NACCHO Aboriginal Health and Disability support : Ombudsman publishes report on Accessibility of Disability Support Pension for remote Indigenous Australians

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 ” This report focuses on the experiences of one particular vulnerable group—Indigenous people living in remote areas. Remote Indigenous Australians face significant disadvantage and unique cultural barriers in accessing a range of government services, including DSP.

The qualification criteria for DSP set a high bar and the claim process is rigorous. Even those applicants who are familiar with the income support and health systems say they find the DSP claim process complex, lengthy and confusing.

Complaints made to our office, along with the anecdotal feedback provided by peak bodies, advocates and community organisations, show that Indigenous people living in rural and remote Australia experience particular difficulty in preparing applications for DSP and meeting the high standard of evidence. “

Download the report here :

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 ” FPDN’s vision is a just and inclusive society, in which First Peoples living with disability are respected and valued for their culture, history and contribution to contemporary life, and in which their human rights are recognised, respected, protected and fulfilled.

First Peoples Disability Network is governed by Aboriginal and Torres Strait Islander people living with disability. FPDN is a member of the Disabled People’s Organisations Australia (DPO) alliance.”

Check out FPDN website

Press Release

Commonwealth Ombudsman, Colin Neave AM, released his report today into the accessibility of Disability Support Pension (DSP) for remote Indigenous Australians.

The Ombudsman’s inquiry responded to complaints from Indigenous Australians living in remote areas who were experiencing issues claiming DSP and with the assessment processes used by the Department of Human Services (DHS).

“We found remote Indigenous Australians face several barriers when claiming DSP. It is harder to access medical services, get appropriate medical evidence to support their claims and engage with DHS’s job capacity and medical assessment processes,” Mr Neave said.

The Ombudsman has made a number of recommendations which seek to address these issues.

From Page 31

5.1 Indigenous Australians living in remote areas face significant barriers in accessing DSP, including:

  •  difficulties in accessing appropriate health care
  •  problems obtaining medical evidence from treating doctors and specialists to support their claims
  •  being disadvantaged by not having face-to-face JCAs and DMAs
  •  a differing concept of ‘disability’
  •  difficulties discussing conditions and their functional impact with health professionals in a meaningful way, due to language and cultural barriers.

5.2 The recommendations made in this report are intended to address some of the most significant challenges we consider remote Indigenous Australians face in:

  •  collecting evidence
  •  preparing applications
  •  accessing, and participating in, JCAs and DMAs
  •  anticipating the need for and accessing a program of support where required

“We have recommended ways to improve administration and reduce accessibility barriers facing remote Indigenous DSP claimants. These include recommendations about the way assessments are carried out, the information sought from and given to treating health professionals and better information about DSP eligibility requirements.”

Overall, DHS and the Department of Social Services (DSS), which is responsible for the relevant legislation and policy, responded positively to the investigation, agreeing to all recommendations.

“DHS is taking steps to improve its DSP assessment processes for remote Indigenous Australians, but more needs to be done,” Mr Neave said.

The assistance received from DHS throughout the investigation and report drafting process was also acknowledged by the Ombudsman.

Mr Neave said the Ombudsman’s office would continue to work closely with DHS to monitor the implementation of the recommendations in this report

Executive summary

Over the past twelve months the Ombudsman’s office has investigated a number of cases in which Indigenous people and their advocates have complained about decisions to refuse Disability Support Pension (DSP) claims. We do not usually investigate where, as in most of those cases, a complainant has a right of review. However, the focus of these complaints was the Department of Human Services’ (DHS) assessment process.

The complainants argued that their medical impairments were not properly or appropriately assessed. We decided to investigate their circumstances and examine DHS’s approach.

Over recent years the qualification criteria for the DSP has been significantly revised and tightened. While it is not the role of the Ombudsman’s office to comment on the merits of government policy, it is appropriate that we are alert to situations where the practical application of a policy has unintended consequences.

This includes the potential to create inequitable access or outcomes that are inconsistent with legislative intent and do not reflect the principles of good administrative decision making.

We acknowledge that DHS assesses over 100,000 DSP claims per year. The majority of these are processed without significant cause for complaint by claimants.

However, the experience of the majority should not necessarily be taken as an indication that the process is working for the most vulnerable in the community.

This report focuses on the experiences of one particular vulnerable group—Indigenous people living in remote areas. Remote Indigenous Australians face significant disadvantage and unique cultural barriers in accessing a range of government services, including DSP.

The qualification criteria for DSP set a high bar and the claim process is rigorous. Even those applicants who are familiar with the income support and health systems say they find the DSP claim process complex, lengthy and confusing.

Complaints made to our office, along with the anecdotal feedback provided by peak bodies, advocates and community organisations, show that Indigenous people living in rural and remote Australia experience particular difficulty in preparing applications for DSP and meeting the high standard of evidence required by social security law.

This report centres on complaints about the DSP claim process and uses them to illustrate some of the common challenges Indigenous people living in remote areas of Australia face when making DSP claims. The report provides a snapshot of areas where the DSP assessment process has fallen short.

Although the number of complaints we receive about DSP is small compared to the total number of DSP claims, the challenges faced by remote Indigenous Australians in navigating the DSP claim process are real and the impact of these challenges can be disproportionately large, given the claimants’ particular vulnerabilities.

We acknowledge the initiatives DHS has implemented to improve access to DSP for remote Indigenous Australians. Despite these efforts, we continue to receive similar complaints at the time of publishing this report. The complaints suggest there remains a gap between DHS’s service delivery commitments and the reality experienced by Indigenous people in remote areas.

The report makes recommendations about the job capacity and medical assessment processes, including the way the assessments are carried out and the information given to Commonwealth Ombudsman—Department of Human Services: Accessibility of Disability Support Pension for remote Indigenous Australians and sought from medical professionals providing reports for DSP claims.

We have recommended steps to increase awareness of the eligibility requirements for DSP, including the need for some applicants to have participated in a ‘program of support’. Given the recent changes to the DSP claim process and the programs of continuous improvement which DHS has outlined in response to our investigation, we have also recommended that the department establishes an implementation, monitoring and evaluation framework to assess the effectiveness of those changes.

Our office will continue to work closely with DHS to monitor the implementation of the recommendations in this report

NACCHO Aboriginal Health and #JustJustice – Accessing Justice for Aboriginal People with Disabilities

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“It’s clear we need to change to law to prevent indefinite detention, but we also need to make sure the supports are available on the ground. People with disabilities who come into contact with the criminal justice system need to be connected to appropriate support,

 “This is especially the case for young people with disabilities in contact with the criminal justice system. We should be intervening as early as possible in a child’s life to identify and address disabilities, and support their parents to care for their child as much as possible.”

Professor Kerry Arabena, a chief investigator on the project Press Release 1 Below

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 “At the same time Aboriginal and Torres Strait Islander women are experiencing high rates of violence, being 34 times more likely to be hospitalised for family violence related assault.

“We know that Aboriginal and Torres Strait Islander imprisonment rates, and experience of violence, are strongly linked to social and economic disadvantage and so the inquiry must include a focus on early intervention, prevention and diversion programs”

Change the Record Coalition ( CTR ) Co-Chair Shane Duffy Press Release 2 Below

Laws that are meant to protect persons with disabilities in the criminal justice system can lead to detention without an end date.

This is particularly so for Aboriginal and Torres Strait Islander People with Disabilities according to researchers at the University of Melbourne and University of New South Wales.

Researchers have collaborated with the Victorian Aboriginal Legal Service and the North Australian Aboriginal Justice Agency to deal with the support needs of accused persons with mental disabilities.

The Unfitness to Plead and Indefinite Detention of Persons with Cognitive Impairments project is about providing support to people with disabilities in the criminal justice system to prevent their indefinite detention.

The researchers recently gave evidence to a Senate Committee Inquiry into the Indefinite Detention of People with Cognitive Impairment in Darwin last week.

The research team, which includes a number of Aboriginal and Torres Strait Islander researchers and advocates, have just concluded a six-month trial of supports for accused persons with disabilities when they reach the court system.

Professor Kerry Arabena, a chief investigator on the project, says Indigenous people with disabilities are clearly over-represented in the criminal justice system.

“It’s clear we need to change to law to prevent indefinite detention, but we also need to make sure the supports are available on the ground. People with disabilities who come into contact with the criminal justice system need to be connected to appropriate support,” she said.

“This is especially the case for young people with disabilities in contact with the criminal justice system. We should be intervening as early as possible in a child’s life to identify and address disabilities, and support their parents to care for their child as much as possible.

It is a travesty that in 2016 we can have over representation in the criminal justice system because we haven¹t prevented or addressed early health, developmental vulnerabilities or intergenerational trauma in the first 2 years of life.  We do not need prison solutions for health issues.” Professor Arabena said.

In many places, the right support is unavailable. Jody Barney, one of the National Advisory Panel members for the project is a leading Aboriginal Disability consultant. She has assisted Aboriginal and Torres Strait Islander people with disabilities in the criminal justice system all over Australia.

“The Unfitness to Plead Project tries to make sure Aboriginal and Torres Strait Islander people with disabilities not only have the right communication access and supports but the physical presence of an advocate and interpreter to assist their understanding of the justice system.”

“While the project doesn’t focus on young people, we have identified the unmet needs of the young people with disabilities during the course of the project. The work needs to be extended to include youth and reduce the recidivism of young Aboriginal and Torres Strait Islander in detention.” she said.

Another member of the advisory panel, Ms Elizabeth McEntyre, a criminal justice social worker has conducted research with Aboriginal communities in NSW and NT on Aboriginal people with mental and cognitive disabilities in the criminal justice system.

”Better education and information are needed for police, teachers, lawyers, magistrates, health, corrections, disability and community service providers regarding understanding and working with Aboriginal and Torres Strait Islander women and men with cognitive impairment and complex support needs, ” she said.

The researchers call for a suite of reforms to ensure accused persons with disabilities get the support they need to access justice on an equal basis with others.

Mr Lenny Clarke, a First Persons Disability Network representative and one of the project’s advisors says that people with disabilities are often subject to prejudice, discrimination and exclusion.

“Most people don’t understand disability and or don’t feel affected – for them it is a case of  ‘That’s other peoples and families problems.’ “

The project team recommends that it should be mandatory for all sections of Law enforcement agencies and administrators of the judicial system to participate in extensive training and awareness programs on disability.

health-justice

Watch live link Here

Australian Law Reform Commission inquiry into Aboriginal and Torres Strait Islander imprisonment must focus on solutions

From

Change the Record (CTR) Coalition

A major national inquiry into the over-imprisonment of Aboriginal and Torres Strait Islander peoples must focus on identifying tangible solutions that address the underlying causes of imprisonment, says the Change the Record (CTR) Coalition.

In welcoming today’s announcement of an Australian Law Reform Commission (ALRC) inquiry into the over-imprisonment of Aboriginal and Torres Strait Islander people, the coalition of peak Aboriginal and Torres Strait Islander, human rights and legal organisations has said it is essential that the inquiry focus on practical measures that invest in and strengthen communities.

CTR Co-Chair Shane Duffy said, “For a long time we have been calling for the Federal Government to take a leadership role on these issues, and so we welcome the Turnbull Government beginning to step up to the plate”.

“This year marks 25 years since the landmark Royal Commission into Aboriginal Deaths in Custody (RCIADIC), but our people continue to experience imprisonment and violence at crisis rates.

The new ALRC inquiry offers an important opportunity to shine a comprehensive light on these issues at a national level, and identify tangible actions for all levels of government” said Mr Duffy. At the time the RCIADIC report was handed down Aboriginal and Torres Strait Islander people were seven times more likely to be in prison, now in 2016 that figure has risen to 13 times.

At the same time Aboriginal and Torres Strait Islander women are experiencing high rates of violence, being 34 times more likely to be hospitalised for family violence related assault.

“We know that Aboriginal and Torres Strait Islander imprisonment rates, and experience of violence, are strongly linked to social and economic disadvantage and so the inquiry must include a focus on early intervention, prevention and diversion programs” said Mr Duffy.

Co-Chair Antoinette Braybrook said, “Whilst the announcement of an ALRC inquiry to examine the factors leading to the over-imprisonment of Aboriginal and Torres Strait Islander people is welcome, it is essential that the inquiry also consider issues relating to the prevention of family violence and reducing barriers for Aboriginal and Torres Strait Islander victims/survivors of family violence to access quality, holistic, culturally safe legal services and supports.”

“It is also critical that the Terms of Reference for the inquiry are developed in close consultation with Aboriginal and Torres Strait Islander peak bodies, and those who are members of Change the Record. To ensure that the inquiry has a meaningful outcome, all levels of Government must commit to implementing the recommendations in full.”

“The Federal Government should also take immediate steps to highlight its commitment to improving justice outcomes for Aboriginal and Torres Strait Islander peoples, including by setting meaningful national justice targets through the Council of Australian Governments (COAG) and committing to review the implementation of RCIADIC” said Ms Braybrook.

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at the 2016 Members Conference closing 8 November
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2.NACCHO Partnership Opportunities

3. NACCHO Interim 3 day Program has been released

4. The dates are fast approaching – so register today
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NACCHO #NTRC Royal Commission and Aboriginal Health : #FASD , Malnutrition, hearing and #mentalhealth are major factors

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 ” The profoundly damaging consequences of heavy drinking by pregnant women, malnutrition in early childhood and intergenerational “psychic trauma” are neither properly diagnosed nor treated in Aborigines coming into contact with the law, a royal commission has heard.

The effects of these conditions, which can stunt a child for life, meant affected youngsters were both more likely to become involved in criminal activity and less likely to benefit from punitive forms of rehabilitation.”

As reported in the Australian today

 ” Studies linked FAS-D to a “profound level of social morbidity in terms of violence, engagement in the justice system, depression, suicidal thoughts, suicide, very low chance of meaningful occupation and a very high risk of being in prison as adults requiring mental institution and support with drug addiction

Professor Boulton and NACCHO FASD Articles

 ” Most infants with FASD are irritable, have trouble eating and sleeping, are sensitive to sensory stimulation, and have a strong startle reflex. They may hyperextend their heads or limbs with hypertonia (too much muscle tone) or hypotonia (too little muscle tone) or both. Some infants may have heart defects or suffer anomalies of the ears, eyes, liver, or joints.

Adults with FASD have difficulty maintaining successful independence. They have trouble staying in school, keeping jobs, or sustaining healthy relationships. They require long-term support and some degree of supervision in order to succeed. “

Make FASD History  Image above a full story see below

 “Many boys caught up in the Northern Territory’s juvenile justice system suffer a “disease of disadvantage” that has crippled almost every aspect of their lives, the Northern Territory’s royal commission into youth detention and protection has heard.

Jody Barney, who works as a deaf indigenous community consultant, told the inquiry she has spoken to several young Aboriginal people with hearing impairments who have had their faces covered by spit hoods and bound behind bars.

News Report

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The Royal Commission website is available at https://www.childdetentionnt.royalcommission.gov.au.

Moreover they were perpetuating, meaning the effects could be passed through neurological and genetic means from generation to generation, the Royal Commission into the Protection and Detention of Children in the NT heard today.

The Commission looks likely to probe these effects more deeply, following depressing but insightful evidence given by University of Newcastle professor of pediatrics John Boulton, who clearly captured the commissioners’ interest.

“I think the Foetal Alcohol Spectrum Disorder issue, together with the evidence that we have had this afternoon about deafness, throws such a complexion upon the participation of so many of these children in the criminal justice system, not to mention the child protection system, that we need to look at this carefully,” Commissioner Margaret White said.

“I think it’s fairly original inasmuch as the other many reports that we’ve been exposed to … have not had an opportunity to consider these areas of study.”

Professor Boulton told the Commission there was an urgent need for FAS-D and to be recognised under the National Disability Insurance Scheme. He said estimates in Canada of the lifelong cost of treating the condition reached into the millions of dollars.

“If there are one or two per cent of the total population of whom a fraction are severely affected with FASD, and therefore suffer the huge mental health and other subsequent complications and disabilities with FASD, then we are talking about an enormous burden to the overall Australian community in the tens of millions of dollars,” he said.

Studies linked FAS-D to a “profound level of social morbidity in terms of violence, engagement in the justice system, depression, suicidal thoughts, suicide, very low chance of meaningful occupation and a very high risk of being in prison as adults requiring mental institution and support with drug addiction” Professor Boulton continued.

He likened FAS-D to the thalidomide disaster, heavy metal poisoning or radiation sickness.

Professor Boulton said progress had been made through alcohol restrictions brought about in the Kimberley towns of Halls Creek and Fitzroy Crossing by local women. He said the restrictions had produced a “massive reduction in the amount of violence and of women seeking refuge”, and that there was evidence young children were growing better.

Earlier in the day the Commission was told many Aboriginal youngsters from the remotest areas suffered hearing problems related to ear infections in early life. In one example retold before the Commission, a boy before court had been crash tackled by a guard who thought he was trying to escape, when in fact the boy simply hadn’t heard an instruction.

Deafness holding NT’s indigenous kids back

Many boys caught up in the Northern Territory’s juvenile justice system suffer a “disease of disadvantage” that has crippled almost every aspect of their lives, the Northern Territory’s royal commission into youth detention and protection has heard.

Jody Barney, who works as a deaf indigenous community consultant, told the inquiry she has spoken to several young Aboriginal people with hearing impairments who have had their faces covered by spit hoods and bound behind bars.

“Taking away another sense from a person who already has a limited sense is frightening. And that fear stays forever… long after their sentence,” she said.

Footage of boys being tear gassed, shackled and put in spit hoods at Don Dale Youth Detention Centre was aired on national television in July, sparking the royal commission

Psychologist Damien Howard told the inquiry a chronic housing shortage is creating an “epidemic” of hearing loss in indigenous children that leads to learning difficulties, family breakdown and criminal involvement.

“It’s very much a disease of disadvantage,” Dr Howard told Darwin’s Supreme Court.

Crowded housing overwhelms a child’s capacity to maintain hygiene, allows infections to pass quickly, and increases exposure to cigarette smoke and loud noises, while the poverty limits nutrition.

On average, non-Aboriginal kids experience middle ear disease for three months of their childhood while indigenous children can get fluctuating hearing loss for more than two years.

This can result in a permanent condition, which Dr Howard says is a “smoking gun” leading to over-representation in the criminal justice system.

Make FASD History

Fetal Alcohol Spectrum Disorders (FASD) are 100% preventable. If a woman doesn’t drink alcohol while she is pregnant, her child cannot have FASD.

There is a humanitarian crisis in the Fitzroy Valley region of remote North Western Australia, which has one of the highest Fetal Alcohol Spectrum Disorders (FASD) in the world.

The effects of alcohol on the fetal brain are a common cause of intellectual impairment in developed countries. Problems that may occur in babies exposed to alcohol before birth include low birth weight, distinctive facial features, heart defects, behavioural problems and intellectual disability.

Most infants with FASD are irritable, have trouble eating and sleeping, are sensitive to sensory stimulation, and have a strong startle reflex. They may hyperextend their heads or limbs with hypertonia (too much muscle tone) or hypotonia (too little muscle tone) or both. Some infants may have heart defects or suffer anomalies of the ears, eyes, liver, or joints.

Adults with FASD have difficulty maintaining successful independence. They have trouble staying in school, keeping jobs, or sustaining healthy relationships. They require long-term support and some degree of supervision in order to succeed.

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Bright Blue is very proud to partner with Nindilingarri Cultural Health Services to support the development and implementation of a comprehensive, evidence-based prevention and community capacity building programme, which aims to make FASD history.

The outcomes of this programme will work to:

  • Improve the health, quality of life and social and economic potential for the next generation of Fitzroy Valley children, and thus the fabric of the community itself;
  • Identify practical strategies that can be implemented elsewhere in Aboriginal and non-Aboriginal communities to reduce and eliminate FASD;
  • Make WA a leader in FASD prevention;
  • Decrease costs associated with service provision, productivity, welfare and justice.

stacks_image_6848Led by Aboriginal community leaders Maureen Carter and June Oscar; and Paediatrician Dr James Fitzpatrick, it is important that the leadership of the Marulu strategy reflects the community ownership of the process.

Bright Blue needs your support to assist in prevention and capacity building, to develop an effective community – level support for women to abstain from drinking during pregnancy and child bearing years, so that all babies born in this community and across Australia have a full potential for a long and productive life.

Become a part of history. Together, let’s make FASD history.

The inquiry led by co-commissioners Margaret White and Mick Gooda continues.

NACCHO #HealthElection16 #TowardsRecovery Mental Health , NDIS , PHN’s and Aboriginal Community Controlled Health

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Current Commonwealth programs migrating to PHN’s

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The mental health sector is in the midst of “a perfect storm” of change, as one speaker put it during the recent VICSERV #TowardsRecovery conference in Melbourne. This comes as the sector grapples with how to offer people with mental illness not just choices but control over their lives.

Mental Health Australia CEO Frank Quinlan told delegates that the system was in a period of “quite unprecedented change”, with the rollout of the National Disability Insurance Scheme (NDIS), the new role in mental health of Primary Health Networks (PHNs) and other reforms planned or underway in response to the National Mental Health Commission’s Review of Mental Health Programmes and Services.”

A delegate from an Aboriginal community controlled health organisation (ACCHO) raised issues for her sector, where Aboriginal communities are estimated to have twice the incidence of disability as non-Aboriginal communities but much less access to services, and agencies that are not specialists for disability support.

“If you focus most of the effort on transitioning current supports (to the NDIS), that will continue to leave Aboriginal communities under-supported,” she told the NDIS panellists.

She was told the NDIA had identified it needed to do a lot more work around Aboriginal disability, and would step up that engagement and transition work. Other culturally and linguistically diverse (CALD) communities will also get a bigger focus.

Another ACCHO representative voiced fears that if Aboriginal people with disability transitioned to other services under the NDIS, only to find they were not culturally safe for them, that the ACCHO workforce might not still be there for them to return to.

Marie McInerney writes: Melissa Sweets edits in

Croakey New

While many of the major system changes underway, including the NDIS, are welcomed in the mental health sector, there is confusion over details and concern that many people with mental health issues could fall through new gaps in the system.

Some at the conference said the upheaval rivals the days of deinstitutionalisation, particularly in Victoria which has just emerged from much criticised recommissioning of mental health services and where there is also uncertainty about what of its mental health community support funds will be committed to the NDIS.

These concerns are only exacerbated by the uncertainty surrounding the policy outcomes likely to result from the July 2 federal election, and the marathon eight-week election campaign and caretaker period.

Despite all the planning for the NDIS, which on 1 July begins its full national rollout after three years of trials, the fate of some programs such as the Personal Helpers and Mentors (PHaMs) program is still not known.

(As a measure of ‘reform fatigue’, Victorian Alcohol and Drug Association CEO Sam Biondo told one session that when he started out in the 1970s, all he wanted was change; now all he wants is some stability).

“Some organisations don’t know what contracted services they’ll be offering on July 1,” Quinlan told Croakey in a follow-up interview yesterday. “That means uncertainty for their clients, people who rely on them, and also for their workforce who don’t know whether they will have employment in six weeks time.”

At the weekend Mental Health Australia released its election platform, saying the important reforms that are underway “cannot be forgotten during the current electoral cycle”. It is calling on political leaders for long-term commitment to:

  • reducing the national suicide rate
  • improving the physical health of people with a mental illness
  • increasing employment rates for people experiencing mental illness and their carers
  • increasing mental health consumer and carer participation and choice in national policy design and implementation
  • maintaining current overall levels of investment in mental health, with measures that support full reinvestment of cost efficiencies and savings.

Mental Health Australia will produce a ‘report card’ to be released prior to the election, outlining the major parties’ response on these issues.

Meanwhile, just a few days after the conference ended, one of its speakers, Professor Jane Burns, CEO of the Young and Well Cooperative Research Centre, joined other mental health leaders in releasing details on suicide across 28 Federal electorates, calling on party leaders and candidates to spell out what they intend to do to address the rising toll of suicide and self-harm across Australia.

NDIS concerns

The mental health sector has welcomed the NDIS, saying a well funded and well run scheme will meet many needs.

But the numbers provide the context for some of the concerns raised at the conference: it is estimated that each year in Australia, there are around 600,000 people who experience severe mental illness, and 300,000 who experience severe mental illness with “complex inter-agency needs”.

By comparison, there are around 60,000 places in the NDIS for people with mental health issues.

VICSERV CEO Kim Koop said the conference message was: “The NDIS is a welcome addition to a contemporary mental health system but is not sufficient replacement for the current offering.”

She said Victorian community managed mental health services were “desperate for more information” about the NDIS.

But the State Government has an equal role to play, she said, pointing out that the bilateral agreement makes clear that the introduction of the NDIS is a shared responsibility between the States and the Commonwealth. “Both need to step up and provide information,” she said.

VICSERV has played a lead role in documenting the Victorian trial of the NDIS in the Barwon area, but is waiting to hear back on how its concerns will be addressed.

Koop said:

The NDIS is not a bad thing (for mental health).

The trouble is that the funding for the existing services is being transferred to the NDIS and that it is still very uncertain if the NDIS will offer a similar range of services.

At the moment it’s just really unclear. We’re waiting to hear from the NDIA (National Disability Insurance Agency) around the review of supports for people with mental illness but until that comes out, we just don’t know what kind of supports, what price they will be at, what workforce (levels) there will be required.”

Delegates at one conference session peppered a panel that included senior managers in the National Disability Insurance Agency (NDIA) about many details of the NDIS’s likely operation.

A delegate told the panel it had been great to have different trials conducted across Australia over the past three years but their different reports on different experiences have created “confusion and misinterpretation…trying to compare apples with oranges”.

Others expressed continuing concern about how people with episodic mental health issues would be included in a Scheme designed around permanent disability.

On markets and mental health

The session followed a keynote by UK philosopher Dr Simon Duffy raising issues such as citizenship and the need to focus on community rather than institutional and organisational interests. By contrast, the language of the NDIS discussions was all around markets, market failures, entrants and competition.

In an aside to me, one delegate questioned whether there is a “market” in people with mental illness.

Asked at another session whether there really was a “fair dinkum market’” for organisations to start competing in, National Mental Health Commissioner Rob Knowles said there wasn’t yet.

But he warned that one would develop as it has in other countries, and he was not sure people in the sector understood the significance of the changes that will occur.

When the UK went down this road, about 80 per cent of existing services were provided by not for profit organisations, the remainder by private providers. That was soon reversed, he said.

A mistake many not-for-profits made was to think “people stick with us”. Knowles said: “People are much more fickle than that. I think there are significant challenges for those operating in this: how they make themselves be a service provider of choice”.

What will PHNs offer mental health?

Another panel session focused on the news, announced last year, that funds will be reallocated from Canberra to primary health networks (PHNs) to commission — but not deliver — mental health services.

Again, the sector has welcomed the move, particularly as a bridge between States and Commonwealth, but with concerns about how it all might work in practice.

Quinlan gaps

The aim of the PHNs, to make sure they get local services on the ground where they are needed, was very welcome, Quinlan said. The concern is how to maintain national standards.

He said: “For example with eating disorders and suicide prevention, you can quickly see you wouldn’t want 31 PHNs across the country all inventing their own way of doing things. Addressing how we tackle some national issues while ensuring local suitability is a big challenge.”

The PHN session involved panelists Jason Trethowan – Chief Executive, Western Victoria PHN, Lyn Morgain – Chief Executive, cohealth, and Christopher Carter – Chief Executive, North Western Melbourne PHN. They outlined what PHNs would cover, and what they wouldn’t.

The questions they sought to answer in their session demonstrated the issues of concern for many of the delegates there:

  • How will planning be undertaken that ensures the range of demographic, clinical, aged related, cultural, socio-economic and comorbidity of people is properly planned for?
  • How will the flexible funding pool work – be prioritised – is it flexible for service models of care?
  • How will PHNs work with the State system, and with each other to ensure continuity – especially given the transient nature of some consumers?
  • What does this mean for existing youth primary mental health services? Youth with severe mental health?
  • How will we ensure that services for Aboriginal and Torres Strait Islander people recognise the social determinants of health and cultural safety?
  • What are the potential approaches to reduce fragmentation (suicide prevention)?
  • What are the commissioning challenges and opportunities for rural communities?
  • There will likely be a gap with the move of specialist recovery based community mental health support services to the NDIS. Will PHN’s be able to fund recovery based CMH or will as suggested PHNs be limited to commissioning only “clinical primary MH” as has been suggested in some of the guidance documents?

PHNs not in scope

PHN perspectives

Croakey later asked panellist Chris Carter for his reflections on the session.

Q: What were the main messages you wanted to get across during the session on the role of PHNs within the context of national mental health reforms?

That the role of PHNs is developing – in the first phase this will be about development of a stepped care model that reflects regional needs, and is focussed around safe, quality mental health care.  There will be a number of stages and phases in the evolution of an integrated system given the high level of fragmentation in the healthcare system.

Q: What key concerns emerged from the session? What’s your response to them?

Not really concerns, but a genuine desire to participate in the conversation about reform – how PHNs will take into account the diversity of populations, families and individuals when considering future planning and investments in the mental health system.

Q: The Federal Opposition said recently: “The PHNs, as the critical commissioners under the new reform agenda, are stuck in an unenviable position, wedged between the enormous pressure to deliver the reforms with unreasonable demands and an information vacuum from the Department of Health and at the same time trying to manage an increasingly agitated mental health sector hungry for information and advice.” What’s your response to that?

Our role as PHNs is to help facilitate as much information sharing and participation in planning processes as is possible.  Some of the tension lies between acute and primary systems, as well as State and Commonwealth systems.  At a regional level, our job is to bring local intelligence / evidence and wisdom to try and meet the needs of consumers / citizens, whilst bringing along the sector – which we acknowledge is reform / change fatigued in Victoria.

Q: What do you want to see promised for mental health in the federal election? Has the campaign put major work on hold? What certainty is needed now?

I support Mental Health Australia’s call for a long-term strategy for mental health – and would add that we need to integrate State and Commonwealth responses at a regional level in order to target diverse populations and diverse needs.  The election campaign has not put our work on hold – we are on track to implement continuing and new arrangements ready for July 1 and beyond in partnership with stakeholders.

Some Twitter observations

PHNs twitterPHNs twitter2

Control, not choice

Another big theme at the conference was given a sharp focus by keynote speaker Simon Duffy – that the idea of ‘choice’ is not enough for people with disabilty.

Rather, he said, control is what’s vital. (See also Duffy’s views about the NDIS in this earlier Croakey story and in this interview on Radio National’s Life Matters).

In a similar vein, RMIT Associate Professor Paul Ramcharan told delegates about the It’s My Choice toolkit (DVD, discussion guide and booklets) developed with Inclusion Melbourne, a day service that supports people with intellectual disability. The project sought to inform people with disabilities, family, friends and others as well as service personnel about how to explore choices within complex lives and relationships. .

Ramcharan later told Croakey:

“Of the nine principles of choice (identified), one in particular challenges us to rethink the notion of choice. In this principle,  the important question is not whether people with disability have choice – given that no one really has a total choice in what happens in their lives and that choices are made within a complex of relationships, services and environments. The question should be whether the limitations placed on their choices are reasonable or not.

Organisations delivering services should be looking at discrimination and community norms and other barriers that get in the way of people expressing their choices not just about mundane matters like what to eat and wear (though important) but pervasive areas relating to health, education, work, family and intimacy.

Choice of services alone does not equate to personal choice. It’s the journey of life that counts, not formal academic indicators, but the rich fabric that enriches our lives day to day.”

(Note: this quote above was added to the original published story to give more context about the project).

See his slide below.

PRINCIPLE6
Conference perspectives

Quinlan view from front

Quinlan twitter

• Marie McInerney is covering the #TowardsRecovery conference for the Croakey Conference News Service. Bookmark this link to track the coverage.

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DOWNLOAD THE A PDF COPY 24 Pages

Response to our NACCHO Aboriginal Health Newspaper from our members, community, stakeholders and Government  has been nothing short of sensational over the past 3 years , with feedback from around the country suggesting we really kicked a few positive goals for Aboriginal health.

NACCHO is the national peak body for Aboriginal health. It is entrusted to represent the needs and interests of Aboriginal health on behalf of its members in the national arena.

NACCHO has and continues to be a living embodiment of the aspirations of Aboriginal people

10 good reasons to advertise in the NACCHO Aboriginal Health Newspaper :

  1. Highly targeted health sector from CEO’s to all staff audience
  2. Quality production and guaranteed national distribution in partnership with the award-winning Koori Mail 14,000 printed copies
  3. Spend any surplus dollars before the end of the financial year
  4. Article space offered with ad bookings
  5. Newspaper also distributed at NACCHO events and workshops
  6. 1500 copies posted to the CEO’s of Australia’s top Aboriginal health organisations and NGO’s and Government departments
  7. Thank you ‘burst’ through NACCHO’s social media network naming all advertisers
  8. Over 100,000 audited readers
  9. Targeted at Aboriginal consumer / clients
  10. Support NACCHO vision to Close the Gap

Our media partner Koori Mail Turns 25 this week

The Koori Mail is an Australian media institution, 100% owned and controlled by Aboriginal people. The fortnightly newspaper circulates all states and covers the issues that matter the most to black Australians. 25 years since its first print, the Indigenous paper is still breaking ground for Indigenous journalism.

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Editorial Opportunities

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We are now looking to all our members, programs and sector stakeholders for advertising, compelling articles, eye-catching images and commentary for inclusion in our next edition.

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This 24-page newspaper is produced and distributed as an insert in the Koori Mail, circulating 14,000 full-colour print copies nationally via newsagents and subscriptions.

Our audited readership (Audit Bureau of Circulations) is 100,000 readers!

Our target audience also includes over 1,500 NACCHO member and affiliate health organisations, relevant government departments, subsidiary indigenous health services and suppliers, as well as the end-users of Australian Indigenous health services nationally.

Your advertising support means we can build this newspaper to a cost-neutral endeavour, thereby guaranteeing its future.

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Note: the earlier you book your ad or submit an article for consideration, the better placement we can offer in the printed newspaper. All prices are GST inclusive. Discounts are available to not-for-profits, NACCHO member organisations and industry stakeholders. All prices include artwork if required.

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NACCHO Aboriginal #HealthElection16 : One Gateway proposed for over 30 phone and online mental health services in Australia,

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“We are undertaking this crucial reform because the Mental Health Commission and Expert Reference Group found there were over 30 phone and online mental health services in Australia, but no co-ordinated way to access them.

This means people with specific mental health needs may not have been aware of specialist services or were falling through the cracks altogether.

It also means many of these mental health phone services were being overburdened – or underutilised – because people were not aware of alternative services that may better suit their mental health needs.”

The Hon. Sussan Ley MP Minister for Health Mental Health Gateway to save lives Press Release May 15 : Picture above example of a Gateway

A re-elected Turnbull Coalition Government will continue delivering on our promise to develop a digital mental health gateway that will ensure Australians get the right help at the right time in a bid to stop people falling through the cracks and save lives.

Reports that some phone counselling services have had their funding ‘axed’ are therefore incorrect and misleading.

Our digital gateway is a key recommendation of the Mental Health Commission’s (MHC) landmark Report and is being implemented in line with the guidance provided by our independent Mental Health Expert Review Committee, who were tasked with taking the MHC’s findings from paper to policy.

In addition to our digital gateway being a first point of entry to mental health services across the country, Australians will have the option to call one single phone number to access the mental health phone and online services they need.

This single phone number will act as a triage service that will put them in touch with a specialist phone or online service that is best suited to their personal circumstances.

For example, the triage service may determine a person would be best serviced by a specialist counselling service addressing LGBTIQ mental health or eating disorders, rather than a general service.

The triage service is not designed to replace existing phone counselling services, but enhance access to them.

Australians will still be able to call their preferred phone counselling service directly if they believe this is the best service to help them.

We are undertaking this crucial reform because the Mental Health Commission and Expert Reference Group found there were over 30 phone and online mental health services in Australia, but no co-ordinated way to access them.

This means people with specific mental health needs may not have been aware of specialist services or were falling through the cracks altogether.

It also means many of these mental health phone services were being overburdened – or underutilised – because people were not aware of alternative services that may better suit their mental health needs.

Another key recommendation of the Mental Health Commission was that some – but not all – phone and online mental health services may be unnecessarily duplicating each other’s work and funding may be better targeted to ensure a high-quality mix of services to cover the varying mental health needs of Australians by filling service gaps.

The Coalition will therefore work with all phone and online mental services to transition to this new model of improving access to over-the-phone/online mental health services from 2017-18, including greater funding security. Until then, all services will continue to be funded at current levels.

I understand the importance of mental health organisations running fundraising drives, however it is important their campaigning methods do not end up hurting those who they are ultimately meant to help.

Labor treated mental health as a “second-term priority”. Only the Coalition is committed to delivering these brave and bold reforms aimed at ensuring Australians with mental health issues no longer fall through the cracks.

Recommendations from the Mental Health Commission’s Landmark Report

“Currently telephone helplines are not integrated, they do not have common standards and there are limited referral pathways. There are various levels of duplication of target client groups and potential to be accessing the ‘wrong door’ by users.”

“For telephone and online support services, the strategic direction is in creating a ‘joined-up’ model of crisis support helplines, with each helpline playing its part according to its expertise. This would reduce duplication, increase efficiency and enable collaborative work.”

“Create a coordinated, better integrated model of telephone and online support services, including crisis support and seamless pathways to online and offline information, education, biometric monitoring and clinical intervention.”

Improve access to services and support through innovative technologies

“Improve emergency access to the right telephone and internet-based forms of crisis support and link crisis support services to ongoing online and offline forms of information/education, monitoring and clinical intervention.”

“Implement cost-effective second and third generation e-mental health solutions that build sustained self-help, link to biometric monitoring and provide direct clinical support strategies or enhance the effectiveness of local services.” Volume 1, page 11

Recommendations from the Mental Health Expert Reference Group Implementation Report

“The ERG acknowledged the evidence that demonstrates telephone and e-mental health services can play a significant role in a stepped care model of mental health service delivery if there were triaging, clinical guidelines and targeting of their use. The ERG endorsed appropriate promotion of existing self-help and clinician moderated e-mental health services to consumers and clinicians as an important component.”

“The ERG noted the significant number of providers in this space, some of whom provide similar or competing services. A simpler structure and a secure funding base for these services is required. A single telephone line linked as appropriate to other telephone based services was proposed. Similarly, the ERG supported the consideration of how a single gateway for web-based services could be utilised to provide initial triage and to facilitate consumer access to the most appropriate services.

This would encourage and enable optimal use of the web-based services that are available, particularly in the context of better promoting the availability of self-help services to individuals who could benefit from them. The ERG recommended the Commonwealth work with the states and territories to streamline entry to all e-mental health services through one national gateway.”

“The Commonwealth should immediately:

Establish a single gateway and platform for initial access to existing web based services.

Similarly with phone based mental health support, a single phone access point should be established with the capacity to provide soft transfer to other phone services. Ensure a simple triage system is developed and offered through these new arrangements.”

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NACCHO #HealthElection16 : AMA launches Key Health Issues / Aboriginal Health policy for 2016 Federal Elections

Brian

” The gap in health and life expectancy between Aboriginal and Torres Strait Islander people and other Australians is still considerable, despite the commitment to closing the gap.

The AMA sees progress being made, particularly in reducing early childhood mortality rates, and in addressing major risk factors for chronic disease, such as smoking. However, to close the gap in Indigenous health, Government must commit to improving resourcing for culturally appropriate primary health care for Aboriginal and Torres Strait Islander people, and the health workforce.

Including increased investment in Aboriginal and Torres Strait Islander community controlled health organisations. Such investment must support services to build their capacity and be sustainable over the long term;

Brian Owler AMA President pictured above Matthew Cooke Chair of NACCHO at recent NACCHO Event Parliament House Canberra : The Aboriginal Policy is part of a 16 Page AMA Health Issues Document  

“The Medicare freeze is not just a co-payment by stealth – it is a sneaky new tax that punishes every Australian family,”

Professor Owler said, with the elderly and chronically ill among those most affected see press release here AMA LAUNCHES NATIONAL CAMPAIGN AGAINST THE MEDICARE REBATE FREEZE (FED)

Putting Health First

Download the 16 Pages here AMA Key Health Issues Federal Election 2016

Health policy will be at the core of the 2016 Federal Election.

The AMA is non-partisan. It is our role during election campaigns, as it is throughout the terms of governments, to highlight the issues we think will be of greatest benefit to the health system, the medical profession, the community, and patients.

As is customary, the AMA will focus on the respective health policy platforms presented by the major parties in the coming weeks.

The next Government must invest significantly in the health of the Australian people.

Investment in health is the best investment that governments can make.

We must protect and support the fundamentals of the health system.

The two major pillars of the system that mean most to the Australian people are quality primary health care services, led by general practice, and well-resourced public hospitals.

The AMA has advocated strongly and tirelessly on these issues for the term of the current Government.

General practice and public hospitals are the priority health issues for this election.

The AMA is calling on the major parties to lift the freeze on the Medicare Benefits Schedule (MBS) patient rebate. The freeze was extended until 2020 in the recent Budget. The freeze means that patients will pay more for their health care. It also affects the viability of medical practices.

We also need substantial new funding for public hospitals. The Government provided $2.9 billion in new funding in the Budget, but this is well short of what is needed for the long term.

We must build capacity in our public hospitals. Funding must be better targeted, patient-focused, and clinician led.

The AMA is also calling for leadership and effective policy from the major parties on Indigenous health, medical workforce and training, chronic disease management, and a range of important public health measures.

The AMA will release a separate Rural Health Plan, responding to the unique health needs of people in rural and regional Australia, later in the election campaign.

Elections are about choices. The type of health system we want is one of those crucial decisions.

In this document, Key Health Issues for the 2016 Federal Election, the AMA offers wide-ranging policies that build on what works. We offer policies that come from the experience of doctors who are at the coalface of the system – the doctors who know how to make the system work best for patients.

The AMA urges all political parties to engage in a competitive and constructive health policy debate ahead of the election on 2 July.

Indigenous Health Policy Continued

Despite the recent health gains, progress remains frustratingly slow and much more needs to be done. A life expectancy gap of around 10 years remains between Aboriginal and Torres Strait Islander people and other Australians, with recent data suggesting that Indigenous people experience stubbornly high levels of treatable and preventable conditions, high levels of chronic conditions at comparatively young ages, high levels of undetected and untreated chronic conditions, and higher rates of co-morbidity in chronic disease. This is completely unacceptable.

It is not credible that Australia, one of the world’s wealthiest nations, cannot address health and social justice issues affecting just three per cent of its citizens. The Government must deliver effective, high quality, appropriate and affordable health care for Aboriginal and Torres Strait Islander people, and develop and implement tangible strategies to address social inequalities and determinants of health.

Without this, the health gap between Indigenous and non-Indigenous Australians will remain wide and intractable.

The AMA calls on the major parties to commit to:

  • correct the under-funding of Aboriginal and Torres Strait Islander health services;
  • establish new and strengthen existing programs to address preventable health conditions that are known to have a significant impact on the health of Aboriginal and Torres Strait Islander people such as cardiovascular diseases (including rheumatic fever and rheumatic heart disease), diabetes, kidney disease, and blindness;
  • increase investment in Aboriginal and Torres Strait Islander community controlled health organisations. Such investment must support services to build their capacity and be sustainable over the long term;
  • develop systemic linkages between Aboriginal and Torres Strait Islander community controlled health organisations and mainstream health services to ensure high quality and culturally safe continuity of care;
  • identify areas of poor health and inadequate services for Aboriginal and Torres Strait Islander people and direct funding according to need;
  • institute funded national training programs to support more Aboriginal and Torres Strait Islander people to become health professionals to address the shortfall of Indigenous people in the health workforce;
  • implement measures to increase Aboriginal and Torres Strait Islander people’s access to primary health care and medical specialist services;
  • adopt a justice reinvestment approach to health by funding services to divert Aboriginal and Torres Strait Islander people from prison, given the strong link between health and incarceration;
  • appropriately resource the National Aboriginal and Torres Strait Islander Health Plan to ensure that actions are met within specified timeframes; and
  • support for a Central Australia Academic Health Science Centre. Central Australia faces many unique and complex health issues that require specific research, training and clinical practice to properly manage and treat, and this type of collaborative medical and academic research, along with project delivery and working in remote communities, is desperately needed.

Australian Medical Association joins campaign against Medicare rebate freeze

AMA POSTER

Download the AMA Press Release

AMA LAUNCHES NATIONAL CAMPAIGN AGAINST THE MEDICARE REBATE FREEZE (FED)

Article below originally published here

Tens of thousands of specialist doctors are joining GPs’ war against the Turnbull government’s extended freeze on Medicare rebates, increasing pressure on the Coalition’s health record ahead of the federal election.

The Australian Medical Association has distributed posters to its members, warning patients that they will be out of pocket because the cost of running the medical practice will continue to rise as Medicare rebates stay frozen until 2020.

“You will pay a new or higher co-payment every time you visit your GP, every time you visit other medical specialists, every time you need a blood test, and every time you need an X-ray or other imaging,” it says, alongside a photo of a woman comforting a crying child.

It comes a week after the Royal Australian College of General Practitioners announced its 32,000 members would urge their patients to lobby local MPs against the move. The groups share about 8000 members, adding about 22,000 more specialist doctors to the campaign.

The AMA’s campaign similarly encourages patients to contact their local MPs and election candidates, but goes further to directly blame the Turnbull government for the extra cost: “The government has cut Medicare and wants you to pay for it.”

While pathologists on Friday agreed to retain bulk-billing rates in exchange for reduced regulatory pressure on rents under a deal with Health Minister Sussan Ley, the AMA maintains that they and diagnostic imaging services will remain under pressure to charge patients, with the government’s cuts to bulk-billing incentive payments deferred till later in the year.

The AMA’s president, Professor Brian Owler, said many doctors had absorbed costs but the extension “has pushed them over the edge”. They may charge patients a $30 co-payment to cover costs associated with moving to a private billing system, more than triple the Abbott government’s failed and deeply unpopular $7 GP co-payment, he said.

“The Medicare freeze is not just a co-payment by stealth – it is a sneaky new tax that punishes every Australian family,” Professor Owler said, with the elderly and chronically ill among those most affected.

While most specialists (about 70 per cent) already charged patients a co-payment, having had their rebates frozen for decades, the extended freeze could reduce the bulk-billing rate further, an AMA spokesman said.

Labor froze indexation for eight months in 2013, lifting it briefly for GPs in 2014-15. The Coalition extended it for four years in 2014, and this year extended it a further two years to 2020, to save $925.3 million.

Opposition Leader Bill Shorten said Labor opposed the extended freeze at the leaders’ debate on Friday, but would not say whether it would commit to lifting it if elected.

Thirty per cent of 400 GPs surveyed by the College said they would stop all bulk-billing, including for concession card holders, due to the extended freeze. Another 18 per cent said the practice would start charging a co-payment, but cap annual out-of-pocket fees for concession card holders.

Thirty per cent said they would maintain a mixed billing policy, and 10 per cent would continue to bulk bill all patients. Twelve per cent said they were already privately billing all their patients.

The Turnbull government plans to cut bulk-billing incentives for pathology and diagnostic imaging services to save $650 million over four years. Pathology Australia, which had warned this would lead more doctors to charge patients for pap smears, blood and urine tests, has agreed to drop its public campaign against the cuts.

Ms Ley said: “The Coalition will increase Medicare investment to $26 billion per year by 2020-21, while introducing revolutionary reforms such as Health Care Homes that cement a GP’s role at the centre of patient care.”

While she appreciated many GPs’ efforts to keep costs down during the indexation freeze, she was disappointed that “there’s no reciprocal offer to assist taxpayers with the immediate financial challenges our budget faces while [Health Care Homes are] implemented”.

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            Send your Aboriginal Health issue message to Canberra for

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NACCHO Aboriginal health #Stroke Stories : Written by the mob for the mob

Stroke 2

“It’s very important that it belongs to the local community.And the community chose the stories, artwork and analogies that would be best to make it work.

The river is compared to the blood flow through the body,” says Rachel. “If it’s dammed with silt and trees then nothing gets past, like when an artery gets blocked. Or if the river floods it kills the land it goes over, which can be like a bleed in the brain.”

Rachel Peake, Stroke Care Coordinator in from Hunter New England Health.

A book of personal stroke stories from Aboriginal community members is proving effective at getting authentic, relatable information across to others in the community and raising stroke awareness.

All the words in Stroke: Written by the Mob for the Mob come from the Aboriginal people of the Kamilaroi/Gomeroi/Gamilaraay/Gamilaroi nations. The booklet was published by the Hunter New England Local Health District of NSW.

Download Stroke: Written by the Mob for the Mob (PDF, 12 MB)

“It’s very important that it belongs to the local community,” says Rachel Peake, Stroke Care Coordinator in from Hunter New England Health. “And the community chose the stories, artwork and analogies that would be best to make it work.”

The stories were gathered through a series of yarning sessions, which let people direct the conversation themselves. This makes sure that nothing important is missed, and that the authentic voices of the participants come through.

The result is a relaxed mix of humour and art. This includes the painting on the booklet’s cover, a representation of stroke and the brain created by students from the Peel High School. This picture also demonstrates the analogy of the river, which is central to the booklet’s message.

“The river is compared to the blood flow through the body,” says Rachel. “If it’s dammed with silt and trees then nothing gets past, like when an artery gets blocked. Or if the river floods it kills the land it goes over, which can be like a bleed in the brain.”

Since its publication the booklet has taken on a life of its own, with hardly any copies left from the original print run of 2000. This is partly due to people’s pride in their own family members, demonstrating that the booklet is reaching the community it was created for.

As Rachel says, “This is the message the community wanted: if they’re given a voice, they can educate their own people.”

You can find the Stroke: Written by the Mob for the Mob booklet on enableme and InformMe, as well as a series of videos of respected community members telling their own stories.

Download Stroke: Written by the Mob for the Mob (PDF, 12 MB)

Declaration: Colin Cowell editor of NACCHO Aboriginal Health News Alerts is stroke survivor and was recently elected to the board of Stroke Foundation as a Consumer director

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Aunty Pam’s story

Audrey’s story

Bill and Coral’s story

Delphine’s story

Tales from Toomelah

  Declaration of interest: Colin Cowell editor of NACCHO Aboriginal Health News Alerts is stroke survivor and was recently elected to the board of Stroke Foundation as a Consumer director

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NACCHO Health Newspaper : Aboriginal people are up to three times more likely to have a stroke

New Microsoft Word Document (4)

We know that Aboriginal and Torres Strait Islander people are up to three times more likely to have a stroke than non-Indigenous Australians, The good news is most strokes are preventable and treatable. However communities need to be empowered to protect themselves from this insidious disease.

In Australia, stroke is the leading cause of long-term disability in adults, accounting for 25 per cent of all chronic disability. The NSF reports that roughly 50,000 strokes occur per year with over 437,000 people living with stroke across the country. While severity varies, two thirds of victims, like Tania, are left with impeding disabilities.

The Stroke Foundation has called on the Federal Government to fund an urgent $44 million campaign to address the gap in stroke care.”

Stroke Foundation Chief Executive Officer Sharon McGowan

For more information on stroke and the campaign, visit strokefoundation.com.au

From page 20 NACCHO Aboriginal Health Newspaper out this week : Free PDF download

The Stroke Foundation is calling for increased stroke awareness initiatives in Aboriginal and Torres Strait Islander communities.

Sharon McGowan said better education about the risks and signs of stroke was crucial to help close the unacceptable health gap which threatens the lives of thousands of people each year.

“Stroke is a serious medical emergency which requires urgent medical attention. However too many Aboriginal and Torres Strait Islanders are unable to recognise the signs of stroke.

“We believe everyone deserves the chance to lead a healthy life. More must be done to educate people about stroke prevention and awareness in the community.

“We are calling on the Federal Government to fund a national campaign to increase awareness of the signs of stroke and how people should respond,” she said.

The Stroke Foundation has a simple acronym to help people remember the signs of stroke:

Face – has their mouth drooped?

Arms – can they raise both of their arms above their head?

Speech – is their speech slurred? Can they understand what you’re saying?

Time – Call triple zero (000) immediately. Do not delay.

Ms McGowan said it was vital that more Aboriginal and Torres Strait Islander people were able to recognise these signs in themselves and their family members.

“Stroke is a sudden interruption of blood flow to the brain. Without the blood to deliver oxygen, the stroke affected parts of the brain start to die. This can lead of death or significant disability for those who survive a large stroke,’’ she said.

“Unfortunately awareness of the signs of stroke in Indigenous communities is low. It is vital that people can recognise the signs of stroke and know to call triple zero immediately

BP

FIND locations here

And then consult your nearest Aboriginal Community Controlled Health Service

Download our NACCHO APP to geo locate and make an appointment

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REPORT FROM NITV

For Tania Lewis, an Awabakal woman, stroke was something that only happened to older people.

“Never had I ever come across one or heard much about them. I had nothing to do with them,” she tells.

But in 2011, Tania suffered a severe stroke at the age of 39 that would leave her with permanent right-sided hemiplegia – paralysis of one side of the body.

Tania Lewis

Tania with husband Leonard at the Barmedman Mineral Pool in 2007. Barmedman is Len’s home town and where the couple were married in 1989.

“When I woke up, I didn’t know what was going on. I couldn’t communicate. I couldn’t tell anyone I was still here. It was really scary. I’d never seen the effects of a stroke.

“First, I lost my voice, then my vision, my [ability to] swallow and my movement of all my body parts. I lost all my bowel and bladder function. I’ve still got bad sight but I can see again. My speech took about six months.”

In Australia, stroke is the leading cause of long-term disability in adults, accounting for 25 per cent of all chronic disability. The NSF reports that roughly 50,000 strokes occur per year with over 437,000 people living with stroke across the country. While severity varies, two thirds of victims, like Tania, are left with impeding disabilities.

Tania Lewis, an Awabakal woman, and her husband Len, a Wiradjuri man, have been best friends since childhood. Now married 27 years, they live in Bonnels Bay, NSW with their teenage daughter, Faith. In 2011, their relationship faced the ultimate test when a severe stroke left Tania paralysed. This is their story.

The burden of stroke doesn’t just fall on the patient, but can take a significant toll on family and carers.

“The doctor at the hospital tried to take Power of Attorney and Guardianship away from me and give it to the Guardianship Board, because he didn’t believe that [my husband] Len or anyone could look after me,” Tania recalls.

“I was put through hell. I figured life wasn’t worth living anymore because they took everything away from me. I couldn’t go home to my family. So I tried to off myself.

I figured life wasn’t worth living anymore because they took everything away from me. I couldn’t go home to my family.

“Then all of a sudden, one day the doctor said, ‘You can go home. We can’t rehabilitate you anymore’. At home, I was having seizures for a while. My hubby wouldn’t sleep. He and his mum would take shifts looking after me. We tried to get assistance but there was nothing for young people. So one day, my husband collapsed on the lounge room floor from exhaustion. It was just a nightmare. That’s how I ended up in aged care.”

Tania spent the next two and a half years between three aged care facilities.

“I wouldn’t wish it upon nobody,” she says.

It was during her nightly ritual of chatting with her daughter via Facebook that Tania typed “young people in nursing homes” into Google. The search engine’s results would lead to her life-changing encounter with the YPINH.

“With help from the Aboriginal Disability Network, they advocated to get me out and get the right support equipment at home. Whatever I need, physio, OT – they’ve got my back. I can’t thank them enough for what they’ve done for me.”

Today, Tania is working with the Aboriginal Disability Network, helping Indigenous Australians navigate their way through the National Healthcare System.

It has long been recognised that Aboriginal and Torres Strait Islander people have a life expectancy that is approximately 20 years less than non-Indigenous Australians (Australian Bureau of Statistics). Recent data from the ABS shows that up to 80 per cent of the mortality gap can be attributed to chronic diseases such as heart disease, stroke, diabetes and kidney disease.

For many Aboriginal communities, especially those in remote regions, socio-economic factors play an important role. Kerin O’Dea from Darwin’s Menzies School of Health Research cites unemployment, poor education outcomes and limited access to fresh foods as key factors in her paper, Preventable chronic diseases among Indigenous Australians.

Lifestyle related risks such as smoking, alcohol misuse, stress, poor diet, and inadequate physical activity also need to be addressed, according to the Australian Institute of Health and Welfare .

But the first step, McGowan says, is for indigenous stroke sufferers to recognise the signs of a stroke in themselves and their family members. The NSF recommends the F.A.S.T. test as the most effective way to remember the most common signs of a stroke.

Face: Check their face. Has their mouth drooped?
Arms: Can they lift both arms?
Speech: Is their speech slurred? Do they understand you?
Time: Is critical. If you see any of these signs call 000 straight away.

“If I had known that because I’d lost my vision I had suffered a stroke, I could’ve put two and two together and got help, but I didn’t know anything,” Tania says.

“I was a heavy smoker, but not anymore – no way. Life’s too important. I didn’t ever know anything about a stroke – I was more thinking when you smoke, you can have lung problems and lose your fingers, like on the packets. But they don’t say anything about a stroke – they don’t advertise that stuff.”

The Stroke Foundation has called on the Federal Government to fund an urgent $44 million campaign to address the gap in stroke care. For more information on stroke and the campaign, visit strokefoundation.com.au.

Declaration of Interest : Colin Cowell Editor of NACCHO NEWSPAPER is a recent #stokesurvivor , following this advice he was in hospital within 15 minutes avoiding serious damage

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NACCHO NDIS News Alert : Indigenous disability advocates speak about the NDIS

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“A lot of our communities don’t acknowledge the word disability, so getting to the next step of having an assessment for themselves or a child is a huge step, so they’re not accessing services,”

“When you look at our kids in school and our kids in the justice system, these behaviours and this inability to fit in with community impact on their lifestyles, and life looks very different for them.”

We’ve got to have hope, if we don’t have hope we don’t have much of a future, it’s only got to be better for us.”

Robyn Smith is a regional coordinator with National Disability Services

PHOTO :Steve Widders, Liza Geddes and Robyn Smith stand together at the ACT Now 3 conference ABC Coffs Coast, Liz Keen

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Indigenous people from throughout northern New South Wales have come together to discuss accessing disability services .

According to the latest Australian Bureau of Statistics figures, Indigenous Australians are 1.7 times more likely to have a disability, although Indigenous disability workers say, because they are less likely to access health care, the real figures are probably much higher.

This week, Aboriginal disability support services and Aboriginal people with disabilities have been meeting in Coffs Harbour to prepare for the roll-out of the National Disability Insurance Scheme, which will land on the North Coast in July 2017.

The gathering, All Communities Coming Together Now, is a the third in a series of joint Indigenous services events that have brought together 340 people with disabilities and service providers from Kempsey to the Tweed.

One of the event organisers, Liza Geddes, works with Indigenous people with physical and intellectual disabilities, and she said the event was trying to address the fact that the uptake of the NDIS by Indigenous people in the launch sites was low.

A lot of our communities don’t acknowledge the word disability, so getting to the next step of having an assessment for themselves or a child is a huge step.

Ms Geddes said the rates of disability were higher among Indigenous communities because of the trauma from colonisation that has lead to mental illness, drug and alcohol abuse, and in turn disadvantage.

“That disadvantage takes a lifecycle of its own, and is repeated generationally and inter-generationally,” she said.

Robyn Smith is a regional coordinator with National Disability Services and she said, from her personal experience, the Aboriginal community around her was still damaged from stolen generations and other past injustices, and because of that she believed the gap was getting bigger, not smaller.

“From my own personal experience we are a long way from that healing moving forward, we are disjointed and fragmented in a lot of ways, but we do have a long way to go and we need a lot of understanding and a lot of empathy from the broader community as well,” she said.

Ms Geddes hoped the NDIS could help break the ongoing cycle of disadvantage.

“The NDIS could be a service system that supports the community to have control, which might bring some redress to that long-term disadvantage,” she said.

“We’ve got to have hope, if we don’t have hope we don’t have much of a future, it’s only got to be better for us.”

Steve Widders is an Aboriginal man who is legally blind and an advocate and a supporter of new initiatives for people who live with disabilities, and he said the NDIS brought hope.

“I think the NDIS is a great vehicle, not only for the Aboriginal people to put their hands up but more for people with disabilities to stand up, to be counted, and to participate,” he said.

“That’s where a good community comes from, from more people participating.”

Hidden rates of disability

The latest figures from the Australian Bureau of Statistics show that while across all ages, Indigenous people are 1.7 times more likely to have a disability, that is worse for Indigenous children who are 2.5 times more likely to have a disability.

Ms Smith said those statistics were in themselves alarming, but in reality there were probably many more people with a disability in Indigenous communities, because they are not accessing health services and also many disabilities in Indigenous communities were not obvious.

“A lot of our communities don’t acknowledge the word disability, so getting to the next step of having an assessment for themselves or a child is a huge step, so they’re not accessing services,” she said.

“When you look at our kids in school and our kids in the justice system, these behaviours and this inability to fit in with community impact on their lifestyles, and life looks very different for them.”

Mr Widders agreed that many people in Aboriginal communities were living with undiagnosed disability.

The best part of Aboriginal communities and disability is they are all-inclusive, they don’t exclude people as non-Aboriginal communities do for having a disability.

Liza Geddes, disability support worker

“People don’t see themselves as disabled and they aren’t regarded as disabled by their families, they just see it as their responsibility to look after them,” he said.

This care of communities for people with a disability might mean fewer people are accessing healthcare, but people like Liza Geddes say it is also a great strength for the communities.

“The best part of Aboriginal communities and disability is they are all-inclusive, they don’t exclude people as non-Aboriginal communities do for having a disability,” she said.

While Robyn Smith was disappointed by how often she saw discrimination in our society, she also said she believed we could see a change for Indigenous people.

“We’ve got to have hope, if we don’t have hope we don’t have much of a future, it’s only got to be better for us.”