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

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

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

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

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

Prime Minister Scott Morrison

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

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

Visit our NACCHO #VoteACCHO Election Campaign page HERE 

#VoteACCHO Recommendation 4.

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

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

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

#VoteACCHO Recommendation 6.

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

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

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

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

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

Extracts from The Guardian

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

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

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

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

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

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

Past 2 #VoteACCHO

1. Indigenous Mental Health and Suicide Prevention

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

2. Mental Health

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

3.Youth Mental Health and Suicide Prevention

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

Natural Disasters

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


Mental Health Facts

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

Suicide and Self-harm Facts

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



NACCHO Aboriginal Health and #SelfDetermination : Our CEO Pat Turner pays tribute to her Uncle Charlie Perkins at opening of new Canberra building named in his honour

“ Even though Uncle Charlie is gone and I have left the Public Service, I can tell you that his vision of self-determination is what I have sought to achieve every day of my life.

I know that fulfilling that vision is what will Close the Gap more than anything else.

It has driven me to lead a Coalition of Aboriginal and Torres Strait Islander peak organisations to seek a partnership with the Commonwealth and State and Territory Governments to jointly decide the next phase of Closing the Gap.

If he was here, I know Uncle Charlie would be standing with me in making sure that our peoples have to be at the table and make decisions about Closing the Gap and take responsibility for them alongside Governments.

This is a very powerful legacy of Uncle Charlie.”

NACCHO CEO Pat Turner speaking at the opening of Charles Perkins House In Canberra : See Full Speech Part 2 Below

Read yesterday Closing the Gap announcement by Prime Minister Morrison 

In 1966, Dr Charles Nelson Perkins AO was the first Aboriginal man to graduate from a university in Australia.

 Importantly Aboriginal people should be aware of this false economy which forms the basis of Aboriginal affairs in this country.

The economic lifeline is maintained only at the discretion of politicians and a fickle public.

We must therefore develop and consolidate a viable economy for our various communities and organisations that will sustain us into the future.

We must create short and long-term economic strategies now and thus create a more independent and secure base for ourselves and our children. The reality is that Aboriginal people under utilise, to put it kindly, their current economic and personnel resources. The potential for economic viability for our people is available now if only we could awake to the opportunity and not be blinded largely by employment survival economics ”

Unless the approaches to Aboriginal health are broadened to include greater attention to the health problems of adults, and are matched by broad ranging strategies aimed at redressing Aboriginal social and economic disadvantages, it is likely that overall mortality will remain high.

Dr Charles Perkins opening the Australia’s First National /International Indigenous and Economic Conference (NIBEC 1993) Alice Springs. 1993 International Year of the World’s Indigenous Peoples and Paul Keating was Prime Minister :

Read his full speech here Aboriginal people and a healthy economy

In a fitting tribute, the building where Indigenous affairs policy is developed was renamed Charles Perkins House last week, in honour of the celebrated anti-discrimination campaigner and former Department of Aboriginal Affairs secretary.

From The Madarin 

The late Dr Charles Perkins  became the first Indigenous Commonwealth secretary in 1984, after being appointed to the top job at the department where he started as a research officer in 1969. Before, during and after his career as a public servant, however, Perkins remained an activist first and foremost.

He was a major figure in the struggle for equal rights, arguing powerfully and publicly on behalf of Aboriginal and Torres Strait Islander people and leaving a towering legacy.

If Perkins had a choice between playing the role of the mild-mannered public servant to stay in the good books or speaking his mind, he chose the latter. He was famously suspended from his government job after publicly labelling the Western Australian government racist rednecks, and countless other anecdotes tell of a man whose life’s work was speaking truth to power, and never giving up on a fair go for the first Australians, above all else.

Staff of the Department of the Prime Minister and Cabinet’s Indigenous affairs group have long worked out of the south Canberra office block, described as “the home of Indigenous affairs” by PM&C, since prior to 2013 when they were brought together into a single structure within the central agency.

Charles Perkins House replaced the much blander “Centraplaza” at a ceremony last week, attended by relatives of Perkins and “other significant names in Indigenous Affairs” according to a brief report from the department.

A spokesperson said the new name would stand as “a reminder of his significant contribution to the Australian Public Service, Indigenous Affairs, and to Australia’s national identity”.

While it’s not a stand-alone department, the creation of the IA group marked a move back towards centralisaton from the arrangements it superseded. It has slightly more autonomy than most comparable groupings as it works under an associate secretary, the former vice-chief of the Australian Defence Force, Ray Griggs. This is one of only two such positions that currently exist in the Australian Public Service and has higher status than deputy secretaries.

Perkins’ niece Patricia Turner, a former APS deputy secretary herself and chief executive of the National Aboriginal Community Controlled Health Organisation, did the honours with PM&C secretary Martin Parkinson and deputy secretary for Indigenous affairs, Ian Anderson.

“Dr Perkins was a proud Arrernte and Kalkadoon man and laid the foundation for the type of forward-thinking Indigenous Affairs policy we aspire to at PM&C,” Parkinson said in the statement.

Anderson said Perkins was “an inspiration to public servants and the Indigenous community alike” and noted he was one of the first Aboriginal people to receive a university degree, leader of the 1965 Australian Freedom Ride, and an influential advocate of the yes-vote in the 1967 referendum that essentially created the policy area where he would later become the chief administrator.

We’re told PM&C “worked closely with the owner of the building to secure its agreement” to rename the building and that no money changed hands with the owner, the evri group.

“The Department also engaged Dr Perkins’ family as well as key Indigenous stakeholders in the naming of the building and design of the tribute to Dr Perkins,” a spokesperson added.



I too want to thank Matilda for the warm welcome.  Of course I also want to pay my respects to the traditional owners and elders, past and present.

This is our national capital, which we are all proud of but it is also the traditional lands of Aboriginal people who lived here for many generations.  That they have survived and are here should also be a source of pride for all of us.

I should point out that Matilda and her family also lived in Pearce and became close personal lifetime friends with my aunty and uncle.

Can I also greet the Perkins family formally, and I am very proud that they are part of my family and that Charles Perkins was my uncle.

Uncle Charlie

My uncle Charlie was an extraordinary man.

He had many roles throughout his life and none more important than being a husband, a father, a son, a brother, an uncle, a grandfather and a part of the Arrente and Kalkadoon First Nations.

His family and his wider extended family and cultural responsibilities were at the essence of his life.

It’s important I think to say that because often the focus is on his career in the public service and the influence that he has brought to bear on Australia over the course of the 20th century.

However, he was an Aboriginal man first and foremost.  That he was so successful at that is obvious – just take a look at his family and his children.  They have been such a success and I take this opportunity to pay tribute to them.


Uncle Charlie had other family of course and I am referring to those who lived at St Frances House in Adelaide.

Soccer was the springboard for his international travel and the experiences of living in another country.

Going overseas and, after returning to Australia, playing soccer with teams of different ethnic backgrounds, opened Uncle Charlie’s eyes to how he was viewed as an Aboriginal man among equals in this setting.

But we know, sadly, that if he was treated as an equal when he was playing soccer and recognised for being an Aboriginal man, the society in which he lived discriminated against him.


We also know, however, that this Aboriginal man decided to do something about it.  Uncle Charlie was strong and proud.  He had many strengths

-a strong work ethic and was very disciplined in fulfilling all his roles and responsibilities.

-Because he worked hard, he expected everyone else around him to do the same.

-I also remember personally his generosity and acts of kindness to me and others.

-At work, he focused on meeting and talking directly with Aboriginal and Torres Strait Islander peoples right around the country.

-He had the most extensive network of contacts that I have ever seen, from people living in the Central Australian desert through to the Prime Minister’s office and heads of corporate Australia.  He was never afraid to pick up the phone.

-Of course his leadership qualities were displayed in the Freedom Rides which others have referred to today.

Priorities for Uncle Charlie

Uncle Charlie was a successful kidney transplant recipient and it made him more driven to get a better deal for Aboriginal people throughout Australia.

In the 1960s as a University student he held a mirror up so that Australian people could see how racist they were and forced them to look at themselves.

Uncle Charlie forced our country to start taking a good hard look at itself.

Sure, many considered him controversial and a stirrer, but we loved him and applauded him for his leadership, his strength of character and his undying commitment to achieve a much better quality of life for First Nations peoples throughout this country and a full suite of our specific rights as First Nations peoples.

We know that his spirit guides us today, and that during his lifetime he taught us a great deal.

Today we all stand on his shoulder as a giant of a man whose legacy we must build upon and bring his vision into reality.


That vision more than anything else was self-determination for Aboriginal and Torres Strait Islander peoples.

By self-determination, Uncle Charlie never meant that we should be able to decide if we are part of Australia or that our development ought to be separate.

I can assure you that Uncle Charlie was a proud Australian and also saw the benefits of mainstream economic development.

What Uncle Charlie meant by self-determination was that;

  • Aboriginal and Torres Strait Islander peoples had to be fully involved in decision making about the policies and programs of governments that affected them,
  • while we had to co-exist with non-Indigenous Australians, we had to have our own structures that allowed us the opportunity to make decisions about our priorities for development;
  • racism in all its forms against us had to be defeated; and
  • while we had to live and succeed in Australia we also had the right to have our culture and identity.

This vision became central to the outlook of a whole generation of public servants who worked in Indigenous Affairs including me.

Even though Uncle Charlie is gone and I have left the Public Service, I can tell you that his vision of self-determination is what I have sought to achieve every day of my life.

I know that fulfilling that vision is what will Close the Gap more than anything else.

It has driven me to lead a Coalition of Aboriginal and Torres Strait Islander peak organisations to seek a partnership with the Commonwealth and State and Territory Governments to jointly decide the next phase of Closing the Gap.

If he was here, I know Uncle Charlie would be standing with me in making sure that our peoples have to be at the table and make decisions about Closing the Gap and take responsibility for them alongside Governments.

This is a very powerful legacy of Uncle Charlie.

Burn Baby Burn!

Reflections on the life of my Uncle Charlie, however, should not end without some other significant moments which many seem to have forgotten.

He had a love/hate relationship with the media, and he certainly knew how and when to cause a storm.

In some cases, I can’t help but laugh even though they were very serious at the time.  Remember the threats of protests in the lead up to the Sydney 2000 Olympics.

Uncle Charlie made a highly controversial declaration in April 2000 that Sydney would “Burn Baby Burn” during the event.

Who can forget the nationwide ruckus this caused.  Funny that we should be naming a building after the Aboriginal man who said it.

As I was walking up the steps just now, I was looking at the new sign “Charles Perkins House” and thinking to myself that I would like to spray paint in brackets “Burn Baby Burn”.

Other anecdotes

My uncle would read the press coverage every morning, and the executive soon learnt we also had to. At times I would walk into his office if I was concerned about a particular emerging issue covered in the press and indicate high level briefing may need to be prepared, and he had a very keen sense of when that was necessary and when it wasn’t. He would often say to us “Today’s news – tomorrow’s fish and chips wrapping”.

One morning we walked into his office in the executive meeting and he exclaimed the headline “Woman crawls 500m to escape croc attack”. “Geez”, he said “fancy that, crawling 500 miles!” I replied “Can’t be, must be 500 metres because she would be dead from exhaustion if she crawled 500 miles!”

Before the age of the mobile, my uncle was addicted to the phone and at home the phone and his personal phone book were forever on his side. He would flick through the phone book to decide who to ring today, and when someone answered he would say “Hello mate, Charlie here, just touching base”. Of course we all knew he was just keeping his finger on the pulse.

He always had a fire in his belly and held is back bone straight, a determination he instilled in us all. I am so proud he was my uncle.

In closing, I want to thank you personally Ian Anderson for all the effort you put into bringing this event to fruition.

It’s fantastic that Australia’s headquarters for Indigenous Affairs has been named after Uncle Charlie and well done to the Australian Government and thank you very much.


NACCHO Aboriginal Health #Racism and #CulturalSafety : Has the The Ways of Thinking and Ways of Doing #WoTWoD  program designed to improve cultural respect in general practice and improve health outcomes for Aboriginal patients failed

“Cultural respect reflects the attitudes and behaviour of the entire medical practice, from reception to consulting room.

In addition, general practice organisations must work in partnership with Indigenous community-controlled organisations to reduce health care disparities, address social determinants of poor health, and increase access to safe, effective and culturally respectful care. ” 

 Professor Siaw-Teng Liaw, professor of General Practice at the UNSW Sydney and and colleagues 

A YEAR-long program designed to improve cultural respect in general practice and improve health outcomes for Aboriginal patients, has failed to either increase the rate of Indigenous health checks or improve cross-cultural behaviours, according to the authors of research published in the Medical Journal of Australia.

Download 6 page copy of research 

Cultural respect in general practice

Read full report online at MJA 

Cover : The painting created for the Ways of Thinking and Ways of Doing (WoTWoD) study by Ashley Firebrace, a Wurundjeri man from Melbourne.

With the majority of Australia’s Aboriginal population living in cities, suburban doctors’ clinics are part of the front-line effort to close the gap in health inequalities.

There are efforts to improve the way general practices treat Indigenous patients, but progress is slow.

A new study into a program designed to make GP clinics more culturally sensitive has found little improvement after 12 months.”

ABC Radio AM Interview with Janine Mohammed. interim chief executive, Lowitja Institute : Teng Liaw, professor of general practice, University of New South Wales and Dr Tim Senior, Aboriginal and Torres Strait Islander health medical advisor, Royal Australian College of General Practice and GP, Tharawal Aboriginal Medical Service

Listen HERE 3 Minutes


Read over 50 Aboriginal Health and Cultural Safety articles here  

The Ways of Thinking and Ways of Doing (WoTWoD) program was developed by a team led by Professor Siaw-Teng Liaw, professor of General Practice at the UNSW Sydney and the Ingham Institute of Applied Medical Research.

It was designed to “translate the systemic, organisational, and clinical elements of the Australian Health Ministers’ Advisory Council Cultural Competency Framework into routine clinical practice”.

The WoTWoD program includes “a toolkit [comprising 10 scenarios that illustrate cross-cultural behaviour in clinical practice], one half-day workshop, cultural mentor support for the practice, and a local care partnership of participating Medicare Locals/PHNs and local ACCHSs for guiding the program and facilitating community engagement”.

In evaluating the program, Liaw and colleagues introduced WoTWoD to 28 intervention general practices and compared the results after 12 months with 25 control practices.

After 12 months “the rates of MBS item 715 claims (health assessment for Aboriginal and Torres Strait Islander People) and recording of risk factors for the two groups were not statistically significantly different, nor were mean changes in cultural quotient scores, regardless of staff category and practice attribute”.

Liaw and colleagues wrote that the negative results may be attributable to “variability in the fidelity of the intervention, especially the local care partnership … the clinical and organisational reasons for low usage rate [of the MBS item 715] … and the length of the trial”.

“The length of the trial (12 months) may not have been sufficient to detect significant changes in professional practice dependent on organisational changes that require time to formulate and implement.

“Nevertheless, it is encouraging and promising that the data trends over the 12 months within each group were positive and participant perceptions of the WoTWoD were very positive.

“Further collaborative and participatory mixed methods research is required to examine the complexities of co-creating, implementing, and evaluating programs that integrate ‘thinking and doing’ cultural respect in the context of the changing needs and priorities of general practice and Indigenous communities,” Liaw and colleagues concluded.

The known: The gap in life expectancy between Indigenous and non‐Indigenous Australians remains large. Urban Indigenous Australian‐controlled health services are under‐resourced, and mainstream primary care services are often not culturally sensitive.

The new: A practice‐based cultural respect program — including a workshop and toolkit of scenarios, with advice from a cultural mentor, and guided by a care partnership of Indigenous and general practice organisations — did not significantly influence Indigenous health check rates or cultural respect levels.

The implications: Cultural respect programs may require more than 12 months to increase Indigenous health check rates and the cultural quotient scores of general practice clinic staff.

Closing the health and care gaps between Aboriginal and Torres Strait Islander (Indigenous) Australians and non‐Indigenous Australians has been a longstanding challenge.,

In 2018, a decade after Australian governments committed themselves to Closing the Gap, mortality and life expectancy for Indigenous Australians had not markedly improved, and nearly 80% of the difference in mortality between adult Indigenous and non‐Indigenous Australians was attributable to chronic disease.

The Practice Incentives Program–Indigenous Health Incentive (PIP‐IHI), introduced in May 2010, assists general practitioners undertake chronic disease care planning for their Indigenous patients. Initial uptake was poor: only 64% of general practices expected to register (1275 of 2000) did so during 2010–11. However, the proportion had increased by May 2012.

The rebate for health assessments for Aboriginal and Torres Strait Islander People (Medicare Benefits Schedule [MBS] item 715), constitutes an additional strategy for improving the access of Indigenous Australians to primary health care matched to their needs. GPs can engage suitably qualified practice nurses or Aboriginal Health Workers to assist with the assessment, including patient history‐taking, clinical examination and investigations, and with providing patients with education and resources for managing their own health.

The proportion of Indigenous Australians for whom payment for MBS item 715 was claimed increased from nearly 11% in 2010–11 to nearly 29% in 2016–17 (New South Wales, 26.8%; Victoria, 17.1%). However, the rate is still low and access to comprehensive care planning for Indigenous Australians is poor

Aboriginal Community Controlled Health Services (ACCHSs) are important providers of primary health care to Indigenous communities. However, most Indigenous Australians living in urban areas also use standard primary care and GP services.

In 2016, Indigenous Australians comprised 3% of the Australian population (744 956 people); 38% lived in New South Wales (229 951) or Victoria (53 663). About one‐third of Indigenous Australians live in major cities, but only 16 of 138 ACCHSs are in major cities; urban ACCHSs have lower staff/client ratios than regional and remote ACCHSs.

Indigenous Australians frequently encounter cultural disrespect in mainstream primary care services., The 2012–13 Australian Aboriginal and Torres Strait Islander Health Survey reported that 16% of Indigenous Australians had experienced racism in health settings; 20% of these respondents reported that doctors, nurses and other hospital or clinic staff were discriminatory, and 7% avoided seeking health care because of unfair treatment.

Of 755 adult Indigenous Victorians surveyed in 2011, 29% had experienced racism in health settings. Lack of cultural respect in health care restricts access to and reduces the quality of care for Indigenous Australians.

We have previously identified trust, access, flexibility, time, support, outreach, and working together as key aspects of cultural respect. Although the Indigenous Chronic Disease Package (2009–2014) supported increased cultural awareness training for health workers, it did not change attitudes or behaviour sufficiently to bridge the cultural gap between health professionals and Indigenous people.

We developed the Ways of Thinking and Ways of Doing (WoTWoD) cultural respect program with a trans‐theoretical approach, harmonising many similar conceptual frameworks and the terminology applied to Indigenous and cross‐cultural health in Australia. The theoretical underpinnings of WoTWoD were described in the article describing our pilot study. The WoTWoD framework translates the systemic, organisational, and clinical elements of the Australian Health Ministers’ Advisory Council Cultural Competency Framework into routine clinical practice. Cultural respect reflects the attitudes and behaviour of the entire medical practice, from reception to consulting room. In addition, general practice organisations must work in partnership with Indigenous community‐controlled organisations to reduce health care disparities, address social determinants of poor health, and increase access to safe, effective and culturally respectful care. This is fundamental to Indigenous Australians’ right to the highest standard of health.,

We undertook a cluster randomised controlled trial to examine whether the WoTWoD program improves clinically appropriate anticipatory care in general practice and the cultural respect of medical practice staff.


NACCHO Aboriginal Health #RefreshTheCTGRefresh News : Dr @mperkinsnsw #ClosingtheGap failures are firmly rooted in racism and Nicholas Biddle From @ANU_CAEPR 4 lessons from 11 years of #ClosingtheGap reports


1. Some targets are easier than others

2. The life-expectancy measure is unpredictable

3. On-track one year, off-track the next

4. Indigenous Australians in the city and country have different needs

5.Closing the Gap Failures are firmly rooted in racism

” Scott Morrison last week became the fifth prime minister to deliver a Closing the Gap report to parliament – the 11th since the strategy began in 2008. Closing the Gap has aimed to reduce disadvantage among Aboriginal and Torres Strait Islander people with particular respect to life expectancy, child mortality, access to early childhood education, educational achievement and employment outcomes.

Almost every time a prime minister delivers the report, he or she states the need to move on from a deficits approach.

Which is exactly what Morrison did this time. But he also did something different. Four of the seven targets set in 2008 were due to expire in 2018.

So last year, the government developed the Closing the Gap Refresh – where targets would be updated in partnership with Indigenous people.

Nicholas Biddle ANU : Four lessons from 11 years of Closing the Gap reports : See in full Part 1 Below 

Read NACCHO Closing the Gap response and download the report

” Once again, minimal progress has been made towards closing the gap on Indigenous disadvantage.

Racism has been mentioned as an issue, but exactly how does racism make a contribution to this “unforgivable” state of affairs ?.

The answer is in the criminal justice system. Studies have shown mass incarceration has a profoundly negative effect on the health, education, and employment of families and communities-and Indigenous Australians are the most incarcerated group on Earth.

The US, the mother of all jailers imprisoned 655 people per 100,000 in 2018. Australia imprisoned 164 non Indigenous people and 2481 Indigenous people per 100,000. Western Australian imprisoned 3663 Aboriginal people per 100,000.

In 1991, when the report on Aboriginal Deaths in Custody was handed down, 14% of all prisoners were First Nations people.  By last year, the figure was 28%. ”

Lesson 5 Dr Meg Perkins is a registered psychologist, researcher and writer : See Part 2 Below

First Published in The Conversation 

The current report and the work leading up to it has led to new targets, such as a “significant and sustained progress to eliminate the over-representation of Aboriginal children in out-of-home care” and old targets framed differently.

For example, the headline new outcome for families, children and youth is that “Aboriginal and Torres Strait Islander children thrive in their early years”. This is on top of more specific targets such as having 95% of Aboriginal and Torres Strait Islander four-years-olds enrolled in early childhood education by 2025 – which this year is on track.

Read more: Closing the Gap is failing and needs a radical overhaul

Looking back on the past 11 years, there are several things we’ve learned. This includes those targets that seem easiest to meet, as well changes in the demographics of the population that complicate the measuring of the targets. Below are three lessons from the last decade of the policy.

1. Some targets are easier than others

The targets where there has been some success tend to be those where government has more direct control. Consider the Year 12 attainment compared to the employment targets. To increase the proportion of Indigenous Australians completing year 12, the Commonwealth government can change the income support system to create incentives to not leave school, while state and territory governments can adjust the school leaving age.

That is not to downplay the efforts of parents, teachers, community leaders, and the students themselves. But, there are some direct policy levers.

To improve employment outcomes, on the other hand, discrimination among employers needs to be reduced, human capital levels increased, jobs need to be in areas where Indigenous people live and to match the skills and experiences of the Indigenous population. These are solvable policy problems with the right settings and community engagement. But, they are substantially more complex.

Read more: Three reasons why the gaps between Indigenous and non-Indigenous Australians aren’t closing

2. The life-expectancy measure is unpredictable

The main target has always been related to Aboriginal and Torres Strait Islander life expectancy. The 2019 report shows the target of closing the gap by 2031 is not on track.

Unfortunately, the life expectancy target is one of the more difficult to measure, as it uses multiple datasets that are potentially affected by different ways Indigenous people are counted in the census and changing levels of identification. The most recent estimates, based on data for 2015-17, are that life expectancy at birth is 71.6 years for Indigenous males and 75.6 years for Indigenous females.

While the gaps with the non-Indigenous population of 8.6 years and 7.8 years respectively are smaller than they were in 2010-12 (the previous estimates) the Australian Bureau of Statistics (ABS) and most demographers suggest extreme caution around the interpretation of this change. The ABS writes:

While the estimates in this release show a small improvement in life expectancy estimates and a reduction in the gap between 2010-2012 and 2015-2017, this improvement should be interpreted with considerable caution as the population composition has changed during this period.

More people have been identifying as being Aboriginal and/or Torres Strait Islander over recent years. What’s more, the newly identified Indigenous people tend to have better outcomes on average (across health, education, and labour market outcomes) than those who were identified previously. This biases our estimates, making it appear there is more rapid progress than there might otherwise be.

Read more: Three charts on: the changing status of Indigenous Australians

The Closing the Gap framework was implicitly designed around improving the circumstances of the 2008 Indigenous population relative to the 2008 non-Indigenous population. However, both populations have changed substantially over the intervening years. There has been a growth of the non-Indigenous population due to international migration. It is hard to measure and track differences in changing populations.

3. On-track one year, off-track the next

There is also the yearly reporting cycle. The target of child mortality, for instance, no longer appears to be on track. This is despite it being on track in previous years. Yearly fluctuations make it hard to gauge the effectiveness of long-term policy settings.

For other indicators, such as employment, the data is available far less frequently than it could be, and we are less able to judge the effect of individual policies and interventions. Having said that, in my view, the sophistication and nuance with which data in the Closing the Gap reports has been presented has improved considerably.

It seems most policies prioritise Indigenous Australians living in remote areas than those in the city. David Clode/Unsplash

4. Indigenous Australians in the city and country have different needs

This isn’t always reflected in policy settings. The current report shows many outcomes are worse in remote compared to non-remote Australia. It also makes the point (though less frequently), that the vast majority of Indigenous Australians live in regional areas and major cities. This creates a tension between relative and absolute need. Unfortunately, the policy responses of government often don’t get that balance right.

Take the signature policy proposal announced with the current report – a suspension or cancelling of HECS debt for teachers who work in remote schools. What the policy ignores is that the vast majority of Indigenous students live outside remote Australia, that outcomes for Indigenous students in non-remote areas are well behind those of non-Indigenous students, and that the schools Indigenous students attend in non-remote areas tend to be very different from those of non-Indigenous students.

Read more: Infographic: Are we making progress on Indigenous education?

Attracting and keeping more high quality teachers in remote areas is a worthwhile policy aim. Alone, it is not sufficient.

The current report and speech by the prime minister states that “genuine partnerships are required to drive sustainable, systemic change” and that the government needs “to support initiatives led by Aboriginal and Torres Strait Islander communities to address the priorities identified by those communities”.

These are admirable goals. But, they require significant resources, a genuine engagement with the evidence (even if it isn’t positive), taking the Uluru Statement from the Heart seriously, and real ceding of control to Aboriginal and Torres Strait Islander people

5.Closing the Gap Failures are firmly rooted in racism

Some people think Aboriginal people must be uniquely anti-social and/or make very bad choices, but research tells us the majority of people in prison are suffering from severe cognitive impairments and/or mental health issues such as post-traumatic stress disorder and major depression.

Why are we punishing people with disabilities for behaviour that may not be intentional ?.

When we look at children in school, we find three times as many Aboriginal children are suspended from school than non-Aboriginal children. Some of the special purpose schools in NSW are filled with Aboriginal children only.

Many youth detention centres in the country have 100 per cent Aboriginal inmates. Why are so many Aboriginal children being suspended from school and set on the road to crime and punishment, and what happens to white Australian children who are not able to behave appropriately in the classroom ?.

It seems mainstream Australian children are referred to health professionals when they have difficulties at school. They are seen as suffering from learning disabilities, autism, or ADHD. Speech therapists and other allied health professionals work to help them catch up with peers and stay in school.

Due to intergenerational disadvantage, Indigenous people often don’t have the resources to find a therapist to assist their child. People born before 1972 were not guaranteed a place in school, and so grand parents may not have had much education.

Parents may have left school in Year 8 or 9 and are not familiar with developmental norms or disabilities. If they know that their child is falling behind at school, they often do not have the money to pay for expensive psychological assessments, which cannot be done in Medicare. Without an assessment, and a diagnosis , the school cannot make allowances for a child with brain-based disabilities.

The racist policies of the past have left many Aboriginal people disadvantaged when it comes to dealing with the education system. If their child is having difficulties, suspensions are often the consequence. Once suspended and out on the street, racism sets in again.

Aboriginal children are searched and arrested more often. We will never close the disadvantage gap until we can offer support to the children of young people. We need to raise the age criminal responsibility from 10 to 15 years, and spend money on supporting children, not punishing them.

Dr Meg Perkins


NACCHO Aboriginal Health @RecAustralia and #Racism : New Australian #ReconciliationBarometer Report shows some increased support but 33% of our mob have still experienced at least one form of verbal racial abuse in the last 6 months

Significantly, almost all Australians (95%) believe that ‘it is important for Aboriginal and Torres Strait Islander people to have a say in matters that affect them’ and 80% believe it is important to ‘undertake formal truth telling processes’, with 86% believing it is important to learn about past issues.

But disturbingly the barometer found that 33% of Aboriginal and Torres Strait Islander people have experienced at least one form of verbal racial abuse in the last 6 months.”

Reconciliation CEO, Karen Mundine launching today The 2018 Australian Reconciliation Barometer, a national research study conducted every two years to measure and compare attitudes and perceptions towards reconciliation:

Download the full Report HERE

Reconcilation Aust 158 pages Barometer -full-report-2018

Download the brochure HERE


Download the 2018 Workplace RAP Barometer 

WorkPlace RAP Barometer -2018_-final-report

Read over 110 Aboriginal Health and Racism articles published by NACCHO in the last 7 years 

Australians’ support for reconciliation and for a greater Aboriginal and Torres Strait Islander say in their own affairs continues to strengthen according to the latest national survey conducted by Reconciliation Australia.

The 2018 Australian Reconciliation Barometer, a national research study conducted every two years to measure and compare attitudes and perceptions towards reconciliation, has found that an overwhelming number of Australians (90%) believe in the central tenet of reconciliation – that the relationship between Aboriginal and Torres Strait Islander people is important.

The 2018 Barometer surveyed a national sample of 497 Aboriginal and Torres Strait Islander people and 1995 Australians in the general community across all states and territories.

Reconciliation CEO, Karen Mundine, said that this latest Barometer once again showed a steady strengthening of the indicators for reconciliation and improved relationships between Aboriginal and Torres Strait Islander people and other Australians.

“Among these indicators is the encouraging fact that 90% of Australians believe in the central tenet of our reconciliation efforts, that the relationship between Aboriginal and Torres Strait Islander people is important, and that 79% agree that Aboriginal and Torres Strait Islander cultures are important to Australia’s national identity,” said Ms Mundine.

“Significantly, almost all Australians (95%) believe that ‘it is important for Aboriginal and Torres Strait Islander people to have a say in matters that affect them’ and 80% believe it is important to ‘undertake formal truth telling processes’, with 86% believing it is important to learn about past issues.

“More Australians than ever before feel a sense of pride for Aboriginal and Torres Strait Islander cultures; this has risen to 62% from 50% in 2008 when the first barometer was conducted,” she said.

Conducted by Reconciliation Australia the Australian Reconciliation Barometer is the only survey undertaken in Australia which measures the progress of reconciliation between Aboriginal and Torres Strait Islander people and non-Indigenous Australians.

Ms Mundine said she was heartened by the 2018 results which indicated that the work of Reconciliation Australia and other organisations which promoted reconciliation, the richness of Aboriginal and Torres Strait Islander culture and the need to truthfully present Australia’s history, was having a positive impact.

“In welcoming these latest results, I must acknowledge the hard work undertaken by so many Aboriginal and Torres Strait islander people to share the incredible beauty and complexity of our cultures across this continent.”

Ms Mundine said that while it was encouraging to see support for reconciliation grow again in the past two years, “there was still plenty of room for improvement”.

“Disturbingly the barometer found that 33% of Aboriginal and Torres Strait Islander people have experienced at least one form of verbal racial abuse in the last 6 months.”

Ms Mundine said that there were a number of actions that should be taken to further improve the situation for Australia’s First Nations and take the next steps towards a reconciled nation.

These include:

  • Developing a deeper reconciliation process through truth, justice and healing, including supporting a process of truth telling, the establishment of a national healing centre, formal hearings to capture stories and bear witness, reform to the school curriculum, and exploration of archives and other records to map massacre sites and understand the magnitude of the many past wrongs;
  • Support for addressing unresolved issues of national reconciliation including through legislation setting out the timeframe and process for advancing the issues proposed in the Uluru Statement from the Heart;
  • Supporting the national representative body for Aboriginal and Torres Strait Islander people – the National Congress of Australia’s First Peoples – and these efforts must be underpinned by the principles of the United Nations Declaration of the Rights of Indigenous Peoples, particularly the right to self-determination;
  • Recommitting to the Council of Australian Government’s (COAG) Closing the Gap framework that involves renewing and increasing investments and national, state/territory and regional agreements to meet expanded Closing the Gap targets that are co-designed with Aboriginal and Torres Strait Islander people;
  • Investing in, and supporting, anti-racism campaigns and resources including maintaining strong legislative protections against racial discrimination and taking leadership to promote a zero-tolerance approach to racism and discrimination.

Read the Summary Report


NACCHO Aboriginal Health and #Racism in the #Media Debate : @ShannanJDodson Why is it more offensive to call someone #racist than to say something racist?

 ” On Monday Studio 10 co-host Kerri-Anne Kennerley berated January 26 protesters.

She questioned whether any one of them had “been out to the outback where children, babies, five-year-olds are being raped, their mothers are being raped, their sisters are being raped. They get no education.”

Fellow panellist Yumi Stynes responded by calling her out as sounding racist, which was met with a shocked “I’m offended” from Kennerley.

This situation was a common example of how deeply offended people become when they are called out for racist behaviour, which is touted as much more offensive than actually being racist.

Indigenous people have had to listen to centuries of non-Indigenous people denigrating and demonising us – that we are a problem to be fixed. The minute that is called out, there is discomfort that the status-quo is not being maintained. It is an immediate and lazy defence mechanism to be offended by being called a racist, rather than unpacking why what you’ve said is perceived as racist and challenging your own stereotypes.

There is no denying that there are social issues that plague Aboriginal and Torres Strait Islander communities (there have been continuous protests to draw attention to this) and it is important to open people’s eyes to the everyday lived reality. But these issues are never explained in context.

They are usually delivered with broad-sweeping statements which are ill-informed by decades of deeply-embedded prejudiced reporting. Most often by non-Indigenous people with little to no knowledge of the issues and with no understanding of the historical racism underpinning it.

There is no explanation of the root of these issues, which is intergenerational trauma caused by colonisation, dispossession, the Stolen Generations, entrenched racism, discriminatory policies and poverty.

January 26 symbolises when these social issues began for our communities.

We cannot deal with the current violence, injustice and pain without looking at ourselves in the mirror and into our history.

What the media says matters. When Indigenous people are persistently portrayed as child abusers and other stereotypical labels, it feeds racist attitudes infiltrating the wider population (which have been conditioned by the media) “

Shannan Dodson is a Yawuru woman and National NAIDOC Committee member. She is Media Diversity Australia’s Indigenous Affairs advisor where she co-authored a handbook for better reporting on Indigenous peoples and issues. See this article in full Part 2 Below 

Follow Shannan @ShannanJDodson

The Australian have an article out at the moment headlined ‘Indigenous leaders back Kerri-Anne Kennerley in racism row’.

The article interviews three members of the Liberal Party for their views on it, suffice it to say that they were all pretty cool with KAK’s comments.

Apparently the Australian are the deciders on who gets to be an ‘Indigenous Leader’, so even though IndigenousX is a site that privileges Indigenous voices, we thought we’d take a different tack on this one.

We thought we’d ask some White leaders about their thoughts on the situation.”

Luke Pearson Founder #IndigenousX  : White leaders condemn Kerri-Anne Kennerley over racism row

The media should take time to reflect on their own views, biases and opinions about Aboriginal and Torres Strait Islander peoples, and use facts and editorial judgement to challenge, rather than reinforce stereotypes.

Negative reporting is commonplace for our communities.

recent study of more than 300 articles about Aboriginal health, published over a 12-month period showed that almost 75 percent of these articles were negative. ”

“On an individual level, exposure to racism is associated with psychological distress, depression, poor quality of life, and substance misuse, all of which contribute significantly to the overall ill-health experienced by Aboriginal and Torres Strait Islander people.

Prolonged experience of stress can also have physical health effects, such as on the immune, endocrine and cardiovascular systems.”

Pat Anderson is chairwoman of the Lowitja Institute, Australia’s National Institute for Aboriginal and Torres Strait Islander Health Research (and a former chair of NACCHO) see her opinion article below

Read article above HERE

The media pick sides in the Kerri-Anne Kennerley racism debate

EMILY WATKINS  Crikey Media reporter

Example of #SackKAK Social media

It didn’t take long for lines to be drawn and sides to be chosen in the latest drama out of Ten’s morning panel show Studio 10.

Panellist and Logie Hall of Famer Kerri-Anne Kennerley suggested those marching to change the date of Australia Day didn’t care about social problems and crime in Indigenous communities. Guest panellist Yumi Stynes — the only non-white person on the panel — said Kennerley sounded racist.

Well! KAK was very offended (as people increasingly are when they are called “racist”).

Producers followed up yesterday by having two Indigenous guests with opposing opinions on the show — Alice Springs town councillor Jacinta Price and former Victorian MP Lidia Thorpe. Meanwhile, the commentariat has fully embraced this latest battle in the culture wars.

In KAK’s corner

Most traditional and conservative media are supporting Kennerley. Sydney’s Daily Telegraph today has come out in full support of KAK — she’s on the front page, with Indigenous leader Warren Mundine saying it’s “stupid” to call her racist. Inside the paper, an opinion piece from Jacinta Price that supports Kennerley is given prominence over a counter-opinion from retired Indigenous figure skater and archaeologist Lowanna Gibson.


Its editorial says Stynes “played the racism card”, while on the opposite page the cartoon shows Stynes calling a barista racist for offering her a “short black” coffee.

The Teles broadsheet stablemate The Australian has also run an opinion piece from Jacinta Price, and quotes Indigenous Health Minister Ken Wyatt as defending Kennerley. Andrew Bolt has used his Sky News program and his blog on the Herald Sun website to support Kennerley’s position.

Over at Sydney’s 2GB, Kennerley defended herself on Ben Fordham’s programbefore KIIS’ Kyle and Jackie O called Stynes and Kennerley to talk to about the spat.

Former Studio 10 executive producer Rob McKnight published a blog post on his industry website TV Blackbox on why he would never have let Stynes on the program:

The producers and executives at 10 might be patting themselves on the back over the amount of publicity this confrontation is generating, but not all publicity is good publicity. The headlines alone are causing one of their regular presenters serious brand damage … None of these paint KAK in a good light. In fact, they are very damaging, especially when they don’t represent the point she was trying to make. Essentially, she has been thrown under a bus by a co-host and that’s not cool.”

Daily Mail Australia, which loves any kind of morning TV drama, has been dining out on the brouhaha, rewriting and churning out its own versions of all the commentary and developments.

In Stynes’ corner

Another example of Social Media activism 

Unsurprisingly, online and youth-focussed outlets have leant towards Stynes’ view

Ten’s own news website Ten Daily is leading its website on Wednesday morning with an opinion piece from Yawuru woman Shannan Dodson asking why it’s more offensive to call someone racist than it is to say something racist. See Below

Junkee‘s coverage of the story relied more heavily on social media commentary than specific criticism of Kennerley’s comments, whilePedestrian took a swing at breakfast TV more generally and and flat-out called Kennerley’s comments “racist” without qualification (which other outlets were reluctant to do).

Meanwhile, Indigenous X founder Luke Pearson has published a piece satirising The Australian‘s coverage.

Part 2 Shannan Dodson is a Yawuru woman continued from opening 

Kennerley’s comments were a veiled concern for Indigenous people to mask her discomfort with Australians protesting against a day that solidifies and elevates her status as the dominant culture.

Her response to the backlash today was to reiterate her offense at being labelled racist rather than reflecting on her own position of privilege and why her approach and words were in fact what was offensive.

She says “if you look at ‘racist’ in the dictionary it’s thinking that another racial group is superior or another group is inferior.” The idea that people believe racism is confined to calling someone a racist term fails to acknowledge that racism is systemic and institutional.

It is not a coincidence that the most recent examples of media personalities being called out for being racist have been white women (although white men often make an appearance as well) — think Sonia Kruger, Samantha Armytage, Prue MacSween.

It is because they are comfortably sitting within the hegemonic culture; that experiences all the perks of it, commonly known as white privilege. Or as sociologist Dr Robin DiAngelo puts it “the defensiveness and discomfort that white people display when their racial worldviews are challenged.”

White privilege means turning on the television and seeing people of your race widely represented. It is having your worldview from a position of power and privilege reiterated and presented above all else, without being questioned or given from a different perspective.

Aboriginal people are rarely represented in these discussions (or often just as a knee-jerk reaction if we are). The media often talks about us, laying judgement, without including us in conversations about our own lives and experiences.

The fact is a non-Indigenous person is not going to have the same experience, perspective or reality as an Indigenous person. Not just because of the racism experienced by our communities, but because the system we are living in was methodically set up to exclude and discriminate against Indigenous people.

Our experience in this country is unique to any other. Almost every Indigenous family and community has been affected by the forcible removal of Indigenous children with the purpose of assimilating us and stripping us of our identity and culture.

My own family has been impacted by the Stolen Generations; two of my aunties were forcibly removed from my grandmother and grandfather.

They were not removed for ‘their wellbeing’, they were removed due to racist policies that also saw my Anglo Grandfather jailed for 18 months for loving my Aboriginal grandmother — because it was illegal to cohabit with an Aboriginal person.

That is recent history, my aunties are still alive and that is still having a ripple effect on not only my family but our community and other Indigenous communities across the country. It is a lived real experience, one that is not just a distant memory in history books.

Where is the nuanced discussion in mainstream media when it comes to discussing the social issues we face? Why aren’t we talking about the immense trauma we are still suffering that is projected out into painful acts because the hurt is too hard to bear?

Kerri-Anne Kennerley also goes on to say “Throwing words around can be dangerous and very, very hurtful”.

I ironically agree with the sentiment. Inaccurate or inflammatory reporting from a position of power has a detrimental impact on already oppressed communities.

The media have an influential and permeating impact on how audiences understand and make sense of the world. Whether deliberate or unconscious, those working in the media have the power to influence how Aboriginal and Torres Strait Islander communities are perceived and understood.

The media should take time to reflect on their own views, biases and opinions about Aboriginal and Torres Strait Islander peoples, and use facts and editorial judgement to challenge, rather than reinforce stereotypes.

Negative reporting is commonplace for our communities.

recent study of more than 300 articles about Aboriginal health, published over a 12-month period showed that almost 75 percent of these articles were negative.

What the media says matters. When Indigenous people are persistently portrayed as child abusers and other stereotypical labels, it feeds racist attitudes infiltrating the wider population (which have been conditioned by the media) and continues to fuel prejudice, misconceptions and ignorance.

These stereotypes are internalised for our people, it creates shame and fuels pain and trauma which often isolates people from participating in mainstream society. This perpetuates the cycle of disadvantage.

We are consistently barraged with commentary about how damaged, destructive and broken we are and that we are not taking any responsibility for this. Why should we be the only ones to carry the weight of colonisation and the social impact it has had on our communities? It is our shared responsibility to dismantle the racist institutions that have systematically worked to oppress Indigenous people.

But frankly, I’m tired of carrying the weight and having to constantly justify my humanity and educate the 97 percent of Australians about why saying inflammatory, ill-informed and stereotypical things are racist.

We need more people like Yumi to step up and share the burden and call out racism in all shapes and forms.

Shannan Dodson is a Yawuru woman and National NAIDOC Committee member. She is Media Diversity Australia’s Indigenous Affairs advisor where she co-authored a handbook for better reporting on Indigenous peoples and issues. Follow Shannan @ShannanJDodson

Part 3  The truth behind Kerri-Anne Kennerley’s ‘racist’ claims on Studio 10

From Mamamia

Morning television has a reputation for being typically, well, sedate. But on Monday’s episode of Studio 10, the panel engaged in a debate that has left people fuming.

It centres around an exchange between daytime television stalwart Kerri-Anne Kennerley and presenter Yumi Stynes regarding protests that took place around the country on January 26, which called for the date of Australia Day to be changed and to highlight ongoing oppression and disadvantages experienced by First Nations people.

Kennerley’s take: “Has any single one of those 5000 people waving the flags, saying how inappropriate the day is, has any one of them been out to the outback where children, babies five-year-old’s are being raped, their mothers are being raped, their sisters are being raped, they get no education? What have you done?”

To Stynes, the comments sounded “racist”; an accusation that left Kennerley “seriously offended”.

“Just because I have an opinion doesn’t mean I’m racist,” she replied.

But Kennerley’s comments weren’t presented as an opinion – they were presented like fact. So, was she actually right? Let’s take a look

Of course, it should be noted that Kennerley was raising a question rather than making a direct accusation. But it was clearly a loaded one.

Author/filmmaker/actor Elizabeth Wymarra, who was among those to lead a protest against Kennerley outside Channel 10’s Sydney HQ this morning, argued that the premise of Kennerley’s question was not only presumptive and unfounded, but hypocritical.

Watch video 

“There was over 50,000 people that came out and marched in the Invasion Day march in Sydney, and a lot of those people were non-Indigenous people. They were non-Indigenous people who care about the oppression and discrimination of my people,” she stated in a Twitter video. “They’re in solidarity with us, unlike you, so it seems… Last time I checked, I don’t see you coming into my house, or my community, helping my people. So who are you to point fingers at people going to marches?

“You don’t know none of those 50,000 people that marched with us. You don’t know they don’t go to community.”

In remote Indigenous communities “…children, babies, five-year-old’s are being raped, their mothers are being raped, their sisters are being raped, they get no education

Breaking it down…

Sexual abuse.

Stynes’ criticism of this statement was that Kennerley was implying that “women aren’t being raped here in big cities, and children aren’t being raped here in big cities”. In other words, that sexual violence is a remote Indigenous issue rather than a national one.

That’s clearly not the case. Australian Institute of Health and Welfare data indicates that one in five women around Australia have experienced sexual violence since age 15.

There is evidence that Indigenous Australians are more likely to experience sexual violence, though. According to the AIHW, in 2016 the rate of Indigenous sexual assault victims (ie. per 100,000 people) across NSW, Queensland, Northern Territory and South Australia was between 2.3 and 3.4 times higher than that among non-Indigenous victims.

When it comes to sexual violence against children, the picture is similar. In 2016 the rate of Indigenous children, aged 0–14, recorded by police as victims of sexual assault in the above states was approximately twice that of non-Indigenous children.

Importantly though, data on the sexual assault of women and children in remote Indigenous communities specifically – or “the outback”, as Kennerley put it – is not comprehensive.


The claim that there’s “no education” in outback communities is quite obviously not true. According to Creative Spirits, there are reportedly 17,000 Indigenous children attending school in remote areas.

That being said, there are barriers to accessing education in particularly remote communities. including availability of teaching staff, transport, weather cutting off roads, etc., which impacts attendance rates and outcomes for Indigenous students. For example, while attendance rates among Indigenous students in inner regional areas stood at 86.8 per cent in the first half of 2017, it dropped to 64.6 per cent in very remote areas according to government data.

But overall, nationwide stats show that the majority of Aboriginal and Torres Strait Islander students attend school and are achieving national minimum standards for literacy and numeracy.

Indigenous university enrolment has also more than doubled over the past decade.


Kennerley responded to that the backlash this morning on Studio 10. While again taking issue with being labelled racist, this time she made an important distinction.

She used the word “some”.

“The statement that I made was about the tragic abuse of women and children in some Indigenous communities,” she said. “Now that is a fact, it’s backed up by a lot of people. It is not a judgement, it doesn’t mean.. thinking a group is superior, or someone is inferior.”


NACCHO Aboriginal #MentalHealth and #SuicidePrevention : @ozprodcom issues paper on #MentalHealth in Australia is now available. It asks a range of questions which they seek information and feedback on. Submissions or comments are due by Friday 5 April.

 ” Many Australians experience difficulties with their mental health. Mental illness is the single largest contributor to years lived in ill-health and is the third largest contributor (after cancer and cardiovascular conditions) to a reduction in the total years of healthy life for Australians (AIHW 2016).

Almost half of all Australian adults have met the diagnostic criteria for an anxiety, mood or substance use disorder at some point in their lives, and around 20% will meet the criteria in a given year (ABS 2008). This is similar to the average experience of developed countries (OECD 2012, 2014).”

Download the PC issues paper HERE mental-health-issues

See Productivity Commission Website for More info 

“Clearly Australia’s mental health system is failing Aboriginal people, with Aboriginal communities devastated by high rates of suicide and poorer mental health outcomes. Poor mental health in Aboriginal communities often stems from historic dispossession, racism and a poor sense of connection to self and community. 

It is compounded by people’s lack of access to meaningful and ongoing education and employment. Drug and alcohol related conditions are also commonly identified in persons with poor mental health.

NACCHO Chairperson, Matthew Cooke 2015 Read in full Here 

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

Despite a plethora of past reviews and inquiries into mental health in Australia, and positive reforms in services and their delivery, many people are still not getting the support they need to maintain good mental health or recover from episodes of mental ill‑health. Mental health in Australia is characterised by:

  • more than 3 100 deaths from suicide in 2017, an average of almost 9 deaths per day, and a suicide rate for Indigenous Australians that is much higher than for other Australians (ABS 2018)
  • for those living with a mental illness, lower average life expectancy than the general population with significant comorbidity issues — most early deaths of psychiatric patients are due to physical health conditions
  • gaps in services and supports for particular demographic groups, such as youth, elderly people in aged care facilities, Indigenous Australians, individuals from culturally diverse backgrounds, and carers of people with a mental illness
  • a lack of continuity in care across services and for those with episodic conditions who may need services and supports on an irregular or non-continuous basis
  • a variety of programs and supports that have been successfully trialled or undertaken for small populations but have been discontinued or proved difficult to scale up for broader benefits
  • significant stigma and discrimination around mental ill-health, particularly compared with physical illness.

The Productivity Commission has been asked to undertake an inquiry into the role of mental health in supporting social and economic participation, and enhancing productivity and economic growth (these terms are defined, for the purpose of this inquiry, in box 1).

By examining mental health from a participation and contribution perspective, this inquiry will essentially be asking how people can be enabled to reach their potential in life, have purpose and meaning, and contribute to the lives of others. That is good for individuals and for the whole community.


In 2014-15, four million Australians reported having experienced a common mental disorder.

Mental health is a key driver of economic participation and productivity in Australia, and hence has the potential to impact incomes and living standards and social engagement and connectedness. Improved population mental health could also help to reduce costs to the economy over the long term.

Australian governments devote significant resources to promoting the best possible mental health and wellbeing outcomes. This includes the delivery of acute, recovery and rehabilitation health services, trauma informed care, preventative and early intervention programs, funding non-government organisations and privately delivered services, and providing income support, education, employment, housing and justice. It is important that policy settings are sustainable, efficient and effective in achieving their goals.

Employers, not-for-profit organisations and carers also play key roles in the mental health of Australians. Many businesses are developing initiatives to support and maintain positive mental health outcomes for their employees as well as helping employees with mental illhealth continue to participate in, or return to, work.

Scope of the inquiry

The Commission should consider the role of mental health in supporting economic participation, enhancing productivity and economic growth. It should make recommendations, as necessary, to improve population mental health, so as to realise economic and social participation and productivity benefits over the long term.

Without limiting related matters on which the Commission may report, the Commission should:

  • examine the effect of supporting mental health on economic and social participation, productivity and the Australian economy;
  • examine how sectors beyond health, including education, employment, social services, housing and justice, can contribute to improving mental health and economic participation and productivity;
  • examine the effectiveness of current programs and Initiatives across all jurisdictions to improve mental health, suicide prevention and participation, including by governments, employers and professional groups;
  • assess whether the current investment in mental health is delivering value for money and the best outcomes for individuals, their families, society and the economy;
  • draw on domestic and international policies and experience, where appropriate; and
  • develop a framework to measure and report the outcomes of mental health policies and investment on participation, productivity and economic growth over the long term.

The Commission should have regard to recent and current reviews, including the 2014 Review of National Mental Health Programmes and Services undertaken by the National Mental Health Commission and the Commission’s reviews into disability services and the National Disability Insurance Scheme.

The Issues Paper
The Commission has released this issues paper to assist individuals and organisations to participate in the inquiry. It contains and outlines:

  • the scope of the inquiry
  • matters about which we are seeking comment and information
  • how to share your views on the terms of reference and the matters raised.

Participants should not feel that they are restricted to comment only on matters raised in the issues paper. We want to receive information and comment on any issues that participants consider relevant to the inquiry’s terms of reference.

Key inquiry dates

Receipt of terms of reference 23 November 2018
Initial consultations November 2018 to April 2019
Initial submissions due 5 April 2019
Release of draft report Timing to be advised
Post draft report public hearings Timing to be advised
Submissions on the draft report due Timing to be advised
Consultations on the draft report November 2019 to February 2020
Final report to Government 23 May 2020

Submissions and brief comments can be lodged

Online (preferred):
By post: Mental Health Inquiry
Productivity Commission
GPO Box 1428, Canberra City, ACT 2601


Inquiry matters: Tracey Horsfall Ph: 02 6240 3261
Freecall number: Ph: 1800 020 083

Subscribe for inquiry updates

To receive emails updating you on the inquiry consultations and releases, subscribe to the inquiry at:


 Definition of key terms
Mental health is a state of wellbeing in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.

Mental illness or mental disorder is a health problem that significantly affects how a person feels, thinks, behaves and interacts with other people. It is diagnosed according to standardised criteria.

Mental health problem refers to some combination of diminished cognitive, emotional, behavioural and social abilities, but not to the extent of meeting the criteria for a mental illness/disorder.

Mental ill-health refers to diminished mental health from either a mental illness/disorder or a mental health problem.

Social and economic participation refers to a range of ways in which people contribute to and have the resources, opportunities and capability to learn, work, engage with and have a voice in the community. Social participation can include social engagement, participation in decision making, volunteering, and working with community organisations. Economic participation can include paid employment (including self-employment), training and education.

Productivity measures how much people produce from a given amount of effort and resources. The greater their productivity, the higher their incomes and living standards will tend to be.

Economic growth is an increase in the total value of goods and services produced in an economy. This can be achieved, for example, by raising workforce participation and/or productivity.

Sources: AIHW (2018b); DOHA (2013); Gordon et al. (2015); PC (2013, 2016, 2017c); SCRGSP (2018); WHO (2001).

An improvement in an individual’s mental health can provide flow-on benefits in terms of increased social and economic participation, engagement and connectedness, and productivity in employment (figure 1).

This can in turn enhance the wellbeing of the wider community, including through more rewarding relationships for family and friends; a lower burden on informal carers; a greater contribution to society through volunteering and working in community groups; increased output for the community from a more productive workforce; and an associated expansion in national income and living standards. These raise the capacity of the community to invest in interventions to improve mental health, thereby completing a positive reinforcing loop.

The inquiry’s terms of reference (provided at the front of this paper) were developed by the Australian Government in consultation with State and Territory Governments. The terms of reference ask the Commission to make recommendations to improve population mental health so as to realise higher social and economic participation and contribution benefits over the long term.

Assessing the consequences of mental ill-health

The costs of mental ill-health for both individuals and the wider community will be assessed, as well as how these costs could be reduced through changes to the way governments and others deliver programs and supports to facilitate good mental health.

The Commission will consider the types of costs summarised in figure 4. These will be assessed through a combination of qualitative and quantitative analysis, drawing on available data and cost estimates, and consultations with inquiry participants and topic experts. We welcome the views of inquiry participants on other costs that we should take into account.


NACCHO Aboriginal Women’s Health : The @DebKilroy #sistersinside #Freethepeople campaign to free Aboriginal women jailed for unpaid fines has raised almost $300K : We do not need to criminalise poverty.


“Originally the campaign asked people to give up two coffees in their week and donate $10 so we could raise $100,000.

“However less than two days later, more than a $100,000 was raised, so the target is now to hit 10,000 donors.”

Campaign organiser Debbie Kilroy, the CEO of advocacy charity Sisters Inside, told Pro Bono News the campaign now aimed to go well beyond the 6,000 donors they had currently. See Part 1 Below 

The money will be there for any woman who’s imprisoned, and the money will be spent on the community for women who have warrants for their arrest by the police.

“Every cent will be spent for the purposes of that … particularly Aboriginal mothers are the ones we want to target and prioritise to pay those fines, so those warrants are revoked, so they don’t end up in prison.”

Ms Kilroy told the ABC the money raised by donors would be spent on supporting formerly incarcerated women and ensuring any outstanding warrants were paid so the women were not at risk of jail. See Part 2 below 

Donate at the the GOFUNDME PAGE

” NACCHO supports the abolition of prisons for First Nations women. The incarceration of Aboriginal and Torres Strait Island women should be a last resort measure.

It is time to consider a radical restructuring of the relationship between Aboriginal people and the state.

Aboriginal and Torres Strait Islander people and their communities must be part of the design, decision-making and implementation of government funded policies, programs and services that aim to reduce – or abolish –the imprisonment of our women.

Increased government investment is needed in community-led prevention and early intervention programs designed to reduce violence against women and provide therapeutic services for vulnerable women and girls. Programs and services that are holistic and culturally safe, delivered by Aboriginal and Torres Strait Islander organisations.

NACCHO calls for a full partnership approach in the Closing the Gap Refresh, so that Aboriginal people are at the centre of decision-making, design and delivery of policies that impact on them.

We are seeking a voice to the Commonwealth Parliament, so we have a say over the laws that affect us. “

Pat Turner NACCHO CEO Speaking at  Sisters Inside 9th International Conference 15 Nov 2018

Read full speaking notes HERE

Part 1: The campaign was launched on 5 January with the aim of raising $100,000 – enough to clear the debt of 100 women in Western Australia who have been imprisoned or are at risk of being imprisoned for unpaid court fines.

But as of this morning 16 January the campaign has already raised $280,460, after attracting international attention.

Australie: une cagnotte pour faire libérer des femmes aborigènes

WA is the only state that regularly imprisons people for being unable to pay fines, and ALP research in 2014 found that more than 1,100 people in WA had been imprisoned for unpaid fines each year since 2010.

Under current state laws, the registrar of the Fines Enforcement Registry, who is an independent court officer, can issue warrants for unpaid court fines as a last resort.

The campaign’s crowdfunding page said this system meant Aboriginal mothers were languishing in prison because they did not have the capacity to pay fines.

“They are living in absolute poverty and cannot afford food and shelter for their children let alone pay a fine. They will never have the financial capacity to pay a fine,” the page said.

Money raised from the campaign has already led to the release of one woman from jail, while another three women have had their fines paid so they won’t be arrested.

Campaign organisers are currently working on paying the fines for another 30 women.

The success of the campaign has put pressure on the WA government to reform the law to stop vulnerable people entering jail.

Kilroy said the current law criminalised poverty and she criticised the Labor government’s inaction on the issue despite making a pledge to repeal the lawwhile in opposition.

“The government said prior to their election victory that this was one of their policy platforms, but it’s now been two years and nothing has changed,” she said.

“It’s just not good enough. It does not take that long to change the laws and so we’re calling on the government to change the law as a matter of urgency.”

A spokeswoman for WA Attorney-General John Quigley told Pro Bono News the government intended to introduce a comprehensive package of amendments to the law in the first half of 2019, so warrants could only be handed down by a court.

“These reforms are designed to ensure that people who can afford to pay their fines do, and those that cannot have opportunities to pay them off over time or work them off in other ways,” the spokesperson said.

The Department of Justice has denied the campaign’s claim that single Aboriginal mothers made up the majority of those in prison who could not pay fines.

Departmental figures provided to Pro Bono News state that on 6 January, two females were held for unpaid fines, one of whom identified as Aboriginal.

According to the department, data suggests there has not been an Aboriginal woman in jail in WA for unpaid fines since the campaign started on 5 January.

Part 2 Update from ABC Website Fewer fine defaulters now in prison: Government

The WA Department of Justice said numbers of people jailed solely for fine defaulting had fallen sharply in the past 12 months — with the average daily population falling to “single digits”.

WA Attorney-General John Quigley agreed, saying said recent figures also showed a recent drop in the number of Indigenous women in custody for fine defaulting.

Mr Quigley said the issue of fine defaulters going to prison would be addressed very soon.

“I have a whole raft of changes to the laws through the Cabinet, and [they] are currently with the Parliamentary Council for drafting to Parliament,” he said.

“I have been working assiduously with the registrar of fines … to find other ways to reduce the numbers.”

In terms of the money raised by Sisters Inside, Mr Quigley said he hoped it was being put to good use.

Ms Kilroy told the ABC the money raised by donors would be spent on supporting formerly incarcerated women and ensuring any outstanding warrants were paid so the women were not at risk of jail.

“The money will be there for any woman who’s imprisoned, and the money will be spent on the community for women who have warrants for their arrest by the police.

“Every cent will be spent for the purposes of that … particularly Aboriginal mothers are the ones we want to target and prioritise to pay those fines, so those warrants are revoked, so they don’t end up in prison.”

Call for income-appropriate fines

WA Aboriginal Legal Service chief executive Dennis Eggington said Indigenous women, and those in poverty, were disproportionately affected by the practice of jailing for fines.

“Fines do not have any correlation to someone’s income. If you get $420 on Centrelink and then face a $1,000 fine you are in real trouble and you are not going to be able to pay the fine,” he said.

A head shot of Dennis Eggington with Aboriginal colours in the background.

PHOTO Dennis Eggington for some people it’s easier to go to jail than find the money for fines.


“WA could lead the country at looking at a way where fines are appropriate to the income no matter the offence.”

“It’s really a matter of indirect discrimination. If women are being overrepresented in warrants of commitment, that is having a devastating impact on children and their families.”

He said there was a culture which had led to many Indigenous people feeling as though they had no choice but to go prison for fines.

“It’s much easier to do a couple of days in jail and cut your fine out than to try and find the money to pay the fine,” Mr Eggington said.

”It’s an indictment on the country; It’s an indictment on Australia as a whole that we as one of the most disadvantaged group in Australia have had to develop those ways to survive.

“It’s a terrible, terrible thing

NACCHO @RACGP Aboriginal Health Survey : 2 of 2 From now until February 2019, NACCHO and @RACGP  wants to hear from you about implementing the National Guide and supporting culturally responsive healthcare for Aboriginal and Torres Strait Islander people

In 2018–19, NACCHO and the RACGP are working on further initiatives and we want your input!

Download this post as PDF and share with your networks


What we are currently doing:

  • Conducting practice team surveys and focus groups to:
    • understand current system requirements and how they can improve identification rates of Aboriginal and Torres Strait Islander patients in mainstream practices and
    • integrate the key recommendations from the National Guide into clinical software
  • Establishing a Collaborative with the Improvement Foundation to conduct rapid quality improvement cycles leading to the provision of better healthcare for Aboriginal and Torres Strait Islander peoples
  • Engaging with medical software vendors to understand how we can improve identification rates and integrate the National Guide into clinical software
  • Developing resources for Aboriginal and Torres Strait Islander people regarding preventive health assessments and follow up care
  • Working with our Aboriginal and Torres Strait Islander-led Project Reference Group to carry out all project activities.

From now until February 2019, we want to hear from you!

Do you have ideas, solutions or examples of good practice relating to:

  • how health services can ensure that Aboriginal and Torres Strait Islander patients receive patient centred, quality health assessments (715) that meet their needs?
  • the resources that would support mainstream general practice teams to provide culturally responsive healthcare for Aboriginal and Torres Strait Islander people?
  • how guidelines, such as the National Guide, can be integrated into clinical software?
  • features of clinical software that will support improved identification of Aboriginal and Torres Strait Islander patients at your practice?
  • features of a 715 health assessment template that will support a comprehensive health assessment?

To participate in a short survey, please CLICK HERE

We also welcome your feedback and input at

With your feedback, we will:

  • understand the needs of our cohort
  • understand what works through our Collaborative model for improvement report
  • develop new resources to support you and your team with delivering better healthcare to Aboriginal and Torres Strait Islander peoples regardless of where care is sought
  • share the lessons with mainstream general practice and Aboriginal Community Controlled Health Services to improve the health and wellbeing of Aboriginal and Torres Strait Islander peoples.

National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people

Early detection, preventing disease and promoting health

The National Guide is a practical resource intended for all health professionals delivering primary healthcare to Aboriginal and/or Torres Strait Islander people.

Its purpose is to provide GPs and other health professionals with an accessible, user-friendly guide to best practice preventive healthcare for Aboriginal and Torres Strait Islander patients.

See Website

New to the third edition!

National Guide podcasts

Subscribe to the National Guide Podcast (listen to the third edition) to hear host Lauren Trask, NACCHO Implementation Officer and CQI expert, speak to GPs  and researchers on updates and changes in the third edition of the National Guide.


 National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (PDF 9.8 MB)

 Evidence base to a preventive health assessment in Aboriginal and Torres Strait Islander people (PDF 9.4 MB)

 National Guide Lifecycle chart (child) (PDF 555 KB)

 National Guide Lifecycle chart (young) (PDF 1 MB)

 National Guide Lifecycle chart (adult) (PDF 1 MB)

NACCHO Aboriginal Health and #Racism : 1 of 2 Medical Advisor for @RACGP Aboriginal and Torres Strait Islander Health, Dr @timsenior discusses racism in healthcare with our Social Justice Commissioner @June_Oscar AO.

 ” The fact there remains a significant health gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians is indisputable.

The reasons behind this are complex, multifactorial and often uncomfortable to discuss, but one factor that may be the most difficult to raise is the presence of racism within the Australian health system.

However, there is increasing evidence, drawn from the lived experience of Aboriginal and Torres Strait Islander peoples, that this form of racism is a barrier faced every day.

Dr Tim Senior : The RACGP has recognised the situation in its Racism in the healthcare system position statement, and recently I was also able to discuss these issues with Aboriginal and Torres Strait Islander Social Justice Commissioner, and Bunuba woman from Fitzroy Crossing in the Central Kimberley, June Oscar AO.

Read over 105 NACCHO Aboriginal Health and Racism articles published over the past 7 years 

One such example is the recent online survey conducted by the Victorian Aboriginal Community Controlled Health Organisation (VACCHO), which found that 86% of its Aboriginal and Torres Strait Islander respondents living in Victoria had personally experienced racism in a mainstream health setting. Of those polled, 88% reported incidences of racism from nurses and 74% from GPs.

When working towards closing the healthcare gap, this is a barrier that cannot be ignored.


I’d like to start by asking, how does racism affect the health and wellbeing of Aboriginal and Torres Strait Islander people, and what does this mean for their everyday lives?

Well, from what I’ve heard with a project I’m leading across the country engaging with Aboriginal and Torres Strait Islander women and girls in this past year, [Wiya Yani U Thangani­ (Women’s Voices’ project)], and what I already know from engaging with communities before coming to this role [Aboriginal and Torres Strait Islander Social Justice Commissioner], experiences with racism are just all too common.

Thank you to the women and girls who came along to our Wiyi Yani U Thangani (Women’s Voices) session in Woorabinda . Thank you for taking the time to be part of this national conversation, a first in 32 years with our women. Your voices will join those of First Nations women and girls around the country in my first report to Federal parliament.

I’ve heard the terrible experiences Aboriginal and Torres Strait Islander people have when they visit health services. The manner in which they’re spoken to at the first point of contact in the service, and the way they’re treated and spoken to by health professionals, whether they be nurses or doctors. And I’ve heard that concern coming from people in remote, regional locations, and cities where there’s major hospitals and services.

So it’s widespread, it’s a huge concern, and it is something we have to address.

What do people say is the effect on their health?

People feel they’re not able to access a service that they have a right to access.

What they’re made to feel is that they shouldn’t be there, that they’re not being believed, they’re not being acknowledged in a respectful way. And so people are not wanting to be in that space, and that makes them feel terribly unwell on top of their state of health and wellbeing at that time.

To be treated like that is not a very nice feeling, so people often leave health services without seeing anybody.

So people are made to compromise their health and wellbeing because of an attitude and a way of communicating and interacting – and often it is non-Indigenous people that are at the other point of this contact.

Can you tell us what stories you’ve heard through the Wiya Yani U Thangani­ (Women’s Voices’) project?

I’m hearing comments like, “We’re sick and tired of going to services when we need to see someone about a genuine concern about our health, only to be spoken to in an unwelcoming, uncaring manner”. To see health professionals that issue Panadol without assessing and conducting full observations of the individuals presenting.

And so people are turning away, and being turned away, from quality of health assessment and diagnosis – which is their right in this country.

How can we start a conversation about, or continue a conversation about, the realities of racism in Australia?

I think services need to screen the types of people who they are recruiting to these roles and place the onus on them, because they are at a critical point of service delivery.

So if they’re seeing outpatients and are the first point of contact for people coming in to the service, there’s a standard at which we want them to be operating, and policies and a scrutiny of how they are conducting themselves in this role.

We have seen in many places that there are people who have been in these roles for a long time and hold these types of attitudes that Aboriginal and Torres Strait Islander people are experiencing.

We can involve Aboriginal and Torres Strait Islander people and organisations, particularly the community-controlled health organisations, in recruitment, and setting the recruitment protocols in places where there is a high population of Aboriginal communities and likelihood of people accessing the health service.

We have to involve Aboriginal and Torres Strait Islander people in the design of service delivery.

Are there any other options that primary healthcare organisations can take to support their staff and patients to challenge racism?

I think organisations can improve on how they ensure that [Aboriginal and Torres Strait Islander] people are accessing their right to quality healthcare service and delivery. We need to have people involved in the organisations that are listening to and incorporating the advice of Aboriginal members involved in that process.

How can clinicians better support their local communities and strengthen their abilities to deliver culturally appropriate healthcare?

I think many of the clinicians come from other places to live in these communities. They need to be aware of the communities and be informed, educated and orientated to the community, the environment and what the issues are.

They need to be made aware of the efforts and the history of these communities, and the long struggle it has been for Aboriginal and Torres Strait Islander people to establish these services, and know that they are not alone and disconnected in a community – they can access support if they have a question, or don’t know quite how to respond.

I think if we can establish stronger networks and relationships between health experts going into a community that they have no idea about, then the onus is on them to be informed well in advance before they get there. And once they’re in the community, they should seek out the supports that exist within the community.

Is there any other advice you have for GPs or practice staff?

GPs and health professionals need to know that people have a right to access these services; they don’t have the right to deny them access.

As citizens of this country, Aboriginal and Torres Strait Islander people have a right to these services.

This interview has been slightly edited for clarity.