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.

NACCHO Aboriginal Youth Health #ClosingTheGap #Mentalheath : @SandraEades Connection to our country, culture and family can be profoundly healing. #OurHealthOurChoiceOurVoice Addressing the health deficits that young Aboriginal people face

For Aboriginal people, connection to our country, culture and family can be profoundly healing. But in the many decades we’ve spent working to improve the health of Australia’s first peoples, it’s a strength that has too often been ignored and squandered.

We need to change that, especially when it comes to addressing the health deficits that young Aboriginal people face, the great burden of which is their mental health.

And in their case, the strengths we need to build on includes the young people themselves.” 

PROFESSOR SANDRA EADES Associate Dean (Indigenous), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne

This article was first published on Pursuit. Read the original article.

” Culturally-appropriate care and safety has a vast role to play in improving the health and wellbeing of our people.

In this respect, I want to make special mention of the proven record of the Aboriginal Community Health Organisations in increasing the health and wellbeing of First Peoples by delivering culturally competent care.

I’m pleased to be here at this conference, which aims to make a difference with a simple but sentinel theme of investing in what works, surely a guiding principle for all that we do

Providing strong pointers for this is a new youth report from the Australian Institute of Health and Welfare.

Equipped with this information, we can connect the dots – what is working well and where we need to focus our energies, invest our expertise, so our young people can reap the benefits of better health and wellbeing “

Minister Ken Wyatt launching AIHW Aboriginal and Torres Strait Islander Adolescent and Youth Health and Wellbeing 2018 report at NACCHO Conference 31 October attended by over 500 ACCHO delegates including 75 ACCHO Youth delegates

Read Download Report HERE

NACCHO Youth Conference 2018

Consider this: Over 75 per cent of Aboriginal young people aged 15 to 24 report being happy all or most of the time.

That is according to last year’s Aboriginal and Torres Strait Islander adolescent and youth health and wellbeing report, by the advisory group I chaired.

The report also found that over 60 per cent of Aboriginal young people recognise their traditional homelands, and over half identify with their clan or language group.

And they are increasingly finishing school and saying no to smoking. In the ten years to 2016, the proportion of Aboriginal young people completing Year 12 rose from 47 per cent to 65 per cent. Among 15 to 24-year-olds, some 56 per cent now report never having smoked compared with just 44 per cent in 2002.

In terms of alcohol consumption among Aboriginal aged 18 to 24 years old, some 65 per cent report that in the last two weeks they either hadn’t had a drink or hadn’t exceeded alcohol risk guidelines. That compares with just 33 per cent of non-Aboriginal 18 to 24-year-olds.

And what do they say when we ask them what they stress about most? Getting a job.

Aboriginal young people know the trajectory they want to take. They want to complete school, go to TAFE or University, and most of all get into work.

This tells us that we have a real opportunity to help them. Like all young people, it’s about helping them achieve small wins that can then build into bigger victories.

If you were to say to someone of British heritage that to be really Australian they had to leave Britain behind, forget their connection to their heritage and integrate, you would be laughed at.

But that is the message that has long been given to Aboriginal people even though we have over 50,000 years of connection to this country.

So, it should be no surprise we don’t feel we have to let go of our culture or let go of the strengths that go with being Aboriginal.

It is these unique strengths that we need to get better at integrating into how we deliver healthcare if we are to address the health gap. And the health gap is real.

Aboriginal young people have higher rates of mortality, self-harm and psychological distress.

Youth is a period of our lives when we are supposed to experiment and take risks. But if you are from a disadvantaged group, and being Aboriginal is the most disadvantaged group in the Australia, the issues of living with this disadvantage and intergenerational trauma, can tip the balance towards unhealthy risk taking.

The mental balance can tip towards hopelessness and despair.

But the overwhelming message from this report is that these health deficits are preventable conditions, and that a large part of the problem is gaps in services and support.

Young people aren’t easy to reach. In my career I’ve researched Aboriginal mothers, babies, young children and older people, and they are all much easier to engage with in health settings – but young people don’t tend to hang out at health clinics.

Engaging with young people isn’t an impossible challenge. In our NextGen research, in which we are surveying face-to-face over 2,000 Aboriginal young people about sensitive health topics, we have had to work differently to connect with them. Where we have had success is in the home and in community neighbourhood centres.

In many respects it is obvious. In our preliminary data, of the young people who tell us they have mental health issues, some 70 per cent say their parent and families are the first people they talk to about their problems.

It tells you that if you want to engage with Aboriginal young people you need to be engaging with their families. We need to rethink how services are delivered if we are to make them more effective in engaging with young people.

Since the 1970s, when the first Aboriginal health service opened in Sydney’s Redfern, a whole network has emerged and they are terrific. But they are largely geared toward maternal and child health, and the treatment of chronic conditions that affect mostly older people.

We need to think about how services can be made more accessible to young people specifically, and look at different delivery models. It might be that we need to extend existing services or we might need to look at creating dedicated services, in the same way that the Headspace mental health services are targeted at youth.

Whatever we do it will require more investment at a time when Aboriginal health services have been under severe funding pressure ever since the 2014 Federal government budget cuts.

But improving the health of young Aboriginals goes well beyond the health sector.

According to the report, among Aboriginal 15 to 24-year-olds, a third reported being unfairly treated because of their indigeneity in the last 12 months. And the most frequent setting for unfair treatment was school, in a training course, or at university.

This underlines the importance of educational institutions in embracing Aboriginal culture.

When I went to university in the 1980s the expectation was that we would have to leave our culture at the door. That is now changing thanks to the hard work of many people and universities have created dedicated centres of Aboriginal culture, like Murrup Barak at the University of Melbourne. This work needs to continue.

We need to allow Aboriginal young people to be who they are, and that means helping them to draw on the strengths in themselves and the strengths in the culture and community they rely on.

This article was first published on Pursuit. Read the original article.

 

NACCHO Aboriginal Health #Drugs #Alcohol : Minister @senbmckenzie An additional 72 Local Drug Action Teams #LDATs will be rolled out across the nation to tackle the harm caused by drugs and alcohol misuse on individuals and families.

 

“ It’s fantastic to welcome 72 new LDATs to the program who will develop and deliver local plans and activities to prevent alcohol and drug misuse in their local communities.

Today’s announcement brings the total number of LDATs to 244 across Australia, exceeding our target of 220 by 2020.

LDATs bring together community organisations to tackle substance misuse which can have devastating impacts on our communities – especially in rural and regional areas – and it’s clear that our communities are increasingly becoming empowered to take action at the local level.

The LDAT partnerships include local councils, service providers, schools, police, young people, Indigenous and primary health services and other non-government organisations, and the teams will have support from the Alcohol and Drug Foundation to assist in prevention activities,” 

Minister for Regional Services, Senator Bridget McKenzie

Download the list 

List of all LDATs by jurisdication and grant round Feb 2019

See NACCHO LDAT ACCHO Coverage HERE 

May 2018 : The Senator with Alcohol and Drug Foundation CEO Dr Erin Lalor and  General Manager of Congress’ Alice Springs Health Services, Tracey Brand in Alice Springs talking about the inspirational Central Australian Local Drug Action Team at Congress and announcing 92 Local Drug Action Teams across Australia building partnerships to prevent and minimise harm of ice alcohol & illicit drugs use by our youth with local action plans

Part 1 Press Release 

Speaking at the Wellington LDAT site in Sale, Victoria, the Minister for Regional Services, Senator Bridget McKenzie today congratulated the local community organisations, along with their partners, that will receive funding from the Federal Government through the fourth round of the successful Local Drug Action Team Program.

The new LDATs are being supported through the $298 million investment under the National Ice Action Strategy to combat drug and alcohol misuse across Australia.

Each of the 72 LDATs will receive an initial $10,000 to help them to refine a local community action plan. Each team will have an opportunity to apply for additional funding to support the delivery of local activities once their plans are finalised.

The Member for Gippsland Darren Chester welcomed today’s funding announcement.

“It’s important that we try to stop people in our community from trying illicit drugs for the first time and reduce binge drinking and alcohol abuse,” Mr Chester said. “One way of doing that is to ensure that everyone feels they are part of the community.”

”Gippsland is no different to other areas and drugs and alcohol are ruining lives and devastating families. Ice and other drugs do not discriminate.

“Many of us personally know families in our community who are dealing with the fallout of these insidious drugs.

“This funding enables the community to band together to fight the problem.”

Minister McKenzie said the LDATs announced will be supported to identify and deliver evidence based prevention, promotion and harm-reduction activities which will work for their local community.

Minister McKenzie acknowledged the importance of LDATs for driving change at a local level and highlighted the great work coming out of the program.

“The Hepburn LDAT, for instance, in Victoria is working to prevent and minimise harm from alcohol and drug misuse by improving access to education and skills development for young people,” Minister McKenzie said.

“The team has developed a 19-week program to up-skill young people and help them to build confidence, improve their knowledge about health and reconnect with their community.”

The Local Drug Action Team Program is a key component of the National Ice Action Strategy.

For free and confidential advice about alcohol and other drugs treatment services, please call the National Alcohol and Other Drug Hotline on 1800 250 015.

More information about LDATs can be found on the Alcohol and Drug Foundation website.

Alcohol and other drug-related harms are mediated by a number of factors – those that protect against risk, and those that increase risk. For example, factors that protect against alcohol and other drug-related harms include social connection, education, safe and secure housing, and a sense of belonging to a community.

Factors that increase risk of alcohol and other drug-related harms include high availability of drugs, low levels of social cohesion, unstable housing, and socioeconomic disadvantage. Most of these factors are found at the community level and must be targeted at this level for change.

Alcohol and other drugs are a community issue, not just an individual issue. Community action to prevent alcohol and other drug-related harms is effective because:

  • the solutions and barriers (protective/risk factors) for addressing alcohol and other drug-related harm are community-based
  • it creates change that is responsive to local needs
  • it increases community ownership and leads to more sustainable change

We encourage Local Drug Action Teams (LDATs) to link with and/or build on existing activity approaches that have been shown to work.

Select an existing evidence-based activity

Existing activities may have an alcohol and other drug focus, or possibly a different overall focus such as preventing gambling harm, or enhancing mental wellbeing. Be prepared to look outside the alcohol and other drug sector for possible approaches; for example, activities that share a focus on strengthening communities to improve other health and social outcomes.

A limited number of existing activities are listed below. You may also find other activities through local health services, peak bodies and by drawing on local knowledge and networks you have access to.

Existing strong and connected community activities in Australia:

Delivered by the Alcohol and Drug Foundation , the Good Sports Program works with local sporting clubs across Australia to provide a safe and inclusive environment, where everyone can get involved. The activity has run for nearly two decades and is proven to reduce harm and positively influence health behaviours, as well as strengthen club membership and boost participation.

Established 25 years ago, Big hART engages disadvantaged communities around Australia in art.

Community Hubs provides a welcoming place for migrant women and their children to learn about the Australian education system. With strong evaluation to support the effectiveness of the program, Community Hubs focuses on engagement, English, early-years and vocational pathways.

A national organisation that uses sport and art to improve the lives of people experiencing complex disadvantage.

If you have found some existing activities that could be incorporated, it is useful to seek out further information to find out if it is relevant.

You might want to consider the following questions (some answers may be available online, others you may have to seek directly from the organisation):

  • Does the activity align with your community needs?
  • Is the activity available in your geographic area? If face-to-face delivery is not available, is remote access an option?
  • Has the activity been shown to be effective at strengthening community cohesion and connection, and reducing and preventing alcohol and other drug-related harms? What evidence is available to demonstrate this?

Due to the limited number of existing activities available and the need for tailored approaches, many Local Drug Action Teams will work with partners to develop and deliver a targeted activity in their community. Review the paragraph below d. Determine resources required and Map your steps for insight into what is required when developing new approaches.

NACCHO Aboriginal #MentalHealth : Minister @KenWyattMP and @NRL roll out the Indigenous All Stars #StateofMind mental health program @DeadlyChoices

” Mental health is about being able to work and study to your full potential, cope with day-to-day life stresses, be involved in your community, and live your life in a free and satisfying way. A person who has good mental health has good emotional and social wellbeing and the capacity to cope with change and challenges.

Feeling down, tense, angry, anxious or moody are all normal emotions for people, but when these feelings persist for long periods of time, or if they begin to interfere with their daily life, they may be part of a mental health problem.

Mental health problems can affect your feelings, thoughts and actions, and can affect your ability to function in their everyday activities, whether at school, at work, or in relationships.

If you feel you know a person whose mental health is getting in the way of their daily life, it is important to let them know you are there to support them.

Most parents can tell when something is out of the ordinary, but there are also signs that suggest a young person might be experiencing a mental health problem. “

See Part 2 Below for More INFO and Support HELP Links

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

 ” The Federal Government is investing $660,000 over three years into the National Rugby League’s (NRL) Indigenous All Stars, State of Mind program.

The initiative will deliver mental health and resilience workshops to over 500 Aboriginal and Torres Strait Islander people, including Indigenous All Stars players, youth summit participants and 15 grassroots clubs with a high proportion of First Nations players.

Elite players will be developed as mental health advocacy leaders within their clubs and communities, encouraging help-seeking behaviours. ”

Minister Ken Wyatt Press Release

With rugby league the most popular participation sport in First Nations communities, the NRL will leverage the game’s reach, profile, clubs and players, to help remove the stigma around mental illness.

Aboriginal and Torres Strait Islander people experience high, or very high, psychological distress, at a rate 2.6 times higher than the rest of the nation.

The NRL developed State of Mind in partnership with Lifeline, Kids Helpline, headspace and the Black Dog Institute.

State of Mind was promoted during the Indigenous All Stars game on Friday 15 February 2019 in Melbourne.

All Star Womens Team

The Deadly Choices and the VAHS ACCHO team set up outside of AAMI Park for the Indigenous All-Stars and visited the Fitzroy clinic

Mental health tools and resources, along with information about the program, is available on the NRL State of Mind website.

Our Government funds a number digital mental health and suicide prevention services, which support Aboriginal and Torres Strait Islander people, including:

    • $34 million from 2017-19 for BeyondBlue, to provide information, resources and services on their website that support social and emotional wellbeing
    • $16.9 million from 2018-21 for MindSpot, for their free, national online clinic for the treatment of anxiety and depression
    • $6.4 million per year for headspace for their eheadspace program, which provides free, confidential and anonymous telephone and web-based support for young people aged 12 to 25 years with, or at risk of developing, mild to moderate mental illness.

If you need help now

If you are in an emergency situation or need immediate assistance, contact mental health services or emergency services on 000.

If you need to speak to someone urgently, call Lifeline on 13 11 14or the Suicide Call Back Service on 1300 659 467.

Or contact one of our 302 ACCHO Clinics

Part 2 State of Mind 

Signs and Symptoms

It can be helpful to talk to someone about what’s going on in your life if you have noticed a change in how you are feeling and thinking. This might include:

  • Feeling things have changed or aren’t quite right
  • Changes in the way that you carry out your day-to-day life
  • Not enjoying, or not wanting to be involved in things that you would normally enjoy
  • Changes in appetite or sleeping patterns
  • Being easily irritated or having problems with friends and family for no reason
  • Finding your performance at school, TAFE, university or work is not as good as it used to be
  • Being involved in risky behavior that you would usually avoid, like taking drugs or drinking too much alcohol, or depending on these substances to feel “normal”
  • Feeling sad or ‘down’ or crying for no apparent reason
  • Having trouble concentrating or remembering things
  • Having negative, distressing, bizarre or unusual thoughts
  • Feeling unusually stressed or worried.

Metal health risk factors

A number of overlapping factors may increase your risk of developing a mental health problem. These can include:

  • Early life experiences: abuse, neglect, or the loss of someone close to you
  • Individual factors: level of self-esteem, coping skills and thinking styles
  • Current circumstances: stress at school or work, money problems, difficult personal relationship, or problems within your family
  • Biological factors: family history of mental health problems

Looking after your mental health

here are a number of things you can do to look after and maintain your mental health and wellbeing. For example, many people cope with stress by getting involved with sports, exercising, meditating, or practising yoga or relaxation techniques. Others express themselves through art, such as poetry, writing or music. What you eat might also affect your mood – a well-balanced diet will help keep you both physically and mentally healthy.

If you are concerned about your own or a friend’s mental health and wellbeing, headspace is a great place to go for help. Getting support can help you keep on track at school, study or work, and in your personal and family relationships. The sooner you get help the sooner things can begin to improve for you.

The link between good mental health and exercise

Physical exercise is good for our mental health and for our brains. Exercise seems to have an effect on certain chemicals (dopamine and serotonin) in the brain. Brain cells use these chemicals to communicate with each other, so they affect your mood and thinking. Exercise can also stimulate other chemicals in the brain (brain derived neurotrophic factors) which help new brain cells to grow and develop. Exercise also seems to reduce harmful changes in the brain caused by stress.

Any exercise is better than none. A moderate level of exercise seems to work best. This is roughly equivalent to walking fast, but being able to talk to someone at the same time. It’s recommended that if you’re aged 12-18 you need 60 minutes, or if you’re over 18 you need 30 minutes, of moderate physical exercise on most, but preferably all days. This can be done in one 30 minute session or broken up into shorter 10 or 15 minute sessions.

When you’re feeling down the last thing you might feel like doing is working out, but studies have suggested that any activity, from walking around the block to yoga to biking could contribute to improving the symptoms of depression and anxiety.

Visit www.headspace.org.au for more information on all of the above topics.