“ Indigenous infants were still suffering damage to brain growth from the impact on parenting on the colonial frontier with “trans-generational psychic trauma” disabling normal pathways of neurological maturation and effecting the capacity to manage stress.
A back of the envelope extrapolation on the figures of keeping children in detention or out-of-home care was also in the tens of millions,”
Paediatrician and Emeritus Professor at the University of Newcastle, John Boulton
Picture above : The Royal Commission into the Protection and Detention of Children in the Northern Territory was told by several speakers at a public meeting in Darwin that the Department of Families and Children was “broken” and should be shut. Photo: Glenn Campbell Reported by SMH
Next weeks Community Consultations
Eighty per cent of boys at the controversial Don Dale Youth Detention Centre had been sexually abused prior to their incarceration.
This was one of the bewildering claims made at a public meeting in Darwin where speaker after speaker attacked NT governments for cutting funds to child protection and allowing generations of public servants to take Indigenous children away from families reports by SMH Damien Murphy
Many said the Department of Families and Children was “broken” and should be shut.
Most demanded that care of Indigenous children be the sole preserve of kin and were highly critical of favouritism given to white foster families who they claimed were not subjected to the same checks and balances by a public service culture that existed to perpetuate itself.
“You want to know why our kids end up in Don Dale? This is a new generation of stolen children,” a woman who said she had been subjected to undue red tape when applying to take a relative into care.
Stuart Davidson, the first deputy superintendent of Don Dale, said 80 per cent of teenagers under his care at the centre had been sexually abused prior to their incarceration.
“The system just didn’t recognise the trauma it is dealing with. And gradually those charged with looking after the boys started to reflect the lack of care of the management and, ultimately, the politicians.”
Welfare worker Lindsay Ah Mat said political parties courted the black vote when it suited them: “But soon as they get it they piss all over us.”
The meeting on Friday at Darwin’s Marrara Sports Complex was called by the Royal Commission into the Protection and Detention of Children in the Northern Territory as part of its community consultation program. It followed three days of public hearings this week.
The royal commission came in the wake of a July Four Corners program with footage showing teenagers at the Don Dale being tear gassed and one in a spit hood handcuffed to a chair.
One of the whistleblowers behind the Four Corners report, Darwin lawyer John Lawrence, told Fairfax Media the royal commission was on track to succeed where scores of other government inquiries on child protection had failed.
“This royal commission exists due to the failure of those in authority in the Territory to stand up for what is right,” he said.
“We’re all guilty. Lawyers, judges, politicians … We’re supposed to protect society. How did we get to a place where a spit hood is an appropriate way to treat a child? Years of complacency gave way to complicity and now process and budgets have usurped principles and ethics.”
The elite of the NT legal fraternity on Tuesday gathered in the NT Parliament just hours after the royal commission sat for the first time in the neighbouring Supreme Court building. One of the few Indigenous people present, James Parfitt, gave a welcome to country and then the Chief Justice of the Supreme Court of Victoria, Marilyn Warren, delivered an oration honouring Austin Asche, a doyen of the Darwin legal establishment, on the topic of young people offending in which she tip-toed around the royal commission.
Down the road in Mitchell Street, an Irish pub and restaurants Thailicious, Hunaman and Monsoon chased tourist dollars while Indigenous men and women sat on footpaths begging, singing and playing clapsticks, their songs drowned out by Neil Diamond and Dire Straits on sound systems.
Life went on in Darwin as if the royal commission was some unwanted outsider. Local media carried the stories but not prominently. One witness, Lowitja Institute chairwoman, Pat Anderson, suggested to the commission the dearth of local interest was shown by the fact that a crocodile story was on the morning’s NT News front page. A desultory process was staged the first day outside the Supreme Court.
The first three days of hearings saw bureaucrats and health professionals give evidence of the plethora of reports carried out on child protection for NT governments. Many were shelved or not acted upon. Meanwhile, funds to child welfare agencies continued to be cut by the federal governments and the Darwin administration failed to step in.
Commissioners were also told of the role that hearing loss and foetal alcohol spectrum disorder had come to play in the lives of teenagers in detention in the NT.
Paediatrician and Emeritus Professor at the University of Newcastle, John Boulton, cited research he conducted in the Kimberley on foetal alcohol spectrum disorder saying communities were breaking down, especially since the 1980s when women started drinking.
“A back of the envelope extrapolation on the figures of keeping children in detention or out-of-home care was also in the tens of millions,” Professor Boulton said.
He said Indigenous infants were still suffering damage to brain growth from the impact on parenting on the colonial frontier with “trans-generational psychic trauma” disabling normal pathways of neurological maturation and effecting the capacity to manage stress.
Commissioners also heard 94 per cent of Indigenous prisoners suffered impaired hearing and research found six out of 10 boys at the notorious Don Dale Detention Centre had hearing difficulties.
A deaf Indigenous community consultant, Jodie Barney, slammed the use of spit hoods and handcuffs on young offenders shown on Four Corners.
“I have had a few young people who have had a spit hood and they have also been bound. So therefore their form of communication is lost in every sense of the word,” she said.
The commission continues with community consultation meetings next week and will conduct further hearings next month.
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” The profoundly damaging consequences of heavy drinking by pregnant women, malnutrition in early childhood and intergenerational “psychic trauma” are neither properly diagnosed nor treated in Aborigines coming into contact with the law, a royal commission has heard.
The effects of these conditions, which can stunt a child for life, meant affected youngsters were both more likely to become involved in criminal activity and less likely to benefit from punitive forms of rehabilitation.”
” Studies linked FAS-D to a “profound level of social morbidity in terms of violence, engagement in the justice system, depression, suicidal thoughts, suicide, very low chance of meaningful occupation and a very high risk of being in prison as adults requiring mental institution and support with drug addiction”
” Most infants with FASD are irritable, have trouble eating and sleeping, are sensitive to sensory stimulation, and have a strong startle reflex. They may hyperextend their heads or limbs with hypertonia (too much muscle tone) or hypotonia (too little muscle tone) or both. Some infants may have heart defects or suffer anomalies of the ears, eyes, liver, or joints.
Adults with FASD have difficulty maintaining successful independence. They have trouble staying in school, keeping jobs, or sustaining healthy relationships. They require long-term support and some degree of supervision in order to succeed. “
“Many boys caught up in the Northern Territory’s juvenile justice system suffer a “disease of disadvantage” that has crippled almost every aspect of their lives, the Northern Territory’s royal commission into youth detention and protection has heard.
Jody Barney, who works as a deaf indigenous community consultant, told the inquiry she has spoken to several young Aboriginal people with hearing impairments who have had their faces covered by spit hoods and bound behind bars.
Moreover they were perpetuating, meaning the effects could be passed through neurological and genetic means from generation to generation, the Royal Commission into the Protection and Detention of Children in the NT heard today.
The Commission looks likely to probe these effects more deeply, following depressing but insightful evidence given by University of Newcastle professor of pediatrics John Boulton, who clearly captured the commissioners’ interest.
“I think the Foetal Alcohol Spectrum Disorder issue, together with the evidence that we have had this afternoon about deafness, throws such a complexion upon the participation of so many of these children in the criminal justice system, not to mention the child protection system, that we need to look at this carefully,” Commissioner Margaret White said.
“I think it’s fairly original inasmuch as the other many reports that we’ve been exposed to … have not had an opportunity to consider these areas of study.”
Professor Boulton told the Commission there was an urgent need for FAS-D and to be recognised under the National Disability Insurance Scheme. He said estimates in Canada of the lifelong cost of treating the condition reached into the millions of dollars.
“If there are one or two per cent of the total population of whom a fraction are severely affected with FASD, and therefore suffer the huge mental health and other subsequent complications and disabilities with FASD, then we are talking about an enormous burden to the overall Australian community in the tens of millions of dollars,” he said.
Studies linked FAS-D to a “profound level of social morbidity in terms of violence, engagement in the justice system, depression, suicidal thoughts, suicide, very low chance of meaningful occupation and a very high risk of being in prison as adults requiring mental institution and support with drug addiction” Professor Boulton continued.
He likened FAS-D to the thalidomide disaster, heavy metal poisoning or radiation sickness.
Professor Boulton said progress had been made through alcohol restrictions brought about in the Kimberley towns of Halls Creek and Fitzroy Crossing by local women. He said the restrictions had produced a “massive reduction in the amount of violence and of women seeking refuge”, and that there was evidence young children were growing better.
Earlier in the day the Commission was told many Aboriginal youngsters from the remotest areas suffered hearing problems related to ear infections in early life. In one example retold before the Commission, a boy before court had been crash tackled by a guard who thought he was trying to escape, when in fact the boy simply hadn’t heard an instruction.
Deafness holding NT’s indigenous kids back
Many boys caught up in the Northern Territory’s juvenile justice system suffer a “disease of disadvantage” that has crippled almost every aspect of their lives, the Northern Territory’s royal commission into youth detention and protection has heard.
Jody Barney, who works as a deaf indigenous community consultant, told the inquiry she has spoken to several young Aboriginal people with hearing impairments who have had their faces covered by spit hoods and bound behind bars.
“Taking away another sense from a person who already has a limited sense is frightening. And that fear stays forever… long after their sentence,” she said.
Footage of boys being tear gassed, shackled and put in spit hoods at Don Dale Youth Detention Centre was aired on national television in July, sparking the royal commission
Psychologist Damien Howard told the inquiry a chronic housing shortage is creating an “epidemic” of hearing loss in indigenous children that leads to learning difficulties, family breakdown and criminal involvement.
“It’s very much a disease of disadvantage,” Dr Howard told Darwin’s Supreme Court.
Crowded housing overwhelms a child’s capacity to maintain hygiene, allows infections to pass quickly, and increases exposure to cigarette smoke and loud noises, while the poverty limits nutrition.
On average, non-Aboriginal kids experience middle ear disease for three months of their childhood while indigenous children can get fluctuating hearing loss for more than two years.
This can result in a permanent condition, which Dr Howard says is a “smoking gun” leading to over-representation in the criminal justice system.
Make FASD History
Fetal Alcohol Spectrum Disorders (FASD) are 100% preventable. If a woman doesn’t drink alcohol while she is pregnant, her child cannot have FASD.
There is a humanitarian crisis in the Fitzroy Valley region of remote North Western Australia, which has one of the highest Fetal Alcohol Spectrum Disorders (FASD) in the world.
The effects of alcohol on the fetal brain are a common cause of intellectual impairment in developed countries. Problems that may occur in babies exposed to alcohol before birth include low birth weight, distinctive facial features, heart defects, behavioural problems and intellectual disability.
Most infants with FASD are irritable, have trouble eating and sleeping, are sensitive to sensory stimulation, and have a strong startle reflex. They may hyperextend their heads or limbs with hypertonia (too much muscle tone) or hypotonia (too little muscle tone) or both. Some infants may have heart defects or suffer anomalies of the ears, eyes, liver, or joints.
Adults with FASD have difficulty maintaining successful independence. They have trouble staying in school, keeping jobs, or sustaining healthy relationships. They require long-term support and some degree of supervision in order to succeed.
Bright Blue is very proud to partner with Nindilingarri Cultural Health Services to support the development and implementation of a comprehensive, evidence-based prevention and community capacity building programme, which aims to make FASD history.
The outcomes of this programme will work to:
Improve the health, quality of life and social and economic potential for the next generation of Fitzroy Valley children, and thus the fabric of the community itself;
Identify practical strategies that can be implemented elsewhere in Aboriginal and non-Aboriginal communities to reduce and eliminate FASD;
Make WA a leader in FASD prevention;
Decrease costs associated with service provision, productivity, welfare and justice.
Led by Aboriginal community leaders Maureen Carter and June Oscar; and Paediatrician Dr James Fitzpatrick, it is important that the leadership of the Marulustrategy reflects the community ownership of the process.
Bright Blue needs your support to assist in prevention and capacity building, to develop an effective community – level support for women to abstain from drinking during pregnancy and child bearing years, so that all babies born in this community and across Australia have a full potential for a long and productive life.
Become a part of history. Together, let’s make FASD history.
The inquiry led by co-commissioners Margaret White and Mick Gooda continues.
” 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
“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.”
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)
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
2.Celebrate #IndigenousDads Registrations now open
ONLY a few Weeks to go / Limited numbers
Aboriginal Male Health National -NACCHO OCHRE DAY
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;
5.National Stroke week kits are now available for ACCHO’s
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.
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.
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
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.
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.
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.
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
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.
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.
“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.
“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.”
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.”
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.
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 Oscar, who helped to bring in an alcohol ban at her home of Fitzroy Crossing. Picture: Richard Hatherly
” 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:
brief advice to quit
cessation (quit) methods (nicotine replacement therapies, which will be provided at no charge)
“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.
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.
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.
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:
brief advice to quit
cessation (quit) methods (nicotine replacement therapies, which will be provided at no charge)
“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.
“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 “
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.
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.
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.
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.
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.”
“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.”
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
“The mental health sector is in the midst of “a perfect storm” of change, as one speaker put it during the recent VICSERV #TowardsRecoveryconference 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 underwayin response to the National Mental Health Commission’s Review of Mental HealthProgrammes 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.
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.
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.
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.
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?
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
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.
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).
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““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.”
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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