NACCHO #FASDAwarenessDay Aboriginal Health : AMA calls for #FASD to be recognised as a disability

FASD

” FASD has a significant impact on education, criminal justice, and child protection services in Australia, and yet has not been included by the Government on the list of recognised disabilities.

“FASD is associated with a range of birth defects including hyperactivity, lack of focus and poor concentration, delayed development, heart and kidney problems, and below average height and weight development,”

“The average life expectancy of a patient with FASD is just 34 years. FASD is extremely costly to our health, education, and justice systems, yet is potentially preventable.

AMA President, Dr Michael Gannon

FASD 3

“High rates of alcohol consumption have been reported in both the Aboriginal and non-Aboriginal population.

Aboriginal women are more likely than non-Aboriginal women to consume alcohol in pregnancy at harmful levels. Australian research indicates that maternal alcohol use is a significant risk factor for stillbirths, infant mortality and intellectual disability in children, particularly in the Aboriginal population.”

NACCHO Newspaper Report

The AMA is calling for Fetal Alcohol Syndrome Disorder (FASD) to be included on the list of recognised disabilities, so that families can have access to much-needed support services.

Ahead of World Fetal Alcohol Syndrome Disorder (FASD) Awareness Day on 9 September, the AMA today released its new Position Statement on Fetal Alcohol Spectrum Disorder – (FASD) 2016.

FASD is a diagnostic term used to describe the range of permanent, severe neurodevelopmental impairments that may occur as a result of maternal alcohol consumption.

Globally, FASD is thought to be the leading cause of preventable birth defects and intellectual disability. World FASD Awareness Day aims to raise awareness about the dangers of drinking during pregnancy and the plight of individuals and families who struggle with FASD.

“The AMA welcomes the efforts of the Government, particularly the Commonwealth Action Plan, through which the Australian Guide to the Diagnosis of FASD was developed, but more must be done.

“The current Commonwealth Action Plan expires in 2017 and the lack of recognition of FASD on the Department of Social Services disability list leaves families without access to much-needed disability support services.

“The AMA urges the Government to continue to provide support for the important preventive and aftercare work being undertaken, and to include FASD on the list of recognised disabilities.”

Dr Gannon said that no safe level of fetal alcohol exposure to alcohol has been identified.

“The AMA believes that the safest option for women who are pregnant or planning a pregnancy is to completely abstain from alcohol consumption,” Dr Gannon said.

“The message is simple and safe – no alcohol during pregnancy.

“The AMA encourages partners, friends, and loved ones to support pregnant women in their choice not to drink,” Dr Gannon said.

The AMA Position Statement on Fetal Alcohol Spectrum Disorder – (FASD)

2016 is available at https://ama.com.au/position-statement/fetal-alcohol-spectrum-disorder-fasd-2016.

Background

  • We do not currently know the true extent of FASD in the Australian community, largely due to the complexity of the diagnostic process.
  • Data from comparable countries suggests FASD may affect roughly between 2 per cent and 5 per cent of the population.
  • Overseas research suggests that individuals with FASD are 19 times more likely to come into contact with the criminal justice system than their peers.
  • In Canada, this is estimated to cost the Juvenile Justice System $17.5 million CND and the adult custodial system $356.2 million CND annually
  • No safe level of fetal alcohol exposure has been identified.
  • The safest option for women who are pregnant or planning a pregnancy is to completely abstain from alcohol consumption.
  • FASD2                                    More Info www.nofasd.org.au

NACCHO Aboriginal Health 27 key Save a dates like #marmotoz #FASDAwarenessDay and #NACCHOAGM2016

Save

Qand a

Sir Michael Marmot will be on tonight 29 August  QandA talking social determinants

Background

As the generators and implementers of policies that underpin improved population health outcomes (Marmot and Bell, 2012).

NACCHO encourages the Commonwealth to recognise that the social determinants of Aboriginal and Torres Strait Islander peoples and their ensuing health inequities are significantly influenced by broad social factors outside the health system.

NACCHO asserts that the Commonwealth is well positioned to identify those factors and act upon them through policy decisions that improve health – supported by current evidence – in housing, law & justice and mining & resource tax redistribution, for example.

1. Closing dates 15 October for next edition 16 November

NACCHO Aboriginal Health Newspaper

To be distributed at the NACCHO AGM and Members meeting 2016

AGM 2016

Editorial and advertising opportunities

front Page - Copy

Editorial Proposals 15 October 2016
Final Ads artwork 31 October 2016
Publication date 16 November 2016

More Info HERE

2.Celebrate #IndigenousDads Registrations now open

ONLY a few Weeks to go / Limited numbers

Aboriginal Male Health National -NACCHO OCHRE DAY

ochreday

This year NACCHO is pleased to announce the annual NACCHO Ochre Day will be held in Perth during September 2016. This year the activities will be run by the National Aboriginal Community Controlled Health Organisation (NACCHO) in partnership with both the Aboriginal Health Council of Western Australia (AHCWA) and Derbarl Yerrigan Health Service Inc.

Beginning in 2013, Ochre Day is an important NACCHO Aboriginal male health initiative. As Aboriginal males have arguably the worst health outcomes of any population group in Australia.

NACCHO has long recognised the importance of addressing Aboriginal male health as part of Close the Gap by 2030.

  • There is no registration cost to attend the NACCHO Ochre Day (Day One or Two)
  • There is no cost to attend the NACCHO Ochre Day Jaydon Adams Memorial Oration Dinner, (If you wish to bring your Partner to this Dinner then please indicate when you register below)
  • All Delegates will be provided breakfast & lunch on Day One and morning & afternoon tea as well as lunch on Day Two.
  • All Delegates are responsible for paying for and organising your own travel and accommodation.

For further information please contact Mark Saunders;

REGISTRATION / CONTACT PAGE

2. CATSINAM International Indigenous Workforce Meeting

Cat

More info HERE

3. NACCHO Members Conference AGM: Save a date  : 6-8 December 2016  Melbourne Further details

Slide1

 

The NACCHO AGM conference provides a forum for the Aboriginal community controlled health services workforce, bureaucrats, educators, suppliers and consumers to:

  • Present on innovative local economic development solutions to issues that can be applied to address similar issues nationally and across disciplines
  • Have input and influence from the ‘grassroots’ into national and state health policy and service delivery
  • Demonstrate leadership in workforce and service delivery innovation
  • Promote continuing education and professional development activities essential to the Aboriginal community controlled health services in urban, rural and remote Australia
  • Promote Aboriginal health research by professionals who practice in these areas and the presentation of research findings
  • Develop supportive networks
  • Promote good health and well-being through the delivery of health services to and by Indigenous and non-Indigenous people throughout Australia
  • INFO CONTACT REGISTER

FASD                         More info www.nofasd.org.au

5.National Stroke week kits are now available for ACCHO’s

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Registrations are open
National Stroke Week is the Stroke Foundation’s annual awareness campaign taking place from September 12 – 18. Taking part in Stroke Week is a great chance to engage in a fun and educational way with your workplace, friends, sporting or community group.
SPEED SAVES
This Stroke Week we want all Australians to know the signs of stroke and act FAST to get to treatment.
Time has a huge impact on stroke and we need your help to spread this message. A speedy reaction not only influences the treatment available to a person having a stroke but also their recovery. Most treatments for stroke are time sensitive so it is important we Think F.A.S.T. and Act FAST!
Get your Stroke Week kit NOW
Whether you are an office, hospital, community group or support group, there are lots of ways you can be involved in Stroke Week 2016 like:
• Organise an awareness activity
• Fundraise for the Stroke Foundation
• Host a health check
There’s no cost for your Stroke Week kit which includes posters, a campaign booklet and resources as well as social media kit and PR support.
Act FAST and register NOW at: 

6.Call for applications research project

Research

Details here

7.National Conference: Closing the Prison Gap: Building Cultural Resilience

WHEN: 10-11 October 2016

WHERE: Mantra on Salt Beach, Gunnamatta Avenue, Kingscliff, NSW

WHO TO CONTACT: Meg Perkins mperkinsnsw@gmail.com Mobile 0417 614 135

The Closing the Gap: Building Cultural Resilience national conference will look closely at issues around changing the Australian criminal justice system while celebrating grassroots, community-led and unfunded activities being undertaken by First Nations People.

Australia has a long history of over-incarceration of First Nations peoples, beginning with the first Aboriginal Protection Act in Victoria in 1869, and culminating in the abuses at the Don Dale Juvenile Detention Centre in the Northern Territory in 2016.

It is obvious that we need to make changes in the Australian criminal justice system – studies on risk and protective factors have shown that cultural resilience is a major factor involved in protecting new generations from the trauma and disadvantage of the past.

Cultural resilience was first mentioned in the literature by Native American educators who noticed that their students on the reservation succeeded, in spite of poverty and exposure to substance abuse and lateral violence, when they were supported by traditional tribal structures, spirituality and cultural practices.

The theory of cultural resilience suggests that the practice of culture creates a psychological sense of belonging and a positive

8. Biennial National Forum from 29 Nov – 1 Dec 2016 Canberra ACT

IAHA

Indigenous Allied Health Australia (IAHA), a national not for profit, member based Aboriginal and Torres Strait Islander allied health organisation, is holding its biennial National Forum from 29 Nov – 1 Dec 2016 at the Rex Hotel in Canberra.

The 2016 IAHA National Forum will host  a diverse range of interactive Professional Development workshops and the 2016 IAHA National Indigenous Allied Health Awards and Gala Dinner.

The fourth IAHA Health Fusion Team Challenge, a unique event specifically for Aboriginal and Torres Strait Islander health students, will precede the Forum.

Collectively, these events will present unique opportunities to:

  • Contribute to achieving Aboriginal and Torres Strait Islander health equality
  • Be part of creating strengths based solutions
  • Build connections – work together and support each other
  • Enhance professional and personal journeys
  • Celebrate the successes of those contributing to improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples.

All workshop participants will receive a Certificate of Attendance, detailing the duration, aims and learning outcomes of the workshop, which can be included in your Continuous Professional Development (CPD) personal portfolio.

Register HERE

9. NATSIHWA  6th & 7th of October 2016

NATSIHWA-Eventbrite

On the 6th & 7th of October 2016 NATSIHWA is holding the bi-annual National Conference at the Pullman Hotel in Brisbane. The conference is the largest event for Aboriginal and Torres Strait Islander health workers and health practitioners.

The theme for this year’s conference is “my story, my knowledge, our future”

my story – health workers and health practitioners sharing their stories about why they came into this profession, what they do in their professional capacity and what inspires them.

my knowledge – being able to gain new knowledge and passing knowledge onto others by sharing and networking.

our future – using stories and knowledge to shape their future and the future of their communities.

Aboriginal and Torres Strait Islander health workers and health practitioners are our valuable frontline primary health care workers and are a vital part of Australia’s health care profession. This conference will bring together health workers and health practitioners from across the country.

Register now and get the early bird special. Each registration includes a ticket to the awards dinner.

Register Now     Book Accomodation

 10. VACCA Cultural Awareness Training – Book Now!

Looking to deepen your cultural journey?

VACCA’s Training and Development Unit offers a range of programs to external organisations working in the field of child and family welfare, to strengthen relationships with Aboriginal organisations, families and communities.

VACCA delivers cultural awareness training throughout the year for people interested in developing cultural competency.

Registrations are now open for August.

See the flyer for all details and how to register for these sessions.

Microsoft Word - VACCA Training - Cultural Awareness Flyer web.d

All enquiries can be emailed to: trainingevents@vacca.org

 

11. HealthinfoNET Conferences, workshops and events

Upcoming conferences and events.

Conferences, workshops and events

  • 17th International Mental Health Conference – Gold Coast, Qld – Wednesday 10 to Friday 12 August 2016 – this conference will provide a platform for health professionals such as, clinical practitioners, academics, service providers and mental health experts, to discuss mental health issues confronting Australia and New Zealand.
  • 2016 National Stolen Generations Conference – Gold Coast, Qld – Wednesday 24 to Friday 26 August 2016 – this conference aims to provide an educational platform to the wider community and endeavours to assist in a sensitive and culturally appropriate way with healing the spirit, mind and body of Aboriginal and Torres Strait Islander peoples.
  • Working with Children and Young People through Adversity – Parramatta, NSW – Friday 29 August 2016 – this one-day workshop equips participants with a framework for working therapeutically with children and young people who are experiencing personal diversity. The key focus of this workshop is working with children and young people with a diagnosis of serious illness.
  • Quality Assurance for Aboriginal and Torres Strait Islander Medical Services (QAAMS) – The workshop program will include full training for people undertaking competency certification for the first time and competency update for those previously trained. The workshop program will also allow for interactive group sessions, presentations from services and education about diabetes care. Darwin, NT – Wednesday 7 and Thursday 8 September 2016
  • RHD
  • Acute Rheumatic Fever & Rheumatic Heart Disease Education Workshop – The workshop is designed for key health staff involved in the diagnosis and management of people with acute rheumatic fever (ARF) and rheumatic heart disease (RHD) in the NT. Darwin, Northern Territory (NT) – Thursday 20 October and Friday 21 October 2016.
    Workshop – Acute Rheumatic Fever& Rheumatic Heart Disease Education Workshop (16 CME/CPD hours)
    Date: 20-21 October 2016
    Time: 08:00 – 16:30 (each day)
    Location: John Matthews Building (Building 58) Menzies, Royal Darwin Hospital Campus, Darwin
    Course overview: The rheumatic heart disease workshop is designed for key health staff involved in the diagnosis and management of people with acute rheumatic fever (ARF) and rheumatic heart disease (RHD) in the Northern Territory. This workshop will engage participants with a combination of objective driven information sessions, and consolidate that knowledge with a series of targeted clinical and practical case studies.
  • Hurting, helping and healing workshop – This workshop aims to bring attention to the mental health and wellbeing of individuals suffering from ‘at risk’ mental states. Perth, WA – Wednesday 23 November 2016.
  • Mental Health Assessment of Aboriginal Clients – This workshop aims to improve the cultural competencies of participants. The workshop will be delivered across Australia. Please refer to the link for the locations and dates.
  • National Aboriginal Community Controlled Health Organisation member’s conference 2016 – This conference is planned to take place in Melbourne,

The CheckUP Forum
2 September, Brisbane
The health system is on notice – transform or be transformed. The forces for change are driving innovation from within and disruption from outside the system. #health2020 represents a new health economy in which value and outcomes, not volumes, matter and where an engaged, informed health consumer is the major driver of value and activity. Find out more here.

Health Law Seminar: Improving patient outcomes
8 September, Sydney
Book your place now for the FREE Health Law Seminar: Improving Patient Outcomes jointly presented by AHHA, the Australian College of Health Service Management (ACHSM) and Holman Webb. A number of expert speakers will present and discuss health law issues in relation to improving patient outcomes. Find out more here.

Mid North Coast Local Health District Rural Innovation and Research Symposium
15-16 September, Coffs Harbour
The Mid North Coast Local Health District (MNCLHD) Rural Innovation and Research Symposium will showcase how innovation and research is embedded into MNCLHD’s everyday work practices. MNCLHD’s focus is on creating a connected health environment – One Health System For You. The Symposium will showcase innovation, research and programs that support integrated care, communication, connectivity and access to services across the health spectrum. The Early Bird registration special closes at midnight on Sunday 14 August. Find out more here.

Health Planning and Evaluation Course
10-11 October, Brisbane
QUT Health is delivering a new course for individuals seeking to develop skills and knowledge in the planning of health services and the translation of health policy into practice. Delivered over two block periods, each block consisting of two days, this new course has been developed and will be delivered by experts in health planning, policy and evaluation. AHHA members are entitled to a 15% discount on the course fees. Read more.

RACMA – Harm Free Health Care Conference
10-11 October, Brisbane
The theme for the Royal Australasian College of Medial Administrators conference this year is “Harm Free Health Care”. This conference is designed to challenge and debate whether health care can be Harm Free and what practical approaches can be considered. As one of their flagship events, the RACMA Annual Scientific Meeting is expected to attract around 250 delegates to Brisbane who will be a mixture of senior managers, clinical specialists with management roles, researchers, educators, policy makers, and health ministry and health provider executives. This year they have an international keynote speaker, Samuel Shem M.D who is also a renowned author sharing his experience at the conference. Find out more here.

Sidney Sax Medal Dinner
19 October, Brisbane
The Sidney Sax Medal is awarded to an individual who has made an outstanding contribution to the development and improvement of the Australian healthcare system in the field of health services policy, organisation, delivery and research. Join us celebrate the awarding of the 2016 Sidney Sax Medal at a networking dinner following the AHHA AGM. The dinner will also feature Sean Parnell, Health Editor at The Australian as the guest speaker. Find out more here.

Stepped Care Models for Mental Health Workshop
28 October, Sydney
Primary Health Networks have been funded by the Commonwealth to facilitate implementation of stepped care models in  Australian mental health services. Effective implementation will require partnerships, resources, new and redefined models and services. With no clear national guideline or agreement on what stepped care models should look like, and the need for a strong coalition across jurisdictions and providers to drive implementation, PHNs do not have a clear road map. This workshop will bring together key players to understand what has been learned to date in the development and implementation of stepped care models and the way forward to effective implementation in the Australian health care system. Find out more here.

Connect with NACCHO

Improving NACCHO communications to members and stakeholders

To reduce the number of NACCHO Communiques we now  send out on Mondays  an executive summary -Save the date on important events /Conferences/training , members news, awards, funding opportunities :

Register and promote your event , send to

NACCHO Grog Wars : To hell and back — how June Oscar battles to dry out Fitzroy Crossing

June

“Evidence from Indigenous health workers of “sly grogging” and “grog runs” is being used to argue alcohol restrictions should be eased in the Fitzroy Valley, where children suffer among the world’s highest rates of brain damage caused by maternal drinking.

Kids are being left hungry as parents spend all their money buying in alcohol as residents, mostly Centrelink recipients, were paying $150 a carton for beer.

“The ban, which still allows full-strength liquor in hotels, was ­extended to Halls Creek in 2009 amid an outcry over alcohol-­fuelled violence, suicide and fetal alcohol syndrome.

Witness statements  tendered by lawyers for hoteliers in the central Kimberley who are lobbying the West Australian ­Director of Liquor Licensing to ease the grog rules.

From the Australian 24 August full text Story 2 Below

Read previous FASD Articles NACCHO NEWS ALERTS

“After attending 50 funerals in 18 months, including a spate of 22 self-harm deaths over 13 months, many alcohol-related and 13 of them suicides, leaders from the Marninwarntikura Fitzroy Women’s Resource Centre (MFWRC) stepped up to fight for their futures.

Over a coffee, she explains that to stem the horrific effects of family violence, child abuse and suicide, they first had to stem the flow of alcohol. As CEO, Oscar led her corporation’s application to the State Government for alcohol restrictions.

“We had to stand up and say enough is enough,” she says. “Alcohol was destroying our community and it was affecting every aspect of life. It was being consumed to a level where everyone’s quality of life in Fitzroy Crossing was shocking. We had to stand up and fight for our future — our children’s future.

It was an Australian first — never before had alcohol been restricted to an entire community on such a scale. The women’s hardline stance was supported by a core group of men, but it also attracted criticism and fierce opposition. Members of their own families, some local councillors and the liquor companies felt the restrictions were too pervasive and too drastic.”

To hell and back — how June Oscar dried out Fitzroy Crossing

DRAPED in a splash of Kimberley colour, proud Bunuba woman June Oscar takes to the stage with some of WA’s big thinkers.

To her right is Chief Justice Wayne Martin and next to him is Perth-born polio-eradication campaigner Michael Sheldrick, a director of New York-based The Global Poverty Project. The rest of the line-up is impressive too, and Oscar, the only woman on the panel, admits she’s a little starstruck because the man asking the questions is academic, writer and TV host Waleed Aly.

“I’m pinching myself,” she says. “I can’t believe I’m here with you blokes. It’s a privilege, and it’s been so great to meet you Waleed. You’re one of my heroes.”

But Oscar, a social activist and community leader from the Fitzroy Valley in the state’s remote north, more than deserves her spot on the panel. She’s at the Disrupted Festival of Ideas in Northbridge — a gathering of mavericks for change — where Oscar has been invited to speak because for the past decade she’s been a lightning rod for sweeping social change in her home town of Fitzroy Crossing.

In May she was presented with the Desmond Tutu Reconciliation Fellowship Award by former governor-general Quentin Bryce, the same award won by Nobel Peace Prize laureate Aung San Suu Kyi. Her acceptance speech received a standing ovation.

After she steps off the stage, a stream of people waits to give her a hug or warmly grab her hand.

Oscar’s long fight to stamp out the ravages of excessive alcohol consumption in her community in the southern Kimberley has won her a swag of awards and a legion of supporters.

In July 2007 she spearheaded a female-led campaign to restrict the sale of full-strength takeaway alcohol across the Fitzroy Valley.

They are among 29 statements, including 10 by local indigenous people including health workers and child carers, to support claims that “sly grogging” and “grog runs” to other towns have thrived since a ban on the sale of full-strength and mid-strength takeaway alcohol in Fitzroy Crossing in 2007.

“There are some people who still don’t agree with the restrictions, but we had to take a stand,” she says. “Alcohol was playing a big part in the level of domestic violence, and it was tearing families apart.

“We could not tackle educating people about their violent behaviours and their emotional triggers until we had restricted their access to alcohol.”

Within six months, the results of the restrictions were undeniable — alcohol-related injuries in hospital presentations had fallen from 85 per cent down to below 20 per cent and alcohol-fuelled domestic violence incidents also fell by 43 per cent.

Children were going to school more often and doctors at the local hospital were staying for longer than three months to help the community rebuild its health and its future. Police reported that rapes, bashings and street drinking were also on the decline.

For Oscar, the fight was very personal. Among the 13 reported suicides in 2006 — which led to a coronial inquiry in 2008 — was her 39-year-old younger brother. Her grief, and the grief of those around her, pushed her to fight the grog head-on.

And then there was Hudson, the little boy from her extended family who was displaying developmental and intellectual deficits. They suspected it was a result of his mother drinking heavily right throughout her pregnancy.

“Everything I’m engaged in comes from a place of personal experience and lived reality,” Oscar says.

“There’s a really personal story for me in all of these issues, and it’s the same for most of the women in Fitzroy Crossing.”

Fitzroy Crossing where June Oscar decided to take action against the “rivers of grog”.

Hudson, and children like him, had facial irregularities, behavioural issues and learning problems. So the Marninwarntikura women held a bush meeting in 2008 and invited health researchers into the community to investigate.

They set up the Marulu: The Liliwan Project, working with researchers from the George Institute, the University of Sydney and the Telethon Kids Institute to study the incidence and prevalence of foetal alcohol spectrum disorder (FASD).

Initial studies of children aged seven and eight who had been born in 2002 and 2003 revealed Fitzroy Crossing had the highest incidence of the disorder in the country, and probably the world.

“When the women learnt that their drinking was harming their babies, they started to change,” Oscar says. “Now we are seeing more and more women who are pregnant abstaining from drinking. Some are finding it very difficult. It’s an ongoing battle.”

Dr James Fitzpatrick, head of FASD research at the Telethon Kids Institute, says Oscar’s intuition about the problems facing Fitzroy Crossing in 2008 has led to a huge drop in the number of women drinking during pregnancy. The rates fell from 65 per cent in 2010 to 18 per cent in 2015.

“June is incredibly courageous in her approach,” Fitzpatrick says. “After a long moment of community sobriety after the restrictions, she approached us to say they were ready to learn about FASD. She knows what she’s talking about and she’s steadfast in navigating what she often calls ‘a road out of hell’.”

Born in the heart of Bunuba country in the southern Kimberley, Oscar was the second of six children, brought up by her mother and mentor, Mona, now 82, a straight-talking domestic worker.

Her father was a white pastoralist, but three weeks after June was born she and Mona were forced to take refuge at the nearby United Aborigines Mission.

“His wife was not happy that he had fathered another child to an Aboriginal woman, so we were driven to the local police station and taken to the mission, where we stayed until I was three,” she says.

“I met him once when I was 19 and that was it.”

Despite this, she’s in regular contact with nieces and nephews from her four half-siblings on her father’s side.

“I’m a Bunuba woman, but I’m also a woman of European heritage and I have family from both sides,” she says. “I see people, I don’t see colour, or creed or ethnicity and I believe we are all connected.”

Mona later took a job at Leopold Downs Station and when Oscar was seven she was sent to boarding school at the nearby mission. Her family visited once a week and she would return to Leopold Downs to be with Mona during the school holidays.

“I don’t see myself as a member of the Stolen Generation,” she says. “I was never taken away from my mother in that sense, but I have lived through the massive impact it had on our people.”

She was sent to high school in Perth, staying at a hostel near John Forrest High School. It was the first time she heard the terms “boong” and “Abo”.

“I was a capable student, and I think I could have done better if I didn’t have to fight racism and taunts most the time I was there,” she says.

But it wasn’t until Oscar worked with Aboriginal activist and Yawuru man Peter Yu at the Aboriginal Legal Service in Derby that she had her own political awakening.

“I was working as a relief legal secretary and receptionist, typing up affidavits for the solicitors and the courts, when it hit home that what I had seen and experienced growing up was unacceptable and discriminatory,” she recalls.

“I reflected on my own life and understood that I could take action and change things for my whole community. Education and information were crucial.”

She was 29 when then Aboriginal Affairs Minister Robert Tickner rang her to invite her on to the first full board of the Aboriginal and Torres Strait Islander Commission. She even hung up on him the first time.

“I thought it was someone playing a prank — sometimes my mob did things like that, pretending to be someone important,” she says.

One of Oscar’s close allies in her work at Fitzroy Crossing is Emily Carter, another Bunuba leader and Oscar’s deputy at the MFWRC. The pair made a big impression on Kim Anderson, a former high school principal, who moved to Fitzroy Crossing five years ago after meeting them in Melbourne when they came to teach students about the languages of the Kimberley.

Anderson says that hearing of the pair’s efforts in teaching women about the effects of drinking during pregnancy impressed her and their “strong stance” in restricting the flow of alcohol was “phenomenal”.

Anderson has witnessed huge changes in the valley first-hand.

“I first went to Fitzroy Crossing in 2005, before the restrictions, and it was a very sad place,” she says. “When I went back in 2010 and the restrictions had been in place for some time — well, my goodness, what a difference. They never wavered in their decision to ban the sale of takeaway alcohol and that was incredibly courageous.”

Oscar and Carter are still working to promote the 28 surviving languages of the Kimberley region, signing up to a cross-cultural program with Melbourne’s Wesley College.

“Kids from Wesley come and stay with us and our kids visit them,” Oscar says. “It’s a chance for the Wesley students to be exposed to indigenous language and culture and issues.”

In 2009, the story of Fitzroy Crossing made it all the way to a commission on the status of indigenous women and children at the United Nations in New York. Oscar and Carter travelled with Labor MP Tanya Plibersek for the summit.

Their story struck such a chord when Yallijarra, a film about the Fitzroy Crossing and its children, aired, some delegates were in tears.

“Sometimes you have to get out of here to make a difference where it matters,” Oscar says. “I will go wherever I need to if it means that my community can grow and thrive from it.”

In the past two decades, Oscar has collected “many hats”, serving as a local councillor, language specialist and Bunuba Films director. She’s a member of the Lowitja Institute for Health Research and Bush Heritage Australia — and the list goes on. Three

Her quest to tell the stories of the valley have taken her all over the world, and she has lunched with the Queen and had drinks with Academy Award winners.

But Oscar is happiest by the Fitzroy River where the sights and smells of her childhood come flooding back.

“I love being ‘on country’,” she says. “Being down by the river just revives me. I love fishing in the spring with Mona. There’s a cave there, near the Geike Gorge, where we always retreat to. The Australian outback is the best part of the country and a big part of me.

“I suppose it’s true what they say,” she laughs. “You can take the girl out of the country, but you can’t take the country out of the girl.”

years ago she became an Officer of the Order of Australia.

To hell and back — how June Oscar dried out Fitzroy Crossing

Grog runs ‘leaving kids hungry’ in Indigenous communities

The ban, which still allows full-strength liquor in hotels, was ­extended to Halls Creek in 2009 amid an outcry over alcohol-­fuelled violence, suicide and fetal alcohol syndrome.

William Johnston, a night ­patrol worker in Halls Creek, says in the hoteliers’ written submission that “there is no less grog in town since the restrictions, maybe more”. “Every day someone is driving to another town like Kununurra to buy full-strength grog like beer and spirits,” he says.

Catherine Ridley, a registered carer with the Department for Child Protection, says in the submission that “kids are being left hungry” as parents spend all their money buying in alcohol.

One local health worker said in a statement that residents, mostly Centrelink recipients, were paying $150 a carton for beer.

Three businesses — Martin Peirson-Jones’s Kimberley Accommodation that owns the main Halls Creek hotel, the Leedal corporation that owns a Fitzroy Crossing pub and supermarket, and the Halls Creek Store — want permission to sell mid-strength takeaway beer.

They acknowledge in their submission, complied by law firm Dwyer Durack, that crime and alcohol-related hospital admissions in Halls Creek and Fitzroy Crossing have decreased since the ban. “While the situation has improved, an unintended consequence of the liquor restrictions is the thriving black market of full-strength liquor and the regular practice of grog runs,” it states, arguing a relaxation might deter this.

However, Fitzroy Crossing’s Women’s Resource Centre has applied to oppose any change. June Oscar, one of the indigenous women supported by West Australian Police Commissioner Karl O’Callaghan to secure the ban on full-strength takeaway alcohol, said the restrictions needed support and time rather than winding back.

When state coroner Alastair Hope examined the drug and alcohol-related deaths of 22 Aboriginal men and women in the region in 2007, he heard evidence that hungry children, neglected by alcoholic parents, had been sucking the teats of dogs.

JUNE 2

June Oscar, who helped to bring in an alcohol ban at her home of Fitzroy Crossing. Picture: Richard Hatherly

NACCHO Health News Alert : Here’s how to #closethegap on #Indigenous women #smoking during pregnancy

Smoking

” In another study, some health workers did not consider it worthwhile to offer quit advice to Indigenous pregnant women, due to low success rates.

To overcome these barriers, we are developing a webinar intervention with six Aboriginal Community Controlled Health Services on how to manage smoking during pregnancy. The Indigenous Counselling and Nicotine (ICAN) Quit in Pregnancy program will use an ABCD approach:

  • ask/assess smoking
  • brief advice to quit
  • cessation (quit) methods (nicotine replacement therapies, which will be provided at no charge)
  • discuss the psychological and social context of smoking.

D” is crucial to understanding and effectively supporting a pregnant Indigenous smoker to quit. The intervention will be trialled in three to four states. If successful, it can be easily scaled up nation-wide.

Gillian Sandra Gould as published in the Conversation

Almost half of pregnant Indigenous women smoke compared to one in eight in the non-Indigenous population. This means 7,000-9,000 Indigenous Australian babies every year are exposed to smoking in the womb.

Children exposed to tobacco smoke before birth are at increased risk of “glue ear”, which causes hearing loss, learning problems and behavioural problems. They are also at greater risk of asthma and bronchiolitis in childhood, and chronic lung disease in adulthood.

Children born to mothers who smoke are more likely to become smokers. Some try smoking as young as five years old.

Our research shows women are well aware of the risks of smoking for their babies, and want to do something about it.

We have identified three key areas that need urgent remediation if Indigenous women are to be effectively supported to quit:

  • subsidised access to oral forms of nicotine replacement therapy
  • clinician training to better manage smoking during pregnancy
  • health promotion messages to address the challenges Indigenous women face when quitting.

Access to nicotine replacement therapy

Australian GP guidelines recommend if a woman cannot quit smoking during pregnancy or when breastfeeding, she should be offered oral forms of nicotine replacement therapy (NRT), such as inhalers or lozenges. These are faster-acting than nicotine patches and should be considered the first-line treatment.

Consumers have to pay around A$800 for a 90-day course of an inhaler. Ray Kelly

 

 

Patches are listed on the Pharmaceutical Benefit Scheme (PBS), but oral NRT (inhalers, lozenges, gum and nicotine spray) is not listed or subsidised. These options are expensive when bought in retail outlets. A full, 12-week course costs around A$500 for the nicotine spray or lozenges, and A$800 for the inhaler.

For the past three years, I have lobbied the government and pharmaceutical companies to remediate this. Because patches are already listed, putting oral NRT on the PBS would involve only a minor change to add extra products to the listing.

But while the government may be willing, the pharmaceutical companies are reluctant to repackage these products for prescription use. My investigations reveal pricing is a key factor: the government is unlikely to pay as much for PBS-listed products as pharmaceutical companies expect.

PBS representatives stepped in to do their own negotiations with pharmaceutical companies, but these appear to be gridlocked.

Health professional training

We recently surveyed 378 Australian GPs and obstetricians and found few are confident to prescribe NRT to pregnant women. Of the respondents:

  • 88% said NRT was safer than smoking
  • 66% considered NRT moderately to highly effective
  • 11% always prescribed NRT to a pregnant smoker
  • 63% agreed management would improve if oral NRT was on the PBS
  • 78% agreed further training was required.

In another study, some health workers did not consider it worthwhile to offer quit advice to Indigenous pregnant women, due to low success rates.

To overcome these barriers, we are developing a webinar intervention with six Aboriginal Community Controlled Health Services on how to manage smoking during pregnancy. The Indigenous Counselling and Nicotine (ICAN) Quit in Pregnancy program will use an ABCD approach:

  • ask/assess smoking
  • brief advice to quit
  • cessation (quit) methods (nicotine replacement therapies, which will be provided at no charge)
  • discuss the psychological and social context of smoking.

“D” is crucial to understanding and effectively supporting a pregnant Indigenous smoker to quit. The intervention will be trialled in three to four states. If successful, it can be easily scaled up nation-wide.

New health promotion messages

A wealth of evidence has amassed in the past five years to better inform messages around Indigenous women smoking during pregnancy. It’s time to translate this knowledge into practice.

Many Indigenous women face difficult life circumstances, coupled with social norms of smoking. Health promotion programs and messages must account for these circumstances and focus on key messages. These include:

  • increasing the visibility of harm for babies
  • addressing the importance of quitting rather than just “cutting down” – making quitting seem worth it
  • reassuring that stress will decrease once nicotine withdrawal is controlled
  • offering high-quality support – women need to know they are not alone and can be helped.

Health promotion programs should be delivered to women through targeted print and film media, and during the consultation at primary care services.

Indigenous women must have an opportunity to address their smoking when pregnant. They need to be supported by making essential medications easily available and affordable, building capacity by training health professionals, and getting a broad reach for the right messages to this high-priority group. This way we can start to move forward and close the gap in this area.

NACCHO #HealthElection16 : Labor to boost funding for #FASD, #Stroke and #Indigenous Affairs

FASD

Strengthening the community response

“A Shorten Labor Government will help communities to develop stronger responses to FASD, particularly in remote and isolated communities, where the disorder is having a particularly harsh impact. The fact that certain communities are disproportionately impacted by this disorder cannot be ignored.

Labor will work with communities in places where there is a high risk of FASD to address this in ways appropriate to their local community.

This package will have an impact of $18.2 million over four years “

Tackling Fetal Alcohol Spectrum Disorder    FACT SHEET

Read 7 NACCHO FASD Stories HERE

Fetal Alcohol Spectrum Disorder (FASD) refers to a range of conditions caused by exposure to alcohol while in the womb. Often not apparent until the child reaches school age, the impacts may be physical, developmental and/ or neurobehavioral and are lifelong.

FASD continues to ruin lives and disproportionately affects Aboriginal and Torres Strait Islander people.

We now know it is much more prevalent across the entire community than previously thought. One in five women continue to consume alcohol whilst pregnant yet health professionals are reluctant to ask about alcohol consumption and few are familiar with the clinical features of FASD.[1]

A Shorten Labor Government will implement a plan to tackle FASD, drawing on expert advice and on programs shown to deliver strong results. Labor will also implement a range of measures to improve training for health professionals and management of this harmful disorder.

Specialist support services

A Shorten Labor Government will provide specialist support services to pregnant women with alcohol-related disorders and implement the FASD diagnostic instrument. This will include providing extra support to women to reduce or cease their alcohol consumption and providing advice on the contraception options available to them.

Unfortunately, many treatment programs in Australia have not been designed with women, particularly mothers, in mind. This affects both accessibility of treatment and the types of treatment available. Many fear that they will lose their children if they admit to problems with alcohol.

That is why Labor will provide funding to alcohol and illicit drug treatment services so that they can develop practices and strategies tailored specifically for pregnant women and mothers.

The Kamira Drug and Alcohol Centre located on the Central Coast of New South Wales is the perfect example of a centre that helps pregnant women and mothers with substance misuse problems. Unfortunately, like many treatment services it is over-stretched and has to turn away women even though it has empty beds (due to resourcing issues). As part of this package Labor has committed $2.2 million over four years to Kamira, to ensure it can operate at full capacity and better meet the growing demand for help.

Improving diagnosis

A Shorten Labor Government will establish FASD diagnostic service clinics to conduct research into the best models for delivering care. Labor understands that we need to improve FASD diagnosis rates if we are going to make any headway in reducing the incidence of this disorder.

FASD is a complicated disorder which requires a multi-disciplinary approach with assessments undertaken by different health professionals including psychologists, speech therapists and paediatricians.

In addition to this, breaking the news to someone that their child may be suffering from FASD can be very confronting, particularly since there is so much stigma attached to the disorder.

That is why Labor will support diagnostic teams to target at-risk communities, including rural and remote communities. This will be based on the success of the Lililwan Project in the Fitzroy Valley in Western Australia where children were assessed by a specialist multi‑disciplinary team that made contact with the community.

This model can be adapted to local communities to make sure that it is targeted and culturally appropriate.

Supporting training and awareness

A Shorten Labor Government will boost training for health professionals to increase their awareness of FASD and facilitate the use of the disorder’s diagnostic instrument.

It is no use having a diagnostic instrument if it is not being used effectively. That is why our plan will focus on increasing awareness of FASD and facilitating use of the new instrument that was released earlier this year.

Unfortunately, many health professionals are either unaware of FASD or are not suitably equipped to help patients suffering from the disorder. This must change.

As part of this strategy we will develop a training and implementation plan to make sure that FASD was being detected and treated appropriately everywhere in Australia.

Labor will draw on the experience of work undertaken in the United States, where training programs have been developed to comprehensively train health professionals on FASD.

There is evidence of the effectiveness of providing better training on particular medical problems which are often misunderstood or misdiagnosed. For example, in 2010 the Royal Australian College of General Practitioners administered a program to train providers to deliver psychological skills training for GPs. We need a similar model for FASD, especially since GPs are often the first point of contact for people affected by FASD.

 

FAST_highres

INVESTING IN LOCAL AND NATIONAL INITIATIVES SURVIVING STROKE

Tackling one of Australia’s biggest killers and a leading cause of disability, the Shorten Labor Government will deliver a $16 million boost to stroke awareness and follow up care.

Read 20 NACCHO Stroke Stories

One in six Australians will have a stroke in their lifetime, with Australians suffering more than 50,000 new or recurrent strokes this year alone.

Almost half a million Australians are already living with the effects of a stroke, a figure that is expected to climb to over 700,000 by 2032 and almost one million by 2050. But it doesn’t have to be this way – access to quick treatment and support services can save lives and reduce disability.

A Shorten Labor Government will partner with the Stroke Foundation to increase awareness of the signs of stroke and ensure better supports for stroke survivors, including improving access to treatments and support.

Labor’s investment will raise awareness of the Stroke Foundation’s FAST test.

Thinking FAST and acting FAST is critical. Early treatment could mean the difference between death or severe disability, and is critical in ensuring a good recovery from stroke.

Using the FAST test involves asking these simple questions:

Face             Check their face. Has their mouth drooped?

Arms            Can they lift both arms?

Speech        Is their speech slurred? Do they understand you?

Time            Time is critical. If you see any of these signs, call 000 straight away.

Strokes can occur to anyone of any age at any time, but every Australian has the power to save a life by thinking FAST and acting FAST when they recognise the signs.

Labor’s investment will raise community awareness by forming local partnerships and re-establishing the StrokeSafe Ambassador program.

The number one issue for stroke survivors is improved care. A Shorten Labor Government will invest in the Stroke Foundation’s follow-up and referral service for around 24,000 stroke survivors. This will facilitate their sustainable, long-term recovery.

Leaving hospital after a stroke can be a very frightening and isolating time for survivors, particularly for those who don’t have family support.

Survivors speak of not being able to access information and services and being left to fend for themselves, unaware of the right places to seek help.

The Stroke Foundation’s follow up and referral service will provide comprehensive post-hospital support to stroke patients, their carers and families.

The service will pro-actively contact stroke survivors via a phone call at around six weeks post discharge providing a needs assessment, offering assistance and community service referral. The follow-up service will also provide vital information for families and carers as they help their loved one adjust to life after a stroke.

Labor’s investment in stroke awareness and care is further proof that only Labor believes that all Australians, no matter where they live or how much they earn, are entitled to the best possible health care.

Response from Stroke Foundation

Vital boost for stroke awareness and support

The Stroke Foundation has welcomed today’s announcement by the Australian Labor Party that, if elected, it will deliver a vital $16 million boost to stroke awareness and stroke survivor support.

Shadow Minister for Health Catherine King pledged to partner with the Stroke Foundation in a national FAST campaign to raise awareness of the signs of stroke and to roll-out a follow up and referral service for stroke survivors and their families. Ms King made the announcement at a community event in Box Hill this morning.

Stroke Foundation Chief Executive Officer Sharon McGowan said the funding would improve outcomes for the one in six Australians that will suffer a stroke in their lifetime.

“Currently stroke kills more women than breast cancer, more men than prostate cancer, and it is a leading cause of acquired disability. However, it does not have to be this way, stroke is treatable and it is beatable,’’ Ms McGowan said.

“Thousands are living with the impact of stroke and this funding will go a long way towards improving community awareness and supporting stroke survivors to make their best recovery possible,” she said.

A stroke is always a medical emergency but the average person has an alarming lack of knowledge about it.

“Getting to hospital FAST is critical to recovery from stroke,” Ms McGowan said.

“When a stroke occurs brain cells die at a rate of 1.9 million a minute, time-critical treatments can help stop the damage spreading and in some cases even reverse it.

“We should all know the signs of stroke, they are easy to learn and someday it might save the life someone you love or even your own.”

Building on the national FAST campaign, funding for the Stroke Foundation’s follow up and referral program will ensure thousands of stroke survivors and their families across Australia get the support they need upon discharge from hospital.

“For many stroke survivors and their families there is a void in support once they return home from the hospital. Up to half of stroke survivors currently leave hospital without a plan to support their transition home, limiting their recovery opportunities,’’ Ms McGowan said.

“The program will deliver stroke survivors, their carers and families with the information and support they need to maximise their recovery. It will help survivors to navigate the often confusing and frightening journey of life after stroke by linking them to the support and services they desperately need.

“There are too many stroke survivors who currently get home from hospital, unable to get through daily tasks, with no idea there is support out there to help them. This program will ensure no survivor is left to go it alone.”

Stroke survivor Bill Gasiamis also welcomed today’s announcement saying it had the potential to transform lives.

“For many stroke survivors, dealing with the aftermath of stroke is a daily battle,” he said.

“This funding will transform the lives of thousands of stroke survivors like myself and our families.”

Ms McGowan said the Foundation was now calling for leadership from all political parties to commit to key priorities to improve the state of stroke, outlined in its Tackling a rising tide platform.

“This election presents an enormous opportunity to make a difference. Stroke is not a hopeless cause – it is largely preventable and treatable, there are actions we can take now to tackle it,” she said.

“I welcome today’s commitment and call on all political parties to make stroke an election priority, recognising the devastating impact it has on our community.

“Stroke doesn’t discriminate – it impacts people across all walks of life. It is time we take a cross-party approach and look at how we can tackle stroke together. Together we can fight stroke and win.”

For more information visit http://www.strokefoundation.com.au

Federal election 2016:

Labor to restore funds to indigenous affairs budget

Picture

“Labor would restore funding to the National Congress of Australia’s First Peoples, stripped in the 2014 budget, dismantle the Coalition’s controversial indigenous Advancement Strategy funding arrangement and fund a range of programs focusing particularly on women and children.”

Shayne Neumann

Making the announcement at Congress’s Sydney headquarters this morning, indigenous affairs spokesman Shayne Neumann described last week’s “Redfern Statement” declaration as talking to a “powerful and uncomfortable truth” and said Labor was “up to the challenge” of answering its demands.

These included restoring around $500 million stripped from the indigenous affairs budget in 2014, restoring funding to Congress, hosting a government summit to hear indigenous voices, giving indigenous Australians the lead in policy decisions and opening talks on a treaty.

Congress would get $15 million over three years under a Shorten government, Mr Neumann said, and around 80 per cent of the $500 million would be returned across a range of programs including early education services, family violence prevention and school attendance programs.

On treaty, he said: “We have never ruled out a treaty or treaty arrangements at some stage in the future but our priority for the first term of a Shorten Labor government is constitutional

recognition. We want to put that to the Australian public, we’re hopeful that we’ll get support from the Australian public, it would be historic, it is really important that we do this.”

Mr Neumann said a Labor government would convene a summit within 100 days “to work with indigenous people to develop priorities”.

Congress co-chair Jackie Huggins said the funding announcements were welcome as they focused in large part on “the most vulnerable targets in our community … family violence is a scourge that has to be tackled really quickly”.

The next NACCHO #HealthElection16 edition will be out 29 June

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

PHNs-in-scope

Current Commonwealth programs migrating to PHN’s

Indigenous ?

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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NACCHO Aboriginal #HealthElection16 #alcpoll2016 : Annual alcohol report 2016: Attitudes and behaviours

 

ALCPOLL-2016-SOCIAL-18

““In Australia, alcohol is responsible for 15 deaths and 430 hospitalisations every day. The poll tells us that almost three in ten Australians have been affected by alcohol-related violence I think it is very clear that we still have a long way to go with changing Australia’s toxic relationship with alcohol that causes more harm than good.

Each year the Foundation for Alcohol Research and Education’s (FARE) national alcohol poll provides valuable trend data and insights into community perspectives on alcohol. Amy Ferguson unpacks the 2017 poll findings, examining what we drink and what we think about alcohol; our awareness of alcohol’s harm, our concerns about the problem, and our support for a range of policy solutions.”

FARE Chief Executive Michael Thorn

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Great expectations: alcohol leaves Aussies disappointed and disillusioned

There’s a big difference between how Australians expect to feel when drinking alcohol and the reality of how they actually feel after their last drinking episode, with the nation’s most comprehensive annual alcohol poll finding there’s less upside and more downside than drinkers imagine.

Now in its seventh year, the Annual alcohol poll 2016: Attitudes and behaviours found the majority of those who drink to get drunk expect to feel happy (56 per cent), and relaxed (54 per cent), with 31 per cent of drinkers expecting to feel a sense of social belonging.

Yet in reality drinkers’ expectations fell well short; with only 28 per cent of drinkers feeling happy after downing alcohol, 31 per cent feeling relaxed and just 15 per cent achieving that sense of belonging.

And when it comes to negative impacts, the difference between expectation and reality is just as pronounced; with 29 per cent of drinkers reporting feeling tired after the last time they were drunk, despite only 13 per cent expecting to feel drowsy. Similarly, 17 per cent were sick (although only five per cent anticipated this), seven per cent felt unattractive (in contrast to four per cent) and 13 per cent felt regret (where only six per cent had predicted that outcome).

Each year the Foundation for Alcohol Research and Education’s (FARE) national alcohol poll provides valuable trend data and insights into community perspectives on alcohol.

In 2016, it found that alcohol is consumed by 78 per cent of Australian adults, with bottled wine continuing to be the beverage of choice (preferred by 33 per cent), ahead of regular strength beer (19 per cent) and spirits (16 per cent). However, not all these people are responsible moderate drinkers, with 37 per cent of Australians admitting they drink alcohol with the specific intent to get drunk.

Conducted by Galaxy Research, the 2016 poll also once again highlighted the nation’s concerns about alcohol; with almost eight in ten Australians indicating that our country has a problem with excess drinking or alcohol abuse (78 per cent), and the majority calling for more to be done to reduce the harm that alcohol causes (78 per cent).

Awareness of the issue and a concern for the level of alcohol use and misuse in the community is reflected in Australians’ support for evidence-based policy measures that would reduce alcohol harms.

More than eight in ten Australians (82 per cent) support measures that would see pubs, clubs and bars close at 3am or earlier, 70 per cent of Australians support a ban on alcohol advertising on television before 8:30pm, and for the first time in the history of the poll, more than half of those surveyed (51 per cent) support increasing the tax on alcohol in order to pay for alcohol-related treatment and prevention initiatives.

FARE Chief Executive Michael Thorn says the alcohol industry is fast finding itself out of step with community attitudes wanting change to Australia’s unhealthy relationship with booze and are ready and willing to embrace the measures which would reduce the harms.

He believes FARE’s Annual alcohol poll contains an important message for policymakers and political leaders, both for jurisdictions that have already embraced effective and evidence-based measures to reduce alcohol harms as well as those states and territories still considering how best to deal with the problem.

“This is the nation’s most comprehensive poll to examine Australians’ attitudes towards alcohol and their drinking behaviours. Each year it consistently delivers three very clear messages: that Australians recognise we have a problem with alcohol in this country, that a clear majority support the evidence-based solutions which will reduce the harms, and that they want governments to embrace meaningful reform,” Mr Thorn said.

2016 was the first year that the poll examines the differences between how Australians presume they’ll feel when consuming alcohol and the reality of how they actually feel, with the findings suggesting that for most drinkers those expectations are not being met.

FARE Director of Policy and Research Caterina Giorgi says while alcohol industry advertising might try hard to suggest that Australians will find happiness, popularity and attractiveness in every bottle, the reality for most Australians is very different.

“When we look at the poll we see that Aussies who drink to get drunk expect to feel happy and relaxed, and tend to downplay the chances of feeling tired, sick or unattractive. They tend to buy into the alcohol industry advertising spin. The reality is very different, with drinkers far more likely to have experienced negative consequences, and far less likely to have felt happy or relaxed,” Ms Giorgi said.

In addition to the emotional toll, Australians are engaging in a range of negative behaviours after knocking a few back; with reports of vomiting (40 per cent), driving a car (19 per cent), and having an argument (19 per cent) under the influence.

A further 29 per cent have been affected by alcohol-related violence, six in every ten Australians regard the city centre to be unsafe on a Saturday night, and 23 per cent of parents say their children have been harmed or put at risk because of someone else’s drinking.

Mr Thorn says the poll provides an important but troubling insight into the extent of alcohol harms in Australia.

“In Australia, alcohol is responsible for 15 deaths and 430 hospitalisations every day. The poll tells us that almost three in ten Australians have been affected by alcohol-related violence I think it is very clear that we still have a long way to go with changing Australia’s toxic relationship with alcohol that causes more harm than good,” Mr Thorn said.

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NACCHO Women’s Health News Alert : Aboriginal women’s lives really do matter

FVPLS

“Lynette was battered, bruised and ultimately destroyed by men’s violence. It was ended by the most obscene disregard for her humanity. The system did not protect her and justice has not been done.

What does it say about us as a nation that it requires an investigative journalist to bring this extreme injustice into the national spotlight before we can expect anything close to an appropriate response?

Tragically, the abuse and violence inflicted on Lynette is not an isolated case. Aboriginal women are at the epicentre of the national family violence crisis.”

Antoinette Braybrook is a Kuku Yalanji woman, the convenor of the National Family Violence Prevention Legal Services Forum and CEO of the Aboriginal Family Violence Prevention & Legal Services Victoria.

Photo above : File image

It shouldn’t require Four Corners to expose the failure of our justice system in dealing with domestic violence towards Aboriginal women. There needs to be urgent investment to tackle this epidemic, writes Antoinette Braybrook in THE DRUM

Australians watching were confronted this week by a tragic reality for too many Aboriginal women.

Four Corners recounted – in horrifying detail – the brutal killing of an Aboriginal woman, the failure of our justice system to respond, and the failure of our community to care.

Lynette was battered, bruised and ultimately destroyed by men’s violence. It was ended by the most obscene disregard for her humanity. The system did not protect her and justice has not been done.

What does it say about us as a nation that it requires an investigative journalist to bring this extreme injustice into the national spotlight before we can expect anything close to an appropriate response?

Tragically, the abuse and violence inflicted on Lynette is not an isolated case. Aboriginal women are at the epicentre of the national family violence crisis.

This reality sadly doesn’t cut through into the national conversation. Stories like Lynette’s are rarely told and justice is a scarcer commodity. The violence perpetrated against Aboriginal women is routinely ignored and our communities’ silence stifles the kind of urgent action that is required.

To protect women like Lynette, our justice system needs to heed the evidence at hand and we need urgent investment in the services for the safety of Aboriginal women – including Aboriginal Family Violence Prevention Legal Services (FVPLS), women’s refugees and housing, counselling and health services.

Instead, like so many frontline services, FVPLSs are not funded to support all the women relying on our service for their safety. This year’s budget includes just a fraction of the funding needed for family violence services across the board – and is expected to leave thousands of Aboriginal women without access to this vital service.

Violence against Aboriginal women and their children is at epidemic levels. If you are an Aboriginal women you are 34 times more likely to be hospitalised and 10 times more likely to be killed by someone who purports to love you.

It is important to note that as with Lynette, the Aboriginal women we work with are hurt by men from many different cultures and backgrounds. Talking about violence against our women is not about pointing the finger at Aboriginal men. This is about addressing men’s violence against women and the system that is failing the women it should be working hardest to support.

By 2021-22 violence against Aboriginal women is estimated to cost the nation an extraordinary $2.2 billion a year. Its moral cost – which sees lives lost and communities destroyed – is unquantifiable.

We must start listening to the voices of Aboriginal women and take strong action to ensure the lives lost and destroyed are not confined to a mere statistical footnote.

Despite these disproportionate statistics, violence against Aboriginal women rarely makes the nation’s media. Two recent cases have also broken this silence and highlighted the failure of the justice system to protect vulnerable women.

Take the case of Ms Dhu, a victim of violence, who at 22 died whilst in police custody for unpaid fines. Or that of Andrea Pickett, who at 39 died at the hands of her husband in front of her young children after police failed to uphold restraining orders.

Sadly, unlike the reporting, these deaths are not isolated. What does it say that these injustices rarely penetrate the national psyche? Can it really be that Aboriginal women’s lives don’t matter?

FVPLSs respond to this crisis by providing essential services for safety of Aboriginal and Torres Strait Islander victims/survivors of family violence. Our wrap around legal and support services would not reach those most in need, or at risk of violence, without our early intervention prevention programs to break the vicious cycle of violence.

Women who come to us do so after being subjected to abuse and violence for many years. Our specialist, culturally safe services ensures women can access the support they need knowing they will not be judged, knowing that we will fight hard for them and their kids in a system that has a history of forced child removal and systematically failing our community. They know that we will use their experiences, without compromising their confidentiality, to call for systemic change.

To address this national crisis we need strong national leadership and huge political will. So far political rhetoric has not been matched with funding commitments needed. And we need to set targets to reduce violence against our women.

To end the unacceptable impact of violence against Aboriginal women, like Lynette, Ms Dhu and Andrea Pickett and the many others we don’t hear about, we need all parties to back up words with investment in services for safety. This includes investment in FVPLSs, Aboriginal and Torres Strait Islander legal services and community legal centres.

As a nation we must draw a line in the sand. We must start listening to the voices of Aboriginal women and take strong action to ensure the lives lost and destroyed are not confined to a mere statistical footnote – out of sight, out of mind.

The NSW Attorney General has asked the Director of Public Prosecutions to review Lynette’s case. This is the least that should happen. Lynette deserves better. All Aboriginal women deserve better because Aboriginal women’s lives really do matter.

If you or someone you know is impacted by sexual assault, domestic or family violence, call 1800RESPECT on 1800 737 7321800 737 732 FREE or visit 1800RESPECT.org.au. In an emergency, call 000.

Learn more about the Aboriginal Family Violence Prevention legal Services across Australia.

Antoinette Braybrook is a Kuku Yalanji woman, the convenor of the National Family Violence Prevention Legal Services Forum and CEO of the Aboriginal Family Violence Prevention & Legal Services Victoria. Follow Antoinette on Twitter @BraybrookA and the National FVPLS Forum

 

NACCHO #healthelection16 : Vulnerable Aboriginal communities must lead their own recovery

Tom 2

“In fact, to those calling for another stolen generation – well, we already have one. Thousands of our children are today involved in child protection services; at a rate eight times higher than non-Indigenous children.

And despite the care and commitment of services and those involved in fostering, there are risks for all children, black or white, involved. This includes “broken placements” and institutionalisation, and increased rates of mental health issues, contact with the criminal justice system, substance use and abuse, and homelessness later in life.

For our children in particular, risks associated with compromising strong Aboriginal identity-formation and the breaking of cultural transmission are well-documented.”

Dr Tom Calma AO and Professor Pat Dudgeon

As originally published in the NACCHO Aboriginal Health Newspaper April

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The recent terrible news that a 10-year-old Aboriginal girl had taken her own life shook many Australians. Yet there would be few Aboriginal families who have not already been affected by the suicide or attempted suicide of their young people. This includes our own extended families and kin.

Our families have suffered the losses of a loved 14-year-old girl and two equally loved young men who were employed and content. All tragic and unexplained losses that have left those grieving feeling hollow and bewildered.

The deaths by suicide of our young people then are not isolated events. The latest statistics show that our 15- 24 year olds are dying by suicide at four times the non-Indigenous rate; and our 1 – 14 year olds at nine times the non-Indigenous rate.

Colonisation still impacts upon us. Our young people and children are not immune from the “deep and persistent disadvantage”, or poverty and social exclusion, that the Productivity Commission reports still characterises about one in 10 Indigenous Australians.

What this means is stressful life events impact on our mental health – be they violence, racism, long term unemployment or poor health. High levels of psychological distress are reported in over one in four of us three times higher than the non-Indigenous rate. Another contributing factor is the use and abuse of drugs and alcohol. Ice is just the latest community and family-destroying scourge.

Trauma, including intergenerational trauma, is also a major issue particularly (but not only) for stolen generations survivors and their descendants. This group report higher rates of mental illness and alcohol and other drug problems than Aboriginal people who weren’t removed from their families, communities and cultures.

This belies the knee jerk response of removing children from families in crisis, rather than working with their families. While removal is necessary in extreme cases, it should always be seen as a last resort. We need to break the intergenerational cycles of despair and dysfunction, not accelerate them.

And removing a child can also exacerbate existing factors, or itself be a suicide risk, and as was reported in the case of the girl who died last week.

What we have then is a concentration of suicide risk factors in many of our communities, with our children and young people in the front line. Yet for some, the response is to close these communities down: put them in the “too hard” basket. But this is lazy policy that will cause as much harm as it might prevent.

So we are all asking: what can be done?

More forced social engineering is not the answer

Aboriginal people have already experienced the trauma of communities being closed down. Historically, peoples with different cultures and languages were forced to live together under the control of missionaries and governments. This is one of the roots of the crises in many communities today.

And where will the people from the closed down communities go? Is it better that they end up homeless in towns that shun them, and live in camps where violence, sexual abuse and alcohol and drug use are just as problematic?

More forced social engineering is the last thing the members of these communities need. People advocating community closures need to ask themselves: what will be the effects be of removing them from sustaining and well being-supporting contact with kin, culture and country? Yes, there are challenges in many communities, but let’s also acknowledge that there are cultural and other strengths that can be built on, and that could be lost in closures.

Stop seeing Indigenous communities as a drain on the public purse

And instead of responding after the event to crisis after crisis, let’s be proactive and preventative in our focus. Let’s think about investing in these communities, rather than seeing them as a drain on the public purse.

In particular, where are the services, including mental health and drug and alcohol services, to meet the needs of these communities? As the National Mental Health Commission reported in its 2015 review, despite much good work in recent decades, on a needs basis there are still significant mental health and other service gaps. This includes services to support our families and communities in crisis situations, and to support them before they get into such situations.

The National Mental Health Commission recommended to Government that there was a Closing the Gap target for improved Indigenous mental health, and a national target to reduce suicide by 50% in a decade – including a 50% reduction in suicide among Indigenous Australians. Further, that an Indigenous mental health action plan be developed. However, there has been no take-up at this time.

Vulnerable communities must lead their own recovery

There are alternative ways to respond to child suicide in our communities without removing children from families or closing communities down, but it requires resources and placing communities in the driver’s seat.

Most broadly, “upstream” activity to mitigate the impact of disadvantage and the associated suicide risk factors is required. Here vulnerable communities must take the lead in identifying their needs and priorities, be it addressing community safety, unemployment or alcohol and drug use. And yes, it might include whole-of-community responses to preventing child sexual abuse.

Developmental factors and culturally-informed norms are crucial

It might also include building on protective culturally-informed norms (including familial norms) and other cultural reclamation work that has been shown to be protective against youth suicide in indigenous Canadian communities, and that we believe has an important role to play here.

In particular, addressing the developmental factors that can pre-dispose our children and young people to suicide is critical. Protecting them from sexual abuse is important, but sexual abuse is not the only cause of suicide among our children and young people. Among some, impulsiveness and overwrought responses to the end of a relationship have been reported as being enough to lead to suicide.

In fact, a comprehensive response might include addressing healthy cognitive development from conception onwards, providing age and culturally appropriate school programs about relationship issues and how to handle break-ups, and promoting cannabis and other drug use reduction. It should involve strategies to reduce the contact of our young people with the criminal justice system including by addressing boredom and increasing employment opportunities.

Communities themselves are also best placed to develop situational analyses to support more focused universal suicide prevention activity, including by identifying specifically suicidal behaviours and suicide risk factors among their members – and appropriate responses.

Access to the same support as all Australians at risk

Our communities must also have access to the same high quality clinical standards, treatments and support available to all Australians at risk of suicide. Critical in this is access to culturally safe mental health service environments, and culturally competent staff (who are able to work effectively, cross-culturally with us).

We should also have access to cultural healers as needed. Effective transitions from community-based primary mental health settings to specialist treatment and then back again to community primary mental health care settings are also important.

After a suicide, postvention is critical

Because many of our communities are small and close knit, a death by suicide can have a significant destabilising impact and may influence other community members to attempt suicide or self harm. As such, when culturally appropriate and with social support as required, postvention is an important suicide prevention measure in our communities. Programs that respond to suicide, such as the one currently piloted in WA by the Australian Government, are a welcome example of this.

And with many responsibilities for suicide prevention being devolved to the primary health networks, it is critical that these bodies partner with our communities in suicide prevention activity. This is particularly so in relation to the implementation of the National Aboriginal and Torres Strait Islander Suicide Prevention Strategy against which $17.8m has been pledged by the Australian government, and that has been entrusted to them.

Sustainable outcomes in the longer term require empowering and meaningfully engaging with Indigenous families and communities including those in crisis situations.

But this is best done long before they reach the terrible point of losing yet another child to suicide.

If you need help call Lifeline on 131114

Conference info

Registration and accommodation bookings are available at http://www.atsispep.sis.uwa.edu.au/natsispc-2016 

Please contact Chrissie Easton at chrissie.easton@uwa.edu.au if you need assistance to complete the application

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