NACCHO Aboriginal Women’s Health #NRW2019 #ClosingTheGap : Aboriginal mothers are incarcerated at alarming rates – and their mental and physical health suffers

 ” Aboriginal women are the fastest growing prison population in Australia.

They comprise around one-third of female prisoners in New South Wales, despite making up just 3% of the population. The majority of Aboriginal women in prison (more than 80%) are mothers.

Our research team interviewed 43 Aboriginal mothers in six prisons across NSW about their physical and mental health and well-being. We found they were overwhelmingly unable to access culturally appropriate treatments for their mental health, well-being and substance use issues.

These circumstances compounded the poor health and well-being of Aboriginal mothers, and in some instances triggered or exacerbated mental health problems.” 

Originally posted in The Conversation

Read over 380 Aboriginal Women’s Health articles published by NACCHO over past 7 years 

A cycle of trauma and incarceration

The mothers we interviewed said intergenerational trauma and the forced removal of their children by government services were the most significant factors affecting their health and well-being.

Mothers recounted their own and their relatives’ experiences of being removed from their families as children, as part of the Stolen Generations, painting a picture of longstanding and ongoing intergenerational trauma.

In prison, many of the Aboriginal mothers experienced significant distress due to the trauma of separation from children combined with the stress of the prison environment. Trauma is associated with high rates of co-occurring mental health disorders.

Many mothers had children in the care of family members, but the long distances between the prison and the family’s home made regular contact extremely difficult.

Phone contact in prison was also difficult if the mothers did not have the money to use the prison phones.

Mothers whose children had been taken by government services were reliant on government caseworkers to facilitate their children’s visits. Many mothers reported that these visits were rare, even though they had been ordered by the court. Mothers worried that their children would not be returned to them.

Some Aboriginal women use substances to cope with past trauma. But this is seen as a law and order issue rather than a health problem or coping method of last resort because they haven’t been able to access services to address intergenerational trauma.

This further increases the risk of contact with the criminal justice system and leads to deterioration of mental health and well-being. But no action is taken to address these underlying causes of discrimination and incarceration.

As a result, more than 80% of Aboriginal mothers in prison in NSW report their offences are drug-related. Aboriginal women are more likely to be charged and imprisoned for minor offences than non-Aboriginal women. Consequently, Aboriginal women often cycle through the prison system on shorter sentences or remand (unsentenced) and experience multiple incarcerations.

Indigenous women are overrepresented in the female prison population in Australia. ArliftAtoz2205/Shutterstock

This compounds intergenerational trauma and cycles of incarceration. It creates another generation of Aboriginal children forcibly removed from their mothers as well as separating Aboriginal mothers from their families and communities.

Poor physical and mental health

The mothers in our study reported having multiple physical health problems too.

Some had sustained injuries caused by family violence. Head injuries produced ongoing symptoms such as head pain, blurred vision, and memory loss, which made it more difficult to access treatment.

The mothers reported a high occurrence of reproductive health problems including endometriosis, ovarian cysts, precancerous changes of the cervix, and cervical cancer. The mothers highlighted the links between reproductive health problems and trauma, injury, and poor social and emotional well-being.

Many of the women reported extensive waiting times to access treatment and support, which exacerbated these problems.


Read more: Acknowledge the brutal history of Indigenous health care – for healing


Many women who had been taking medication that had been effective for a mental health problem in the community, for example prescription medication for anxiety, were not able to continue on that medication on admission to prison.

They were forced to withdraw from it and wait, sometimes weeks, to see a prison psychiatrist, presenting a serious and imminent risk to their stability, health and well-being.

What can be done?

The incarceration of Aboriginal mothers is a serious public health issue. The gross over-representation of Aboriginal women in prison reflects the inequity and discrimination they face, and the failure of multiple systems to address their needs and divert them from prison.

We urgently need culturally informed approaches to address the health and well-being of Aboriginal mothers in prison and after release to stop ongoing cycles of incarceration and child removal.

The mothers in our study highlighted the need for culturally appropriate services in the community that promote healing for intergenerational trauma. This includes an Aboriginal women’s healing and drug and alcohol service, long-term housing, trauma-informed counselling, and facilities specifically to support Aboriginal women in regaining access to their children.

Aboriginal mothers know what it means to be healthy and stay healthy, but too often do not have access to culturally safe services to support them in their mothering, to realise their health goals, and to remain out of prison and in the community.

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NACCHO Aboriginal Health and #SuicidePrevention : WA Government releases preliminary response to Aboriginal youth suicide reports and  accepts all 86 recommendations : Download report HERE

It is beyond distressing to see report after report about young Aboriginal people who see their lives as so bleak that they see no other option but to take their own lives.

The Statement of Intent underscores the Government will co-design services with Aboriginal people.

We are committed to be a Government that listens to and works with Aboriginal people to make a real difference in this area.

We are also determined to working with the Commonwealth Government and local groups in order to bring about a truly co-operative and collaborative approach to addressing this problem.”

WA Aboriginal Affairs Minister Ben Wyatt

“Young Aboriginal people continue to take their own lives at an unfathomable rate. I extend my deepest sympathies to those families and communities that have been heartbroken by these tragic events.

The issues are complex and it is clear that we need to develop a comprehensive reform agenda that is informed by the community, designed by the community and driven by the community.

The Statement of Intent makes it clear that our Government is absolutely committed to addressing the recommendations of the Coroner’s Inquest and the Message Stick report, to deliver real, long-term positive change for Aboriginal people.

The McGowan Government is determined to work across community and governments to ensure that this does not become another report that collects dust.”

Deputy Premier Roger Cook

  • McGowan Government releases preliminary response to the Coroner’s Inquest into Aboriginal youth suicide in the Kimberley and the Message Stick Inquiry
  • McGowan Government accepts all 86 recommendations, combined in both reports
  • Statement of Intent outlines Government’s commitment to work with Aboriginal people to tackle the issues that contribute to Aboriginal youth suicide
  • A reform agenda will be developed in partnership with local Aboriginal people to address the recommendations
  • Following further consultation with Aboriginal communities, full response expected by end of the year

The McGowan Government today released its preliminary response to the State Coroner’s Inquest into the deaths of 13 children and young people in the Kimberley and the 2016 Message Stick Inquiry into Aboriginal youth suicide in remote areas.

 

Download Here Statement-of-Intent-Aboriginal-youth-suicide

The Statement of Intent outlines the McGowan Government’s unwavering commitment to a partnership approach to address the recommendations from the Coroner’s Inquest and Message Stick Inquiry.

Of the combined 86 recommendations included in both reports, the Government has fully accepted 22, accepted 33 in principle, has already implemented or started implementing 16 and is still considering the feasibility or implications of a further 11. Four of the Message Stick recommendations have been superseded by subsequent events.

The McGowan Government will be working with Aboriginal people to develop a whole-ofgovernment reform agenda to address the recommendations, and a comprehensive response to the reports is expected by the end of the year.

The Government will co-design place-based initiatives in partnership with Aboriginal people, communities and organisations, which will positively impact the livelihood of young Aboriginal people.

4.Address Aboriginal and Torres Strait Islander youth suicide rates 

  • Provide $50 million over four years to ACCHOs to address the national crisis in Aboriginal and Torres Strait Islander youth suicide in vulnerable communities o Fund new Aboriginal support staff to provide immediate assistance to children and young people at risk of self-harm and improved case management
  • Fund regionally based multi-disciplinary teams, comprising paediatricians, child psychologists, social workers, mental health nurses and Aboriginal health practitioners who are culturally safe and respectful, to ensure ready access to professional assistance; and
  • Provide accredited training to ACCHOs to upskill in areas of mental health, childhood development, youth services, environment health, health and wellbeing screening and service delivery

Read all previous 140 NACCHO Aboriginal Health and Suicide Prevention Articles HERE

The McGowan Government is committed to addressing Aboriginal youth suicide, and a number of initiatives are included in this year’s State Budget that support Aboriginal youth wellbeing:

  • $6.5 million for the Aboriginal Community Connectors program to improve community safety and reduce community consequences of alcohol and other drugs and related ‘at risk’ behaviours;
  • Diversionary programs in the Kimberley, including the Kununurra PCYC ($2 million) and the West Kimberley Youth and Resilience Hub ($1.3 million);
  • $20.1 million for the North West Drug and Alcohol Support Program to reduce the harm caused by alcohol and other drugs in the Kimberley, Pilbara, and Mid-West;
  • Continued support for the work of the Mental Health Commission in reducing suicide risk in Western Australia via the Suicide Prevention: 2020 strategy ($8.1 million); and
  • A Kimberley Juvenile Justice Strategy ($900,000) to develop place-based prevention and diversion initiatives for young people across the Kimberley.

The Statement of Intent, which includes the Government’s preliminary response to the Coroner’s Inquest and Message Stick Inquiry, can be downloaded from the Department of the Premier and Cabinet’s website.

Useful Links

2018 Message Stick Response

State Coroner’s Inquest into the deaths of 13 children and young person in the Kimberley Region

The former Health and Education Standing Committee 2016 report, Learnings from the message stick: the report of the inquiry into Aboriginal youth suicide in remote areas.

Contact Us

If you wish to make contact with regard to the Western Australian Government’s response to the Statement of Intent, please do so via the details below:

Department of the Premier and Cabinet
Dumas House
2 Havelock Street
West Perth
Western Australia 6005

Email: AboriginalPolicy@dpc.wa.gov.au

If you would like a response, please include your preferred contact details.

 

 

NACCHO Aboriginal Health and #SuicidePrevention Recommendation 4 of 10 : Why does an Aboriginal ACCHO Health Service in one of Australia’s worst suicide regions have to self-fund #MentalHealth roles

“I think it’s appalling that we have to raise Medicare funds to subsidise services when the need is clearly demonstrated in umpteen coroner’s reports.

There are many gaps in the services that are currently available across Australia.

We welcome Labor policies to move SEWB funding into the federal health department, as well as its proposed multi-disciplinary teams of paediatricians, social workers, psychologists and Aboriginal counsellors.

But I criticize the “piecemeal approach” of the major parties. What governments don’t get is that the overall needs based funding required for Aboriginal community controlled health organisations (ACCHOs) to deliver fully on comprehensive primary healthcare hasn’t been built in to our model of care funding.”

As a result, the sector has had to seek additional funding for services like SEWB, instead of receiving a sufficient level as the base

We call for money to go to ACCHOs instead of mainstream services for Aboriginal healthcare.

We have a much better understanding of the issues [Aboriginal communities] deal with day in and day out. I also believe there should be workers engaged in the communities who are available out of hours, because most people don’t suicide between 9 and 5.”

Pat Turner AM  CEO of the National Aboriginal Community Controlled Health Organisation, told BuzzFeed News it was unacceptable, given the situation in the Kimberley

“We need those two positions given everything that’s happening in the community. People know them, they trust them, they will work with them. And it takes a long time to build up that trust with Aboriginal people.

Derby Aboriginal Health Service ( DAHS CEO )  Lynette Henderson-Yates said she is unsure how much longer DAHS will be able to find the $330,000 funding

Recommendation 4.Address Aboriginal and Torres Strait Islander youth suicide rates

  • Provide $50 million over four years to ACCHOs to address the national crisis in Aboriginal and Torres Strait Islander youth suicide in vulnerable communities
  • Fund new Aboriginal support staff to provide immediate assistance to children and young people at risk of self-harm and improved case management
  • Fund regionally based multi-disciplinary teams, comprising paediatricians, child psychologists, social workers, mental health nurses and Aboriginal health practitioners who are culturally safe and respectful, to ensure ready access to professional assistance; and
  • Provide accredited training to ACCHOs to upskill in areas of mental health, childhood development, youth services, environment health, health and wellbeing screening and service delivery.

More info https://www.naccho.org.au/media/voteaccho/

 Part 1 This is what it’s actually like to work on the frontline of Australia’s youth suicide Crisis

 “Alongside its beauty and isolation, the Kimberley is also known for its suicide rate. Last year, Indigenous health minister Ken Wyatt told the World Indigenous Suicide Prevention Conference: “If [the Kimberley] was a nation, it would have the highest suicide rate in the world.”

About eight years ago, Derby was at the epicentre of this ongoing catastrophe. In 2011 three young people died by suicide in as many weeks. The following year, the Aboriginal community of Mowanjum, 10km out of town, was rocked by the suicides of six people within six months.

Trent Ozies, 27, is a Djugun man from the Broome area who grew up in Derby. Ozies also has Filipino, Chinese and European heritage, as well as a gentle manner and a thoroughly infectious laugh. But he is grave as he recalls this terrible period.

“It was almost as if we went full circle,” he says. “Someone passed. Had their funeral, had the wake, someone passed. Had the funeral, had the wake, someone passed.

Read article in full HERE

Part 2

An Aboriginal health service in one of Australia’s worst suicide affected regions faces losing its psychologist and Aboriginal mental health worker, after money for the positions was cut in a state funding restructure last year.

The community controlled Derby Aboriginal Health Service (DAHS), located 220km east of Broome in Western Australia’s Kimberley region, delivers social and emotional wellbeing (SEWB) services in Derby.

The region has long struggled with the issue of Indigenous youth suicide. Coroner Ros Fogliani’s recent report into the deaths of 13 Aboriginal children and young people who died in the Kimberley found that 12 had died by suicide, the tragedies prompted by widespread poverty and intergenerational trauma.

The five person SEWB team in Derby is considered a model for how community mental health outreach should work in remote towns, according to Rob McPhee, the deputy CEO of Kimberley Aboriginal Medical Services.

But in a state funding restructure last year, DAHS lost funding for psychologist Maureen Robertson and mental health worker Ash Bin Omar and is now covering the $330,000 per year with money raised through Medicare consultations. SEWB services are generally funded by the Commonwealth.

Omar, who works with young Aboriginal men and boys, is also running a new project aimed at families with a low to medium risk of having their children removed to try and improve the situation and keep families together.

“For us not to have a psychologist and an Aboriginal mental health worker is really crazy,” Henderson-Yates said. “To my mind, there’s no debate about whether you have them or not have them.”

Senator Pat Dodson, who will become Indigenous affairs minister if Labor wins the election on May 18, told BuzzFeed News a Labor government would look to provide Commonwealth funding for two positions in Derby.

Labor has pledged $30 million over three years to support Aboriginal mental health and SEWB services in three high-need regions, including the Kimberley.

“If you don’t have these people being employed through the community health services, it just makes the effort to try and assist young people from taking these extreme measures totally impossible,” Dodson said.

Indigenous health minister Ken Wyatt told BuzzFeed News in a statement that the $19.6 million for suicide prevention pledged by the Coalition “builds on existing funding” provided through the Indigenous Advancement Strategy (IAS) in the department of prime minister and cabinet.

The sum includes $15 million for the rollout of mental health first aid training in 12 Indigenous communities and for youth, as well as continuing training for frontline workers. Another $4.6 million will go towards community-led programs — designed to complement existing services — in areas such as leadership, sports and culture.

The IAS currently funds about $55 million per year for SEWB, Wyatt said.

If you or someone you know needs help, you can visit your nearest ACCHO or call Lifeline Australia on 13 11 14 or Beyond Blue Australia on 1300 22 4636.

 

NACCHO #VoteACCHO Aboriginal Health and #SuicidePrevention debate @TracyWesterman Suicide risk factors are being incorrectly stated as suicide causes : and Comments from Harley Thompson @TheAHCWA Youth Co-ordinator

” First, we need to recognise the significant societal contributors to escalating rates of child suicides.

And we need to start with changing the narrative on indigenous suicides.

The core driver is that indigenous suicide is badly understood and myths about so-called causes of suicide are portrayed as if they exist as a direct linear relationship.

Suicide risk factors are being incorrectly stated as suicide causes and this is critical to this whole issue. Alcohol, poverty, abuse, colonialisation — these are not causes. They are risk factors, not causes. It is vital we understand this distinction to ensure adequate prevention efforts.

So, what separates Person A, who has been abused and becomes suicidal, from Person B, who has been abused and does not?

While this is an essential question, we do not have clear evidence of these critical causal pathways ” 

Adjunct professor Tracy Westerman is a clinical psychologist and proud Njamal woman from the Pilbara region of Western Australia. She was named Western Australia’s Australian of the Year last year for working to reduce the burden of mental ill health and suicide in Aboriginal communities. See full article from The Australian below Part 1

 ” Labor’s response to rising rates of indigenous youth suicide is a vote of confidence in Aboriginal health organisations such as the one Ms Thompson works for. A Shorten Labor government would make an “urgent investment” of $29.6 million in those Aboriginal community-controlled health organisations that already treat 350,000 indigenous people a year.

The money would be used to create regionally based multi­disciplinary teams of paediatricians, child psychologists, social workers, mental health nurses and ­Aboriginal health practitioners tasked with suicide prevention in vulnerable communities. “

What Ms Harley Thompson has learned in her role as a youth ­program co-ordinator at the Aboriginal Health Council of Western Australia has been seized upon by politicians scrambling to respond to Australia’s indigenous youth suicide crisis. See Full Story part 2 below 

Read all NACCHO 130+ Aboriginal Health and Suicide Articles Here 

#VoteACCHO Recommendation 4 of 10.

Address Aboriginal and Torres Strait Islander youth suicide rates

  • Provide $50 million over four years to ACCHOs to address the national crisis in Aboriginal and Torres Strait Islander youth suicide in vulnerable communities
  • Fund new Aboriginal support staff to provide immediate assistance to children and young people at risk of self-harm and improved case management
  • Fund regionally based multi-disciplinary teams, comprising paediatricians, child psychologists, social workers, mental health nurses and Aboriginal health practitioners who are culturally safe and respectful, to ensure ready access to professional assistance; and
  • Provide accredited training to ACCHOs to upskill in areas of mental health, childhood development, youth services, environment health, health and wellbeing screening and service delivery.

See all 10 #VoteACCHO recommendations HERE

Part 1

Indigenous Affairs Minister Nigel Scullion has allocated $134 million for indigenous suicide prevention. This crudely translates to $248,000 per death based on the suicide mortality rate — without adding state funding into the mix.

From the Australian April 20

Despite this, and as a country facing a growing tragedy of generational indigenous child suicides, we still have no nationally accepted evidence-based programs across the spectrum of early intervention and prevention activities.

Staggeringly, funded programs are not required to demonstrate evidence of impact, nor are they required to demonstrate a measurable reduction in suicide and mental health risk factors.

So, given this, can governments truly claim they are funding suicide prevention? You cannot claim prevention if you aren’t measuring risk. It’s that simple.

In an area as complex as indigenous suicide, it is crucial that funding decisions unsupported by clinical and cultural expertise are challenged and redirected in the best way possible: towards the evidence. Report after report has pointed to the need for “evidence-based approaches”, but has anyone questioned why this continues to remain elusive?

Perhaps we need to start with what constitutes evidence.

It doesn’t mean attendance. This is not evidence of impact. It means measurable, outcome-based evidence — a reduction in suicide risk factors attributable to the intervention provided.

Without measurability there is no accountability. Without measurability we are failing to gather crucial evidence of what works to better inform current and future practitioners struggling to halt the intergenerational transmission of suicide risk.

Clinicians terrified

Up to 30 per cent of clinicians will experience the suicide death of a client in our clinical lifetime. It is complex, it is scary, and very few of us understand what it is like to feel as though you are holding someone’s life in your hands.

I can tell you that, despite extensive training, suicide prevention challenges you at every level.

It challenges your core values about the right of people to choose death over life; it stretches you therapeutically despite your training in best practice; and it terrifies you that you have missed something long after you have left your at-risk client.

The nature of suicide risk is that it changes. Being able to predict and monitor it takes years of clinical expertise and well-honed clinical insight and judgment.

Throw culture into the mix and this becomes a rare set of skills held by few in this country. Indeed, back-to-back coronial inquiries, a 2016 parliamentary inquiry and 2018 Senate inquiry all concluded that not only are ser­vices lacking in remote and rural areas of Australia but culturally appropriate services were often non-existent.

Prevention focus

First, we need to recognise the significant societal contributors to escalating rates of child suicides.

And we need to start with changing the narrative on indigenous suicides.

The core driver is that indigenous suicide is badly understood and myths about so-called causes of suicide are portrayed as if they exist as a direct linear relationship.

Suicide risk factors are being incorrectly stated as suicide causes and this is critical to this whole issue. Alcohol, poverty, abuse, colonialisation — these are not causes. They are risk factors, not causes. It is vital we understand this distinction to ensure adequate prevention efforts.

So, what separates Person A, who has been abused and becomes suicidal, from Person B, who has been abused and does not? While this is an essential question, we do not have clear evidence of these critical causal pathways.

Once we establish a causal pathway, we can then focus on determining treatments of best practice to ensure that clinicians are focused in the best possible way to eliminate the established cause.

This can be done only through rigorous assessment of individual risk factors. Some of these risk factors will be static and historical, meaning they cannot be changed: you cannot change someone’s date or place of birth, for example.

Other risk factors will be dynamic and changeable: we can work on changing anxiety and responses to trauma.

Once we have a comprehensive picture of an individual’s risk factors, treatment is then determined as being effective based on a reduction in the symptoms attributable to the clinical intervention. Presenting poverty and colonialisation as causes offers little to clinicians, who need to focus therapeutic interventions on what is alterative and treatable.

It distracts us from the true causes of indigenous suicide that enable a genuine opportunity for prevention. Our people are not killing themselves because they are poor. They are killing themselves because of racism, trauma, most likely co-morbid with depression and alcohol and drug use, isolation and a lack of access to culturally competent clinicians and evidence-based programs.

A further danger in confusing causes with risk factors is that it also informs government approaches to this issue.

So, taking this example of alcohol, the government decided to solve suicides through establishing dry communities and restricting alcohol. There has not been a decrease in suicide in alcohol-restricted communities; in fact, the opposite is true. Suicide is so multidimensional and multifaceted that, unless you can undertake rigorous assessment, there is going to be an endless cycle of risk that is “predicted” only once a child dies by suicide.

The most distressing outcome of failing to understand suicide causes is it further stigmatises bereaved Aboriginal parents, inferring that most, if not all, are perpetrators or alcoholics.

Perpetuating such stereotypes contributes to a general lack of empathy for Aboriginal people bereaved by suicide. It is a “they did it to themselves” mentality that is not only inaccurate but also unhelpful and unkind.

When non-indigenous children die by suicide, we rightly look for deficits in society or systems and how we need to “do better” as a society.

When indigenous children die by suicide, we look for deficits in their families, in their culture. Why don’t we have a more empathetic view of indigenous child suicides and for indigenous families bereaved by suicide?

Finding answers

Unfortunately the gaps are obvious and have been for decades.

First, universities need to set minimum standards of cultural competence as prerequisites in the degrees undertaken by those in the “helping professions”.

Most would be lucky to have an hour of cultural training in their degrees and then are sent out to remote indigenous communities where cultural barriers are so significant they render the most gifted clinicians into paralysis.

I have developed a normed Aboriginal Mental Health Cultural Competency Profile, which has demonstrated the capacity to measure, support and improve cultural competency development. This is objective and measurable, and provides a useful method for educational institutions to set minimum standards.

Second, we need to assess and screen for early risk. My PhD resulted in the development of the Westerman Aboriginal Symptom Checklist, a culturally validated psychometric test to screen youth at risk.

Despite this, we do not have a widely accepted methodology to assess for suicide risk in indigenous people.

While the youth version (WASCY) and adult version (WASCA) have existed for two decades, and more than 25,000 clinicians have chosen to be accredited in it, access into high-risk areas is limited by the lack of wide-scale government rollout of the tool.

Third, we need to understand the causes of indigenous suicide. The priority needs to be to analyse the suicide death data to firmly establish causal pathways to suicide. If the suicide data were analysed in a way that determined “causal” pathways it would quite simply change the paradigm of this area.

The big-picture thinking is to use continuous suicide data (suicide risk factors that move and change) gathered by the WASCY and WASCA to determine causal pathways and co-variates (that is, impulsivity, depression and suicide risk) and determine whether a reduction in these factors reduces the overall suicide death rate.

This is complex but these two data sets will enable us to determine what risk factors are reducing the suicide death rate in more of an immediate, measurable and responsive way.

Access to this data is likely to take many more months to pass through several ethics committees, but we will self-fund this analysis to fast-track this vital information and to speed up crucial gaps in our knowledge in this area.

Fourth, we need to determine whether indigenous suicide is different. The WASCY has determined a different set of risk factors for indigenous suicide, finding among other things that up to 60 per cent of suicide risk is accounted for by impulsivity.

Those with impulse-control issues are likelier to have limited coping mechanisms that enable self-soothing specific to interpersonal conflict. This pattern often occurs with those who have trauma and attachment-related issues — the origins of which for Aboriginal families often lie in the forcible removal from primary attachment figures.

With the increasing evidence of the impacts of race-based trauma there is a need to address societal contributors to indigenous suicides. Thema Bryant-Davis and Carlota Ocampo, among others, have noted similar courses of mental illness between victims of violent crime and victims of racism.

In Australia, Yin Paradies has found that racism explains 30 per cent of depression and reduces Aboriginal life expectancy more than smoking.

Just as trauma frequently becomes a central organising principle in the psychological structure of the individual, trauma has become a central organising principle in the psychological structure of whole communities. This is known as “repetition compulsion”, meaning individuals who have had a previous traumatic event are at increased risk for future trauma experiences.

Suicide “clusters” are an obvious and common consequence of trauma repetition compulsion.

From a suicide prevention perspective, racism manifests as a sense of hopelessness and helplessness, which has consistently been implicated in suicide risk. When the origin of this lies in rac­ial identity it seems inherently “untreatable” as a core risk factor and unchallengeable as a core driver when a suicidal individual develops thought processes based on a belief they don’t matter.

When those within the “system” and broader community show no visible sign of caring, this cognition then becomes increasingly ingrained through daily reinforcement.

The best I can do as a clinician is to assist my clients to develop healthy and robust cultural identity and develop the skills and resilience to manage racist events.

The WASCY provides a cultural resilience assessment that enables clinicians to “treat” factors that have been demonstrated to moderate or buffer suicide risk. This is crucial to prevention.

We are also about to publish on the impacts of a whole-of-community suicide intervention response to indigenous deaths.

This is the first evidence-based program to demonstrate a measurable reduction in suicide risk factors. It is crucial that these programs are widely available in high-risk communities.

Epigenetics tells us that racism impacts on Aboriginal people in the same way as a traumatic event. The fact most of our suicides are so impulsive makes absolute sense from a trauma perspective.

Finally, we turn to our political leadership. We look for guidance in what resonates in the conscience of our nation.

I wrote recently about the silence of our political leaders during the Fogliani coronial inquiry into the 13 deaths of indigenous children in the Kimberley.

Not a single question in the lower house of the West Australian parliament has been asked about the coroner’s report, nor what was going to be done about it.

The ABC reported only nine of the 95 members of parliament have brought up the inquest in any way, in either chamber, this year.

Studies support that a “hierarchy of newsworthiness” exists in which “cultural proximity” to the audience plays a crucial role in the extent of empathy generated for victims. The more the audience relates to victims, the greater the newsworthiness.

If the broader community can’t connect in a “this could happen to me or my family” manner, then there is less community outcry, and significantly less pressure on politicians to respond because, ­ultimately, they are very aware there will be little to no backlash about it.

When those who are mandated to care fail to respond your trauma becomes magnified.

The silence of our political leaders has served to magnify the trauma of these families and in effect has become systemically perpetuated by them.

Part 2

Hayley Thompson has been listening as Indigenous teenagers tell her what makes them happy as well as what troubles them, and she says the answers might surprise adults who believe social media makes young people miserable and even suicidal.

From The Australian April 20

“The young people don’t talk about social media as a problem,” Ms Thompson said. “The good thing about listening to the young people is you hear what they think is important, and that can be quite different to what older generations think is important.”

What Ms Thompson has learned in her role as a youth ­program co-ordinator at the Aboriginal Health Council of Western Australia has been seized upon by politicians scrambling to respond to Australia’s indigenous youth suicide crisis.

Indigenous Australians die by suicide at twice the rate of other Australians and this rate is even higher for youth. So far this year, 12 indigenous boys aged 12 to 18 have taken their own lives.

The tragedies have prompted questions about what works and what should happen next. In Inquirer today, clinical psychologist Tracy Westerman writes: “Suicide risk factors are being incorrectly stated as suicide causes and this is critical to this whole issue.”

Labor’s response to rising rates of indigenous youth suicide is a vote of confidence in Aboriginal health organisations such as the one Ms Thompson works for. A Shorten Labor government would make an “urgent investment” of $29.6 million in those Aboriginal community-controlled health organisations that already treat 350,000 indigenous people a year.

The money would be used to create regionally based multi­disciplinary teams of paediatricians, child psychologists, social workers, mental health nurses and ­Aboriginal health practitioners tasked with suicide prevention in vulnerable communities.

The Coalition’s mental health and suicide prevention plan includes $34.1m to “support indigenous leadership that delivers culturally appropriate, trauma-informed care” as well as “services that recognise the value of community, cultural artistic traditions and protective social factors”.

Indigenous Health Minister Ken Wyatt earlier gave just over $1m to the youth strategy Ms Thompson is part of. She says young indigenous people in cities and remote areas all tell her they want to feel closer to their culture.

NACCHO #VoteACCHO Aboriginal Health #Election2019 @billshortenmp and @SenatorDodson set to unveil a $115 million #Labor plan to tackle the Indigenous health crisis today in Darwin : Including $ for @DeadlyChoices #SuicidePrevention  #MentalHealth #RHD #SexualHealth #EyeHealth

“Labor believes innovative and culturally appropriate health care models are central to improving the health outcomes of First Australians and closing the gap, noting that improving Indigenous health was “critical to our journey towards reconciliation. Labor would be funding programs “co-designed with and led by First Nations peoples – driven by the Aboriginal health workforce “

The Opposition Leader, who is also Labor’s spokesman for Indigenous affairs, will unveil the commitment while on the campaign trail with his assistant spokesman Senator Pat Dodson in the Northern Territory today;

Summary of the Labor Party $115 million commitments against NACCHO #VoteACCHO Recommendations

See all 10 NACCHO #VoteACCHO Recommendations Here

Refer NACCHO Recommendation 4

$29.6 million to improve mental health and prevent youth suicide : to administer the mental health funds through Aboriginal Community Controlled Health Services

See our NACCHO Chair Press Release yesterday

Refer NACCHO Recommendation 6

Sexual health promotion would get a $20 million boost

$13 million would be invested to tackle preventable eye diseases and blindness.

$3 million in seed funding provided to Aboriginal Medical Services to develop health and justice programs addressing the link between incarceration and poor health

Deadly Choices campaign would get $16.5 million for advertising to raise awareness of health and lifestyle choices

Refer NACCHO Recommendation 3

$33 million to address rheumatic heart disease

Media report from

‘Critical to reconciliation’: Labor’s plan to close the gap on Indigenous health

Bill Shorten is set to unveil a $115 million plan to tackle the Indigenous health crisis, as he seeks to position Labor as the only party capable of closing the ten-year gap in life expectancy between Aboriginal and Torres Strait Islander Australians and their non-Indigenous peers.

The package includes $29.6 million to improve mental health and prevent youth suicide, which has rocked communities in remote areas including the Kimberley where a spate of deaths has been linked to intergenerational trauma, violence and poverty.

The Opposition Leader, who is also Labor’s spokesman for Indigenous affairs, will unveil the commitment while on the campaign trail with his assistant spokesman Senator Pat Dodson in the Northern Territory on Thursday.

“Labor believes innovative and culturally appropriate health care models are central to improving the health outcomes of First Australians and closing the gap,” Mr Shorten said, noting that improving Indigenous health was “critical to our journey towards reconciliation”.

Labor’s package is $10 million more than the $19.6 million Prime Minister Scott Morrison announced for Indigenous suicide prevention on Saturday, after the suicide of an 18-year-old girl from the Kimberley last week.

Indigenous health advocates have previously raised concerns that the Coalition’s wider mental health package could be consumed by “mainstream” services like Headspace.

Mr Shorten highlighted Labor would be funding programs “co-designed with and led by First Nations peoples – driven by the Aboriginal health workforce”.

The Labor plan is to administer the mental health funds through Aboriginal Community Controlled Health Services, which employ teams of paediatricians, child psychologists, social workers, mental health nurses and Aboriginal health practitioners in vulnerable communities.

Official statistics show a ten-year gap in life expectancy between Indigenous and non-Indigenous Australians, with the rate of preventable hospital admissions and deaths three times higher for Aboriginal and Torres Strait Islander people.

Labor’s Indigenous health plan, which would be delivered over four years, also includes $33 million to address rheumatic heart disease, a preventable cause of heart failure, death and disability which is common in Aboriginal and Torres Strait Islander people.

Sexual health promotion would get a $20 million boost, while $13 million would be invested to tackle preventable eye diseases and blindness.

The Deadly Choices campaign would get $16.5 million for advertising to raise awareness of health and lifestyle choices and $3 million in seed funding provided to Aboriginal Medical Services to develop health and justice programs addressing the link between incarceration and poor health.

Mr Shorten said Labor would reinstate the National Aboriginal and Torres Strait Islander Health Equality Council, abolished by the Abbott Government in 2014.

Crisis support can be found at Lifeline: (13 11 14 and lifeline.org.au), the Suicide Call Back Service (1300 659 467 and suicidecallbackservice.org.au) and beyondblue (1300 224 636 and beyondblue.org.au) Or 1 of 302 ACCHO Clinics 

NACCHO #VoteACCHO Aboriginal Health #Election2019 #AusVotesHealth and #SuicidePrevention : @NACCHOChair Donnella Mills and other #health #justice leaders express concern that recent Indigenous #MentalHealth funding will go to mainstream services like @headspace_aus

What we know from the federal budget is a significant amount has been allocated towards Headspace and again, if it’s working with Aboriginal and Torres Strait Islander people the call is for it to go back to our community health organisations.

Evidence shows that Aboriginal and Torres Strait Islander people access services where they feel culturally safe… Aboriginal people engage with community controlled health organisations because of that trust.

We want to see the money go towards community-driven health organisations so they can each determine what mental health programs would look like in their own communities

Acting Chairperson for NACCHO Donnella Mills told NITV News it was “absolutely a worry” the funding would be put into the hands of services like Headspace. See Full Article below from NITV

Read over 130 Aboriginal health and Suicide Prevention articles written by NACCHO over past 7 years

The above photo from Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project

“I would like to visit and sit down with the Indigenous Elders in the community and first of all share the sorrow.

Our first Australians need us, so their kids can see hope and not choose the darkest of all possible options.”

The PM Scott Morrison told reporters combating youth suicide was his big priority

See PM and Minister Ken Wyatt Press Release HERE

Visit our NACCHO #VoteACCHO Election Campaign page HERE 

Especially #VoteACCHO Recommendation 4.

The incoming Federal Government must invest in ACCHOs, so we can address youth suicide

Provide $50 million over four years to ACCHOs to address the national crisis in Aboriginal and Torres Strait Islander youth suicide in vulnerable communities.

  • Fund new Aboriginal support staff to provide immediate assistance to children and young people at risk of self-harm and improved case management.
  • Fund regionally based multi-disciplinary teams, comprising paediatricians, child psychologists, social workers, mental health nurses and Aboriginal health practitioners who are culturally safe and respectful, to ensure ready access to professional assistance.
  • Provide accredited training to ACCHOs to upskill in areas of mental health, childhood development, youth services, environment health, health and wellbeing screening and service delivery.

#VoteACCHO Recommendation 6.

The incoming Federal Government must allocate Indigenous specific health funding to Aboriginal Community Controlled Health Organisations.

● Transfer the funding for Indigenous specific programs from Primary Health Networks to ACCHOs.

● Primary Health Networks assign ACCHOs as preferred providers for other Australian Government funded services for Aboriginal and Torres Strait Islander peoples unless it can be shown that alternative arrangements can produce better outcomes in quality of care and access to services.

With the federal election coming up next month, Prime Minister Scott Morrison has pledged additional funding towards combating youth and Aboriginal suicide, but Indigenous health advocates are concerned the money isn’t making it into the right places.

Edited from Brook Fryer NITV

Prime Minister Scott Morrison announced a boost towards mental health services on Saturday for young and Indigenous people, leaving Aboriginal health representatives concerned the funding will be put into the hands of conventional services.

If the Coalition is re-elected next month in the federal election, Mr Morrison has pledged to roll out an additional $42.1 million on top of the already committed $461 million that was announced as part of the federal budget earlier this month.

The promise includes $12.5 million towards making mental health services more effective for Indigenous people as well as $22.5 million to boost the governments Youth Mental Health and Suicide Prevention strategy.

The remainder will be put towards digital tools for mental health issues that are impacting young people including depression, anxiety and substance abuse.

Announced as part of the federal budget, the youth mental health organisation received $263.3 million to be rolled out over seven years.

In January, Headspace also received a $47 million boost from the Coalition, which was the third announcement of funding given to the youth mental health organisation since October last year.

Hannah McGlade, Senior Indigenous Research Fellow at Curtin University and a justice advocate, reiterated the need to have funding given to Indigenous initiatives.

“Cultural safety and cultural competency is critical for mental health care for Indigenous people and Indigenous youth and it’s simply too much of a challenge for non-Indigenous people,” she said.

Ms McGlade said there is a real concern the amount of funding won’t be enough to combat the First Nations suicide crisis.

The latest reported suicide was an 18-year-old female from the remote Western Australia community of Balgo, in the Kimberley region, on Thursday.

This year alone there have been 47 Aboriginal suicides with more than half under the age of 26 and around 12 under the age of 18, said Gerry Georgatos, the CEO of the National Critical Response Trauma Project.

“20 have been females,” he said.

“There have been four [First Nations] suicides across the country in the last week.”

Ms McGlade said she is expecting very little to come out of Mr Morrison’s visits to affected communities.

“Tony Abbott did the same thing and it lead to nothing, this is not a government that is at all committed to human rights… there is no indication that this government is at all interested in Aboriginal human rights,” she said.

The government is also pledging a further $19.6 million through the Indigenous Advancement strategy to prevent Indigenous youth suicide, with Indigenous Affairs Minister Nigel Scullion saying the funding would be largely used in the Kimberley.

Readers seeking support and information about suicide prevention can contact: Lifeline on 13 11 14 or a local ACCHO Aboriginal Health Service 302 locations

 Indigenous Australian psychologist services can be found here.

NACCHO #VoteACCHO Aboriginal #Mental Health and #SuicidePrevention : For #Election2019 #AusVotesHealth Prime Minister @ScottMorrisonMP and Indigenous Health Minister @KenWyattMP  Announce a  further $42m on mental health initiatives for young and some for Indigenous Australians

Young Indigenous people face many barriers to accessing healthcare including finding services that are safe and tailored to meet their needs.

This work will help change the way we deliver general mental health services so they draw on the value of culture, community and country to enrich the care provided to our First Nations people ”  

 Indigenous Health minister, Ken Wyatt. See extensive FACT SHEETS Part 2 below

“Our government will do  whatever it takes and whatever we can to break the curse of youth suicide in our country and ensure young people get the support they need”

Prime Minister Scott Morrison

Read over 130 Aboriginal Health and Suicide Prevention articles published by NACCHO over past 7 years  

Read over 200 Aboriginal Mental Health articles published by NACCHO over the past 7 years 

Visit our NACCHO #VoteACCHO Election Campaign page HERE 

#VoteACCHO Recommendation 4.

The incoming Federal Government must invest in ACCHOs, so we can address youth suicide

Provide $50 million over four years to ACCHOs to address the national crisis in Aboriginal and Torres Strait Islander youth suicide in vulnerable communities.

  • Fund new Aboriginal support staff to provide immediate assistance to children and young people at risk of self-harm and improved case management.
  • Fund regionally based multi-disciplinary teams, comprising paediatricians, child psychologists, social workers, mental health nurses and Aboriginal health practitioners who are culturally safe and respectful, to ensure ready access to professional assistance.
  • Provide accredited training to ACCHOs to upskill in areas of mental health, childhood development, youth services, environment health, health and wellbeing screening and service delivery.

#VoteACCHO Recommendation 6.

The incoming Federal Government must allocate Indigenous specific health funding to Aboriginal Community Controlled Health Organisations.

● Transfer the funding for Indigenous specific programs from Primary Health Networks to ACCHOs.

● Primary Health Networks assign ACCHOs as preferred providers for other Australian Government funded services for Aboriginal and Torres Strait Islander peoples unless it can be shown that alternative arrangements can produce better outcomes in quality of care and access to services.

Part 1 : Coalition vows to ‘break the curse of youth suicide’ with mental health package

The Coalition has pledged a further $42m on mental health initiatives for young and Indigenous Australians, on top of $461m in the budget for mental health and suicide prevention.

Extracts from The Guardian

Of the new funding, $22.5m will be spent on research grants to help find better treatments for mental health problems and $19.6m on the Indigenous advancement strategy to prevent suicide, particularly in the Kimberley.

In the first three months of this year, there were at least 35 suicides among Indigenous people, three of whom were only 12 years old.

The findings of an inquest into 13 suicides among young Aboriginal people in the Kimberley, handed down in February, found that crushing intergenerational trauma and poverty, including from the harmful effect of colonisation and loss of culture, were to blame.

The Morrison government has made “securing essential services” central to its re-election pitch, using its projection of a surplus in 2019-20 and perceived strength of economic management to pre-empt Labor attacks that it is not spending enough on health and other social causes.

Labor is promising to not only build bigger budget surpluses but also outspend the Coalition in health, beginning with its $2.3bn cancer package that it announced in the budget reply.

The research component of the Coalition’s mental health package has been allocated to a series of grants, including about emergency department management of acute mental health crises and culturally appropriate mental healthcare for Indigenous Australians.

Past 2 #VoteACCHO

1. Indigenous Mental Health and Suicide Prevention

  • The rate of suicide among Australians, particularly young First Australians is one of the most heartbreaking challenges we face as a country.
  • We have provided $88.8 million for Indigenous-specific mental health services, as well as local, culturally-safe mental health services for Aboriginal and Torres Strait Islanders through our $1.45 billion investment in PHNs.
  • The Minister for Indigenous Health, the Hon Ken Wyatt MP, has championed new measures to address Indigenous suicide prevention measures. Under the Youth Mental Health and Suicide Prevention Plan the Morrison McCormack Government is providing $14.5 million to support Indigenous leadership to help our health care system provide culturally safe and appropriate care, as well as new funding to enable young Indigenous people to participate in place-based cultural programs; build a centre of excellence in childhood wellness; and adapt psychological treatments to meet the needs of Indigenous Australians.
  • The Morrison McCormack Government is also making a new $19.6 million investment through the Indigenous Advancement Strategy to prevent Indigenous youth suicide, particularly in the Kimberley. This new $19.6 million investment will help build resilience and leadership skills in at-risk communities and provide new pathways for engagement, including some which the Kimberley Aboriginal Youth Suicide Prevention Forum told us are needed to support fellow young people.

2. Mental Health

  • The mental health of Australians is a priority for the Morrison McCormack Government.
  • One in five people in Australia experience a common mental disorder each year. Nearly half of the Australian population will experience mental illness at some point in their lives, but less than half will access treatment.
  • We are doing more than any other previous government to safeguard the mental wellbeing of Australians, providing record funding of $4.8 billion in 2018-19.
  • We are delivering more frontline services that meet the specific needs of local communities through a record $1.45 billion investment in our Primary Health Networks. We are providing long-term support for local psychologists, mental health nurses, and social workers, ensuring that the right services are available in the right place and at the right time.
  • We have expanded the headspace network, boosted headspace services, and established the Mental Health in Education Initiative with Beyond Blue to provide young Australians with additional help and support.
  • We have pioneered Medicare telehealth services allowing Australians in rural areas to access care from their homes. We have also expanded free or low-cost digital services, accessible through our new head to health portal to cater for those who prefer to access support online.
  • We have been the first to fully recognise the need for intensive support for Australians with eating disorders – the deadliest of all psychiatric illnesses – by creating specific Medicare funded services, a National Helpline, and providing $70.2 million for new residential treatment centres.
  • We have introduced key reforms such as a Productivity Commission Inquiry into Mental Health, changes to private health insurance, and innovative models of care such as the $114.5 million trial of 8 mental health centres.
  • Investing in mental health and suicide prevention is not a choice, it is a must.
  • The Liberal and Nationals Government’s track record in delivering a strong economy ensures we can invest in essential services such as youth mental health and suicide prevention services.

3.Youth Mental Health and Suicide Prevention

  • The tragedy of suicide touches far too many Australian families. Suicide is the leading cause of death of our young people – accounting for one-third of deaths of Australians aged 15-24.
  • The Government will provide $503.1 million for a Youth Mental Health and Suicide Prevention Plan to prevent suicide and promote the mental wellbeing of young Australians. This represents the single largest investment in youth suicide prevention in the country’s history.
  • We are prioritising three key areas as our nation’s best protection against suicide – strengthening the headspace network, Indigenous suicide prevention and early childhood and parenting support.
  • We will ensure young people get help where and when needed by investing an additional $375 million to expand and improve the headspace network. headspace provides youth-friendly services for the challenges facing young Australians: across physical health, alcohol and other drug use, vocational support and mental health.
  • To strengthen Indigenous youth suicide prevention, we will invest $34.1 million including support for Indigenous leadership that will help our health care system deliver culturally appropriate, trauma-informed care as well as services that recognise the value of community, cultural artistic traditions and protective social factors. Out support includes $19.6 million for measures to prevent Indigenous youth suicide, particularly in the Kimberley.
  • To support parents and their children we will invest $11.8 million in a range of initiatives to help parents recognise when their children are struggling, improve mental health skills training in schools, enhance peer support networks and boost counselling support services for young people.
  • We are also providing an additional $22.5 million in specific youth and Indigenous health research projects as part of our $125 million ‘Million Minds Mission’.
  • The Liberal and Nationals Government established this ten-year $125 million Mission through the Medical Research Future Fund. It will unlock key research into the cause of mental health as well as better treatments and therapies.
  • For Australians living in rural and regional we are ensuring that services are available where they are most needed by establishing more than 20 new headspace sites in rural and regional Australia, and by providing new mental health telehealth services funded through Medicare.
  • .

Natural Disasters

  • We are also addressing the mental health needs of those affected by natural disasters through:
    • $5.5 million for additional mental health services in Victoria, Queensland and Tasmania. This includes Medicare items for GPs to provide telehealth services to flood affected communities in Queensland.
    • $21.9 million for the Empowering our Communitiesinitiative to support community-led mental health programmes in nine drought-affected Primary Health Network regions.

Background

Mental Health Facts

  • One in five Australians aged 16 to 85 experiences a common mental illness (e.g. anxiety disorder, depression) in any year; nearly half (45 per cent) of all Australians will experience a mental health problem over the course of their lives. In 2016, one in seven children aged 4 to 17 years was assessed as having a mental health disorder in the previous 12 months.
  • Approximately 730,000 Australians experience severe mental health disorders. Another 4-6 per cent of the population (about 1.5 million people) are estimated to have a moderate disorder and a further 9-12 per cent (about 2.9 million people) a mild disorder.
  • Mental illness costs the Australian economy over $60 billion per year (around four per cent of Gross Domestic Product).

Suicide and Self-harm Facts

  • In 2017, 3,128 people died from intentional self-harm (12.6 deaths per 100,000 people), rising 9.1% from 2,866 in 2016. The 2017 rate is on par with 2015 as the highest recorded rate of suicide in the past 10 years. Most states saw an increase in their suicide rates, with Queensland and the Australian Capital Territory experiencing the largest rises. However, there were declines in Tasmania, South Australia and Victoria.
  • Suicide remained the leading cause of death among people aged between 15-44 years, and the second leading cause of death among those 45-54 years of age.
  • While intentional self-harm accounts for a relatively small proportion (1.9 per cent) of all deaths in Australia, it accounts for a higher proportion of deaths among younger people (36 per cent of deaths among people aged 15 to 24).

 

 

NACCHO Aboriginal Community Control and #Justice Health : @NACCHOChair Donnella Mills full speech at the @_PHAA_   #JusticeHealth2019 Conference #ClosingtheGap #justicereinvestment

” Given ACCHOs commitment to providing services based on community identified needs, it is not surprising, then, to learn that we are starting to address justice inequities by developing innovative partnerships with legal services.

Health justice partnerships are similar to justice reinvestment in that they target disadvantaged population groups and are community led. They differ in that funding is not explicitly linked to correctional budgets and secondly, the primary population groups targeted through these partnerships are those people at risk of poor health.[i]

Health justice partnerships in the ACCHO context address people’s fears and distrust about the justice system, by providing a culturally safe setting in which to have conversations about legal matters.

I believe that the development of collaborative, integrated service models such as Law Yarn can provide innovative and effective solutions for addressing not only the overrepresentation of Aboriginal and Torres Strait Islander peoples in the justice system, but also the health gaps between Indigenous and non-Indigenous Australians.

Selected extracts from Donnella Mills Acting Chair of NACCHO keynote speaker 9 April 

See PHAA #JusticeHealth2019 Website

Aboriginal community control and justice health

A justice target has been proposed to focus government efforts towards closing the gap on Aboriginal and Torres Strait Islander peoples’ overrepresentation in the justice system.

Discussion of the role of community leadership to address this serious issue must begin with a commitment to self-determination, community control, cultural safety and a holistic response. Aboriginal community controlled health services understand the interplays between intergenerational trauma, the social determinants of health, family violence, institutional racism and contact with the justice system.

As trusted providers within their communities, they deliver services based on community identified needs.

The presentation explores how the principles, values and beliefs underpinning the Aboriginal community controlled health service model provide the foundations for preventing and reducing Aboriginal and Torres Strait Islander peoples’ exposure to the justice system

I would like to acknowledge that the land we meet on today is the traditional lands for the Gadigal people of the Eora Nation, and that we respect their spiritual relationship with their Country.

I also acknowledge the Gadigal people as the traditional custodians of this place we now call Sydney. Their cultural and heritage beliefs are still as important to the living Gadigal people today.

This is also true for all Aboriginal and Torres Strait Islander peoples that are here this morning. We draw on the strength of our lands, our Elders past and on the lived experience of our community members.

For those who don’t know me, I am a proud Torres Strait Islander woman with ancestral and family links to Masig and Nagir.

I thank the Public Health Association of Australia for welcoming me here so warmly. I am delighted to be here today to share ideas with you on a topic that I care so deeply about.

Scene setting

Some of you may be aware that, late last month, a Partnership Agreement on Closing the Gap was signed between the Council of Australian Governments and the Coalition of Aboriginal and Torres Strait Islander Peak Bodies.

The agreement sets out how governments and Aboriginal and Torres Strait Islander representatives will work together on targets, implementation and monitoring arrangements for the Close the Gap strategy.

NACCHO and almost 40 other peak Aboriginal and Torres Strait Islander bodies negotiated the terms and conditions of this historic agreement on the understanding that when Aboriginal and Torres Strait Islander peoples are included and have a real say in the design and delivery of services that impact on them, the outcomes are far better. This understanding informs the premise of my presentation.

I am here to talk to you about how the principles, values and beliefs underpinning the Aboriginal community controlled service model provide the foundations for preventing and reducing Aboriginal and Torres Strait Islander peoples’ exposure to the justice system.

But first, a little bit about NACCHO, for those of you who are unfamiliar with our work.

NACCHO, which stands for the National Aboriginal Community Controlled Health Organisation, is the national peak body representing 145 Aboriginal Community Controlled Health Organisations – ACCHOs – across the country, on Aboriginal health and wellbeing issues.

Our members provide about three million episodes of holistic primary health care per year for about 350,000 people.

In very remote areas, our services provide about one million episodes of care in a twelve-month period. Collectively, we employ about 6,000 staff (56 per cent whom are Indigenous), which makes us the single largest employer of Indigenous people in the country.

SLIDE 2: Rates of representation in prisons and youth detention facilities

It is timely to come together and consider justice health issues in Aboriginal and Torres Strait Islander communities. It is likely that, for the first time, a justice target may be included in the Close the Gap Refresh strategy.

I am heartened to know that, for the first time, Aboriginal and Torres Strait Islander peak bodies will guide the finalisation of targets and oversee the strategy’s implementation, monitoring and evaluation. I am hopeful that, for the first time, we can begin to address the issues and see some improvements.

All of you hear today will have read and heard the shocking statistics, the increasing rates of incarceration among Indigenous Australians.

Last month it was reported that Aboriginal and Torres Strait Islander men are imprisoned at a rate 14.7 times greater than non-Indigenous men, and for women the rate is even higher, 21.2 times higher than non-Indigenous women.[ii]

Our women represent the fastest growing population group in prisons; their imprisonment rate is up 148% since 1991.[iii]

Imprisoning women affects the whole community. Children may be removed and placed in out-of-home care. Research has found there are links between detainees’ children being placed into out-of-home care and their subsequent progression into youth detention centres and adult correctional facilities.[iv] Communities suffer, and the cycle of intergenerational trauma and disadvantage is perpetuated.

Figures on the incarceration of Aboriginal and Torres Strait Islander children and young people in detention facilities reveal alarmingly high trends of overrepresentation:

  • On an average night in the June quarter 2018, nearly 59% of young people aged 10–17 in detention were Aboriginal and Torres Strait Islander, despite Aboriginal and Torres Strait Islander young people making up only 5% of the general population aged 10–17.
  • Indigenous young people aged 10–17 were 26 times as likely as non-Indigenous young people to be in detention on an average night.[v]

A concerning factor is the link between disability and imprisonment. A Senate Inquiry found that about 98% of Aboriginal and Torres Strait Islander prisoners also have a cognitive disability.[vi]

People living with physical disabilities such as hearing loss, and people with undiagnosed cognitive or psycho-social disabilities may struggle to negotiate the justice system and their symptoms are likely to be correlated with their offending behaviours, and receive punitive responses rather than treatment and care.

SLIDE 3: Overrepresentation – causal factors

Our experiences of incarceration are not only dehumanising. They contribute to our ongoing disempowerment, intergenerational trauma, social disadvantage, and burden of disease at an individual as well as community level. Indeed, ‘imprisonment compounds individual and community disadvantage.’[vii]

The question – why Aboriginal and Torres Strait Islander peoples are overrepresented in prisons – is complex. It can partly be explained by exploring how structural, geographic, historic, social and cultural factors intersect and impact individuals’ lives.

While people have some agency in how they respond to the circumstances they are born into, they are also constrained by many generations’ experiences of marginalisation, discrimination, poverty and disadvantage. This is particularly relevant and disturbing when one considers Aboriginal and Torres Strait Islander peoples’ experiences in navigating the justice system.[viii]

Issues of access and equity also disadvantage Aboriginal and Torres Strait Islander peoples in their dealings with the justice system. Some of these may relate to their geographical location – remote and very remote regions have limited legal services. Given the limited service infrastructure available in remote settings, geography also determines people’s access to community based options.

Some of the other barriers faced by our people relate to the lack of language interpreters and inappropriate modes and technologies of communication. People have different levels of English language literacy and IT capacities. These factors can result in peoples’ experiences of structural discrimination in the justice system and result in miscarriages of justice.[ix]

We have heard of the over-policing of Indigenous Australians and how this impacts on their exposure to the justice system. In his submission to the Senate Inquiry into Aboriginal and Torres Strait Islander experiences of law enforcement and justice services, Chief Justice Martin referred to ‘systemic discrimination’ through over-policing:

Aboriginal people are much more likely to be questioned by police than non-Aboriginal people. When questioned they are more likely to be arrested rather than proceeded against by summons. If they are arrested, Aboriginal people are much more likely to be remanded in custody than given bail. Aboriginal people are much more likely to plead guilty than go to trial, and if they go to trial, they are much more likely to be convicted. If Aboriginal people are convicted, they are much more likely to be imprisoned … and at the end of their term of imprisonment they are much less likely to get parole … So at every single step in the criminal justice process, Aboriginal people fare worse than non-Aboriginal people.[x]

There are other contributing factors that explain the overrepresentation of Aboriginal and Torres Strait Islander people in the justice system. The inadequate resourcing of Aboriginal community controlled legal services plays a major role in the growing level of unmet need in communities.[xi] As noted by the National Aboriginal and Torres Strait Islander Services:

Aboriginal and Torres Strait Islander people don’t just need access to more legal services; they need greater access to culturally appropriate legal services. … Cultural competency is essential for effective engagement, communication, delivery of services and the attainment of successful outcomes.[xii]

Aboriginal and Torres Strait Islander peoples’ experiences of institutional racism and discrimination, the trauma caused to members of the Stolen Generations and entire families and communities, which continues today with increasing numbers of children being placed in out-of-home care, contribute to the distrust, fear and unwillingness of many people to engage with legal services.

The Senate Inquiry into Aboriginal and Torres Strait Islander experiences of law enforcement and justice services heard that ‘for Aboriginal people in particular, there is this historical fear of about walking into a legal centre’.[xiii]

Governments’ inertia and lack of commitment to genuinely addressing the issues have contributed to a worsening situation. The National Indigenous Law and Justice Framework 2009-2015 was never funded, attracted no buy in from state and territory governments, and the review findings of the Framework were never made public.

SLIDE 4: Justice reinvestment

Increasing funding for the corrective service sector will not and does not address the issue of Aboriginal and Torres Strait Islander peoples’ exposure to the justice system. As Allison and Cunneen note, ‘the solutions to offending are found within communities, not prisons.’[xiv] They are referring to justice reinvestment, a strategy and an approach, whereby correctional funds – a portion of money for prisons – are diverted back into disadvantaged communities.

The concept of justice reinvestment centres on the belief that imprisoning people does not address the causal factors that give rise to their exposure to the justice system. Ignoring the causal factors leads not only to recidivism and repeat incarceration, it also reproduces intergenerational cycles of disadvantage and exposure to the justice system.

Reinvesting the money into community identified and led solutions not only addresses causation; it also strengthens communities. Depending on the project, justice reinvestment may not only help to reduce people’s exposure to the justice system; it may also improve education, health, and employment outcomes for Aboriginal and Torres Strait Islander peoples.

Allison and Cunneen’s analysis of justice reinvestment projects in Northern Australia shows how the underpinning principles of this approach reaffirm self-determination and strengthen cultural authority and identity. Justice reinvestment projects address the driving factors of many Aboriginal and Torres Strait Islander peoples’ interactions with the justice system: their historical experiences of colonisation, discrimination, dispossession and disempowerment.[xv]

It is encouraging to note that in its 2016 report of the inquiry into Aboriginal and Torres Strait Islander experience of law enforcement and justice services, the Finance and Public Administration References Committee recommended that the Commonwealth Government support Aboriginal led justice reinvestment projects.[xvi] In December 2017, the Australian Law Reform Commission recommended that Commonwealth, state and territory governments should provide support for:

  • the establishment of an independent justice reinvestment body; and
  • justice reinvestment trials initiated in partnership with Aboriginal and Torres Strait Islander communities.[xvii]

SLIDE 5: Closing the gap on justice outcomes: best practice approach

Emerging out of these inquiries is a growing understanding that closing the gap on justice outcomes must begin with a commitment to self-determination, community control, cultural safety and a holistic response.

Appropriately resourced, culturally safe, community controlled services are essential for addressing these barriers. Best practice approaches for developing solutions to preventable problems of Aboriginal and Torres Strait Islander peoples’ exposure to the justice system must begin with enabling their access to trusted services that are governed by principles and practices of self-determination, community control, cultural safety and a holistic response.[xviii]

NACCHO’s member services – the ACCHOs – embody these principles. The cultural safety in which ACCHOs’ services are delivered is a key factor in their success. They provide comprehensive primary care consistent with clients’ needs.

This includes home and site visits; provision of medical, public health and health promotion services; allied health, nursing services; assistance with making appointments and transport; help accessing child care or dealing with the justice system; drug and alcohol services; and providing help with income support.

The Aboriginal Community Controlled Health model of care recognises that Aboriginal and Torres Strait Islander peoples require a greater level of holistic care due to the trauma and dispossession of colonisation, dispossession and discrimination, which are linked to our poor health outcomes and over-representation in prisons.

ACCHOs understand the interplays between intergenerational trauma, the social determinants of health, family violence, and institutional racism, and the risks these contributing factors carry in increasing Aboriginal and Torres Strait Islander peoples’ exposure to the criminal justice system. We understand the importance of comprehensive health services that are trauma informed; and providing at risk families with early support. Within the principles, values and beliefs of the Aboriginal community controlled service model lie the groundwork for our communities’ better health outcomes.

SLIDE 6: Health justice partnerships

Given ACCHOs commitment to providing services based on community identified needs, it is not surprising, then, to learn that we are starting to address justice inequities by developing innovative partnerships with legal services.

Health justice partnerships are similar to justice reinvestment in that they target disadvantaged population groups and are community led. They differ in that funding is not explicitly linked to correctional budgets and secondly, the primary population groups targeted through these partnerships are those people at risk of poor health.[xix]

Health justice partnerships in the ACCHO context address people’s fears and distrust about the justice system, by providing a culturally safe setting in which to have conversations about legal matters.

In testimony given to a Senate Inquiry, an ACCHO representative describes how:

We form relationships with the health services and actually provide a legal service, for example, within the Aboriginal medical service. We have a lawyer embedded in the Aboriginal medical service in Mount Druitt so that when the doctor sees the person and they mention they have a housing issue – ‘I’m about to get kicked out of my place’ – they can say, ‘Go and see the lawyer that is in the office next door.’[xx]

ACCHOs are increasingly recognising the benefits of working with legal services to develop options that enable services to be delivered seamlessly, safely, and appropriately for their communities. Lawyers may be trained to work as part of a health care team or alternatively, health care workers may be upskilled to start a non-threatening, informal conversation about legal matters with the clients, which results in referrals to pro bono legal services.

 Case study: Law Yarn

As a lawyer and Chair of the Cairns-based Wuchopperen Health Service, I was aware of the need to provide better legal supports for my community. In conversations with local Elders and LawRight, Wuchopperen entered into a justice health partnership in 2016. LawRight is an independent, not-for-profit, community-based legal organisation which coordinates the provision of pro bono legal services for individuals and community groups.

The aim of the partnership was to improve health outcomes by enhancing access to legal rights and early intervention. Initially, it was decided that, as community member and lawyer employed by LawRight, I would provide the free legal services at Wuchopperen’s premises.

One of the challenges of justice health partnerships is ongoing funding, and in 2017 we were forced to close our doors for several months. We knew the partnership was addressing a real need in our community, so we submitted a funding proposal to the Queensland Government, and received funding of $55,000 to trial ‘Law Yarn’.

Law Yarn is a unique resource that supports good health outcomes in Aboriginal and Torres Strait Islander communities. It helps health workers to yarn with members of remote and urban communities about their legal problems and connect them to legal help. A handy how-to guide includes conversation prompts and advice on how to capture the person’s family, financial, tenancy or criminal law legal needs as well as discussing and recording their progress.

Representatives from LawRight, Wuchopperen Health Service, Queensland Indigenous Family Violence Legal Service and the Aboriginal Torres Strait Islander Legal Services came together and created a range of culturally safe resources based on LawRight’s successful Legal Health Check resources.

SLIDE 8: Law Yarn – your law story

SLIDE 9: Four aspects of Law

These symbols have been created to help identify and represent the four aspects of law that have been identified as the most concerning for individuals when presenting with any legal issues. If these four aspects can be discussed, both the Health worker and Lawyer can establish what the individual concerns are and effectively action a response.

Each symbol is surrounded by a series of 10 dots; these dots can be coloured in on both the artwork and the referral form by the Health worker to help establish what areas of law their clients have concerns with.

SLIDE 11: Launch of Law Yarn

Law Yarn was officially launched at Wuchopperen Health Service, Cairns, on 30 May 2018 by the Queensland Attorney General as a Reconciliation Week Event.

The trial has been funded to 30 June 2019 and will be comprehensively evaluated by independent academic researchers who specialise in this field.

Legal and health services throughout Australia have expressed interest in this holistic approach to the health and wellbeing of Aboriginal and Torres Strait Islander peoples. And we are hopeful that the evaluation findings will support the rollout of our model to ACCHOs across Australia.

In conclusion, I believe that the development of collaborative, integrated service models such as Law Yarn can provide innovative and effective solutions for addressing not only the overrepresentation of Aboriginal and Torres Strait Islander peoples in the justice system, but also the health gaps between Indigenous and non-Indigenous Australians.

Address the legal problems, and you will have better health outcomes. Justice health partnerships provide a model of integrated service delivery that go to the heart of the social determinants of health, key causal factors contributing to Aboriginal and Torres Strait Islander peoples’ over-exposure to the justice system.[xxi] With Aboriginal community control at the front and centre of service design, these partnerships are able to deliver both preventive law and preventive health for Aboriginal and Torres Strait Islander peoples.

SLIDE 12: Thank you

[i] Health Justice Australia. 2017. Integrating services; partnering with community. Submission to national consultation on Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023.

[ii] https://www.lawcouncil.asn.au/media/media-releases/recommendations-to-reduce-disproportionate-indigenous-incarceration-must-not-be-ignored

[iii] Law Council of Australia. 2018. The Justice Project, Final Report – Part 1. Aboriginal and Torres Strait Islander People.

[iv]. Law Council of Australia. 2018. The Justice Project, Final Report – Part 1. Aboriginal and Torres Strait Islander People.

[v] Australian Institute of Health and Welfare. 2018. Youth detention population in Australia. AIHW Bulletin 145.

[vi] Ibid., 2010 Senate Inquiry into hearing health in Australia.

[vii] Australian Human Rights Commission. 2009. Social Justice Report, pp. 53-54, cited in Finance and Public Administration References Committee. 2016. Aboriginal and Torres Strait Islander experience of law enforcement and justice services. The Senate: Australian Parliament House.

[viii] Law Council of Australia. 2018. The Justice Project, Final Report – Part 1. Aboriginal and Torres Strait Islander People.

[ix] Finance and Public Administration References Committee. 2016. Aboriginal and Torres Strait Islander experience of law enforcement and justice services. The Senate: Australian Parliament House; Law Council of Australia. 2018.

[x] Finance and Public Administration References Committee. 2016. Aboriginal and Torres Strait Islander experience of law enforcement and justice services. The Senate: Australian Parliament House. Testimony from Chief Justice Martin.

[xi] Finance and Public Administration References Committee. 2016. Aboriginal and Torres Strait Islander experience of law enforcement and justice services. The Senate: Australian Parliament House; Law Council of Australia. 2018. The Justice Project, Final Report – Part 1. Aboriginal and Torres Strait Islander People.

[xii] National Aboriginal and Torres Strait Islander Legal Service, Submission No. 109 to ALRC, 60, cited in Law Council of Australia. 2018. The Justice Project, Final Report – Part 1. Aboriginal and Torres Strait Islander People.

[xiii] Finance and Public Administration References Committee. 2016. Aboriginal and Torres Strait Islander experience of law enforcement and justice services. The Senate: Australian Parliament House, p. 31. Testimony from Ms Porteous, NACLC, Committee Hansard, 23 September 2015, p. 28.

[xiv] Allison, Fiona and Chris Cunneen. 2018. Justice Reinvestment in Northern Australia. The Cairns Institute Policy Paper Series, p. 5.

[xv] Allison, Fiona and Chris Cunneen. 2018. Justice Reinvestment in Northern Australia. The Cairns Institute Policy Paper Series, p. 8.

[xvi] Finance and Public Administration References Committee. 2016. Aboriginal and Torres Strait Islander experience of law enforcement and justice services. The Senate: Australian Parliament House.

[xvii] Australian Law Reform Commission. 2017. Pathways to Justice—An Inquiry into the Incarceration Rate of Aboriginal and Torres Strait Islander Peoples, Final Report No 133, p. 17.

[xviii] Thorburn, Kathryn and Melissa Marshall. 2017. The Yiriman Project in the West Kimberley: an example of justice reinvestment? Indigenous Justice Clearinghouse, Current Initiatives Paper 5; McCausland, Ruth, Elizabeth McEntyre, Eileen Baldry. 2017. Indigenous People, Mental Health, Cognitive Disability and the Criminal Justice System. Indigenous Justice Clearinghouse. Brief 22; AMA Report Card on Indigenous Health 2015. Treating the high rates of imprisonment of Aboriginal and Torres Strait Islander peoples as a symptom of the health gap: an integrated approach to both; Richards, Kelly, Lisa Rosevear and Robyn Gilbert. 2011. Promising interventions for reducing Indigenous juvenile offending Ibid. Indigenous Justice Clearinghouse, Brief 10.

[xix] Health Justice Australia. 2017. Integrating services; partnering with community. Submission to national consultation on Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023.

[xx] Finance and Public Administration References Committee. 2016. Aboriginal and Torres Strait Islander experience of law enforcement and justice services. The Senate: Australian Parliament House, p. 31. Testimony from Ms Hitter, Legal Aid NSW, Committee Hansard, 23 September 2015, p.28

[xxi] Ibid., p. 4; Chris Speldewinde and Ian Parsons. 2015. Medical-legal partnerships: connecting services for people living with mental health concerns. 13th National Rural Health Conference, Darwin; Barry Zuckerman, Megan Sandel, Ellen Lawton, Samantha Morton. Medical-legal partnerships: transforming health care. 2008. The Lancet, Vol 372.

NACCHO Aboriginal Mental Health and #SuicidePrevention : @ruokday ? launches #RUOKSTRONGERTOGETHER resources a targeted suicide prevention campaign to encourage conversation within our communities. Contributions inc Dr Vanessa Lee @joewilliams_tew @ShannanJDodson

“Nationally, Indigenous people die from suicide at twice the rate of non-Indigenous people. This campaign comes at a critical time.

As a community we are Stronger Together. Knowledge is culture, and emotional wellbeing can be learned from family members such as mothers and grandmothers.

These new resources from R U OK? will empower family members, and the wider community, with the tools to look out for each other as well as providing guidance on what to do if someone answers “No, I’m not OK”.”

Dr Vanessa Lee BTD, MPH, PhD Chair R U OK’s Aboriginal and Torres Strait Islander Advisory Group whose counsel has been integral in the development of the campaign

Read over 130 + NACCHO Aboriginal Health and Suicide Prevention articles

The Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP)

https://www.atsispep.sis.uwa.edu.au/

I have struggled with depression and anxiety for as long as I can remember. I’m 32 years old and only this year did I have the first psychologist ever ask me about my family history and acknowledge the intergenerational trauma that runs through Indigenous families.

Like many others, I have thought about taking my own life. There were a myriad of factors that led to that point, and a myriad of factors that led to me not following through. But one of the factors was the immense weight of intergenerational trauma that I believe is embedded into my heart, mind and soul and at times feels too heavy a burden to carry.

We can break this cycle of trauma. We need culturally safe Indigenous-designed suicide prevention programs and to destigmatise conversations around mental health. My hope is that, by sharing my own experiences of dealing with this complex subject, other people will be able to see that intergenerational trauma affects all of our mob.

The more we identify and acknowledge it, we’ll be stronger together “

Shannan Dodson is a Yawuru woman and on the RUOK? Indigenous Advisory committee that has launched the Stronger Together campaign targeted at help-givers – those in our communities who can offer help to those who are struggling ;

See full story Part 2 Below or HERE

R U OK? has launched STRONGER TOGETHER, a targeted suicide prevention campaign to encourage conversation within Aboriginal and Torres Strait Islander communities.

Developed with the guidance and oversight of an Aboriginal and Torres Strait Islander Advisory Group and 33 Creative, an Aboriginal owned and managed agency, the campaign encourages individuals to engage and offer support to their family and friends who are struggling with life. Positive and culturally appropriate resources have been developed to help individuals feel more confident in starting conversations by asking R U OK?

The STRONGER TOGETHER campaign message comes at a time when reducing rates of  suicide looms as one of the biggest and most important challenges of our generation.

Suicide is one of the most common causes of death among Aboriginal and Torres Strait

Islander people. A 2016 report noted that on average, over 100 Aboriginal and Torres Strait Islander people end their lives through suicide each year, with the rate of suicide twice as high as that recorded for other Australians [1]. These are not just numbers. They represent lives and loved ones; relatives, friends, elders and extended community members affected by such tragic deaths.

STRONGER TOGETHER includes the release of four community announcement video

The video series showcases real conversations in action between Aboriginal and Torres Strait Islander advocates and role models.

The focus is on individuals talking about their experiences and the positive impact that sharing them had while they were going through a tough time.

“That weekend, I had the most deep and meaningful and beautiful conversations with my Dad that I never had.

My Dad was always a staunch dude and I was always trying to put up a front to, I guess, make my Dad proud. But we sat there, and we cried to each other.

I started to find myself and that’s when I came to the point of realising that, you know, I’m lucky to be alive and I had a second chance to help other people.”

When we talk, we are sharing, and our people have always shared, for thousands of years we’ve shared experiences, shared love. The only way we get out of those tough times is by sharing and talking and I hope this series helps to spread that message.”

Former NRL player and welterweight boxer Joe Williams has lent his voice to the series.

Born in Cowra, Joe is a proud Wiradjuri man. Although forging a successful professional sporting career, Joe has battled with suicidal ideation and bipolar disorder. After a suicide attempt in 2012, a phone call to a friend and then his family’s support encouraged him to seek professional psychiatric help.

Australian sports pioneer Marcia Ella-Duncan OAM has also lent her voice to the series. Marcia Ella-Duncan is an Aboriginal woman from La Perouse, Sydney, with traditional connection to the Walbunga people on the NSW Far South Coast, and kinship connection to the Bidigal, the traditional owners of the Botany Bay area.

“Sometimes, all we can do is listen, all we can do is be there with you. And sometimes that might be all you need. Or sometimes it’s just the first step towards a much longer journey,” said Marcia.

Click here to access the STRONGER TOGETHER resources on the RUOK? website.

If you or someone you know needs support, go to:  ruok.org.au/findhelp

Part 2

Shannan Dodson is a Yawuru woman and on the RUOK? Indigenous Advisory committee that has launched the Stronger Together campaign targeted at help-givers – those in our communities who can offer help to those who are struggling ;

Originally Published the Guardian and IndigenousX

It is unacceptable and a national disgrace that there have been at least 35 suicides of Indigenous people this year – in just 12 weeks – and three were children only 12 years old.

The Kimberley region – where my mob are from – has the highest rate of suicide in the country. If the Kimberley was a country it would have the worst suicide rate in the world.

A recent inquest investigated 13 deaths which occurred in the Kimberley region in less than four years, including five children aged between 10 and 13.

Western Australia’s coroner said the deaths had been shaped by “the crushing effects of intergenerational trauma”.

When we’re talking about Indigenous suicide, we have to talk about intergenerational trauma; the transfer of the impacts of historical trauma and grief to successive generations.

These multiple layers of trauma can have a “cumulative effect and increase the risk of destructive behaviours including suicide”. Many of our communities are, in essence, “not just going about the day, but operating in crisis mode on a daily basis.”

I have struggled with depression and anxiety for as long as I can remember. I’m 32 years old and only this year did I have the first psychologist ever ask me about my family history and acknowledge the intergenerational trauma that runs through Indigenous families.

Like many others, I have thought about taking my own life. There were a myriad of factors that led to that point, and a myriad of factors that led to me not following through. But one of the factors was the immense weight of intergenerational trauma that I believe is embedded into my heart, mind and soul and at times feels too heavy a burden to carry.

Indigenous suicide is different. Suicide is a complex issue, there is not one cause, reason, trigger or risk – it can be a web of many indicators. But with Aboriginal and Torres Strait Islander people intergenerational trauma and the flow-on effects of colonisation, dispossession, genocide, cultural destruction and the stolen generations are paramount to understanding high Indigenous suicide rates.

When you think about the fact that most Indigenous families have been affected, in one or more generations, by the forcible removal of one or more children, that speaks volumes. The institutionalisation of our mob has had dire consequences on our sense of being, mental health, connection to family and culture.

Just think about that for a moment. If every Indigenous family has been affected by this, of course trauma is transmitted down through generations and manifests into impacts on children resulting from weakened attachment relationships with caregivers, challenged parenting skills and family functioning, parental physical and mental illness, and disconnection and alienation from the extended family, culture and society.

The high rates of poor physical health, mental health problems, addiction, incarceration, domestic violence, self-harm and suicide in Indigenous communities are directly linked to experiences of trauma. These issues are both results of historical trauma and causes of new instances of trauma which together can lead to a vicious cycle in Indigenous communities.

Our families have been stripped of the coping mechanisms that all people need to thrive and survive. And while Aboriginal and Torres Strait Islander people are resilient, we are also human.

Our history does shape us. Let’s start from colonisation. My mob the Yawuru people from Rubibi (Broome) were often brutally dislocated from our lands, and stripped of our livelihood. Our culture was desecrated and we were used for slave labour.

My great-grandmother was taken from her father when she was very young and placed in a mission in Western Australia. My grandmother and aunties then all finished up in the same mission. And two of those aunties spent a considerable time in an orphanage in Broome, although they were not orphans.

In 1907, a telegram from Broome station was sent to Henry Prinsep, the “Chief Protector of Aborigines for Western Australia” in Perth. It reads: “Send cask arsenic exterminate aborigines letter will follow.” This gives a glimpse of the thinking of the time and that of course played out in traumatic and dehumanising ways.

In the late 1940s a magistrate in the court of Broome refused my great-grandmother’s application for a certificate of citizenship under the Native Citizen Rights Act of Western Australia. Part of his reasons for refusing her application was that she had not adopted the manner and habits of civilised life.

My anglo grandfather was imprisoned for breaching the Native Administration Act of Western Australia, in that he was cohabiting with my grandmother. He was jailed for loving my jamuny (grandmother/father’s mother).

My dad lost his parents when he was 10 years old. My grandfather died in tragic circumstances – and then my grandmother, again in tragic circumstances, soon after.

My dad was collected by family in Katherine and taken to Darwin. There was a fear that he would be taken away – Indigenous families knew well the ways of the Native Welfare authorities, and I suspect they were protecting my dad from that fate. Unlike many Indigenous families, he was permitted to stay with them and became a state child in the care of our family.

My family has suffered from ongoing systematic racism and research has shown that racism impacts Aboriginal people in the same way as a traumatic event.

My family and community have suffered premature deaths from suicide, preventable health issues, grief and inextricable trauma.

We can break this cycle of trauma. We need culturally safe Indigenous-designed suicide prevention programs and to destigmatise conversations around mental health. My hope is that, by sharing my own experiences of dealing with this complex subject, other people will be able to see that intergenerational trauma affects all of our mob. The more we identify and acknowledge it, we’ll be stronger together.

 

 

NACCHO Aboriginal Health #Saveadate Events and Conferences : This week features @TheAHCWA #AHCWAConf @NRHAlliance #MentalHealth Survey closes 2 April #RuralHealthConf @CongressMob International Conference #HousingCrisis #WIHC2019

This weeks featured NACCHO SAVE A DATE events

March 26 – 28 West Australian Aboriginal Community Controlled Health Sector Conference

Download the 2019 Health Awareness Days Calendar 

28 March Close : DSS are drafting the Terms of Reference for the Royal Commission into Violence, Abuse, Neglect & Exploitation of People with Disability. @FPDNAus

2 April National Rural Health Alliance Invitation to participate in rural, regional and remote workforce training needs to improve mental health services survey closes

20 -24 May 2019 World Indigenous Housing Conference. Gold Coast

18 -20 June Lowitja Health Conference Darwin

2019 Dr Tracey Westerman’s Workshops 

7 -14 July 2019 National NAIDOC Grant funding round opens

23 -25 September IAHA Conference Darwin

24 -26 September 2019 CATSINaM National Professional Development Conference

16 October Melbourne Uni: Aboriginal and Torres Strait Islander Health and Wellbeing Conference

5-8 November The Lime Network Conference New Zealand 

Featured Save date

March 26 – 28 West Australian Aboriginal Community Controlled Health Sector Conference

Welcome to the 2019 West Australian Aboriginal Community Controlled Health Sector Conference, which is hosted annually by the Aboriginal Health Council of Western Australia (AHCWA).

We are pleased to advise that The Hon. Ken Wyatt  AM, MP – Minister for Aged Care; Minister for Indigenous Health will be officially opening the conference and the Hon. Roger Cook MLA – Deputy Premier; Minister for Health; Mental Health will be delivering a Keynote Address.

The Conference Program will focus on the theme – Lead the Way, Challenge the Possibilities, Imagine the Future. 

The Conference will promote the journey of the sector so far, the successes along the way and plans for the future of Aboriginal holistic health care delivery provided by (AHCWA’s) 23 Aboriginal community controlled health services (ACCHS) located throughout Western Australia.

Our national body, the National Aboriginal Community Controlled Health Organisation (NACCHO) defines Aboriginal health as ‘not just the physical well-being of an individual but refers to the social, emotional and cultural well-being of the whole Community in which each individual is able to achieve their full potential as a human being thereby bringing about the total well-being of their Community’.

NACCHO CEO Pat Turner will be speaking at the Conference

Special guests will provide the forum with exciting new information on health initiatives and there will be state and federal government updates on where the sector will be heading, in 2019 and beyond.

The Lead the Way, Challenge the Possibilities, Imagine the Future Conference will also showcase the AHCWA member services through a series of presentations over the two days as well as highlighting the following:

  • Who led the Way in Perth Metro?
  • Who led the Way in the Bush?
  • Sustainable Aboriginal Workforce and Pathways
  • Youth Health and the AHCWA Aboriginal Youth Strategy
  • Improving Water Quality in Remote Communities
  • Public Health Issues and Outbreaks
  • Sustainable Health Review Report
  • National Disability Insurance Scheme (NDIS)
  • Rheumatic Heart Disease (RHD) National Roadmap
  • Precision Public Health
  • Mappa Project Update – Feedback on the Controlled Live Trial

Delegates will be provided with an opportunity for professional development, networking and capacity building whilst sharing their wisdom on Aboriginal ways of working and successful program experience.

AHCWA acknowledges the land on which the conference will be held – the Whadjuk People and elders past, present and future. 

Download the NACCHO 2019 Calendar Health Awareness Days

For many years ACCHO organisations have said they wished they had a list of the many Indigenous “ Days “ and Aboriginal health or awareness days/weeks/events.

With thanks to our friends at ZockMelon here they both are!

It even has a handy list of the hashtags for the event.

Download the 53 Page 2019 Health days and events calendar HERE

naccho zockmelon 2019 health days and events calendar

We hope that this document helps you with your planning for the year ahead.

Every Tuesday we will update these listings with new events and What’s on for the week ahead

To submit your events or update your info

Contact: Colin Cowell www.nacchocommunique.com

NACCHO Social Media Editor Tel 0401 331 251

Email : nacchonews@naccho.org.au

28 March

28 March Close : DSS are drafting the Terms of Reference for the Royal Commission into Violence, Abuse, Neglect & Exploitation of People with Disability. @FPDNAus

https://engage.dss.gov.au/royal-commission-into-violence-abuse-neglect-and-exploitation-of-people-with-disability/

They have set up an on-line survey that is only open for the next 10 days. closes 28 March

https://www.surveymonkey.com/r/LSXH77X8

2 April National Rural Health Alliance Invitation to participate in rural, regional and remote workforce training needs to improve mental health services survey closes

The National Rural Health Alliance invites you to participate in a survey to find out what are the mental health training needs of the rural, regional and remote workforce to improve mental health care, services and health outcomes.

The Productivity Commission is currently undertaking an inquiry into the costs of mental health in Australia. The Productivity Commission is interested in finding out what are the training needs of the workforce to be able to deliver effective mental health care.

Data collected from the survey will be used to inform the National Rural Health Alliance’s response to the Productivity Commission and also inform ongoing strategic planning. The survey is anonymous and your participation is voluntary.

The survey opens Friday, 22 March 2019 and closes 5pm Tuesday, 2 April 2019.

To access the survey, click the link here:  https://www.surveymonkey.com/r/53MJYYX

Any queries about the survey please contact Dr Joanne Walker –   jo@ruralhealth.org.au

Thank you, once again, for your participation in the survey

20 -24 May 2019 World Indigenous Housing Conference. Gold Coast

Thank you for your interest in the 2019 World Indigenous Housing Conference.

The 2019 World Indigenous Housing Conference will bring together Indigenous leaders, government, industry and academia representing Housing, health, and education from around the world including:

  • National and International Indigenous Organisation leadership
  • Senior housing, health, and education government officials Industry CEOs, executives and senior managers from public and private sectors
  • Housing, Healthcare, and Education professionals and regulators
  • Consumer associations
  • Academics in Housing, Healthcare, and Education.

The 2019 World Indigenous Housing Conference #2019WIHC is the principal conference to provide a platform for leaders in housing, health, education and related services from around the world to come together. Up to 2000 delegates will share experiences, explore opportunities and innovative solutions, work to improve access to adequate housing and related services for the world’s Indigenous people.

Event Information:

Key event details as follows:
Venue: Gold Coast Convention and Exhibition Centre
Address: 2684-2690 Gold Coast Hwy, Broadbeach QLD 4218
Dates: Monday 20th – Thursday 23rd May, 2019 (24th May)

Registration Costs

  • EARLY BIRD – FULL CONFERENCE & TRADE EXHIBITION REGISTRATION: $1950 AUD plus booking fees
  • After 1 February FULL CONFERENCE & TRADE EXHIBITION REGISTRATION $2245 AUD plus booking fees

PLEASE NOTE: The Trade Exhibition is open Tuesday 21st May – Thursday 23rd May 2019

Please visit www.2019wihc.com for further information on transport and accommodation options, conference, exhibition and speaker updates.

Methods of Payment:

2019WIHC online registrations accept all major credit cards, by Invoice and direct debit.
PLEASE NOTE: Invoices must be paid in full and monies received by COB Monday 20 May 2019.

Please note: The 2019 WIHC organisers reserve the right of admission. Speakers, programs and topics are subject to change. Please visit http://www.2019wihc.comfor up to date information.

Conference Cancellation Policy

If a registrant is unable to attend 2019 WIHC for any reason they may substitute, by arrangement with the registrar, someone else to attend in their place and must attend any session that has been previously selected by the original registrant.

Where the registrant is unable to attend and is not in a position to transfer his/her place to another person, or to another event, then the following refund arrangements apply:

    • Registrations cancelled less than 60 days, but more than 30 days before the event are eligible for a 50% refund of the registration fees paid.
    • Registrations cancelled less than 30 days before the event are no longer eligible for a refund.

Refunds will be made in the following ways:

  1. For payments received by credit or debit cards, the same credit/debit card will be refunded.
  2. For all other payments, a bank transfer will be made to the payee’s nominated account.

Important: For payments received from outside Australia by bank transfer, the refund will be made by bank transfer and all bank charges will be for the registrant’s account. The Cancellation Policy as stated on this page is valid from 1 October 2018.

Terms & Conditions

please visit www.2019wihc.com

Privacy Policy

please visit www.2019wihc.com

18 -20 June Lowitja Health Conference Darwin


At the Lowitja Institute International Indigenous Health and Wellbeing Conference 2019 delegates from around the world will discuss the role of First Nations in leading change and will showcase Indigenous solutions.

The conference program will highlight ways of thinking, speaking and being for the benefit of Indigenous peoples everywhere.

Join Indigenous leaders, researchers, health professionals, decision makers, community representatives, and our non-Indigenous colleagues in this important conversation.

More Info 

2019 Dr Tracey Westerman’s Workshops 

More info and dates

7 -14 July 2019 National NAIDOC Grant funding round opens 

The opening of the 2019 National NAIDOC Grant funding round has been moved forward! The National NAIDOC Grants will now officially open on Thursday 24 January 2019.

Head to www.naidoc.org.au to join the National NAIDOC Mailing List and keep up with all things grants or check out the below links for more information now!

https://www.finance.gov.au/resource-management/grants/grantconnect/

https://www.pmc.gov.au/indigenous-affairs/grants-and-funding/naidoc-week-funding

23 -25 September IAHA Conference Darwin

 

24 -26 September 2019 CATSINaM National Professional Development Conference

 

 

The 2019 CATSINaM National Professional Development Conference will be held in Sydney, 24th – 26th September 2019. Make sure you save the dates in your calendar.

Further information to follow soon.

Date: Tuesday the 24th to Thursday the 26th September 2019

Location: Sydney, Australia

Organiser: Chloe Peters

Phone: 02 6262 5761

Email: admin@catsinam.org.au

16 October Melbourne Uni: Aboriginal and Torres Strait Islander Health and Wellbeing Conference

The University of Melbourne, Department of Rural Health are pleased to advise that abstract
submissions are now being invited that address Aboriginal and Torres Strait Islander health and
wellbeing.

The Aboriginal & Torres Strait Islander Health Conference is an opportunity for sharing information and connecting people that are committed to reforming the practice and research of Aboriginal & Torres Strait Islander health and celebrates Aboriginal knowledge systems and strength-based approaches to improving the health outcomes of Aboriginal communities.

This is an opportunity to present evidence-based approaches, Aboriginal methods and models of
practice, Aboriginal perspectives and contribution to health or community led solutions, underpinned by cultural theories to Aboriginal and Torres Strait Islander health and wellbeing.
In 2018 the Aboriginal & Torres Strait Islander Health Conference attracted over 180 delegates from across the community and state.

We welcome submissions from collaborators whose expertise and interests are embedded in Aboriginal health and wellbeing, and particularly presented or co-presented by Aboriginal and Torres Strait Islander people and community members.

If you are interested in presenting, please complete the speaker registration link

closing date for abstract submission is Friday 3 rd May 2019.
As per speaker registration link request please email your professional photo for our program or any conference enquiries to E. aboriginal-health@unimelb.edu.au.

Kind regards
Leah Lindrea-Morrison
Aboriginal Partnerships and Community Engagement Officer
Department of Rural Health, University of Melbourne T. 03 5823 4554 E. leah.lindrea@unimelb.edu.au

5-8 November The Lime Network Conference New Zealand 

This years  whakatauki (theme for the conference) was developed by the Scientific Committee, along with Māori elder, Te Marino Lenihan & Tania Huria from .

To read about the conference & theme, check out the  website.