk factors present.

“Safe sleeping advice needs to be evidence-based but also transferable in a way that is practical, acceptable and valuable for families caring for their babies.

“The Pēpi-Pod Program helps families move safe sleep advice to safe sleep action.”

Ms Fentiman said an education and awareness program, including antenatal workshops, will be rolled out in conjunction with the Pēpi-Pod Program through local community-controlled health networks.

“The Queensland Government and Family Matters are also working together to develop an action plan that lays the platform for our efforts to improve the lives of Indigenous people and ensure that their children are safe, healthy and have the same opportunities as other Queensland children,” she said.

Background

Co-sleeping is a culturally valued practice by many Indigenous families, however is associated with sudden unexpected death in infancy (SUDI) in hazardous circumstances. This study aimed to evaluate a safe sleep strategy in collaboration with Aboriginal and Torres Strait Islander families with high risk for SUDI.

A project team from USC have collaborated with Change for our Children Limited in New Zealand for the first trial of a safe sleep enabler in Australia. The Pēpi-Pod Safe Sleep Program was initiated in New Zealand by Change for our Children in 2011 as a public health response for babies at a higher risk of SUDI.

Methods

The Pēpi-Pod® Program, comprising a safe sleep enabler, safe sleeping parent education and safety briefing; and family commitment to share safe sleeping messages in social networks, was delivered to Aboriginal and Torres Strait Islander families with identified SUDI risks, recruited through Queensland maternal and child health services (n=10 services, 25 communities) across metropolitan, regional and rural/remote areas.

Results

Program acceptability and feasibility was established and raised awareness of safe sleeping in communities. Families reported benefits including safety, convenience and portability. Partnering health services reported that the program was feasible, flexible, sustainable, and built local workforce capacity with integration into current service models.

Awards

This project was recognised with two national awards in 2014:

  • Winner, HESTA Australian Nursing Awards – Team Innovation
  • National Winner, National Lead Clinicians Group Award for Excellence in Innovative Implementation of Clinical Practice (Indigenous Health Category).

Conclusion

This is the first evaluation of a safe sleep enabler in Australia. Evaluating innovative and culturally respectful strategies to reduce SUDI risk through enabling safe sleep environments, which support community ownership, develop multidisciplinary team skills, and reorient services from safe sleep advice to safe sleep action, will better inform the evidence-base used by educators, clinicians, researchers and policy makers in supporting parents and reducing infant deaths.

More information

Please contact Professor Jeanine Young, Chief Investigator, Australian Pepi-Pod® Program.

Recruitment information for partnering sites in the Pēpi-Pod® Program:

For more information about the New Zealand and Australian Pepi-Pod® Safe Sleep Program please see Introducing the Pepi-Pod Safe Sleep Program and Change for our Children website.

NACCHO Aboriginal Health : Five things wrong with government Aboriginal Cultural Safety and Security policies

mark-lock

 ” Australian organisations seeking to be culturally safe and secure would have little confidence in Australian Governments’ policy documents to provide them with high-quality evidence for restructuring organisational governance.

I have assessed the various current Australian policies (listed below) around Aboriginal cultural safety and security.

Why would organisations follow guidelines that have no underlying evidence base, are not endorsed by Aboriginal community organisations, and have no assessment of their effectiveness for improving Aboriginal cultural safety and security?”

Dr Mark Lock  is a researcher who studies committees professionally and he’s looking at ways Aboriginal people can make their voices heard. “In my research, covering 53 towns around Hunter New England Local Health District, currently I have 2,500 committees and about 3,500 people,” Mr Lock said. It’s a surprising statistic.

“Aboriginal people sit on many different committees and I want to know: Where is my voice? Where is Aboriginal voice? How do Aboriginal people influence decision-making processes through sitting on all these different types of committees? Contact

See the recent full ABC Meet the Mob interview below

Five things:

1) No endorsement from any peak Aboriginal organisation (except Victoria – Victorian Aboriginal Child Care Agency),

2) No detail about the developmental process, with statements such as “thanks to the many people who were involved in developing this framework”,

3) Limited evidence base for the long list of domains, strategies, and actions, 4) No key performance indicators for measurement, and

5) No evaluations to assess their effectiveness.

Those policies evaluated

  1. Cultural Respect Framework for ATSI Health 2016 – 2026 (AHMAC)
  2. Aboriginal Cultural Security Framework 2016-2026 (Northern Territory)
  3. Aboriginal and Torres Strait Islander Cultural Capability A Framework for Commonwealth Agencies (Australian Public Service Commission, 2015)
  4. Towards Culturally Appropriate and Inclusive Services 2014-2018 (Australian Capital Territory)
  5. A Framework for Working Effectively with Aboriginal People (Agency for Clinical Innovation, NSW Health, 2013)
  6. WA Health Aboriginal Cultural Learning Framework 2012-2016 (Western Australia)
  7. Respecting the Difference-An Aboriginal Cultural Training Framework for NSW Health (NSW Health, 2011)
  8. Queensland Health ATSI Cultural Capability Framework 2010-2033 (Queensland)
  9. Aboriginal Cultural Competence Framework (Victoria, 2008) and Matrix (2009)
  10. Aboriginal Cultural Respect Framework 2007-2012 (South Australia)

 NACCHO RESEARCH See our Cultural Safety posts

Download the Australian Indigenous Doctors Association FACT SHEET

cultural-safety-factsheet1

The National Cultural Respect Framework for Aboriginal and Torres Strait Islander Health 2016–2026 (the Framework) was recently launched by the Australian Health Ministers’ Advisory Council .

This ten year framework seeks to guide delivery of culturally safe, responsive, and quality health care to Aboriginal and Torres Strait Islander people and communities.

Download the COAG Cultural Respect Framework here :

cultural_respect_framework_1december2016_1

The recent full ABC Meet the Mob interview 

“I got a cheque for three dollars when I was a little boy. I don’t know who did that but I really value that three dollars. It came through good committee processes about giving financial independence to Aboriginal people.”

Mark Lock is a researcher who studies committees professionally and he’s looking at ways Aboriginal people can make their voices heard.

“In my research, covering 53 towns around Hunter New England Local Health District, currently I have 2,500 committees and about 3,500 people,” Mr Lock said.

It’s a surprising statistic.

“Aboriginal people sit on many different committees and I want to know: Where is my voice? Where is Aboriginal voice? How do Aboriginal people influence decision-making processes through sitting on all these different types of committees?

“They’re all connected because the chairperson of one committee will be a member of another committee, and the chairperson of that committee will be a member of another committee. It’s a network perspective like a spider’s web of committees.”

Mr Lock is keen to find out how policy makers make decisions.

“How do they say, ‘Oh, Aboriginal priorities, close the gap, number one. There’s an Aboriginal voice coming from Boggabri. I need to give that priority over anybody else’s voice.’ I don’t know how it happens and that’s what I’m investigating,” he said.

“There’s many more committees out there operating in our communities and that’s a fantastic thing, but with a population with high needs and so few people, how can their voice be better heard in all the noise? That’s what I want to try and get to.”

Mr Lock’s journey into this unique field of research started with a humble trophy from his grandmother that still sits in his office at the Hunter Medical Research Institute.

“My grandmother, Marjorie Woodrow, gave this to me in 1978 when I got straight As as a little boy in Narromine. I grew up in the same class as Glenn McGrath, that’s my brush with fame. We played cricket together,” Mr Lock said.

“To me, a little boy at the time, I felt so proud that Nan acknowledged this and said, ‘Go and get educated like white fellas and do good for our mob.’ I am 46-years-old now and that was when I was 12-years-old. It’s propelled me to this point always.”

Being a blackfella is not straightforward for Mr Lock.

“I’ve always been challenged about blackness and I’m always being challenged about, ‘Am I good enough to be a blackfella because I don’t look like blackfella? It’s constantly a battle to maintain identity, but I’m very strong about it now,” he said.

“My mob is the Ngiyaampaa mob out from Murrin Bridge, and on my website profile, you’ll see I don’t identify as Aboriginal because Aboriginal is a Latin term imposed upon us by Europeans.

“I’ve got all these mixed ancestries; convict, Latvian, Ngiyaampaa. But my history is very strongly of growing up around my Aboriginal family in country New South Wales and all the stories around that.”

Mr Lock lives in Newcastle but he has lived in many different places.

“I moved 28 times by the time I was 21. We went all over, in caravans, tents on river banks, wherever we could live,” he said.

“It started out with Nan who was always moving around with her children because she didn’t want them taken away by the welfare agencies, and it just transferred on to how we lived. I actually thought it was quite normal.

“When I met my wife Steph in Newcastle 26 years ago I thought she was a weirdo because she had only ever lived in the one place. No. It turns out that my story is not normal – 28 moves by the time I was 21!

“Moving is common in Aboriginal communities. People just move around. I think it’s related to that history of not having a solid root, of a solid foundation where you grew up, where you sang songs, where you sat by the fire, where you went fishing.”

Mr Lock travelled the country as a child and travelled the world as an adult, living in far-east Russia with his wife.

“I wanted to send a really clear message that I’m going to support my wife and I support women in this country. She’s an engineer. I was a stay-at-home dad looking after the kids,” he said.

“She has lived in Gabon, China, all over the place. She’s a fantastic engineer and we made a decision together that her career was the most important career.

“I said okay. Not only that; it’s not a token thing but it’s a serious issue for me, to promote that positive bias towards women, I changed my last name too.”

So Mark Lutschini took his wife’s surname and became Mark Lock

Mark Lock applies his independent thinking to his research.

He employs two full-time social media experts to publish findings as an ongoing part of his research process, rather than leaving it all to be published at the end of the process.

“My social media researchers have Twitter, Facebook, LinkedIn, Google Plus and Pinterest because Aboriginal voice is expressed in different ways; images, video, writing in different forms,” Mr Lock said.

“We write many blogs. We tweet a lot. We also write journal articles. They capture as I gather the data for the study. I send it to them and then tweet about it to people who are interested in the study.”

Mr Lock would like to see committees take up social media to be more transparent.

“If you’re sitting down with a bunch of people around a table making decisions, why not write minutes, post them on a website so anyone in the community can access the minutes of the meeting?” he said.

And Mark’s personal experience on committees?

“I try to avoid committees. I was in the public service for 10 years and they were very debilitating. Dreadfully boring and often times you just want to go to sleep.”

Hosted by Jill Emberson, Mornings presenter on 1233 ABC Newcastle, Meet the Mob is a weekly profile of Aboriginal people in the Hunter region of New South Wales.

You can listen to each Meet the Mob interview by clicking on the audio player or you can download each interview as an mp3 by right clicking on the blue heading under the audio.

 

 

NACCHO Invites all health practitioners and staff to a webinar : Working collaboratively to support the social and emotional well-being of Aboriginal youth in crisis

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NACCHO invites all health practitioners and staff to the webinar: An all-Indigenous panel will explore youth suicide in Aboriginal and Torres Strait Islanders. The webinar is organised and produced by the Mental Health Professionals Network and will provide participants with the opportunity to identify:

  • Key principles in the early identification of youth experiencing psychological distress.
  • Appropriate referral pathways to prevent crises and provide early intervention.
  • Challenges, tips and strategies to implement a collaborative response to supporting Aboriginal and Torres Strait Islander youth in crisis.

Join hundreds of doctors, nurses and mental health professionals around the nation for an interdisciplinary panel discussion. The panellists with a range of professional experience are:

  • Dr Louis Peachey (Qld Rural Generalist)
  • Dr Marshall Watson (SA Psychiatrist)
  • Dr Jeff Nelson (Qld Psychologist)
  • Facilitator: Dr Mary Emeleus (Qld GP and Psychotherapist)

Read more about the panellists.

Working collaboratively to support the social and emotional well-being of Aboriginal and Torres Strait Islander youth in crisis.

Date:  Thursday 23rd February, 2017

Time: 7.15 – 8.30pm AEDT

REGISTER

No need to travel to benefit from this free PD opportunity. Simply register and log in anywhere you have a computer or tablet with high speed internet connection. CPD points awarded.

Learn more about the learning outcomes, other resources and register now.

For further information, contact MHPN on 1800 209 031 or email webinars@mhpn.org.au.

The Mental Health Professionals’ Network is a government-funded initiative that improves interdisciplinary collaborative mental health care practice in the primary health sector.  MHPN promotes interdisciplinary practice through two national platforms, local interdisciplinary networks and online professional development webinars.

 

 

 

 

 

 

NACCHO Aboriginal Health : Death by #racism: Is bigotry in the health system harming Indigenous patients ?

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” Death by racism should be a category on death certificates, because the racism in hospitals is hindering the recovery of many Aboriginal and Torres Strait Islander people.

Spend some time as a patient in a hospital and you soon find out that the medical profession is full of bigots and people who might not consider themselves racist, but have preconceived ideas on race and hold outdated beliefs in racial stereotypes.”

 We need cultural awareness programs on all levels of the system, writes Colleen Lavelle for IndigenousX : Our stories, our way” – each week, a new guest hosts the @IndigenousX Twitter account to discuss topics of interest to them as Aboriginal and/or Torres Strait Islander people. Produced with assistance of Guardian Australia staff.

NACCHO background info

Read previous 69 articles NACCHO Aboriginal health and racism

Read previous 10 articles NACCHO Aboriginal health / Cultural safety

 ” The National Cultural Respect Framework for Aboriginal and Torres Strait Islander Health 2016–2026 (the Framework) was recently launched by the Australian Health Ministers’ Advisory Council .

This ten year framework seeks to guide delivery of culturally safe, responsive, and quality health care to Aboriginal and Torres Strait Islander people and communities.

Download the COAG Cultural Respect Framework here :

cultural_respect_framework_1december2016_1

I have been in and out of hospital for years with a brain tumour and have experienced the bigotry within the system first hand. I have also collected stories from Indigenous people around the country and a common thread is either: “Is it me or do they treat all of us like this?” or “Am I being overly sensitive?”

Indigenous cancer patients have even had pain relief denied to them. This might happen for a couple of reasons. First, because apparently some people think we Indigenous people can cope with more pain than our European counterparts. Let me state now that that ethnocentric view is not true. Another common view is that we are “faking it” to get drugs. Now, I don’t know about you, but if someone has cancer and is crying in pain, it’s pretty obvious they are not trying to get some cheap thrills.

A similar misconception is that we are drunk. I have even heard of cancer patients having their blood alcohol level tested before a doctor will see them. This assumption that we all take drugs or drink is outdated and just insulting.

Traditional people from remote communities have had to deal with their cultural mores being completely overlooked. Men have been shamed by having a young female nurse attend to them, when a male nurse is required. The same happens to our women too: a male attendant will try to do something that should only be done with or by a female. And when women ask to have another female in with them, they are quite often overlooked. I can’t understand why our cultural needs are overlooked when other peoples have their cultural rules respected.

The medical system seems so against us in so many ways, particularly if we are sent to a hospital away from home and English is not our first language. Good luck trying to find a translator to help! Governments, both at state and federal level can’t say they are doing all they can when our needs are not even considered important. All we hear are excuses like, “The cost is prohibitive for translators, patient transport, mobile medical units …”

We are the first people of this country and as such we shouldn’t be constantly overlooked. Perhaps fewer trips to the Gold Coast and a little bit more money into Indigenous health could help.

There are ways to make the road to good health better. For starters, no doctor or nurse should be allowed to work with Aboriginal people unless they have had cultural awareness training. It should be a requirement that all medical professionals do a cultural awareness course, with a refresher course after every year. Make it part of the accreditation process. It should be a part of the Close The Gap scheme that every general practice has to sign on to do cultural awareness. Even if it’s just one person in the practice doing it online. There could also be an incentive, such as the practice receives money for each Indigenous patient they see.

If every doctor and nurse across the country had this training and if hospitals and health executives spent quality time with Aboriginal and Torres Strait Islander patients, they might learn we are not so different. We might have some different needs, but they shouldn’t compromise the levels of compassion, caring and proper medial attention that we need.

NACCHO Aboriginal #Heart Health @HeartAust @AusHealthcare : Lighthouse Hospital project employment opportunities

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What is the Lighthouse hospital project?

  • The Lighthouse hospital project is a joint initiative of the Heart Foundation and the Australian Healthcare and Hospitals Association (AHHA).
  • The aim: to improve care and health outcomes for Aboriginal and Torres Strait Islander peoples experiencing coronary heart disease, the leading cause of death among this population.

Australia is a privileged nation by world standards. Despite this, not everyone is equal when it comes to heart health and Aboriginal and Torres Strait Islander people are the most disadvantaged. The reasons are complex and not only medical in nature. Aboriginal and Torres Strait Islander people have a troubled history with institutions of all kinds, including hospitals.

The Lighthouse Hospital project aims to change this experience by providing both a medically and culturally safe hospital environment. A culturally safe approach to healthcare respects, enhances and empowers the cultural identity and wellbeing of an individual.

This project matters because the facts are sobering. Cardiovascular disease occurs earlier, progresses faster and is associated with greater co-morbidities in Aboriginal and Torres Strait Islander peoples. They are admitted to hospital and suffer premature death more frequently compared with non-Indigenous Australians[1].

Major coronary events, such as heart attacks, occur at a rate three times that of the non- Indigenous population. Fatalities because of these events are 1.5 times more likely to occur, making it a leading contributor to the life expectancy gap [2].

Current employment opportunities

1.The National Project Manager – Lighthouse Hospital Project

Will manage the development, delivery and evaluation of the Lighthouse Hospital Project (Phase 3) across 18 hospital sites nationally. The role will lead project partnerships and oversee a national team of four to drive sustainable change in acute settings to improve cardiac care and outcomes for Aboriginal and Torres Strait Islander peoples. Regular interstate travel will be required.

Download job description

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2.The Lighthouse Hospital Project ( 3 ) Coordinators

Will manage the day to day support for the development, implementation and evaluation of the Lighthouse Hospital Project (Phase 3) in approximately six hospital sites each. The Coordinators will support the development of local and state-based project partnerships and work as part of a national project team of five to drive sustainable change in acute settings to improve cardiac care and outcomes for Aboriginal and Torres Strait Islander peoples. Regular interstate travel will be required.

Download job Description

nat-lighthouse-hospitals-project-coordinator-final

Contact:

Fiona Patterson, National Programs Manager,

fiona.patterson@heartfoundation.org.au, 03 9321 1591

Phase 1 (2012–2013)

Aim – To improve the care of Aboriginal and Torres Strait Islander peoples experiencing acute coronary syndrome (ACS).

We developed this project was developed in response to a 2006 report from the Australian Institute of Health and Welfare (AIHW).

The project first focused on providing culturally safe and positive consumer experiences, which were reviewed by 10 organisations known for providing exemplary care in the treatment of Aboriginal and Torres Strait Islander patients with acute coronary syndromes (ACS).

The project identified key elements that make a difference to ACS care:

  • expanding roles for Aboriginal Liaison Officers, Health Workers, Patient Pathway Officers and equivalent roles
  • better identification of Aboriginal and Torres Strait Islander patients
  • building strong partnerships and communication channels with local Aboriginal and Torres Strait Islander communities and other relevant organisations
  • fostering and supporting clinical champions
  • building capacity for patient-focused care
  • use of technology
  • use of an industry-based quality matrix.

Phase 2 (2013–2016)

Aim – To drive systemic change in acute care hospital settings to improve care for and the experience of Aboriginal and Torres Strait Islander peoples experiencing ACS.

In Phase two, the scope was to improve activities in eight public hospitals across Australia to improve clinical and cultural care for Aboriginal and Torres Strait Islander patients with ACS.

The toolkit

We developed a quality improvement toolkit, ‘Improving health outcomes for Aboriginal and Torres Strait Islander peoples with acute coronary syndrome’, to provide a framework to address health disparities.

The toolkit aimed to:

  • ensure care providers met minimum standards of care, cultural safety
  • identify practices and actions that can and/or should be improved
  • foster engagement
  • improve healthcare services for Aboriginal and Torres Strait Islander peoples with ACS.

The toolkit outlined four areas that were critical in providing holistic care for Aboriginal and Torres Strait Islander peoples and their families as they journeyed through the hospital system and return to their communities.

The four domains were:

  • governance
  • cultural competence
  • workforce
  • care pathways.

The pilot

Eight pilot hospitals participated in testing the toolkit:

  • Bairnsdale Regional Health Service, Victoria
  • Coffs Harbour Health Campus, New South Wales
  • Flinders Medical Centre, South Australia
  • Liverpool Hospital, New South Wales
  • Princess Alexandra Hospital, Queensland
  • Royal Perth Hospital, Western Australia
  • St Vincent’s Hospital, Victoria
  • Tamworth Rural Referral Hospital, New South Wales.

Each hospital developed an action plan that outlined the areas they would address and the quality improvement activities they would undertake during the pilot. The project outcomes were dependent on community engagement, capacity to embed change, project support and the governance structures at each site.

Key Phase 2 achievements

  • Improved relationships with Aboriginal and Torres Strait Islander patients
  • Strengthening relationships with the Aboriginal and Torres Strait Islander community and medical services
  • Creating culturally safe environments for Aboriginal and Torres Strait Islander patients
  • Increased self-identification among Aboriginal and Torres Strait Islander patients
  • Streamlining processes related to culturally appropriate clinical care of Aboriginal and Torres Strait Islander patients
  • Enhanced staff capacity to respond to the needs of Aboriginal and Torres Strait Islander patients

Phase 3

We are awaiting funding for Phase three of the Lighthouse Project.

This will aim to increase the reach and the critical mass of Aboriginal and Torres Strait Islander peoples experiencing an acute coronary syndrome who receive evidence based care in a culturally safe manner.

Within this phase there will be a focus on integration of health services and care coordination by enhancing the relationships between local community groups, hospitals, local Aboriginal Community Controlled Organisations and Primary Health Networks.

The implementation of this phase would enable hospitals to address the actions in the revised Australian Commission on Safety and Quality in Healthcare National Safety and Quality Health Service.

The Lighthouse hospital project is a joint initiative of the Heart Foundation and the Australian Healthcare and Hospitals Association and is funded by the Australian Government Department of Health.

Download the poster.

References

  1. Australian Health Ministers Advisory Council (AHMAC). Aboriginal and Torres Strait Islander Health Performance Framework 2012 Report. Canberra: AHMAC, 2012.
  2.  Mathur S, Moon L, Leigh S. Aboriginal and Torres Strait Islander people with coronary heart disease: further perspectives on health status and treatment. Cardovascular disease series no. 25. Canberra: Australian Institute of Health and Welfare, 2006.

NACCHO Aboriginal Health and Human Rights : Nomination open 2017 National Indigenous #HumanRights Awards

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 ” The National Indigenous Human Rights Awards recognises Aboriginal and Torres Strait Islander persons who have made significant contribution to the advancement of human rights and social justice for their people.”

The awards were established in 2014, and will held annually. The inaugural awards were held at NSW Parliament House, and were welcomed by the Hon Linda Burney, MP and included key note speakers Dr Yalmay Yunupingu, Ms Gail Mabo, and Mr Anthony Mundine. A number of other distinguished guests such as political representatives, indigenous leaders and others in the fields of human rights and social justice also attended.

The Awards were presented by leading Aboriginal and Torres Strait Islander elders, and leading Indigenous figures in Indigenous Social Justice and Human Rights. All recipients of the National Human Rights Award will be persons of Aboriginal or Torres Strait Islander heritage.

To nominate someone for one of the three awards, please go to https://shaoquett.wufoo.com/forms/z4qw7zc1i3yvw6/
 
For further information, please also check out the Awards Guide at https://www.scribd.com/document/336434563/2017-National-Indigenous-Human-Rights-Awards-Guide

AWARD CATEGORIES:

 

DR YUNUPINGU AWARD – FOR HUMAN RIGHTS
 
To an Aboriginal and/or Torres Strait Islander person who has made a significant contribution to the advancement of Human Rights for Aboriginal and/or Torres Strait Islander peoples. Dr Yunupingu is the first Aboriginal from Arnhem Land to achieve a university degree. In 1986 Dr Yunupingu formed Yothu Yindi in 1986, combining Aboriginal (Yolngu) and non-Aboriginal (balanda) musicians and instrumentation.

In 1990 was appointed as Principal of Yirrkala Community School, Australia’s first Aboriginal Principal. Also in that year he established the Yothu Yindi Foundation to promote Yolngu cultural development, including Garma Festival of Traditional Cultures Dr Yumupingu was named 1992 Australian of the Year for his work in building bridges between Indigenous and non-Indigenous communities across Australia.

THE EDDIE MABO AWARD FOR ACHIEVEMENTS IN SOCIAL JUSTICE

In memory of Eddie Koiki Mabo (1936-1992), this award recognises an Aboriginal and/or Torres Strait Islander person who has made a significant contribution to the advancement of Social Justice for Aboriginal and/or Torres Strait Islander peoples.
Eddie Koiki Mabo was a Torres Straits Islander, most notable in Australian history for his role in campaigning for indigenous land rights.

From 1982 to 1991 Eddie campaigned for the rights of the Aboriginal and Torres Strait Islanders to have their land rights recognised. Sadly, he died of cancer at the age of 56, five months before the High Court handed down its landmark land rights decision overturning Terra Nullius. He was 56 when he passed away.

THE ANTHONY MUNDINE AWARD FOR COURAGE

 

To an Aboriginal and/or Torres Strait Islander person who has made a significant contribution to the advancement of sports among Aboriginal and/or Torres Strait Islander peoples.

Anthony Mundine is an Australian professional boxer and former rugby league player. He is a former, two-time WBA Super Middleweight Champion, a IBO Middleweight Champion, and an interim WBA Light Middleweight Champion boxer and a New South Wales State of Origin representative footballer. Before his move to boxing he was the highest paid player in the NRL.

In 2000 Anthony was named the Aboriginal and Torres Strait Islander Person of the Year in 2000. He has also won the Deadly Award as Male Sportsperson of the Year in 2003, 2006 and 2007 amongst others.

He has a proud history of standing up for Indigenous peoples, telling a journalist from the Canberra Times: “I’m an Aboriginal man that speaks out and if I see something, I speak the truth.”

NACCHO Aboriginal Health : A call to acknowledge the harmful history of nursing for Aboriginal people

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 ” While we ourselves did not work there, the societal beliefs interwoven with the professional theories practised at that time are a legacy we have inherited. Those attitudes and practices remain present within our professional space.

Have we done sufficient work to decolonise ourselves?

Decolonising is a conscious practice for Aboriginal and Torres Strait Islander nurses. It involves recognising the impact of the beliefs and practices of the coloniser on ourselves at a personal and professional level, then disavowing ourselves from them.

We talk about this in CATSINaM with our Members. We invite our non-Indigenous colleagues to engage in this self-reflective conversation through many aspects of our work.

janine-mohamed-indigenous-x-profile-picture

Janine Mohamed (right), CEO of the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM), argues we should.

Is it time for the nursing and midwifery professions to reflect on our historical involvement in the subjugation of Aboriginal and Torres Strait Islanders and consider whether we owe a statement of regret for our failures as part of the wider healthcare system to respond to the needs of Aboriginal Australians?

Do formal apologies mean anything?

We welcome your input on this fundamental issue for Australians – and especially input from Aboriginal and Torres Strait Islander nurses and midwives.

Editorial Nurse Uncut Conversations

In September 2016, the Australian Psychological Society issued a formal apology to Indigenous Australians for their past failure as a profession to respond to the needs of Aboriginal patients.

In the past, the NSW Nurses and Midwives’ Association and the ANMF more broadly have issued statements of apology for our professions’ involvement in the practices associated with the forced adoption of babies from the 1950s to 1980s.

In doing so we recognised that while those nurses and midwives were working under direction, it was often they who took the babies away from mothers who had been forced, pressured and coerced into relinquishing their children and we apologised for and acknowledged the pain these mothers, fathers and children had experienced in their lives as a result.

Following the recent commendable move by the Australian Psychological Society, is it now time for the nursing and midwifery professions to reflect on our historical involvement as healthcare providers in the subjugation of Aboriginal and Torres Strait Islanders and consider whether we owe a similar statement of regret for our failures as part of the wider healthcare system to respond to the needs of Aboriginal Australians?

But firstly, do such apologies mean anything?

Professor Alan Rosen AO (a non-indigenous psychiatrist) makes a cogent argument for an apology by the Australian mental health professions to Aboriginal and Torres Strait Islander peoples:

The recent apology by the Australian Psychological Society to Aboriginal and Torres Strait Islander people is of profound national and international significance.

The APS is believed to be the first mental health professional representative body in the world to endorse and adopt such a specific apology to indigenous peoples for what was done to them by the profession as part of, or in the name of, mental health/psychological assessment, treatment and care.

The APS Board also substantially adopted the recommendation of its Indigenous Psychologists’ Advisory Group (IPAG), whose Indigenous and non-Indigenous members crafted this apology together. This sets a fine precedent.

As some other Australian mental health professional bodies are still considering whether to make such an apology, it is to be hoped that the APS has set a new trend. The APS has provided a robust example of how to do it well and in a way that it is more likely to be considered to be sincere and acceptable by Aboriginal and Torres Strait Islander peoples.

Historically, Aboriginal and Torres Strait Islander peoples have suffered much more incarceration, inappropriate diagnoses and treatments and more control than care in the hands of mental health professionals, facilities and institutions.

This is also true for all First Nations peoples, globally.

Professor Rosen argues that such apologies demonstrate concern for possible historical wrongs, either deliberate or unwitting, by professionals and institutions and the enduring mental health effects of colonialism. The Croakey.org article goes on to describe the purposes and goals of an apology, why they are worth doing and proposes a template.

So, just as we have recognised and apologised for the role our professions played in forced adoptions, is it now time to examine and take responsibility for our professions’ historical contribution to undermining Indigenous Australians’ social and emotional health and wellbeing?

Janine Mohamed (right), CEO of the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM), argues we should.

Between 1908 and 1919, hundreds of Aboriginal patients were incarcerated in the Lock Hospitals off the coast of Carnarvon, with more than 150 people dying there. The West Australian government established the hospitals for the treatment of Aboriginal people with sexually transmitted infections, but there remains considerable doubt as to the accuracy of such diagnoses – many of which were made by police officers.

The Fantome Island Lock Hospital operated in Queensland from 1928-45 under similar arrangements, detaining Aboriginal people with suspected sexually transmitted infections. There was also a lazaret on Fantome Island (1939-73) for segregated treatment of Aboriginal people with Hansen’s disease.

Aboriginal people taken to the hospitals were often forcibly removed from their families and communities and transported in traumatic conditions, in chains and under police guard. There is also evidence of medical experimentation and abuse.
The NSW Nurses and Midwives’ Association has embarked on the process of developing a Reconciliation Action Plan. As a first step, over coming months we will be working on developing a more thorough understanding of how historical practices have affected Aboriginal and Torres Strait Islander people in our care.

We welcome feedback, especially from our Aboriginal and Torres Strait Islander colleagues.

NACCHO Aboriginal Health News Alert : Expressions of interest invited from emerging consumer/carer leaders @CHFofAustralia , @NRHAlliance , @AUMentalHealth

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 ” Our aim is to involve individuals who are emerging consumer/carer leaders.  By this we mean individuals who have started to be involved in health consumer/carer representation or advocacy work, perhaps at a local, regional or state/territory level, and who are enthusiastic and interested in doing more or different roles, particularly at the national level.

The Colloquium is occurring at a time when the value of people-centred approaches to policy is gaining currency.  The health and social care horizon is rapidly changing and we face many challenges as well as growing opportunity for reform and innovation.”

CHF, NRHA and MHA are working together to hold a Consumer and Carer Leadership Colloquium on 20-21 March 2017 in Canberra.  Colloquium participants are being selected from CHF, NRHA and MHA networks.

CHF therefore seeks expressions of interest from individuals who are interested in participating in the Colloquium, and who will benefit from its focus on emerging consumer/carer leaders.

Online applications here

Why a Colloquium?

The three host organisations all work with consumers/carers who are interested in advocating for a better Australian health system.

Our ways of working with these leaders may differ and we may use different terminology, but we have a shared interest in:

  • identifying and nurture emerging consumer/carer leaders with potential and interest to participate in and shape health reform at the national level;
  • supporting consumer/carer leaders to act with impact and influence;
  • providing opportunities for cross-fertilisation of ideas from consumer/carer leaders with different perspectives on the health system; and
  • growing and diversifying our pools of consumer/carer leaders.

What is a colloquium?

A colloquium is an interactive conference-style event. Our Colloquium is an opportunity to discuss issues of importance to emerging health consumer/carer leaders. It will have a learning, development and planning focus.

Who is the Colloquium aimed at?

Up to 80 consumers/carers will participate in the Colloquium.  The Colloquium is a learning and development forum.  We seek participants who want to achieve a more consumer-centred health system and enjoy sharing ideas with other like-minded people.

Our aim is to involve individuals who are emerging consumer/carer leaders.  By this we mean individuals who have started to be involved in health consumer/carer representation or advocacy work, perhaps at a local, regional or state/territory level, and who are enthusiastic and interested in doing more or different roles, particularly at the national level.

All expressions of interest will be assessed on their merits.

What is the time commitment?

You will need to be able to be in Canberra for:

  • the Colloquium networking dinner on the evening of 20 March 2017; and
  • the Colloquium itself on 21 March 2017.

You will also benefit from participating in two lead-in webinars on 8 and 15 March 2017.  The webinars will be for one hour.

The Colloquium program will include a mix of interactive and expert-led sessions, including peer experts.  The two lead-in webinars will provide background information about national health reform, allowing more informed discussion at the Colloquium itself.

What is the cost?

Your travel and accommodation costs will be met.  Meals will be provided, but not drinks at the networking dinner.  Sitting fees will not be paid.

What will participants get out of the Colloquium?

As an emerging consumer/carer leader, the Colloquium program will provide you with an opportunity to:

  • to discuss and better understand the health reform environment, implications and opportunities;
  • learn some new leadership skills and mentorship practices;
  • join an emerging leaders network as well as existing consumer/carer networks through CHF, MHA and NRHA;
  • discuss and identify development, mentorship and leadership needs of emerging consumer/carer leaders.

What outcomes will result from the Colloquium?

In addition to what you as an individual can expect to get out of your participation at the Colloquium, the Colloquium is designed to generate a plan of action for future co-operation to strengthen the role of the consumer/carer community in shaping health and related policy.  Such an action plan could include, for example, a future webinar program, online discussion forums, etc.

How do I express interest in participating in the Colloquium?

If you would like to be considered as a Colloquium participant, please complete the following form and submit it by 5 February 2017.  Following our selection process, we will advise you if your expression of interest has been successful by 24 February 2017.

 Online applications here