Aboriginal #NACCHOYouth19 #MentalHealth #ClosingTheGap #HaveYourSayCTG : According to new @blackdoginst  @MissionAust report 32 % of Aboriginal and Torres Strait Islander young people met the criteria for psychological distress, compared to 23.9% for non-Indigenous young people

It is essential that Aboriginal and Torres Strait Islander young people have access to culturally and age-appropriate mental health services that are in close proximity to their homes.

The Australian Government should invest in building the capacity of Aboriginal and Torres Strait Islander-led and controlled health organisations to deliver these services in communities.

Why ? A greater proportion of Aboriginal and Torres Strait Islander respondents indicated concerns about suicide (40.2% compared with 6% of non-Indigenous respondents).

Relative to non-Indigenous respondents, a greater proportion of Aboriginal and Torres Strait Islander respondents with psychological distress indicated concerns about gambling (13.8% compared with 4.2%), domestic/family violence (26.3% compared with 16.8%), drugs (20.1% compared with 10.9%), discrimination (26.3% compared with 18.6%) and alcohol (15.2% compared with 8.6%).

See dedicated focus on Aboriginal and Torres Strait Islander young people Part 2 Below

Read Brooke Blurton’s speaker BIO Here 

” Have you seen the brilliant line-up of speakers at the NACCHO Youth Conference, 4 November 2019 at the Darwin Convention Centre? https://www.naccho.org.au/home/naccho-youth-conference-2019/

Are you under 29 years and working in the Aboriginal and Torres Strait Islander health or related sectors?

If so, register NOW for our free NACCHO Youth Conference. Closing 25 October

Places are filling quick! 👉🏾 http://bit.ly/2qALFkH

Part 1 Press Release : A new joint report by Mission Australia and Black Dog Institute indicates that considerably more young people in Australia are experiencing psychological distress than seven years ago.

Almost one in four young people in 2018 say they are experiencing mental health challenges, with young females twice as likely as males to face this issue.

A higher proportion of Aboriginal and Torres Strait Islander young people also met the criteria for psychological distress than their non-Indigenous peers.

The Can we talk? Seven year youth mental health report – 2012-2018 Youth Survey findings of the past seven years – and is co-authored with Black Dog Institute experts – to ascertain and investigate rates of psychological distress experienced by young people in Australia who are aged 15-19.

The report further examines the concerns, general wellbeing and help-seeking behaviours of the close to 27,000 participants of the 2018 Youth Survey aged 15-19, including those who are experiencing psychological distress – highlighting the vital role that friends, parents, services, schools and the internet play as sources of help for young people who are struggling with their mental health.

Key findings include:

  • Close to one in four young people met the criteria for experiencing psychological distress – a substantial increase over the past seven years (rising by 5.5% from 18.7% in 2012 to 24.2% in 2018).
  • In 2018, more than three in ten (31.9%) of Aboriginal and Torres Strait Islander young people met the criteria for psychological distress, compared to 23.9% for non-Indigenous young people.
  • Across seven years, females were twice as likely as males to experience psychological distress. The increase in psychological distress has also been far more marked among females (from 22.5% in 2012 to 30.0% in 2018, compared to a rise from 12.7% to 15.6% for males).
  • Stigma and embarrassment, fear and a lack of support were the three most commonly cited barriers that prevent young people from seeking help.
  • The top issues of personal concern for young Australians experiencing psychological distress were coping with stress, mental health and school or study problems. There was also a notably high level of concern about other issues including body image, suicide, family conflict and bullying/emotional abuse.
  • Almost four times the proportion of young people with psychological distress reported concerns about suicide (35.6% compared with 9.4% of respondents without psychological distress).
  • Young people experiencing psychological distress reported they would go to friend/s, parent/s or guardian/s and the internet as their top three sources of help. This is compared to friend/s, parent/s or guardian/s and a relative/family friend for those without psychological distress.

In response to these findings, Mission Australia’s CEO James Toomey said: “It’s deeply concerning that so many young people are experiencing psychological distress. Youth mental health is a serious national challenge that must be tackled as a priority.

“The sheer volume of young people who are struggling with mental health difficulties shows that there remains urgent need for improved access to timely, accessible and appropriate support. Irrespective of their location, background or gender, young people must have the resources they need to manage their individual mental health journey with access to youth-friendly and evidence-based mental health supports.

“Parents, peers, schools and health professionals are vital sources of support for our young people, so it’s important they are adequately equipped with the skills and knowledge they need to provide effective support when needed. For schools right across Australia, more resourcing is needed to train staff, embed wellbeing personnel and provide evidence-based early intervention and prevention programs.

“In light of these findings, I urge governments to listen to young people’s concerns about mental health and co-design solutions with them.”

With the report confirming that young people experiencing psychological distress are less likely to seek help than those without mental health concerns, Black Dog Institute Director and Chief Scientist, Professor Helen Christensen said: “Global research tells us that over 75% of mental health issues develop before the age of 25, and these can have lifelong consequences.

“We are still in the dark as to why mental health and suicide risk has increased in our current cohort of youth, a finding that is not unique to Australia.

“Adolescence is a critical time in which to intervene, but we also know that young people experiencing psychological distress can be harder to reach. This report shows that young people in distress will seek help directly from the internet. As such, we need to continue to provide online and app-based tools that may be a key part of the solution. We also need to catch the problems upstream by prioritising early intervention and prevention efforts.”

Part 2 Meeting the diversity of young people’s need  : Dedicated focus on Aboriginal and Torres Strait Islander young people

Nearly one third (31.9%) of Aboriginal and Torres Strait Islander young people indicated some form of psychological distress, compared with just under one quarter (23.9%) of non-Indigenous respondents.

Aboriginal and Torres Strait Islander young people experiencing psychological distress were more likely than their non-Indigenous peers to report feeling as though they had no control over their life and to report lower levels of self-esteem. Further, a greater proportion of Aboriginal and Torres Strait Islander young people with psychological distress reported having issues that they did not seek help for, despite thinking they needed to (41.2% compared with 36.2% of non-Indigenous respondents).

Positively the Aboriginal and Torres Strait Islander adolescent and youth health and wellbeing 2018 report found that in 2014–15 over three-quarters of Aboriginal and Torres Strait Islander young people aged 15–24 said, they were happy all or most of the time in the previous 4 weeks.

However, around two-thirds of Aboriginal and Torres Strait Islander people aged 15–24 experienced one or more personal stressors in the previous year, the most common being not being able to get a job, and one in three reported being treated unfairly because they were Indigenous.

This report also showed that most Aboriginal and Torres Strait Islander people aged 15–24 (67%) experienced low to moderate levels of psychological distress in the previous month, while 33% experienced high to very high level.

When responding to the Youth Survey 2018 greater proportions of Aboriginal and Torres Strait Islander respondents with psychological distress also indicated concerns about gambling, domestic/family violence, drugs, discrimination, alcohol, LGBTIQ issues and suicide than non- Indigenous respondents with psychological distress.

It is important to take into account these often compounding concerns, as research shows that the leading causes of hospitalisation for mental and behavioural disorders among Aboriginal and

Torres Strait Islander people aged 10-24 years were due to substance abuse, schizophrenia, and reactions to severe stress.

Aboriginal and Torres Strait Islander communities have endured and survived a traumatic and deeply challenging colonisation period that affected all aspects of their collective lives, and which continues to challenge communities, families and individuals today.

At the population level, higher rates  of mental health  difficulties among Aboriginal and Torres  Strait Islander people are intertwined with entrenched poverty, substandard and overcrowded housing, health conditions and disabilities, intergenerational un/under-employment, stressors and trauma, racism and discrimination, and at-risk behaviours in response to sometimes desperate situations.80 In particular, the members of the Stolen Generations and their descendants are ‘more likely to have had contact with mental health services,’ with children in their care often challenged by higher rates of emotional and behavioural difficulties.81

In many cases, responding to population mental health challenges means addressing their deeper, structural causes. These should be identified and solutions co-designed and co-implemented under Aboriginal and Torres Strait Islander community-leadership, including community-controlled organisations and health services. The needs of young people should be prioritised as directed by Aboriginal and Torres Strait Islander communities and their representative organisations.

Community-led programs that build on cultural determinants of social and emotional wellbeing and cultural strengths should be supported to help provide Aboriginal and Torres Strait Islander young people with protective factors against mental health challenges, and particularly against suicide, by supporting a strong sense of ‘social, cultural and emotional wellbeing’ that includes a positive Indigenous/cultural identity. These cultural determinants vary but can include culturally- shaped connections to family, kin, community, and country.

Yet, in many cases, mainstream health and mental health programs fail to incorporate culturally appropriate practices or awareness when working with or treating Aboriginal and Torres Strait Islander people experiencing challenges to their wellbeing.

Program funding must be flexible enough to provide for differences, tailor services to meet community and individual needs and to support younger age groups where critical issues arise. It is essential that Aboriginal and Torres Strait Islander young people have access to culturally and age-appropriate mental health services that are in close proximity to their homes. The Australian Government should invest in building the capacity of Aboriginal and Torres Strait Islander-led and controlled health organisations to deliver these services in communities.

Sources of support

Friend/s (63.6%), internet (44.3%) and parent/s or guardian/s (43.5%) were the most commonly cited sources of help for Aboriginal and Torres Strait Islander young people with psychological distress. Smaller proportions of Aboriginal and Torres Strait Islander respondents than non-

Indigenous respondents with psychological distress said they would turn to close personal connections for help, such as friend/s, parent/s or guardian/s, a GP or health professional, school counsellor, brother/sister or a relative/family friend.

Aboriginal and Torres Strait Islander communities have identified challenges in relation to mainstream models of health care offered and their affordability. Aboriginal Controlled Health Organisations have a strong role to play and should be appropriately funded.

Conversely, greater proportions of Aboriginal and Torres Strait Islander respondents indicated turning to a community agency, social media or a telephone hotline for help. Community agencies therefore need to be funded to provide culturally appropriate support to Aboriginal and Torres Strait Islander young people experiencing psychological distress.

Suicide prevention

A greater proportion of Aboriginal and Torres Strait Islander respondents indicated concerns about suicide (40.2% compared with 35.6% of non-Indigenous respondents).

The rate of Aboriginal and Torres Strait Islander suicide is a critical public health challenge for Australia. Over the 5 years from 2013 to 2017, one in four Australian children and young people aged 5-17 years who died by suicide were Aboriginal and Torres Strait Islanders.86

Designed to complement the mainstream National Suicide Prevention Strategy, the 2013 National Aboriginal and Torres Strait Islander Suicide Prevention Strategy87 was developed to respond to this public health challenge. It recognises the need for investment in holistic and integrated approaches that helps individuals, families and communities have hope for, and optimism about, the future.

In addition to mainstream integrated approach interventions, the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP) highlighted the need for community- led, locally-based and culturally-appropriate ‘upstream’ preventative activities to address community-level challenges associated with suicide.

Further, ATSISPEP underlined the need for programs that build on cultural determinants of social and emotional wellbeing and its protective factors to have a positive impact against complex mental health challenges, including risks of suicide.88

Recognising the intersectionality between mental health, suicide and substance dependence, the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing requires the integration of mental health, alcohol and other drug, and suicide prevention services in communities.89 However, the Strategy needs a focused implementation plan that is properly costed and operationalised if it is to shape the mental health space.

Part 3 National : Closing the Gap / Have your say CTG deadline extended to Friday, 8 November 2019.

 

The engagements are now in full swing across Australia and this is generating more interest than we had anticipated in our survey on Closing the Gap.

The Coalition of Peaks has had requests from a number of organisations across Australia seeking, some Coalition of Peak members and some governments for more time to promote and complete the survey.

We want to make sure everyone has the opportunity to have their say on what should be included in a new agreement on Closing the Gap so it is agreed to extend the deadline for the survey to Friday, 8 November 2019.

This will help build further understanding and support for the new agreement and will not impact our timeframes for negotiating with government as we were advised at the most recent Partnership Working Group meeting that COAG will not meet until early 2020.

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

 

 

 

NACCHO Aboriginal Health and #FamilyMatters Report 2019 Download : The crisis of Aboriginal and Torres Strait Islander children being over-represented in the child protection systems continues to escalate at an alarming rate.

“If we do not change our course of action the number of Aboriginal and Torres Strait Islander children in care will more than double in the next 10 years.

Aboriginal and Torres Strait Islander children are seven times more likely to be on a permanent care order until 18 years. They are at serious risk of permanent separation from their families, cultures and communities.

The trauma associated with child removal is intergenerational.

It affects a person’s functioning in the world, has an adverse impact on family relationships and creates vulnerability in families.

Healing is an important part of reclaiming the resilience we need to deal with life’s challenges and address the burden of trauma in our communities,”

Family Matters Co-Chair Richard Weston.

The crisis of Aboriginal and Torres Strait Islander children being over-represented in the child protection systems continues to escalate at an alarming rate, reveals The Family Matters Report 2019

The report also shows a growing trend towards permanent placement away from their families and that Aboriginal and Torres Strait Islander children continue to experience high levels of disadvantage.

Aboriginal and Torres Strait Islander children are 37.3% of the total out-of-home care population, including foster care, but only 5.5% of the total population of children.

Aboriginal and Torres Strait Islander children are now 10.2 times more likely to be removed from their families than non-Indigenous children.

The decreasing rate of placement of Aboriginal and Torres Strait Islander children with Indigenous carers dropped from 49.4% to 45% in a year and has declined from 65.3% in 2006.

The Family Matters Report 2019 also reveals poverty and homelessness has a profound impact on children being removed from their home.

Nearly one in three Aboriginal and Torres Strait Islander people are living below the poverty line. Aboriginal and Torres Strait Islander householders are almost twice as likely to experience rental stress.

“Household income and access to safe and healthy housing have a substantial impact on the capacity of families to provide safe and supportive care for children,” says Family Matters Co-Chair Natalie Lewis.

“Aboriginal and Torres Strait Islander children experience disadvantage across a range of early childhood areas, are more likely to be developmentally delayed at the age of five and attend childcare services at half the rate of non-Indigenous children.

“We stress the need for an increased investment in prevention and early intervention to redress the over-representation of Aboriginal and Torres Strait Islander children in out-of- home care. Consistently, more funding is invested in child protection services than support services,” says Ms Lewis.

The Family Matters Report 2019 calls for:

  1. A national comprehensive Aboriginal and Torres Strait Islander children’s strategy that includes generational targets to eliminate over-representation and address the causes of Aboriginal and Torres Strait Islander child
  2. Investment in quality Aboriginal and Torres Strait Islander community-controlled integrated early years services through a specific program with targets to increase coverage in areas of high Aboriginal and Torres Strait Islander population and high levels of
  3. Establishing state-based and national Aboriginal and Torres Strait Islander children’s commissioners to enable improved government accountability and oversight.
  4. An end to legal orders for permanent care and adoption for Aboriginal and Torres Strait Islander children, replaced by a focus on supporting their connections to kin, culture and

Family Matters is Australia’s national campaign to ensure Aboriginal and Torres Strait Islander children and young people grow up safe and cared for in family, community and culture. It aims to eliminate the over-representation of Aboriginal and Torres Strait Islander children in out-of-home care by 2040.

Family Matters – Strong communities. Strong culture. Stronger children. is led by SNAICC

– National Voice for our Children and a group of eminent Aboriginal and Torres Strait Islander leaders from across the country. The campaign is supported by a Strategic Alliance of over 150 Aboriginal and Torres Strait Islander and non-Indigenous organisations.

Since 2016, the campaign has released an annual Family Matters report that examines how Australia is faring in improving the safety and wellbeing of Aboriginal and Torres Strait Islander children.

Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander children  #HaveYourSay about #closingthegapCTG

Aboriginal and Torres Strait Islander people know what works best for us.

We need to make sure Aboriginal and Torres Strait Islander youth voices are reflected and expertise is recognised in every way at every step on efforts to close the gap in life outcomes between Aboriginal and Torres Strait Islander people and other Australians.’

‘The Coalition of Peaks is leading the face to face discussions, not governments.

The Peaks are asking Aboriginal and Torres Strait Islander youth to tell us what should be included in a new Closing the Gap agreement and we will take this to the negotiating table.’

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

 

 

Aboriginal #MentalHealth and #Wellbeing #SuicidePrevention : NATSIMHL and @cbpatsisp #GayaaDhuwi (Proud Spirit) Declaration and Indigenous Governance workshop : Keynote Speech from John Paterson CEO @AMSANTaus

“ AMSANT understands that social determinants of health are critical to improving health outcomes for Aboriginal Communities and recognises the role that these determinants play in the development of mental health and harmful substance use issues within communities.

AMSANT therefore recognises that a crucial component of providing support to the delivery of AOD and Mental Health programs and services through the Community Controlled Sector is to continue to advocate and lobby for the improvement of the social determinants of health and mental health for Aboriginal people.

We understand that these determinants extend beyond issues relating to, for example, housing, education, and employment, to more fundamental issues relating to the importance of control, culture and country and the legacy of a history of trauma and loss.

Strong and empowered community governance is the backbone to community resilience and Self-Determination and leads to better health outcomes

We have great challenges and great opportunities here in the Territory and with your commitment to self-determination, Aboriginal Governance, policies and practices that do not re-traumatise, we can achieve strong outcomes together

But first we need to recognise and acknowledge the past to inform our future journey and the sometimes difficult paths we will need to take. 

We as Aboriginal people understand the inter-connectivity of all things;

Our call to action is what part will you play, where are you positioned within this connectivity to ensure health and wellbeing is strong for Gayaa Dhuwi our Proud Spirit. “

John Paterson CEO AMSANT ( Pictured above with Kerry Arabena ) Keynote speech see Part 2 Below

Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander people see part 3 below #HaveYourSay about #closingthegap   

Part 1 Help close the Aboriginal and Torres Strait Islander mental health gap by pledging support for the Gayaa Dhuwi (Proud Spirit) Declaration.

The mental health of Aboriginal and Torres Strait Islander peoples is significantly worse than that of other Australians across many indicators. In particular, the suicide rates are twice as high.

The reasons for the gap are many but include the lack of culturally competent and safe services within the mental health system, that balance clinical responses with culturally-informed responses including access to cultural healing.

To rectify this, Aboriginal and Torres Strait Islander leadership is needed in those parts of the mental health system that work with Aboriginal and Torres Strait Islander populations.

Pledging your organisation’s or personal support for the Gayaa Dhuwi (Proud Spirit) Declaration is a first step in supporting Aboriginal and Torres Strait Islander leadership in appropriate parts of the mental health system to improve our mental health and reduce suicide.”

More info sign HERE

Or Download the 6 Page Brochure HERE

Gayaa-Dhuwi-Declaration_Proud-Spirit

Part 2

The Aboriginal Medical Services of the NT is the peak body for the community controlled Aboriginal primary health care (PHC) sector in the Northern Territory (NT). We have 25 members providing Aboriginal comprehensive primary health care (CPHC) right across the NT from Darwin to the most remote regions.

AMSANT has been established for 25 years and just recently celebrated our 25 year anniversary in Alice Springs.   AMSANT has a major policy and advocacy role at the NT and national levels, including as a partner with the Commonwealth and NT governments in the Northern Territory Aboriginal Health Forum (NTAHF).

The ACCHSs sector in the NT is comparatively more significant than in other jurisdictions, being the largest provider of primary health care services to Aboriginal people in the NT. Over half of all the episodes of care approximately 60% and contacts 65% in the Aboriginal PHC sector in the Northern Territory are provided by ACCHSs. Moreover, ACCHS deliver comprehensive primary health care that incorporates social and emotional wellbeing, mental health and AOD services, family support services and early childhood services, delivered by multidisciplinary teams within a holistic service model.

Aboriginal people experience a disproportionate morbidity and mortality burden from mental health and alcohol and other drug (AOD) problems. Nationally, mental health conditions are estimated to account for 12% of the life expectancy gap between Indigenous and non-Indigenous Australians, with suicide contributing another 6% and alcohol another 4% (Vos et al. 2007). Tragically, from 2011-15, the Indigenous suicide rate was twice that of the non-Indigenous population (AHMAC 2017).

At AMSANT, we have come to believe that encouraging an understanding of trauma and its impact and facilitating trauma informed perspectives and ways of working – for all staff throughout our health services – can enhance service delivery and outcomes for the communities in which these services are based.

Some of the most challenging, complex and life threatening issues faced within our health services can be better understood in the context of historical and ongoing experiences of trauma. But as we understand these difficulties in relation to the stories of trauma that communities have lived through since colonisation, it is vital that we also see and understand the strengths and resilience of Aboriginal and Torres Strait Islander peoples and communities – and that we recognise the central role of connection to culture, cultural identity and cultural continuity in maintaining these strengths and keeping people well.

Many Aboriginal people in the NT are happy, engaged with their families and culture, and prepared to make a positive contribution to their communities. The physical and mental health of Aboriginal people have been maintained through beliefs, practices and ways of life that supported their social and emotional wellbeing across generations and thousands of years.

However, factors unique to the Aboriginal experience—including the historical and ongoing process of colonisation that has seen loss of land, suppression of language and culture, forcible removal of children from families, and experiences of racism—have all contributed to profound feelings of loss and grief and exposure to unresolved trauma, which continues disadvantage, poor health and poor social outcomes for far too many Aboriginal people.

This process has directly involved the disruption and severing of the many connections that are protective in maintaining strong mental health and wellbeing – Our connections to a strong spirit

Identifying the extent and impacts of poor mental health among Aboriginal people must be founded on an understanding of this context and the reality that Aboriginal understandings and experiences of mental health and wellbeing are in many ways very different to that of mainstream society.

Also in relation to health and mental health, there is an acknowledgement of the significance of the social determinants of health.  There is an understanding of how ongoing marginalisation, disempowerment, discrimination and stress contribute to poor health and mental health outcomes.

AMSANT understands that social determinants of health are critical to improving health outcomes for Aboriginal Communities and recognises the role that these determinants play in the development of mental health and harmful substance use issues within communities.

AMSANT therefore recognises that a crucial component of providing support to the delivery of AOD and Mental Health programs and services through the Community Controlled Sector is to continue to advocate and lobby for the improvement of the social determinants of health and mental health for Aboriginal people.

We understand that these determinants extend beyond issues relating to, for example, housing, education, and employment, to more fundamental issues relating to the importance of control, culture and country and the legacy of a history of trauma and loss.

Strong and empowered community governance is the backbone to community resilience and Self-Determination and leads to better health outcomes.  For this reason APONT’s Partnership Principles have been developed to improve collaboration and coordination between service providers with the aim of strengthening and rebuilding an Aboriginal controlled development and service sector in the NT.

It is widely understood that mental illness carries a certain amount of social stigma. The impact of this is magnified however for Aboriginal people, who are often subject to systemic racism and discrimination in their everyday lives.  This is demonstrated in the overrepresentation of Aboriginal young people in justice and child protection systems

Census data from June 2017 revealed that among the 964 young people in detention on an average night in Australia, 53% were Aboriginal or Torres Strait Islander and 64% had not been sentenced. In the Northern Territory, these rates were as high as 95% for Aboriginal or Torres Strait Islander children, with 70% not sentenced.

It is now well known that unresolved traumatic experience impacts the developing brain, causing an over-developed fear response leading to increased stress sensitivity and related symptoms can include isolation, aggression, lack of empathy and impulsive behaviour.

Often children in the youth justice system may appear to be violent, aggressive, oppositional, unreachable or disturbed, however, underlying these behaviours is the grief of a child who has had to live through experiences that no human being should ever experience especially a child who does not have the agency to repair, respond and heal, resulting in feelings of powerlessness, anxiousness, and depression.

For these reasons, having a youth justice system that incorporates punishment as a form of behavioural management will only perpetuate the child’s belief that their world is unsafe, and further compound and escalate complex and violent behaviours. If the emotional and psychological wounds do not get appropriately addressed then there is risk of a lifelong pattern of anger, aggression, self-destructive behaviours, academic and employment failures, and rejection, conflict, and isolation in every key relationship. This cycle of trauma and violence can continue across generations.

AMSANT believes that a youth justice system that is trauma informed and sits within a social emotional wellbeing (SEWB) framework would be a positive way forward in redirecting youth away from the justice system, supporting social and emotional health and aiding in community re-entry.

It is also necessary to understand and confront the cumulative impacts of institutional racialism and discriminative policies. For example, the Intervention in the Northern Territory involved the imposition of a series of punitive measures against 73 Aboriginal communities and denied opportunities for community leaders to govern their own communities. The effects of the Intervention on Indigenous people throughout the NT and the fundamental disempowerment that it represented, can hardly be overstated and is demonstrated in our continuing unacceptable disparity in health outcomes.

However Aboriginal Territorian are working together and in collaboration to overcome these disparities.  For example, here in the Territory we have the Aboriginal Health Forum which provides high-level guidance and decision-making. The Forum enables joint planning and information sharing, where partners work together in a spirit of partnership and collaboration.

Nationally AMSANT is involved through the Coalition of Peaks in developing agreed policy positions to negotiate a new National Agreement on Closing the Gap with the Council of Australian Governments or COAG.  For a long time, Aboriginal and Torres Strait Islander peoples have been calling to have a much greater say in how programs and services are delivered to our peoples.

See Part 3 below to have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander people #HaveYourSay about #closingthegap

As a result of the work of the Coalition of Peaks, we are now formally represented on the Joint Council on Closing the Gap – which is the first time an external non-government partner has been included within a COAG structure.

Finally we are seeing a change in the policy conversation on Closing the Gap, with our mob at the decision-making table.

And regionally, leadership exists throughout all of our communities.   Even without the resources and empowerment that would allow for leadership and governance to thrive, it is intrinsically there, understood and followed by the protocols of community life and our kinship systems.

Our ACCHS in the Northern Territory recognise social emotional wellbeing as holistic and interconnected which includes our cultural knowledge and practices as well as mental health and the social determinants of health.

Having control and governance over our service delivery has paved the way for innovation and best practice within our SEWB programs.

We have great challenges and great opportunities here in the Territory and with your commitment to self-determination, Aboriginal Governance, policies and practices that do not re-traumatise, we can achieve strong outcomes together

But first we need to recognise and acknowledge the past to inform our future journey and the sometimes difficult paths we will need to take.

We as Aboriginal people understand the inter-connectivity of all things;

Our call to action is what part will you play, where are you positioned within this connectivity to ensure health and wellbeing is strong for Gayaa Dhuwi our Proud Spirit.

Part 3 Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander people #HaveYourSay about #closingthegap

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

 

NACCHO Aboriginal #MentalHealth Download @NMHC National Report 2019 Released today : The Australian Government encourages PHNs to position Aboriginal Community Controlled Health Services as preferred providers for mental health and suicide prevention services for our mob

” Working to improve the health of Aboriginal and Torres Strait Islander people is a priority area for PHNs.

The PHN Advisory Panel Report recommended that PHN funds for mental health and suicide prevention for Aboriginal and Torres Strait Islander people should be provided directly to Aboriginal Community Controlled Health Services (ACCHS) as a priority, unless a better arrangement can be demonstrated.

The Senate Inquiry into the accessibility and quality of mental health services in rural and remote Australia also made a similar recommendation.

PHNs should continue to work on formalising partnerships with ACCHS.

The NMHC supports the recommendations made by both these reports and recommends that the Australian Government encourages PHNs to position ACCHS as preferred providers for mental health and suicide prevention services for Aboriginal and Torres Strait Islander people “

Extract from Page 14 

Recommendation 16: The Australian Government encourages PHNs to position Aboriginal Community Controlled Health Services as preferred providers for mental health and suicide prevention services for Aboriginal and Torres Strait Islander people.

The National Mental Health Commission today released its National Report 2019 on Australia’s mental health and suicide prevention system, including recommendations to improve outcomes.

Download the full 97 Page Report HERE 

National_Report_2019

or 9 Page Summary HERE 

National Report 2019 Summary – Accessible PDF

The Commission continues to recommend a whole-of-government approach to mental health and suicide prevention.

This broad approach ensures factors which impact individuals’ mental health and wellbeing such as housing, employment, education and social justice are addressed alongside the delivery of mental health care.

National Mental Health Commission Advisory Board Chair, Lucy Brogden, said we are living in a time when we’re seeing unprecedented investment and interest in making substantial improvements to our mental health system.

“Current national reforms are key, but complex, interrelated and broad in scope, and will take time before their implementation leads to tangible change for consumers and carers,” Mrs Brogden said.

“The National Report indicates while there are significant reforms underway at national, state and local levels, it’s crucial that we maintain momentum and implement these recommendations to ensure sustained change for consumers and carers.”

National Mental Health Commission CEO Christine Morgan said the National Report findings align with what Australians are sharing as part of the Connections Project, which has provided opportunities for the Commission to hear directly from consumers, carers and families, as well as service providers, about their experience of the current mental health system.

“What’s clear is we must remain focused on long term health objectives. Implementation of these targeted recommendations will support this focus,” Ms Morgan said.

The NMHC recommendations require collaboration across the sector.  As part of its ongoing monitoring and report role, the NMHC will work with stakeholders to identify how progress of the recommendations can be measured.

For your nearest ACCHO contact for HELP 

NACCHO Aboriginal #MentalHealth and #SuicidePrevention : Read and Watch @beyondblue Chair The Hon Julia Gillard AC speech @UniofAdelaide Truth-telling and reconciliation will enhance the social and emotional wellbeing of Indigenous Australians.

” Suicide in our Indigenous communities is one of the greatest challenges of our times and its causes are complex.

Beyond Blue cannot claim or seek to be a specialist or comprehensive provider of social and emotional wellbeing or suicide prevention services for Aboriginal and Torres Strait Islander people.

That is a role which is more appropriately the domain of Aboriginal-led and community-controlled organisations.

But we can apply what we have learnt so far through our Reconciliation Action Plan, our growing cultural competencies, and strong relationships with Aboriginal and Torres Strait Islander peoples, leaders and organisations.

We can complement the work of the Aboriginal organisations and others by ensuring our major interventions are suitable for, and accessible to, Aboriginal and Torres Strait Islander people wherever possible, and use our well-known brand and strength in communications to fight racism and discrimination.

We will recognise those inherent protective factors of Indigenous cultures and communities – those powerful forces of resilience, humour, spirituality and connectedness – that can and should be utilised as sources of strength and healing.

We are ready to work alongside Indigenous people and communities in co-designing solutions to provide better outcomes for health and wellbeing.

We intend to be the best ally we can be, lend our voice when required and listen to learn.

We need to educate ourselves and ask questions when we need to; to commit, to support, to ally.

We pledge to be a positive force for change as the nation addresses the issue of constitutional recognition of Aboriginal and Torres Strait Islander peoples.

Aboriginal and Torres Strait Islander peoples have always resisted actions designed to destroy their culture, disperse their families and sever their connections to Country.

The day will come when we look with pride upon that determination, and indeed celebrate it as a complete history.

The Hon Julia Gillard AC University of Adelaide public lecture 2019 3 September 2019

Yellaka Dance Group 

Read over 230 Aboriginal Mental Health articles published by NACCHO in past 7 years

Read over 150 Aboriginal Suicide Prevention articles published by NACCHO in Past 7 years

I acknowledge the traditional owners of the land on which we meet and in the spirit of reconciliation, pay my respects to Elders past and present. Yellaka, thank you for your warm Greeting to Country.

Introduction

The is the second time I have had the privilege of being so welcomed by Yellaka. The first time was at the recent South Australian State dinner to celebrate 125 years of women’s suffrage in our State – a milestone to be inspired by.

In fact, that dinner was very important for me in preparing for this lecture.

It caused to me to reflect on the complexity of history; on our achievements and failings. In that speech I spoke about the need to erect a permanent monument to celebrate the fight for women’s suffrage and all that was gained here in South Australia in 1894.

But in doing so, I said care must be taken to tell the whole story, not part of it.

Despite Aboriginal men and, as a result of women’s suffrage, Aboriginal women having the right to vote, it was common for them neither be told about it nor supported to enrol. Sometimes this oppressive neglect morphed into a more active discouragement from participating.

This pernicious repudiation of a human right was compounded by a direct legal bar, when in the 1902 Commonwealth Franchise Act, Aboriginal and Torres Strait Islander people were excluded from voting in federal elections. It was not until 1962 that Indigenous Australians could have a say in who governed our nation.

We cannot tell the history of how our democracy developed without looking squarely at how equality was denied for so long.

This is just one example of the need to tell the deeper truths that lie beyond the surface.

To quote the words of Labor Prime Minister Paul Keating in his famed Redfern Speech, we need:

Recognition that it was we who did the dispossessing.

We took the traditional lands and smashed the traditional way of life. We brought the diseases. The alcohol.

We committed the murders.

We took the children from their mothers.

We practised discrimination and exclusion.

It was our ignorance and our prejudice.

And our failure to imagine these things being done to us.

With some noble exceptions, we failed to make the most basic human response and enter into their hearts and minds.

We failed to ask – how would I feel if this were done to me?

Friends, this question is as profoundly challenging today as it was when Paul spoke those words almost thirty years ago. Trying to answer it requires honesty, empathy, intellectual understanding, spiritual depth.

Today, I am asking you to bring those characteristics with you as we discuss the tragic topic of suicide and Indigenous Australians.

Honesty

First, with honesty, let’s confront the facts.

Since 2012, suicide has been the leading cause of death among young Aboriginal and Torres Strait Islander people aged 15 to 34.

The suicide rate for Aboriginal and Torres Strait Islander teenagers aged 15 to 19 of both genders is around four times that of their non-Indigenous peers.

Despite Aboriginal and Torres Strait Islander people comprising around three per cent of the Australian population, they account for thirty per cent of the suicide deaths among those under 18 years of age.

There are significant suicide or self-harming clusters that can occur within a single community or locale over a period of weeks or months.

For example, In February, Western Australia’s State Coroner handed down her report on a cluster of 13 deaths that occurred in less than four years in the Kimberley region and included five children aged 10 to 13.

The Coroner spoke of the deaths as profoundly tragic, individually and collectively, of dysfunction, alcohol, domestic violence and grief.

But she added:

to focus only upon the individual events that occurred shortly before their deaths would not adequately address the circumstances attending the deaths. These tragic individual events were shaped by the crushing effects of inter-generational trauma and poverty upon entire communities. That community-wide trauma, generated multiple and prolonged exposures to individual traumatic events for these children and young persons.

Watch video 

Please note : Julia Gillard starts her talk at about 27 minutes into the 1hr 10 min event, and talks for just under 30 minutes. It finishes with a Q&A session (of about 20 minutes).

Empathy

The Coroner here is calling to our ability to show empathy. To walk alongside our First Peoples and try to understand how history and lived reality come together and can create circumstances of despair.

Great damage has been done to our Aboriginal and Torres Strait Islander communities through two centuries of discrimination, dislocation and cultural disruption.

Culture is a word that is often tangled up with nationality, but it entails much more.

Our culture determines so much of our identity; our values, the way we view the world, the way we interact with others, our sense of belonging.

And if the foundations of culture are systemically disrupted – connection to land, traditional places and practices, languages, spirituality, family and kinship ties – it causes devastation across generations.

But honesty also requires us to recognise that there is both deep lingering pain from our history, and new pain that arises in the present.

Imagine not getting the job you’re qualified for because of the colour of your skin; to know you are being followed by a store detective just for being you; to feel the stranger sitting beside you slip sideways to create greater distance.

These are everyday situations – the constant but subtle cues of difference – and where being racially different is nearly always positioned as a liability.

Put simply, racism, including these kinds of behaviours, is not only bad for mental health and wellbeing – it both causes and perpetuates high levels of social and emotional distress for Aboriginal and Torres Strait Islanders. In addition, there is a ‘dose’ effect for psychological distress caused by racism: the more a person is exposed to it, the greater the impact.

That was why Beyond Blue launched its Stop, Think, Respect invisible discriminator campaign in 2014 with a repeat run in 2016.

The campaign – the most viewed and shared in Beyond Blue’s history – highlights the routine everyday impact of subtle racism on the social and emotional wellbeing of Aboriginal and Torres Strait Islander people.

The campaign aimed to change behaviour by encouraging non-Indigenous Australians to think about their often, unconscious behaviours and to think again before they act.

  • To think before they laughed along – even uncomfortably – at a racist joke in the pub.
  • To challenge why they may not sit beside an Aboriginal person on a crowded bus.

But it was the reaction from Indigenous people that was most revealing.

They told us they loved the campaign because finally somebody had noticed that, for them, every day could be a little tougher than it should be.

Over half of Aboriginal and Torres Strait Islander people who experience racial discrimination report feelings of psychological distress, meaning they are at elevated risk of anxiety and depression, substance use and contemplating or attempting suicide.

Empathy requires us to recognise that the threads of the past and the attitudes shown in the present day are woven together. For non-Indigenous Australians, our collective failure to face up to all of the brutal truth of our history and its ongoing effects holds us back from full understanding today.

For Indigenous Australians, the interconnected issues of cultural dislocation, personal trauma and the ongoing stresses of disadvantage, racism and exclusion are absolutely contributing to the heightened risk of mental health problems, substance misuse and suicide.

All this was acknowledged by the Royal Commission Into Aboriginal Deaths In Custody. That report was tabled in 1991.

Intellectual understanding

Driven by empathy, we also need to engage intellectually on the best ways to provide culturally appropriate services and supports to prevent Indigenous suicide.

Nothing less than profound systemic reform is needed to improve social and emotion wellbeing.

Such major change must be culturally informed and co-designed. As many Aboriginal and Torres Strait Islander people continue to remind us, Indigenous policies and responses must be led by Indigenous people, which might mean solutions that look different to anything that has been implemented before.

Innovation and new efforts are needed nationally and locally.

In 2009 the Rudd Government launched the ‘Closing the Gap’ response as a measurable account of Indigenous disadvantage that would be reported to parliament annually on progress.

In the 10 years since launch most of the indicators of disadvantaged have remained stubbornly unmoved. Aboriginal and Torres Strait Islander people can expect to live 10 to 17 years less than other Australians.

While there have been some improvements against some performance indicators, these have been small and incremental.

And babies born to Indigenous mothers still die at more than twice the rate of other Australian babies.

Aboriginal and Torres Strait Islander people experience higher rates of preventable illness such as heart disease, kidney disease and diabetes.

And a major contributing factor to the life expectancy gap is suicide.

There are no mental health or suicide prevention targets in Australia’s Closing the Gap strategy despite the alarming statistics on Indigenous suicide and psychological distress, but as a member of the steering committee, Beyond Blue is adding our voice to rectifying this.

At the same time, we are calling for this act of national leadership, as an organisation we are trying to be a good partner in locally led change models.

In November 2018, Beyond Blue launched Be You: a Commonwealth-funded national initiative that aims to strengthen the mental health literacy, resilience, self-care and help-seeking of every member of Australia’s school communities and early childhood settings.

In January, Minister Wyatt announced $2.3 million over two years to pilot and evaluate a culturally appropriate, place-based adaptation of Be You for schools in the Kimberley and Pilbara regions of WA, in partnership with Aboriginal communities.

That work is now underway. And we are taking a very different approach to this work than what we would normally.

Local stakeholder engagement has confirmed that we must be guided by local communities to genuinely co-design the project; to employ people with community relationships and credibility; and to engage Aboriginal community-controlled organisations to support implementation and delivery of the program.

It’s still very early days, but we are gaining much from partnering with Indigenous communities.

Spiritual depth – Uluru Statement from the Heart

Honesty, empathy, intellectual understanding, all are necessary in the cause of tackling the rate of Indigenous suicide.

But so is spiritual depth, the ability to transcend a divided past, address the dispiriting inequalities of the present and embrace a united future.

Just over two years ago, 250 Aboriginal and Torres Strait Islander leaders endorsed by standing ovation the Uluru Statement from the Heart.

In burning prose it describes that the sovereignty of this nation’s First peoples is ‘a spiritual notion: the ancestral tie between the land, or ‘mother nature’, and the Aboriginal and Torres Strait Islander peoples who were born therefrom, remain attached thereto, and must one day return thither to be united with our ancestors. This link is the basis of the ownership of the soil, or better, of sovereignty.’

It goes on to say:

Proportionally, we are the most incarcerated people on the planet. We are not an innately criminal people. Our children are aliened from their families at unprecedented rates. This cannot be because we have no love for them. And our youth languish in detention in obscene numbers. They should be our hope for the future.

These dimensions of our crisis tell plainly the structural nature of our problem. This is the torment of our powerlessness.

We seek constitutional reforms to empower our people and take a rightful place in our own country. When we have power over our destiny our children will flourish. They will walk in two worlds and their culture will be a gift to their country.

We call for the establishment of a First Nations Voice enshrined in the Constitution.’

As we all know, changing our constitution is difficult in every sense. Conducting and carrying a referendum by a special majority is hard to do. Our history books are littered with the stories of failed referendums. Nineteen referendums proposing 44 changes to the Constitution have been held since Federation but the Australian people have agreed to only eight changes with the last ‘yes’ vote occurring in 1977.

Of course, the Indigenous leaders who gave us the Uluru statement from the heart know this history. They neither underestimate how hard it is to have voters accept change, nor the joy that can come when they do. Many of them were alive when more than 90 percent of Australians voted in the 1967 referendum to allow First Nations people to be included in the census and for the Federal Parliament to have the power to legislate for an improved future.

In the Uluru statement, Indigenous leaders are specifically calling for a comparable act of national unity. There is some reason to believe that voting Australians in their millions are prepared to answer that call.

The Australian Reconciliation Barometer is a national research study conducted every two years to measure and compare attitudes and perceptions towards reconciliation.

In 2018 the Barometer found:

  • 90 per cent of Australians believe the relationship between Aboriginal and Torres Strait Islander people is important;
  • 95 per cent believe that it is important for our First Peoples to have a say in matters that affect them;
  • and 80 per cent support a formal truth telling process.

That there is a public mood for change is further confirmed by the Australian Constitutional Values Survey of 2017 released by the Centre for Governance and Public Policy at Griffith University.

It found 61 per cent of respondents would vote “yes” in a referendum to add an Indigenous voice to Parliament.

So, we increasingly desire a richer understanding of our shared history and some form of national reconciliation, but change can be hard to achieve, even when the majority is willing.

Successive Prime Ministers and governments, Indigenous leaders and organisations have tried to advance this cause.

The government I led set out to bring a referendum on constitutional recognition to the people by the 2013 election. I appointed an Expert Panel on Constitutional Recognition of Indigenous Australians to advise on the wording.

On that panel were some of our most persuasive and respected Indigenous leaders, including The Hon. Ken Wyatt AM, the first Indigenous Australian to serve in the House of Representatives.

The panel’s recommendations were sensible and smart.

But before we could proceed, we needed to diagnose the prospects of success at a referendum. The very worst thing we could do would be to put a referendum proposal forward only to have it fail.

The consensus was we did not have time to build momentum for change ahead of a 2013 election.

That need for certainty remains a critical issue for today’s leaders as they move towards a proposal to put to the people.

But much has changed since 2013 and we can all be heartened by that.  I am especially heartened that we have, for the first time, extremely talented and respected Aboriginal people from both sides of politics leading Indigenous policy and discussion on this issue.

With bi-partisan support, shared commitment and collaboration, change is achievable.

We know wellbeing is intrinsically linked to a strong sense of self, connections to community, and recognition of culture.

That is why I and my Beyond Blue Board colleagues recently approved a comprehensive Aboriginal and Torres Strait Islander Strategy to guide our contribution for the next five years. Through the Strategy, we have resolved to continue to advocate on national issues of importance to Aboriginal and Torres Strait Islander people.

We are particularly determined to raise our voice in support of an openhearted and respectful response to the Uluru Statement from the Heart.

Beyond Blue acknowledges that there are still community and political discussions occurring about constitutional change and recognition. As that conversation continues, Beyond Blue advocacy will be aimed at our nation adopting the kind of far-sighted change that can bring a new era of healing and unity.

This isn’t a mental health organisation dabbling in politics. We do it because structural discrimination has a profound and proven negative impact on individual and community wellbeing and mental health.

This is absolutely about ‘sticking to our knitting’.

This is about the Board of Beyond Blue supporting action on the basis there will be significant benefit to a population group at higher risk of mental health conditions and suicide, and who experience discrimination and disadvantage.

The Board of Beyond Blue also accepts the invitation issued in the Uluru Statement from the Heart to walk with you in ‘a movement of the Australian people for a better future’.

To our federal parliamentarians who are working through how best to respond to the Uluru statement my personal message is this; I know what it is like to be beset with doubts about the best way to respond to a call to address trauma and despair. To worry about making the wrong decision, one that risks more damage.

I went through every painful permutation of that in my head when I worked through whether to call a Royal Commission into Child Sexual Abuse in Institutional Settings. I am not ashamed to say here that in the face of such a major decision, I was afraid.

Specifically, I was afraid that holding a Royal Commission would retraumatise, rather than heal.

As history records, I worked through those fears and called the Commission. I know now from my own observations of the impact of the Royal Commission that great healing can come from heeding the call, truth-telling and acknowledgement of past trauma.

I ask our current leaders on all sides of the parliamentary chamber to work through their fears and concerns. I ask our current leaders to heed the call of the Uluru Statement from the Heart.

Conclusion

Suicide in our Indigenous communities is one of the greatest challenges of our times and its causes are complex.

Beyond Blue cannot claim or seek to be a specialist or comprehensive provider of social and emotional wellbeing or suicide prevention services for Aboriginal and Torres Strait Islander people.

That is a role which is more appropriately the domain of Aboriginal-led and community-controlled organisations.

But we can apply what we have learnt so far through our Reconciliation Action Plan, our growing cultural competencies, and strong relationships with Aboriginal and Torres Strait Islander peoples, leaders and organisations.

We can complement the work of the Aboriginal organisations and others by ensuring our major interventions are suitable for, and accessible to, Aboriginal and Torres Strait Islander people wherever possible, and use our well-known brand and strength in communications to fight racism and discrimination.

We will recognise those inherent protective factors of Indigenous cultures and communities – those powerful forces of resilience, humour, spirituality and connectedness – that can and should be utilised as sources of strength and healing.

We are ready to work alongside Indigenous people and communities in co-designing solutions to provide better outcomes for health and wellbeing.

We intend to be the best ally we can be, lend our voice when required and listen to learn.

We need to educate ourselves and ask questions when we need to; to commit, to support, to ally.

We pledge to be a positive force for change as the nation addresses the issue of constitutional recognition of Aboriginal and Torres Strait Islander peoples.

Aboriginal and Torres Strait Islander peoples have always resisted actions designed to destroy their culture, disperse their families and sever their connections to Country.

The day will come when we look with pride upon that determination, and indeed celebrate it as a complete history.

I look forward with hope to that day and I thank you.

NACCHO Aboriginal Health and #SuicidePrevention @pat_dudgeon @TTanja23 : Download New @CBPATSISP guidelines to improve assessments for our mob presenting to hospital with self-harm and suicidal thoughts

There is now growing evidence that the legacy of colonisation has contributed to the disproportionate rat.   es of suicide and suicidal behaviours and other disadvantages experienced by Aboriginal and Torres Strait Islander people.

The effects of colonisation are evident in the structural barriers and lack of access to culturally responsive hospitals and family support services that underscore the urgent need for these guidelines as part of a broader suicide prevention strategy.”

Professor Pat Dudgeon, Director of the Centre for Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention  ( CBPATSISP )

“Assessing risk of suicide is a complex task in any setting, but particularly in the hospital setting, as it can be a very discomforting time for people. There is a pressing need to respond adequately and carefully during this time.”

Aboriginal clinical psychologist, Tanja Hirvonen

Read over 150 Aboriginal Health and Suicide Prevention articles published by NACCHO over past 7 years 

The Menzies School of Health Research (Menzies), commissioned by CBPATSISP have developed evidenced-based the Guidelines for best practice psychosocial assessment of Aboriginal and Torres Strait Islander people presenting to hospital with self-harm and suicidal thoughts (the Guidelines) to improve the quality of care and outcomes for people presenting with suicidal thoughts and behaviours.

Download 30 Page PDF Copy 

CBPATSISP best practice_guidelines_FINAL

A history of self-harm is one of the strongest known risk factors for suicide and represents an important opportunity to engage with people in a preventive intervention.

The Guidelines contain 227 evidence-based recommendations that have been endorsed by an expert panel of Aboriginal and Torres Strait Islander and non-Indigenous professionals and those with lived experience using the Delphi method for establishing an expert consensus on best practice.

The Guidelines provide the principled basis for culturally appropriate health care. To better achieve cultural responsiveness in practice and improve the quality of care for Aboriginal and Torres Islander people presenting to hospital with self-harm and suicidal thoughts, the guidelines contains recommendations for appropriately and effectively interacting with and engaging Aboriginal and Torres Strait Islander people in ways that are empowering and de-stigmatising.

Tanja Hirvonen states,

“It was highlighted that the type of assessment tool that is used is significant, but just as critical is to ensure that the right information is gathered, and people are appropriately supported during a very critical time in their lives, within a culturally safe model of practice and care.”

Recommendations in the guidelines for evaluating risks, strengths and needs of Aboriginal and Torres Strait Islander people have a strong grounding in the concept of social and emotional wellbeing to ensure that assessments inform the most appropriate and effective options for care in the hospital and recovery in the community.

A number of recommendations have also been included to help clinicians respond in developmentally and culturally appropriate ways to self-harm and suicidal thoughts amongst young Aboriginal and Torres Strait Islander people.

Professor Pat Dudgeon concluded:

“These new Guidelines have potential to make a genuine difference for Aboriginal people at risk of suicide or self-harm who present at emergency departments. CBPATSISP is committed to disseminating these guidelines widely and we will advocate to ensure that relevant agencies, such as the Australian Indigenous Psychology Association, are supported to develop cultural competence training and engage hospitals in embedding these guidelines into practice at a national level.”

The guidelines can be also be found online from CBPATSISP and Menzies websites

If you or someone you know needs help contact your nearest ACCHO or call:

 

NACCHO Aboriginal #MentalHealth and #SuicidePrevention : Remote jobless ” CDP ” to be trained as Indigenous ‘crisis’ contacts says @KenWyattMP #Garma2019

 

“In the past we used to walk with our fathers and our grand­fathers and have a yarn with them.

If we had a proper look at the data we would find there were a lot less suicides when our communities were strong and our families were there all the time.

And then the policies of the past impacted that level of bonding, families have been broken in some instances.”

Mr Wyatt revealed his plan as he prepares to visit Garma and a remote Northern Territory community where leaders say jobs have helped save their young people.

On Saturday 3 August at 11.15 the Voices workshop at Garma

The official Program Booklet can be viewed HERE

Featuring

Minister for Indigenous Australians Ken Wyatt

Pat Turner : Coalition of Peak Organisations

Mick Dodson

June Oscar

From Today’s Australian 

Unemployed Indigenous people in remote towns and communities will be trained as round-the-clock emergency contacts for troubled young people as part of the Morrison government’s plan to address the scourge of indigenous suicide.

Minister for Indigenous Australians Ken Wyatt wants some of the 29,000 Aboriginal people in the Community Development Program — formerly work-for-the-dole — to serve as “permanent part-time youth engagement people”.

CDP participants are required to complete 20 hours a week of work-like duties that benefit their community, but so far none have performed this role.

Those indigenous people found suitable for the role would complete a mental health first aid course and be available to listen and mentor, Mr Wyatt said.

Aboriginal Australians take their own lives at twice the rate of other Australians, and the figures are even higher among indigenous youth.

The Arnhem Land community of Gunyangara was crippled by ­indigenous youth suicide in the years before the local Aboriginal corporation took control of the town’s services and began employing its young residents to run a diverse range of businesses. ­Locals now build their own houses, including by making bricks and milling the wood for frames.

Djawa Yunupingu said the community had survived “very bad times”. No resident had taken their own life for 10 years: “We made our own destiny,” he said.

Mr Wyatt will visit 10 newly built houses at Gunyangara today before facing some of the nation’s most respected backers of the Uluru Statement from the Heart at the Garma festival at nearby Gulkula.

He has pledged to take Australians to a referendum on constitutional recognition of indigenous Australians, one of the elements of the Uluru statement. He has not committed to what many consider the most important first step — a constitutionally enshrined voice. Woolworths — Australia’s biggest employer — and mining giants BHP and Rio Tinto are among corporate supporters of a constitutionally enshrined voice, and two former High Court chief justices have set out to explain why it can be achieved without compromising the authority of parliament. But yesterday Mr Wyatt made his strongest plea yet for Uluru backers to compromise.

“There are some things I have had to set aside from my younger days when I had fire in my belly,” he said. “We hope to have what we want, an optimum outcome. We also have to be pragmatic.”

Mr Wyatt warned that if the referendum failed, statistics showed it was unlikely to be resurrected. He indicated it was better to take the question of constitutional recognition of indigenous Australians to a referendum and win, than to ­include the question of a constitutionally enshrined voice and lose.

NACCHO Aboriginal Health and #SuicidePrevention #MentalHealth #ClosingTheGap : Read full speech @BeyondBlue Chair The Hon. Julia Gillard AC opening #NSPC19

 ” I acknowledge the Traditional Owners of the land on which we meet, the Boon Wurrung people of the Kulin Nation, and, in a spirit of reconciliation, pay my respect to their Elders – past and present………….

Today, First Nations people are twice as likely to die by suicide than non-Indigenous people.

Since 2012, suicide has been the leading cause of death among young Aboriginal and Torres Strait Islander people aged 15 to 34 years of age.

Improving social and emotional wellbeing in Aboriginal and Torres Strait Islander communities and reversing the suicide toll are inextricably linked to issues of post-colonial, intergenerational trauma, the need for secure housing, a fair go inside and outside the justice system, access to education and employment opportunities, and tackling racism.

And as many Aboriginal and Torres Strait Islander people continue to remind us, Indigenous policies must be led by Indigenous people whose solutions look different to ours. “

The Hon Julia Gillard Chair of Beyond Blue and 27th Prime Minister of Australia.

To read full speech 

Read over 140 + Aboriginal health and Suicide Prevention articles published by NACCHO over past 7 years 

Here are selected extracts

1.Today, First Nations people are twice as likely to die by suicide than non-Indigenous people.

In every part of our country, and for the sake of our society and economy, we need to continue to stress that maintaining good mental health and preventing suicide is a social, economic and political imperative.

As we all know, this imperative is especially vital for some groups who face significantly higher risk of suicide.

People of culturally and linguistically diverse backgrounds, LGBTI communities, rural and regional Australians, and our young people and the most elderly.

Once again, I am drawn to the leadership of Professor De Leo who observed that great cultural sensitivity should be applied when designing effective suicide-prevention strategies to tackle social issues of such importance and magnitude.

That they must reflect the unique needs and experiences of communities and that the communities themselves must show us the way.

He points out that many risk factors for suicide are the same for both Indigenous and non-Indigenous people: trauma, housing stress, substance abuse and unemployment among them.

But there are also personal issues that show more frequently in Indigenous suicide such as relationship breakdown and recent bereavement.

The significance of culture has never been as apparent to me as when I visited Aboriginal and Torres Strait Islander communities.

Culture is a word that is often tangled up with nationality, but it entails much more.

Our culture determines so much of our identity; our values, the way we view the world, the way we interact with others, our sense of belonging.

Our culture protects us.

And if a single piece of our culture is taken away, erased or replaced, it leaves us feeling uncertain, disconnected.

Today, First Nations people are twice as likely to die by suicide than non-Indigenous people.

Since 2012, suicide has been the leading cause of death among young Aboriginal and Torres Strait Islander people aged 15 to 34 years of age.

Improving social and emotional wellbeing in Aboriginal and Torres Strait Islander communities and reversing the suicide toll are inextricably linked to issues of post-colonial, intergenerational trauma, the need for secure housing, a fair go inside and outside the justice system, access to education and employment opportunities, and tackling racism.

And as many Aboriginal and Torres Strait Islander people continue to remind us, Indigenous policies must be led by Indigenous people whose solutions look different to ours.

I am heartened that we have, for the first time, Aboriginal people from both sides of politics leading Indigenous policy.

It is hard to believe that, despite the alarming statistics on Indigenous suicide and psychological distress, there are no mental health or suicide prevention targets in Australia’s Closing the Gap strategy.

Rectifying this is something Beyond Blue has been calling for.

2. Research and the #YouCanTalk Campaign 

In February 2018, Beyond Blue released research by the University of Melbourne and Whereto Research Based Consulting, which detailed what advice can be given to the public to increase the likelihood that they will ask about and support someone who may be at risk of suicide.

This was rigorous, scientific but also humanistic research that I hope Diego would approve of.

The research team spoke to experts, studied existing literature and surveyed over 3,000 Australians from all walks of life.

People who said they had not been affected in any way by suicide.

People who had been touched directly by suicide.

And people who had attempted suicide in the previous 12 months.

Those who had thought about or attempted suicide confirmed that having someone listen to them with empathy and show care and support was the most important and helpful thing to them.

The research confirmed a deep community concern about suicide, and that most people want to do more to prevent suicide in their communities, but don’t know how.

They were unsure where to start, how to identify the often very subtle verbal and non-verbal warning signs.

The words to use, or even whether they should say anything at all.

Because:

• 50 per cent of research participants believed only a professional can help prevent suicide;

• 40 per cent worried that talking about suicide made things worse;

• And 30 per cent believed discussing suicide would make it happen.

That research underpinned a collaborative response by the Black Dog Institute, Everymind, headspace, Lifeline, ReachOut, RU OK? and Beyond Blue.

The result was the #YouCanTalk campaign.

#YouCanTalk aims to debunk the myths, build up the confidence of the community, and equip individuals to have safe and helpful conversations about suicide and provide empathetic and practical support to people thinking about suicide.

It is about mobilising the community and empowering family and friends to act as ‘eyes and ears’, hopefully before their loved ones reach crisis point.

The first phase of the social media campaign went live in July last year.

Using the combined power and reach of the social networks and online communities of all seven organisations, the message reached an audience of over 18 million and was the top trending Twitter topic on launch day.

A second phase is in development with an expanded group that now includes SANE Australia, the Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention and Roses in the Ocean.

#YouCanTalk is owned, and can be used, by everyone.

And it’s already having positive ripple effects.

NACCHO Aboriginal #MentalHealth @georgeinstitute Download new screening tool to help Aboriginal and Torres Strait Islander people combat depression

“ This tool, which was developed in conjunction with Aboriginal communities and researchers, will help us address easily treated problems that often go undiagnosed. It will also help us to assess the scale of mental health problems in communities.

Up until now, we couldn’t reliably ascertain this in a culturally appropriate way, which has remained a huge concern.

We need better resources and funding for mental health across Australia, but particularly for Aboriginal and Torres Strait Islander people and within under-resourced health services. We hope this tool will be a turning point.”

Lead researcher Professor Maree Hackett, of The George Institute for Global Health, said mental health problems experienced by Aboriginal and Torres Strait Islander peoples have been overlooked, dismissed and marginalised for too long. 

A culturally-appropriate depression screening tool for Aboriginal and Torres Strait Islander peoples not only works, it should be rolled out across the country, according to a new study.

Researchers at The George Institute for Global Health, in partnership with key Aboriginal and Torres Strait primary care providers conducted the validation study in 10 urban, rural and remote primary health services across Australia.

The screening tool is an adapted version of the existing 9-item patient health questionnaire (PHQ-9) used across Australia and globally accepted as an effective screening method for depression. The adapted tool (aPHQ-9) contains culturally-appropriate questions asking about mood, appetite, sleep patterns, energy and concentration levels. It is hoped the adapted questionnaire will lead to improved diagnosis and treatment of depression in Aboriginal communities.

The results of the validation study were published in the Medical Journal of Australia 1 July 2019

Download the 7 page study  mja250212

The aPHQ-9 is freely available in a culturally-appropriate English version, and can be readily used by translators when working with First Nation communities where English is not the patients first language.

It is estimated up to 20 per cent of Australia’s general population with chronic disease will have a diagnosis of comorbid major depression. [1]

Approximately similar proportions will meet criteria for moderate or minor depression. Mental illness and depression are also considered to be key contributors in the development of chronic disease.

Across the nation, chronic disease (cardiovascular disease, cerebrovascular disease, diabetes, chronic kidney disease and chronic obstructive pulmonary disease) accounts for 80 per cent of the life expectancy gap experienced by Aboriginal people [2]  

How the tool works

The adapted tool, which was evaluated with 500 Aboriginal and Torres Strait Islander peoples, contains culturally-appropriate questions.

For example, the original (PHQ-9) questionnaire asks:

  • Over the last two weeks, how often have you been bothered by any of the following problems: Little interest or pleasure in doing things?
  • Feeling down, depressed or hopeless

The adapted (aPHQ-9) tool instead asks:

  • Over the last two weeks have you been feeling slack, not wanted to do anything?
  • Have you been feeling unhappy, depressed, really no good, that your spirit was sad?

Download: Adapted Patient Questionnaire with scoring (PDF 117 KB)

Download: Adapted Patient Questionnaire without scoring(PDF 114 KB)

Professor Alex Brown, of the South Australian Health and Medical Research Institute, who was co-investigator on the study, said the importance of using culturally appropriate language with First Nations people cannot be underestimated.

“In Australia, as with many countries around the world, everything is framed around Western understandings, language and methods. Our research recognises the importance of an Aboriginal voice and giving that a privileged position in how we respond to matters of most importance to Aboriginal people themselves.

“What we found during this study was that many questions were being lost in translation. Instead of a person scoring highly for being at risk of depression, they were actually scoring themselves much lower and missing out on potential opportunities for treatment.

“It was essential that we got this right and that we took our time speaking with Aboriginal people and ascertaining how the wording needed to be changed so we can begin to tackle the burden of depression.”

Aboriginal psychologist Dr Graham Gee, of the Murdoch Children’s Research Institute, saidAboriginal communities have unacceptably high rates of suicide which need to be addressed. “Identifying and treating depression is an important part of responding to this major challenge. It’s clear this tool is much needed.”

The new tool will be available for use at primary health centres across Australia and will be available to download here from Monday July 1.

The George Institute for Global Health

The George Institute for Global Health conducts clinical, population and health system research aimed at changing health practice and policy worldwide.

Established in Australia and affiliated with UNSW Sydney, it also has offices in China, India and the UK, and is affiliated with the University of Oxford.  Facebook at thegeorgeinstitute  Twitter @georgeinstitute Web georgeinstitute.org.au

[1] https://www.aihw.gov.au/reports/mentalhealthservices/mentalhealthservicesinaustralia/reportcontents/summary/prevalenceandpolicies

[2] https://www.aihw.gov.au/reports/indigenousaustralians/contributionofchronicdiseasetothegapinmort/contents/summary

Additional Media 

Doctors can now use the new tool

Extract from the Conversation 1 July 2019

In 2014-15, more than half (53.4%) of Aboriginal and Torres Strait Islander peoples aged 15 years and over reported their overall life satisfaction was eight out of ten or more. Almost one in six (17%) said they were completely satisfied with their life. These positive data are testament to Aboriginal and Torres Strait Islander peoples’ ongoing endurance.

But over the years, events like colonisation, racism, relocation of people away from their lands, and the forced removal of children from family and community have disrupted the resilience, cultural beliefs and practices of many Aboriginal and Torres Strait Islander Australians. In turn, these factors have impacted their social and emotional well-being.

This may explain why Aboriginal and Torres Strait Islander peoples are twice as likely to be hospitalised for mental health disorders and die from suicide than their non-Aboriginal counterparts.

Teenagers aged 15 to 19 are five times more likely than non-Indigenous teenagers to die by suicide.

The importance of being able to more accurately identify those at risk can’t be understated.

While screening all Aboriginal and Torres Strait Islander peoples who present to general practice for depression is not recommended, the new questionnaire is a free, easy to administer, culturally acceptable tool for screening Aboriginal and Torres Strait Islander peoples at high risk of depression.

People who might be at heightened risk of depression include those with chronic disease, a history of depression and those who have been exposed to abuse and other adverse events.

Without a culturally appropriate tool, Aboriginal and Torres Strait Islander people with depression and suicidal thoughts might fly under the radar. This questionnaire will pave the way for important discussions and the provision of treatment and services to those most in need.

If this article has raised issues for you or you’re concerned about someone you know, call Lifeline on 13 11 14. Visit the Beyond Blue website to access specific resources for Aboriginal and Torres Strait Islander people.

Maree Hackett, Professor, Faculty of Medicine, UNSW and Geoffrey Spurling, Senior lecturer, Discipline of General Practice, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

NACCHO Aboriginal #MentalHealth #SuicidePrevention @NMHC Communique : @GregHuntMP roundtable meeting to review investment to date in mental health and suicide prevention : #TimeToFixMentalHealth #TomCalma @AUMentalHealth @FrankGQuinlan @PatMcGorry @amapresident @headspace_aus

” Minister for Health, Greg Hunt, hosted a Government-led roundtable this week to review investment to date in mental health and suicide prevention, to hear from the sector on current gaps and priorities, to understand what is and is not working, and to advise on the upcoming national forum on youth mental health and suicide prevention.

Minister Hunt and Prime Minister Scott Morrison are committed to working towards zero-suicide for all Australians, including our youth.

From the National Mental Health Commission 6 June 

( The Indigenous ) Suicide rates are an appalling national tragedy that is not only depriving too many of our young people of a full life, but is wreaking havoc among our families and communities.

As anyone who has experienced a friend or family member committing suicide will know, the effects are widespread and devastating and healing can be elusive for those left behind.

It is time that we draw a line under this tragic situation that is impacting so significantly on Aboriginal and Torres Strait Islander communities  “

Noting Professor Tom Calma AO was a participant in the meeting via telephone link and opened the meeting with a discussion on Indigenous suicide. 

See this quote and 140 Plus Aboriginal Health and Suicide Prevention articles published by NACCHO in last 7 Years 

Those in attendance welcomed the Government’s commitment, with a number noting that suicide prevention needs to be a priority across all age groups, especially those groups with the highest suicide rates.

The conversation covered a range of key issues, challenges and opportunities for reform and action. Particular discussion points included:

  • Social determinants of mental health: there is a fundamental need to focus on the social determinants of mental health for all Australians, noting and emphasising the range of factors that contribute to distress in young Australians. This is an important factor for all young people and communities, with particular reference to the factors impacting on Aboriginal and Torres Strait Islander children and youth.
  • The impact of trauma and disadvantage: conversation centred on the impacts of trauma and disadvantage and the importance of supporting, for example, young people in out-of-home care, those living in poverty and individuals who are in the justice system.
  • Support for children and families: in order to improve the lives of young Australians, there is a need to better support children and families in the early years. This includes support for neurodevelopmental disorders. In the same way headspace has been developed for young people, there was a suggestion that mental health services focused on children and families could show real benefits.  There is strong support for a focus on prevention
  • Support for Schools: a continued need was highlighted around the role of, and support for, schools, including primary schools and early learning centres. Schools are a critical component of a ‘whole of community’ approach in building supportive environments for children and young people.   It was suggested that for families who may not seek services but who were in need a way of ‘connecting’ may be through digital tools, to identify and support children and parents in those families.
  • Impact on youth: young people can be seriously impacted and influenced by the suicide death of other young people who are their friends, peers, family members or celebrities. More timely and sophisticated data and comprehensive local responses are needed to assist in the reduction of risk for further lives being lost following a suicide.
  • Data: The importance of being able to collect, analyse and provide accurate data was highlighted.  This data is significant across mental health services and particularly for suicide prevention, treatment and support services.
  • Service reform: there is a need for service reform to better respond to people with mental health concerns that are too complex to be managed by a GP at a primary health care level but not so acute as to require specialist tertiary mental health services. While there are some good programs and services to build upon, there is a lack of equity across all regions and access remains a key issue for those requiring psychological and other services. We also need to integrate mental health services with drug and alcohol services.
  • Workforce development: there is an urgent need to focus on training and supporting the diverse professionals working with those at risk of or with mental health issues – health and allied health staff, drug and alcohol workers, school counsellors, psychologists, peer workers and many others. The role of peer workers was recognised as being a critical one and this must be included in all workforce development strategies and initiatives.
  • Peer and carer support: many families and peers supporting those who are in suicidal distress and/or living with challenging mental health and drug and alcohol concerns needed immediate and quality support themselves as they are also at risk for mental ill-health. Families and friends are the largest non-clinical workforce providing care and support for Australians and there is an immediate need to provide better supports for them.
  • Regional and national leadership: while attendees were supportive of regional planning and action, it was suggested that stronger guidance at a national level was needed in order to ensure equity and quality of service responses across the country, with a recognition of the importance of the role of Primary Health Networks.  Further work is needed to ensure that the roles and responsibilities of all governments were clarified, together with accountability. The Fifth National Mental Health and Suicide Prevention Plan, and particularly the Suicide Prevention Implementation Plan, are key drivers for clearer accountability and integrated and coordinated responses.
  • Funding models: there was discussion on how best to fund services across the range of needs, including the current review of Medicare and the role of private health insurance.

A collective agreement and strong commitment was reached that a collaborative approach is vital to achieving improved mental health outcomes for all Australians, including children and youth.

There is significant support for a 2030 Vision for mental health and suicide prevention, to be led by the Commission and to ensure that the systematic changes required to best service the community can be identified, prioritised and achieved. This Vision would be look beyond the current plans and strategies.

Attendees acknowledged the commitment to mental health and quality program responses in recent years, together with the increased funding in the 2019/20 federal budget for expanded youth and adult mental health services in the community, together with initiatives to strengthen the collection of critical data around suicide and mentally healthy workplaces.  They also noted the current enquiries being undertaken by the Productivity Commission and the Victorian Royal Commission.  However, there needs to be an increased focus on longer term systems reform.  The Commission has been tasked with taking a leading role in this and will work closely with the sector to develop a reform pathway.

Participants embraced the importance of hope, recognising not only the significant investment to date but that youth mental health services in Australia have been copied by other nations.  There is strong support for improvements in mental health and suicide prevention across all levels of government and community.

As outlined by the Minister for Health, this was an opportunity to review the current status and continue this important discussion.  It is one of many conversations that will continue with the sector at organisational, group and individual levels.

The Commission will provide updates in sector engagement and discussions as they occur.

Lucy Brogden

Chair, National Mental Health Commission

Christine Morgan

CEO, National Mental Health Commission