NACCHO Aboriginal Health #NAIDOC2017 : Recognising the communication gap in Indigenous health care

 ” The communication gap between health professionals and Indigenous Australians has a significant impact on health outcomes

Limited health literacy is not confined to Indigenous people, but it is greatly magnified for speakers of Indigenous languages in comparison, for example, to non-English speaking migrants from countries where a scientific approach to medicine is practised and where these health concepts are already codified.”

Dr Robert Amery Medical Journal Australia NAIDOC Week 2017

 

Introduction Press Release

Communication gap puts Indigenous health at risk

The need for health professionals to have a stronger focus on communication with Indigenous people has been highlighted by the University of Adelaide’s Head of Linguistics, who says some lives are being put at risk because of a lack of patient-doctor understanding.

In a paper published (Monday 3 July) in the Medical Journal of Australia coinciding with the NAIDOC Week theme of Our Languages Matter – Dr Robert Amery has raised concerns not just about language but also a lack of cultural awareness that also impacts on good communication with Indigenous patients.

Dr Robert Amery, who heads Linguistics within the University of Adelaide’s School of Humanities and is a Kaurna language expert, says poor communication can lead to “mistrust and disengagement with the health sector” among

Indigenous patients, leading to a lack of compliance with treatment, and ultimately poor health outcomes.

He says there’s a 16-year gap in life expectancy for Indigenous people living in the Northern Territory compared with non-Indigenous Australians. Of these Indigenous people in the NT, 70% live in remote areas, and 60–65% speak an Indigenous language at home.

“While many speakers of Indigenous languages living in remote areas can engage with outsiders and converse in English about everyday matters, they often have a poor grasp of English when it comes to health communications and other specialised areas,” Dr Amery says.

Miscommunication can be subtle, and previous studies have shown that while both parties think they have understood each other, they can in fact come away with very different understandings.

“Miscommunication isn’t just about language. Some of these difficulties also arise from the interface of communication and culture, which are often derived from differences in worldview,” he says.

“For traditionally oriented Aboriginal people living in remote areas, understanding of disease causation is fundamentally different. Serious diseases, even accidents, are often attributed to sorcery. Germ theory and the immune system are foreign concepts.

“Silence plays an important role in Indigenous cultures. Indigenous people often respond to questions after a prolonged pause, a concept foreign to those doctors who see silence as impolite in their own cultures.

They compensate by filling the silence and disrupting Indigenous patients’ thoughts. There is a simple solution: pause and allow the patient to think.”

He also suggests healthcare professionals avoid the use of “intangible” conceptual English words and vague sentences, instead focusing on factual communication; that they demonstrate how a medical procedure works; and use simple diagrams to explain medical issues.

“These examples may seem plain and obvious, but astoundingly, despite the many hours dedicated to communication in medical education, such concepts are not taught,” Dr Amery says.

“An investment of time in the consult will have immense payoffs over the long term.”

 Download MJA paper here MJA Dr Robert Amery

Published with permission from Robert Amery and Medical  Journal Australia

 See website for references or PDF

The communication gap is most pronounced in remote areas where cultural and linguistic differences are greatest. The close interdependence of language and culture amplifies the gap, such that communication difficulties in these communities run deeper than language barriers alone.

Life expectancy for Indigenous Australians living in remote areas is considerably shorter than for those living in rural and urban areas.6 Figures are not available for the life expectancy of native speakers of Indigenous languages as a cohort, but the gap in life expectancy exceeds 16 years for Indigenous people living in the Northern Territory,7 70% of whom live in remote areas, and 60–65% speak an Indigenous language at home. The life expectancy gap is, of course, multifactorial, although most studies focus on causes of death.8 The communication gap as a contributor is under-rated and under-researched.1,9

An understanding of the Indigenous language landscape is critical to improving communication. In the 2011 Australian census, 60 550 people, or 11.8% of Indigenous respondents, claimed to speak an Indigenous language at home, and 17.5% claimed not to speak English well.10

More have difficulty with specialised language, with common terms such as infection, tumour, high blood pressure, stroke and bacteria often misunderstood. Native Indigenous language speakers communicate in over 100 different traditional languages and live primarily in the NT, the Kimberley region of Western Australia, northern South Australia and northern Queensland, including Torres Strait.

None of these languages have more than 6000 speakers, and many are now reduced to a mere handful, yet each of these languages is a vast storehouse of knowledge built up over thousands of years. It can be daunting to enter a large English-speaking hospital if you communicate in a language spoken by so few people.

Speakers of some languages have shifted to dominant regional languages, such as Murrinh-Patha (Wadeye, NT), while others have shifted to a creole language, such as Kriol (the Kimberley region and the Barkly Tableland area of the NT and North West Queensland).

Aboriginal people often speak distinctive varieties of Aboriginal English that differ from mainstream English. For most Aboriginal people in remote areas, their Aboriginal English is an inter-language variety, in the same way that Japanese speakers have their own distinctive accent and turn of phrase in English, which may be a challenge for medical personnel to understand.

Data might suggest that only a small proportion (less than 10%) of Indigenous adults under 60 years do not speak English well, and that communication issues would therefore not be significant (Box 1).

However, while many speakers of Indigenous languages living in remote areas can engage with outsiders and converse in English about everyday matters, they often have a poor grasp of English when it comes to health communications and other specialised areas. In a study on comprehension of 30 common legal terms (assault, bail, guilty, warrant, etc),11 200 Yolŋu people (north-east Arnhem Land) were surveyed with over 95% unable to correctly identify the meaning of these terms (Box 2).

A parallel health study has not been conducted, but it is likely that understanding of common specialised health terms would be no better. Personal experience supports this view. In 1990, I taught a short course in medical interpreting to a group of Yolŋu students. In teaching the difference between idiomatic and literal language, I introduced an example (“He chucked his guts up”) that I thought everyone would understand. The Yolŋu students interpreted this idiom literally, thinking he ripped out his intestines and threw them in the air. Even simple little things that might be said, such as “let’s keep an eye on it”, can be baffling, because these expressions are often taken literally.

Proportion of Indigenous Australians who speak an Indigenous language and who are reported to speak English “not well” or “not at all”, 2006 and 2011*

Yolŋu comprehension of 30 common legal terms*

Misinterpretations also arise from the interface of communication and culture, here derived from differences in worldview rather than linguistics. In the 1980s, I talked with Tjapaltjarri (skin name, now deceased), a senior Pintupi Aboriginal health worker, about the location of a relative’s house in Alice Springs. Tjapaltjarri referred to various landmarks such as trees and rocks. I asked him about prominent street names including Bloomfield Street. We conversed with full understanding, but I could not follow Tjapaltjarri’s directions. I never paid attention to these landmarks, he never noticed street names. This was not a linguistic issue. It was literally a matter of different worldview. Extrapolate from this example to appreciate the difficulties first language speakers of Aboriginal languages might have in following medical explanations, even when they seemingly speak good English.

These communication gaps are confirmed in health settings. A study of Yolŋu patients undergoing dialysis in Darwin2 identified, through exit interviews, significant misunderstanding of test results despite both patient and renal nurse having revealed that they were satisfied with the communication.

Trudgen9 discusses a Yolŋu patient suffering from severe diabetes and renal failure who was able to avoid dialysis once his condition was explained to him in meaningful terms, and goes on to estimate that 75–95% of communication with Yolŋu patients fails, even with an Aboriginal health worker involved. Aboriginal health workers are not necessarily trained interpreters, nor is interpreting their primary role, although they are often expected to interpret.

How do we improve? Surprisingly simple communication methods, which are easy to teach within mainstream medical education, can help. Trudgen demonstrates how to explain to a Yolŋu patient their 2% residual renal function.9 Many Yolŋu and speakers of other Indigenous languages do not understand the concept of percentages. A picture of a kidney was drawn, shading in the 2% still functioning and showing the remainder, which was sclerosed (Box 3). The patient responded in shock and, no doubt, with better dialysis participation.

Box 3

Template to explain residual renal function of 2% (hatched area) in an otherwise sclerosed kidney (dots)

Aboriginal patients may not be as trusting of medical implements as others. Refusal of an ear examination, for example, may be overcome by allowing such a patient to look through the otoscope to understand how it works. Silence plays an important role in Indigenous cultures.9,12,13

Indigenous people often respond to questions after a prolonged pause, a concept foreign to those doctors who see silence as impolite in their own cultures. They compensate by filling the silence and disrupting Indigenous patients’ thoughts. There is a simple solution — pause and allow the patient to think.

Studies1,2,3,4,14 have identified a widespread belief among Yolŋu people that information is deliberately withheld, mirroring culturally based misconceptions that lead many professionals to believe that Aboriginal patients do not want to know or that they do not experience pain.15

However, several studies1,4,14 clearly demonstrate the desire of Aboriginal people, both from the Top End and from Central Australia, for information about their illnesses and treatment. Effective communication methods, including the use of interpreters, are grossly underutilised, and frequently there is a failure to recognise that patients do not understand.

In a study of 41 Yolŋu people, only 11 found explanations about diagnosis and treatment satisfactory.4 Other studies have shown that even when patients are satisfied, gross misunderstandings may still exist.2 Trudgen9 again gives an example of how this may occur. A doctor explained to a patient that he “could not tell conclusively why [the patient’s] heart was enlarged”. The patient subsequently interpreted this to be that the doctor had no idea why his heart was enlarged and decided not to engage in treatment. Had the doctor avoided use of “intangible” conceptual English words and vague unrevealing sentences, instead focusing on factual communication, this error could have been avoided.

A failure to develop an adequate understanding does run deeper than words. For traditionally oriented Aboriginal people living in remote areas, understanding of disease causation is fundamentally different. Serious diseases, even accidents, are often attributed to sorcery.16,17 Germ theory and the immune system are foreign concepts.

Traditionally oriented Aboriginal people typically have detailed knowledge of anatomy from hunting, butchering and observing nature,9,18 but the perceived function of the kidneys, lungs, pancreas and other internal organs may be quite different. Finding common ground between these understandings is no easy task, but it is important to understand that it may play into medical treatments in the same way as having insight into the use of alternative medicines does in other cultures.

These examples may seem plain and obvious, but astoundingly, despite the many hours dedicated to communication in medical education, such concepts are not taught. Some strategies are provided in Box 4. There is an urgent need to pay more attention to communication needs of remote Aboriginal people.

Communication strategies

A refusal to take Aboriginal languages seriously not only results directly in less than optimal medical outcomes, but also in mistrust and disengagement with the health sector and non-compliance with treatment regimens.3

An investment of time in the consult will have immense payoffs over the long term. We cannot expect our medical students and colleagues to adapt without teaching.

Concepts are simple to grasp with knowledge of the languages and cultures. Is effective establishment of the Aboriginal patient–doctor relationship not one of the more teachable aspects of communication for generations of doctors?

Education is the way forward to a practical and high impact population of medical staff who contribute to the health and pride of the people who are Australia’s national treasures.

NACCHO Aboriginal Health : #NTIntervention: Ten years on and what has been achieved?

 

” The intervention was a “debacle” and a new attempt with Indigenous involvement “couldn’t do any worse .

I suggest a “mark two of what was attempted under the intervention”: a 10-year “Marshall plan” between federal and territory governments but with Aboriginal people as expert advisers on a planning, oversight and implementation committee.

It’s not enough to pay us the cursory privilege of being consulted, where our voices are not listened to and where we have no role in decision-making,” she said. “We couldn’t do any worse than what’s being done today, surely.”

Olga Havnen, the chief executive of the Danila Dilba Aboriginal health service see Part 2 story below

 “I  describe the intervention as “a complete violation of the human rights of Aboriginal people in the Northern Territory.

The legacy is that Aboriginal people were completely disempowered.

They had the Army going into communities in their uniforms. They had no idea why the Army was there. People were terrified that they’d come to take the kids away.”

National Aboriginal Community Controlled Health Organisation chief executive Pat Turner see story part 3 NT Intervention: Australia’s most costly ‘political stunt’

As the national representative body for Aboriginal and Torres Strait Islander peoples, the National Congress of Australia’s First Peoples calls for a fundamental reset of government and community relations with us, beginning with the implementation of the Uluru Statement resolutions for constitutional reform. Congress stands ready to fill the role of the advisory body to parliament.”

“We also call for the immediate implementation of the Redfern Statement, which provides a roadmap for how governments can work collaboratively with us to develop efficient and effective programs”

Congress press release Part 1 Below

Part 1 The Northern Territory Intervention: Ten years on and what has been achieved?

As a federal election loomed a decade ago, facing disappointing polls the government of the day was scandalized by sexual abuse in Northern Territory Aboriginal communities and proposed an intervention to improve the life chances of Aboriginal children.

The program won bipartisan support and continued under a new name, Stronger Futures, when the government changed. Closing the Gap targets were announced and hundreds of millions of dollars have been spent to improve the health, education, housing and employment status of Aboriginal and Torres Strait Islander people around the country, and especially those living in remote communities.

A decade on, it is timely to consider results:

  • The annual Closing the Gap report shows that six of the seven targets are not on track.
  •  We understand that there has not been a single prosecution for child sexual abuse as a result of these programs.
  •  Aboriginal men have been stigmatized as drunken, irresponsible pedophiles.
  •  Provisions of the Racial Discrimination Act have been ignored to allow the Intervention to proceed.
  •  Communities have been weakened by the downgrading of local self-government. Those who presume to know what is best for Aboriginal and Torres Strait Islander peoples have had their way.
  •  Tax payers are askance at the shocking waste of public monies on ineffective programs, for which many blame Aboriginal people.
  •  Most notably in the Northern Territory, but in the states as well, shocking abuses of Aboriginal and Torres Strait Islander juveniles have been uncovered.
  •  Incarceration rates of Aboriginal and Torres Strait Islander men, women and children have sky rocketed.
  •  United Nations representatives have issued reports critical of the Intervention and of government relations with Aboriginal and Torres Strait Islander peoples.
  • The 97 recommendations of the 2007 Ampe Akelyernemane Meke Mekarle (Little Children are Sacred) report have been ignored.

A longer list would add to the inevitable conclusion that there is a crisis in Indigenous Affairs.

“The rationale for the Intervention was to protect Aboriginal children and to provide them with a better future. Health, education and well-being statistics demonstrate failure of the Intervention. There have been very few positive outcomes to show for the hundreds of millions of dollars that have been spent on the Intervention and related programs,” he said.

Part 2 NT intervention a ‘debacle’ and second attempt should be made, commission told

from Helen Davidson The Guardian

A 10-year Northern Territory intervention “mark two” could address the failings of the first one, which has seen most of the money “squandered”, the Northern Territory royal commission has heard.

Olga Havnen, the chief executive of the Danila Dilba Aboriginal health service, said the intervention was a “debacle” and a new attempt with Indigenous involvement “couldn’t do any worse”.

Havnen, who is also a former coordinator general for remote services in the NT, made the comments before the royal commission into the protection and detention of children on Thursday.

The hearing has coincided with the 10-year anniversary of the federal government’s emergency intervention into the region, which has been criticised as draconian and removing self-determination from Indigenous communities while failing to address Indigenous inequality.

Havnen told the hearing the NT was still reliant on federal funds and still failing to involve Indigenous people and organisations properly.

This week the commission heard the rates of child protection cases and notifications has more than doubled in the 10 years since the intervention. Separately, NT budget estimates revealed the number of children in out of home care had tripled, while the proportion in had dropped 20%.

Havnen said many government contracts were still procured without proper assessment of whether the organisation had the capability to work with Indigenous communities.

“These arrangements are absolutely stunning and I think are largely a legacy of the intervention supposedly committed to improving Aboriginal communities,” she said.

“By any measure the vast majority of that money has been squandered, and the people who made those decisions need to be held to account in my view.

“Just on the very cursory amount of information we have access to, you have to go: what the hell is actually really going on here and why does this continue to happen?”

Earlier this week the commission heard evidence a private business, Safe Pathways, had charged the Northern Territory government $85,000 a month to run a residential home for a maximum of four children.

A former Safe Pathways manager, Tracey Hancock, told the commission the amount would include staff wages but she didn’t have any further information on what the money was for.

Safe Pathways reportedly told the ABC the charges had been approved and accepted by the NT government.

“We get held up to be accountable as Aboriginal service providers and our level of accountability and transparency – every dollar we spend and commit, including performance outcomes, is well and truly documented,” Havnen said on Thursday.

“But you go and look at these websites for a lot of these NGOs running out-of-home services, there’s no detail about their governance arrangement, there’s no annual report, there’s no financial transparency or accountability. How is this good for anybody?”

Havnen earlier told the commission governments treated large non-Indigenous organisations as equal partners more than they did Indigenous organisations. She also said there were Indigenous organisations across the NT that were “well placed” to provide services currently contracted to non-Indigenous NGOs.

Aboriginal health services across the NT would be asked by the department to provide client medical records when there was an investigation “and yet we seem to be completely invisible to them as a capable partner and potential resource” to assist the department and vulnerable families, she said.

She said it seemed ironic and suggested the commission look at where remote Aboriginal health services were located. “Many of them are in those communities where we know large numbers of Aboriginal children are being removed from.”

Story 3 NT Intervention: Australia’s most costly ‘political stunt’

THE Federal Government’s radical plan to forcibly intervene in Aboriginal communities and impose restrictions on individuals was a billion dollar “political stunt”, a former political head has said.

WATCH SKYNEWS COVERAGE

The Northern Territory Emergency Response, known as “the Intervention”, was launched unilaterally by the Howard Government 10 years ago today.

It saw widespread alcohol bans and other restrictions imposed on 73 remote indigenous communities, as well as forced land leases, and changes to welfare under the Northern Territory Response Act 2007. The Racial Discrimination Act was suspended by the Commonwealth so thousands of indigenous people could have their welfare payments put onto “basics cards” for essential items. The Army, federal police and medical professionals were deployed to the communities for logistical support and health checks. The community development employment projects (CDEP) scheme was disbanded which limited job prospects for locals and an already limited support of bilingual education was cut off.

Communities that boasted distinctive ways of life as the oldest living culture in the world were suddenly referred to as “prescribed areas”, then “towns”, with individuals in need of reform.

Mr Howard said the Commonwealth had “responded” because the NT government of the day had failed to take action as recommended by the Little Children are Sacred report on child sexual abuse in NT indigenous communities.

The Intervention has cost Australian taxpayers more than one billion dollars but has largely proved ineffective in making a positive impact on the lives of those it denigrated.

NT’s first Labor chief minister Clare Martin said it was nothing more than a “political stunt” that was rolled out without her consultation when she was in power.

“(Then Prime Minister John Howard) didn’t ring me to say ‘can we talk about a possible intervention’, he rang me and said ‘there is an intervention taking place, I’m not going to talk to you about it, and it’s a done deal’,’ she told Sky News earlier today.

“I was stunned. I had no idea it was going to happen. I don’t think most people in the Territory — Aboriginal people who were the subject of it — they didn’t know it was going to happen, and very quickly you worked out it was mostly a political stunt.”

Ms Martin told the program she offered to fly to Canberra to discuss the plan but Mr Howard told her he was ‘too busy’ to meet.

“I thought for six years I had worked reasonably well with John Howard,” she said.

“I wasn’t in the same party as John Howard, but we always seemed to manage to sort things out, and then to be used as a political strategy like it obviously was, I just felt really deflated.

“My first thought when Howard rang me was to say expletives and resign and then I thought ‘well that’s just not mature’, but I did after that plan when I would leave.”

Ms Martin kept her position in the 2007 federal election then resigned as chief minister in November of the same year.

But she wasn’t the only one critical of the Intervention with the full scale of the blunder quickly revealing itself. It has widely been criticised for not directly involving Aboriginal people and instead giving rise to a remarkable spurt of government-funded activity that went on around them.

Twenty thousand Territorians are now on income management, despite the scheme not meeting its aims, according to a report.

Earlier this week, royal commissioners were told child protection notifications, substantiations and out-of-home placements had all more than doubled since 2007.

About 50 per cent of indigenous children in the NT now come to the attention of the child protection system by the age of 10, the Royal Commission into the Protection and Detention of Children in the Northern Territory heard on Monday.

Aboriginal women from the remote Central Australian community of Ampilatwatja performing at a public ceremony in 2010 to protest against the Northern Territory intervention. Picture: Chris Graham.

Aboriginal women from the remote Central Australian community of Ampilatwatja performing at a public ceremony in 2010 to protest against the Northern Territory intervention. Picture: Chris Graham.Source:Supplied

Signs — like this one outside Alice Springs — were erected in many Aboriginal communities following the rollout of the NT Intervention.

Signs — like this one outside Alice Springs — were erected in many Aboriginal communities following the rollout of the NT Intervention.Source:News Limited

New figures by the Menzies School of Health research that were presented to the Royal Commission indicated the intervention has not made a difference.

“The data that we have shows that since the intervention rates of child protection notifications, substantiations and out of home care have all doubled and so if that’s an outcome we’re looking at, the intervention has really failed to make a difference for that particular outcome,” school spokesperson Sven Silburn said.

Professor Silburn said the lack of proper community engagement, which he said might have given the Intervention a better chance of success, was a “great mistake”.

Footage of children detained at Don Dale recently sparked a royal commission into the maltreatment of youths in detention. It came as the Territory’s incarceration rate hit a 15-year high — the highest per capita rate in Australia — with one per cent of the population behind bars and more than 85 per cent of inmates indigenous.

Federal indigenous Affairs Minister Nigel Scullion recently said the Intervention was flawed.

“I think it would have been far better to do some of the same things with the full compliance of the community rather than the community having the sense that it was imposed on us, so yes of course we could have done it better,” Mr Scullion said during a recent visit to the central Australian community of Mutitjulu, which was at the front line of the Intervention.

“Aboriginal and Torres Strait Islander people, community, families have to be at the centre of the decisions, if we’re going to make substantive and sustainable change.”

Central Australian Aboriginal leader Bess Price has been vocal about the high level of violence in central Australian indigenous communities and supported the Northern Territory intervention.

Central Australian Aboriginal leader Bess Price has been vocal about the high level of violence in central Australian indigenous communities and supported the Northern Territory intervention.Source:Supplied

 

Some high profile indigenous politicians and community members have expressed support for the Intervention.

Former Chair of the Northern Territory’s indigenous Affairs Advisory Council, Bess Price previously said the Intervention has “had an impact on the grog, the alcohol, and it’s made life a bit better for the children”.

“It’s gonna take years to fix not everything, but right now, it’s done a huge amount of, you know, change in the way people have thought about children as well in regards to their health and wellbeing,” Ms Price told the ABC in 2011.

Ms Price later came under attack for her comments from indigenous lawyer Larissa Behrendt who used her Twitter account to describe watching bestiality on TV as “less offensive than Bess Price”.

News.com.au has contacted Ms Price for comment.

megan.palin@news.com.au

NACCHO Aboriginal Health : NT Government invests in safer and healthier families / communities: cuts grog to problem drinkers

Budget 2017 is delivering on the Territory Labor Government’s election commitments, investing $33 million in our communities and tackling the causes of domestic, family and sexual violence to ensure that Territorians feel safe

“The Northern Territory has the highest rates of domestic and family violence in Australia, and that comes at an enormous social and economic cost.

Minister for Territory Families Dale Wakefield (see article 1 below )

 ” The BDR supported police in stopping alcohol related crime and antisocial behaviour and its return will make a difference. Police previously described it as one of the best tools for combating antisocial behaviour.

“We know that 60% of domestic violence incidents are alcohol related – this is simply unacceptable and cutting grog to problem drinkers will help address this blight.”

Chief Minister Michael Gunner today said returning the Banned Drinker Register (BDR) on September 1 is the number one thing the Territory Labor Government can do to tackle antisocial behaviour and crime – including the devastating rates of domestic violence.         (see article 2 below )

 ” The Territory Labor Government says the new Banned Drinkers Register will help ease pressures on frontline health workers by reducing the supply of alcohol to those who cause so much harm.

We’ve listened to concerns from medical professionals and community that critical resources are being diverted to deal with alcohol related harm and violence.

While every Territorian is entitled to have a drink and enjoy that responsibly, we know too many people are drinking at dangerous levels, harming themselves, their families and their communities.”

The Minister for Health Natasha Fyles ( See Article 3 below )

Article 1

More than $33 million will be invested in frontline services, infrastructure and strategies to support the prevention of domestic and family violence that will help keep Territorians safe.

Minister for Territory Families Dale Wakefield said Budget 2017 acknowledges the cost and serious impact that domestic and family violence has on our society, and today’s announcement will improve services and facilities for Territorians.

“Budget 2017 is delivering on the Territory Labor Government’s election commitments, investing in our communities and tackling the causes of domestic, family and sexual violence to ensure that Territorians feel safe,” Ms Wakefield said.

“The Northern Territory has the highest rates of domestic and family violence in Australia, and that comes at an enormous social and economic cost.

“This budget will address both infrastructure and policy issues to ensure we have the necessary foundations to firstly reduce the rates of domestic and family violence, but also to provide victims essential support.”

This includes:

  • $6.2 million to continue current domestic violence services in the Territory, left unfunded by the CLP government
  • $3 million to refurbish Alice Springs Domestic Violence Court to improve the safety, experience and outcomes for people affected by domestic and family violence
  • $6 million for the replacement of the Alice Springs Women’s Shelter, so that women can establish independence and recover from trauma
  • $1 million to establish a remote women’s safe house in Galiwinku.

The Territory Labor Government is restoring trust in Government, creating jobs, investing in children and building safer, fairer and stronger communities – right across the Territory.

The Minister also reaffirmed additional investments being made right now into domestic and family violence programs that allow for community led solutions, including:

  • $700,000 over two years to expand the “NO MORE” violence prevention campaign
  • $350,000 to Charles Darwin University and Menzies School of Research to review key domestic and family violence reduction programs in the NT, particularly their impact and effectiveness in remote communities
  • $150,000 to NTCOSS to build the capacity of the domestic and family violence sector
  • $80,000 to improving services provided by the Gove Crisis Accommodation service
  • $30,000 to NPY Women’s Council towards a sexual violence research project.

Minister Wakefield said Budget 2017 is investing in the Territory’s future through jobs, children and community.

“We are going through a challenging economic period – everyone knows this and we have been very upfront about it,” Ms Wakefield said.

“This budget will create and support jobs, deliver on our election commitments and be a fair plan for our future

Article 2 : A BETTER BDR TACKLING SECONDARY SUPPLY AND CUTTING RED TAPE

Chief Minister Michael Gunner today said returning the Banned Drinker Register (BDR) on September 1 is the number one thing the Territory Labor Government can do to tackle antisocial behaviour and crime – including the devastating rates of domestic violence.

Mr Gunner today announced that the new BDR would address weaknesses in the old version by better addressing the problem of secondary supply and cutting red tape.

“We have listened to Police, the community and local businesses and taken action – we will introduce tougher punishment for secondary suppliers to banned drinkers,” Mr Gunner said.

“It will now be a criminal offence to intentionally supply alcohol to a person known to be on the BDR. Once charged with this offence police have the power to place the secondary supplier on the BDR. The offence can also carry significant fines.

“Another improvement cutting red tape is that once given a Banned Drinker Order, a person will go straight onto the BDR and will not require a tribunal hearing or appearance.

“Importantly, Banned Drinker Orders issued by Police will be automatically processed through the Integrated Justice Information System to immediately place problem drinkers on the BDR. This will happen within 48 hours which will help both Police and victims in urgent domestic and family violence situations.”

Mr Gunner said the Territory Labor Government introduced the BDR in July 2011 and the chaotic CLP Government scrapped it in 2012 for political reasons.

“Territorians hated that the chaotic CLP Government scrapped the BDR and they want it returned because it worked – we have listened and taken action,” he said.

“The BDR supported police in stopping alcohol related crime and antisocial behaviour and its return will make a difference. Police previously described it as one of the best tools for combating antisocial behaviour.

“We know that 60% of domestic violence incidents are alcohol related – this is simply unacceptable and cutting grog to problem drinkers will help address this blight.”

Mr Gunner said alcohol related crime and antisocial behaviour in our city centres is an issue facing many businesses and is hindering efforts to revitalise these areas.

“We want to make our city centres a vibrant place and the BDR will combat antisocial behaviour, in turn encouraging tourists and locals back into these areas,” he said.

“Undoing the CLP’s failed replacement scheme and bringing back the BDR is a significant piece of work and new legislation will be introduced into Parliament in May we are working as fast as we can because we know this will make a difference.”

Mr Gunner said Government is taking action on the causes of crime because every Territorian has the right for them and their homes and business to be safe.

He said measures including the recent $18.2 million overhaul of the broken youth justice system (which includes 52 Youth Diversion Workers, more funding for boot camps, supporting the enforcement of bail conditions and victims conferencing), greater powers for police (including electronic monitoring bracelets), more police officers and better training for staff in youth justice facilities showed his Government was taking crime very seriously.

Article 3 FRONTLINE HEALTH WORKERS TO BENEFIT FROM BDR (NT)

The Territory Labor Government says the new Banned Drinkers Register will help ease pressures on frontline health workers by reducing the supply of alcohol to those who cause so much harm.

The Minister for Health Natasha Fyles said Territorians have the right to access the high quality services our hospitals offer.

“We’ve listened to concerns from medical professionals and community that critical resources are being diverted to deal with alcohol related harm and violence,” Ms Fyles said.

“We’re empowering Territorians by creating more pathways to the BDR.

“The new BDR unveiled this week will have new provisions allowing medical officers, families and carers to refer problem drinkers to the BDR and to the rehabilitation they need.

“While every Territorian is entitled to have a drink and enjoy that responsibly, we know too many people are drinking at dangerous levels, harming themselves, their families and their communities.

“Our paramedics and hospital staff are dealing with the highest rates of alcohol related harm and injury at rates not seen in any other jurisdiction across the country

“The Territory continues to have the highest rates of alcohol related injury and disease in the nation – the number of deaths related to alcohol in the NT is three times the national average.

“Alcohol related harm costs the Territory more than $642 million a year and that is continuing to grow.

“The BDR was scrapped by the chaotic former CLP government in 2012 – delivering a sharp spike in alcohol related harm over the two most violent years on record.

“Department records show alcohol related Emergency Department presentations peaked at over 3000 across the Territory in 2013.

“We made an election promise to Territorians that we would bring back the BDR and we are delivering on that promise

“Seventy per cent of alcohol sold in the Territory is takeaway, so we know cutting supply to problem drinkers is a key way to curb alcohol fuelled violence and crime.

From September 1 the BDR will be reinstated, with Territorians and tourists having to show ID to purchase takeaway alcohol.

Those identified as being on the BDR won’t be able to buy takeaway alcohol.

More than a thousand people will be automatically included on the BDR from day one.

That figure is expected to grow to around 2500 by Christmas.

The legislation will be introduced to parliament next month.

 

 

NACCHO Aboriginal Health Closing the Gap #justjustice : PM overturns Government’s opposition to target Indigenous imprisonment

             This post contains 7 articles on the issue of reducing Indigenous Incarceration rates  #JustJustice

“I am pleased that COAG has agreed to progress renewed targets in the year ahead.

A cornerstone of the refresh will be engaging meaningfully with Aboriginal and Torres Strait Islanders and organisations, including at a local level to make sure the agenda reflects their needs and aspirations for the future.”

 

1.Prime Minister Malcolm Turnbull has overturned his Government’s staunch opposition to establishing a target for reducing Indigenous imprisonment rates.

 ” The Labor Party is encouraged by reports today that the Prime Minister might finally overturn his government’s ridiculous opposition to implementing justice targets under the Closing the Gap framework.

Indigenous Affairs Minister Nigel Scullion has long ignored the calls for justice targets, despite repeated urgings from Aboriginal and Torres Strait Islander organisations and expert bodies.

If Malcolm Turnbull is ready to accept that his Minister is wrong, and to adopt Labor’s policy, that is excellent news.

National justice targets will allow us to focus on community safety, particularly the protection of women and children, preventing crime and reducing incarceration rates among Aboriginal and Torres Strait Islander Australians.

2.The Hon Bill Shorten LEADER OF THE OPPOSITION SHADOW MINISTER FOR INDIGENOUS AFFAIRS or read in full below

Download Press Release 25 March Labor CTG Prison Rates

 

 ” Lives can be changed, hope can flourish and outcomes achieved but the helping hand is needed – pre-release and post-release. As a society we should be doing everything possible to keep people out of prison – and not everything we can to jail people, but where incarceration is the outcome, then everything must be done to help the people within them.

“They look at us like we are nothing or we are animals,” Former prisoner

It is better I am here so my children can have some hope,” Prisoner

“There is nothing for us to do inside except to keep our heads down and avoid trouble,” Prisoner

We need to invest in education opportunities while people are incarcerated in Juvenile Detention and in adult prisons and from effectively as soon as someone is incarcerated. What is on the outside can also be on the inside – prisons do not have to be vile dungeons of psychological torment. They can be communities of educational institutions, places of learning, social support structures.

3.Transform Australia’s prisons by Gerry Georgatos from Stringer

4.NACCHO

NACCHO Aboriginal Health and #prisons #JustJustice : Terms of references released Over-representation of Aboriginal peoples in our prisons

 ” It’s a record, but not one to be proud of: one in four prisoners in NSW jails are Indigenous, a statistic that has risen by 35 per cent since the Coalition government came to power in 2011.

The Minister for Corrections David Elliott conceded “it is a tragedy”. Aboriginal and Torres Strait islanders represented 24 per cent of the prison population in October 2016, up from 22 per cent in March 2011 “

5. NSW See Article here

” We know being incarcerated affects someone’s health and yet it is not one of the Closing the Gap targets. It’s Close the Gap Day and the Close the Gap Campaign Steering Committee’s Progress and Priorities report 2017 has been released.

The 2017 report calls for a social and cultural approach and covers many issues, including justice. This is the forth report from the Steering Committee to call for Justice Targets.

Since 2004, there has been a 95 per cent increase in the number of Aboriginal and Torres Strait Islander people in custody. Over the same time, we have seen the crime rates decrease across the country.

Urgent action is required to reduce incarceration if we are ever to see life expectancy parity between Aboriginal and Torres Strait Islander people and other Australians.”

6.Summer May Finlay from Just Justice Croakey : Read Full report HERE Or Below

7.Dan Conifer for ABC TV reports from here

Despite making up just 3 per cent of the general population, about a quarter of Australia’s prison population is Aboriginal or Torres Strait Islander.

The Greens, Labor, the Australian Medical Association, lawyers and other groups have long urged the Coalition to add a federal justice target to the Closing the Gap goals.

Greens Senator Rachel Siewert last month renewed her push in a letter to Mr Turnbull.

Mr Turnbull recently replied, indicating the target would be considered amid a current review of the decade-old targets.

“I am pleased that COAG has agreed to progress renewed targets in the year ahead,” Mr Turnbull wrote.

“A cornerstone of the refresh will be engaging meaningfully with Aboriginal and Torres Strait Islanders and organisations, including at a local level to make sure the agenda reflects their needs and aspirations for the future.

“I have invited the Opposition and the crossbench to participate, particularly all of our Indigenous members of Parliament.”

Conspicuously, Mr Turnbull did not rule out the target.

Indigenous Affairs Minister Nigel Scullion has repeatedly rejected the idea of a federal justice target.

“The Commonwealth can’t have a justice target,” Senator Scullion said in September last year.

“It does absolutely nothing because we have none of the levers to affect the outcomes in terms of incarceration or the justice system but the states and territories do.”

Mr Turnbull reports to Parliament every year on seven Closing the Gap targets, such as Indigenous school attendance and life expectancy.

Senator Siewert said she was now more hopeful of change.

“I’m a little bit more optimistic that in fact they’re now looking at it a bit more favourably and see the sense in having a justice target,” she said.

“I hope they move swiftly on it and I’m looking forward to progress.”

Aboriginal or Torres Strait Islander young people are over 20 times more likely to be in jail than their peers.

The rate of Aboriginal women going to prison has more than doubled since 2000.

And fresh statistics from New South Wales show there has been a 35 per cent increase in Aboriginal inmates in the state’s prisons since 2011 — from 2,269 to 3,059.

‘I find it embarrassing’: Wyatt

Northern Territory Chief Minister Michael Gunner said he was glad the door had been opened to the idea.

“That’s very heartening, especially as we go through a [youth detention] royal commission process,” he said.

“We are talking with the Commonwealth about what that may mean as a future investment into the broken youth justice system here in the territory.”

Mr Gunner said if a federal target was not implemented, the Territory would go it alone.

West Australian Labor’s Ben Wyatt is the nations’ first Indigenous Treasurer.

He has backed the federal target, but knows it is states that control the levers which make a difference.

“I would support anything that focuses the mind of a Government to reduce the rate of Indigenous incarceration,” he said.

“Western Australia is the worst in the nation, we need to have a strong, powerful look at how we go about reducing the number of Aboriginal people we have in our prisons.

“I find it embarrassing and personally distressing that my state continues to do that.”

2.TURNBULL MUST ACT ON INCARCERATION RATES & SUPPORT JUSTICE TARGETS : Labor Press Release

The Labor Party is encouraged by reports today that the Prime Minister might finally overturn his government’s ridiculous opposition to implementing justice targets under the Closing the Gap framework.

Indigenous Affairs Minister Nigel Scullion has long ignored the calls for justice targets, despite repeated urgings from Aboriginal and Torres Strait Islander organisations and expert bodies.

If Malcolm Turnbull is ready to accept that his Minister is wrong, and to adopt Labor’s policy, that is excellent news.

National justice targets will allow us to focus on community safety, particularly the protection of women and children, preventing crime and reducing incarceration rates among Aboriginal and Torres Strait Islander Australians.

The targets should be developed in cooperation with state and territory governments, law enforcement agencies, legal and community services, and guided by community leaders, Elders and Aboriginal representative organisations.

There has to be as much focus on the factors that can help prevent the high levels of incarceration, as well as what happens to individuals once in the criminal justice and corrective services system.

A young Indigenous man today is more likely to go to jail than university, and an Indigenous adult is 15 times more likely to be imprisoned than a non-Indigenous adult.

These appalling numbers demand action, including the reversal of the Government’s cuts to Aboriginal and Torres Strait Islander Legal Services, further examination of noncustodial options and alternatives to mandatory detention, as well as a focus on justice reinvestment.

We call on the Prime Minister to urgently confirm this report, and work with Labor to make justice targets a reality.

The Turnbull Government can’t keep ignoring the Indigenous incarceration crisis. It must start showing national leadership and confront this challenge. Business as usual will not work. If we continue with the same approach, we’ll get the same results.

SATURDAY, 25 March

6.What gets measured gets managed

Summer May Finlay writes:

We know being incarcerated affects someone’s health and yet it is not one of the Closing the Gap targets. It’s Close the Gap Day and the Close the Gap Campaign Steering Committee’s Progress and Priorities report 2017 has been released.

The 2017 report calls for a social and cultural approach and covers many issues, including justice. This is the fourth report from the Steering Committee to call for Justice Targets.

Since 2004, there has been a 95 per cent increase in the number of Aboriginal and Torres Strait Islander people in custody. Over the same time, we have seen the crime rates decrease across the country.

Urgent action is required to reduce incarceration if we are ever to see life expectancy parity between Aboriginal and Torres Strait Islander people and other Australians.

Despite the urgency of the need, and the calls by Aboriginal and Torres Strait Islander people and organisations for an urgent response to this need, there has been no indication that governments are responding with the level of urgency required.

While governments fail to measure justice targets at the national level, there can be no management of the issues.

It’s been 25 years since the Royal Commission into Aboriginal Deaths in Custody and very few of the recommendations have been implemented. It should be no surprise then that in the four years the Close the Gap Steering Committee have been calling for Justice targets that the Federal Government is moving at a glacial pace.

Former Prime Minister Tony Abbott and Minister for Indigenous Affairs Nigel Scullion had resisted the calls for Closing the Gap justice targets. Until late 2016, there appeared to be no consideration that the federal government might even have a role to play in reducing incarceration.

In September 2016, Minister Scullion said he would push the states and territories to introduce Aboriginal and Torres Strait Islander justice targets. He said it is a state/territory responsibility and that the Federal government doesn’t have any of the levers to reduce Aboriginal and Torres Strait Islander incarceration. This demonstrates a clear lack of understanding of the issues that drive incarceration, such as violence rates, including social determinants such as poverty and socio-economic disadvantage.

We have yet to hear whether Minister Scullion was able to work with the states and territories and see them introduce targets.

The Steering Committee reports are not the only reports which address the Aboriginal and Torres Strait Islander incarceration rates.

Prime Minster Malcolm Turnbull was handed the Redfern Statement by Aboriginal and Torres Strait Islander leaders at a breakfast at Parliament House last month. It calls for a focus on targets addressing incarceration and access to justice.

Aboriginal and Torres Strait Islander leaders want to see solutions which are evidence-based with a focus on prevention and early intervention.

Despite the Prime Minister being handed the Statement, the Federal Government do not appear to even seriously consider the inclusion of a justice target. At the Redfern Statement breakfast, the Prime Minister said:

“My Government will not shy away from our responsibility. And we will uphold the priorities of education, employment, health and the right of all people to be safe from family violence.”

He made no mention of incarceration and justice.

The Redfern Statement represented the unified voice of Aboriginal and Torres Strait Islander leaders in health, justice, children and families, disability and family violence sectors. Eighteen Aboriginal and Torres Strait Islander organisations were the drivers. These organisations have a wealth of knowledge and experience that should not be dismissed. Aboriginal and Torres Strait Islander organisations’ core business is Aboriginal and Torres Strait Islander affairs. They know what works in our communities.

The Federal Government can act quickly when they want on Aboriginal and Torres Strait Islander justice issues. After Four Corners aired video footage of an Aboriginal boy Dylan Voller hooded and strapped to a chair in the youth detention centre Don Dale, Prime Minister Turnbull initiated a Royal Commission into youth detention and child protection in the Northern Territory.

Our people are continuing to die way too young and one of the contributing factors is incarceration; the Federal Government is either ignoring the issue, or hoping someone else deals with it.

How many more people do we need to lose before they look to address all factors contributing to a reduced life expectancy, including #JustJustice?

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


 

3.Transform Australia’s prisons

The more west we journey across the nation the higher the arrest rates, the higher the jailing rates. In the last two decades Australia’s prison population has doubled. The national prison population is nearly 40,000. More than 85 per cent of inmates have not completed a Year 12 education, more than 60 per cent have not completed Year 10, while 40 per cent did not get past Year 9. More than half were not in any paid employment when they were arrested, while half had been homeless.

According to the Australian Bureau of Statistics (2015), Tasmanian prisons incarcerated 519 inmates, the Australian Capital Territory 396, NSW 11,797, Queensland 7,318, Victoria 6,219, South Australia 2,732, the Northern Territory 1,593 and Western Australia incarcerated 5,555. There are 5 prisons in Tasmania, one in the ACT, 34 in NSW, 10 in Queensland, 13 in Victoria, 8 in South Australia, 4 in the Northern Territory and 16 in Western Australia.

As the prison population has increased so has the number of privately managed prisons – 2 in NSW, 2 in Queensland, one in South Australia and 2 in Western Australia. The national prison population may double again but it appears this will only take ten years. Privately managed prisons will increase. The majority of the prison population is comprised of males but the female prison population is increasing. Ten per cent of Queensland’s prison population is comprised of women, 9 per cent in Western Australia and the Northern Territory.

More than 10,000 inmates are Aboriginal and/or Torres Strait Islanders – 28 per cent of the total prison population. 94 per cent of the Northern Territory prison population is comprised of Aboriginal peoples, 38 per cent in Western Australia, 32 per cent in Queensland, 24 per cent in NSW, 23 per cent in South Australia, 19 per cent in the ACT, 15 per cent in Tasmania and 8 per cent in Victoria. Non-Aboriginal Australians are incarcerated at less than 200 per 100,000 adults but Aboriginal and Torres Strait Islanders adults are incarcerated at 2,330 per 100,000 Aboriginal and Torres Strait Islander adults. It is worst in Western Australia where Aboriginal adults are incarcerated at close to the world’s highest jailing rate – 2nd highest at 3,745 per 100,000. But Western Australia enjoys the nation’s highest median wage – one of the world’s highest but not so for its Aboriginal peoples. If you are born Black in Western Australia you have a two in three chance of living poor your whole life.

If you are born Black in the Northern Territory you have a three in four chance of living poor your whole life. One in 8 of the nation’s Aboriginal and/or Torres Strait Islanders have been to jail. One in 6 has been to jail in Western Australia and for the Northern Territory. Poverty, homelessness, racism sets up people for failure, for prison, for reoffending. The situational trauma of incarceration is compounded by its ongoing punitive bent – and the majority of people come out of prison in worse condition than when they went in.

Art programs alone and some recreation will not transform the lives of the majority in the significant ways that matter. The prison experience is one of dank concrete cells, of isolation, of a constancy of trauma and anxieties, of entrenching depression and for many a degeneration to aggressive complex traumas. Australian prisons are not settings for healing, trauma recovery, restorative therapies, wellbeing, educational opportunities and positive future building. But they should be and can be.

Lives can be changed, hope can flourish and outcomes achieved but the helping hand is needed – pre-release and post-release. As a society we should be doing everything possible to keep people out of prison – and not everything we can to jail people, but where incarceration is the outcome, then everything must be done to help the people within them.

They look at us like we are nothing or we are animals,” Former prisoner

It is better I am here so my children can have some hope,” Prisoner

There is nothing for us to do inside except to keep our heads down and avoid trouble,” Prisoner

We need to invest in education opportunities while people are incarcerated in Juvenile Detention and in adult prisons and from effectively as soon as someone is incarcerated. What is on the outside can also be on the inside – prisons do not have to be vile dungeons of psychological torment. They can be communities of educational institutions, places of learning, social support structures.

There are 10, 11 and 12 year olds in Juvenile Detention facilities – child prisons – and the situational trauma of incarceration should not be allowed to degenerate these children into serious psychological hits. These are critically at-risk children who need support and not the rod. The majority of the children will respond to the helping hand, as long as they are validated and not denigrated.

With Aboriginal and/or Torres Strait Islander children, nearly 80 per cent will be jailed again after release from their first stint in Juvenile Detention. The punitive with all its associated denigrations is not working. The psychosocial self has been humiliated, debilitated, stressed by traumas. It is positive that there is an increased onus on post-prison mentoring, healing and education and work programs. There should be much more of this but we should not be waiting for this as post-prison options only and that all this should be in place from the commencement of incarceration. This would assist in reducing depression, anxieties and the building up of a sense of hopelessness. I am advocating for all so-called correctional facilities to be significantly transformed into communities of learning and opportunity. This is what any reasonably-minded society would support.

In NSW, 48 per cent of adult prisoners released during 2013 returned to prison within two years. In Victoria, 44 per cent returned within two years. In Queensland it was 41 per cent. In Western Australia it was 36 per cent. Western Australia incarcerates Aboriginal and Torres Strait Islanders at 17 times the non-Aboriginal rate while for Queensland, NSW and Victoria it is 11 times. In South Australia 38 per cent of adult prisoners released during 2013 returned within two years. South Australia incarcerates Aboriginal people at 13 times the non-Aboriginal rate. In Tasmania 40 per cent were returned within two years. In the ACT 39 per cent were returned and Aboriginal people were 15 times more likely to be incarcerated. In the Northern Territory 58 per cent were returned and Aboriginal people were 14 times more likely to be incarcerated. Australia’s prisons – no different in my experience with child protection authorities – carry on as if people cannot change. Australian prisons are administered by the States and Territories and therefore the onus for change must be argued to them although the Commonwealth can galvanise change and argue an onus on the humane, educative, transformational instead of the punitive which has led to the building of more ‘correctional facilities’ and the filling of them.

 

“The degree of civilization in a society can be judged by entering its prisons,” Fyodor Dostoyevsky

As soon as we are locked up there should be plans for us to better us,” Former prisoner

Too many of us come out with less hope than ever before,” Former prisoner

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

 

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

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

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

Kriti Sharma is a disability rights researcher for Human Rights Watch

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

Further NACCHO reading

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Kriti Sharma is a disability rights researcher for Human Rights Watch

 

croakey-new

How you can support #JustJustice

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

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

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

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

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

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

Readers may also be interested in these articles:

NACCHO Invites all health practitioners and staff to a webinar : Working collaboratively to support the social and emotional well-being of Aboriginal youth in crisis

atsi

NACCHO invites all health practitioners and staff to the webinar: An all-Indigenous panel will explore youth suicide in Aboriginal and Torres Strait Islanders. The webinar is organised and produced by the Mental Health Professionals Network and will provide participants with the opportunity to identify:

  • Key principles in the early identification of youth experiencing psychological distress.
  • Appropriate referral pathways to prevent crises and provide early intervention.
  • Challenges, tips and strategies to implement a collaborative response to supporting Aboriginal and Torres Strait Islander youth in crisis.

Join hundreds of doctors, nurses and mental health professionals around the nation for an interdisciplinary panel discussion. The panellists with a range of professional experience are:

  • Dr Louis Peachey (Qld Rural Generalist)
  • Dr Marshall Watson (SA Psychiatrist)
  • Dr Jeff Nelson (Qld Psychologist)
  • Facilitator: Dr Mary Emeleus (Qld GP and Psychotherapist)

Read more about the panellists.

Working collaboratively to support the social and emotional well-being of Aboriginal and Torres Strait Islander youth in crisis.

Date:  Thursday 23rd February, 2017

Time: 7.15 – 8.30pm AEDT

REGISTER

No need to travel to benefit from this free PD opportunity. Simply register and log in anywhere you have a computer or tablet with high speed internet connection. CPD points awarded.

Learn more about the learning outcomes, other resources and register now.

For further information, contact MHPN on 1800 209 031 or email webinars@mhpn.org.au.

The Mental Health Professionals’ Network is a government-funded initiative that improves interdisciplinary collaborative mental health care practice in the primary health sector.  MHPN promotes interdisciplinary practice through two national platforms, local interdisciplinary networks and online professional development webinars.

 

 

 

 

 

 

NACCHO Aboriginal Health : A call to acknowledge the harmful history of nursing for Aboriginal people

nurses

 ” While we ourselves did not work there, the societal beliefs interwoven with the professional theories practised at that time are a legacy we have inherited. Those attitudes and practices remain present within our professional space.

Have we done sufficient work to decolonise ourselves?

Decolonising is a conscious practice for Aboriginal and Torres Strait Islander nurses. It involves recognising the impact of the beliefs and practices of the coloniser on ourselves at a personal and professional level, then disavowing ourselves from them.

We talk about this in CATSINaM with our Members. We invite our non-Indigenous colleagues to engage in this self-reflective conversation through many aspects of our work.

janine-mohamed-indigenous-x-profile-picture

Janine Mohamed (right), CEO of the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM), argues we should.

Is it time for the nursing and midwifery professions to reflect on our historical involvement in the subjugation of Aboriginal and Torres Strait Islanders and consider whether we owe a statement of regret for our failures as part of the wider healthcare system to respond to the needs of Aboriginal Australians?

Do formal apologies mean anything?

We welcome your input on this fundamental issue for Australians – and especially input from Aboriginal and Torres Strait Islander nurses and midwives.

Editorial Nurse Uncut Conversations

In September 2016, the Australian Psychological Society issued a formal apology to Indigenous Australians for their past failure as a profession to respond to the needs of Aboriginal patients.

In the past, the NSW Nurses and Midwives’ Association and the ANMF more broadly have issued statements of apology for our professions’ involvement in the practices associated with the forced adoption of babies from the 1950s to 1980s.

In doing so we recognised that while those nurses and midwives were working under direction, it was often they who took the babies away from mothers who had been forced, pressured and coerced into relinquishing their children and we apologised for and acknowledged the pain these mothers, fathers and children had experienced in their lives as a result.

Following the recent commendable move by the Australian Psychological Society, is it now time for the nursing and midwifery professions to reflect on our historical involvement as healthcare providers in the subjugation of Aboriginal and Torres Strait Islanders and consider whether we owe a similar statement of regret for our failures as part of the wider healthcare system to respond to the needs of Aboriginal Australians?

But firstly, do such apologies mean anything?

Professor Alan Rosen AO (a non-indigenous psychiatrist) makes a cogent argument for an apology by the Australian mental health professions to Aboriginal and Torres Strait Islander peoples:

The recent apology by the Australian Psychological Society to Aboriginal and Torres Strait Islander people is of profound national and international significance.

The APS is believed to be the first mental health professional representative body in the world to endorse and adopt such a specific apology to indigenous peoples for what was done to them by the profession as part of, or in the name of, mental health/psychological assessment, treatment and care.

The APS Board also substantially adopted the recommendation of its Indigenous Psychologists’ Advisory Group (IPAG), whose Indigenous and non-Indigenous members crafted this apology together. This sets a fine precedent.

As some other Australian mental health professional bodies are still considering whether to make such an apology, it is to be hoped that the APS has set a new trend. The APS has provided a robust example of how to do it well and in a way that it is more likely to be considered to be sincere and acceptable by Aboriginal and Torres Strait Islander peoples.

Historically, Aboriginal and Torres Strait Islander peoples have suffered much more incarceration, inappropriate diagnoses and treatments and more control than care in the hands of mental health professionals, facilities and institutions.

This is also true for all First Nations peoples, globally.

Professor Rosen argues that such apologies demonstrate concern for possible historical wrongs, either deliberate or unwitting, by professionals and institutions and the enduring mental health effects of colonialism. The Croakey.org article goes on to describe the purposes and goals of an apology, why they are worth doing and proposes a template.

So, just as we have recognised and apologised for the role our professions played in forced adoptions, is it now time to examine and take responsibility for our professions’ historical contribution to undermining Indigenous Australians’ social and emotional health and wellbeing?

Janine Mohamed (right), CEO of the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM), argues we should.

Between 1908 and 1919, hundreds of Aboriginal patients were incarcerated in the Lock Hospitals off the coast of Carnarvon, with more than 150 people dying there. The West Australian government established the hospitals for the treatment of Aboriginal people with sexually transmitted infections, but there remains considerable doubt as to the accuracy of such diagnoses – many of which were made by police officers.

The Fantome Island Lock Hospital operated in Queensland from 1928-45 under similar arrangements, detaining Aboriginal people with suspected sexually transmitted infections. There was also a lazaret on Fantome Island (1939-73) for segregated treatment of Aboriginal people with Hansen’s disease.

Aboriginal people taken to the hospitals were often forcibly removed from their families and communities and transported in traumatic conditions, in chains and under police guard. There is also evidence of medical experimentation and abuse.
The NSW Nurses and Midwives’ Association has embarked on the process of developing a Reconciliation Action Plan. As a first step, over coming months we will be working on developing a more thorough understanding of how historical practices have affected Aboriginal and Torres Strait Islander people in our care.

We welcome feedback, especially from our Aboriginal and Torres Strait Islander colleagues.

NACCHO Aboriginal Health and #NTRC : Appalling treatment of youth highlighted at Royal Commission Inquiry

 dylan

 ” I was regularly stripsearched from the age of 11 and on one occasion was left in a cell overnight with no mattress, sheets or clothes. They turned the aircon on full blast, I was freezing all night … I was actually crying asking for a blanket.

I was left handcuffed in the back of a stifling hot van during a 1400 kilometre prison transfer from Alice Springs to Darwin. On the trip, I was denied bathroom stops “

Dylan Voller now aged 19 giving evidence at the NT Royal Commission into Youth Detention about his 8 years in out of detention centres . See full evidence article 2 below

Aboriginal Peak Organisations Northern Territory ( APO NT ) congratulates the Commonwealth and NT Government on calling the Royal Commission Inquiry into Youth Detention and Child Protection.

APO NT has for many years raised with the government the shocking treatment of youth in detention and the long term effects it has on youth

Today Dylan Voller gave evidence at the Royal Commission hearing and broke his silence about his treatment by authorities in Northern Territory youth detention centres.

Finally youth feel confident to tell their stories to Australia knowing they have strong support behind them.

Today’s evidence is moving, this is Dylan’s personal story which shows how troubled his life was and how fragile he is. We congratulate Dylan for having the courage to tell his story as it is good for the public to understand how difficult life is for many youth who have been in and are currently in youth detention

What we witnessed today is a story of how the juvenile justice system in the Northern Territory denied young people in its care the opportunity to enjoy even the most basic aspects of a normal life.

APO NT supports the Royal Commission inquiry to uncover where the systems have failed and make recommendations on how to improve laws, policies and practices in the Northern Territory to provide a safer future for our children. ”

John Paterson CEO AMSANT (NACCHO Affiliate ) and Spokesperson for APO NT

The Aboriginal Peak Organisations Northern Territory—APO NT—is an alliance comprising the Central Land Council (CLC), Northern Land Council (NLC), North Australian Aboriginal Justice Agency (NAAJA), Central Australian Aboriginal Legal Aid Service (CAALAS) and the Aboriginal Medical Services Alliance of the NT (AMSANT).

The alliance was created to provide a more effective response to key issues of joint interest and concern affecting Aboriginal people in the Northern Territory, including providing practical policy solutions to government.

 Support Services thru NACCHO Members and Relationship Australia

Discussing experiences of the child protection system or time spent in youth detention can be difficult. This is especially so for people who experienced abuse and are telling their story for the first time.

If you need support you can call 1800 500 853 – a free helpline answered locally

  • This is a free service and is available 9am to 5pm Monday to Friday
  • Support is available to children, young people, their families and others impacted by the Royal Commission into the Protection and Detention of Children in the Northern Territory
  • Experienced and qualified staff can refer you to a range of services including counsellors, therapeutic support, and health professionals.

Please note that calls made from a mobile phone may incur additional costs.

You can also contact the following services directly:

Danila Dilba Health Service

Services include:

  • face to face and telephone counselling,
  • support,
  • mental health support (including suicide prevention),
  • therapeutic group services, outreach, and referrals.
Phone
(08) 8942 5400 (Darwin, Palmerston and Malak)Website
Danila Dilba Health Service
Relationships Australia NT

Services include:

  • culturally appropriate support and information on how to engage with the Royal Commission and what to expect from the enquiry process,
  • face to face and telephone counselling by qualified counsellors,
  • support through legal processes,
  • referrals to legal and advocacy services,
  • pre and post counselling support to those directly affected who are giving evidence as well as their families,
  • mentoring by Aboriginal and Torres Strait Islander cultural advisors, and healing camps on Country.
Phone
(08) 8923 4999 (Darwin and Katherine office with outreach to other areas) (08) 8950 4100 (Alice Springs office with outreach to other areas)Website
Relationships Australia Northern Territory
The Central Australian Aboriginal Congress

Services include:

  • peer support including social, emotional, cultural, social and therapeutic support with intensive case management to young people at risk
  • support
  • outreach
  • trauma-informed counselling
  • medical support care coordination, and referrals.
Phone
(08) 8959 4750 (Alice Springs and surrounding areas)Website
Central Australian Aboriginal Congress, Alice Springs, NT

There are a number of other services available which can provide support wherever you are in the Northern Territory.

If you need support you can call the following services:

Dylan Voller gives evidence at Royal Commission

DYLAN Voller has broken his silence about his treatment by authorities in Northern Territory youth detention centres in shocking admissions at the Royal Commission.

As reported by Megan Pain News Ltd

Mr Voller’s treatment at Darwin’s Don Dale Youth Detention Centre sparked the Northern Territory child detention royal commission after footage of him shackled to a chair in a spit hood and a group of detainees being tear-gassed appeared on ABC’s Four Corners.

Mr Voller, 19, this afternoon told the commission that conditions in detention, which he first entered aged 11, were often miserable. He said detainees were regularly denied access to food, water and toilets as punishment for bad behaviour.

“There was one instance where I was in an isolation placement at Alice Springs detention centre and I was busting to go to the toilet … I had been asking for at least four or five hours,” Mr Voller said.

“They’d just been saying ‘no’.

“I ended up having to defecate into a pillow case because they wouldn’t let me out to go to the toilet.

“Eventually when I got let out the next morning, I was able to chuck that pillow case out.”

The key witness said on other occasions he was forced “to urinate out the door, out the back window, even in just normal rooms because they haven’t been able to come down”.

He said other detainees urinated out “the back window or into water bottles and chucking them out, like drink bottles and chucking them out the next day”.

Mr Voller said when guards allowed him to visit the bathroom they would only give him “five tiny little squares of toilet paper”.

“I’d go to the toilet, they’d only rip off, like, five tiny little squares of toilet paper and say: ‘That’s all you’re getting … make it last’,” Mr Voller said.

“They wouldn’t give us enough toilet paper.

“They done (sic) that quite a bit.”

According to the teen, detainees in Don Dale had to share underwear if they didn’t have enough money to buy their own. He described a prison economy where detainees could earn money through good behaviour and use it to buy items including underwear, deodorant, and CDs.

“The max you could earn was $4.50 a day and they’d take $1.50 off us every day for rent,” Mr Voller said.

“If you don’t buy your own underwear, the only other underwear you have the choice of wearing is the underwear everyone else wears.

“It gets washed, you pick out another pair, it gets washed and it goes through all of the males in Don Dale.”

The court heard Mr Voller was regularly stripsearched from the age of 11 and on one occasion was left in a cell overnight with no mattress, sheets or clothes. “They turned the aircon on full blast, I was freezing all night … I was actually crying asking for a blanket,” he said.

Mr Voller said he was left handcuffed in the back of a stifling hot van during a 1400 kilometre prison transfer from Alice Springs to Darwin. On the trip, he was denied bathroom stops and forced to defecate in his shirt.

“I threatened self-harm … choking myself with seat belts,” Mr Voller said.

He said the guards smoked heavily the whole way which made him vomit.

“I was vomiting, vomiting, I couldn’t get up, I was laying down in the chair and I was trying to break the chair so I could lay down flat,” he said.

Although poised throughout his testimony, Mr Voller’s eyes welled up on the stand, when senior counsel assisting Peter Callaghan SC moved his line of questioning to the topic of family.

“I had one case worker I remember that was saying my family didn’t really care about me and stuff like that,” Mr Voller said through tears.

“For a long time I started believing it, I guess.”

Mr Voller was this morning taken from the Darwin Correctional Centre to the Darwin Supreme Court to speak at the inquiry, which will also hear from Antoinette Carroll, a youth justice advocate who worked with Mr Voller for seven years.

This image from Four Corners screened on ABC shows Dylan Voller in the spit hood.

This image from Four Corners screened on ABC shows Dylan Voller in the spit hood.Source:ABC

The Royal Commission comes after footage screened in July showed Mr Voller and five other youths being tear-gassed and spit hooded at the Don Dale centre. Vision of Mr Voller strapped to a chair wearing a hood while in the notorious detention centre shocked many when they were screened by ABC’s Four Corners.

The court was closed but Mr Voller’s evidence was streamed online after the NT government lost a bid to delay further witnesses. He will not be cross-examined despite making allegations against 31 guards.

Other youths from Don Dale are expected to also give evidence.

According to his lawyer Peter O’Brien, Mr Voller has been eager to voice his version of events since the inquiry was announced on July 28.

Mr Voller was jailed at Holtze prison, Darwin in 2014 for a violent drug-fuelled binge.

“I’m definitely not proud of it, and it’s just humiliating and a lot of mistakes,” he said.

Both Mr O’Brien and Mr Voller’s mother, Joanne, said Mr Voller was concerned about giving evidence while still in custody and feared repercussions from prison guards.

“I have never seen my son so scared in all of his life,” Ms Voller said after visiting her son on Tuesday.

Mr Voller’s family has repeatedly called for his release from prison so he can speak freely before the commission.

He has also previously requested a transfer to Alice Springs prison.

But his mother said prison guards in Darwin have told him that going to Alice Springs would “increase his chances of getting bashed” because of its lack of CCTV cameras.

Mr Voller today told the court he finished school at age 10 and spent the following seven years in and out of care and youth detention.

He said it was during his first year in care he was first introduced to smoking marijuana and encouraged to commit crimes by older boys.

He described small, institutional rooms with painted-over windows.

“It was disgusting: cockroaches, dust, you felt trapped, you couldn’t really talk to anyone else,” Mr Voller said.

“The only bit of the outside world you got was when you were driving to court or yelling out at the top of your lungs to young people next door at the school.”

— With AAP

megan.palin@news.com.au

NACCHO Aboriginal Health report alert : 2016 #AHRC Social Justice / Close the Gap report released

social-justice

   “ The Australian Government follow through on the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023 by:

  • providing new, quarantined funding for each of the activities outlined in that plan; and
  • continuing to work with the National Health Leadership Forum to oversee the progress of the plan. “

  Recommendation 7 see all 28 recommendations below

“Indigenous people are self-determining and resilient. We can provide clear input on policy, based on evidence and experience. The question is, when will governments listen?

“Governments and their policymakers must listen to, value and implement the practical solutions proposed by Indigenous Australians,”

Deputy Aboriginal and Torres Strait Islander Social Justice Commissioner, Robynne Quiggin

The Social Justice and Native Title Report 2016, tabled today 3 December  in Federal Parliament, includes an agenda for reform based on solutions proposed by Indigenous Australians.

DOWNLOAD the Social Justice report here : ahrc_sjntr_2016

Or Word file copy here

Close the Gap

This year also marks 10 years since the beginning of the Close the Gap Campaign on 17 March 2006. The response of the Australian Government to the campaign has led to a broader community understanding of the challenges for addressing Indigenous health inequality, and has led governments to make substantial improvements to their policies and programs nationwide.

This has included through the adoption of benchmarks and targets over a 25 year period, and significant reforms to inter-governmental funding arrangements to meet these. Solid progress has been made over the last decade, including in the areas of infant and child health, smoking rates and increased access to medicines.10

There is still a long way to go to achieve health equality for Aboriginal and Torres Strait Islander peoples within a generation, but it is important to acknowledge that sustained change is a long term goal. It will require consistent and concerted efforts to maintain funding and policy directions and support direct initiatives such as community controlled medical services.

DOWNLOAD the previous released Close the Gap Report referred to here

progress_priorities_report_ctg_2016_0

Australian Human Rights Commission President, Gillian Triggs, said governments must genuinely engage with Aboriginal and Torres Strait Islander Peoples to address issues such as property rights, justice targets and escalating incarceration rates.

Professor Triggs, who is acting Aboriginal and Torres Strait Islander Social Justice Commissioner, said significant numbers of Indigenous Australians are passing away from violence, illness or a combination of both while detained by the state.

“This rate of incarceration and death, 25 years after the Royal Commission into Aboriginal Deaths in Custody, is intolerable,” Professor Triggs said.

Deputy Aboriginal and Torres Strait Islander Social Justice Commissioner, Robynne Quiggin, said reforms proposed by Indigenous Australians during the year include:

  • Delivering on measures set out in the Redfern Statement
  • Implementing reforms developed by the Indigenous Property Rights Project
  • Allowing income programs to be opt-in

Ms Quiggin said these initiatives, together with continuing consultations on constitutional recognition, would enable structural change and deliver a system which values Indigenous knowledge and the human rights of Indigenous peoples.

The Social Justice and Native Title Report 2016 is the seventh and final report covering the term of the previous Aboriginal and Torres Strait Islander Social Justice Commissioner, Mick Gooda.

Commissioner Gooda resigned in August 2016 to join the Royal Commission into the Child Protection and Youth Detention Systems of the Northern Territory.

Text Box 1.2: Call for Action by Aboriginal and Torres Strait Islander peak organisations[i]
  Commit to resource Aboriginal and Torres Strait Islander led solutions, by:

Restoring, over the forward estimates, the $534 million cut from the Indigenous Affairs portfolio in the 2014 Budget to invest in priority areas outlined in this statement; and

Reforming the Indigenous Advancement Strategy and other Federal funding programs with greater emphasis on service/need mapping (through better engagement) and local Aboriginal and Torres Strait Islander organisations as preferred providers.

Commit to better engagement with Aboriginal and Torres Strait Islander peoples through their representative national peaks, by:

Funding the National Congress of Australia’s First Peoples (Congress) and all relevant Aboriginal and Torres Strait Islander peak organisations and forums; and

Convening regular high level ministerial and departmental meetings and forums with the Congress and the relevant peak organisations and forums.

Recommit to Closing the Gap in this generation, by and in partnership with COAG and Aboriginal and Torres Strait Islander people:

Setting targets and developing evidence-based, prevention and early intervention oriented national strategies which will drive activity and outcomes addressing:

  • family violence (with a focus on women and children);
  •  incarceration and access to justice;
  •  child safety and wellbeing, and the over-representation of Aboriginal and Torres Strait Islander children in out-of-home care; and
  •  increasing Aboriginal and Torres Strait Islander access to disability services;

Secure national funding agreements between the Commonwealth and States and Territories (like the former National Partnership Agreements), which emphasise accountability to Aboriginal and Torres Strait Islander peoples and drive the implementation of national strategies.

Commit to working with Aboriginal and Torres Strait Islander leaders to establish a Department of Aboriginal and Torres Strait Islander Affairs in the future, that:

  •  Is managed and run by senior Aboriginal and Torres Strait Islander public servants;
  •  Brings together the policy and service delivery components of Aboriginal and Torres Strait Islander affairs and ensures a central department of expertise;
  •  Strengthens the engagement for governments and the broader public service with Aboriginal and Torres Strait Islander people in the management of their own services.

Commit to addressing the unfinished business of reconciliation, by:

Addressing and implementing the recommendations of the Council for Aboriginal Reconciliation, which includes an agreement making framework (treaty) and constitutional reform in consultation with Aboriginal and Torres Strait Islander peoples and communities.

[i] Aboriginal and Torres Strait Islander Peak Organisations Unite, ‘The Redfern Statement’ (Group statement, 9 June 2016) 5, 15-17 <http://nationalcongress.com.au/the-redfern-statement/>.

Recommendations

Recommendation 1: The Australian Government follow up the initial meetings with Indigenous leadership with regular consultations which materially inform policy and legislation impacting Aboriginal and Torres Strait Islander peoples.

Recommendation 2: The Australian Government pursue the key priorities for change and recommendations outlined in the Redfern Statement, utilising the Council of Australian Governments and other processes to engage states and territories.

Recommendation 3: The Australian Government establish and promote a monitoring and reporting framework to measure government progress in relation to Indigenous child welfare.

Recommendation 4: The Australian Government, as a matter of urgency, support the development of justice targets, Justice Reinvestment initiatives and other evidence based state and territory legislative, administrative and service delivery initiatives that will contribute to substantial reductions in Indigenous incarceration rates.

Recommendation 5: The Australian Government prioritise early intervention and prevention initiatives that provide comprehensive support and protection from violence to vulnerable Indigenous populations including women, children and the elderly.

Recommendation 6: The Australian Government ratify the Optional Protocol to the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (OPCAT).

Recommendation 7: The Australian Government follow through on the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023 by:

  • providing new, quarantined funding for each of the activities outlined in that plan; and
  • continuing to work with the National Health Leadership Forum to oversee the progress of the plan.

Recommendation 8: The Australian Government work with the Western Australian Government to ensure that the principles of free, prior and informed consent underpin the consultation with Aboriginal peoples regarding any proposed land tenure changes as a part of its Regional Services Reform policy.

Recommendation 9: The Australian Government support the outcomes of the national consultations conducted by the Referendum Council.

Recommendation 10: The Australian Government include the United Nations on the Declaration on the Rights of Indigenous Peoples (UNDRIP) in the definition of human rights in the Human Rights (Parliamentary Scrutiny) Act 2011 (Cth) and review existing legislation, policies and programmes for conformity with the UNDRIP.

Recommendation 11: The Australian Government encourage state and territory governments to consult with Indigenous peoples about the need to establish or re-establish stolen wages reparations schemes.

Recommendation 12: The Australian Government should make the Cashless Debit Card and the Community Development Program in remote communities’ voluntary, opt-in schemes (See Social Justice Native Title Report 2015, Recommendation 5).

Recommendation 13: The Australian Government conduct independent evaluations of the Cashless Debit Card Trials and Community Development Program which involve participation and feedback from Aboriginal and Torres Strait Islander peoples directly affected and make these evaluations publically available.

Recommendation 14: The Australian Government work with the states, territories and relevant stakeholders including the National Native Title Tribunal, to ensure the integration of key information about the Indigenous Estate on state and territory land title information systems.

Recommendation 15: The Australian Government support Indigenous land holders to more comprehensively map the extent of their Indigenous Estate.

Recommendation 16: The Australian Government support the Indigenous Strategy Group’s endorsed model(s) for long-term leasing.

Recommendation 17: The Australian Government support the review of state and territory land use planning regimes in consultation with Indigenous organisations to ensure the Traditional Owners of the Indigenous Estate can exercise the right to free, prior and informed consent regarding land use planning decisions.

Recommendation 18: The Australian Government:

  • recognise the key roles that native title Prescribed Bodies Corporate (PBCs), Native Title Representative Bodies and Service Providers (NTRB/SPs), the National Native Title Council and locally based, Indigenous-led specialist cultural and economic development organisations play in driving and supporting economic development on the Indigenous Estate; and
  • ensure these Indigenous-led organisations are properly funded and supported to carry out this important work, in addition to any statutory duties they may have.

Recommendation 19: The Australian Government support locally based research and scoping initiatives to identify Indigenous-led economic development opportunities suited to the unique land holdings and strengths of Traditional Owner groups, including opportunities to develop the cultural economy, partner with local operations and ‘tap in’ to industry initiatives in the broader region.

Recommendation 20: The Australian Government fund effective, applied training in business and other skills to build the capacity of Aboriginal and Torres Strait Islander directors and managers.

Recommendation 21: The Australian Government support the analysis of risks for both Indigenous land holders and financial institutions with the objective of developing a new risk framework to underpin decision making, investment and business practices regarding the Indigenous Estate in partnership with Indigenous people and financial institutions.

Recommendation 22: The Australian Government support legislative and policy measures to allow Prescribed Bodies Corporate (PBCs) to freely choose the best incorporation method for their purposes and support the regulators to assist PBCs in governance and incorporation matters.

Recommendation 23: The Australian Government continue to support and resource locally designed employment programs including ranger and other culturally based land management programs beyond the current 2020 commitment.

Recommendation 24: The Australian Government support the development of tailored governance arrangements and other tools to support effective benefit sharing and wealth management strategies.

Recommendation 25: The Australian Government work with the states and territories to avoid limiting recognition of native title rights to take resources in consent determinations.

Recommendation 26: The Australian Government prioritise funding Native Title Representative Bodies and Native Title Service Providers (NTRB/SPs) to pursue native title compensation claims on behalf of their clients through litigation or agreement making.

Recommendation 27: The Australian Government continue to support and resource the Australian Human Rights Commission to facilitate the Indigenous Property Rights Project with Aboriginal and Torres Strait Islander peoples, government and other stakeholders, in order for the agenda developed by the Indigenous Strategy Group to be further advanced and achieved.

Recommendation 28: The Australian Government, in cooperation with representative bodies, use the UNDRIP to develop subject specific indicators and work with the Australian Human Rights Commission to monitor the implementation of UPR recommendations relating to Aboriginal and Torres Strait Islander people.

 

NACCHO Aboriginal Health and #FASD : Record Indigenous incarceration #justjustice rates could be avoided with early clinical assessment: experts

hay10390_fm-1

 “Australia’s prison population recently reached a record 33,791 with 27 per cent of those identifying as Aboriginal or Torres Strait Islanders

Leading experts in Fetal Alcohol Spectrum Disorder (FASD) believe Australia’s record rates of Indigenous incarceration could be dramatically reduced if children were clinically assessed when their troubled behaviour first emerged in the classroom or at home.

In one form or another, Federal, State and Territory Governments have been inquiring into Indigenous prison rates since the 1987 leaving behind a long list of mostly-ignored recommendations “

As reported by Russell Skelton ABC

fasd

NACCHO partnered with the Menzies School of Health Research and the Telethon Kids Institute (TKI) to develop and implement health promotion resources and interventions to prevent and reduce the impacts of Fetal Alcohol Spectrum Disorders (FASD) on Aboriginal and Torres Strait Islander families and young children.

NACCHO Report 1 of 4 :Prevent and reduce the impacts of Fetal Alcohol Spectrum Disorders (FASD)

Key points:

  • Experts say Indigenous incarceration rates could be reduced with early behavioural assessment
  • Fetal Alcohol Spectrum Disorder (FASD) affects many of those incarcerated
  • People with FASD are often unable to instruct a lawyer, understand court procedures and even the decisions handed down when convicted

The facts about FASD

  • FASD covers a range of conditions that can occur in children whose mothers drink during pregnancy
  • Conditions vary from mild to severe
  • The effects can include learning difficulties, behavourial problems, growth defects and facial abnormalities
  • The Australian Drug Foundation believes the condition is “significantly under-reported” in Australia
  • National Health and Medical Research Council guidelines say not drinking at all all during pregnancy is the safest option

A major issue in recent months:

  • Last month the Northern Territory’s adult prison population hit an alarming 15-year high. According to Corrections Commissioner Mark Payne 958 people are being held — almost half aboriginal and Torres Strait Islanders. He expects half will reoffend within two years of being released.
  • A report by Amnesty International Australia found, and ABC Fact Check confirmed, that incarceration rates for Indigenous children were 24 times higher than they were for non-Indigenous children.In WA the rate is 76 per 10,000, in the US, where rates of black incarceration are regarded as the highest in the western world, it is 52.
  • Attorney-General George Brandis and the Indigenous Affairs Minister Nigel Scullion announced the Federal Government have commissioned the Australian Law Reform Commission to investigate factors behind the over representation of Indigenous Australians in prison and to recommend reforms to “ameliorate the national tragedy”.
  • The appointment of a Royal Commission to investigate brutal treatment and years of detainee abuse at Darwin’s Don Dale Youth detention facility.The move followed detailed allegations of mistreatment by the ABC’s Four Corner program.

cyozzgxuoaej2c2

The #JustJustice book is was launched  at Gleebooks in Sydney yesterday by Professor Tom Calma AO, and NACCHO readers are invited to download the 242-page e-version

The Federal Government must make good on its promise to listen to, and work with, Aboriginal and Torres Strait Islander people, including engaging with the solutions put forward in the forthcoming #JustJustice essay collection.

The book includes more than 90 articles on solutions to protect the rights of Australia’s First Peoples.

The experts said parents, teachers and health workers were often well aware of unacceptable behaviour in young people — both Indigenous and non-Indigenous — long before they appeared before the courts.

Around 70 per cent of young people in the juvenile justice system are Aboriginal, and research shows rates of the disorder amongst Aboriginal communities are significantly higher than non-Aboriginal communities.

Elizabeth Elliot, professor of Paediatrics and Child Health a Sydney University, said: “What we need is screening tool so teachers and health workers can assess a child’s executive functions and red flag cognitive impairments early on before they encounter the justice system.”

Paediatrician and clinical research fellow at Perth’s Telethon Kids Institute Dr Raewyn Mutch agreed, saying there was a growing need to identify serious behavioural issues associated with FASD and other developmental disorders such as autism so affected children can be better managed.

Fetal Alcohol Spectrum Disorder, known as FASD, occurs in the children whose mothers consumed alcohol during pregnancy.

Symptoms include lifelong physical, mental, behavioural and learning difficulties. It can cause severe intellectual impairment, learning and memory disorders, high-risk and violent behaviour.

Professor Elliott said reform in Australia had been “glacial” compared with Canada and the United States, as authorities have been slow to acknowledge the extent of the problem.

“In Canada it is estimated that 60 per cent of kids in the juvenile justice system are FASD, it is a huge number,” she said.

“We don’t need another inquiry into the justice system, we need governments to act on the evidence before them from past inquiries,

Professor Elliott was the paediatric specialist involved the ground-breaking Lililwan study initiated by Aboriginal women. The study that found that one in five Indigenous children living in WA Fitzroy River Valley had FASD. Although still teenagers, many were before the juvenile justice.

“For children suffering from FASD, it’s like having the umpire removed from an AFL match, they have difficulties deciding best choices or understanding cause and effect,” Dr Mutch said.

“A person with FASD may have cognitive impairment, language difficulties as severe as being illiterate.”

Professor Elliott, a widely acknowledged authority on FASD, said offenders — non-Indigenous and Indigenous — with fetal alcohol brain damage were often incapable of changing their behaviour and learning from mistakes.

“These are young people who can be easily led, are incapable of understanding the consequences of their actions, have difficulty understanding the boundaries for acceptable behaviour. They can confess to crimes they did not commit.”

Dr Mutch said not only FASD affected individuals ended up in the justice system, but children with developmental difficulties and also children traumatised by conflict and abuse.

She is involved in landmark study of young offenders in WA’s Banksia Hill Detention Centre to establish the prevalence of FASD and other neurological disorders. The study is likely to revolutionise strategies for handling juveniles with “neurodevelopmental” issues.

The study will establish the first authoritative estimate in Australia of FASD among young people in detention. It involves a two day multi-disciplined clinical assessment of children with the hope of developing a screening tool for application among all young people entering the juvenile justice system.

“Children in the juvenile justice system have ended up there for a variety of reasons, many of these kids have learning and memory problems,” Dr Mutch said.

“They may also have speech and language problems. Not all are FASD affected, but all I would predict have experienced severe trauma.”

A ‘national tragedy’

A Productivity Commission report into Indigenous disadvantage released last week confirmed rates of incarceration had failed to drop despite a string of reports, inquiries and recommendations dating back to 1987 Deaths in Custody Royal Commission.

Dr Mutch said children were being excluded from society because their behaviour.

“The central question is what are the factors that caused them to be like that and how best to rehabilitate them,” she said.

Both Professor Elliott and Dr Mutch believe screening and clinical assessments in childhood would identify cognitive problems, enable early treatment and result in profound improvements in troublesome behaviours.

This would have an impact on child protection placements including foster care and the management of group homes where evidence has emerged of inappropriate placements and poor supervision.

Offenders with FASD are easily led, coerced by their peers. They can be incapable of providing a record of events, names of associates and often confabulate even to the extent of making false confessions.

They are often unable to instruct a lawyer, understand court procedures and even the decisions handed down when convicted.

In one form or another, Federal, State and Territory Governments have been inquiring into Indigenous prison rates since the 1987 leaving behind a long list of mostly-ignored recommendations.

The Senate is also inquiring into the indefinite detention of people with cognitive impairments — a central issue when it comes to explaining the “national tragedy”.

The Telethon Kids Institute noted in a submission to Senate inquiry into the indefinite detention of people with cognitive and psychiatric impairment that diagnosis of FASD has been limited by a lack of knowledge and until recently an absence of accepted national diagnostic framework.

Australia’s prison population recently reached a record 33,791 with 27 per cent of those identifying as Aboriginal or Torres Strait Islanders.