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

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

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

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

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

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

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

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

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

Download the 7 page study  mja250212

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

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

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

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

How the tool works

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

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

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

The adapted (aPHQ-9) tool instead asks:

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

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

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

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

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

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

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

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

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

The George Institute for Global Health

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

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

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

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

Additional Media 

Doctors can now use the new tool

Extract from the Conversation 1 July 2019

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

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

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

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

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

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

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

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

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

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

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

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

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

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

From the National Mental Health Commission 6 June 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Lucy Brogden

Chair, National Mental Health Commission

Christine Morgan

CEO, National Mental Health Commission

 

NACCHO Aboriginal Health and #Ice #ClosingTheGap : Some call it an epidemic, others call it the “Ice Age”. What ever you call it , it is destroying families, and Indigenous culture

“You need to trust us to be able to deliver a service to our own people linked in with culture. Who are the right people to deliver that? Our people.

I have seen it a thousand times over. Once they are addicted to ice, culture’s gone, you don’t care about your kids, your primary focus is ‘I need this drug.’ It is worse than heroin.

Ice has a terrible impact on the family. Yet there was nothing to explain to families “why all your stuff is being sold at the pawn shop” and how to get help “

Tanya Bloxsome, a Waddi Waddi woman of the Yuin, who is chief executive of a residential rehabilitation service for men, Oolong House

Read over 60 Aboriginal Health and Ice articles published by NACCHO

Originally published SMH Julie Power

It makes Nowra grandmother Janelle Burnes’ day when her grandson Lucas* says, “Nanny, you’ve got a beautiful smile. I love you.”

The Wiradjuri woman has been punched and kicked by eight-year-old Lucas, who hears voices and suffers psychosis.

Janelle Burnes had to give up work to care for her eight-year-old grandson. He suffers from a range of mental illnesses, including psychosis, attributed to his parents’ ice addictions.

Abandoned by his mother as a baby, Lucas has fetal alcohol and drug syndrome attributed to his parents’ ice use when he was conceived.

Experts told the NSW special commission of inquiry into ice in Nowra last week that they were increasingly seeing multiple generations of users living together, exposing children to violence, neglect, abuse and witnessing sex and drug use by intoxicated adults.

Some call it an epidemic, others call it the “Ice Age”.

When Lucas hit his grandmother over the head with a guitar, she didn’t yell at him. Determined to stop the boy from becoming part of another generation broken by ice, Ms Burnes ignored the blood running down her face and the waiting ambulance.

“I walked back to him, I hugged him, I cuddled him, I told him, ‘You are going to hurt Nanny if you do stuff like that.’ And I gave him a kiss and I told him I still loved him.”

Ice is a stronger and more addictive stimulant than speed, the powder form of methamphetamine, the Alcohol and Drug Foundation says. It causes aggression, psychosis, stroke, heart attacks and death. It causes confusion, making it nearly impossible to get a rational response from someone under the drug’s influence.

Tanya Bloxsome, chief executive of Oolong House, a residential rehabilitation service where more than 90 per cent of its male residents have been addicted to ice. CREDIT:LOUISE KENNERLEY

Ms Burnes doesn’t blame Lucas for his behaviour, but ice. It is destroying Indigenous and non-Indigenous families across the Shoalhaven region. It is also destroying Indigenous culture.

To recover, Indigenous leaders say they have to develop role models and restore pride in their identity.

“You need to trust us to be able to deliver a service to our own people linked in with culture. Who are the right people to deliver that? Our people,” said Tanya Bloxsome, a Waddi Waddi woman of the Yuin, who is chief executive of a residential rehabilitation service for men, Oolong House.

“I have seen it a thousand times over. Once they are addicted to ice, culture’s gone, you don’t care about your kids, your primary focus is ‘I need this drug.’ It is worse than heroin.

“Ice has a terrible impact on the family,” she said. Yet there was nothing to explain to families “why all your stuff is being sold at the pawn shop” and how to get help.

Nearly two-thirds of 52 Indigenous and non-Indigenous children placed in out-of-home care in the Nowra region in the past year were removed because of ice use by their parents. It was also a “risk factor” in about 40 per cent of the 124 families working with Family and Community Services’ case managers.

When Indigenous groups met the commission last week, they said they needed more culturally appropriate programs, rehabilitation places and detoxification units (the closest are in Sydney, Canberra and Dubbo).

Indigenous Australians are more than 2.2 times as likely to take meth/amphetamine than other Australians.

In the opening address to the commission, Sally Dowling, SC, said the impacts of colonisation and dispossession, intergenerational trauma and socio-economic disadvantage had continued to contribute to high levels of amphetamine use in Indigenous communities.

Ice use in Nowra is not as bad as out west. But the region has seen the biggest year-on-year growth in arrests for possession and use since 2014, with a 31 per cent increase compared with 6 per cent across the state.

Cheaper than Maccas

Getting high on ice was “cheaper than going for Maccas”, said Nowra’s Aboriginal Medical Corporation’s substance abuse counsellor Warren Field, who runs a weekly men’s group for recovering addicts.

Ice had also become a “rite of passage” for some young people after they had received their first Centrelink payment or wage.

Mr Field said “99 per cent” of ice users had suffered some form of trauma. Nearly all had other mental health problems, including anxiety and depression.

“Everyone says there is nothing [like it] that will numb the pain and take the grief and loss away,” he said. It also makes women lose weight and gives men incredible sexual prowess.

“Most people are vulnerable when they go through a traumatic event and the Aboriginal community has had more than its fair share of that,” he said.

He argues they know what works – culturally appropriate rehabilitation which develops strong role models and a sense of identity. But there had to be more support when people came out of rehabilitation to stop them from relapsing.

The first year of rehabilitation was particularly hard. People in recovery were often depressed and their ability to feel happiness or pleasure without the drug was dulled.

Mr Field said “black fellas” were also unfairly targeted by police who, he argued, should spend more time closing the crack houses that “everyone” knew about.

 

At Oolong House, 21 men – 18 of whom were Indigenous – were getting themselves breakfast while 42-year-old Bobby McLeod jnr played guitar and a mate accompanied him on the didgeridoo.

More than 90 per cent of men in the program had been using ice, very often with other drugs, and increasingly with heroin, Ms Bloxsome said.

“Every addicted person who comes in here has a mental health issue,” she said. And residents addicted to ice were more psychotic than those addicted to other drugs.

Most residential programs are 12 weeks, but Oolong offers 16 weeks, and Ms Bloxsome believes even longer programs would be better. But like services up and down the South Coast, it can’t keep up with demand.

The program offered cognitive behavioural therapy, addressed mental and physical health, and encouraged the men to undertake training that would help them get work. Nearly all the men arrived with hepatitis C and those released from jail were, with few exceptions, addicted to the drug, bupe (buprenorphine).

The most powerful medicine, though, was getting back to culture by doing traditional dance, learning language and going on bush walks. After a lifetime in prison, Mr McLeod  said painting and writing songs about his life had helped his recovery.

When everything else was bad, ice had made him “feel invincible”. But it cost him his family and caused anxiety and depression, which made him feel suicidal.

His old man was a successful singer, his brother had travelled around the world with an Indigenous dance group, but he was the one who “went to jail”, Mr McLeod said.

Raising money for a funeral 

Ms Burnes lives in fear of a phone call telling her that Lucas’ 39-year-old mother is dead.

In anticipation of the inevitable – her nephew died earlier this year from a heart attack caused by his ice addiction – she is raising money for anticipated funeral costs.

Lucas’ mother has had three heart attacks caused by decades of addiction.

Janelle Byrnes is planning a funeral for her ice-addicted daughter. In a Facebook post, her 39-year-old daughter asks others to stop using ice. CREDIT:FACEBOOK

In a Facebook post, her daughter wrote about how her “huge addiction” had caused two heart attacks in two weeks.

“Now I’ve got to plan my funeral just in case I don’t make the next,” she wrote. “That’s not the saddest thing. It is listening to my mum cry and plan it with me. ”

“If U love your family reconsider having that pipe or putting that needle in your arm,” Ms Burnes’ daughter said.

In the meantime, Ms Burnes does everything she can to provide a stable home for Lucas.

She quit her job of 22 years as an Aboriginal education officer to care for her grandson, to ensure he gets to doctors’ appointments and maintain his schooling.

She’s been working with him to maintain his good results in reading and spelling, despite frequent suspensions for getting into fights, so he has a chance of fulfilling his dream of becoming a police officer.

* name changed

With additional reporting by Louise Kennerley.

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

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

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

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

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

Originally posted in The Conversation

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

A cycle of trauma and incarceration

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

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

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

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

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

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

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

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

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

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

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

Poor physical and mental health

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

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

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

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


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


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

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

What can be done?

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

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

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

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

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

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

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

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

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

WA Aboriginal Affairs Minister Ben Wyatt

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

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

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

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

Deputy Premier Roger Cook

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

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

 

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

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

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

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

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

4.Address Aboriginal and Torres Strait Islander youth suicide rates 

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

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

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

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

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

Useful Links

2018 Message Stick Response

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

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

Contact Us

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

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

Email: AboriginalPolicy@dpc.wa.gov.au

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

 

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Read article in full HERE

Part 2

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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

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

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

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

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

Prime Minister Scott Morrison

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

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

Visit our NACCHO #VoteACCHO Election Campaign page HERE 

#VoteACCHO Recommendation 4.

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

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

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

#VoteACCHO Recommendation 6.

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

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

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

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

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

Extracts from The Guardian

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

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

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

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

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

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

Past 2 #VoteACCHO

1. Indigenous Mental Health and Suicide Prevention

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

2. Mental Health

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

3.Youth Mental Health and Suicide Prevention

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

Natural Disasters

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

Background

Mental Health Facts

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

Suicide and Self-harm Facts

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

 

 

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

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

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

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

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

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

See PHAA #JusticeHealth2019 Website

Aboriginal community control and justice health

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

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

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

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

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

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

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

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

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

Scene setting

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

SLIDE 3: Overrepresentation – causal factors

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

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

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

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

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

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

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

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

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

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

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

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

SLIDE 4: Justice reinvestment

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

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

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

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

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

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

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

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

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

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

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

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

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

SLIDE 6: Health justice partnerships

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

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

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

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

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

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

 Case study: Law Yarn

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

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

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

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

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

SLIDE 8: Law Yarn – your law story

SLIDE 9: Four aspects of Law

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

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

SLIDE 11: Launch of Law Yarn

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

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

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

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

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

SLIDE 12: Thank you

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Read over 130 + NACCHO Aboriginal Health and Suicide Prevention articles

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

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

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

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

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

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

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

See full story Part 2 Below or HERE

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

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

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

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

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

STRONGER TOGETHER includes the release of four community announcement video

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

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

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

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

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

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

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

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

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

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

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

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

Part 2

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

Originally Published the Guardian and IndigenousX

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

 

NACCHO Aboriginal Health and #SuicidePrevention News Alerts : #Closethegap : #NACCHO and @TheRACP Peak Health bodies call for Prime Minister and state and territory leaders to declare Aboriginal youth #suicide crisis an urgent national health priority

The recent Aboriginal youth suicides represent a national emergency that demands immediate attention.

Aboriginal community controlled health services need to be properly resourced to ensure our children are having regular health checks and to develop community led solutions.’

NACCHO CEO, Ms Patricia Turner : See NACCHO RACP press release : see Part 1 below

See all 130 + NACCHO Aboriginal Health and Suicide Prevention articles published over last 7 years 

“Funded programs are not required to demonstrate a measurable reduction in suicide and mental health risk factors, which is staggering,

We just aren’t demanding that basic level of accountability

The first priority must be analyses of suicide mortality data to identify the causal pathways,  

Suicide risk is the most complex thing to assess and monitor … communities are crying out for specialist assistance and just not getting it. “Children as young as 10 are dying by suicide … this is no longer an Aboriginal issue, it’s a national one,

Indigenous psychologist Adjunct Professor Tracy Westerman said Australia had failed to collect crucial evidence to determine what intervention strategies work. See Part 2 below 

 ” Community driven action plans to prevent suicide are extending across the Kimberley, with four more communities implementing plans to save lives and improve health and well-being.

As part of the Kimberley Aboriginal Suicide Prevention Trial, Kununurra, Balgo, Wyndham and Halls Creek now have local plans, joining Broome, Derby and Bidyadanga.

Each community receives up to $130,000 to help roll out its action plan which reflects and responds to local issues

See Minister Ken Wyatt Press Release and Communique Part 3 and 4 Below

Part 1 RACP and NACCHO Press Release

JOINT STATEMENT

HEALTH BODIES DECLARE ABORIGINAL YOUTH SUICIDE AN URGENT NATIONAL PRIORITY

  • Health bodies call for Prime Minister and state and territory leaders to declare urgent national health priority
  • Immediate investment in Aboriginal-led mental health and wellbeing services needed to stop child deaths
  • Long-term solution of Aboriginal and Torres Strait Islander self-determination requires commitment to Uluru Statement from the Heart

The Royal Australasian College of Physicians (RACP), the Royal Australian and New Zealand College of Psychiatrists (RANZCP) and the National Aboriginal Community Controlled Health Organisation (NACCHO) are calling on the Prime Minister to make tackling Aboriginal and Torres Strait Islander youth suicides a national health priority.

Suicide was once unknown to Aboriginal and Torres Strait Islander peoples but now every community has been affected by suicide.

In response to the recent Aboriginal youth suicides and the release of the WA Coroner’s report on the inquest into the deaths of thirteen children and young persons in the Kimberley Region, we are calling on the Prime Minister and state and territory leaders to put the issue at the top of the COAG agenda and to implement a coordinated crisis response to urgently scale up Aboriginal led mental health services before more young lives are tragically lost.

An urgent boost to Aboriginal community controlled health services is required to build on the existing range of initiatives that are being rolled out. We also call on the Government to expand upon evidence-based resilience and cultural connection programs to be adapted and attuned to local needs.

We are calling on the Federal Government to:

  • Provide secure and long-term funding to Aboriginal community controlled health services to expand their mental health, social and emotional wellbeing, suicide prevention, and alcohol and other drugs services, using best-practice traumainformed approaches
  • Increase funding for ACCHSs to employ staff to deliver mental health and social and emotional wellbeing services, including psychologists, psychiatrists, speech pathologists, mental health workers and other professionals and workers;
  • Increase the delivery of training to Aboriginal health practitioners to establish and/or consolidate skills development in mental health care and support, including suicide prevention
  • Commit to developing a comprehensive strategy to build resilience and facilitate healing from intergenerational trauma, designed and delivered in collaboration with Aboriginal and Torres Strait Islander communities

RACP spokesperson Dr Mick Creati, said: “The unspeakable child suicide tragedy that has been unfolding requires a national response and the attention of the Prime Minister. Unless we see urgent boost to investment in Aboriginal-led mental health services then the deaths will continue.”

RANZCP President Dr Kym Jenkins, said: ‘We must address the factors underlying suicidality in Aboriginal and Torres Strait Islander communities, including intergenerational trauma, disadvantage and distress. For this, we urgently need an increased capacity of mental health and wellbeing services to help people and communities recover from trauma and build resilience for the future.’

Part 2 Leaders urged to declare Aboriginal child suicides a ‘national crisis’

 Kate Aubusson From the Brisbane Times 20 March 

Prime Minister Scott Morrison must declare Indigenous child suicides a national emergency and overhaul current strategies, peak medical and health bodies have demanded.

The call comes in the wake of harrowing Aboriginal and Torres Strait Islander child suicide rates, and the WA coroner’s inquest into the deaths of 13 young people, five aged between 10 and 13 years in the Kimberley region.

A joint statement from the Royal Australasian College of Physicians (RACP), the Royal Australian and New Zealand College of Psychiatrists (RANZCP) and the National Aboriginal Community Controlled Health Organisation (NACCHO) has urged Mr Morrison and all state and territory leaders to make Indigenous youth suicides an “urgent national health priority”.

The organisations called on the leaders to launch a “coordinated crisis response” and invest in Aboriginal-led strategies “before more young lives are tragically lost”.

In January, five Aboriginal girls aged between 12 and 15 years took their own lives.

The latest ABS data shows Indigenous children aged 10 to 14 die of suicide at 8.4 times the rate of non-Indigenous children. One in four aged under 18 who suicided were Aboriginal.

None of the 13 children who died by suicide had a mental health assessment, according to the coroner’s report.

The international journal The Lancet Child and Adolescent Health recently called Australia’s Indigenous youth suicide rate an “unmitigated crisis”.

NACCHO CEO Pat Turner said the recent Aboriginal youth suicides was “a national emergency that demands immediate attention”.

The joint statement called for Indigenous community-led solutions, long-term funding boosts to Aboriginal Community Controlled Health Services (ACCHS) for best-practice and trauma-informed mental health, suicide prevention, and drug and alcohol programs.

The organisations also pushed for more ACCHS funding to employ more psychologists, psychiatrists, speech pathologists and mental health workers, increase training for Aboriginal health practitioners to develop a comprehensive strategy focused on resilience and intergenerational trauma healing.

In September the Morrison government announced $36 million in national suicide prevention projects.

Paediatrician with Victorian Aboriginal Health Service Dr Mick Creati said Indigenous suicides could not be prevented by a “white bread psychiatry model”.

Aboriginal suicides were often radically different from those among the general population, research shows. They were more likely to be impulsive, potentially triggered by some kind of interpersonal conflict.

The crisis demanded a “different, culturally appropriate model”, Dr Creati said.

“We don’t know exactly what the right model is yet … but Aboriginal people need to be included [in their development] to make sure they are appropriate for Aboriginal populations.”

But Indigenous psychologist Adjunct Professor Tracy Westerman said Australia had failed to collect crucial evidence to determine what intervention strategies work.

“Funded programs are not required to demonstrate a measurable reduction in suicide and mental health risk factors, which is staggering,” Professor Westerman said.

“We just aren’t demanding that basic level of accountability”.

The first priority must be analyses of suicide mortality data to identify the causal pathways,  Professor Westerman said.

“Suicide risk is the most complex thing to assess and monitor … communities are crying out for specialist assistance and just not getting it. “Children as young as 10 are dying by suicide … this is no longer an Aboriginal issue, it’s a national one,” she said.

Part 3 The eighth meeting of the Kimberley Suicide Prevention Trial Working Group was held on 14 March in Broome communique

The Working Group discussed the findings of WA Coroner’s Report into suicide deaths in the Kimberley and continued its consideration of resources and strategies to support activity as part of the suicide Prevention trial.

The meeting today was chaired by the Hon Ken Wyatt, Minister for Indigenous Health (Commonwealth) and attended by the Hon Roger Cook, Deputy Premier and Minister for Health (WA State Government), Senator the Hon Patrick Dodson (Commonwealth) and Member for the Kimberley, the Hon Josie Farrer MLC (WA State Government). Apologies were received from the Hon Ben Wyatt, Minister for Indigenous Affairs (WA State Government).

The meeting was also attended by over 40 representatives from communities, organisations and government agencies.

Key messages from today’s discussion included:

  • A shared commitment to work together at all levels of government to develop place-based, and Aboriginal-led and designed responses.
  • A commitment to ongoing collaboration.
  • Acknowledgement of the good work achieved thus far – but noting more needs to be done.
  • The role of the community liaison officers on the ground across Kimberley communities was highlighted as an example of good progress – connecting services and projects with what people want.
  • The need to continue mapping services was agreed.
  • The need for holistic approaches was highlighted.
  • Community organisations are keen to work with the State and Commonwealth Governments on solutions that address the recommendations in relation to the report of the WA Coronial Inquest and all other referenced reports.

Part 4 Minister Wyatt Press release

Community driven action plans to prevent suicide are extending across the Kimberley, with four more communities implementing plans to save lives and improve health and well-being.

As part of the Kimberley Aboriginal Suicide Prevention Trial, Kununurra, Balgo, Wyndham and Halls Creek now have local plans, joining Broome, Derby and Bidyadanga.

Each community receives up to $130,000 to help roll out its action plan which reflects and responds to local issues.

However, the four new plans have a common thread – they are centred on people working and walking together on country, with a series of camps involving high-risk groups.

The camps are planned to provide a range of supports around suicide including healing and sharing and respecting cultural knowledge and traditions. They will also support close engagement with Elders.

A strong cultural framework underpins all the Trial’s activities and all the projects identified by the communities fit within the systems-based approach, guided by the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP).

Nine communities are involved in the Kimberley Aboriginal Suicide Prevention Trial, with Community Liaison Officers playing a critical role.

The outcomes will contribute to a national evaluation which aims to find the most effective approaches to suicide prevention for at-risk populations and share this knowledge across Australia.

The Morrison Government is supporting the Kimberley Aboriginal Suicide Prevention Trial with $4 million over four years, from 2016-2020.

It is one of 12 Suicide Prevention Trials being conducted across the nation, with total funding of $48 million.