Aboriginal #MentalHealthWeek @GregHuntMP launches 5th National #MentalHealth and #SuicidePrevention Plan

 

” For the first time this plan commits all governments to work together to achieve integration in planning and service delivery at a regional level. Importantly it demands that consumers and carers are central to the way in which services are planned, delivered and evaluated.

Furthermore this plan recognises the tragic impact of suicide on the lives of so many Australians and sets a clear direction for coordinated actions by both levels of government to more effectively address this important public issue.

This plan is also the first to specifically outline an agreed set of actions to address social and emotional wellbeing, mental illness and suicide amongst Aboriginal and Torres Strait Islander peoples as a priority, as well as being the first to elevate the importance of addressing the physical health needs of people who live with mental illness and reducing the stigma and discrimination that accompanies mental illness.”

The Hon Jill HennessyChair, COAG Health Council

” Aboriginal and Torres Strait Islander leadership in mental health services is fundamental to building culturally capable models of care. Governance, planning processes, systems and clinical pathways will be more effective if they include Aboriginal and Torres Strait Islander workers at key points in the consumer journey, such as assessment, admission, case conferencing, discharge planning and development of mental health care plans.

Strong ACCHSs are an important component of a culturally responsive mental health service system.

These organisations can play a vital role in:

  1. prevention and early intervention to address risk of developing mental health problems
  2. enabling access to primary and specialist mental health services and allied health
  3. facilitating the transition of consumers across the primary and specialist/acute interface
  4. connecting consumers with the range of community-based social support services
  5. working with mainstream community mental health and hospital services to enhance cultural capability through provision of cultural mentorship, advice and training placements for non-Indigenous staff
  6. working as part of multi-agency and multidisciplinary teams aimed at delivering shared care arrangements.

Building a culturally competent service system also requires a well-supported Aboriginal and Torres Strait Islander mental health workforce.

Aboriginal and Torres Strait Islander mental health workers require opportunities and support to attain advanced qualifications and recruitment and retention processes that maximise opportunities for Aboriginal and Torres Strait Islander peoples. Aboriginal and Torres Strait Islander organisations and workforces should be complemented by mainstream services and clinicians that are responsive to the needs of Aboriginal and Torres Strait Islander peoples.

From Page 30 Aboriginal and Torres Strait Islander peoples 

Download 84 page Plan PDF HERE

 Fifth National Mental Health and Suicide Prevention Plan

Health Minister Greg Hunt Press Release 14 October

Around four million Australians who experience a mental health condition will benefit from a strengthened mental health system under the Fifth National Mental Health and Suicide Prevention Plan.

The Plan, which was endorsed in August by all health ministers at Council of Australian Governments Health Council, has been released as Mental Health Week comes to a close

The Turnbull Government is committed to ensuring people with mental health challenges get the support and treatment they need and this Plan will see a more coordinated national approach to mental health from all governments and stakeholders.

More than 2,800 Australians take their lives each year and the Plan will provide an additional focus of suicide prevention.

Evidence-based approaches and strategies to prevent suicide will be implemented through a community-wide approach, including more effective follow-up support for people who have attempted to take their own lives.

The Turnbull Government recently committed $47 million for more frontline services for suicide prevention.

Last week as part of our over $4 billion annual investment in mental health we launched the Head to Health website, which is a one-stop shop for services and resources delivered by some of Australia’s most trusted mental health service providers.

NACCHO Aboriginal #MentalHealthDay : Australia’s new digital #mentalhealth gateway now live

NACCHO Aboriginal #MentalHealthDay 2/2 @KenWyattMP Minister Scullion : Download Building a Better Understanding of Aboriginal Social and Emotional Wellbeing and Mental Health

And yesterday the Turnbull Government announced a wide ranging package of reforms to make private health insurance simpler and more affordable for Australians, including better access for mental health services without a waiting period.

A particular focus of the Plan is addressing eating disorders. These can have a catastrophic impact on both individuals and their families. It will be a personal priority as we frame further policy in the future.

The Plan includes eight nationally agreed priority areas and 32 coordinated actions for the next five years with a view to achieving an integrated mental health system.

What will we do?

From Page 3o + Aboriginal and Torres Strait Islander peoples 

Action 10 Governments will work with PHNs and LHNs to implement integrated planning and service delivery for Aboriginal and Torres Strait Islander peoples at the regional level. This will include:

  1. engaging Aboriginal and Torres Strait Islander communities in the co-design of all aspects of regional planning and service delivery
  2. collaborating with service providers regionally to improve referral pathways between GPs, ACCHSs, social and emotional wellbeing services, alcohol and other drug services and mental health services, including improving opportunities for screening of mental and physical wellbeing at all points; connect culturally informed suicide prevention and postvention services locally and identify programs and services that support survivors of the Stolen Generation
  3. developing mechanisms and agreements that enable shared patient information, with informed consent, as a key enabler of care coordination and service integration
  4. clarifying roles and responsibilities across the health and community support service sectors
  5. ensuring that there is strong presence of Aboriginal and Torres Strait Islander leadership on local mental health service and related area service governance structures.

Action 11 Governments will establish an Aboriginal and Torres Strait Islander Mental Health and Suicide Prevention Subcommittee of MHDAPC, as identified in the Governance section of this Fifth Plan, that will set future directions for planning and investment and:

  1. provide advice to support the development of a nationally agreed approach to suicide prevention for Aboriginal and Torres Strait Islander peoples for inclusion in the National Suicide Prevention Implementation Strategy
  2. provide advice on models for co-located or flexible service arrangements that promote social and emotional wellbeing incorporating factors, including a person’s connection to country, spirituality, ancestry, kinship and community
  3. identify innovative strategies, such as the use of care navigators and single care plans, to improve service integration, support continuity of care across health service settings and connect Aboriginal and Torres Strait Islander peoples with community-based social support (non-health) services
  4. provide advice on suitable governance for services and the most appropriate distribution of roles and responsibilities, recognising that the right of Aboriginal and Torres Strait Islander communities to self-determination lies at the heart of community control in the provision of health services
  5. oversee the development, dissemination and promotion in community, hospital and custodial settings of a resource that articulates a model of culturally competent Aboriginal and Torres Strait Islander mental health care across the health care continuum and brings together (a) the holistic concept of social and emotional wellbeing and (b) mainstream notions of stepped care, trauma-informed care and recovery-oriented practice
  6. provide advice on workforce development initiatives that can grow and support an Aboriginal and Torres Strait Islander mental health workforce, incorporate Aboriginal and Torres Strait Islander staff into multidisciplinary teams and improve access to cultural healers
  7. provide advice on models of service delivery that embed cultural capability into all aspects of clinical care and implement the Cultural Respect Framework for Aboriginal and Torres Strait Islander Health 2016–2026 in mental health services
  8. provide advice on culturally appropriate digital service delivery and strategies to assist Aboriginal and Torres Strait Islander peoples to register for My Health Record and to understand the benefits of shared data.

Action 12 Governments will improve Aboriginal and Torres Strait Islander access to, and experience with, mental health and wellbeing services in collaboration with ACCHSs and other service providers by:

12.1. developing and distributing a compendium of resources that includes (a) best-practice examples of effective Aboriginal and Torres Strait Islander mental health care, (b) culturally safe and appropriate education materials and resources to support self-management of mental illness and enhance mental health literacy and (c) culturally appropriate clinical tools and resources to facilitate effective assessment and to improve service experiences and outcomes

12.2. increasing knowledge of social and emotional wellbeing concepts, improving the cultural competence and capability of mainstream providers and promoting the use of culturally appropriate assessment and care planning tools and guidelines

12.3. recognising and promoting the importance of Aboriginal and Torres Strait Islander leadership and supporting implementation of the Gayaa Dhuwi (Proud Spirit) Declaration (Appendix B)

12.4. training all staff delivering mental health services to Aboriginal and Torres Strait Islander peoples, particularly those in forensic settings, in trauma-informed care that incorporates historical, cultural and contemporary experiences of trauma.

Action 13 Governments will strengthen the evidence base needed to improve mental health services and outcomes for Aboriginal and Torres Strait Islander peoples through:

13.1. establishing a clearinghouse of resources, tools and program evaluations for all settings to support the development of culturally safe models of service delivery, including the use of cultural healing and trauma-informed care

13.2. ensuring that all mental health services work to improve the quality of identification of Indigenous peoples in their information systems through the use of appropriate standards and business processes

13.3. ensuring that future investments are properly evaluated to inform what works

13.4. reviewing existing datasets across all settings for improved data collection on the mental health and wellbeing of, and the prevalence of mental illness in, Aboriginal and Torres Strait Islander peoples

13.5. utilising available health services data and enhancing those collections to improve services for Aboriginal and Torres Strait Islander peoples.

How will we know things are different?

What will be different for Aboriginal and Torres Strait Islander consumers and carers?

  • Both your clinical and social and emotional wellbeing needs, and the needs of your community, will be addressed when care is planned and delivered.
  • Your care will be coordinated, and you will be supported to navigate the health system.
  • You will receive culturally appropriate care.
  • Services will actively follow up with you if you are at a higher risk of suicide, including after a suicide attempt.
  • If you are at risk of suicide, you will have timely access to support and be clear about which services in your area are responsible for providing you with care and support.

Press Release Continued

A key priority area is strengthening regional integration of mental health services to support more effective treatments for those in need.

In partnership with consumers and carers, Primary Health Networks and Local Hospital Networks will plan and design mental health services to meet specific local needs.

An implementation plan has been developed to guide and monitor implementation efforts of governments.

Improving the mental health system and outcomes for people with mental illness can only be done in partnership with the community, sector and all governments.

For people looking for mental health and suicide prevention support, I encourage them to visit the newly launched Head to Health website.

NACCHO Aboriginal #MentalHealthDay : Australia’s new digital #mentalhealth gateway now live

 ” Today we are launching our new digital mental health gateway – Head to Health.

Head to Health is an essential tool for the one in five working age Australians who will experience a mental illness each year.

The website helps people take control of their mental health in a way they are most comfortable with and can complement face-to-face therapies.

Evidence shows that for many people, digital interventions can be as effective as face-to-face services.

Head to Health provides a one-stop shop for services and resources delivered by some of Australia’s most trusted mental health service providers.

They include free or low-cost apps, online support communities, online courses and phone services.

Head to Health provides a place where people can access support and information before they reach crisis.

The Hon. Greg Hunt MP Minister for Health launching www.headtohealth.gov.au

See full press release from Minister Part 3 below

 ” For Aboriginal and Torres Strait Islander peoples, the strength of personal identity is often connected to culture, country and family.

Like all of us, however, you can have problems with everyday things like money, jobs and housing that can impact your social and emotional wellbeing. On top of that, you might have to deal with racism, discrimination, bullying, gender-phobia, and social inequality ”

READ MORE ON THIS TOPIC HERE

 ” Aboriginal and Torres Strait Islander health and wellbeing combines mental, physical, cultural, and spiritual health of not only the individual, but the whole community. For this reason, the term “social and emotional wellbeing” is generally preferred and better understood than terms like “mental health” and “mental illness”.

Addressing social and emotional wellbeing for Aboriginal and Torres Strait Islander peoples requires the recognition of human rights, the strength of family, and the recognition of cultural diversity – including language, kinship, traditional lifestyles, and geographical locations (urban, rural, and remote).”

READ MORE ON THIS TOPIC HERE  

Part 1 NACCHO BACKGROUND

Read over 160 NACCHO Aboriginal Mental Health Articles published over 5 yrs

Read over 115 NACCHO Suicide Prevention Articles published over 5 yrs Including

NACCHO Aboriginal Health : #ATSISPEP report and the hope of a new era in Indigenous suicide prevention

Our NACCHO CEO Pat Turner as a contributor to the report attended the launch pictured here with Senator Patrick Dodson and co-author Prof. Pat Dudgeon

After almost two years of work, ATSISPEP released a final report in Canberra on the 10th of November 2016.

Download the final #ATSISPEP report here

atispep-report-final-web-pdf-nov-10

Part 2 Mental Health Australia campaign

We need to see tackling stigma around mental health as a way to improve the health of the nation, improve our productivity, improve our community engagement, and improve our quality of life.”

“Yes we’ve come a long way to challenge and change perceptions, and paved the way for many to tell their story, but there is still great stigma associated with mental illness.”

“This year, my #mentalhealthpromise is to challenge Australia to look at mental health through a different light. Let’s look at the positives we can achieve as a community by reducing stigma and changing our approach to improving someone’s health.”

Mental Health Australia CEO Mr Frank Quinlan

Today World Mental Health Day – Tuesday 10 October – and Mental Health Australia is calling on the nation to further reduce stigma and promise to see mental health in a positive light.

‘Do you see what I see?’ challenges perceptions on mental illness aiming to reduce stigma.

‘Do you see what I see?’ promotes a positive approach to tackling an issue that affects one in five Australians.

‘Do you see what I see?’ aims to put a new light on the conversation… from dark to bright. Incorporating the successful #MentalHealthPromise initiative, which last year saw both the

Prime Minister and Opposition Leader make a mental health promise to the nation, ‘Do you see what I see?’ will also feature a series of photos from across Australia, shedding light and colour on an issue which is still cloaked in darkness.

“We’ve all seen it before… The stock black and white photo of someone sitting with their head in their hands signifying mental illness. That’s stigma… and stigma is still the number one barrier to people seeking help. Help that can prevent and treat,” said Mental Health Australia CEO Mr Frank Quinlan.

“We have to see things differently, and see the positive outcomes of tackling this issue if we are to see real benefits and reductions in the rate of mental illness affecting the nation.”

“We need to see mental health, and mental wealth through our own eyes, through the eyes of a family member or close friend and through the eyes of those in our community who don’t have that support around them.”

‘What will your #MentalHealthPromise be?

Making and sharing a mental health promise is easy and takes just a few minutes at www.1010.org.au

Part 3 The Hon. Greg Hunt MP Minister for Health press release Continued

Australia’s new digital mental health gateway now live

As part of our over $4 billion annual investment in mental health, the Turnbull Government is today launching our new digital mental health gateway – Head to Health.

Head to Health provides a place where people can access support and information before they reach crisis.

And it will continue to grow with additional services, a telephone support service to support website users, and further support for health professionals to meet the needs of their patients.

I encourage not only people seeking help and support, but anyone wanting to learn more on how to maintain good mental health wellbeing, to visit the website at: www.headtohealth.gov.au.

The Turnbull Government supports the need for a long term shift in mental health care towards early intervention, and the Head to Health gateway will help with this.

We have recently announced $43 million in funding for national suicide prevention leadership and support activity to organisations across Australia such as R U OK?, Suicide Prevention Australia and Mindframe.

This year we are investing $92.6 million in the headspace program to improve access for young people aged 12–25 years who have, or are at risk of, mental illness.

In addition, we have provided $52.6 million to beyondblue, which will partner with headspace and Early Childhood Australia to provide tools for teachers to support kids with mental health concerns and provide resources to help students deal with challenges.

Digital mental health services are an important part of national mental health reform and have been identified in the recently endorsed Fifth National Mental Health and Suicide Prevention Plan.

Building a digital mental health gateway was a key part of the Government’s response to the National Mental Health Commission’s Review of Mental Health Programs and Services.

 

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

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

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

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

Download the full 168 page report

National Drug Strategy Household Survey 2016

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

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

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

Indigenous Australians

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

Smoking

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

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

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

Read over 113 NACCHO Smoking articles published last 5 years

Alcohol

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

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

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

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

Illicit drugs

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

Read over 64 NACCHO Ice drug articles published last 5 years

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

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

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

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

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

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

Certain groups disproportionately experience drug-related risks

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

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

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

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

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

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

Source: Australian Institute of Health and Welfare

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Aboriginal #MentalHealth and #RUOKDay 14 Sept Advanced Speeches : The cause bringing Turnbull and Shorten together

 ” The truth is that mental health is enormously costly, in every respect.

It’s costly for individuals who suffer, its costly to their families but it’s especially costly when people take their own lives.

So we all have a vested interest in each others’ mental health. The most important thing we can do is to look out for each other.

Yes, governments and parliaments and health professionals spend money and trial new approaches and use digital technologies more effectively and we’re doing all these things and we’ll no doubt do much more in the future.

But you know, just four letters ‘R U OK?’ can make a difference. Because they represent another four letters, ‘L O V E’ – love. That’s what it’s about; showing that love and care for the people with whom you are with, whether they are your families, your friends or your workmates. Reach out to them, ask are you okay, show you care.

You could not just change a life, you could save a life.

Prime Minister Malcolm Turnbull addressing the RUOK Breakfast 12 September

Download his speech or read in full Part 2 Below PM Malcolm Turnbull RUOK

Read over 150 Aboriginal Mental Health articles published by NACCHO over 5 years

” We know that suicide is the scourge of rural and regional communities.

It takes a shocking toll on our people in the bush.

We know the suicide rate is twice as high amongst our First Australians, Pat Dodson has written movingly about those nights when his phone rings with the tragic news that another young person in the Kimberley has taken their life.

There is always time to start a conversation.

I think about all the people that I have known – and I am not sure I could have done anything then to change something.

But I wish that I knew then what I know now, and was able to ask these people: ‘Are you ok?’ “

Opposition Leader  Bill Shorten addressing the RUOK Breakfast 12 September

Download his speech or read in full Part 3 Below Bill Shorten RUOK

Part 1 The cause bringing Turnbull and Shorten together

From SBS Report

When Bill Shorten sat down to prepare some remarks for a parliamentary breakfast on suicide, he reflected on how many people he knew who had taken their own life.

He stopped at about seven.

“The thing about these people I thought about is that they remain forever young,” the opposition leader told an ‘R U Ok?’ gathering at Parliament House in Canberra on Tuesday.

Mr Shorten said he questioned what he could have done to help them or whether people didn’t see a sign.

He’s not alone. Seven people commit suicide on average every day in Australia.

“It is a silent crisis at the heart of our nation,” he said.

“These are preventable deaths.”

Mr Shorten reflected on veterans who feel let down by the nation they served and young people who feel like they don’t fit in.

The world of social media had created a form of emotional distance, a world of exotic holidays and glamorous events, he noted.

“The challenge is to look beyond the superficial snapshots of endless good times. To go further than simply clicking ‘like’.”

Mr Shorten believes MPs and senators are actually well placed to understand the message of the suicide prevention charity.

“In this very large building with thousands of people it can be a hard and isolating experience.”

“Suicide knows no boundaries, we are all in this together” Professor Gracelyn Smallwood in Townsville

Prime Minister Malcolm Turnbull said suicide prevention was about people but the high statistics demand everyone do much better.

He believes a reluctance to talk about mental health issues – whether because of stigma or taboo – has been a barrier.

“You can’t deal with a problem that you don’t acknowledge,” he said.

Mr Turnbull noted the work of the late Watson’s Bay resident Don Ritchie who invited anxious people at The Gap nearby in for a chat and a cuppa.

“He would gently lure them back from the brink by doing no more than showing that he cared for them,” he said.

“That is why ‘R U Ok?’ day is so important.”

Mr Shorten was glad the event brought the two leaders together.

“It’s a galling thing when you’re leader of the opposition and the prime minister yells slogans at you,” he said.

“But then occasionally sometimes he gives a speech like that and I think ‘you’re not too bad after all’.”

Both agreed the mutual feeling would be over by question time.

Readers seeking support and information about suicide prevention can contact Lifeline on 13 11 14.

Part 2 Prime Minister Malcolm Turnbull addressing the RUOK Breakfast 13 September

Well good morning. It’s great to be here with Andrew Wallace who is standing in for Julian Leeser, who together with Mike Kelly are Co-Chairs of the Friendship Group.

I acknowledge Greg Hunt, the Minister for Health and Sport, Bill Shorten, Julie Collins the Shadow Minister for Ageing and Mental Health, Murray Bleach, the Chairman Suicide Prevention Australia, Mike Connaghan – Chairman of RUOK? and Mike and I were reflecting on how many decades it is since we first met and worked together in advertising but there it is. You’re looking very youthful. That’s what happens if you don’t go into politics.

And of course Professor Batterham is our guest speaker this morning – and so many other leaders in health and in suicide prevention, and of course all my Parliamentary colleagues here as well.

Now we’re all united here behind Suicide Prevention Day and R U OK? Day. Suicide Prevention Day was on Sunday and R U OK? Day is later this week.

Each year, around one in every five Australians experience mental illness and in 2015, more than 3,000 took their own life.

Now, suicide is about people, it’s about families, not numbers. But the statistics confront us all and call on us to do much better.

I am firmly of the view that our reluctance to talk about mental health issues – whether you call it a stigma or a taboo – has been a very real barrier to addressing this issue. You can’t deal with a problem that you do not acknowledge.

So we have started to talk about suicide and mental health and in an open and honest way, as we have not done in the past.

Now my own electorate of Wentworth includes one of the most beautiful yet tragic places in Australia, The Gap. It is a place where many, many Australians take their lives. A part of The Gap story until he died in 2012 was an extraordinary man called Don Ritchie who was an old sailor and also very tall, I might add.

For the best part of half a century, he lived near The Gap and when he would go for walks and he saw somebody there – anxious, perhaps standing on the wrong side of the fence – he would talk to them.

He would say: “Are you OK? How are you going? Do you want to have a chat? Do you want to come in and have a cup of tea?” He would gently lure them back from the brink by doing no more than showing that he cared for them.

That is why ‘R U OK? Day?’ is so important. Because what it is all about, is showing that we do care. Four letters ‘R U O K’ import so much. They send a message of love, they send a message of care. Critically important and what could be more Australian than looking out for your mates? Or looking out for people you don’t even know? Looking out for somebody who seems anxious, worried, or someone at work that isn’t quite themselves. It is a caring and a loving question. And it raises very prominently this issue of awareness, to the forefront.

At Gap Park for example, as the local Member, I’ve pushed for more funding and support for suicide prevention. Since 2010 there has been implemented a ‘Gap Master Plan’ and I want to acknowledge the support that Julia Gillard provided as Prime Minister to support the local government, the Woollahra Council, towards that funding.

It was a series of measures of signs, telephones, obviously of cameras so that the police can keep an eye on what’s going on there and also a very innovative design in defences that are hard to get over, but easier to get back over, if you know what I mean.

So all of this makes a difference and since 2010 the local police tell me there has been a significant increase in the number of successful interventions at The Gap. But still, far, far too many people die there and in many other places around Australia.

Now, we’re working better to understand the factors that have contributed to rising suicide rates and to support communities to respond to their own unique circumstances.

We’re committed to reducing suicide rates through regional trials, research and building the evidence base with flexible models that address regional needs and work in our local communities.

This includes the implementation of 12 regional suicide prevention trial sites in Townsville, the Kimberley and Darwin and other places. Digital innovation trials and ten lead sites to trial different care models. All looking to see what actually works.

We’re also investing a great deal more in mental health and making services more effective, accessible and tailored to local needs.

Since 2016, we’ve invested an additional $367.5 million in mental health and suicide prevention support.

That includes a $194.5 million election package towards building a modern 21st century mental health system and our $173 million in new funding in the 2017‑18 Budget and $58.6 million to expand mental health and suicide prevention services for current and ex-serving ADF members and their families.

So we’re putting existing resources to work. But you know, the most important resource is you, is all of us. You know my very good friend and a good friend of all of yours, I know, Ian Hickie has got a great concept. He talks about the ‘mental wealth of nations’, sort of elaborating from Adam Smith.

The truth is that mental health is enormously costly, in every respect.

It’s costly for individuals who suffer, its costly to their families but it’s especially costly when people take their own lives.

So we all have a vested interest in each others’ mental health. The most important thing we can do is to look out for each other.

Yes, governments and parliaments and health professionals spend money and trial new approaches and use digital technologies more effectively and we’re doing all these things and we’ll no doubt do much more in the future.

But you know, just four letters ‘R U OK?’ can make a difference. Because they represent another four letters, ‘L O V E’ – love. That’s what it’s about; showing that love and care for the people with whom you are with, whether they are your families, your friends or your workmates. Reach out to them, ask are you okay, show you care. You could not just change a life, you could save a life.

Thank you very much.

Part 3 Opposition Leader  Bill Shorten addressing the RUOK Breakfast 13 September

Good morning everybody.

I’d like to acknowledge the traditional owners of this land, I pay my respect to their elders both past and present.

I’m actually going to spend a moment on what the Prime Minister said and thank him for his words.

It’s a galling thing when you’re Leader of the Opposition that the Prime Minister yells slogans at you one day, and you think oh why did he do that?

But then occasionally he gives a speech like that and I think, you’re not too bad after all.

It really was a good set of words.

Mind you, by Question Time that thought will be erased.

I’d like to thank Mike Kelly and Andrew Wallace filling in for Julian Leeser for bringing all of us here today.

We’ve got the Shadow Minister Julie Collins and we’ve got the Minister Greg Hunt.

Yesterday afternoon when I was preparing my words for this morning, I stopped to think about people I’d known who’d taken their own lives. And you start to construct that list.

I’m sure I’m not unique. I think most Australians find out after the event, someone they liked or loved has taken their own life.

As I got thinking about it, I could think of about seven people I knew. I actually stopped there. Because I knew the longer I thought, I could think of families with their kids and other people.

The thing about these people I thought about, is that they remain forever young.

You can still imagine them. You can remember not everything that you should, but you can remember some of their jokes perhaps, some of their ideas, some of their abilities.

I think about RUOK and I thought what could we have done then, what could I have done then?

And what has been done today to help this be prevented in the future.

I think about each of these people, and I went through the process of writing down their names just to start reconstructing.

Because you don’t always think about the people who have passed, you move on, the events move on.

And I think, was there some sign that they weren’t well? Was there some signal, some marker?

Is there something you could have done differently?

Some of the people I think of were teenagers, highly-talented. They seemed to be very successful at everything they did. But inside they were battling illness and great, great depression.

And when I thought about seven people I could think of I was reminded that seven Australians take their life on average every day, and possibly seven more will today. Every single day.

It is a silent crisis at the heart of our nation.

I’m sure all of you have sat with parents at their table when they’re numb with incomprehension, when they’re shattered by grief.

When they’re trying to write words to say farewell to their child or their adult child, taken too soon.

I still recall a school assembly where the school captain or someone very senior in the school said he died on a train, that’s what we were told. It was only years after that I found out that was the way the school dealt with the fact that he had taken his own life.

And you do think about what you could have done.

I think about veterans who are let down by the nation that they served.

Seven Australians – every day.

And what I wanted to say is that these are preventable deaths – we are not talking about a terminal condition, some dreadful metastasising cancer spread throughout a human body.

These deaths are preventable, there is nothing inevitable about suicide.

And we know that expert assistance can make the difference but it is in short supply.

Our emergency departments work very well. If you turn up with say chest pains, terrible chest pains I reckon nearly all of the time you’ll get the right diagnosis and the care is there.

When I was talking to Professor Pat McGorry who is here today, you know and he worries that you can turn up to an emergency department and you’ve got a very serious case of potential self-harm, or as a suicide risk.

Do we have the resources there to the same proportion as a medical condition, another medical condition? I don’t think we do.

And I know every Member of Parliament here regardless of their political affiliation will have constituents who come to them desperate, red-eyed saying I’ve got a child, an adult child who really needs that sub-acute care. And the search for the beds that aren’t there.

We know that suicide is the scourge of rural and regional communities.

It takes a shocking toll on our people in the bush.

We know the suicide rate is twice as high amongst our First Australians, Pat Dodson has written movingly about those nights when his phone rings with the tragic news that another young person in the Kimberley has taken their life.

We know, as Mike Kelly alluded to, that suicide is more common and more frequently attempted by young LGBTI Australians grappling with their sexuality, fearing rejection.

Completely alienated and unsure of where they fit in.

And we all do have a responsibility to call-out that hateful discrimination and language, particularly in the weeks ahead.

The simple truth is no part of our nation has a wall tall enough to keep the scourge of suicide from that postcode. Suicide is no respecter of ethnicity, of income.

It does not care which god you pray to, or who you love, it affects every Australian and therefore it is within the power of every Australian to do something about it.

We live in a world where it has been easier than ever to see what our friends and our family are up to.

I remember when I was a backpacker 25 years ago, I could be back home before any of the postcards which I had sent to Mum and Dad.

These days you feel like you’re on everybody else’s holiday half the time, as soon as you turn on the computer.

Australians aged between 15 and 24 spend an average of around 18 hours a week online.

And while social media has a tremendous ability to bring us closer together, Instagram,

Facebook and Snapchat also create emotional distance. A carefully-curated view of each other’s lives: exotic holidays, glamorous events, fun nights out, fancy meals.

We have now got a situation where before teenagers will eat the food, they will photograph it.

But the challenge for us is to look beyond the superficial snapshots of endless good times, to go further than simply clicking ‘like’ and scrolling on down the feed.

It’s about digging a bit deeper.

And in conclusion, that’s why we are here.

It’s time to make that call, to send a message, to drop-in for a visit – to really see how someone is going.

I actually think Parliamentarians are well placed to understand RUOK Day.

We’ve all seen our own challenges with mental health, I think previously in this parliament.

In this very large building with thousands of people, it can be hard and isolating experience.

It is important that RUOK day occurs because it is a reminder that we need to distinguish and not let the urgent distract us from the important.

There is always time to

  • Ask
  • Listen
  • Encourage action
  • And check-in

There is always time to start a conversation.

I think about all the people that I have known – and I am not sure I could have done anything then to change something.

But I wish that I knew then what I know now, and was able to ask these people: ‘Are you ok?’

NACCHO Aboriginal Health and @MHPNOnline free webinar : Reducing the mental health impact of Indigenous incarceration

NACCHO Member Alert speaker update August 30

 ” Our CEO Pat Turner and NACCHO staff would like to invite all health workers to be a part of this free webinar: Reducing the mental health impact of Indigenous incarceration on people, communities and services.
 
Developed by NACCHO and produced by Mental Health Professionals’ Network (MHPN) the webinar features Q&A with a panel of experts and will explore the key issues and the impact that incarceration has on individuals, families and communities.”

Download FLYER HERE and share /promote this free webinar

No need to travel to benefit from this free PD opportunity.
Simply register and log in to participate from your home, work or anywhere you have a computer or tablet with a high speed internet connection.
 
Register now to attend this free webinar for health practitioners on
Wednesday 13 September 2017, from 4:30pm – 5:45pm AEST.
 
NACCHO also invites all Member services to ask staff to register now to access a free Mental Health Professionals’ Network webinar for their own professional development.
 
The Indigenous interdisciplinary panel will explore and discuss ways of reducing the mental health impact of Indigenous incarceration on people, communities and services.
 
This professional development opportunity is free and the previous webinar conducted by the MHPN had 680 participants across Australia.
 
The webinar features a Q&A with a panel of experts and will explore the key issues and the impact that incarceration has on Aboriginal and Torres Strait Islander peoples.
The panel will discuss strategies to enhance cultural awareness and develop responsive services for Indigenous communities affected by incarceration.

WHO’S ON THE PANEL?
 
Julie Tongs OAM : CEO Winnunga Nimmityjah Aboriginal Health Service ACT
Dr Louis Peachy : QLD-based rural medical advisor
Dr Marshall Watson : SA-based psychiatrist
Dr Jeff Nelson : QLD-based psychologist
 
Facilitator: Dr Mary Emeleus (QLD-based general practitioner and psychotherapist).
 
Simply register and log in to participate from your home, work or anywhere you have a computer or tablet with a high speed internet connection.
Registrations close at midnight on Tuesday 12th September, 2017.
 
Please find attached a flyer about the updated webinar and it would be appreciate if you could distribute this to your local network.
 
 

NACCHO @TheAHCWA Aboriginal Health and the Cashless Welfare card debate

 

 ” Graphic video footage played recently to Prime Minister Malcolm Turnbull and other influential politicians cuts to the core. It is horrific, sickening and gut-wrenching, and would affect any compassionate human being.

But the intent behind the carefully edited emotive video – further pushing a ( Cashless Welfare ) card to supposedly tackle every imaginable social problem in vulnerable communities – is ill-conceived and ideologically driven.

Michelle Nelson-Cox Chair  : Aboriginal Health Council of Western Australia press release Opinion piece (part 2 Below )

 

 ” We need to recognise that the best way of dealing with problems is with respect, working together, and focussed on commonly agreed goals. We do not need a new generation of community members under the control of those who want to use punitive measures to coerce and control them. When has this approach ever been shown to work?

We need to ask why we are not doing it differently, treating the very causes of the dislocation and alienation of our communities — facing up to and turning around the hopelessness and despair that beleaguers them.

The Rural Doctors have made it clear when they said: “Those that do have problems will not be helped by measures that feel punitive, such as switching them to a cashless debit card, rather than payments. Tough love is rarely successful in treating substance abuse – particularly when it’s from the Government.”

I support the Rural Doctors and our community organisations working with families dealing with these issues. This is where we have to take this debate.”

Shadow assistant minister for Indigenous affairs and Aboriginal and Torres Strait Islanders Senator for Western Australia, Patrick Dodson responds to article portraying the state as a ‘war zone’ .Full article HERE

” Senator Rachel Siewert has criticised a new video campaign showing graphic depictions of violence in Indigenous communities as shock tactics designed to scare the Federal Government into rolling out more cashless welfare cards in remote Western Australia.

Using violent imagery then offering a one-dimensional, paternalistic and previously failed approach to a complex problem shows that Andrew Forrest is more concerned about furthering his ideologies than looking at what works.

“I share concerns about disadvantage and agree we need to be addressing severe disadvantage in communities like Port Hedland. We need a multifaceted approach including addressing alcohol supply, drug and alcohol services, and wrap around services driven by the community.

“I agree we do need to be investing in communities but in approaches that work ‘ Senator Rachel Siewert

Read Senator Rachel Siewert full press release part 4 below

Mining magnate Andrew Forrest and local leaders from the East Kimberley region, last week launched #timetoact an online anti-violence campaign in the nation’s capital. It features a video that shows disturbing scene of violence.”

Watch video HERE

” The concerted push by outgoing WA Police Commissioner Karl O’Callaghan that the cashless welfare system should be expanded to somehow protect children from sexual abuse, particularly in the north-west town of Roebourne, is fundamentally flawed.

There has been no conclusive evidence to date that cashless welfare cards play any role in reducing the impact of issues such as illicit drug use or child sexual abuse.

Instead, greater investment is needed in programs that address social determinants and build strong families and communities.

Ultimately, we need to see an increase in community programs and comprehensive support services to help address these complex social issues in Aboriginal communities.

AHCWA does not support simplistic apparent solutions imposed from outside Aboriginal communities. Rather, it advocates for greater investment in community designed and driven programs to build strong families and communities.

Our sector has been delivering positive outcomes in Aboriginal health for more than 40 years, but in that time we have often dealt with the unintended negative consequences of whatever “silver bullet” solution is politically fashionable at the time.

Extracts from Michelle Nelson-Cox Chair  : Aboriginal Health Council of Western Australia press release (part 1and 2 below)

 

Elder Ted Carlton with a card

Part 1 : AHCWA rejects Karl O’Callaghan’s call to expand cashless welfare

The Aboriginal Health Council of Western Australia has challenged outgoing Police Commissioner Karl O’Callaghan to look in his own backyard and adequately police remote communities rather than advocate for greater disempowerment of indigenous Australians.

AHCWA chairperson Michelle Nelson-Cox today rejected calls by Mr O’Callaghan, whose contract ends on August 15 after 13 years at the helm of WA Police, for an urgent expansion of the cashless welfare system to combat child sex crimes in regional WA.

“The cashless welfare card is not a panacea to complex social problems,” Ms Nelson-Cox said.

“While AHCWA supports the government’s commitment to improve the health outcomes of Aboriginal people and prevent child sexual abuse, we do not support the ill-conceived idea that cashless welfare cards can turn the tide on the abhorrent abuse of children.

“There has been no conclusive evidence to date that cashless welfare cards play any role in reducing the impact of issues such as illicit drug use or child sexual abuse.

“Instead, greater investment is needed in programs that address social determinants and build strong families and communities.

“Ultimately, we need to see an increase in community programs and comprehensive support services to help address these complex social issues in Aboriginal communities.”

Ms Nelson-Cox said Mr O’Callaghan’s admissions in The West Australian newspaper that his officers could not protect children in remote communities was gravely concerning.

“At what point does the buck stop with police and governments to keep communities safe? Over the past 13 years, how have the high instances of sexual abuse not have been addressed earlier?” she said.

“There is a large police presence in Roebourne, and admissions by Karl O’Callaghan that ‘police were not capable of protecting children in those communities’ and ‘neither the police nor government can guarantee protection of these children’ shows a lack of commitment to work with communities to effectively address these issues.

“The reality is there are a huge number of people very unhappy with the way they have been affected by the cashless welfare system imposed by the Federal Government.

“If anything, this is a failure of policing in the Roebourne area to address these crimes.

“The cashless welfare card does not need to be expanded. The solution does not lie in the disempowerment of Aboriginal people, but rather additional police resources and a greater commitment to stamp out these shocking and abhorrent crimes.”

AHCWA is the peak body for Aboriginal health in WA, with 22 Aboriginal Community Controlled Health Services (ACCHS) currently engaged as members.

Part 2 : AHCWA rejects Karl O’Callaghan’s call to expand cashless welfare

 

Graphic video footage played recentlt to Prime Minister Malcolm Turnbull and other influential politicians cuts to the core. It is horrific, sickening and gut-wrenching, and would affect any compassionate human being.

But the intent behind the carefully edited emotive video – further pushing a card to supposedly tackle every imaginable social problem in vulnerable communities – is ill-conceived and ideologically driven.

The concerted push by outgoing WA Police Commissioner Karl O’Callaghan that the cashless welfare system should be expanded to somehow protect children from sexual abuse, particularly in the north-west town of Roebourne, is fundamentally flawed.

The belief that the cashless welfare card can prevent child sexual abuse is based on nothing more than a distorted perception that quarantining income will address all social problems in remote Aboriginal communities.

To date, there has been no conclusive evidence that cashless welfare cards play any role in reducing the impact of issues such as illicit drug use or sexual abuse.

In fact, the most comprehensive review of income management in the Northern Territory has proven that this strategy will not work and will likely only create further dependence.

WA communities like Roebourne do not need the next new idea imposed by white people who live elsewhere.

Instead, they need to work with Aboriginal people and support under resourced local initiatives already being worked on.

The Aboriginal Health Council of Western Australia (AHCWA) is the peak body for Aboriginal health in WA, with 22 Aboriginal Community Controlled Health Services (ACCHSs) currently engaged as members.

AHCWA does not support simplistic apparent solutions imposed from outside Aboriginal communities. Rather, it advocates for greater investment in community designed and driven programs to build strong families and communities.

Our sector has been delivering positive outcomes in Aboriginal health for more than 40 years, but in that time we have often dealt with the unintended negative consequences of whatever “silver bullet” solution is politically fashionable at the time. These days, the cashless welfare card is seen as the quick fix.

The cashless welfare card has been delivered as part of a Cashless Debit Card Trial (CDCT), a program developed to reduce the harm associated with alcohol consumption, illicit drug use and gambling in Ceduna in South Australia and the East Kimberley in WA (Kununurra and Wyndham).

The trial began in early 2016, when participants were issued a debit card which could not be used to buy alcohol, gambling products or to withdraw cash.

The system quarantines 80 per cent of income support payments into a restricted account linked to the card, with the remainder of these payments accessible through a normal, unrestricted bank account.

Remarkably, and perhaps unsurprisingly, an evaluation of the current trial showed that the majority of people using the card, and their families, did not report gambling, using illicit drugs, or consuming alcohol in excess.

To put it simply, this trial has been socially disempowering for a huge number of community members. Strong resistance and opposition has been made clear at public meetings, strikes and petitions.

Admissions by Karl O’Callaghan in the video shown to the PM that “police can’t save them” shows a lack of commitment to work with communities to effectively address these issues.

If anything, his comments reflect a failure of policing in the Roebourne area to address these crimes and protect the town’s most vulnerable people.

We support any commitment to improve the safety and health of Aboriginal people, particularly children, in WA and turn the tide on the appalling abuse of our youngsters, but the answer is not an expansion of the cashless welfare card.

The solution does not lie in the disempowerment of Aboriginal people, which has been an ongoing tactic by governments. Instead it lies in additional police resources and a genuine commitment to work with communities to stamp out these shocking and abhorrent crimes.

We agree it is time to act – it is time for the police to act.

“Using violent imagery then offering a one-dimensional, paternalistic and previously failed approach to a complex problem shows that Andrew Forrest is more concerned about furthering his ideologies than looking at what works,” Senator Siewert said today.

“I share concerns about disadvantage and agree we need to be addressing severe disadvantage in communities like Port Hedland. We need a multifaceted approach including addressing alcohol supply, drug and alcohol services, and wrap around services driven by the community.”

Part 3  :  Graphic video campaign pushing for welfare card slammed as ‘one dimensional’  

Continued from opening                                

Mr Forrest was joined yesterday by Jean O’Reerie, Aboriginal Education Worker from Wyndham in East Kimberley- a Cashless Debit Card trial site, her colleague, local Bianca Crake, and the Mayor of Port Hedland, Mr Camillo Blanko.

Mr Forrest claims that the government’s current system to stop drug and alcohol fuelled violence against children in the Pilbara and East Kimberley region isn’t working.

Linking what he described as horrific child abuse to alcohol and drug use, Mr Forrest is pushing for the Cashless Welfare Card to be introduced into more West Australian communities.

“Elders of communities, mayors of major towns are standing up and saying enough is enough. We need the system to change. What we have had is not enough. It’s delivering our children into hell and they have to be protected,” he told a media conference yesterday.

Mr Forrest yesterday brough elders and civic leaders, from Western Australia and South Australia, to meet personally with the Prime Minister Malcolm Turnbull, the leader of the opposition Bill Shorten and his deputy leader Tanya Plibersek.

Figures from the West Australian Police Commissioner Karl O’Callaghan’s department claimed that one in three children are being abused, in a town of 500 children – 158 were sexually assaulted, 36 men face 300 charges of child abuse and in another town six children committed suicide in six months. It was not specified whether the children affected were Indigenous or Non- Indigenous.

Jean O’Reerie an Aboriginal Education Worker from Wyndham in the East Kimberley was emotional as she described the situation in her community.

“We need help, we need the government to intervene and help us out as community leaders. We can’t do it on our own. We need change for our community, our kids are hurting,” she said.

“We, the grassroots people, live with it every day. The hurt, the suffering, and the abuse.”

Part 4 : Trying to scare people into supporting the cashless card a worrying ramp up of Andrew Forrest’s campaign: Senator Rachel Siewert

Andrew Forrest is trying to use similar shock tactics to those of the previous Howard Government to scare people into supporting the cashless welfare card, Australian Greens Senator Rachel Siewert said last week

“We are seeing a worrying ramp up of Andrew Forrest’s cashless welfare card campaign that uses children, violence and fear just like the Howard Government did in 2007 over the NT Intervention.

“The Howard Government did this to justify the Northern Territory Intervention to impose income management and the Basics Card, at the time the Little Children are Sacred report was used to scare people into supporting income management.

“The final evaluation of the NT Intervention shows that it met none of its objectives. Ten years on we are still seeing the number of children going into out of home care increasing and appalling disadvantage persists.

Using violent imagery then offering a one-dimensional, paternalistic and previously failed approach to a complex problem shows that Andrew Forrest is more concerned about furthering his ideologies than looking at what works.

“I share concerns about disadvantage and agree we need to be addressing severe disadvantage in communities like Port Hedland. We need a multifaceted approach including addressing alcohol supply, drug and alcohol services, and wrap around services driven by the community.

“I agree we do need to be investing in communities but in approaches that work. The Government invested over $1.2 billion in the NT Intervention which met none of its objectives. We should stop wasting money on income management style approaches and start looking at real solutions that work”.

 

NACCHO NEWS ALERT: COAG Health Ministers Council Communique acknowledge the importance #ACCHO’s advancing Aboriginal health

 

  Included in this NACCHO Aboriginal Health News Alert

  1. All issues 11 included in  Communique highlighting ACCHO health
  2. Health Ministers approve Australia’s National Digital Health Strategy
  3. Transcript Health Minister Hunt Press Conference

” The Federal Minister for Indigenous Health, Ken Wyatt, attended the COAG Health Council discussed the Commonwealth’s current work on Indigenous health priorities.

In particular this included the development of the 2018 iteration of the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023 that will incorporate strategies and actions to address the social determinants and cultural determinants of health.

Ministers also considered progress on other key Indigenous health issues including building workforce capability, cultural safety and environmental health, where jurisdictions can work together more closely with the Commonwealth to improve outcomes for Aboriginal and Torres Strait Islander peoples.

Ministers acknowledged the importance of collaboration and the need to coordinate activities across governments to support a culturally safe and comprehensive health system.

Ministers also acknowledge the importance of community controlled organisations in advancing Aboriginal and Torres Strait Islander health. ”

1.Development of the next iteration of the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023 COAG Health Council 

Read over 50 NACCHO NATSIHP Articles published over past 50 years

INTRODUCTION

The federal, state and territory Health Ministers met in Brisbane on August 4 at the COAG Health Council to discuss a range of national health issues.

The meeting was chaired by the Victorian Minister for Health, the Hon Jill Hennessy MP.

Health Ministers welcomed the New South Wales Minister for Mental Health, the Hon Tanya Davies MP, the Victorian Minister for Mental Health, the Hon Martin Foley MP, the ACT Minister for Mental Health Mr Shane Rattenbury and the Minister for Aged Care and Minister for Indigenous Health, the Hon Ken Wyatt AM, MP who participated in a joint discussion with Health Ministers about mental health issues.

Major items discussed by Health Ministers today included:

2.Andrew Forrest and the Eliminate Cancer Initiative

Mr Andrew Forrest joined the meeting to address Health Ministers in his capacity as Chairman of the Minderoo Foundation to discuss the Eliminate Cancer Initiative. The Minderoo Foundation is one of Autralia’s largest and most active philanthropic groups. It has established the Eliminate Cancer Initiatve (the Initiative), a global initiative dedicated to making cancer non-lethal with some of the world’s leading global medicine and anti-cancer leaders.

The Initiative is a united effort to convert cancer into a non-lethal disease through global collaboration of scientific, medical and academic institutes, commercially sustained through the support of the philanthropic, business and government sectors worldwide.

Australia has a critical role to play in this highly ambitious and thoroughly worthwhile goal.

3.Family violence and primary care

Today, Health Ministers discussed the significant health impacts on those people experiencing family violence.

Health Ministers acknowledged that health-care providers, particularly those in a primary care setting, are in a unique position to create a safe and confidential environment to enable the disclosure of violence, while offering appropriate support and referrals to other practitioners and services.

Recognising the importance of national leadership in this area, Ministers agreed to develop a plan to address barriers to primary care practitioners identifying and responding to patients experiencing family violence.

Ministers also agreed to work with the Royal Australian College of General Practitioners to develop and implement a national training package.

Further advice will be sought from Primary Health Networks on existing family violence services, including Commonwealth, State and NGO service providers in their regions, with a view to developing an improved whole-of-system responses to the complex needs of clients who disclose family violence

4.Fifth National Mental Health and Suicide Prevention Plan

Health Ministers endorsed the Fifth National Mental Health and Suicide Prevention Plan 2017-2022 and its Implementation Plan.

The Fifth Plan is focused on improvements across eight targeted priority areas:

1. Achieving integrated regional planning and service delivery

2. Effective suicide prevention

3. Coordinated treatment and supports for people with severe and complex mental illness

4. Improving Aboriginal and Torres Strait Islander mental health and suicide prevention

5. Improving the physical health of people living with mental illness and reducing early mortality

6. Reducing stigma and discrimination

7. Making safety and quality central to mental health service delivery

8. Ensuring that the enablers of effective system performance and system improvement are in place

The Fifth Plan also responds to calls for a national approach to address suicide prevention and will be used to guide other sectors and to support health agencies to interact with other portfolios to drive action in this priority area.

Ongoing collaboration and engagement across the sector and with consumers and carers is required to successfully implement the Fifth Plan and achieve meaningful reform to improve the lives of people living with mental illness including the needs of children and young people.

Health Ministers also agreed that mental health workforce issues would be considered by the Australian Health Ministers’ Advisory Council.

5.The National Psychosocial Supports Program

Health Ministers agreed to establish a time-limited working group to progress the Commonwealth’s National Psychosocial Supports program. This will have the objective of developing bilateral agreements to support access to essential psychosocial supports for persons with severe mental illness resulting in psychosocial disability who are not eligible for the NDIS.

Those bilateral agreements will take into account existing funding being allocated for this purpose by states and territories.

6.Strengthened penalties and prohibition orders under the Health Practitioner Regulation National Law

Health Ministers agreed to proceed with amendments to the Health Practitioner Regulation National Law (the National Law) to strengthen penalties for offences committed by people who hold themselves out to be a registered health practitioner, including those who use reserved professional titles or carry out restricted practices when not registered.

Ministers also agreed to proceed with an amendment to introduce a custodial sentence with a maximum term of up to three years for these offences.

These important reforms will be fast tracked to strengthen public protection under the National Law. Preparation will now commence on a draft amendment bill to be brought forward to Ministers for approval, with a view to this being introduced to the Queensland Parliament in 2018. The Western Australian Parliament is also expected to consider legislative changes to the Western Australian National Law.

7.Amendment to mandatory reporting provisions for treating health practitioner

Health Ministers agree that protecting the public from harm is of paramount importance as is supporting practitioners to seek health and in particular mental health treatment as soon as possible.

Health Ministers agreed that doctors should be able to seek treatment for health issues with confidentiality whilst also preserving the requirement for patient safety.

A nationally consistent approach to mandatory reporting provisions will provide confidence to health practitioners that they can feel able to seek treatment for their own health conditions anywhere in Australia.

Agree for AHMAC to recommend a nationally consistent approach to mandatory reporting, following discussion paper and consultation with consumer and practitioner groups, with a proposal to be considered by COAG Health Council at their November 2017 meeting, to allow the amendment to be progressed as part of Tranche 1A package of amendments and related guidelines.

8.National Digital Health Strategy and Australian Digital Health Agency Forward Work Plan 2018–2022

Health Ministers approved the National Digital Health Strategy and the Australian Digital Health Agency Work Plan for 2018-2022.

Download Strategy and work plan here  

The Strategy has identified the priority areas that form the basis of Australia’s vision for digital health.

This Strategy will build on Australia’s existing leadership in digital health care and support consumers and clinicians to put the consumer at the centre of their health care and provide choice, control and transparency.

Expanding the public reporting of patient safety and quality measures

Health Ministers supported Queensland and other interested jurisdictions to collaboratively identify options in relation to aligning patient safety and quality reporting standards across public and private hospitals nationally.

Ministers agreed that the Australian Commission on Safety and Quality in Health Care (ACSQHC) would undertake work with other interested jurisdictions to identify options in relation to aligning public reporting standards of quality healthcare and patient safety across public and private hospitals nationally.

The work be incorporated into the national work being progressed on Australia’s health system performance information and reporting frameworks.

 

9.National human biomonitoring program

Health Ministers noted that human biomonitoring data can play a key role in identifying chemicals which potentially cause adverse health effects and action that may need to be taken to protect public health.

Health Ministers agreed that a National Human Biomonitoring Program could be beneficial in assisting with the understanding of chemical exposures in the Australian population.

Accordingly, Ministers agreed that the Australian Health Ministers’ Advisory Council will explore this matter in more detail by undertaking a feasibility assessment of a National Human Biomonitoring Program.

Clarification of roles, responsibilities and relationships for national bodies established under the National Health Reform Agreement

States and territories expressed significant concern that the proposed Direction to IHPA will result in the Commonwealth retrospectively not funding activity that has been already delivered by states and territories but not yet funded by the Commonwealth.

States and territories were concerned that this could reduce services to patients going forward as anticipated funding from the Commonwealth will be less than currently expected.

The Commonwealth does not agree with the concerns of the states and territories and will seek independent advice from the Independent Hospital Pricing Authority (IHPA) to ensure hospital service activity for 2015-2016 has been calculated correctly. The Commonwealth committed to work constructively and cooperatively with all jurisdictions to better understand the drivers of increased hospital services in funding agreements.

10.Legitimate and unavoidable costs of providing public hospital services in Western Australia

Health Ministers discussed a paper by Western Australia on legitimate and unavoidable costs of providing public hospital services in Western Australia, particularly in regional and remote areas, and recognised that those matters create a cumulative disadvantage to that state. Health Ministers acknowledged that Western Australia will continue to work with the Commonwealth Government and the Independent Hospital Pricing Authority to resolve those matters.

11.Vaccination

Health Ministers unanimously confirmed the importance of vaccination and rejected campaigns against vaccination.

All Health Ministers expressed their acknowledgement of the outgoing Chair, the Hon Ms Jill Hennessy and welcomed the incoming Chair Ms Meegan Fitzharris MLA from the Australian Capital Territory.

Health Ministers approve Australia’s National Digital Health Strategy

Digital information is the bedrock of high quality healthcare.

The benefits for patients are signicant and compelling: hospital admissions avoided, fewer adverse drug events, reduced duplication of tests, better coordination of care for people with chronic and complex conditions, and better informed treatment decisions. Digital health can help save and improve lives.

To support the uptake of digital health services, the Council of Australian Governments (COAG) Health Council today approved Australia’s National Digital Health Strategy (2018-2022).

Download Strategy and work plan here  

In a communique issued after their council meeting in Brisbane August 4 , the Health Ministers noted:

“The Strategy has identified the priority areas that form the basis of Australia’s vision for digital health. It will build on Australia’s existing leadership in digital health care and support consumers and clinicians to put the consumer at the centre of their health care and provide choice, control, and transparency.”

Australian Digital Health Agency (ADHA) CEO Tim Kelsey welcomed COAG approval for the new Strategy.

“Australians are right to be proud of their health services – they are among the best, most accessible, and efficient in the world.

Today we face new health challenges and rapidly rising demand for services. It is imperative that we work together to harness the power of technology and foster innovation to support high quality, sustainable health and care for all, today and into the future,” he said.

The Strategy – Safe, seamless, and secure: evolving health and care to meet the needs of modern Australia – identifies seven key priorities for digital health in Australia including delivery of a My Health Record for every Australian by 2018 – unless they choose not to have one.

More than 5 million Australians already have a My Health Record, which provides potentially lifesaving access to clinical reports of medications, allergies, laboratory tests, and chronic conditions. Patients and consumers can access their My Health Record at any time online or on their mobile phone.

The Strategy will also enable paper-free secure messaging for all clinicians and will set new standards to allow real-time sharing of patient information between hospitals and other care professionals.

Australian Medical Association (AMA) President Dr Michael Gannon has welcomed the Strategy’s focus on safe and secure exchange of clinical information, as it will empower doctors to deliver improved patient care.

“Doctors need access to secure digital records. Having to wade through paperwork and chase individuals and organisations for information is

archaic. The AMA has worked closely with the ADHA on the development of the new strategy and looks forward to close collaboration on its implementation,” Dr Gannon said.

Royal Australian College of General Practitioners (RACGP) President Dr Bastian Seidel said that the RACGP is working closely and collaboratively with the ADHA and other stakeholders to ensure that patients, GPs, and other health professionals have access to the best possible data.

“The Strategy will help facilitate the sharing of high-quality commonly understood information which can be used with confidence by GPs and other health professionals. It will also help ensure this patient information remains confidential and secure and is available whenever and wherever it is needed,” Dr Seidel said.

Pharmacy Guild of Australia National President George Tambassis said that technology would increasingly play an important role in supporting sustainable healthcare delivery.

“The Guild is committed to helping build the digital health capabilities of community pharmacies and advance the efficiency, quality, and delivery of healthcare to improve health outcomes for all Australians.

“We are working with the ADHA to ensure that community pharmacy dispensing and medicine-related services are fully integrated into the My Health Record – and are committed to supporting implementation of the National Digital Health Strategy as a whole,” George Tambassis said.

Pharmaceutical Society of Australia (PSA) President Dr Shane Jackson said that the Strategy would support more effective medicationmanagement, which would improve outcomes for patients and improve the efficiency of health services.

“There is significant potential for pharmacists to use digital health records as a tool to communicate with other health professionals, particularly during transitions of care,” Dr Jackson said.

The Strategy will prioritise development of new digital services to support newborn children, the elderly, and people living with chronic disease. It will also support wider use of telehealth to improve access to services, especially in remote and rural Australia and set standards for better information sharing in medical emergencies – between the ambulance, the hospital, and the GP.

Consumers Health Forum (CHF) Leanne Wells CEO said that the Strategy recognises the importance of empowering Australians to be makers and shapers of the health system rather than just the users and choosers.

“We know that when consumers are activated and supported to better self-manage and coordinate their health and care, we get better patient experience, quality care, and better health outcomes.

“Digital health developments, including My Health Record, are ways in which we can support that to happen. It’s why patients should also be encouraged to take greater control of their health information,” Leanne Wells said.

Medical Software Industry Association (MSIA) President Emma Hossack said that the Strategy distils seven key themes that set expectations at a national level.“The strategy recognises the vital role industry plays in providing the smarts and innovation on top of government infrastructure.

This means improved outcomes, research, and productivity. Industry is excited to work with the ADHA to develop the detailed actions to achieve the vision which could lead to Australia benefitting from one of the strongest health software industries in the world,” Emma Hossack said.

Health Informatics Society of Australia (HISA) CEO Dr Louise Schaper welcomed the Strategy’s focus on workforce development.

“If our complex health system is to realise the benefits from information and technology, and become more sustainable, we need clinical leaders with a sound understanding of digital health,” Dr Schaper said.

The Strategy was developed by all the governments of Australia in close partnership with patients, carers and the clinical professionals who serve them – together with leaders in industry and science.

The Strategy draws on evidence of clinical and economic benefit from many sources within Australia and overseas, and emphasises the priority of patient confidentiality as new digital services are implemented.

The ADHA has established a Cyber Security Centre to ensure Australian healthcare is at the cutting edge of international data security.

The ADHA, which has responsibility for co-ordinating implementation of the Strategy, will now be consulting with partners across the community to develop a Framework for Action. The framework will be published later this year and will detail implementation plans for the Strategy.

The National Digital Health Strategy Safe, seamless and secure: evolving health and care to meet the needs of modern Australia is available on

https://www.digitalhealth.gov.au/australias-national-digital-health-strategy (https://www.digitalhealth.gov.au/australias-national-digital-health-strategy)

Greg Hunt Press Conference

Topics: COAG Health Council outcomes; The Fifth National Mental Health and Suicide Prevention Plan; support for doctors and nurses mental health; hospital funding; same-sex marriage

GREG HUNT:
Today was a huge breakthrough in terms of mental health. The Fifth National Mental Health Plan was approved by the states.

What this is about is enormous progress on suicide prevention. It has actually become the Fifth National Mental Health and Suicide Prevention Plan, so a real focus on suicide prevention.

In particular, the focus on what happens when people are discharged from hospital, the group in Australia that are most likely to take their own lives.

We actually know not just the group, but the very individuals who are most at risk. That’s an enormous step.

The second thing here is, as part of that plan, a focus on eating disorders, and it is a still-hidden issue. In 2017, the hidden issue of eating disorders, of anorexia and bulimia, and the prevalence and the danger of it is still dramatically understated in Australia.

The reality is that this is a silent killer and particularly women can be caught up for years and years, and so there’s a mutual determination, a universal determination to progress on eating disorders, and that will now be a central part of the Fifth National Mental Health and Suicide Prevention Plan.

And also, as part of that, we’ve included, at the Commonwealth’s request today, a real focus on early intervention services for young people under 16. Pat McGorry has referred to it as CATs for Kids, meaning Crisis Assessment Teams, and the opportunity.

And this is a really important step because, for many families, when they have a crisis, there’s nowhere to turn. This is a way through. So those are all enormous steps forward.

The other mental health area where we’ve made big, big progress is on allowing doctors to seek routine mental health treatment.

There’s an agreement by all of the states and territories to work with the Commonwealth on giving doctors a pathway so as they can seek routine mental health treatment without being reported to the professional bodies.

JOURNALIST:
What has led to the increased focus on eating disorders? Has there been an uptick in the number of suicides resulting from that, or has there been an uptick in the number of cases?

GREG HUNT:
No, this has been silently moving along. It’s a personal focus. There are those that I have known, and then when we looked the numbers shortly after coming in, and dealt with organisations such as the Butterfly Foundation, they explained that it’s been a high level issue with the worst rate of loss of life amongst any mental health condition.

And so that’s a combination both of suicide, but also of loss of life due to physical collapse. And so it’s what I would regard as a personal priority from my own experience with others, but then the advocacy of groups like Butterfly Foundation has finally landed. It should’ve happened earlier, but it’s happening on our watch now.

JOURNALIST:
That would be my next question, is that I’m sure advocacy groups will say this is great that it’s happened, but it’s taken the Government so long. Why is it that you’re focussing on it now as opposed to…?

GREG HUNT:
I guess, I’ve only just become Minister. So from day one, this is one of the things I’ve wanted to do, and I’m really, personally, deeply pleased that we’ve made this enormous progress.

So I would say this, I can’t speak for the past, it is overdue, but on our watch collectively we’ve taken a huge step forward today.

Then the last thing is I’ve seen some reports that Queensland and Victoria may have been upset that some of their statistical anomalies were referred to what’s called IHPA (Independent Hospital Pricing Authority).

The reason why is that some of their figures simply didn’t pass the pub test.

The independent authority will assess them, but when you have 4000 per cent growth in one year in some services, 3300 per cent growth in some years in other services, then it would be negligent and irresponsible not to review them.

It may be the case that there was a more than 40-fold increase in some services, but the only sensible thing for the Commonwealth to do is to review it.

But our funding goes up each year every year at a faster rate than the states’ funding, and it’s gone up by $7.7 billion dollars since the current health agreement with the states was struck.

JOURNALIST:
Is that, sorry, relating to private health insurance, or is that something separate?

GREG HUNT:
No, that’s just in relation to, a couple of the states lodged claims for massive growth in individual items.

JOURNALIST:
Thank you. So was there a directive given today regarding private health policies to the states? Was that something that was discussed or something that …?

GREG HUNT:
Our paper was noted, and the states will respond. So we’ve invited the states to respond, they’ll respond individually.

JOURNALIST:
And regarding that mental health plan, besides their new focus on eating disorders, how is it different from previous mental health plans?

GREG HUNT:
So, a much greater focus on suicide prevention, a much greater focus on eating disorders, and a much greater focus on care for young children under 16.

JOURNALIST:
Is that something that you can give more specific details about? You’re saying there’s a much greater focus, but is there any specific information about what that would mean?

GREG HUNT:
As part of the good faith, the Commonwealth, I’ve written to the head of what’s called the Medical Benefits Schedule Review, so the Medicare item review, Professor Bruce Robinson and asked him and their team to consider, for the first time, specific additional treatment, an additional treatment item and what would be appropriate for eating disorders.

NACCHO Aboriginal Health : Pat Dudgeon “Closing the Mental Health Gap ” Special Issue : Indigenous Psychology

 
” The available data on Aboriginal and Torres Strait Islander disadvantage has shone a light on the Indigenous mental health and wellbeing gap.

In their commentary in this special issue, Calma, Dudgeon, and Bray (2017) provide details of the challenges in mental health for Aboriginal and Torres Strait Islander peoples and what needs to happen to change the situation.All articles in this issue are concerned with and aimed at contributing to closing the mental health gap.”

Pat Dudgeon Pictured above with NACCHO CEO Pat Turner at the recent launch of the ATSISPEP report

Download all reports HERE

Articles

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    The Australian Psychological Society’s Apology to Aboriginal and Torres Strait Islander People (pages 261–267)Timothy A Carey, Pat Dudgeon, Sabine W Hammond, Tanja Hirvonen, Michael Kyrios, Louise Roufeil and Peter Smith

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We acknowledge the Traditional Owners of the land across Australia and pay our respect to the Elders past, present and future.

We also acknowledge young people as they are our future leaders, the custodians of our stories, cultures, histories and languages.

We as seniors must create opportunities and encourage our youth to realise their full potential (Calma, 2015).This special issue on Indigenous psychology is timely in a changing landscape for Aboriginal and Torres Strait Islander (hereon Indigenous) people and their participation in an Australian nationhood. A range of significant landmark events suggests that both Aboriginal and Torres Strait Islander people and Australians are in a process of decolonisation.

In our first special issue of Australian Psychologist: Indigenous Australian Psychologies (2000), we marked the changes that were taking place and our hopes for a better future. Here our focus was on psychology, Indigenous issues, and reconciliation. Looking back to that time 17 years ago, Aboriginal and Torres Strait Islander affairs have clearly advanced.As a result of the work of Indigenous communities, their leaders, and social justice advocates, there is now a greater public awareness of the social and cultural determinants of Indigenous health and a range of government policies and actions aimed at closing the health and life expectancy gap between the Indigenous peoples of the land and other Australians.In his role as the Aboriginal and Torres Strait Islander Social Justice Commissioner, Professor Tom Calma released a landmark document, the Social Justice Report (2005).This called for the nation to commit to achieving health equality for Indigenous people by 2030, and saw the establishment of the Close the Gap campaign in 2007.Dialogues about the underlying and deeply entrenched socio-economic disadvantage that contributes to this gap are now part of the national dialogue. Government policies and action to close the gap have also now become a national priority that is annually reviewed.This year, the Prime Minster presented the ninth annual report card to Parliament (Closing the Gap Prime Minister’s Report, 2017).Notably, Indigenous mental health and suicide prevention is highlighted as a priority in this report, which is acknowledged by all Australian governments.
Closing the Mental Health Gap

The available data on Aboriginal and Torres Strait Islander disadvantage has shone a light on the Indigenous mental health and wellbeing gap.

In their commentary in this special issue, Calma, Dudgeon, and Bray (2017) provide details of the challenges in mental health for Aboriginal and Torres Strait Islander peoples and what needs to happen to change the situation.
All articles in this issue are concerned with and aimed at contributing to closing the mental health gap.
For example, in Addressing the Mental Health Gap in Working with Indigenous Youth: Some Considerations for non-Indigenous Psychologists Working with Indigenous Youth (Ralph & Ryan, 2017), an overview of therapeutic approaches with Aboriginal and Torres Strait Islander people, particularly youth, is provided.
Ralph and Ryan (2017) stress that an understanding of Indigenous social and emotional wellbeing (SEWB) is necessary for all those who work with youth: “for practitioners working with Indigenous youth and others there is a need to work from within a social and emotional wellbeing framework and a need to adapt the application of any focused psychological strategies to the cultural context of the individual client.” They also express justifiable concerns that “the average number of sessions provided under ATAPS for youth aged 12–25 is only 4.8 sessions.”

The SEWB of Aboriginal and Torres Strait Islander youth is also the focus of Using Culturally Appropriate Approaches to the Development of KidsMatter Resources to Support the Social and Emotional Wellbeing of Aboriginal Children (Smith, O’Grady, Cubillo, & Cavanagh, 2017).

In this article, Smith, O’Grady, Cubillo, and Cavanagh (2017) describe the methodology behind the development of resources in the KidsMatter Aboriginal Children’s Social and Emotional Wellbeing Project. An inclusive process of workshops and consultations with Aboriginal people was informed by participatory action, narrative therapy, and critically reflexive practice. This process enabled researchers and the community to build effective learning tools for children for use by Aboriginal families, schools, and early childhood and health and community services.

Another article in this special issue, Narratives of Twitter as a Platform for Professional Development, Innovation and Advocacy (Geia, Pearson, & Sweet, 2017) offers a compelling argument for the online engagement of psychologists—both Indigenous and non-Indigenous—in raising community awareness of strategies for decolonisation, for circulating empowering, strength-based approaches to Indigenous wellbeing, and supporting and recruiting potential practitioners.

This paper describes the significant success of some transformative Indigenous Twitter movements. Lynore Geia, a Bwgcolman woman from Palm Island in Queensland, discusses #IHMayDay the day long Twitter festival raising awareness of health issues; Luke Pearson, a Gamilaroi man, describes how he set up @IndigenousX and the subsequent global and local impact on healing and knowledge building, and Melissa Sweet discusses the important #JustJustice campaign.

The connections between the criminal justice system and SEWB are also focused on in a significant paper on the urgent need for justice reinvestment, Keeping on Country: Understanding and Responding to Crime and recidivism in Remote Indigenous Communities (Dawes, Davidson, Walden, & Isaacs, 2017). Outcomes from a qualitative study using a multidisciplinary research team that engaged the community through a specific participatory action research process are discussed.

Their findings resonate with the principles of justice reinvestment; Dawes, Davidson, Walden and Isaacs (2017) suggest that with the right methodological approach Indigenous communities themselves can easily identify the underlying factors contributing to crime. With the community, localised strategies to address over-representation in the justice system can be developed. Further, adopting a self-determination approach provides a strength-based position for psychologists working in the area.

Cross-cultural understanding and developing and maintaining local culture in remote communities is the focus of another unique article, The Uti Kulintjaku Project: The Path to Clear Thinking. An Evaluation of an Innovative, Aboriginal-led Approach to Developing Bi-cultural Understanding of Mental Health and Wellbeing (2017).

The results of 3 years of research was an innovative approach to strengthen shared understandings in mental health. The research work undertaken is at the heart of cross-cultural relationships, that is, exploring and articulating deep understandings of language and concepts. Both the community leaders and the non-Indigenous workers in the research team have benefited from this appropriately long-term project.

 

It increased the empowerment and capacity building of the leaders involved, and increased the cultural understanding of non-Indigenous service providers. Togni (2017) demonstrates that the building of stronger bi-cultural wellbeing literacies will “lead to increased help-seeking, strengthened cultural competency within health services and Anangu leadership in strengthening Anangu social and emotional wellbeing (SEWB).”

The importance of recognising the contributions of Indigenous concepts of SEWB is also the focus of Decolonising Psychology: Validating Social and Emotional Wellbeing (Dudgeon, Bray & D’Costa, Walker, 2017) which uses findings from the National Empowerment Project to explore the seven domains of SEWB, namely body, mind and emotions, family, community, culture, Country, and spirituality.

 

In this article, Dudgeon, Bray, D’Costa, and Walker (2017) highlight how SEWB, (an emerging concept within Indigenous psychology), is important in holistically addressing the well being needs of Indigenous people.

The breadth of topics and approaches of the articles in this special issue are a testament to the strong emergence of Australian Indigenous psychology and are just some of the numerous innovations being made in the field across the nation. New methodologies, important findings, strategies for research futures, and guides for practitioners are offered. Each paper makes a significant contribution to both the discipline, the project of Indigenous social justice, and closing the mental health gap.

Indigenous PsychologyIndigenous psychology is emerging as a powerful new discipline and was recognised at a global level with the establishment of the Task Force for Indigenous Psychology in the Society for Humanistic Psychology, Division 32, American Psychological Association in 2010. The Task Force describes Indigenous psychology as:

  1. A reaction against the colonisation/hegemony of Western psychology.
  2. The need for non-Western cultures to solve their local problems—Indigenous practices and applications.
  3. The need for a non-Western culture to recognise itself in the constructs and practices of psychology.
  4. The need to use Indigenous philosophies and concepts to generate theories of global discourse.

We address each of these factors below; however, it is noted that implicit within these is a recognition that the principle of self-determination, confirmed as an underlying principle in the United Nations Declaration of the Rights of Indigenous People (UNDRIP) (2007), is central to wellbeing and the survival of cultural rights. Specifically, there are provisions regarding obligations to respect, recognise, and uphold Indigenous peoples’ individual and collective rights to develop, maintain, and use their own health systems, institutional structures, distinctive customs, spirituality, traditions, procedures, and practices in pursuit of their right to health and mental health and wellbeing. Authors such as Dudgeon and Walker (2015) have examined this relationship in other papers.

  • 1.A reaction against the colonisation/hegemony of Western psychology

The measured and principled response of Australia Indigenous psychology to the colonising impacts of Western psychology has challenged the discipline to re-think foundational assumptions. Since the 1990s Indigenous psychologies across the world have illuminated the ways in which Western therapeutic paradigms have privileged a concept of individual mental health. In short, the normalisation of Western individualism has reduced our understanding of psychological distress and healing. Indigenous therapeutic knowledge about the self as a dynamic flow of connections have until quite recently been silenced, and even pathologised. Yet gains in the discipline over the last few decades have seen a shift from Indigenous people being framed as objects of research to being agents of meaning and transformation. The marginalisation of Indigenous psychological research within the academy is still, however, an issue which requires change.

  • 2.The need for non-Western cultures to solve their local problems—Indigenous practices and applications

There is a broad consensus across Australian Indigenous communities that culturally strong therapeutic knowledge and practices are ones which articulate solutions identified by local communities (Dudgeon et al., 2014). Respect for the cultural knowledge of Elders is also important in the capacity building of on-country healing programs aimed at reducing youth suicide and “highlight the need for continued support for Elders in maintaining and passing on their cultural knowledge to young people” (Solutions That Work: What the Evidence and Our People Tell Us, 2016, p. 22).

  • 3.The need for a non-Western culture to recognise itself in the constructs and practices of psychology

This form of recognition is foundational to the process of decolonisation and for communities to identity their own solutions and articulate their own cultural concepts. However, it is equally important for Western psychology to recognise how the discipline has constructed Indigenous subjectivity and practiced culturally inappropriate therapeutic interventions. In this respect, the Australian Psychological Society has made history by being the first to formally apologise to Indigenous peoples for past oppressive practices and to vow to make systemic changes. The 2016 people was made at the Australian Psychological Society Congress 2016 in Melbourne. This has become a significant event that gained considerable worldwide media attention and has impact not only in Australia but internationally, with the American Psychological Association now developing a similar apology to their Indigenous people. It is fitting that those involved with progressing the APS apology comment in this special edition. Carey et al. provide a brief overview of the APS’s involvement with Aboriginal and Torres Strait Islander people and issues, tracing the history that contextualises the apology. The apology, how it came about and the reaction to it, particularly by APS members, describes a changing discipline. Following the Australian Government’s landmark apology to Aboriginal and Torres Strait Islander people Stolen Generations in 2008, the APS apology speaks to a maturing sense of race relations and nationhood. In my opinion, the apology formally owns and acknowledges the wrongs done, and the denial of the past, the injustice and oppression that was the lot of many Aboriginal and Torres Strait Islander people. In some respects, Aboriginal and Torres Strait Islander people have suffered a double burden—of suffering injustice and also of having that suffering denied. The apology from the nation and the APS is important; they value people and their experiences and give people respect and a genuine presence. A shared journey of healing for us as a nation can progress.

  • 4.The need to use Indigenous philosophies and concepts to generate theories of global discourse

There is a growing recognition of how psychology has been complicit in the processes of colonisation and oppressing Indigenous peoples. Recognising and acknowledging this past is important, hence the importance of the APS apology. Such acknowledgement and apology allows us to move forward, acknowledging colonisation allows decolonisation for both groups and into a more advanced discipline. It allows space for other viewpoints and understandings to emerge that not only benefit Indigenous peoples but all Australians. There is reason for optimism and the potential for empowerment and genuine inclusion of Aboriginal peoples in the discipline. In order to decolonise psychology in Australia, the discipline needs to consider and incorporate Aboriginal culture and beliefs into mental health services and research. We see this happening from the papers in this special edition. There is focus on the development of Aboriginal paradigms, standpoints, and concepts such as social and emotional wellbeing. Further, there is a deep appreciation of cultural difference and a willingness to work to develop mutual understandings. The papers in the special edition show the promise of different approaches and the development of a new phase of Australian psychology.

In 2017 we stand at a new beginning. We are living in a time of continual change. Twenty years ago Ernest Hunter wrote:

Self determination’, ‘quality of life’, ‘wellbeing’: these are terms that have only recently entered the vocabulary of mental health professionals working in indigenous settings. They are unfamiliar and handled with uncertainty and, at times, temerity; they are also unavoidable (1997, p. 821).

This special issue attests to how such terms are now a common part of discussions about Aboriginal and Torres Strait Islander wellbeing, and part of a vanguard movement in psychology.

Such terms have a substantial material force and a political history, as well as being part of the discourse of Indigenous psychology. Globally, the focus on decolonisation has emerged as a new defining movement which is in the process of transforming all disciplines, not only psychology. Decades of complex Indigenous struggles, debates, and victories are driving decolonisation, and it is because of this that terms such as “self-determination” and “wellbeing” resonate with a particular historical dignity.

The Aboriginal and Torres Strait Islander mental health movement is decolonising the discourse of Australian mental health not only within specialised journals but within the public sphere through the opening up of national debates about the relationship between racism and wellbeing. In doing so, the movement has also contributed to the national projects of overcoming racism and de-stigmatising psychological distress by providing insights into the social and cultural determinants of mental health.

TerminologyA range of words are used to describe Aboriginal and Torres Strait Islanders and non-Aboriginal peoples. The term Indigenous is also used by authors, as this includes both Aboriginal and Torres Strait Islander people. While encouraging authors to use terms that best fit the people they write with, I acknowledge that the preferred term is “Aboriginal and Torres Strait Islander peoples.” The Australian Human Rights Commission explains this term in further detail:

Aboriginal and Torres Strait Islander peoples retain distinct cultural identities whether they live in urban, regional or remote areas of Australia. The word ‘peoples’ recognises that Aborigines and Torres Strait Islanders have a collective, rather than purely individual, dimension to their lives. This is affirmed by the United Nations Declaration on the Rights of Indigenous Peoples (2012, p. 6).

NACCHO Aboriginal Health #CarersGateway : Free online resources to support #Aboriginal #carers

It’s rewarding work, but without help Dolly finds herself emotionally and physically drained. Dolly reached out and found that she could get services to help her.

Like Dolly, millions of people in Australia care for others who need help with their everyday lives.

A carer may be someone who looks after their husband or wife, partner, grandparent, uncle, aunty, cousin, child, grandchild or any other family member, a neighbour, a friend or someone in their community who needs help.

Everyone’s situation is different. Some carers look after someone who is an older person or who is unwell or has difficulties getting around. Some carers may look after someone who has a disability, a mental illness or dementia, a chronic condition or a long-term illness or drug and alcohol problems.

Many people looking after someone else don’t think of themselves as carers. They just see caring as what they do to help their families or friends or people in their communities.

Carers need help too – someone they can talk to and find out about services that can help. Carer Gateway is a free, Australian Government funded service that provides information for carers and helps people get in touch with their local services. People can ring up and have a private chat or go online and find out about support in their area, free financial and legal help and what to do in emergencies.  They can also get tips on how to look after themselves so they don’t get burnt out while caring for someone else.

Carer Gateway has short videos about real-life carers in the community – showing how they cope and deal with problems – and how they make the most of the time they spend caring for someone in need.

The videos include Dolly’s story. Dolly is a mother and full-time carer for her two adult daughters, who both need support with their everyday needs.

“It’s pretty much 24/7 around the clock. Four years ago, I realised I was doing a care role and I was also a working mum so quite busy. I thought you know what, it’s time for me to step back and start looking after my own,” she said.

There are free online resources to support Aboriginal carers, including a guided relaxation audio recording and information brochures and posters for use by health and community groups  which can also be ordered from the Carer Gateway ordering form and a Carer Gateway Facebook page to keep up to date on services and supports for carers.

To find out more, Carer Gateway can be contacted on 1800 422 737, Monday to Friday between 8am and 6pm,

or by visiting carergateway.gov.au

You can join the Carer Gateway Facebook community by visiting https://www.facebook.com/carergateway/

 

 

 

NACCHO Aboriginal Mental Health : Download report “Mental health in remote and rural communities “

 ” The poorer mental health of remote and rural Indigenous Australians is also impacted by the social determinants of Indigenous health, which are well recognised nationally and internationally.

These relate to the loss of language and connection to the land, environmental deprivation, spiritual, emotional and mental disconnectedness, a lack of cultural respect, lack of opportunities for self-determination, poor educational attainment, reduced opportunities for employment, poor housing, and negative interactions with government systems

The relationship of remoteness to health is particularly important for Indigenous Australians, who are overrepresented in remote and rural Australia (Australian Institute of Health and Welfare, 2014a).

The National Mental Health Commission (2014a, p. 19) identified that “the mental health needs of Aboriginal and Torres Strait Islander people are significantly higher than those of other Australians.”

Photo above

“ The women of Inkawenyerre, a small settlement in the Utopia community four hours by road north of Alice Springs, regularly take part in a different kind of mental health therapy, known as ‘narrative therapy.’

Narrative therapy taps into the centuries-old tradition among Aboriginal people of story-telling and expression through art. At the family Urapuntja Clinic, both women and children take part in narrative therapy.

They recreate what is commonly seen on any given evening in an Aboriginal community—people sitting around the fire, relating to one another and telling stories.

The activity is enjoyable for participants with group members often laughing and supporting one another as they tell stories and work on their painting—all while promoting good mental health living practice,”

Lynne Henderson, former RFDS Central Operations mental health clinician.

“People who live in the country get less access to care. And they become sicker,”

To increase the access to care, the RFDS said it needed a massive increase in funding. Country Australians see mental health professionals at only a fifth the rate of those who live in the city,

So there should be a five-fold increase in access to mental health care for country Australians.”

RFDS CEO Martin Laverty see story Part 2 below

Mental health in remote and rural communities

Mental health disorders are not more common in rural and regional Australia than they are in Australia’s cities, according to a new report from the Royal Flying Doctor Service (RFDS), but they are a lot harder to treat.

The report, Mental Health in Remote and Rural Communities, found about one in five remote and rural Australians — 960,000 people — experience mental illness.

Download the report HERE

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But a combination of lack of access to facilities, social stigma, and cultural barriers present challenges to getting people the help they need.

AHCRA believes that’s something that everyone should be concerned about, with access to care regardless of location.

 

Part 1  Indigenous mental health and suicide

Data from the 2011 Australian Census demonstrated that 669,881 Australians, or 3% of the population, identified as Indigenous (Australian Bureau of Statistics, 2013b), and that 142,900 Indigenous Australians, or 21% of the Indigenous population, lived in remote and very remote areas (Australian Institute of Aboriginal and Torres Strait Islander Studies, 2014).

Around 45% of people in very remote Australia (91,600 people), and 16% of people in remote Australia (51,300 people) were Indigenous (Australian Bureau of Statistics, 2013b; Australian Institute of Aboriginal and Torres Strait Islander Studies, 2014).

In 2011–2012 around one-third (30%) of Indigenous adults reported high or very high levels of psychological distress—almost three times the rate for non-Indigenous Australians (Australian Bureau of Statistics, 2014).

In 2008–2012, in NSW, Queensland (Qld), WA, SA and the NT, there were 347 Indigenous deaths11 from mental health-related conditions (Australian Institute of Health and Welfare,

2015a). Specifically, age-standardised death data demonstrated that Indigenous Australians (49 per 100,000 population) were 1.2 times as likely as non-Indigenous Australians (40 per 100,000 population) to die from mental and behavioural disorders (Australian Institute of Health and Welfare, 2015a). Age-standardised deaths from mental and behavioural disorders increased with increasing age in both Indigenous and non-Indigenous Australians in 2008–2012.

Very few Indigenous and non-Indigenous Australians under the age of 35 years died as result of mental and behavioural disorders in 2008–2012. However, Indigenous Australians aged 35 years or older were more likely to die from mental and behavioural disorders than non-Indigenous

Australians in 2008–2012. Specifically, Indigenous Australians (7.2 per 100,000 population) aged 35–44 years were 5.7 times as likely as non-Indigenous Australians (1.3 per 1200,000 population) to die from mental and behavioural disorders (Australian Institute of Health and

Welfare, 2015a). In 2008–2012, Indigenous Australians (14.7 per 100,000 population) aged 45–54 years were 4.9 times as likely as non-Indigenous Australians (3.0 per 100,000 population) to die from mental and behavioural disorders (Australian Institute of Health and Welfare, 2015a).

In 2008–2012, Indigenous Australians (18.3 per 100,000 population) aged 55–64 years were 2.7 times as likely as non-Indigenous Australians (6.9 per 100,000 population) to die from mental and behavioural disorders (Australian Institute of Health and Welfare, 2015a). In 2008–2012,

Indigenous Australians (91.2 per 100,000 population) aged 65–74 years were 2.9 times as likely

as non-Indigenous Australians (31.3 per 100,000 population) to die from mental and behavioural disorders (Australian Institute of Health and Welfare, 2015a).

Further exploration of death data from mental and behavioural disorders illustrates the significant impact of psychoactive substance use (ICD-10-AM codes F10–F19) on Indigenous mortality (Australian Institute of Health and Welfare, 2015a). In 2008–2012, 29.1% of Indigenous deaths due to mental and behavioural disorders were the result of psychoactive substance use, such as alcohol, opioids, cannabinoids, sedative hypnotics, cocaine, other stimulants such as caffeine, hallucinogens, tobacco, volatile solvents, or multiple drug use. During this period, Indigenous Australians (7.3 per 100,000 populations) were 4.8 times as likely as non-Indigenous Australians to die as a result of psychoactive substance use (Australian Institute of Health and Welfare, 2015a).

Similarly, in 2006–2010, there were 312 Indigenous deaths from mental health-related conditions (Australian Institute of Health and Welfare, 2013a). Indigenous Australians living in NSW, Qld, WA, SA and the NT were 1.5 times as likely as non-Indigenous Australians to die from mental and behavioural disorders in 2006–2010 (Australian Institute of Health and Welfare, 2013a).

11 Deaths from mental and behavioural disorders do not include deaths from intentional self-harm (suicide). Intentional self-harm is coded under ICD-10-AM Chapter 19—Injury, poisoning and certain other consequences of external causes.

Age-standardised death data demonstrated that Indigenous males (49 per 100,000 population) were 1.7 times as likely as non-Indigenous males to die from mental and behavioural disorders. Indigenous females were 1.3 times as likely as non-Indigenous females to die from mental and behavioural disorders (Australian Institute of Health and Welfare, 2013a).

The greater number of deaths from mental and behavioural disorders with age may also represent the impact of conditions associated with ageing, such as dementia. For example, in 2014, Indigenous Australians (50.7 per 100,000 population) in NSW, Qld, SA, WA and the NT were 1.1 times as likely as non-Indigenous Australians (45.3 per 100,000 population) to die from dementia (including Alzheimer disease) (Australian Bureau of Statistics, 2016a).

In 2014–2015, Indigenous Australians (28.3 per 1,000 population) were 1.7 times as likely as non-Indigenous Australians (16.3 per 1,000 population) to be hospitalised for mental and behavioural disorders (Australian Institute of Health and Welfare, 2016a).

In 2011–2013, 4.2% of Indigenous hospitalisations were for mental and behavioural disorders (Australian Institute of Health and Welfare, 2015a). Age-standardised data demonstrated that Indigenous Australians (27.7 per 1,000 population) were twice as likely as non-Indigenous Australians (14.2 per 1,000 population) to be hospitalised for mental and behavioural disorders in 2011–2013 (Australian Institute of Health and Welfare, 2015a).

In 2008–2009, Indigenous young people aged 12–24 years (2,535 per 100,000 population) were three times as likely to be hospitalised for mental and behavioural disorders than non-Indigenous young people (Australian Institute of Health and Welfare, 2011).

 

The leading causes of hospitalisation for mental and behavioural disorders amongst Indigenous young people were schizophrenia (306 per 100,000 population), alcohol misuse (348 per 100,000 population) and reactions to severe stress (266 per 100,000 population) (Australian Institute of Health and Welfare, 2011).

A preliminary clinical survey of 170 Aboriginal and Torres Strait Islander Australians in Cape York and the Torres Strait, aged 17–65 years, with a diagnosis of a psychotic disorder, was undertaken to describe the prevalence and characteristics of psychotic disorders in this population (Hunter, Gynther, Anderson, Onnis, Groves, & Nelson, 2011).

Researchers found that: 62% of the sample had a diagnosis of schizophrenia, 24% had substance-related psychoses, 8% had affective psychoses, 3% had organic psychoses and 3% had brief reactive psychoses; Indigenous Australians aged 30–39 years were overrepresented in the psychosis sample compared to their representation in the population (37% of sample versus 29% of population) with slightly lower proportions in the 15–29 years and 40 years and older age groups; almost three-quarters (73%) of the sample were male (versus 51% for the Indigenous population as a whole); Aboriginal males (63% in the sample compared to 46% for the region as a whole) were overrepresented; a higher proportion of males (42%) than females (5%), and Aboriginal (44%) than Torres Strait Islander patients (10%) had a lifetime history of incarceration; comorbid intellectual disability was identified for 27% of patients, with a higher proportion for males compared to females (29% versus 20%) and Aboriginal compared to Torres Strait Islander patients (38% versus 7%); and alcohol misuse (47%) and cannabis use (52%) were believed to have had a major role in the onset of psychosis (Hunter et al., 2011).

In 2015, Indigenous Australians (25.5 deaths per 100,000 population) in Qld, SA, NT, NSW and WA were twice as likely as non-Indigenous Australians (12.5 deaths per 100,000 population) to die from suicide (Australian Bureau of Statistics, 2016b). In their spatial analysis of suicide, Cheung et al. (2012) concluded that higher rates of suicide in the NT and in some remote areas could be explained by the large numbers of Indigenous Australians living in these areas, who demonstrate higher levels of suicide compared with the general population.

The poorer mental health of remote and rural Indigenous Australians is also impacted by the social determinants of Indigenous health, which are well recognised nationally and internationally.

These relate to the loss of language and connection to the land, environmental deprivation, spiritual, emotional and mental disconnectedness, a lack of cultural respect, lack of opportunities for self-determination, poor educational attainment, reduced opportunities for employment, poor housing, and negative interactions with government systems

Part 2 Flying Doctors fight barriers to treat mental illness in rural Australia

Source ABC

Like so many in the bush, Brendan Cullen has a lot on his plate.

He manages a 40,000-hectare property south of Broken Hill. There are 8,000 sheep to keep track of. And that’s just a fraction of the number he looked after previously at another station.

A few years ago, the mustering, the maintenance, juggling bills and family — it all caught up to him.

“You just bottle stuff up. And sometimes you can’t find an out,” he said.

“In the bush you have a lot of time by yourself.”

He spent a lot of that time thinking about his problems. But Mr Cullen was lucky.

He heard about a mental health clinic being run by the Royal Flying Doctor Service (RFDS) in a nearby community and decided to go along.

“Catching up with one of the mental health nurses gave me the tools to be able to work out how I go about living a day-to-day life,” he said.

“My life’s a hell of a lot easier now than what it used to be.”

Mental health disorders are not more common in rural and regional Australia than they are in Australia’s cities, according to a new report from the RFDS, but they are a lot harder to treat.

The report, Mental Health in Remote and Rural Communities, found about one in five remote and rural Australians — 960,000 people — experience mental illness.

But a combination of lack of access to facilities, social stigma, and cultural barriers present challenges to getting people the help they need.

“People who live in the country get less access to care. And they become sicker,” RFDS CEO Martin Laverty said.

To increase the access to care, the RFDS said it needed a massive increase in funding.

“Country Australians see mental health professionals at only a fifth the rate of those who live in the city,” Mr Laverty said.

“So there should be a five-fold increase in access to mental health care for country Australians.”

The impact of distance and isolation when it comes to treating mental disorders can be seen in suicide rates. In remote Australia, the rate is nearly twice what it is in major metropolitan areas — 19.6 deaths per 100,000 people.

The suicide rate is even greater in very remote communities.

If you or anyone you know needs help:

The RFDS has responded by increasing its mental health outreach. In communities like Menindee, about an hour’s drive from Broken Hill in the far west of New South Wales, a mental health nurse is on call once a fortnight.

“I have needed them in the past. I got down to rock bottom at one stage. Even now I appreciate that support,” Menindee resident Margot Muscat said.

Ms Muscat plays an active role in the remote community. But she has also felt pressure in the past to manage that role, her work, and family commitments.

Mental health counselling has given her a valuable outlet.

“Just to know that I wasn’t alone. And that you don’t have to take the drastic step of suiciding, so to speak,” Ms Muscat said.

Some the RFDS’s mental health counselling is done over the airwaves. From its regional base in Broken Hill, mental health nurse Glynis Thorp counsels patients over the phone. Often calls are simply people checking in.

“It’s critically important…often there might only be two people on the property. So no one to talk to maybe,” she said.

“We might get out to a clinic every fortnight, but we might have follow up phone calls to check how people are going. For myself it’s probably a ratio of four to one.”

The RFDS report reveals every year hundreds of serious mental illness incidents require airplanes to be dispatched to remote areas to fly patients out for treatment.

Over three years from July 2013 the RFDS conducted 2,567 ‘aeromedical retrievals’.

The leading causes for evacuation flights due to mental disorder are

The RFDS also uses airplanes to carry its mental health nurses to very remote areas. On a typical day in Broken Hill, the medical team takes off just after dawn to head to three communities hundreds of kilometres away: Wilcania, White Cliffs and Tilpa.

In the opal mining town of White Cliffs, the mental health nurse sees patients at the local clinic. One is “Jane”, who doesn’t want her full name used.

“Without them, we would really be lost here,” she said.

Jane has been counselled by the RFDS and was recently directed to mental health treatment in Broken Hill. But she’s still reluctant to talk openly in town about the help she’s getting.

“In a small community it’s not wise to talk to other people in town,” she said. “And mental health, it does carry a stigma.”

Back on his station south of Broken Hill, Mr Cullen believes that stigma over mental health is slowly changing in the bush.

“People get wind that someone’s had a mental health problem, people talk now. As opposed to, let’s go back five years even, 10 years. It was a closed book,” he said.

“With these clinics, once upon a time you might have had a dental nurse, a doctor, and the like.

“But now you have a mental health nurse…And these clinics are close by. So you’re able to go to them. They come to you.”