NACCHO Aboriginal #Mentalhealth #SuicidePrevention and #RUOKday : If you ask #RUOK ? What do you do if someone says ‘no’? Plus Sponsorships for 10 #Indigenous young people to take participate #chatsafe campaign

R U OK Day today encouraging all of us to check in with others to see if they’re OK.

But what if someone says “no”? What should you say or do? Should you tell someone else?

What resources can you point to, and what help is available?

Read NACCHO Aboriginal Health articles over the past 6 Years

Mental Health 189 posts 

Suicide Prevention 124 Posts

Here is a guide 

Stop and listen, with curiosity and compassion

We underestimate the power of simply listening to someone else when they’re going through a rough time. You don’t need to be an expert with ten years of study in psychology to be a good listener. Here are some tips:

Listen actively. Pay attention, be present and allow the person time to speak.

Be curious. Ask about the person’s experience using open questions such as

what’s been going on lately?

you don’t seem your usual self, how are you doing/feeling?

Validate their concerns. See the situation from the person’s perspective and try not to dismiss their problems or feelings as unimportant or stupid. You can say things like

I can see you’re going through a tough time

it’s understandable to feel that way given everything you’ve been going through.

There are more examples of good phrases to use here.

Don’t try to fix the problem right now

Often our first instinct is wanting to fix the person’s problems. It hurts to see others in pain, and we can feel awkward or helpless not knowing how to help. But you don’t have to have all of the answers.

Instead of jumping into “fix it” mode right away, accept the conversation may be uncomfortable and allow the person to speak about their difficulties and experiences.

Sometimes it’s not the actual suggestion or practical help that’s most useful but giving the person a chance to talk openly about their struggles. Also, the more we understand the person’s experience, the more likely we are to be able to offer the right type of help.

Encourage them to seek help.

Ask:

how can I help?

is there something I can do for you right now?

Sometimes it’s about keeping them company (making plans to do a pleasant activity together), providing practical support (help minding their kids to give them time out), or linking them in with other health professionals.

Check whether they need urgent help

It’s possible this person is suffering more than you realise: they may be contemplating suicide or self-harm. Asking about suicidal thoughts does not worsen those thoughts, but instead can help ease distress.

It’s OK to ask them if they’re thinking about suicide, but try not to be judgemental (“you’re not thinking of doing anything stupid, are you?”). Listen to their responses without judgement, and let them know you care and you’d like to help.

Read more: How to ask someone you’re worried about if they’re thinking of suicide

There are resources and programs to help you learn how to support suicidal loved ones, and crisis support lines to call:

  • Contact the Social and Emotional team at your nearest ACCHO
  • Lifeline (24-hour crisis telephone counselling) 13 11 14
  • Suicide Callback Service 1300 659 467
  • Mental health crisis lines

If it is an emergency, or the person is at immediate risk of harm to themselves or others, call 000.

Encourage them to seek professional help

We’re fortunate to be living in Australia, with access to high quality mental health care, resources and support services. But it can be overwhelming to know what and where to seek help. You can help by pointing the person in the right direction.

The first place to seek help is the general practitioner (GP). The GP can discuss treatment options (psychological support and/or medication), provide referrals to a mental health professional or arrange access to local support groups. You can help by encouraging your friend to make an appointment with their GP.

There are great evidence-based online courses and self-help programseducational resources and free self-help workbooks that can be accessed at any time.

There are also online tools to check emotional health. These tools help indicate if a person’s stress, anxiety and depression levels are healthy or elevated.

What if they don’t want help?

People with mental health difficulties sometimes take years between first noticing the problem and seeking professional help. Research shows approximately one in three people experiencing mental health problems accesses treatment.

So even if they don’t want help now, your conversation may have started them thinking about getting help. You can try understanding what’s stopping them from seeking help and see if there’s anything you can do to help connect them to a professional. You don’t need to push this, but simply inviting the person to keep the options in mind and offering your ongoing support can be useful in the long run.

Follow up. If appropriate, organise a time to check in with the person again to see how they’re doing after your conversation. You can also let the person know you’re around and they are always welcome to have a chat with you. Knowing someone is there for you can itself be a great source of emotional support.

Read more: Five types of food to increase your psychological well-being

The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences bursary

Orygen, The National Centre of Excellence is seeking expressions of interest (EOI) from all Aboriginal and Torres Strait Islander young people who would like to share their expertise, advice, and ideas and contribute to the development of a suicide prevention social media campaign!

About the #chatsafe campaign

We would like to partner with Aboriginal and Torres Strait Islander young people to co-design a suicide prevention social media campaign specifically for the Aboriginal community. The campaign will focus on educating and empowering young people to support themselves and other young people within their online social networks. Rather than speaking on behalf of Aboriginal communities, we wish to draw on the expertise, cultural identities, and strengths of the community to inform campaign materials.

The co-design workshop will involve a yarning circle, where young people will be given the opportunity to share their experiences and express their needs. The yarning circle will be facilitated by an Aboriginal and Torres Strait Islander person. The workshop will also involve working together, in groups, to generate ideas for a social media campaign (e.g., digital storytelling, drawing, etc.).

The workshop will be hosted in Perth, as a part of the The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences. The workshop will be conducted in the morning and breakfast will be provided. Young people will be reimbursed $30.00 per hour for their time.

Opportunity for financial support

Oyrgen would like to sponsor 10 Aboriginal and Torres Strait Islander young people to take part in our co-design workshop and The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences, hosted from 20 to 23 November, in Perth, by providing a bursary.

SEE CONFERENCE WEBSITE

Eligibility

To be eligible for Orygen’s bursary funding, the applicant must be an Aboriginal and Torres Islander young person, aged between 18 and 25 years. We encourage young people from all geographic regions, across Australia, to apply.

Submitting your application

If you would like to be a part of the co-design workshop, please email your application to Jo at

The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences bursary

Orygen, The National Centre of Excellence is seeking expressions of interest (EOI) from all Aboriginal and Torres Strait Islander young people who would like to share their expertise, advice, and ideas and contribute to the development of a suicide prevention social media campaign!

About the #chatsafe campaign

We would like to partner with Aboriginal and Torres Strait Islander young people to co-design a suicide prevention social media campaign specifically for the Aboriginal community. The campaign will focus on educating and empowering young people to support themselves and other young people within their online social networks. Rather than speaking on behalf of Aboriginal communities, we wish to draw on the expertise, cultural identities, and strengths of the community to inform campaign materials.

The co-design workshop will involve a yarning circle, where young people will be given the opportunity to share their experiences and express their needs. The yarning circle will be facilitated by an Aboriginal and Torres Strait Islander person. The workshop will also involve working together, in groups, to generate ideas for a social media campaign (e.g., digital storytelling, drawing, etc.). The workshop will be hosted in Perth, as a part of the The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences. The workshop will be conducted in the morning and breakfast will be provided. Young people will be reimbursed $30.00 per hour for their time.

Opportunity for financial support

Oyrgen would like to sponsor 10 Aboriginal and Torres Strait Islander young people to take part in our co-design workshop and The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences, hosted from 20 to 23 November, in Perth, by providing a bursary.

Eligibility

To be eligible for Orygen’s bursary funding, the applicant must be an Aboriginal and Torres Islander young person, aged between 18 and 25 years. We encourage young people from all geographic regions, across Australia, to apply.

Submitting your application

If you would like to be a part of the co-design workshop, please email your application to Jo at jo.robinson@orygen.org.au. Submissions can be made on, or before Sunday, 30 September, 2018.

Selection process

In the first week of October, a panel consisting of Oyrgen staff, a Culture is Life representative, Professor Pat Dudgeon from the conference organising committee, Summer May Finlay (a Yorta Yorta woman), and young people will review all written applications and select 10 successful applicants. The selection panel will endeavour to select a diverse range of young people. The 10 successful applicants will be notified by email by mid-October. The success applicants will have until 31 October, 2018 to accept the bursary offered.

Requirements

The successful recipients of the bursaries are required to attend a half-day co-design workshop. Recipients will also be asked to complete and submit a ‘Wellness Plan’, ‘Bank Details Form’, and ‘Consent Form’ prior to participation in the w

. Submissions can be made on, or before Sunday, 30 September, 2018.

Selection process

In the first week of October, a panel consisting of Oyrgen staff, a Culture is Life representative, Professor Pat Dudgeon from the conference organising committee, Summer May Finlay (a Yorta Yorta woman), and young people will review all written applications and select 10 successful applicants. The selection panel will endeavour to select a diverse range of young people. The 10 successful applicants will be notified by email by mid-October. The success applicants will have until 31 October, 2018 to accept the bursary offered.

Requirements

The successful recipients of the bursaries are required to attend a half-day co-design workshop. Recipients will also be asked to complete and submit a ‘Wellness Plan’, ‘Bank Details Form’, and ‘Consent Form’ prior to participation in the w

Anyone seeking support and information about mental health can contact beyondblue on 1300 22 46 36. For information about suicide and crisis support, contact Lifeline on 13 11 14 or the Suicide Callback Service on 1300 659 467

 

NACCHO Aboriginal Health NEWS : @AIHW report : The consumption of #alcohol, #tobacco and other #drugs is a major cause of preventable disease and illness in our communities

The consumption of alcohol, tobacco and other drugs is a major cause of preventable disease and illness in our comminities

There are a wide range of data sources available that contribute to our understanding of alcohol, tobacco and other drug use.

This web report from AIHW is intended to be a general reference for contemporary data on alcohol, tobacco and other drugs in Australia.

SEE Full Report 

This report consolidates the most recently available information regarding the use of tobacco, alcohol, cannabis, meth/amphetamines and other stimulants, the non-medical use of pharmaceutical drugs, illicit opioids (heroin) and new (and emerging) psychoactive substances (NPS).

Key trends in the availability, consumption, harms and treatment are identified and detailed data are presented for vulnerable populations.

These population groups include Aboriginal and Torres Strait Islander people, homeless people, older people, people from culturally and linguistically diverse backgrounds, people identifying as lesbian, gay, bisexual, transgender, intersex or queer (LGBTIQ), people in contact with the criminal justice system, people with mental health conditions, young people and people who inject drugs

Key findings Aboriginal and Torres Strait Islander people 

  • There has been significant declines in the proportion of Aboriginal and Torres Strait Islander people smoking and consume alcohol that exceeds lifetime risk guidelines (consuming more than two standard drinks per day on average).
  • The prevalence of smoking by Indigenous people has declined from 55% in 1994 to 45% in 2014–15.
  • The proportion of Indigenous people that consume alcohol as levels that exceed lifetime risk guidelines has reduced from 19% in 2008 to 15% in 2014–15.
  • In 2011, tobacco use accounted for 12% of the burden of disease for Indigenous Australians. This accounts for 23.3% of the health gap between Indigenous and non-Indigenous Australians.
  • In 2016, more than 1 in 4 (27%) Indigenous Australians used an illicit drug in the last 12 months. This was 1.8 times higher than for non-Indigenous Australians (15.3%).
  • The most commonly used illicit drug by Indigenous Australians is cannabis (16.7%), followed by the non-medical use of pharmaceutical drugs (11.0%).
  • Of clients of alcohol and other drug, treatment services, 15% were Indigenous Australians aged 10 and over, which is an overrepresentation relative to their population size.

Currently there are almost 800,000 Aboriginal or Torres Strait Islander people (see Box ATSI1) living in Australia, accounting for 2.8% of the Australian population [1]. There are substantial differences in measures of health and welfare between Aboriginal or Torres Strait Islander people and non-Indigenous Australians.

Box ATSI1: Aboriginal and Torres Strait Islander people

The terms ‘Aboriginal and Torres Strait Islander people’ is preferred in Australian Institute of Health and Welfare (AIHW) publications when referring to the separate Indigenous peoples of Australia. However, the term ‘Indigenous’ Australians is used interchangeably with ‘Aboriginal and Torres Strait Islander’ in order to assist readability.

The Australian Burden of Disease Study identified that Aboriginal or Torres Strait Islander people experience a burden of disease that is 2.3 times the rate of non-Indigenous Australians [2]. The gap in the disease burden is due to a range of factors including disconnection to culture, traditions and country, social exclusion, discrimination and isolation, trauma, poverty, and lack of adequate access to services [3]. Tobacco, alcohol, and other drugs are key risk factors contributing to the health gap between Indigenous and non-Indigenous Australians [2].

Box ATSI2. Data sources examining tobacco, alcohol and other drug use by Aboriginal and Torres Strait Islander people

There are a number of data sources that provide information about tobacco, alcohol and other drug use by Aboriginal and Torres Strait Islander people.

The National Aboriginal and Torres Strait Islander Social Survey (NATSISS) [4] and the Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) [5] collected by the ABS are designed to obtain a representative sample of Indigenous Australians. In relation specifically to tobacco smoking, the ABS has consolidated data from six large, national, multistage random household surveys to identify trends between 1994 and 2014–15 [6].

The AIHW’s National Drug Strategy Household Survey (NDSHS) uses a self-completion questionnaire to capture information about drug and alcohol use among the general Australian population; however it is not specifically designed to obtain reliable national estimates for Indigenous people. In 2016, 2.4% of the NDSHS (unweighted) sample aged 12 and over (or 568 respondents) identified as being of Aboriginal or Torres Strait Islander origin. The estimates produced by the NDSHS should be interpreted with caution due to the low sample size [7].

There are also other data sources that provide information relevant to Aboriginal and Torres Strait Islander people.

  • Australia’s Burden of Disease study analyses the impact of nearly 200 diseases and injuries in terms of living with illness (non-fatal burden) and premature death (fatal burden). In 2015, a report was released that provides estimates of burden of disease between Indigenous and non-Indigenous Australians [8].
  • The National Perinatal Data Collection covers each birth in Australia and includes information on Indigenous mothers and their babies [6].
  • The Alcohol and Other Drug Treatment Services National Minimum Dataset (AODTS-NMDS) contains information on treatment provided to clients by publicly funded alcohol and other drug services including Indigenous clients [9].
  • The Online Services Report (OSR) contains information on the majority of Australian Government-funded Aboriginal and Torres Strait Islander substance use services [6].

Tobacco smoking

While tobacco smoking is declining in Australia, it remains disproportionately high among Indigenous Australians. Data from the Australian Bureau of Statistics (ABS) has shown:

  • In 1994, the Indigenous Australian survey data showed that 55% of Indigenous Australians aged 18 and over were smokers; 20 years later, in 2014–15, this had declined to 45% (Table S3.4).
  • Over a similar 20-year period, the National Health Survey (NHS) the proportion of non-Indigenous smokers aged 18 and over declined, from 24% in 1995 to 16% in 2014–15 (Table S3.5).
  • There appears to have been no change to the gap in smoking prevalence between the Indigenous Australian adult population and the non-Indigenous Australian adult population from 1994 to 2014–15. Even though the Indigenous Australian smoking rates are declining, the non-Indigenous rate is declining at a similar rate, therefore the gap remained constant [6] (Figure ATSI1).

Most of the decline in smoking occurred in non-remote areas. Over the 20-year period, the proportion of Indigenous Australians aged 18 and over in non-remote areas who were smokers declined from 55% to 42%, while the proportion in remote areas remained relatively stable at between 54% and 56% (Table S3.4).

In 2014–15, Indigenous males were more likely than Indigenous females to be smokers (47% compared with 42%) [1].

Geographic trends

The 2014–15 NATSISS provides estimates of tobacco smoking for Indigenous Australians by jurisdiction. According to the 2014–15 NATSISS, 39% of Indigenous Australians aged 15 and over smoked daily. Those from the Northern Territory (45%) and Western Australia (42%) surpassed this national average, while Indigenous Australians from South Australia (35%) were the least likely to be a current daily smoker [4] (Table S3.3).

Tobacco smoking in pregnancy

Indigenous Australians are at an elevated risk of smoking during pregnancy compared with non-Indigenous Australians. The National Perinatal Data Collection showed that:

  • Indigenous mothers accounted for 19% of mothers who smoked tobacco at any time during pregnancy in 2015, despite accounting for only around 4% of mothers.
  • The age-standardised rate of Indigenous mothers smoking during pregnancy has decreased from 50% in 2009 to 45% in 2015.
  • Almost 1 in 2 (45%) Indigenous mothers reported smoking during pregnancy—compared with 12% of non-Indigenous mothers (age-standardised).
  • The age-standardised rate of Indigenous mothers quitting smoking during pregnancy (14%) is about half that of non-Indigenous mothers (25%) (based on mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy) [10].

Alcohol consumption

Abstinence (non-drinkers)

  • The 2016 NDSHS found that Indigenous Australians aged 14 and over were more likely to abstain from drinking alcohol than non-Indigenous Australians (31% compared with 23%, respectively) and abstinence among Indigenous Australians has been increasing since 2010 when it was 25% [7] (Table S3.1).
  • This pattern is consistent with data from the 2012–13 AATSIHS, where 28% of Indigenous Australians reported abstaining from drinking compared with 18% of non-Indigenous Australians [5].

Lifetime risk

  • The 2014–15 NATSISS found that the proportion of Indigenous Australians aged 15 years and over who exceeded the NHMRC lifetime risk guidelines for alcohol consumption (consuming more than 2 standard drinks per day on average) decreased between 2008 and 2014–15 (19% compared with 15%; non age-standardised proportions). The overall change is largely due to a decline in non-remote areas (19% in 2008 to 14% in 2014–15) [4] (Table S3.6).
  • Comparisons between Indigenous and non-Indigenous Australians are only available using age-standardised data from the 2012–13 AATSIHS and is not comparable to the 2014–15 NATSISS. The findings showed that lifetime risky drinking of Indigenous Australians aged 15 and over was similar to that of non-Indigenous Australians (9.8% compared with 9.7%; age-standardised) [5] (Table S3.7).

Single occasion risk

  • According to the 2014–15 NATSISS, 30% of Indigenous Australians aged 15 and over exceeded the single occasion risk guidelines for alcohol consumption (non age-standardised proportions), which is a decline since 2002 (35%).
  • Comparisons between Indigenous and non-Indigenous Australians are only available using age-standardised data from the 2012–13 AATSIHS and is not comparable to the 2014–15 NATSISS. The 2012–13 AATSIHS reported that 1 in 2 (50%) Indigenous Australians exceed the single occasion risky drinking guidelines (more than 4 standard drinks on a single occasion in past year). This was 1.1 times the rate that non-Indigenous Australians (44%) that exceeded these guidelines [5] (Table S3.7).

Risky alcohol consumption

  • According to the 2016 NDSHS, almost 1 in 5 Indigenous Australians (18.8%) consumed 11 or more standard drinks at least once a month. This was 2.8 times the rate that non-Indigenous Australians (6.8%) consumed this amount of alcohol [7] (Table S3.1).

Geographic trends

Between 2002 and 2014–15 there was a decline in the proportion of Indigenous Australians that resided in New South Wales Victoria, Queensland, South Australia, Western Australia and the Australian Capital Territory that exceeded the lifetime and single occasion risk guidelines (Figure ATSI2). Indigenous Australians residing in Tasmania (36%), the Australian Capital Territory (ACT) (35%), Queensland (33%) and Western Australia (33%) had higher rates of exceeding the single occasion drinking guidelines than the national average [4] (Table S3.8).

Indigenous Australians residing in Western Australia (16%), New South Wales (16%) and Queensland (15%) surpassed the national average for exceeding lifetime risk guidelines [4] (Table S3.9).

Illicit drug use

In the 2014–15 NATSISS, Aboriginal and Torres Strait Islander people aged 15 and over were asked whether they had used illicit substances in the last 12 months, and the types of illicit substances they had used during that period [4]. The data showed that:

  • Almost one-third (30%) of Indigenous Australians aged 15 and over reported having used illicit substances in the last 12 months, up from 22% in 2008.
  • Males were significantly more likely than females to have used illicit substances (34% compared with 27%), as were people in non-remote areas compared with those in remote areas (33% compared with 21%).
  • Cannabis was the most commonly reported illicit drug used by Aboriginal and Torres Strait Islander people in the last 12 months at 19% (25% of males compared with 14% of females).
  • The non-medical use of analgesics and sedatives (such as painkillers, sleeping pills and tranquilisers) was also relatively common (13%), with females (15%) being more likely than males (11%) to have used analgesics and sedatives.
  • One in twenty (5%) Indigenous Australians aged 15 and over reported having used amphetamines or speed in the last 12 months (6% of males compared with 3% of females) [4] (Figure ATSI3).

The 2016 NDSHS data showed that (other than ecstasy and cocaine), Indigenous Australians aged 14 and over recent used of illicit drugs was at a higher rate than non-Indigenous Australians (Table S3.1). Rates of illicit drug use in 2016 for Indigenous Australians aged 14 and older were:

  • Over one in four (27%) used any illicit drug in the last 12 months—1.8 times higher than non-Indigenous Australians (15.3%)
  • One in five (19.4%) used cannabis in the last 12 months—1.9 times higher than non-Indigenous Australians (10.2%)
  • Around one in 10 (10.6%) used a pharmaceutical for non-medical use—2.3 times higher than non-Indigenous Australians (4.6%) [7] (Table S3.1)
  • 3.1% used meth/amphetamines in the last 12 months—2.2 times higher than non-Indigenous Australians (1.4%).

The differences between Indigenous and non-Indigenous Australians were still apparent even after adjusting for differences in age structure (Figure ATSI4). There were no significant changes in illicit use of drugs among Indigenous Australians between 2013 and 2016, however due to the small sample sizes for Indigenous Australians, the estimates of the NDSHS should be interpreted with caution.

Geographic trends

Indigenous Australians aged 15 and over residing in the Northern Territory (22%) were the least likely to report substance use, while those from the Australian Capital Territory (41%) and Victoria (40%) were the most likely to report using substances.

Indigenous Australians from the Northern Territory (22%) and Queensland (29%) were the only jurisdictions below the national average (30%) [4] (Table S3.3).

Health and harms

The health status of Aboriginal and Torres Strait Islander people are considerably lower than for non-Indigenous Australians. For instance:

  • 35.1% of Aboriginal or Torres Strait Islander people compared with 58.3% of non-Indigenous Australia self-assessed their health as ‘excellent’ or ‘very good’ (age-standardised per cent).
  • 32.5% of Indigenous Australians compared with 12.3% of non-Indigenous Australians reported high/very high psychological distress (age-standardised per cent).
  • 71.0% of Aboriginal or Torres Strait Islander people reported having a long-term health condition compared with 55.3% of non-Indigenous Australians (age-standardised per cent) [4] (Table S3.6).

Almost 1 in 2 Indigenous Australians with a mental health condition were a daily smoker (46%) and about 2 in 5 (39%) to have used substances in the last 12 months. This was higher than for Indigenous  Australians with other long-term health conditions (33% and 24%, respectively) or those with no long term health condition (39% and 29% respectively) [4] (Table S3.11).

The Australian Burden of Disease Study provides an indication of the risk factors that contribute to the health gap between Indigenous and non-Indigenous Australians. In 2011, tobacco use accounted for 23.3% of the gap, and alcohol and drug use contributed to 8.1% and 4.1% of the gap, respectively [8] (Table S3.12).

Treatment

Indigenous Australians are also overrepresented in drug and alcohol treatment services. In 2016–17, the Alcohol and Other Drug Treatment Services National Minimum Dataset (AODTS-NMDS) showed that 15% of clients were Indigenous Australians aged 10 and over (Table S3.13). Indigenous Australians (3,313 per 100,000 population) were 7 times more likely to receive AOD treatment services than non-Indigenous Australians (430 per 100,000 population) were. Specifically where:

  • Amphetamines was the principal drug of concern, Indigenous Australians (1,204 per 100,000 population) were 8 times more likely than non-Indigenous Australians (155 per 100,000 population).
  • Heroin was the principal drug of concern Indigenous Australians (911 per 100,000 population) were 7 times more likely than non-Indigenous Australians (123 per 100,000 population) were.
  • Cannabis was the principal drug of concern Indigenous Australians (867 per 100,000 population) were 7 times more likely than non-Indigenous Australians (126 per 100,000 population) were.
  • Alcohol was the principal drug of concern Indigenous Australians (136 per 100,000 population) were 7 times more likely than non-Indigenous Australians (26 per 100,000 population) [9] (Table S3.14).

Dependence on opioid drugs (including codeine, heroin and oxycodone) can be treated with pharmacotherapy therapy using substitute drugs such as methadone or buprenorphine. The National Opioid Pharmacotherapy Statistics Annual Data collection (NOPSAD) provides information on clients receiving opioid pharmacotherapy treatment on a snapshot day each year. For jurisdictions where data was provided, in 2017:

  • Around 1 in 10 clients (9%) were Indigenous, an overrepresentation relative to their population size.
  • Indigenous Australians were almost 3 times as likely (70 clients per 10,000 population) to receive pharmacotherapy treatment as non-Indigenous Australians (26 clients per 10,000 population) [11] (Table S3.15).

Data from the OSR shows that 2015–16, there were 80 organisations around Australia that provided alcohol and other drug treatment services to around 32,700 Aboriginal and Torres Strait Islander clients [6]. The OSR data also shows that:

  • All 80 organisations reported that alcohol was one of the top five common substance-use issue, followed by cannabis (94%) and amphetamines (70%)
  • Treatment episodes were more likely to be to occur in non-residential settings (87%)
  • One third of all treatment episodes were in Very remote areas (32%) and the highest proportion of clients were located in Major cities (35%).

Policy context

The Aboriginal and Torres Strait Islander Health Performance Framework 2017

The Aboriginal and Torres Strait Islander Health Performance Framework 2017 includes a suite of products that give the latest information on how Aboriginal and Torres Strait Islander people in Australia are faring according to a range of 68 performance measures across 3 tiers: Tier 1—health status and outcomes, Tier 2—determinants of health, and Tier 3—health system performance. The measures are based on the Aboriginal and Torres Strait Islander Health Performance Framework and cover data that has been collected on the entire health system, including Indigenous-specific services and programs, and mainstream services [12].

National Aboriginal Torres Strait Islander Peoples Drug Strategy 2014–2019

The National Aboriginal and Torres Strait Islander Peoples’ Drug Strategy 2014–2019 was a sub-strategy of the National Drug Strategy 2010–2015 and remains a sub-strategy under the National Drug Strategy 2017–2025. The overarching goal of this sub-strategy is to improve the health and wellbeing of Aboriginal and Torres Strait Islander people by preventing and reducing the harmful effects of alcohol and other drugs (AOD) on individuals, families and their communities [13].

NACCHO Aboriginal Health #AFL @AlcoholDrugFdn #NRW2018 #WorldNoTobaccoDay : Senator Bridget McKenzie Minister for Sport and Rural Health supports Redtails Pinktails #SayNoMore Drugs, #Smoking and #FamilyViolence #SayYesTo #Education #Employment #Family #Community

 

 ” Over the weekend Senator Bridget McKenzie had a chat pregame to local Central Australia Redtails before they took on Darwin’s TopEnd Storm curtain raiser to AFL Sir Doug Nicholls Indigenous round , a 6 hour broadcast on Channel 7 nationally : The Redtails and PinkTails Right Tracks Program is funded by the Local Drug Action Teams Program ”

See Part 1 Below

Part 2 Say No more to Family Violence all players link up

Part 3 #WorldNoTobaccoDay May 31 launched in the Alice

 ” Tobacco smoking is the largest preventable cause of death and disease in Australia and the Coalition Government is further committing to reduce the burden on communities.

In the lead up World No Tobacco Day on 31 May, today I am pleased to launch the next phase of the Coalition Government’s highly successful campaign Don’t Make Smokes Your Story,”

Watch video launch in the

The Minister for Rural Health, Senator Bridget McKenzie was also is in Alice Springs to launch the next phase of the National Tobacco Campaign and said that smoking related illness devastates individuals, families and the wider community : see Part 3 below

PART 1

Arrernte Males AFL Opening Ceremony

Arrernte women AFL Opening Ceremony

Part 1 The Australian Government and the ADF are excited to welcome an additional 92 Local Drug Action Teams, in to the LDAT program

The Senator with Alcohol and Drug Foundation CEO Dr Erin Lalor and  General Manager of Congress’ Alice Springs Health Services, Tracey Brand in Alice Springs talking about the inspirational Central Australian Local Drug Action Team at Congress and announcing 92 Local Drug Action Teams across Australia building partnerships to prevent and minimise harm of ice alcohol & illicit drugs use by our youth with local action plans

WATCH VIDEO of Launch

The Local Drug Action Team Program supports community organisations to work in partnership to develop and deliver programs that prevent or minimise harm from alcohol and other drugs (AOD).

Local Drug Action Teams work together, and with the community, to identify the issue they want to tackle, and to develop and implement a plan for action.

The Alcohol and Drug Foundation provides practical resources to assist Local Drug Action Teams to deliver evidence-informed projects and activities. The community grants component of the Local Drug Action Team Program may provide funding to support this work.

Each team will receive an initial $10,000 to develop and finalise a Community Action Plan and then to implement approved projects in your community. Grant funding of up to a maximum of $30k in the first year and up to a maximum of $40k in subsequent years is also available to help deliver approved projects in Community Action Plans. LDAT funding is intended to complement existing funding and in kind support from local partners.

LDATs typically apply for grants of between $10k and $15k to support their projects

 

See ADF website for Interactive locations of all sites

The power of community action

Community-based action is powerful in preventing and minimising harm from alcohol and other drugs.

Alcohol and other drugs harms are mediated by a number of factors – those that protect against risk, and those that increase risk. For example, factors that protect against alcohol and other drug harms include social connection, education, safe and secure housing, and a sense of belonging to a community. Factors that increase risks of alcohol and other drug harms include high availability of drugs, low levels of social cohesion, unstable housing, and socioeconomic disadvantage. Most of these factors are found at the community level, and must be targeted at this level for change.

Alcohol and other drugs are a community issue, not just an individual issue.

Community action to prevent alcohol and other drug harms is effective because:

  • the solutions and barriers (protective/risk factors) for addressing alcohol and other drugs harm are community-based
  • it creates change that is responsive to local needs
  • it increases community ownership and leads to more sustainable change

Part 2 Say No more to Family Violence all players link up

Such a powerful message told here in Alice Springs today as the Redtails Football Club, Top End Storm football club, link arms with the Melbourne Football Club, Adelaide Football Club for the NO MORE Campaign AU before the AFL Indigenous Round started.

WEBSITE Link up and say ‘No More’

 

 Watch Channel 7 Coverage of this special statement from all players

Part 3 #WorldNoTobaccoDay May 31 launched in the Alice

Tobacco smoking is the largest preventable cause of death and disease in Australia and the Coalition Government is further committing to reduce the burden on communities.

In the lead up World No Tobacco Day on 31 May, today I am pleased to launch the next phase of the Coalition Government’s highly successful campaign Don’t Make Smokes Your Story,”

Watch the ABC TV Interview HERE

Watch video of launch in the Alice

Successful Tobacco Campaign Continues

Tobacco smoking is the largest preventable cause of death and disease in Australia and the Coalition Government is further committing to reduce the burden on communities.

The Minister for Rural Health, Senator Bridget McKenzie was in Alice Springs to launch the next phase of the National Tobacco Campaign and said that smoking related illness devastates individuals, families and the wider community.

“In the lead up World No Tobacco Day on 31 May, today I am pleased to launch the next phase of the Coalition Government’s highly successful campaign Don’t Make Smokes Your Story,” Minister McKenzie said.

“The latest phase of Don’t Make Smokes Your Story continues to focus on Indigenous Australians aged 18–40 years who smoke and those who have recently quit. The campaign also concentrates on pregnant women and their partners with Quit for You, Quit for Two.

“An evaluation of the first two phases of the campaign revealed they had successfully helped to reduce smoking rates.

“More than half of the Aboriginal and Torres Strait Islander participants who saw the campaign took some action towards quitting smoking — and 8 per cent actually quit.

“These are very promising stats, however, we must continue to support and encourage those Australians who want to quit, but need help.”

The launch of the next phase of the campaign aligns with World No Tobacco Day and this year’s theme is Tobacco and heart disease.

“Cardiovascular disease is one of the leading causes of death in Australia, killing one person every 12 minutes,” Minister McKenzie said.

“There is a clear link between tobacco and heart and other cardiovascular diseases, including stroke — a staggering 45,392 deaths in Australia can be attributed to cardiovascular disease in 20151.

“Latest estimates show that tobacco use and exposure to second-hand tobacco smoke not only costs the lives of loved ones, but it costs the Australian community $31.5 billion in social — including health — and economic costs.”

“The Coalition Government, along with all states and territories, has made significant efforts to reduce tobacco consumption across the board.

“For example, we know that tobacco is the leading cause of preventable disease for Aboriginal and Torres Strait Islander people accounting for more than 12 per cent of the overall burden of illness.

“The Coalition Government has recently invested $183.7 million continuing to boost the Tackling Indigenous Smoking program to cut smoking and save lives.

“This comprehensive program has helped to cut the rates of Aboriginal and Torres Strait Islander people smoking and we want to build on this success.

“The Government’s investment in this program highlights our long-term commitment to Closing the Gap in health inequality.”

The ABS report Aboriginal and Torres Strait Islander People: Smoking Trends, Australia, 1994 to 2014-15, reported a decrease in current (daily and non-daily) smoking rate in those aged 18 years and older from 55 per cent in 1994 to 45 per cent in 2014-15, which shows Indigenous tobacco control is working.

For help to quit smoking, phone the Quitline on 13 7848, visit the Department of Health’s Quitnow website or download the free My Quitbuddy app.

Your doctor or healthcare provider can also help with information and support you may need to quit.

 

NACCHO Aboriginal Health #Alcohol and other Drugs #GAPC2017 Download @AIHW National drug household survey

  ” The Australian Institute of Health and Welfare (AIHW) have released the National drug household survey: detailed findings 2016 report.

The report aims to provide insight into Australians’ use of, and attitudes to, drugs and alcohol in 2016.

A key finding of the report is around mental health and alcohol and other drug (AOD) use. ( see Part 2 below for full details )

Download the full 168 page report

National Drug Strategy Household Survey 2016

Read over 186 NACCHO Alcohol and other Drug articles published over 5 years

This report expands on the key findings from the 2016 National Drug Strategy Household Survey (NDSHS) that were released on 1 June 2017.

It presents more detailed analysis including comparisons between states and territories and for population groups. Unless otherwise specified, the results presented in this report are for those aged 14 or older.

Indigenous Australians

As Indigenous Australians constitute only 2.4 per cent of the 2016 NDSHS (unweighted) sample (or 568 respondents), the results must be interpreted with caution, particularly those for illicit drug use.

Smoking

In 2016, the daily smoking rate among Indigenous Australians was considerably higher than non-Indigenous people but has declined since 2010 and 2013 (decreased from 35% in 2010 to 32% in 2013 and to 27% in 2016) (Figure 8.7). The NDSHS was not designed to detect small differences among the Indigenous population, so even though the smoking rate declined between 2013 and 2016, it was not significant.

The Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) and the National Aboriginal and Torres Strait Islander Social Survey (NATSISS) were specifically designed to represent Indigenous Australians (see Box 8.1 for further information).

After adjusting for differences in age structures, Indigenous people were 2.3 times as likely to smoke daily as non-Indigenous people in 2016 (Table 8.7).

Read over 113 NACCHO Smoking articles published last 5 years

Alcohol

Overall, Indigenous Australians were more likely to abstain from drinking alcohol than non-Indigenous Australians (31% compared with 23%, respectively) and this has been increasing since 2010 (was 25%) (Figure 8.8).

Among those who did drink, a higher proportion of Indigenous Australians drank at risky levels, and placed themselves at harm of an alcoholrelated injury from single drinking occasion, at least monthly (35% compared with 25% for non-Indigenous).

The (rate ratio) gap in drinking rates was even greater when looking at the consumption of 11 or more standard drinks at least monthly. Indigenous Australians were 2.8 times as likely as non-Indigenous Australians to drink 11 or more standard drinks monthly or more often (18.8% compared with 6.8%).

About 1 in 5 (20%) Indigenous Australian exceeded the lifetime risk guidelines in 2016; a slight but non-significant decline from 23% in 2013, and significantly lower than the 32% in 2010. The proportion of non-Indigenous Australians exceeding the lifetime risk guidelines in 2016 was 17.0% and significantly declined from 18.1% in 2013.

Illicit drugs

Other than ecstasy and cocaine, Indigenous Australians aged 14 or older used illicit drugs at a higher rate than the general population (Table 8.6). In 2016, Indigenous Australians were: 1.8 times as likely to use any illicit drug in the last 12 months; 1.9 times as likely to use cannabis; 2.2 times as likely to use meth/amphetamines; and 2.3 times as likely to misuse pharmaceuticals as non-Indigenous people. These differences were still apparent even after adjusting for differences in age structure (Table 8.7). There were no significant changes in illicit use of drugs among Indigenous Australians between 2013 and 2016.

Read over 64 NACCHO Ice drug articles published last 5 years

1 in 8 Australians smoke daily and 6 in 10 have never smoked

  • Smoking rates have been on a long-term downward trend since 1991, but the daily smoking rate did not significantly decline over the most recent 3 year period (was 12.8% in 2013 and 12.2% in 2016).
  • Among current smokers, 3 in 10 (28.5%) tried to quit but did not succeed and about 1 in 3 (31%) do not intend to quit.
  • People living in the lowest socioeconomic areas are more likely to smoke than people living in the highest socioeconomic area but people in the lowest socioeconomic area were the only group to report a significant decline in daily smoking between 2013 and 2016 (from 19.9% to 17.7%).

8 in 10 Australians had consumed at least 1 glass of alcohol in the last 12 months

  • The proportion exceeding the lifetime risk guidelines declined between 2013 and 2016 (from 18.2% to 17.1%); however, the proportion exceeding the single occasion risk guidelines once a month or more remained unchanged at about 1 in 4.
  • Among recent drinkers: 1 in 4 (24%) had been a victim of an alcohol-related incident in 2016; about 1 in 6 (17.4%) put themselves or others at risk of harm while under the influence of alcohol in the last 12 months; and about 1 in 10 (9%) had injured themselves or someone else because of their drinking in their lifetime.
  • Half of recent drinkers had undertaken at least some alcohol moderation behaviour. The main reason chosen was for health reasons.
  • A greater proportion of people living in Remote or very remote areas abstained from alcohol in 2016 than in 2013 (26% compared with 17.5%) and a lower proportion exceeded the lifetime risk guidelines (26% compared with 35%).

About 1 in 8 Australians had used at least 1 illegal substance in the last 12 months and 1 in 20 had misused a pharmaceutical drug

  • In 2016, the most commonly used illegal drugs that were used at least once in the past 12 months were cannabis (10.4%), followed by cocaine (2.5%), ecstasy (2.2%) and meth/amphetamines (1.4%).
  • However, ecstasy and cocaine were used relatively infrequently and when examining the share of Australians using an illegal drug weekly or more often in 2016, meth/amphetamines (which includes ‘ice’) was the second most commonly used illegal drug after cannabis.
  • Most meth/amphetamine users used ‘ice’ as their main form, increasing from 22% of recent meth/amphetamine users in 2010 to 57% in 2016.

Certain groups disproportionately experience drug-related risks

  • Use of illicit drugs in the last 12 months was far more common among people who identified as being homosexual or bisexual; ecstasy and meth/amphetamines use in this group was 5.8 times as high as heterosexual people.
  • People who live in Remote and very remote areas, unemployed people and Indigenous Australians continue to be more likely to smoke daily and use illicit drugs than other population groups.
  • The proportion of people experiencing high or very high levels of psychological distress increased among recent illicit drug users between 2013 and 2016—from 17.5% to 22% but also increased from 8.6% to 9.7% over the same period for the non-illicit drug using population (those who had not used an illicit drug in the past 12 months).
  • Daily smoking, risky alcohol consumption and recent illicit drug use was lowest in the Australian Capital Territory and highest in the Northern Territory.

The majority of Australians support policies aimed at reducing the acceptance and use of drugs, and the harms resulting from drug use

  • There was generally greater support for education and treatment and lower support for law enforcement measures.

‘In 2016, 42% of meth/amphetamine users had a mental illness, up from 29% in 2013, while the rate of mental illness among ecstasy users also rose from 18% to 27%,’ said AIHW spokesperson, Matthew James. ‘Drug use is a complex issue, and it’s difficult to determine to what degree drug use causes mental health problems, and to what degree mental health problems give rise to drug use.’

About 1 in 20 Australians reported misusing pharmaceuticals, with 75% of recent painkiller users reporting misusing an ‘over the counter’ codeine product in the past 12 months. The AIHW will be publishing more detailed data on pharmaceutical misuse later in 2017.

In addition to illicit drugs, the report also provides insights into Australians’ use of alcohol and tobacco, and notes some improvements in risky behaviour (such as driving while under the influence of alcohol), as well as improved smoking rates among people living in lower socioeconomic areas.

Source: Australian Institute of Health and Welfare

 Part 3 Mental illness rising among meth/amphetamine and ecstasy users

Mental illnesses are becoming more common among meth/amphetamine and ecstasy users, according to a report released today by the Australian Institute of Health and Welfare (AIHW).

The report, National Drug Strategy Household Survey: detailed findings 2016, builds on preliminary results released in June, and gives further insight into Australians’ use of, and attitudes to, drugs and alcohol in 2016.

The report shows that among people who had recently (in the last 12 months) used an illicit drug, about 27% had been diagnosed or treated for a mental illness—an increase from 21% in 2013. Rates of mental illness were particularly high—and saw the most significant increases—for meth/amphetamine and ecstasy users.

‘In 2016, 42% of meth/amphetamine users had a mental illness, up from 29% in 2013, while the rate of mental illness among ecstasy users also rose from 18% to 27%,’ said AIHW spokesperson Matthew James.

‘Drug use is a complex issue, and it’s difficult to determine to what degree drug use causes mental health problems, and to what degree mental health problems give rise to drug use’.

Similarly, the report also reveals a complex relationship between employment status and drug use.

‘For example, people who were unemployed were about 3 times as likely to have recently used meth/amphetamines as employed people, and about 2 times as likely to use cannabis or smoke tobacco daily. On the other hand, employed people were more likely to use cocaine than those who were unemployed,’ Mr James said.

Today’s report also shows higher rates of drug use among people who identify as gay, lesbian or bisexual, with the largest differences seen in the use of ecstasy and meth/amphetamines.

‘Homosexual and bisexual people were almost 6 times as likely as heterosexual people to use each of these drugs, and were also about 4 times as likely to use cocaine as heterosexual people, and 3 times more likely to use cannabis or misuse pharmaceutical drugs.’ Mr James said.

Overall, about 1 in 20 Australians reported misusing pharmaceuticals, with 75% of recent painkiller users reporting misusing an ‘over the counter’ codeine product in the past 12 months. The AIHW will be publishing comprehensive data on pharmaceutical misuse later in 2017.

‘Our report also shows that more Australians are in favour of the use of cannabis in clinical trials to treat medical conditions—87% now support its use, up from 75% in 2013. We also found that 85% of people now support legislative changes to permit its use for medical purposes in general, up from 69% in 2013,’ Mr James said.

In addition to illicit drugs, today’s report also provides insights into Australians’ use of alcohol and tobacco, and notes some improvements in risky behaviour (such as driving while under the influence of alcohol), as well as improved smoking rates among people living in lower socioeconomic areas.

The report also contains data for each state and territory in Australia, and shows differences in drug use between the jurisdictions. For example, recent use of meth/amphetamine was highest in Western Australia, but the use of cocaine was highest in New South Wales.

NACCHO Aboriginal Health and #Ice : Counselling , treatment and information : Helping our mob take their lives back from drugs

 

” The AIHW reported that ‘Aboriginal and Torres Strait Islander people were 1.5 times more likely to have recently used meth/amphetamine than non-Indigenous people.

According to a 2012–13 National Australian Aboriginal and Torres Strait Islander Health Survey, 2.7 per cent of Indigenous Australians living in non-remote areas reported the use of speed or amphetamine in the past year.

The committee heard that Australia’s Indigenous communities are at a higher risk of developing problematic crystal methamphetamine use.

Indigenous communities share the same vulnerabilities as other people found in regional and remote communities however, these vulnerabilities are more complex due to other factors such as the ‘disparity in the general health of Aboriginal Australians compared to non-Indigenous Australians’93 and the imprisonment rates of Indigenous people being ’14 times higher than the rate of non-Indigenous population’.

Extract from Parliamentary Joint Committee on Law Enforcement Inquiry into crystal methamphetamine (ice) First Report September 2017 Download 162 page report Ice

Read over 60 NACCHO Ice related articles published over the past 5 years

Download PDF Copy  NACCHO-ICE-V2-FINAL

 ‘ The Turnbull Government is teaming up with key community groups across the country to tackle the scourge of ice at a grass-roots level, with the next 40 Local Drug Action Teams rolling out.”

 Grass roots response to win ice war ( See part 2 below )

The Turnbull Government is today launching the next phase of our National Drugs Campaign to help tackle the use of illicit drugs, particularly ice, among young Australians.

The new television and online campaign illustrates the range of risks associated with drug use and provides information on the range of resources, support and treatment options available.

View here

The $10 million campaign has resources for parents, including the Positive Choices Online Portal, to help them learn about drugs and be able to have important conversations with their kids.

We’re also promoting the new National Alcohol and Other Drug Hotline – 1800 250 015 – which links to existing state and territory alcohol and other drug telephone services that offer free and confidential support, information, counselling and referral.

I’d encourage anyone wanting information to visit the new website at www.drughelp.gov.au.

We’re launching the campaign at St Vincent’s Hospital in Melbourne – where doctors and surgeons are all too familiar with the dangers of drugs. They’ve treated people suffering from drug-induced psychosis and teenagers who have taken MDMA and gone into cardiac arrest.

It takes courage for someone to admit they may have a problem with drugs, and it’s the first step to overcoming it.

The Turnbull Government is offering more help than ever before and has committed more than $685 million over four years to reduce the impact that drug and alcohol misuse has on individuals, families and communities.

This includes the unprecedented $298 million investment over four years through the National Ice Action Strategy.
Drug use in Australia is high and continues to rise. In fact, Australia has one of the highest rates of methamphetamine use in the world.

So we need to increase our efforts against illicit drugs at every level – individuals, families, communities and governments.

And as we approach schoolies season at the end of the year, it’s important that young people and their parents are armed with the facts about drugs. That’s why the new campaign also has a focus on party drugs such as MDMA, “caps”, ecstasy and pills.

The 2016 National Drug Strategy Household Survey found that around 3.1 million Australians (more than 15.6 per cent) had used an illicit drug at least once in the past year. This was slightly higher than in 2013 and reflects a steady increase from 13.4 per cent in 2007.

Methamphetamine or ‘ice’ is a particular problem. Recent data from police, health and emergency services suggests the number of ice users in Australia is now well above 200,000 – with more than 60,000 of these people using it weekly or more often.

And in 2016, around 1.8 million people reported being victims of a drug-related incident.

These are truly shocking statistics and highlight the need to take action.

A 2016 report into the social costs of methamphetamine conducted by the National Drug Research Institute (NDRI) found that the social cost of methamphetamine in Australia was over $5 billion in the year studied (2013-14).

The primary contributors to this cost were: crime, including police and court costs ($3.2 billion); workplace absenteeism ($290 million); child maltreatment ($260 million); and health ($200 million).

For more information about the campaign visit www.drughelp.gov.au

Resources Factsheets and booklets

Here you can find a range of evidence-based information and resources. They will help you to stay informed, communicate effectively and implement strategies to protect yourself or someone you care about from alcohol and drug related harm.

Download from Here

Example of resources How to start the conversation about Drug use

 Part 2 Grass roots response to win ice war

The Turnbull Government is teaming up with key community groups across the country to tackle the scourge of ice at a grass-roots level, with the next 40 Local Drug Action Teams rolling out.

This means there are now 80 teams across the country delivering a targeted local response to help tackle drug use and addiction.

More than 300 partnerships have now been formed between local councils, service providers, schools, police, sporting groups and non-government organisations to bring these teams together to prevent and reduce the harms of drugs.

Each team will receive an initial $10,000 to develop locally-focused drug and alcohol prevention activities, with support from the Alcohol and Drug Foundation.

The Turnbull Government is providing $19.2 million for the program which will establish 220 Local Drug Action Teams over the next three years.

The teams will deliver community-led education and mentoring programs, early intervention and prevention programs, and support for vulnerable people to minimise their risk of alcohol and other drug related harms.

This initiative is part of the Government’s $298 million investment over four years to combat illicit drug and alcohol use through the National Ice Action Strategy.

Australians are proportionally using more methamphetamine, including ice, than almost any other country. Conservative estimates suggest there are more than 200,000 ice users in Australia.

We know a community response to an issue like drug and alcohol misuse is one of the best ways to effectively prevent and reduce the harms caused by drugs.

We must also continue to stop these drugs entering Australia and we have already made significant investments in policing our borders and our streets to combat the supply of ice.

The AFP has seized over 12 tonnes of methamphetamine since January 2013. This included a 903kg haul of ice which was discovered in April this year – Australian largest methamphetamine seizure.

The first 40 Local Drug Action Teams rolled out in April this year and delivered local drug and alcohol forums for parents and students, mentoring and professional training for at-risk young people, school based reduction programs, and promoted the role of local sporting clubs.

Interested community groups can apply for the next application round, which opens in late 2017.

Information can be found on the Alcohol and Drug Foundation website.

 

Aboriginal Health and the @AusLawReform inquiry into the incarceration rate of Aboriginal peoples

 

” The Terms of Reference for this Inquiry ask the ALRC to consider laws and legal frameworks that contribute to the incarceration rate of Aboriginal and Torres Strait Islander peoples and inform decisions to hold or keep Aboriginal and Torres Strait Islander people in custody.

ALRC Home page

Download this 236 page discussion paper

discussion_paper_84_compressed_no_cover

Full Terms of reference part B below

The ALRC was asked to consider a number of factors that decision makers take into account when deciding on a criminal justice response, including community safety, the availability of alternatives to incarceration, the degree of discretion available, and incarceration as a deterrent and as a punishment

The Terms of Reference also direct the ALRC to consider laws that may contribute to the rate of Aboriginal and Torres Strait Islander peoples offending and the rate of incarceration of Aboriginal and Torres Strait Islander women.

Submissions close on 4 September 2017.

Make a submission

Part A Proposals and Questions

1. Structure of the Discussion Paper

1.40     The Discussion Paper is structured in parts. Following the introduction, Part 2 addresses criminal justice pathways. The ALRC has identified three key areas that influence incarceration rates: bail laws and processes, and remand; sentencing laws and legal frameworks including mandatory sentencing, short sentences and Gladue-style reports; and transition pathways from prison, parole and throughcare. These were the focus of stakeholder comments and observations in preliminary consultations.

1.41     Part 3 considers non-violent offending and alcohol regulation. It provides an overview of the detrimental effects of fine debt on Aboriginal and Torres Strait Islander peoples, including the likelihood of imprisonment in some jurisdictions. Fine debt can be tied to driver licence offending, and the ALRC asks how best to minimise licence suspension caused by fine default. Part 3 also looks at ways laws and legal frameworks can operate to decrease alcohol supply so as to minimise alcohol-related offending in Aboriginal and Torres Strait Islander communities.

1.42     Part 4 discusses the incarceration of Aboriginal and Torres Strait Islander women. It contextualises Aboriginal and Torres Strait Islander female offending within experiences of trauma, including isolation; family and sexual violence; and child removal. It outlines how proposals in other chapters may address the incarceration rates of Aboriginal and Torres Strait Islander women, and asks what more can be done.

1.43     Part 5 considers access to justice, and examines ways that state and territory governments and criminal justice systems can better engage with Aboriginal and Torres Strait Islander peoples to prevent offending and to provide better criminal justice responses when offending occurs. The ALRC places collaboration with Aboriginal and Torres Strait Islander organisations at the centre of proposals made in this Part, and suggests accountability measures for state and territory government justice agencies and police. The remoteness of communities, the availability of and access to legal assistance and Aboriginal and Torres Strait Islander interpreters are also discussed. Alternative approaches to crime prevention and criminal justice responses, such as those operating under the banner of ‘justice reinvestment’, are also canvassed.

2. Bail and the Remand Population

Proposal 2–1        The Bail Act 1977 (Vic) has a standalone provision that requires bail authorities to consider any ‘issues that arise due to the person’s Aboriginality’, including cultural background, ties to family and place, and cultural obligations. This consideration is in addition to any other requirements of the Bail Act.

Other state and territory bail legislation should adopt similar provisions.

As with all other bail considerations, the requirement to consider issues that arise due to the person’s Aboriginality would not supersede considerations of community safety.

Proposal 2–2        State and territory governments should work with peak Aboriginal and Torres Strait Islander organisations to identify service gaps and develop the infrastructure required to provide culturally appropriate bail support and diversion options where needed.

3. Sentencing and Aboriginality

Question 3–1        Noting the decision in Bugmy v The Queen [2013] HCA 38, should state and territory governments legislate to expressly require courts to consider the unique systemic and background factors affecting Aboriginal and Torres Strait Islander peoples when sentencing Aboriginal and Torres Strait Islander offenders?

If so, should this be done as a sentencing principle, a sentencing factor, or in some other way?

Question 3–2        Where not currently legislated, should state and territory governments provide for reparation or restoration as a sentencing principle? In what ways, if any, would this make the criminal justice system more responsive to Aboriginal and Torres Strait Islander offenders?

Question 3–3        Do courts sentencing Aboriginal and Torres Strait Islander offenders have sufficient information available about the offender’s background, including cultural and historical factors that relate to the offender and their community?

Question 3–4        In what ways might specialist sentencing reports assist in providing relevant information to the court that would otherwise be unlikely to be submitted?

Question 3–5        How could the preparation of these reports be facilitated? For example, who should prepare them, and how should they be funded?

4. Sentencing Options

Question 4–1        Noting the incarceration rates of Aboriginal and Torres Strait Islander people:

(a)     should Commonwealth, state and territory governments review provisions that impose mandatory or presumptive sentences; and

(b)     which provisions should be prioritised for review?

Question 4–2        Should short sentences of imprisonment be abolished as a sentencing option? Are there any unintended consequences that could result?

Question 4–3        If short sentences of imprisonment were to be abolished, what should be the threshold (eg, three months; six months)?

Question 4–4        Should there be any pre-conditions for such amendments, for example: that non-custodial alternatives to prison be uniformly available throughout states and territories, including in regional and remote areas?

Proposal 4–1        State and territory governments should work with peak Aboriginal and Torres Strait Islander organisations to ensure that community-based sentences are more readily available, particularly in regional and remote areas.

Question 4–5        Beyond increasing availability of existing community-based sentencing options, is legislative reform required to allow judicial officers greater flexibility to tailor sentences?

5. Prison Programs, Parole and Unsupervised Release

Proposal 5–1        Prison programs should be developed and made available to accused people held on remand and people serving short sentences.

Question 5–1        What are the best practice elements of programs that could respond to Aboriginal and Torres Strait Islander peoples held on remand or serving short sentences of imprisonment?

Proposal 5–2        There are few prison programs for female prisoners and these may not address the needs of Aboriginal and Torres Strait Islander female prisoners. State and territory corrective services should develop culturally appropriate programs that are readily available to Aboriginal and Torres Strait Islander female prisoners.

Question 5–2        What are the best practice elements of programs for Aboriginal and Torres Strait Islander female prisoners to address offending behaviour?

Proposal 5–3        A statutory regime of automatic court ordered parole should apply in all states and territories.

Question 5–3        A statutory regime of automatic court ordered parole applies in NSW, Queensland and SA. What are the best practice elements of such schemes?

Proposal 5–4        Parole revocation schemes should be amended to abolish requirements for the time spent on parole to be served again in prison if parole is revoked.

6. Fines and Driver Licences

Proposal 6–1        Fine default should not result in the imprisonment of the defaulter. State and territory governments should abolish provisions in fine enforcement statutes that provide for imprisonment in lieu of unpaid fines.

Question 6–1        Should lower level penalties be introduced, such as suspended infringement notices or written cautions?

Question 6–2        Should monetary penalties received under infringement notices be reduced or limited to a certain amount? If so, how?

Question 6–3        Should the number of infringement notices able to be issued in one transaction be limited?

Question 6–4        Should offensive language remain a criminal offence? If so, in what circumstances?

Question 6–5        Should offensive language provisions be removed from criminal infringement notice schemes, meaning that they must instead be dealt with by the court?

Question 6–6        Should state and territory governments provide alternative penalties to court ordered fines? This could include, for example, suspended fines, day fines, and/or work and development orders.

Proposal 6–2        Work and Development Orders were introduced in NSW in 2009. They enable a person who cannot pay fines due to hardship, illness, addiction, or homelessness to discharge their debt through:

  • work;
  • program attendance;
  • medical treatment;
  • counselling; or
  • education, including driving lessons.

State and territory governments should introduce work and development orders based on this model.

Question 6–7        Should fine default statutory regimes be amended to remove the enforcement measure of driver licence suspension?

Question 6–8        What mechanisms could be introduced to enable people reliant upon driver licences to be protected from suspension caused by fine default? For example, should:

(a)     recovery agencies be given discretion to skip the licence suspension step where the person in default is vulnerable, as in NSW; or

(b)     courts be given discretion regarding the disqualification, and disqualification period, of driver licences where a person was initially suspended due to fine default?

Question 6–9        Is there a need for regional driver permit schemes? If so, how should they operate?

Question 6–10      How could the delivery of driver licence programs to regional and remote Aboriginal and Torres Strait Islander communities be improved?

7. Justice Procedure Offences—Breach of Community-based Sentences

Proposal 7–1        To reduce breaches of community-based sentences by Aboriginal and Torres Strait Islander peoples, state and territory governments should engage with peak Aboriginal and Torres Strait Islander organisations to identify gaps and build the infrastructure required for culturally appropriate community-based sentencing options and support services.

8. Alcohol

Question 8–1        Noting the link between alcohol abuse and offending, how might state and territory governments facilitate Aboriginal and Torres Strait Islander communities, that wish to do so, to:

(a)     develop and implement local liquor accords with liquor retailers and other stakeholders that specifically seek to minimise harm to Aboriginal and Torres Strait Islander communities, for example through such things as minimum pricing, trading hours and range restriction;

(b)     develop plans to prevent the sale of full strength alcohol within their communities, such as the plan implemented within the Fitzroy Crossing community?

Question 8–2        In what ways do banned drinkers registers or alcohol mandatory treatment programs affect alcohol-related offending within Aboriginal and Torres Strait Islander communities? What negative impacts, if any, flow from such programs?

9. Female Offenders

Question 9–1        What reforms to laws and legal frameworks are required to strengthen diversionary options and improve criminal justice processes for Aboriginal and Torres Strait Islander female defendants and offenders?

10. Aboriginal Justice Agreements

Proposal 10–1       Where not currently operating, state and territory governments should work with peak Aboriginal and Torres Strait Islander organisations to renew or develop Aboriginal Justice Agreements.

Question 10–1      Should the Commonwealth Government develop justice targets as part of the review of the Closing the Gap policy? If so, what should these targets encompass?

11. Access to Justice Issues

Proposal 11–1       Where needed, state and territory governments should work with peak Aboriginal and Torres Strait Islander organisations to establish interpreter services within the criminal justice system.

Question 11–1      What reforms to laws and legal frameworks are required to strengthen diversionary options and specialist sentencing courts for Aboriginal and Torres Strait Islander peoples?

Proposal 11–2       Where not already in place, state and territory governments should provide for limiting terms through special hearing processes in place of indefinite detention when a person is found unfit to stand trial.

Question 11–2      In what ways can availability and access to Aboriginal and Torres Strait Islander legal services be increased?

Proposal 11–3       State and territory governments should introduce a statutory custody notification service that places a duty on police to contact the Aboriginal Legal Service, or equivalent service, immediately on detaining an Aboriginal and Torres Strait Islander person.

12. Police Accountability

Question 12–1      How can police work better with Aboriginal and Torres Strait Islander communities to reduce family violence?

Question 12–2      How can police officers entering into a particular Aboriginal or Torres Strait Islander community gain a full understanding of, and be better equipped to respond to, the needs of that community?

Question 12–3      Is there value in police publicly reporting annually on their engagement strategies, programs and outcomes with Aboriginal and Torres Strait Islander communities that are designed to prevent offending behaviours?

Question 12–4      Should police that are undertaking programs aimed at reducing offending behaviours in Aboriginal and Torres Strait Islander communities be required to: document programs; undertake systems and outcomes evaluations; and put succession planning in place to ensure continuity of the programs?

Question 12–5      Should police be encouraged to enter into Reconciliation Action Plans with Reconciliation Australia, where they have not already done so?

Question 12–6      Should police be required to resource and support Aboriginal and Torres Strait Islander employment strategies, where not already in place?

13. Justice Reinvestment

Question 13–1      What laws or legal frameworks, if any, are required to facilitate justice reinvestment initiatives for Aboriginal and Torres Strait Islander peoples?

Part B The Term of reference

ALRC inquiry into the incarceration rate of Aboriginal and Torres Strait Islander peoples

I, Senator the Hon George Brandis QC, Attorney-General of Australia, refer to the Australian Law Reform Commission, an inquiry into the over-representation of Aboriginal and Torres Strait Islander peoples in our prisons.

It is acknowledged that while laws and legal frameworks are an important factor contributing to over‑representation, there are many other social, economic, and historic factors that also contribute. It is also acknowledged that while the rate of imprisonment of Aboriginal and Torres Strait Islander peoples, and their contact with the criminal justice system – both as offenders and as victims – significantly exceeds that of non‑Indigenous Australians, the majority of Aboriginal and Torres Strait Islander people never commit criminal offences.

Scope of the reference

  1. In developing its law reform recommendations, the Australian Law Reform Commission (ALRC) should have regard to:
    1. Laws and legal frameworks including legal institutions and law enforcement (police, courts, legal assistance services and prisons), that contribute to the incarceration rate of Aboriginal and Torres Strait Islander peoples and inform decisions to hold or keep Aboriginal and Torres Strait Islander peoples in custody, specifically in relation to:
      1. the nature of offences resulting in incarceration,
      2. cautioning,
      3. protective custody,
      4. arrest,
      5. remand and bail,
      6. diversion,
      7. sentencing, including mandatory sentencing, and
      8. parole, parole conditions and community reintegration.
    2. Factors that decision-makers take into account when considering (1)(a)(i-viii), including:
      1. community safety,
      2. availability of alternatives to incarceration,
      3. the degree of discretion available to decision-makers,
      4. incarceration as a last resort, and
      5. incarceration as a deterrent and as a punishment.
    3. Laws that may contribute to the rate of Aboriginal and Torres Strait Islander peoples offending and including, for example, laws that regulate the availability of alcohol, driving offences and unpaid fines.
    4. Aboriginal and Torres Strait Islander women and their rate of incarceration.
    5. Differences in the application of laws across states and territories.
    6. Other access to justice issues including the remoteness of communities, the availability of and access to legal assistance and Aboriginal and Torres Strait Islander language and sign interpreters.
  2.  In conducting its Inquiry, the ALRC should have regard to existing data and research[1] in relation to:
    1. best practice laws, legal frameworks that reduce the rate of Aboriginal and Torres Strait Islander incarceration,
    2. pathways of Aboriginal and Torres Strait Islander peoples through the criminal justice system, including most frequent offences, relative rates of bail and diversion and progression from juvenile to adult offending,
    3. alternatives to custody in reducing Aboriginal and Torres Strait Islander incarceration and/or offending, including rehabilitation, therapeutic alternatives and culturally appropriate community led solutions,
    4. the impacts of incarceration on Aboriginal and Torres Strait Islander peoples, including in relation to employment, housing, health, education and families, and
    5. the broader contextual factors contributing to Aboriginal and Torres Strait Islander incarceration including:
      1. the characteristics of the Aboriginal and Torres Strait Islander prison population,
      2. the relationships between Aboriginal and Torres Strait Islander offending and incarceration and inter‑generational trauma, loss of culture, poverty, discrimination, alcohol and drug use, experience of violence, including family violence, child abuse and neglect, contact with child protection and welfare systems, educational access and performance, cognitive and psychological factors, housing circumstances and employment, and
      3. the availability and effectiveness of culturally appropriate programs that intend to reduce Aboriginal; and Torres Strait Islander offending and incarceration.
  3. In undertaking this Inquiry, the ALRC should identify and consider other reports, inquiries and action plans including but not limited to:
    1. the Royal Commission into Aboriginal Deaths in Custody,
    2. the Royal Commission into the Protection and Detention of Children in the Northern Territory (due to report 1 August 2017),
    3. Senate Standing Committee on Finance and Public Administration’s Inquiry into Aboriginal and Torres Strait Islander Experience of Law Enforcement and Justice Services,
    4. Senate Standing Committee on Community Affairs’ inquiry into Indefinite Detention of People with Cognitive and Psychiatric impairment in Australia,
    5. Senate Standing Committee on Indigenous Affairs inquiry into Harmful Use of Alcohol in Aboriginal and Torres Strait Islander Communities,
    6. reports of the Aboriginal and Torres Strait Islander Social Justice Commissioner,
    7. the ALRC’s inquiries into Family violence and Family violence and Commonwealth laws, and​
    8. the National Plan to Reduce Violence against Women and their Children 2010-2022.

The ALRC should also consider the gaps in available data on Aboriginal and Torres Strait Islander incarceration and consider recommendations that might improve data collection.

  1. In conducting its inquiry the ALRC should also have regard to relevant international human rights standards and instruments.

Consultation

  1. In undertaking this inquiry, the ALRC should identify and consult with relevant stakeholders including Aboriginal and Torres Strait Islander peoples and their organisations, state and territory governments, relevant policy and research organisations, law enforcement agencies, legal assistance service providers and the broader legal profession, community service providers and the Australian Human Rights Commission.

Timeframe

  1. The ALRC should provide its report to the Attorney-General by 22 December 2017.

 

NACCHO Aboriginal Health @amapresident says Treat Dependence And Addiction As Chronic Brain Disease

Behavioural addictions – such as pathological gambling, compulsive buying, or being addicted to exercise or the internet – and substance dependence are recognised as chronic diseases of the brain’s reward, motivation, memory, and related circuitry,

Substance abuse is widespread in Australia. Almost one in seven Australians over the age of 14 have used an illicit substance in the past 12 months, and about the same number report drinking 11 or more standard alcoholic drinks in a single session.

Left unaddressed, the broader community impacts include reduced employment and productivity, increased health care costs, reliance on social welfare, increased criminal activity, and higher rates of incarceration.”

AMA President, Dr Michael Gannon pictured above with NACCHO Chair on a recent visit to NT ACCHO Danila Dilba

Read view over 170 Articles last 5 years NACCHO Alcohol and other drugs

Substance dependence and behavioural addictions are chronic brain diseases, and people affected by them should be treated like any other patient with a serious illness, the AMA says.

Releasing the AMA’s Harmful Substance Use, Dependence, and Behavioural Addiction (Addiction) 2017 Position Statement today, AMA President, Dr Michael Gannon, said that dependence and addiction often led to death or disability in patients, yet support and treatment services were severely under-resourced.

Download copy Harmful Substance Use, Dependence and Behavioural Addiction (Addiction) – 2017 – AMA position statement

“Substance use does not inevitably lead to dependence or addiction. A patient’s progression can be influenced by many factors – genetic and biological factors, the age at which the use first started, psychological history, family and peer dynamics, stress, and access to support.

“The costs of untreated dependence and addictions are staggering. Alcohol-related harm alone is estimated to cost $36 billion a year.

“Those affected by dependence and addictions are more likely to have physical and mental health concerns, and their finances, careers, education, and personal relationships can be severely disrupted.

“Left unaddressed, the broader community impacts include reduced employment and productivity, increased health care costs, reliance on social welfare, increased criminal activity, and higher rates of incarceration.

“About one in 10 people in our jails is there because of a drug-related crime.

“Given the consequences of substance dependence and behavioural addictions, the AMA believes it is time for a mature and open discussion about policies and responses that reduce consumption, and that also prevent and reduce the harms associated with drug use and control.

“Services for people with substance dependence and behavioural addiction are severely under-resourced. Being able to access treatment at the right time is vital, yet the demand for services outweighs availability in most instances.

“Waiting for extended periods of time to access treatment can reduce an individual’s motivation to engage in treatment.

“While the Government responded quickly to concerns about crystal methamphetamine use with the National Ice Action Strategy, broader drug policy appears to be a lower priority.

“The recently-released National Drug Strategy 2017-2026 again lists methamphetamine as the highest priority substance for Australia, despite the Strategy noting that only 1.4 per cent of Australians over the age of 14 had ever tried the drug.

“The Strategy also notes that alcohol is associated with 5,000 deaths and more than 150,000 hospitalisations each year, yet the Strategy puts it as a lower priority than ice.

“The updated National Drug Strategy is disappointing. The fact that no additional funding has been allocated to the Strategy to date means that any measures that require funding support are unlikely to occur in the short to medium term.

“The Government must focus on those dependencies and addictions that cause the greatest harm, including alcohol, regardless of whether some substances are more socially acceptable than others.

“General practitioners are a highly trusted source of advice, and they play an important role in the prevention, detection, and management of substance dependence and behavioural addictions. Unfortunately, limited access to suitable treatment can undermine GPs’ efforts in these areas.”

 

NACCHO Research Alert : @NRHAlliance Aboriginal health risk factors #rural and #remote populations

 ” Health risk factors like smoking, excessive drinking, illicit drug use, lack of physical activity, inadequate fruit and vegetable intake and overweight have powerful influences on health, and there are frequently clear inter-regional differences between the prevalence of these.

While it can be argued that there is some degree of personal choice involved in whether individuals have a poor health risk profile, there is clear evidence that external factors such as environment, opportunity, and community culture each have very strong influences.

For example, access to affordable healthy food can often be poor in smaller communities and this, coupled with lower incomes in these areas, adversely affects the quality of peoples’ diets, the prevalence of overweight, and consequently the prevalence of chronic disease.”

From the National Rural Health Alliance Research View HERE

National data pertaining to personal health risk factors typically comes from the ABS National Health Survey and the AIHW National Drug Strategy Household Survey (NDSHS). Some State and Territory Health Departments run their own health surveys (which cannot be aggregated nationally with each other or with the ABS survey because of the different methodologies and definitions used (think different State rail gauges). Consequently data describing aspects of health in regional and especially remote areas can be thin (ie with imprecise estimates in some or all areas).

Example 1

Table 14: Fruit and vegetable consumption, Aboriginal and Torres Strait Islander people 15+ years, 2012-13

Roughly 60% of Aboriginal and Torres Strait Islander Australians 15+ in Major cities and regional/rural areas have inadequate fruit intake, closer to 50% in remote areas (compared with around 50% of all Australians 18+ in major cities and regional/rural areas).

Roughly 95% of Aboriginal and Torres Strait Islander Australians 15+ in Major cities and regional/rural areas have inadequate vegetable intake, perhaps higher (98%) in Very remote areas (compared with around 90%-94% of all Australians 18+ in major cities and regional/rural areas).

Example 2

NACCHO provided graphic

Table 16 Below : Overweight and Obesity, Aboriginal and Torres Strait Islander people 15+ years, 2012-13

Aboriginal and Torres Strait Islander people in rural/regional and Remote areas (29%-33%) were a little more likely to be overweight than those in Major cities (28%), with those in Very Remote areas (26%) least likely to be overweight.

Aboriginal and Torres Strait Islander people in Inner regional areas (41%) were more likely to be obese than those in Major cities (38%), but those in Outer regional (36%) and remote areas (~33%) were less likely to be obese.

Overall, Aboriginal and Torres Strait Islander people in Inner Regional areas were most likely to be overweight/obese (70%), those in Major cities, Outer Regional and Remote areas were less likely to be overweight/obese (~66%), while those in Very Remote areas were the least likely to be overweight/obese (59% )

At the time of writing, the most recent National Health Survey was conducted in 2014-15[1], while the most recent AIHW NDSHS[2] was conducted in 2016, with most recently available results from the 2013 NDSHS. The most recent ABS Australian Aboriginal and Torres Strait Islander Health Survey[3] was conducted in 2012-13.

Some organisations (eg the Public Health Information Development Unit (PHIDU)) have calculated modelled estimates for small areas (eg SLA’s and PHN’s), where the prevalence of some risk factors has been predicted based on the age, sex and socioeconomic profile of the population living there.

Some sites (eg ABS) present risk factor data as crude rates, other sites (eg PHIDU) present risk factor data as age-standardised rates.  The advantage of the age-standardised rates is that the effect of age is largely removed from inter-population comparisons.

For example, older populations (eg those in rural/regional areas) would be expected to have higher average blood pressure than younger (eg Major cities) populations even though the underlying age-specific rates happened to be identical in both populations (because older people tend to have higher blood pressure than younger people).

While crude rates for the older population will be higher, the age-standardised rates in such a comparison would be the same – indicating a higher rate that is entirely explainable by the older age of one of the populations.

Both crude and age standardised rates are useful in understanding the health of rural and remote populations.

 


[1] http://www.abs.gov.au/ausstats/abs@.nsf/mf/4364.0.55.001

[3] http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4727.0.55.0012012-13?OpenDocumentSmoking

Table 1: Smoking status, by remoteness, 2013 and 2014-15

MC

IR

OR/Remote

Percentage

Current daily smoker (18+) (crude) 2014-15 (a)

13.0

16.7

20.9

Current smoker (18+) (Age standardised) 2014-15 (b) (includes daily, weekly, social etc smoking)

14.6

19.0

22.4

MC

IR

OR

Remote+ Very Remote

Current smoker (daily, weekly, or fortnightly) 14+ (crude) 2013 (c)

14.2

17.6

22.6

24.6

Current smoker (daily, weekly, or fortnightly) 14+ (Age standardised) 2013 (d)

14.2

18.6

23.6

24.4

Mean number of cigarettes smoked per week, smokers aged 14 years or older 2013 (e)

85.9

113.1

109.4

126.2

Sources:

Compared with Major cities (13%), the prevalence of daily smoking by people 18 years and older in Inner regional (17%) and Outer regional/Remote areas (21%) is higher.

The NDSH survey reflects these trends albeit with a slightly different age group (14+) and a different definition of smoking (daily plus less frequently), but the NDSH survey adds detail for remote areas where smoking rates are higher again (around 25% versus around 23% in Outer regional).

In addition, the average number of cigarettes smoked by each smoker is higher in regional/rural areas (~110/week) than in Major cities (86/week), and higher again (126/week) in remote areas.

 

Smoking – exposure, uptake, establishment, quitting

Table 2: Smoking characteristics by Remoteness, 2013, 2014 and 2014-15

MC

IR

OR

remote

8.8

17.8

19.3

27.8

Proportion of pregnant women who gave birth and smoked at any time during the pregnancy (2013, crude, National Perinatal Data Collection, exposure tables, Table 5.1.2 )

8.5

17.0

18.9

27.5

Proportion of pregnant women who gave birth and smoked in the first 20 weeks of pregnancy (2013, crude, National Perinatal Data Collection) exposure tables, Table 5.2.2)

3.6

3.1

4.1

*9.4

Proportion of dependent children (aged 0–14) who live in a household with a daily smoker who smokes inside the home (2013, crude, NDSHS exposure tables, Table 6.3)

2.5

2.0

2.7

*2.9

Proportion of adults aged 18 or older who live in a household with a daily smoker who smokes inside the home (2013, crude, NDSHS, exposure tables, Table 7.3)

16.2

15.4

14.7

15.5

Average age at which people aged 14–24 first smoked a full cigarette (2013, crude, NDSHS, uptake tables, Table 9.3)

17.8

22.7

17.8

28.3

Proportion of 12–17 year old secondary school students smoking at least a few puffs of a cigarette (2014, crude, Australian Secondary Students Alcohol and Drug Survey 2014, uptake tables, Table 10.3

54.7

61.1

64.9

67.2

Proportion of persons (aged 18 or older) who have smoked a full cigarette (2013, crude,  NDSHS, uptake tables, Table 10.8)

2.5

3.4

2.5

3.7

Proportion of secondary school students (aged 12–17) who have smoked more than 100 cigarettes in their lifetime (2014, crude, Australian Secondary Students Alcohol and Drug Survey 2014, transition tables, Table 2.3)

20.2

25.9

44.1

45.2

Proportion of young people (aged 18–24) who have smoked more than 100 cigarettes in their lifetime (2013, crude, NDSHS, transition tables, Table 2.6)

21.3

16.8

19.0

15.5

Quitting: Proportion successfully gave up for more than a month (2013, crude, NDSHS, cessation tables, Table 4.3)

29.2

34.2

31.7

32.9

Quitting, Proportion unsuccessful (2013, crude, NDSHS, cessation tables, Table 4.3)

46.3

48.0

47.4

45.2

Quitting: Proportion any attempt (2013, crude, NDSHS, cessation tables, Table 4.3)

35.2

36.3

36.1

36.0

Mean age at which ex-smokers aged 18 or older reported no longer smoking (2013, crude, NDSHS, cessation tables, Table 11.2)

53.1

51.5

46.3

45.0

The proportion of ever smokers aged 18 or older who did not smoke in the last 12 months (2013, crude, NDSHS, cessation tables, Table 12.3)

4.9

6.0

4.8

7.0

Proportion of secondary school students (aged 12–17) who were weekly smokers (2014, crude, Australian Secondary Students Alcohol and Drug Survey 2014, established tables, Table 1.3)

6.9

9.3

6.8

10.4

Proportion of secondary school students (aged 12–17) who were monthly smokers (2014, crude, Australian Secondary Students Alcohol and Drug Survey 2014, established tables, Table 13.3)

13.0

16.7

21.2

18.8

Proportion of adults aged 18 or older who are daily smokers (2014-15, crude, ABS NHS, established tables, Table 3.3)

10.9

7.8

2.9

n.p.

Proportion of smokers aged 18 or older who are occasional smokers (smoke weekly or less than weekly) (2014-15, crude, ABS NHS, established tables, Table 14.3)

40.1

44.7

42.3

52.7

Proportion of Aboriginal and Torres Strait Islander people aged 18 or older who are daily smokers (2012-13, crude, ABS Australian Aboriginal and Torres Strait Islander Health Survey 2012–13, established tables, Table 8i.3)

Source: http://www.aihw.gov.au/alcohol-and-other-drugs/data/ (sighted 11/7/17)
Note: Those estimates above with asterix have large standard errors and should be treated carefully.

Women in rural and remote areas were much more likely to smoke during pregnancy, with 28% of women in remote areas smoking during pregnancy, compared with 18-19% in regional/rural areas, and 9% in Major cities.

It is unclear whether exposure to environmental tobacco smoke varies by remoteness.

Young people outside major cities appeared to have their first cigarette at an earlier age (~15 years as opposed to ~16 years in Major cities.

Secondary school students in Inner regional (~23%) and remote (~28%) areas were more likely to have had at least a few puffs of a cigarette than those in major cities (~18%).

While 20% of young people in Major cities had smoked more than 100 cigarettes in their lifetime, 26%, 44% and 45% of young people in Inner regional, Outer regional and remote areas had done so.

People outside Major cities were as likely or slightly more likely to have attempted to quit smoking, but were less likely to be successful (and more likely to be unsuccessful).

A higher proportion of secondary students outside Major cities were weekly or monthly smokers (6%, 5% and 7% in IR, OR and remote areas versus 5% in Major cities weekly, 9%, 7%, and 10% in IR, OR and remote areas versus 7% in Major cities monthly).

Table 3: Current daily smoker, Aboriginal and Torres Strait Islander people 15+ years, by Remoteness, 2012-13

MC

IR

OR

R

VR

Crude Percent

Current daily smoker

36.2

40.9

39.8

47.4

51.1

Source: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4727.0.55.0012012-13?OpenDocument Table 2 (sighted 12/7/17)

Prevalence of smoking amongst Aboriginal and Torres Strait Islander people 15 years and older is around 35%-40% in Major cities and regional/rural areas, and close to 50% in remote areas. Note that while the pattern is similar in Table 2 and Table 3 above, the figures for 18+ and 15+ year olds are slightly different.

Smoking Trends

Table 4: Comparison of declines in smoking rate estimates across remoteness areas, people 18+, based on ABS NHS surveys, 2001 to 2011-12

Survey year

MC

IR

OR/Rem

Australia

Crude percent daily smokers

2001

21.9

21.9

26.5

22.4

2004-05

19.9

23.0

26.2

21.3

2007-08

17.5

20.1

26.1

18.9

2011-12

14.7

18.3

22.2

16.1

2014-15

13.0

16.7

20.9

14.5

Source: ABS National Health Surveys

From Table 4 above, rates of smoking have clearly declined in Major cities areas, but have been slower to decline in Inner regional and Outer regional/Remote areas. Rates of smoking in rural areas, apparently static last decade, now appear to be declining. Rates in Major cities and Inner regional areas have declined to 0.59 and 0.76 times the 2001 rates in these areas. The 2014-15 rate in Outer regional areas is 0.79 times the 2001 rate.

Figure 1: Daily smokers 18 years and older, 2007-08, 2011-12 and 2014-15, NHS

Figure 1: Daily smokers 18 years and older, 2007-08, 2011-12 and 2014-15, NHS

Source: ABS NHS http://www.aihw.gov.au/alcohol-and-other-drugs/data/ established tables, Table 3.3 (sighted 11/7/17)

Figure 2: Smokers 14 years and older, 2007, 2010 and 2013, NDSHS

Figure 2: Smokers 14 years and older, 2007, 2010 and 2013, NDSHS

Source: AIHW NDSHS http://www.aihw.gov.au/alcohol-and-other-drugs/data/ tobacco smoking table S3.12 (sighted 11/7/17)

Note: Smokers include daily, weekly and less frequent smokers.

Figures 1 and 2 above both show clear declines in Major cities and Inner regional areas, but the trend in Outer regional and Remote areas is less clear, with ABS data showing a decline in daily smoking rates for people aged 18+ between 2007-8 and 2014-15, but NDSHS data showing little change in smoking rates for people 14+ between 2007 and 2013.

Alcohol

Table 5: Alcohol risk status, by remoteness, 2013 and 2014-15

Alcohol consumption

MC

IR

OR/Rem

Exceeded 2009 NHMRC lifetime risk guidelines, people 18+, crude %, 2014-15 (a)

16.3

18.4

23.4

Exceeded 2009 NHMRC lifetime risk guidelines, people 15+, age standardised %, 2014-15 (b)

15.7

17.4

22.0

Exceeded 2009 NHMRC single occasion risk guidelines, people 18+, crude %, 2014-15 (a)

42.7

48.5

46

MC

IR

OR

R/VR

Abstainer/ex-drinker, crude %, 14+, 2013 (c)

23.1

18.9

20.5

17.5

Low lifetime risk, crude %, 14+, 2013 (c)

60.2

62

56.9

47.6

High lifetime risk, crude %, 14+, 2013 (c)

16.7

19.1

22.6

34.9

low single occasion risk, crude %, 14+, 2013 (c)

40.4

41.8

38.1

30.8

Single occasion risk less than weekly, crude %, 14+, 2013 (c)

23.5

24.4

23.6

22.8

Single occasion risk at least weekly, crude %, 14+, 2013 (c)

13

14.9

17.8

28.9

Sources:

Table 6: Alcohol consumption against 2009 NHMRC guidelines, Aboriginal and Torres Strait Islander people 15+ years, by Remoteness 2012-13

MC

IR

OR

R

VR

Percent

Exceeded lifetime risk guidelines

18.0

18.7

18.2

22.5

14.3

Exceeded single occasion risk guidelines

56.7

57.4

50.7

59.0

41.4

Source: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4727.0.55.0012012-13?OpenDocument Table 2 (sighted 12/7/17)

The figures in Table 6 are not strictly comparable with those for the total population in Table 5, because  Table 6 refers to people who are 15 years and older, while Table 5 refers to people who are 18 years and older.

The percentage of the 15+ ATSI population exceeding 2009 NHMRC Lifetime risk guidelines is around 15-20% with little apparent inter-regional variation, compared with, for the total population 18+,  16% in Major cities, increasing to 23% in Outer regional/remote areas.

The percentage of the 15+ ATSI population exceeding the 2009 single occasion risk guidelines is around 50-60%, and around 40% in Very remote areas, compared with, for the total population 18+,  40-50% in Major cities, rural and regional areas.

Alcohol trends

Table 7: Type of alcohol use and treatment for alcohol, by remoteness area (per 1,000 population)

MC

IR

OR

R/VR

single occasion risk (monthly) 2004

287

304

321

370

2007

285

292

312

437

2010

274

312

329

413

2013

250

273

315

422

lifetime risk 2004

200

215

234

262

2007

199

210

238

314

2010

189

225

251

310

2013

167

191

226

349

very high risk – yearly 2004

167

185

206

243

2007

172

183

206

288

2010

161

183

218

266

2013

151

166

194

258

very high risk – monthly 2004

77

84

104

130

2007

78

89

100

153

2010

79

94

113

154

2013

70

70

100

170

very high risk – weekly 2004

21

27

41

38

2007

24

28

24

50

2010

37

43

54

78

2013

27

28

38

70

Closed treatment episodes 2004–05

61

72

60

58

2007–08

76

84

80

129

2010–11

69

96

87

135

2013–14

68

79

93

155

Source: NDSHS,  http://www.aihw.gov.au/alcohol-and-other-drugs/data/  alcohol -supplementary data tables, Table S18

Notes:
Single occasion risk (monthly): Had more than 4 standard drinks at least once a month
Lifetime risk: On average, had more than 2 standard drinks per day
Very high risk (yearly): Had more than 10 standard drinks at least once a year
Very high risk (monthly): Had more than 10 standard drinks at least once a month
Very high risk (weekly): Had more than 10 standard drinks at least once a week

There is a clear increase in the prevalence of people who drink alcohol in such a way as to increase their single occasion risk (eg from car accident, assault, fall, etc) and their lifetime risk (eg from chronic disease – liver disease, dementia, cancer etc) as remoteness increases.

In 2013, single occasion risk ranged from 25% of people 14 years or older in major cities to 42% of people in remote areas, while lifetime risk increased from 17% in major cities to 35% in remote areas.

In 2013, The prevalence of people who drank more than 10 standard drinks in one sitting at least once per week, increased from just under 3% in Major cities to 7% in remote areas.

In 2013-14, there were just under 70 closed treatment episodes per 1,000 people living in Major cities, increasing to around 80 and 90 per 1,000 population in Inner and Outer regional areas, to 155 per 1,000 people living in remote Australia.

 

Illicit drug use 2013

Table 8: Illicit drug use, “recent users” 14+, 2013

MC IR OR remote

Crude percent

Cannabis

9.8

10.0

12.0

13.6

Ecstasy

2.9

1.5

1.6

*1.8

Meth/amphetamine

2.1

1.6

2.0

*4.4

Cocaine

2.6

0.8

*1.1

*2.5

Any illicit drug

14.9

14.1

16.7

18.7

Source: AIHW National Drug Strategy Household Survey, 2013. http://www.aihw.gov.au/alcohol-and-other-drugs/data/  Illicit drug use (supplementary) tables S5.6, S5.11, S5.17, S5.21, S5.26.

Note: * indicates large standard error (therefore some degree of uncertainty)

Illicit drug use appears to be higher in Outer regional and remote areas compared with Major cities and Inner regional areas, in large part due to higher rates of cannabis use in these areas, but with apparent lower use of ecstasy and cocaine in regional areas compared with Major cities.

 

Physical activity

Table 9: Physical inactivity, people 18+, 2014-15

MC

IR

OR/Remote

Percentage of people aged 18+ who undertook no or low exercise in the previous week (crude) (a)

64.3

70.1

72.4

Percentage of people aged 18+ who undertook no or low exercise in the previous week (age standardised) (b)

64.8

68.6

71

Sources:
(a) ABS NHS (http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012014-15?OpenDocument Table 6.3)
(b) PHIDU (ABS NHS data) (http://phidu.torrens.edu.au/social-health-atlases/data#social-health-atlas-of-australia-remoteness-areas) sighted 18/7/2017

Note that level of exercise is based on exercise undertaken for fitness, sport or recreation in the last week.

Physical inactivity appears to be more prevalent with remoteness, increasing from 65% of people in Major cities to 71% in Outer regional/remote areas.

Table 10: Average daily steps, 2011-12

MC

IR

OR/Rem

Average daily steps, 18+ years, 2011-12 (a)

7,393

7,388

7,527

Average daily steps, 5-17years, 2011-12 (b)

9,097

9,266

9,160

Sources:

In 2011-12, adults living in Outer regional/Remote areas took slightly more steps than those living in Major cities or Inner regional areas, while the number of steps taken by children and adolescents in regional/Remote areas was slightly greater compared with those in Major cities.

Table 11: Average time spent on physical activity and sedentary behaviour by persons aged 18+, 2011-12

MC

IR

OR/Remote

Australia

Hours

Physical activity(a)

3.9

3.4

3.9

3.8

Sedentary behaviour (leisure only)(b)

29.3

28.0

27.9

28.9

Sedentary behaviour (leisure and work)(b)

40.2

35.2

36.0

38.8

Notes:
(a) Includes walking for transport/fitness, moderate and vigorous physical activity.
(b) Sedentary is defined as sitting or lying down for activities.

Source: ABS 2011-12 Australian Health Survey (Physical activity) http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0042011-12?OpenDocument  Table 5.1

Adults living in Inner regional and Outer regional/Remote areas were about as likely as (or very slightly less likely than) those in Major cities to be sedentary in their leisure time, but appeared to be slightly less likely to be sedentary overall (ie their work involved a greater level of physical activity).

Table 12: Whether children aged 2-17 years met physical and screen-based activity recommendations, 2011-12

MC

IR

OR/Rem

Crude percentage

Met physical activity recommendation on all 7 days(a)(b)

27.5

34.3

34.2

Met screen-based activity recommendation on all 7 days(b)(c)

28.0

29.7

31.0

Met physical activity and screen-based recommendations on all 7 days (a)(b)(c)

9.7

10.9

14.2

Notes:
(a) The physical activity recommendation for children 2–4 years is 180 minutes or more per day, for children 5-17 years it is 60 minutes or more per day. See Physical activity recommendation in Glossary.
(b) In 7 days prior to interview.
(c) The screen-based recommendation for children 2–4 years is no more than 60 minutes per day, for children 5-17 years it is no more than 2 hours per day for entertainment purposes.

Source:
ABS 2011-12 Australian Health Survey (Physical activity) http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0042011-12?OpenDocument  Table 14.3

Children in rural and regional Australia appeared more likely (34% vs 28%) to meet physical activity recommendations and slightly more likely (30%vs 28%) to meet screen-based activity recommendations than their Major cities counterparts.

 

Fruit and vegetable consumption

Table 13: Fruit and vegetable consumption, people 18+ years, by remoteness, 2014-15

MC

IR

OR/Remote

Crude Percentage

Inadequate fruit consumption(a)

50.0

50.6

51.2

Inadequate fruit consumption(b)

50.4

48.3

48.0

Inadequate vegetable consumption(a)

93.4

93.5

89.3

Inadequate vegetable consumption(b)

n.p.

n.p.

n.p.

Sources:
(a) ABS NHS (http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012014-15?OpenDocument Table 6.3)
(b) PHIDU (ABS NHS data) (http://phidu.torrens.edu.au/social-health-atlases/data#social-health-atlas-of-australia-remoteness-areas) sighted 18/7/2017

Note that adequacy of consumption is based on comparison with 2013 NHMRC guidelines.

Half of adult Australians eat insufficient fruit, with little clear difference between major cities and regional/rural areas.

Around 90% of adult Australians ate insufficient vegetables, with little clear difference between major cities and regional/rural areas.

Table 14: Fruit and vegetable consumption, Aboriginal and Torres Strait Islander people 15+ years, 2012-13

MC

IR

OR

R

VR

Crude Percent

Inadequate daily fruit consumption (2013 NHMRC Guidelines)

59.0

60.6

56.9

54.9

49.1

Inadequate daily fruit consumption (2003 NHMRC Guidelines)

62.1

63.6

59.8

58.3

51.6

Inadequate daily vegetables consumption (2013 NHMRC Guidelines)

95.9

93.5

93.6

94.5

97.9

Inadequate daily vegetables consumption (2003 NHMRC Guidelines)

93.8

90.6

90.5

91.2

96.1

Source: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4727.0.55.0012012-13?OpenDocument Table 2 (sighted 12/7/17)

Roughly 60% of Aboriginal and Torres Strait Islander Australians 15+ in Major cities and regional/rural areas have inadequate fruit intake, closer to 50% in remote areas (compared with around 50% of all Australians 18+ in major cities and regional/rural areas).

Roughly 95% of Aboriginal and Torres Strait Islander Australians 15+ in Major cities and regional/rural areas have inadequate vegetable intake, perhaps higher (98%) in Very remote areas (compared with around 90%-94% of all Australians 18+ in major cities and regional/rural areas).

 

 

Overweight and Obesity

Table 15: Overweight and Obesity, people 18+ years, by remoteness, 2014-15

MC

IR

OR/Remote

Crude Percentage

Persons, overweight/obese (a)

61.1

69.2

69.2

Age standardised percentage

Males overweight (b)

43.8

41.1

34.3

Males obese (b)

25.8

33.1

38.2

Females overweight (b)

28.9

28.3

30.1

Females obese (b)

25.0

32.4

33.7

People  overweight (b)

36.2

34.4

31.4

People obese (b)

25.4

32.6

35.8

Sources:
(a) ABS NHS (http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012014-15?OpenDocument Table 6.3)
(b) ABS NHS http://phidu.torrens.edu.au/social-health-atlases/data#social-health-atlas-of-australia-remoteness-areas

Adults in rural/regional areas are more likely to be overweight or obese than people in Major cities (69% vs 61%).

However, there were inter-regional BMI and gender differences:

  • Compared with those in Major cities, males in Inner regional and especially Outer-regional areas were less likely to be overweight (41% and 34%, vs 44%) but much more likely to be obese (33% and 38% vs 26%).
  • Compared with those in Major cities, females in Inner regional and Outer-regional areas were about as likely to be overweight (~29%) but much more likely to be obese (~33% vs 25%).

 

Table 16: Overweight and Obesity, Aboriginal and Torres Strait Islander people 15+ years, 2012-13

MC

IR

OR

R

VR

Crude Percent

Overweight

27.5

28.8

30.1

32.5

26.4

Obese

37.9

41.3

36.2

33.1

32.3

Overweight/obese

65.4

70.1

66.2

65.6

58.8

Aboriginal and Torres Strait Islander people in rural/regional and Remote areas (29%-33%) were a little more likely to be overweight than those in Major cities (28%), with those in Very Remote areas (26%) least likely to be overweight.

Aboriginal and Torres Strait Islander people in Inner regional areas (41%) were more likely to be obese than those in Major cities (38%), but those in Outer regional (36%) and remote areas (~33%) were less likely to be obese.

Overall, Aboriginal and Torres Strait Islander people in Inner Regional areas were most likely to be overweight/obese (70%), those in Major cities, Outer Regional and Remote areas were less likely to be overweight/obese (~66%), while those in Very Remote areas were the least likely to be overweight/obese (59%).

These figures compare with 61% – the prevalence of overweight/obesity for (predominantly non-Indigenous) people living in Major cities.

 

High blood pressure

Table 17: High blood pressure, people 18+, by Remoteness, 2014-15

MC

IR

OR/Remote

Percentage

Crude % (a)

21.9

27.1

24

Age standardised % (b)

22.7

24.6

22.1

Sources:

(a) ABS NHS (http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012014-15?OpenDocument Table 6.3)
(b) ABS NHS http://phidu.torrens.edu.au/social-health-atlases/data#social-health-atlas-of-australia-remoteness-areas

Age for age, people in rural/regional Australia appeared to be as likely, or very slightly more likely to have high blood pressure than their counterparts in Major cities (~23% vs ~24%). However, because people in rural/regional areas are older (on average), the prevalence of people with high blood pressure is higher (~26% vs 22%) than

Updated 31/07/2017
To view archived Risk Factors click here

NACCHO Aboriginal Health and #Alcohol : Cashless welfare card in Indigenous communities ‘cuts use of alcohol and drugs says new report

“But what we had before the card, which is just open sort of slather of people buying heaps of alcohol with the money that they get, the amount of damage it was doing, I think that this is definitely an improvement on what we had previously,”

I  would support the card being rolled out across the country.

Yes I do, I think this is a more responsible way of actually delivering support and social services to our people regardless of what colour they are,”

Ian Trust, the executive director of the Wunan Foundation, an Aboriginal development organisation in the East Kimberley in Western Australia, said his support for the card had come at a personal cost. SEE ABC Report Photo: A Kununurra resident in WA’s Kimberley holding a cashless welfare card. (ABC News: Erin Parke)

“Inevitably, people would prefer to have fewer restrictions than more restrictions, particularly if you are an alcoholic, but the evaluation and the data shows that it is having a positive net impact on reducing alcoholism, gambling and illicit substance abuse.

The rights of the community, of the children and of elderly citizens to live in a safe community are equally important as the rights of welfare recipients.”

Human Services Minister Alan Tudge said while the card was not a “panacea”, it had led to stark improvements in the trial communities, warranting an extension of the card, despite it not being popular with all welfare recipients. Reported by Sarah Martin in Todays Australian

A cashless welfare card that stops government benefits being spent on drugs and alcohol will be made permanent in two remote communities and looks set to be ­expanded, after trials found it greatly reduced rates of substance abuse and gambling.

The 175-page government commissioned review by Orima Research of the year-long trial.

The evaluation involved interviewing stakeholders, participants and their families.

It found on average a quarter of people using the card who drank said they were not drinking as often.

While just under a third of gamblers said they had curbed that habit.

The Turnbull government will today release the first major independent audit of the cashless welfare system and announce that the card will continue in Ceduna and East Kimberley, subject to six-monthly reviews.

Establishing a clear “proof of concept” in the two predomin­antly indigenous communities also paves the way for the ­Coalition to roll out the welfare spending restrictions further, with townships in regional Western Australia and South Australia believed to be under consideration.

In October, Malcolm Turnbull flagged that an expansion of the welfare card was dependent on the results of the 12-month trial, but praised the scheme’s ­initial success in reducing the amount of taxpayer money being spent on alcohol and illicit drugs.

Under the welfare shake-up, first flagged in Andrew Forrest’s review of the welfare system in 2014, 80 per cent of a person’s benefit is restricted to a Visa debit card that cannot be used for spending on alcohol or gambling products or converted to cash. After year-long trials at the two sites capturing $10 million in welfare payments, the first quantitative assessment of the scheme has found that 24 per cent of card users reported less alcohol consumption and drug use in their communities, with 27 per cent of people noting a drop in gambling.

See full details support and Q and A below from DSS

Binge drinking and the frequency of alcohol consumption by card users was also down by about 25 per cent among those who said they were drinkers ­before the trials began.

Those not on welfare saw even greater benefits, with an average of 41 per cent of non-participant community members across the two trial sites reporting a ­reduction in the drinking of alcohol in their area since the trial started. The report concluded that, overall, the card “has been effective in reducing alcohol consumption, illegal drug use and gambling — establishing a clear ‘proof-of-concept’ and meeting the necessary preconditions for the planned medium-term outcomes in relation to reduced levels of harm related to these behaviours”.

However the audit, undertaken by ORIMA Research, found that despite the community improvements, many people remained unhappy with the welfare restrictions, with about half saying it had made their lives worse, and 46 per cent reporting they had problems with the card.

This view was reversed in the wider community, with 46 per cent of non-participants saying the trial had made life in their community better, and only 18 per cent reporting that it had made life worse.

Many of the reported problems with the card were attributed to user error or “imperfect knowledge and systems” among some merchants. Of the 32,237 declined transactions between April and September last year, 86.2 per cent were because of user error, with more than half found to be because account holders had insufficient funds.

While there was a large amount of anecdotal evidence in favour of the card, there were also reports of a rise in humbugging — where family members are harassed for money — and some reports of an increase in crime linked to the need for cash, including prostitution.

Human Services Minister Alan Tudge said while the card was not a “panacea”, it had led to stark improvements in the trial communities, warranting an extension of the card, despite it not being popular with all welfare recipients. However, he stressed that no decision had been made to expand the card to new sites, which would require legislation.

“Inevitably, people would prefer to have fewer restrictions than more restrictions, particularly if you are an alcoholic, but the evaluation and the data shows that it is having a positive net impact on reducing alcoholism, gambling and illicit substance abuse,” Mr Tudge said. “The rights of the community, of the children and of elderly citizens to live in a safe community are equally important as the rights of welfare recipients.”

The government has introduced the card only to regions where it has the support of community leaders, allowing the Coalition to secure the backing of Labor for the two trial sites despite opposition from the Greens and the Australian Council of Social Service.

Liberal MP Melissa Price, who represents the vast West Australian regional electorate of Durack, said yesterday she was hopeful the card could be rolled out across the Kimberley, the Pilbara and the Goldfields, estimating that about half of the 52 councils in her electorate had expressed an interest in signing up.

“I know it is not popular with everybody, but we are in government and we need to make these decisions to improve people’s lives; if we don’t make changes, nothing changes,” Ms Price said.

Cashless Debit Card Trial – Overview

The Commonwealth Government is looking at the best possible ways to provide support to people, families and communities in locations where high levels of welfare dependence exist alongside high levels of harm related to drug and alcohol abuse.

The Cashless Debit Card Trial is aimed at finding an effective tool for supporting disadvantaged communities to reduce the consumption and effects of drugs, alcohol and gambling that impact on the health and wellbeing of communities, families and children.

How the cashless debit card works

The cashless debit card looks and operates like a normal bank card, except it cannot be used to buy alcohol or gambling products, or to withdraw cash.

The card can be used anywhere that accepts debit cards. It will work online, for shopping and paying bills. The Indue website lists the approved merchants (link is external) and excluded merchants (link is external) for the trial.

Who will take part in the trial?

Under the trial, all recipients of working age income support payments who live in a trial location will receive a cashless debit card.

The full list of included payments is available on the Guides to Social Security Law website.

People on the Age Pension, a veteran’s payment or who earn a wage can volunteer to take part in the trial. Information on volunteering for the trial is available. Application forms for people who wish to volunteer can be downloaded from the Indue website (link is external).

How will it affect Centrelink payments?

The trial doesn’t change the amount of money a person receives from Centrelink. It only changes the way in which people receive and spend their fortnightly payments:

  • 80 per cent is paid onto the cashless debit card
  • 20 per cent is paid into a person’s regular bank account.

Cashless debit card calculator

To work out how much will be paid onto your cashless debit card, enter your fortnightly payment amount into the following calculator.

Enter amount of fortnightly Centrelink payment Calculate

Money on the card 

Use it for:

  • Groceries
  • Pay bills
  • Buy clothes
  • Travel
  • Online

Anywhere with eftpos except:

  • No grog
  • No gambling
  • No cash

   Note: 100% of lump sum payments will be placed on the card. More information is available on the Guides to Social Security Law website.

More information

For more information, email debitcardtrial@dss.gov.au (link sends e-mail) or call 1800 252 604

This weeks NACCHO Aboriginal Health News Alerts will  include

Wednesday Job alerts Thursday NACCHO Members Good News

How to submit ? Email to Colin Cowell NACCHO Media   4.30 pm  day before publication

NACCHO #IWD2017 Aboriginal Women’s #justjustice :Indigenous, disabled, imprisoned – the forgotten women of #IWD2017

 

” Merri’s story is not uncommon. Studies show that women with physical, sensory, intellectual, or psychosocial disabilities (mental health conditions) experience higher rates of domestic and sexual violence and abuse than other women.

More than 70 per cent of women with disabilities in Australia have experienced sexual violence, and they are 40 per cent more likely to face domestic violence than other women.

Indigenous women are 35 times more likely to be hospitalised as a result of domestic violence than non-Indigenous women. Indigenous women who have a disability face intersecting forms of discrimination because of their gender, disability, and ethnicity that leave them at even greater risk of experiencing violence — and of being involved in violence and imprisoned

Kriti Sharma is a disability rights researcher for Human Rights Watch

This is our last NACCHO post supporting  International Women’s Day

Further NACCHO reading

Women’s Health ( 275 articles )  or Just Justice  See campaign details below

” In-prison programs fail to address the disadvantage that many Aboriginal and Torres Strait Islander prisoners face, such as addiction, intergenerational and historical traumas, grief and loss. Programs have long waiting lists, and exclude those who spend many months on remand or serve short sentences – as Aboriginal and Torres Strait Islander people often do.

Instead, evidence shows that prison worsens mental health and wellbeing, damages relationships and families, and generates stigma which reduces employment and housing opportunities .

To prevent post-release deaths, diversion from prison to alcohol and drug rehabilitation is recommended, which has proven more cost-effective and beneficial than prison , International evidence also recommends preparing families for the post-prison release phase. ‘

Dying to be free: Where is the focus on the deaths occurring post-prison release? Article 1 Below

Article from Page 17 NACCHO Aboriginal Health Newspaper out Wednesday 16 November , 24 Page lift out Koori Mail : or download

naccho-newspaper-nov-2016 PDF file size 9 MB

As the world celebrates International Women’s Day, this week  I think of ‘Merri’, one of the most formidable and resilient women I have ever met.

A 50-year-old Aboriginal woman with a mental health condition, Merri grew up in a remote community in the Kimberley region of Western Australia. When I met her, Merri was in pre-trial detention in an Australian prison.

It was the first time she had been to prison and it was clear she was still reeling from trauma. But she was also defiant.

“Six months ago, I got sick of being bashed so I killed him,” she said. “I spent five years with him [my partner], being bashed. He gave me a freaking [sexually transmitted] disease. Now I have to suffer [in prison].”

I recently traveled through Western Australia, visiting prisons, and I heard story after story of Indigenous women with disabilities whose lives had been cycles of abuse and imprisonment, without effective help.

For many women who need help, support services are simply not available. They may be too far away, hard to find, or not culturally sensitive or accessible to women.

The result is that Australia’s prisons are disproportionately full of Indigenous women with disabilities, who are also more likely to be incarcerated for minor offenses.

For numerous women like Merri in many parts of the country, prisons have become a default accommodation and support option due to a dearth of appropriate community-based services. As with countless women with disabilities, Merri’s disability was not identified until she reached prison. She had not received any support services in the community.

Merri has single-handedly raised her children as well as her grandchildren, but without any support or access to mental health services, life in the community has been a struggle for her.

Strangely — and tragically — prison represented a respite for Merri. With eyes glistening with tears, she told me: “[Prison] is very stressful. But I’m finding it a break from a lot of stress outside.”

Today, on International Women’s Day, the Australian government should commit to making it a priority to meet the needs of women with disabilities who are at risk of violence and abuse.

In 2015, a Senate inquiry into the abuse people with disabilities face in institutional and residential settings revealed the extensive and diverse forms of abuse they face both in institutions and the community. The inquiry recommended that the government set up a Royal Commission to conduct a more comprehensive investigation into the neglect, violence, and abuse faced by people with disabilities across Australia.

The government has been unwilling to do so, citing the new National Disability Insurance Scheme (NDIS) Quality and Safeguard Framework as adequate.

While the framework is an important step forward, it would only reach people who are enrolled under the NDIS. Its complaints mechanism would not provide a comprehensive look at the diversity and scale of the violence people with disabilities experience, let alone at the ways in which various intersecting forms of discrimination affect people with disabilities.

The creation of a Royal Commission, on the other hand, could give voice to survivors of violence inside and outside the NDIS. It could direct a commission’s resources at a thorough investigation into the violence people with disabilities face in institutional and residential settings, as well as in the community.

The government urgently needs to hear directly from women like Merri about the challenges they face, and how the government can do better at helping them. Whether or not there is a Royal Commission, the government should consult women with disabilities, including Indigenous women, and their representative organizations to learn how to strengthen support services.

Government services that are gender and culturally appropriate, and accessible to women across the country, can curtail abuse and allow women with disabilities to live safe, independent lives in the community.

Kriti Sharma is a disability rights researcher for Human Rights Watch

 

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How you can support #JustJustice

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

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

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

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

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

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

Readers may also be interested in these articles: