NACCHO Aboriginal Health News : Roadmap for Regional and Remote Aboriginal Communities launched

WA

 “The roadmap outlined new approaches to support families to succeed, including working collaboratively with Aboriginal communities and focusing resources on prevention, earlier intervention, capacity building and family empowerment.

“The Government will also engage with Aboriginal communities that want to reduce alcohol-related harm by introducing or strengthening restrictions on alcohol supply and consumption,”

Regional Development Minister Terry Redman and Child Protection Minister Andrea Mitchell released the ‘Resilient Families: Strong Communities’ roadmap, which sets out 10 actions the State Government will undertake in partnership with Aboriginal people to strengthen families, improve living conditions, increase job prospects and accelerate education outcomes.

The ministers launched the roadmap in Kununurra after more than 12 months of discussions with Aboriginal leaders and communities about their aspirations for the future.

The WA Government has laid out its plan to overhaul the servicing of Aboriginal communities, with Indigenous leaders involved in the process describing it as a “once-in-a-lifetime” opportunity for change.

The future of WA’s 274 Aboriginal communities has been under the microscope following Premier Colin Barnett’s comments that the State Government could no longer afford to keep funding all communities, and some would have to close.

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The unit formed eight months ago to review the future of Aboriginal communities will today release details of the changes planned.

The report — described as a “roadmap for Regional and Remote Aboriginal Communities” — outlines a focusing of funding and support on larger communities, and a withdrawal of the minor services currently delivered to more than 1

Mr Redman said the roadmap was a milestone in the Government’s regional services reform and was a long-term commitment to change, supported by immediate actions and engagement with Aboriginal people on specific focus areas.

“The poor living conditions and general lack of opportunities for Aboriginal people in regional WA are not acceptable and must change,” he said.

“The status quo is unacceptable.  This roadmap marks the beginning of a transition to a new way of working – one which builds opportunities and strengthens outcomes, while maintaining access to country, culture and kin.”

Ms Mitchell said the roadmap outlined new approaches to support families to succeed, including working collaboratively with Aboriginal communities and focusing resources on prevention, earlier intervention, capacity building and family empowerment.

“The Government will also engage with Aboriginal communities that want to reduce alcohol-related harm by introducing or strengthening restrictions on alcohol supply and consumption,” she said.

The 10 priority actions are:

  • creation of a $175 million fund for extra housing for Aboriginal families in the Kimberley and Pilbara over four years, tied to greater participation in school and work
  • a three-year $25 million Kimberley Schools Project targeting improved attendance, engagement and learning in Kimberley schools and communities
  • ensuring residents of Aboriginal town-based reserves receive the same services and have the same responsibilities as other residents of nearby towns, starting with a $20 million project in the Pilbara
  • creating work opportunities for Aboriginal people by changing how the Western Australian public sector recruits staff, lets contracts and buys goods and services in the regions
  • identifying up to 10 communities by the end of 2016 with which to work to upgrade essential and municipal infrastructure, and introduce commensurate charges
  • working with community leaders and organisations in Roebourne in 2016–17 to co-design a reorientation of Government-funded services to respond better to local needs and achieve better local outcomes
  • publishing mapping of Government-funded services in the Kimberley and Pilbara during 2016–17 to support work between government agencies, other organisations and communities on developing place-based service systems
  • commencing an initiative in Kununurra in 2016–17 with community leaders and organisations to co-design a family-centred, earlier intervention service delivery model to support and enable better outcomes for local families
  • continuing to support the trial and evaluation of the Australian Government’s cashless debit card in the East Kimberley
  • working with the Australian Government to implement the Compulsory Rent Deduction Scheme in WA.

Mr Redman said the State Government would invest over time to upgrade essential and municipal infrastructure such as power, water and roads, starting in larger remote communities that had the most potential to grow and be sustainable.

Fact File

  • About 12,000 Aboriginal people live in remote communities in WA
  • Regional services reform is focused initially on the Kimberley and Pilbara and will expand to other regions over time
  • The $175 million housing program, $25 million Kimberley Schools Project and $20 million town-based reserves project are supported by the Royalties for Regions program
  • ‘Resilient Families: Strong Communities: A roadmap for regional and remote Aboriginal communities’ is available at http://www.regionalservicesreform.wa.gov.au

However Regional Development Minister Terry Redman has emphasised no-one will be forced to leave the smaller bush out-stations, even though small government contributions, such as fuel subsidies, will be withdrawn. 

“One of the not-negotiables in the work we did, was that we’re not going to remove, or force Aboriginal people to be removed from land, and access to their culture and heritage, access to their kin,” he said.

“So what’s imperative in this, is if someone wants to stay living on the land, living where they’ve always lived, they can do so.”

The 120 communities that have less than 10 residents, or which are only occupied occasionally, will therefore be required to be self-sufficient, while resources are focused on larger centres.

“By the end of the year, we’ll identify 10 of the larger communities and sequentially start coordinating investment into key municipal infrastructure, to give them much better service delivery around water, power, sewerage and the like going forward,” Mr Redman said.

“It may even be some of the bigger centres, where there is access to employment and good quality education, that they could get transitioned into a town.”

Tough decisions needed to ensure future success

The Premier’s comments in December 2012 prompted a widespread backlash, with protests held in capital cities across the country to emphasise the rights of Aboriginal people to remain living on their traditional country.

But Aboriginal leaders who helped develop the remote reform roadmap being released today have urged communities to come on board with the process.

Putijurra woman Kate George, who has been providing feedback from communities in the Pilbara, said the proposed changes are a once-in-a-lifetime opportunity for Aboriginal people.

“I’m optimistic, because the principles in the roadmap document are the things we’ve been advocating for a long time,” she told the ABC.

“So here is an opportunity, but we’ve actually got to go for it. And for me as an Aboriginal woman, I’m saying to the Aboriginal leadership we actually have to grab this, because I don’t think the sushi train’s going to come along too often.

“When you look at our culture and our communities, and the way we’ve lived in the past, there have always been rules. We’ve just been caught up in chaos for the last 55-plus years, and I think everyone wants some order.

“There will have to be some tough decisions made, but ultimately we need to get back to a situation of peace and prosperity.”

Reform process still a mystery to many

But those sitting outside the process appear far more ambivalent about the reform process that will change their lives over the next few years.

The ABC this week visited the community of Pandanus Park, 60 kilometres south of Derby and home to about 100 people.

Local woman Patricia Riley, who runs the community office, said neither she nor the other local families knew anything about the remote reform process.

“I don’t know if it will benefit our community, not just our community but the remote communities,” she said.

“We’d love to have more funding allocated back to our remote communities, and have employment for a proper CEO.

“I’m doing my best trying to get childcare funding up and running, a telecentre to have literacy and numeracy programs, and have the internet services running properly.

“Because now, the majority of people are on Centrelink, and we’d like to get them off Centrelink and get proper employment for them.”

Patricia Riley

Pandanus Park’s size and location means it will continue to receive funding, as it sits just off the region’s main highway and is only half an hour’s drive from the town of Derby.

But Ms Riley said many people had already started leaving small bush communities in the area as Government funding dried up.

“It makes me feel sad, heartbroken,” she said.

“The majority of people have moved out through lack of funding and communication, no support, so they’ve moved because they have to look for a job, so they move into towns or a bigger community that’s got jobs and they leave the little places which is their home.

“We are all struggling, especially the smaller ones. All the service providers that are supposed to be out here helping us, I don’t know what they’re there for, probably just window-dressers.

“The bigger communities, they’ve got the majority of people who got educated and got all these skills, but some of us are still left in the Stone Age.

“We’re still trying to pick things up and trying to keep the community going with whatever knowledge or education we got.”

Opportunity to support a special edition #HealthElection16 NACCHO Aboriginal Health Newspaper PUBLISH DATE June 29

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The Koori Mail is an Australian media institution, 100% owned and controlled by Aboriginal people. The fortnightly newspaper circulates all states and covers the issues that matter the most to black Australians. 25 years since its first print, the Indigenous paper is still breaking ground for Indigenous journalism.

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NACCHO #HealthElection16 : AMA launches Key Health Issues / Aboriginal Health policy for 2016 Federal Elections

Brian

” The gap in health and life expectancy between Aboriginal and Torres Strait Islander people and other Australians is still considerable, despite the commitment to closing the gap.

The AMA sees progress being made, particularly in reducing early childhood mortality rates, and in addressing major risk factors for chronic disease, such as smoking. However, to close the gap in Indigenous health, Government must commit to improving resourcing for culturally appropriate primary health care for Aboriginal and Torres Strait Islander people, and the health workforce.

Including increased investment in Aboriginal and Torres Strait Islander community controlled health organisations. Such investment must support services to build their capacity and be sustainable over the long term;

Brian Owler AMA President pictured above Matthew Cooke Chair of NACCHO at recent NACCHO Event Parliament House Canberra : The Aboriginal Policy is part of a 16 Page AMA Health Issues Document  

“The Medicare freeze is not just a co-payment by stealth – it is a sneaky new tax that punishes every Australian family,”

Professor Owler said, with the elderly and chronically ill among those most affected see press release here AMA LAUNCHES NATIONAL CAMPAIGN AGAINST THE MEDICARE REBATE FREEZE (FED)

Putting Health First

Download the 16 Pages here AMA Key Health Issues Federal Election 2016

Health policy will be at the core of the 2016 Federal Election.

The AMA is non-partisan. It is our role during election campaigns, as it is throughout the terms of governments, to highlight the issues we think will be of greatest benefit to the health system, the medical profession, the community, and patients.

As is customary, the AMA will focus on the respective health policy platforms presented by the major parties in the coming weeks.

The next Government must invest significantly in the health of the Australian people.

Investment in health is the best investment that governments can make.

We must protect and support the fundamentals of the health system.

The two major pillars of the system that mean most to the Australian people are quality primary health care services, led by general practice, and well-resourced public hospitals.

The AMA has advocated strongly and tirelessly on these issues for the term of the current Government.

General practice and public hospitals are the priority health issues for this election.

The AMA is calling on the major parties to lift the freeze on the Medicare Benefits Schedule (MBS) patient rebate. The freeze was extended until 2020 in the recent Budget. The freeze means that patients will pay more for their health care. It also affects the viability of medical practices.

We also need substantial new funding for public hospitals. The Government provided $2.9 billion in new funding in the Budget, but this is well short of what is needed for the long term.

We must build capacity in our public hospitals. Funding must be better targeted, patient-focused, and clinician led.

The AMA is also calling for leadership and effective policy from the major parties on Indigenous health, medical workforce and training, chronic disease management, and a range of important public health measures.

The AMA will release a separate Rural Health Plan, responding to the unique health needs of people in rural and regional Australia, later in the election campaign.

Elections are about choices. The type of health system we want is one of those crucial decisions.

In this document, Key Health Issues for the 2016 Federal Election, the AMA offers wide-ranging policies that build on what works. We offer policies that come from the experience of doctors who are at the coalface of the system – the doctors who know how to make the system work best for patients.

The AMA urges all political parties to engage in a competitive and constructive health policy debate ahead of the election on 2 July.

Indigenous Health Policy Continued

Despite the recent health gains, progress remains frustratingly slow and much more needs to be done. A life expectancy gap of around 10 years remains between Aboriginal and Torres Strait Islander people and other Australians, with recent data suggesting that Indigenous people experience stubbornly high levels of treatable and preventable conditions, high levels of chronic conditions at comparatively young ages, high levels of undetected and untreated chronic conditions, and higher rates of co-morbidity in chronic disease. This is completely unacceptable.

It is not credible that Australia, one of the world’s wealthiest nations, cannot address health and social justice issues affecting just three per cent of its citizens. The Government must deliver effective, high quality, appropriate and affordable health care for Aboriginal and Torres Strait Islander people, and develop and implement tangible strategies to address social inequalities and determinants of health.

Without this, the health gap between Indigenous and non-Indigenous Australians will remain wide and intractable.

The AMA calls on the major parties to commit to:

  • correct the under-funding of Aboriginal and Torres Strait Islander health services;
  • establish new and strengthen existing programs to address preventable health conditions that are known to have a significant impact on the health of Aboriginal and Torres Strait Islander people such as cardiovascular diseases (including rheumatic fever and rheumatic heart disease), diabetes, kidney disease, and blindness;
  • increase investment in Aboriginal and Torres Strait Islander community controlled health organisations. Such investment must support services to build their capacity and be sustainable over the long term;
  • develop systemic linkages between Aboriginal and Torres Strait Islander community controlled health organisations and mainstream health services to ensure high quality and culturally safe continuity of care;
  • identify areas of poor health and inadequate services for Aboriginal and Torres Strait Islander people and direct funding according to need;
  • institute funded national training programs to support more Aboriginal and Torres Strait Islander people to become health professionals to address the shortfall of Indigenous people in the health workforce;
  • implement measures to increase Aboriginal and Torres Strait Islander people’s access to primary health care and medical specialist services;
  • adopt a justice reinvestment approach to health by funding services to divert Aboriginal and Torres Strait Islander people from prison, given the strong link between health and incarceration;
  • appropriately resource the National Aboriginal and Torres Strait Islander Health Plan to ensure that actions are met within specified timeframes; and
  • support for a Central Australia Academic Health Science Centre. Central Australia faces many unique and complex health issues that require specific research, training and clinical practice to properly manage and treat, and this type of collaborative medical and academic research, along with project delivery and working in remote communities, is desperately needed.

Australian Medical Association joins campaign against Medicare rebate freeze

AMA POSTER

Download the AMA Press Release

AMA LAUNCHES NATIONAL CAMPAIGN AGAINST THE MEDICARE REBATE FREEZE (FED)

Article below originally published here

Tens of thousands of specialist doctors are joining GPs’ war against the Turnbull government’s extended freeze on Medicare rebates, increasing pressure on the Coalition’s health record ahead of the federal election.

The Australian Medical Association has distributed posters to its members, warning patients that they will be out of pocket because the cost of running the medical practice will continue to rise as Medicare rebates stay frozen until 2020.

“You will pay a new or higher co-payment every time you visit your GP, every time you visit other medical specialists, every time you need a blood test, and every time you need an X-ray or other imaging,” it says, alongside a photo of a woman comforting a crying child.

It comes a week after the Royal Australian College of General Practitioners announced its 32,000 members would urge their patients to lobby local MPs against the move. The groups share about 8000 members, adding about 22,000 more specialist doctors to the campaign.

The AMA’s campaign similarly encourages patients to contact their local MPs and election candidates, but goes further to directly blame the Turnbull government for the extra cost: “The government has cut Medicare and wants you to pay for it.”

While pathologists on Friday agreed to retain bulk-billing rates in exchange for reduced regulatory pressure on rents under a deal with Health Minister Sussan Ley, the AMA maintains that they and diagnostic imaging services will remain under pressure to charge patients, with the government’s cuts to bulk-billing incentive payments deferred till later in the year.

The AMA’s president, Professor Brian Owler, said many doctors had absorbed costs but the extension “has pushed them over the edge”. They may charge patients a $30 co-payment to cover costs associated with moving to a private billing system, more than triple the Abbott government’s failed and deeply unpopular $7 GP co-payment, he said.

“The Medicare freeze is not just a co-payment by stealth – it is a sneaky new tax that punishes every Australian family,” Professor Owler said, with the elderly and chronically ill among those most affected.

While most specialists (about 70 per cent) already charged patients a co-payment, having had their rebates frozen for decades, the extended freeze could reduce the bulk-billing rate further, an AMA spokesman said.

Labor froze indexation for eight months in 2013, lifting it briefly for GPs in 2014-15. The Coalition extended it for four years in 2014, and this year extended it a further two years to 2020, to save $925.3 million.

Opposition Leader Bill Shorten said Labor opposed the extended freeze at the leaders’ debate on Friday, but would not say whether it would commit to lifting it if elected.

Thirty per cent of 400 GPs surveyed by the College said they would stop all bulk-billing, including for concession card holders, due to the extended freeze. Another 18 per cent said the practice would start charging a co-payment, but cap annual out-of-pocket fees for concession card holders.

Thirty per cent said they would maintain a mixed billing policy, and 10 per cent would continue to bulk bill all patients. Twelve per cent said they were already privately billing all their patients.

The Turnbull government plans to cut bulk-billing incentives for pathology and diagnostic imaging services to save $650 million over four years. Pathology Australia, which had warned this would lead more doctors to charge patients for pap smears, blood and urine tests, has agreed to drop its public campaign against the cuts.

Ms Ley said: “The Coalition will increase Medicare investment to $26 billion per year by 2020-21, while introducing revolutionary reforms such as Health Care Homes that cement a GP’s role at the centre of patient care.”

While she appreciated many GPs’ efforts to keep costs down during the indexation freeze, she was disappointed that “there’s no reciprocal offer to assist taxpayers with the immediate financial challenges our budget faces while [Health Care Homes are] implemented”.

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            Send your Aboriginal Health issue message to Canberra for

#HealthElection16

Advertising and editorial is invited from

All political parties

NACCHO 150 Members and Affiliates

Stakeholders/ Aboriginal organisations

Peak Health bodies

Closing 17 June for publishing election week 29 June

Contact for Advertising rate cards/bookings/editorial

NACCHO Aboriginal Male Health News : Shame’ deters males from sexual health help

Ingkintja Male Health Congress Alice Springs

“The sexual health of men in remote Indigenous communities would likely improve if they had access to “male safe areas” in health clinics .If Indigenous men are reluctant to present to clinics because the service does not feel appropriate to them, we would argue that the health service is inequitable.

Our findings may also have implications for other important areas of men’s health, such as chronic disease of mental health management if a sex disparity in screening, testing and treatments is found in these areas

School of Health Associate Professor Suzanne Belton Charles Darwin University ” Gendered sexual health services are needed in remote communities “

“Sexual health programs need to be conducted in appropriate settings for males, and it is notable that while women may be screened opportunistically at several convenient events (Ante natal Clinic, Pap smear and breast check, while bringing kids in to the Primary Health Care Centre) there are fewer opportunities for adult males.
For adolescent males there are even less opportunities, so targeted interventions will be necessary at times. Aboriginal men occupy a range of sexualities and all should have appropriate unbiased access to primary health care including, gay males, men who have sex with men (MSM) and sister-girls (transgender)

NACCHO Blueprint for Aboriginal Male Health: Sexual and Reproductive Health (see full Blueprint below )

Photo Above : Ingkintja Male Health Congress Alice Springs

The sexual health of men in remote Indigenous communities would likely improve if they had access to “male safe areas” in health clinics or male-specific outreach services, a Charles Darwin University academic says in the May edition of an international health journal.

School of Health Associate Professor Suzanne Belton said men’s sense of shame from being seen by women while visiting a clinic was one of several factors that contributed to high rates of sexually transmitted infections in remote communities.

“Some men do not seek testing for sexually transmitted infections because they cannot see a male clinician, which is particularly important in this type of clinical encounter,” Dr Belton said.

“If Indigenous men are reluctant to present to clinics because the service does not feel appropriate to them, we would argue that the health service is inequitable.

“Until culturally and gender appropriate approaches to sexual health services are implemented, sexually transmitted infection (STI) rates in Indigenous Australians are likely to remain high.”

Dr Belton and co-authors Dr Jiunn-Yih Su and Dr Nathan Ryder posed the question “Why are men less tested for sexually transmitted infections in remote Australian Indigenous communities” in an article published this month in Culture, Health and Sexuality.

“To our knowledge, this is the first study in Australia to investigate the reasons for disparity in STI testing rates between men and women in remote Indigenous communities,” Dr Belton said.

The study in a remote Northern Territory community confirmed a low level of health literacy among some Indigenous men.

“Culturally appropriate sexuality education and health promotion to men and boys would improve understanding of their own sexual health needs. “Men and boys require sexuality knowledge to be able to look after themselves and their sexual partners.”

Dr Belton said Indigenous men and women deserved the highest standard of health care that a country was able to provide and if men’s sexual and reproductive health remained poor this impacted on women’s and infants’ health.

NACCHO Blueprint for Aboriginal Male Health:

(this document contains an area that deals with Sexual, Reproductive Health)

NACCHO’s position paper on Aboriginal male health (2010) describes the key policy areas and programs NACCHO has documented should be developed in male health.

These include physical health, strong minds, brother care, healing and men’s business, as well as Aboriginal male health workforce development. It summarises that Aboriginal male health should be a core primary health care service provided by Aboriginal Community Controlled Health Organisations (ACCHOs). NACCHO as a cultural organisation has always supported the proper gender based approaches to health service provision, which fits within the current approaches of primary health care service quality and research and evaluation.

Aboriginal Males have a unique and important role in their communities.

All too often Aboriginal male health is approached negatively, with programs only aimed at males as perpetrators. Examples include alcohol, tobacco and other drug Services, domestic violence, prison release, and child sexual abuse programs. These programs are vital, but are essentially aimed at the effects of males behaving badly to others, not for promoting the value of males themselves as an essential and positive part of family and community life.
To address the real social and emotional needs of males in our communities, NACCHO proposes a positive approach to male health and wellbeing. We need to celebrate Aboriginal masculinities, and uphold our traditional values of respect for our laws, respect for elders, culture and traditions, responsibility as leaders and men, teachers of young males, holders of lore, providers, warriors and protectors of our families, women, old people, and children.

The NACCHO approach is to support Aboriginal males to live longer healthier lives as males for themselves. The flow-on effects will hopefully address the key effects of poor male behaviour by expecting and encouraging Aboriginal males to be what they are meant to be.
In many communities, males have established and are maintaining men’s groups, and attempting to be actively involved in developing their own solutions, to the well documented men’s health and wellbeing problems, though almost all are unfunded and lack administrative and financial support.

Health and Wellbeing
Aboriginal males have arguably the worst health outcomes of any population group in Australia.
Key health issues continue to be
•       Injury and suicide
•       Cardiovascular disease
•       Respiratory disease
•       Diabetes.
There are however, a number of male specific health issues not identified here which are poorly documented, this includes mental health and wellbeing issues.

Social determinants relating to identity culture, language and land, as well as violence, alcohol, employment and education remain significant issues.
In considering the health and wellbeing of Aboriginal males, it is important also to take into account the construction of ‘masculinity’, the relationships between Aboriginal males and females, and concepts of health which may differ from Anglo-European ways of thinking.

Integration of Aboriginal male health in targeted strategies
Male health should be identified and prioritised (as appropriate) in all health strategies developed for Aboriginal Community Controlled Health Organisations (ACCHOs) including that all relevant programs being progressed in these services will be expected to ensure Aboriginal male health is considered in the planning phase or as the program progresses.
Specialised Aboriginal male health programs and targeted interventions should be developed to address male health intervention points across the life cycle continuum.

This may include
•       Community specific adolescent programs
•       Adult male health and include men as boyfriends, schoolchildren, partners, fathers, grandfathers, and children
•       Men’s business programs should be developed as appropriate
Male (Men’s Business) camps may be the most appropriate context for group education and information sessions on specific male health issues such as sexual health and sexually transmitted infections, These camps may also be the most appropriate forum for males to develop their own responses to address domestic violence, alcohol and substance abuse as well as child sexual abuse and neglect.

Improving Access to health care


Accessibility of health services to males has been identified as an issue in numerous male health conferences and summits This includes access to Primary Health Care in all contexts, but especially the clinical services.
Wherever possible males should have access to
•       male Aboriginal Health Workers,
•       Registered Nurses,
•       GPs and male specialists as required.
Accessibility within the Primary Health Care Centre may mean restructuring clinics to accommodate male specific areas, or off-site areas, and may include specific access (back door entrance) to improve attendance and cultural gender issues. For men that work, services should investigate the potential for holding regular after hour’s clinics to accommodate their needs. This need not be onerous, and could be additional 5-6 pm clinics to be held fortnightly.

Sexual and Reproductive Health
Sexual health programs need to be conducted in appropriate settings for males, and it is notable that while women may be screened opportunistically at several convenient events (Ante natal Clinic, Pap smear and breast check, while bringing kids in to the Primary Health Care Centre) there are fewer opportunities for adult males.
For adolescent males there are even less opportunities, so targeted interventions will be necessary at times. Aboriginal men occupy a range of sexualities and all should have appropriate unbiased access to primary health care including, gay males, men who have sex with men (MSM) and sister-girls (transgender)

While there are obvious funding constraints on these innovations there is much that can be achieved within current primary health care practice as well.

Workforce
A key element in providing appropriate services for males is the development of a sufficient quantity and quality of male health workforce. This includes both Aboriginal and non-Aboriginal males in the health workforce. Every service should have accessible male clinical staff for males.  Where there are deficiencies in male health workforce, recruitment should note gaps and target male recruitment.  Male Aboriginal Health Workers should be able to have access to specialist male health training and male health career opportunities, including subspecialist status as per child health and women’s health. Any service specific male health strategy and appropriate workforce should be supported by a full time male health coordinator.

A healthier generation
Male health outcomes are affected from conception to old age and insults to the body at any time, such as chemical, physical, emotional all have an effect.
Interventions to minimise risk therefore start at preconception with the health and wellbeing of the new mother having an impact on the developing foetus. This may include nutritional status, smoking cigarettes, alcohol intake and emotional stress amongst others. Males have a role to play even at this early stage, and can assist their sons and nephews by ensuring the mother is supported and help her to minimise risks.
At each life stage there are intervention points, though some are more difficult than others. Adolescence is a significant time for young males, but also a time when they least engage with health services. Services need to target this group and each service should develop strategies with Men’s Groups to engage this population.

Conclusion
The Boomerang Method
NACCHO encourages all Aboriginal males (of all ages) to ensure that they have an Aboriginal Community Controlled Health Service where they can go regularly for their health check, for monitoring and review of ongoing health problems,  for a consultation when new problems arise, and to co-ordinate their ongoing health care. NACCHO also encourages and supports all Aboriginal males who do not have ready access to a culturally safe primary health care service which is able to address all the health needs of Aboriginal males, to take appropriate action with other Aboriginal people and their organisations to overcome these access problems.

Contact details NACCHO OCHRE DAY

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NACCHO Aboriginal #HealthElection16 : Storytelling ,leadership ,Ken Wyatt MP and healthy hearts

KW and Eddie Masina

Eddie, your story is an important story because if we’re going to change health and the health outcomes of our people, we need to hear the stories from those who’ve been affected. …the work you do – what you think is not important – it is actually absolutely critical because you are keeping our storytellers and our cultural knowledge as a part of life.

And you are perpetuating our culture through the work that you do. The work that we do collectively to keep people alive much longer, means families and the communities have the opportunity to share the knowledge. Closing the gap is a challenge to achieve that requires a concerted effort by all.

Because if we are to make a difference, then collectively we as Australians, not just governments, we as Australians, need to work very closely, but more importantly, we need to encourage people like Eddie to become the storytellers so that we develop the understanding.

The Hon. Ken Wyatt, AM, MP, Assistant Minister for Health and Aged Care, was a keynote speaker at a recent RHDA Conference in Brisbane. He paid tribute to RHD patient Eddie Masina and spoke about the need to utilise old traditions of storytelling to spread the word amongst Indigenous communities. 

 Pictured below Minister Wyatt signing the Close the Gap Statement of Intent 2008
KW

 

Australia has one of the highest recorded rates of Rheumatic Heart Disease (RHD), despite the disease being almost eliminated in developed countries.

RHDAustralia, in association with the Heart Foundation and Queensland RHD Control Program, hosted the RHD Close the Gap Conference on 22 and 23 March, where over 200 Queensland healthcare professionals learnt about best practice approaches to the prevention, treatment and management of rheumatic fever and

RHD and heard the latest developments in RHD control in Australia.

Along with educating and informing healthcare workers, the Conference laid the groundwork for potential policy change and highlighted the importance of collaboration at a National and State level to address this issue.

RHD is a significant public health issue in Queensland; recent audits undertaken by Queensland Department of Health have uncovered a previously unknown burden of the disease in urban centres with approximately 380 new cases identified in the past 12 months. This is in addition to over 2,000 people already on the rheumatic heart disease register in Queensland and over 6,000 people on registers across the country.

Approximately 40% on these registers are under the age of 24 and at risk of premature death or disability.

Storytelling – finding new ways for stories to be shared

Many patients related their personal stories with rheumatic heart disease over the course of the conference, including Eddie Masina, a Djirbalngan man now living in Townsville. Eddie shared his journey, which started at age 5. He told how the disease has impacted his life, with five open-heart surgeries and a stroke. RHD has affected his family, his employment opportunities and his education. His story highlights the need for early detection and diagnosis by informed clinicians.

The Hon. Ken Wyatt, AM, MP, Assistant Minister for Health and Aged Care, was a keynote speaker at the Conference events. He paid tribute to Eddie Masina and spoke about the need to utilise old traditions of storytelling to spread the word amongst Indigenous communities.

Think ARF. Stop RHD.

“In the past our elder women and mothers taught the next generations of young women about those things that kept us healthy and strong; that enabled us for 40,000 years to live on this continent and grow in number and strength.

“We seem to have stopped that, which is a pity because I think if we start to go back to the sharing of knowledge in a way that is culturally appropriate and built around our matriarchal system, then I think we will see some changes emerge.”

The stories of those affected by RHD – patients, families, and communities – must be heard; they are a catalyst for action and they inspire and inform improved practice. Those in attendance at the Conference were motivated by Eddie Massina to do more, learn more, advocate more for those living with this disease, and to safeguard future young generations from the damage done by this devastating disease that is a marker of poverty and disadvantage.

There is a role for a broader group of champions from clinical, political and social sectors who can assist in raising the profile of RHD in multiple settings. Oral storytelling is at the heart of Aboriginal and Torres Strait culture – we should embrace this and work to find more ways for stories to be shared.

Greater Leadership

The World Heart Federation (WHF) has adopted the World Health Assembly’s goal of reducing premature non-communicable diseases mortality by 25% by 2025, developing roadmaps in priority areas. The WHF recognises that the political windows opened by governments’ coordinated efforts to meet the global goal represent a once-in-a-generation opportunity to influence policy makers and dramatically accelerate action around cardiovascular disease.

In Australia, we have many committed individuals taking action to raise awareness of ARF (Acute Rheumatic Fever) and RHD and to bring an end to this entirely preventable disease. However, there is widespread concern that in our wealthy, developed nation, more should be done to address Indigenous disadvantage and the resultant health conditions. RHDAustralia sincerely thanks the Hon. Ken Wyatt, AM, MP, (Assistant Minister for Health and Aged Care) and the Hon. Cameron Dick (Queensland Minister for Health) for being part of the RHD education and awareness raising events in Brisbane.

Senator Nigel Scullion recently noted that this year’s Closing the Gap report has highlighted there are still major challenges to eliminating Indigenous disadvantage, despite the progress that is being made. Senator

Fiona Nash recently announced a further $2.5 million for Indigenous Eye Health to ensure that Australia is able to eliminate trachoma by 2020 and close the gap in eye health between our Indigenous and non- Indigenous Australians. The RHD community applauds this and other initiatives to Close the Gap on Indigenous health outcomes, but there needs to be a more concerted effort from Governments at all levels to commit to eliminating the factors that contribute to all preventable, communicable diseases.

New opportunities, new knowledge and new technology make us optimistic that we can make a real difference. The vision is that by working collaboratively we can eliminate what is an entirely preventable condition.

RHDAustralia acknowledges the Federal Government’s commitment in the 2016-2017 Budget to extending funding to the National Partnership for the Rheumatic Fever Strategy until June 2017.

For further information please contact Catherine Halkon at RHDAustralia – Catherine.Halkon@menzies.edu.au

National Approach Needed for Heart Disease

Today’s burden of disease report, released by the Australian Institute of Health and Welfare – represents a major wake up call for all parties contesting the federal election, highlighting the huge impact a small number of risk factors have on the national disease burden.

The risk factors causing the most burden were tobacco use, high body mass, alcohol use, physical inactivity and high blood pressure, which are all major factors in heart disease. The report found that a third of the burden experienced by the population could be prevented by reducing the exposure to modifiable risk factors.

Heart Foundation Chief Medical Advisor Prof Garry Jennings

Today’s burden of disease report, released by the Australian Institute of Health and Welfare

Although the largest fall in the fatal burden was seen in heart disease, the Heart Foundation Chief Medical Advisor Prof Garry Jennings said there was no room for complacency.

“We need to lift our effort to reduce the impact of these risk factors if we are to continue to tackle Australia’s number one killer heart disease,” Prof Jennings said.

“This major AIHW study demonstrates the need to invest more in addressing those critical risk factors of tobacco use, high body mass, alcohol use, physical inactivity and high blood pressure.”

Heart disease was one of the five chronic diseases that dominate in terms of total burden, with this quintet accounting for 69% in males and 62% in females of the total disease burden.

“Australia performs well when it comes to tobacco control – a credit to all major parties. But we are well behind the eight-ball when it comes to other major risk factors,” he said.

“We need to see the same effort invested in addressing physical inactivity, overweight/obesity and alcohol misuse.”

Prof Jennings added that Australia needed to see much greater attention paid to early detection, especially for those at risk of heart attack, stroke and other vascular conditions such as type 2 diabetes and kidney disease.

“We would also like to see more effective treatment for people with heart disease to address treatment gaps as well as more support for heart research as the disease burden evolves.

“Both the major parties are committed to a 12.5% annual increase in tobacco tax and we must keep the pedal to the metal to maintain that progress, especially with parts of the population with high smoking prevalence.”

Some of the $4.7bn raised over the next four years should be invested in prevention, making this a cost neutral measure for government.

Sadly, Australia is in the bottom third of OECD nations when it comes to investing in public health. Australian governments invest less than 2% of total health care expenditure in prevention, well behind class leaders New Zealand, on 7%, and Canada, on 5.9%.

In Australia in 2008-09 hospital costs attributed to heart disease was nearly $1.9b, with today’s estimate at $2.5b.

“When it comes to addressing the risk factors of heart disease, we know what will work is a comprehensive approach,” Prof Jennings said.

“These include national action plans for heart disease and stroke as well as physical activity, introducing an integrated health check, improving participation in cardiac rehabilitation programs, funding for cardiovascular research and directing focus of the new Medical Research Future Fund investment on major causes of the Australian disease burden.

“By adopting the recommended actions, we can prevent premature death, improve quality of life and reduce the immense economic burden heart disease places on the health system.”

The Heart Foundation urges all major parties to read this report and take decisive action.

– ends

 

NACCHO #healthelection16 : Client contacts at Aboriginal health organisations continue to increase

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Australian Government-funded primary health care organisations saw around 435,000 individual clients through over 3.5 million episodes of care, an average of 8.2 episodes of care per client, in 2014-15, according to a report released today by the Australian Institute of Health and Welfare (AIHW).

DOWNLOAD THE REPORT AIHW Aboriginal Health Organisations May 2016

The report, Aboriginal and Torres Strait Islander health organisations: Online services report-key results 2014-15 includes information from 278 organisations across Australia providing health services to Aboriginal and Torres Strait Islander people.

Seventy-three per cent of these organisations (203) provided primary health-care services and 68% (138) of these were Aboriginal Community Controlled Health Organisations.

‘The health services and activities provided by these organisations play an important role in delivering health care to Indigenous people,’ said AIHW spokesperson Dr Fadwa Al-Yaman.

‘This includes clinical care, health promotion, child and maternal health, social and emotional wellbeing support and substance-use prevention’.

In 2014-15, most organisations (220) provided maternal and child health services, with 7,400 Indigenous women accessing antenatal services through 34,100 visits. Around 22,100 health checks for Indigenous children aged 0-4 years were conducted.

Social and emotional wellbeing services-counselling, family tracing and reunion support services-were provided by 97 organisations employing 221 counsellors, a 17% increase in counsellors compared with 2013-14.

Substance-use services were offered at 67 organisations, and saw 25,200 clients through 151,000 episodes of care, an average of 6 episodes of care per client.

Compared with 2013-14, the number of client contacts increased by 9% while client numbers increased by 4%. Over time, the average number of contacts per client per year has increased from 7.7 in 2008-09 to 11.6 in 2014-15.

There were 4,454 health staff employed in primary health care organisations and 2,905 other staff. Just over half (53%) of all staff were Indigenous. The most common health workers were nurses and midwives (15%), followed by Aboriginal health workers (11%) and doctors (6%).

‘Staffing varied by location, with 39% of nurses and midwives employed in Very remote areas and 31% of Aboriginal health workers employed in Outer regional areas,’ said Dr Al-Yaman.

Client contacts by nurses and midwives represented 50% of all client contacts in Very remote areas compared with 29% nationally.

The AIHW is a major national agency set up by the Australian Government to provide reliable, regular and relevant information and statistics on Australia’s health and welfare.

This seventh national report presents information from 278 organisations across Australia, funded by the Australian Government to provide one or more of the following health services to Aboriginal and Torres Strait Islander people: primary health care, maternal and child health care, social and emotional wellbeing services, and substance-use services. These organisations participated in the 2014–15 Online Services Report data collection. Information is presented on the characteristics of these organisations, the health services and activities provided to clients and staffing levels. Other information presented includes client numbers, client contacts and episodes of care, and service gaps and challenges.

Primary health client contacts increased

  • In 2014–15, 203 of the organisations (73%) were funded to provide primary health-care services and many of these were Aboriginal Community Controlled Health Organisations (138 or 68%).
  • These organisations employed 7,359 full-time equivalent staff and just over half (53%) were Indigenous, a similar proportion to 2013–14 (53%). The workforce was made up of 4,454 health staff (61%) and 2,905 other staff (39%). Nurses and midwives were the most common type of health worker, representing 15% of employed staff. This was followed by Aboriginal health workers (11%) and doctors (6%). However, the relative proportions of these varied by remoteness area, with more nurses and midwives being employed in Very remote areas (39%) and more Aboriginal health workers in Outer regional areas (31%).
  • Health staff provided primary health-care services to around 434,600 clients through 5.0 million client contacts. Since 2013–14, client contacts increased by 9%. Although the number of staff per 1,000 clients was similar to 2013–14 (18 per 1,000 clients), the number of contacts per client showed a small increase and continued an upward trend in average contacts per client overtime, which has gone from 7.7 in 2008–09 to 11.6 in 2014–15.

An average of nearly 5 antenatal visits per woman

In 2014–15, 220 of the organisations (79%) provided maternal and child health services, either through primary health or New Directions funding. Around 34,100 antenatal visits were reported for 7,400 Indigenous women, an average of 4.6 visits per woman. Around 22,100 child health checks were conducted for Indigenous children aged 0–4 years.

More social and emotional wellbeing counsellors

In 2014–15, 97 of the organisations (35%) were funded to provide social and emotional wellbeing services. They employed 221 counsellors, an increase of 17% compared with 2013–14. Around 60% of counsellors were Indigenous, a similar proportion to 2013–14 (62%). Services were provided to around 21,100 clients through 100,200 client contacts.

Amphetamines seen as an important substance-use issue

In 2014–15, 67 of the organisations (24%) were funded to provide substance-use services. They saw around 25,200 clients through 151,000 episodes of care. Most episodes of care (89%) were for non-residential or after-care services. The proportion of these organisations that reported amphetamines as one of their most important issues in terms of staff time and organisational resources increased from 45% in 2013–14 to 70% in 2014–15.

Watch NACCHO TV to learn about Aboriginal Health In Aboriginal hands

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NACCHO News Alert : Australian Story ABC TV : Dr Mark Wenitong, reggae musician and #Indigenous health leader

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Dr Mark Wenitong describes himself, first and foremost, as a musician.

He certainly plays a mean guitar in his reggae band. But he is also the father of multi-award winning musicians who have played to packed stadiums — Shakaya, Local Knowledge and The Last Kinection.

At the same time, Mark is a leader in Indigenous health who says his greatest role model was his mother Lealon, who in the 1950s and ’60s fought against the odds to become a pioneering Indigenous health worker.

Eight years ago the family was plunged into crisis when a car crash nearly claimed the life of Mark’s daughter Naomi — one half of chart-topping duo Shakaya. Now Mark’s son, Joel, who was at the wheel on that night, is following his father’s footsteps from music into medicine — and “doing something practical to help our mob”.

Realising an ‘impossible dream’

Lealon, one of Australia's first indigenous health workers

Mark grew up in Gladstone, one of six children being raised by his mother Lealon, who was on her own after throwing out a violent husband.

“She had an ethic that said you either study or you work, ‘but you’re not doing nothing’,” he recalls. “Studying was easier than working, so I went to uni.”

Mark met Deb Sisson, a classically trained musician, at university. The couple fell in love and formed a reggae band which paid the rent and fed the mouths of their rapidly expanding family.

Mark studied laboratory science and became a pathology technician in Cairns.

He began to notice the Third World health problems facing Cape York communities and realised he had to try to do something about the problem.

His mother spotted a small announcement in the paper, offering medical training for Indigenous students at Newcastle University.

Mark went off to Newcastle as a mature-aged student, entering a world he had previously thought had been unattainable.

“Newcastle Medical School, to the best of my knowledge, is responsible for graduating about half of all Indigenous doctors in the country,” says Dr Louis Peachey, one of Australia’s first Indigenous doctors.

“When Mark went through, it was the impossible dream, couldn’t be done, so you needed a very resilient group of people who got to do it.”

Mark and his wife had to work two or three nights a week performing music gigs to put food on the table while studying.

Mixing music, medicine, and raising a young family

In 1995 Mark graduated, one of the first Aboriginal men to become a doctor.

Mark’s eldest son Joel remembers “when Dad was doing medicine, you don’t have enough money to do anything, especially with a bunch of us kids who were just eating everything”.

“So they were performers. I was in bands with Mum and Dad, I was kind of performing with them as well.”

In 1995, Mark became the third Aboriginal male to graduate from Newcastle University Medical School.

After graduating, Mark began a medical odyssey which continues to this day, joining World Vision and working in Central Australia where he came face to face with some of the harshest health challenges

Mark Wenitong graduating from medicine

From there, he worked in the health policy area in Canberra before finally returning to Cairns where he took up clinical roles in the Queensland Indigenous Health Service.

“Dad did become a bit of a working machine. I don’t think there was a community or a job that he didn’t do, that he couldn’t do for medicine,” Joel says.

“You have to be really well organised to fit family time, and mum and dad definitely struggled with finding that balance.”

The medical life and travel took its toll on Mark and Deb’s relationship and they divorced.

Stop Calling Me and the rise of Shakaya

However, music continued to be a huge part of the family’s lives.

Mark’s daughter Naomi met Simone Stacey, another descendent of South Sea Islanders. Together they formed the duo Shakaya and instantly had a chart-topping hit with Stop Calling Me in 2002.

They achieved four platinum records for their singles and toured with Destiny’s Child and Human Nature, but success was not enough for Naomi.

“Just being successful and being black for me for a while, it was really fulfilling,” she said.

“But things were happening in this country that were shocking, you know, like, deaths in custody and stuff, all over the news, and we were on stage singing Cinderella?”

Meanwhile, Joel, who had remained in Newcastle, had been successful with rap group Local Knowledge, which performed edgy political songs.

Naomi and Joel decided to join forces and formed The Last Kinection, named after Lealon, the last of the traditional elders in the family.

Singing his daughter back to life

It was after a successful national tour that Joel and Naomi found themselves driving home along the Sydney-Newcastle freeway.

Suddenly they were run off the road and their car became impaled on a steel guardrail.

Naomi, thrown out of the car by the 100 kilometres per hour impact, was declared dead at the scene.

It was only with the subsequent arrival of two doctors at the accident scene that Naomi’s body moved and she was then resuscitated. But she was in a very bad way.

Mark remembers her injuries: “She had a fractured jaw, a frontal lobe contusion, fractured ribs, fractured wrist, compound fracture of femur, broken hip, broken pelvis.”

Deb kept vigil with her other children and resorted to the healing powers of music.

“I just turned to Mark and I said ‘you’d better start singing that song’ — because he used to sing her this little song,” she said.

“And when I came back he was singing and oh, I just … I just thought that was just beautiful.”

Naomi was in a coma for weeks and when she regained consciousness, she had lost her memory, which included that fact that her beloved Nan had passed away.

“I was like, Nanny’s funeral, is Nanny gone?” she recalls.

“It was just like I had heard it for the first time. I hadn’t mourned … and so I was heartbroken.”

Tragedy gave new perspective on life

Joel, although not suffering physical trauma like Naomi, was in a very dark place.

As the driver, he felt responsibility.

“I’d just be crying for no reason, you know, and, just smells, even smells, like there’s a car accident smell that happens as well, you just start crying, and I just remember having these nightmares with Naomi looking at me going ‘this is your fault, you did this to me’,” he said.

Naomi recovered — learning to walk again and regaining much of her memory.

As she healed, Joel healed too, but it had a dramatic effect on his outlook.

He decided to take up medicine and follow his father’s career.

“Seeing Joel graduate was an immensely proud moment for me. He’ll have a great career in medicine,” Mark said.

“It did start with my mother as a health worker, and she started late in life. I started late in life and then Joel was 33 or 34 before he started medicine.”

Today, Mark is heavily involved in preventative health and is concerned about the growing ice problem in far north Queensland.

He is working with the Gindaja Indigenous residential rehabilitation centre that is treating both indigenous and white ice addicts.

He remains focused on his community’s health needs and inspiring the next generation of young Aboriginal students to be doctors.

“The choices for me to come back and work with communities and with my own mob up this way was kind of an easy one really,” Mark observed.

“I wasn’t particularly interested in a career in medicine or specialising.

“It was more getting the paper (qualifications) behind me and being able to have a voice in Aboriginal health and to be able to do something practical to help our mob.”

See the full Australian Story on ABC TV at 8pm.

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NACCHO Aboriginal health and nutrition : Jamie Oliver’s Ministry of Food to partner with our Apunipima Cape York Health Council

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A culinary classroom on wheels run by Jamie’s Ministry of Food will visit the remote Aboriginal community of Mossman Gorge in north Queensland this June to deliver a five-week, hands-on cooking program to interested locals.

The mobile food kitchen, a huge truck spanning 15 metres in length bearing the celebrity chef’s branding, will operate in Mossman Gorge from 13 June, providing cheap ‘Jamie-style’ cooking lessons, recipes and tips to help locals make nutritional food, fast and on a budget.

Original Published NITV

PHOTO ABOVE : Jamie’s Ministry of Food Mobile Kitchen recently rolled out its home cooking program in an Aboriginal community for the first time. Here’s a sneak peek of what the residents of Cherbourg (Australia’s 3rd largest Aboriginal community) thought about the program.

The upcoming program, marking the van’s second-ever visit to an Indigenous community in Australia, will aim to empower families with the confidence needed to improve their diet and in-turn, their health.

“The food we want to cook is not unattainable and it uses basic ingredients,” says food trainer for Jamie’s Ministry of Food mobile kitchen, Bree Kennedy.

“By participating in these classes, people will gain confidence in the kitchen to make meals from scratch.

“Once you have that sort of confidence ignited within yourself, it is infectious. I see it every day.”

Jamie Oliver’s traveling food education program will be delivered in the Daintree community by The Good Foundation with support from Apunipima Cape York Health Council (ACYHC) and Mossman Gorge’s governing body, Bamanganga Bubu Ngadimunku.

Community nutritionist at ACYHC and Torres Strait Islander woman, Carny Thompson, explains that her nutrition team helped get the Ministry of Food’s Mobile Kitchen to the Gorge.

“There’s been a lot of consultation that has taken place to enable us to host the program,” she says.

“It’s such a great opportunity for the area and pretty exciting to have a mobile kitchen come to town.”

Community-wide consultation and elder input has enabled the program’s organisers to modify the cooking classes to suit local needs and respect traditions.

“We are approaching the community from a place of great respect, as well as respect for the traditional owners of the land and traditional food customs of sharing and ritual,” adds Ms Kennedy.

“The local community has told us they do a lot of batch cooking to provide food for, sometimes for eight people. So we want to make sure our recipes are adaptable to that situation.

“The food trainers and myself also want to cook food that is traditional for local participants. For example, ordinarily we might use beef mince in a recipe but we could talk about the benefits of using kangaroo mince instead.”

“Once you have that sort of confidence ignited within yourself, it is infectious. I see it every day.”

According to the Queensland Health Preventive Health Survey (2015), more than two-thirds of Aboriginal and Torres Strait Islander adults in Queensland are overweight or obese.

Indigenous Queenslanders are also 12 per cent more likely to be overweight or obese than non-Indigenous Queenslanders.

Mossman Gorge has seen its fair share of health programs operate within the community. But Ms Thompson truly believes this community-based course could change people’s eating habits.

“I think a program like this is really good because it targets families and encourages people to develop cooking skills and knowledge around food.

“When parents or aunties and uncles go along and learn how to cook healthy, affordable food, it’s a great opportunity to pass that information onto young people and children.

“We would really like local community members to participate in the program. We want people to learn new ideas about food and hold onto them, and carry them through to their families.”

SEE NACCHO NEWS : An invitation to Jamie Oliver from the Wadeye community

 The Cherbourg community get involved in Jamie's Ministry of Food program in 2015

The Cherbourg community get involved in Jamie’s Ministry of Food program in 2015 (supplied).

The Cherbourg community get involved in Jamie’s Ministry of Food program in 2015.

The upcoming visit to Mossman Gorge is a first for Jamie’s mobile kitchen. The van, one of two in Australia, visited the Indigenous community in Queensland’s Cherbourg last year.

A program evaluation, conducted by Deakin University and University of Melbourne, showed that participants who completed the Cherbourg course, gained new cooking skills and food knowledge, were more confident in cooking meals from scratch, purchased and consumed more vegetables and spent less on take away foods.

Research also found that participation in the course brought families together to share a meal around the table, and that behavioural changes were sustained six months after completing the course.

“I’ve been lucky enough to be able to do this job for a year and a half, and facilitate those changes,” says Ms Kennedy. “I’ve witnessed those changes and seen that food is a real instigator that influences people’s habits.

“Five weeks may not seem like a long time to change people’s habits but it’s a great place to start.”

Get involved

  • There are around 180 spots available for Mossman Gorge locals aged 12 and above.
  • The course will be run by food trainers and volunteers.
  • Locals can either drop in for a single class at $2 each or participate in the whole five-week program, attending one class once a week for a subsidised amount of $10.
  • The mobile kitchen will be located on Mossman Gorge Road, Mossman Gorge, Queensland.

For more information on the program, visit The Good Foundation.

 

NACCHO Aboriginal Health News Alert : ABS Releases Comprehensive Indigenous Health/ Social Survey

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“Aboriginal adults today can expect that their kids are less likely to smoke than they were and less likely to suffer health harms their generation will.”

Tobacco smoking is estimated to be the leading cause of the burden of disease on Indigenous people.

The fact more than one third of Indigenous people who have ever smoked had successfully quit was significant and showed it was “not an impossible task”.

“Aboriginal and Torres Strait Islander people are successfully becoming ex-smokers and in so doing are dramatically improving their health outcomes,”

  “This is something Aboriginal people have achieved.”

Associate prof David Thomas, the head of the tobacco control program at the Menzies Health research centre : See Guardian Article below

For the first time the rate of smoking among Aboriginal and Torres Strait Islander people has dropped below 40% and a third of those who have previously smoked have now successfully quit, new data shows. However, the rate remains much higher than non-Indigenous Australians and it is unlikely the gap will close any time soon.

The Australian Bureau of Statistics (ABS) has released its most comprehensive survey so far so far that measures the socio-economic markers of the Indigenous population.

The 2014/15 National Aboriginal and Torres Strait Islander Social Survey (NATSISS) brings together a broad range of information that explores cultural identity, social networks, housing, health, employment and education, crime and justice experiences and general life satisfaction in the Indigenous population.

The 2014–15 NATSISS collected a range of health-related data, including information on health risk factors, depending on the age of the respondent.

Health analyses presented in this publication are:

PHOTO ABOVE :  Wayne Quilliam who covered the Canberra launch for ABS

The wide-ranging report collected information on adult participation in organised sport, experiences of homelessness and mental health.

ABS senior reconciliation champion Dr Paul Jelfs said the survey found an upward trend in educational achievements, both in Year 12 completion rates and non-school qualifications, along with strong improvements across housing and health. 29 percent of Aboriginal and Torres Strait Islander people experienced homelessness at some point in their life.

However incarceration rates did not decline, with one in seven people reporting that they had been arrested in the last five years. One in three people experienced racial discrimination while one in eight experienced some form of physical violence.

“Overall life satisfaction is high. More than half of those surveyed rated their lives as eight out of 10 or better. A third of people in remote areas felt their community was a better place to live, compared to the previous 12 months, but 16 percent felt it was getting worse,” Jelfs said.

The report found that 38 per cent of men were more likely to be in full-time employment compared to 18 per cent of women. 23 per cent of women were more likely to be working in part-time positions compared to 14 per cent of men.

Professor Tom Calma AO, a former Aboriginal and Torres Strait Islander social justice commissioner, said the survey was vital in accurately reflecting Indigenous issues in government policies, programs and services.

The NATSISS is conducted every six years and was first run in 1994, after various recommendations from the Royal Commission into Aboriginal and Torres Strait Islander Deaths in Custody for a better information base to understand the socio-economic circumstances and outcomes of Aboriginal and Torres Strait Islander Australians.

Introduction

The National Aboriginal and Torres Strait Islander Social Survey (NATSISS) was conducted from September 2014 to June 2015 with a sample of 11,178 Aboriginal and Torres Strait Islander people living in private dwellings across Australia.

The NATSISS is a six-yearly multidimensional social survey which provides broad, self-reported information across key areas of social interest for Aboriginal and Torres Strait Islander people, primarily at the national level and by remoteness.

As this is a summary publication, not all of the information collected in the survey is presented here. We encourage users to look at the full range of tables presented and the explanatory materials.

A summary of the key findings from the 2014–15 NATSISS are presented in this publication. Wherever data have been compared (for example, between two points in time, or by sex or remoteness), the difference between the two proportions is statistically significant, unless otherwise stated.

Key areas of progress

Education

In 2014–15, the proportion of Aboriginal and Torres Strait Islander people aged 15 years and over who had completed Year 12 or equivalent was 25.7%, up from 20.4% in 2008 and 16.9% in 2002. Between 2002 and 2014–15, there were significant improvements in both non-remote areas (up 9.4 percentage points) and remote areas (up 5.6 percentage points) (Table 1).

The proportion of Aboriginal and Torres Strait Islander people aged 15 years and over who had attained a non-school qualification (such as a Certificate or Diploma) was 46.5%, up from 32.3% in 2008 and 26.1% in 2002. Between 2002 and 2014–15, there were significant improvements in both non-remote areas (up 20.6 percentage points) and remote areas (up 16.7 percentage points) (Table 1).

Health and health risk factors

Children aged 0–14 years

In 2014–15, about one in 10 (9.8%) Aboriginal and Torres Strait Islander children aged 0–3 years had a birth mother who drank alcohol during pregnancy, half the rate in 2008 (19.6%). Between 2008 and 2014–15 there was a significant improvement in non-remote areas (down 10.3 percentage points) (Table 6).

The proportion of Aboriginal and Torres Strait Islander children aged 0–3 years with a birth mother who took folate prior to, or during, pregnancy was 58.0% in 2014–15, up from 48.8% in 2008. Between 2008 and 2014–15 there was a significant improvement in non-remote areas (up 10.1 percentage points) (Table 6).

Just over one-third (34.4%) of Aboriginal and Torres Strait Islander children aged 4–14 years had teeth or gum problems in 2014–15, down from 39.1% in 2008 (Table 7).

The proportion of Aboriginal and Torres Strait Islander children aged 0–14 years who were living in a household in which there was at least one daily smoker was 56.7% in 2014–15, down from 63.2% in 2008 (Table 8).

People aged 15 years and over

In 2014–15, the proportion of Aboriginal and Torres Strait Islander people aged 15 years and over who were daily smokers was 38.9%, down from 44.6% in 2008 and 48.6% in 2002. Between 2002 and 2014–15, there was a significant improvement in non-remote areas (down 11.4 percentage points) (Table 1).

About six in 10 (60.3%) Aboriginal and Torres Strait Islander people aged 15 years and over were living in a household in which there was at least one daily smoker in 2014–15 (Table 16), down from 67.5% in 2008.

Almost one in seven (14.7%) Aboriginal and Torres Strait Islander people aged 15 years and over exceeded the lifetime risk guidelines for alcohol consumption in 2014–15, down from 19.2% in 2008. Between 2008 and 2014–15 there was a significant improvement in non-remote areas (down 5.3 percentage points) (Table 1).

The proportion of Aboriginal and Torres Strait Islander people aged 15 years and over who exceeded the single occasion risk guidelines for alcohol consumption was 30.1% in 2014–15, down from 37.9% in 2008. Between 2008 and 2014–15 there was a significant improvement in non-remote areas (down 9.6 percentage points) (Table 1).

Housing

In 2014–15, the proportion of Aboriginal and Torres Strait Islander people aged 15 years and over who were living in a dwelling that was overcrowded (requiring at least one more bedroom) was 18.4%, down from 24.9% in 2008 and 25.7% in 2002. Between 2008 and 2014–15 there were significant improvements in both remote areas (down 10.3 percentage points) and non-remote areas (down 4.3 percentage points) (Table 1).

Other key findings

Language and culture

Around one-third (33.7%) of Aboriginal and Torres Strait Islander children aged 4–14 years and 38.3% of those aged 15 years and over spoke an Australian Indigenous language (including those who spoke some words) (Table 7 and Table 9).

About one in 10 (10.5%) Aboriginal and Torres Strait Islander people aged 15 years and over spoke an Australian Indigenous language as their main language at home (Table 9).

More than one-quarter (28.7%) of Aboriginal and Torres Strait Islander children aged 4–14 years spent some time with a leader or elder each week (50.5% in remote areas compared with 23.2% in non-remote areas) (Table 7).

Almost three-quarters (74.1%) of Aboriginal and Torres Strait Islander people aged 15 years and over recognised an area as homelands or traditional country (Table 9).

Social networks and wellbeing

The majority (82.6%) of Aboriginal and Torres Strait Islander people aged 15 years and over had face-to-face contact with family or friends at least once a week (Table 10).

Around one-quarter (25.5%) of Aboriginal and Torres Strait Islander people aged 15 years and over provided care for a person with disability, a long-term health condition or old age (29.8% of females compared with 20.8% of males) (Table 4).

About one-third (33.5%) of Aboriginal and Torres Strait Islander people aged 15 years and over felt that they had been treated unfairly at least once in the previous 12 months, because they were of Aboriginal or Torres Strait Islander origin (34.9% in non-remote areas compared with 28.2% in remote areas) (Table 14).

More than half (53.4%) of Aboriginal and Torres Strait Islander people aged 15 years and over reported an overall life satisfaction rating of at least 8 out of ten (51.9% in non-remote areas and 58.3% in remote areas) (Table 17).

In remote areas, 30.7% of Aboriginal and Torres Strait Islander people aged 15 years and over felt that their community was a better place to live compared to 12 months previously, 49.2% felt that their community was about the same as 12 months ago, and 16.4% felt that it was a worse place to live (Table 10).

Education

Most (96.0%) Aboriginal and Torres Strait Islander children aged 4–14 years usually attended school (Table 7).

Almost two-thirds (63.2%) of Aboriginal and Torres Strait Islander children aged 4–14 years were being taught about Aboriginal and Torres Strait Islander culture at school (Table 7).

Just over one in five (21.5%) Aboriginal and Torres Strait Islander people aged 15 years and over were enrolled in formal study (24.2% in non-remote areas compared with 11.8% in remote areas) (Table 11).

Employment

Less than half (46.0%) of Aboriginal and Torres Strait Islander people aged 15 years and over were employed — 27.7% working full-time and 18.3% working part-time (Table 11).

Aboriginal and Torres Strait Islander males were more than twice as likely as females to be working full-time (37.9% compared with 18.4%), and were less likely to be working part-time (13.7% compared with 22.6%) (Table 11).

Almost half (49.0%) of Aboriginal and Torres Strait Islander people aged 15 years and over in non-remote areas were working, compared with 35.6% in remote areas (Table 11).

The unemployment rate for Aboriginal and Torres Strait Islander people aged 15 years and over was 20.6% nationally (27.4% in remote areas compared with 19.3% in non-remote areas) (Table 11).

Health and health risk factors

Children aged 0–3 years

The majority (93.4%) of Aboriginal and Torres Strait Islander children aged 0–3 years had a birth mother who went for check-ups during pregnancy (Table 6).

Around four in 10 (39.2%) Aboriginal and Torres Strait Islander children aged 0–3 years had a birth mother who had smoked or chewed tobacco during pregnancy (Table 6).

The majority (79.8%) of Aboriginal and Torres Strait Islander children aged 0–3 years had been breastfed (Table 6).

Children aged 4–14 years

Around one in eight (12.7%) Aboriginal and Torres Strait Islander children aged 4–14 years had eye or sight problems (14.4% in non-remote areas compared with 6.3% in remote areas) (Table 7).

About one in 10 (10.4%) Aboriginal and Torres Strait Islander children aged 4–14 years had ear or hearing problems (Table 7).

Children aged 0–14 years

The majority (82.7%) of Aboriginal and Torres Strait Islander children aged 0–14 years were said to be in excellent or very good health (Table 8).

Around one in eight (13.3%) Aboriginal and Torres Strait Islander children aged 0–14 years were living in a household in which someone smoked inside (17.1% in remote areas compared with 12.6% in non-remote areas) (Table 8).

People aged 15 years and over

Almost four in 10 (39.7%) Aboriginal and Torres Strait Islander people aged 15 years and over rated their health as excellent or very good (Table 12).

Just under half (45.1%) of Aboriginal and Torres Strait Islander people aged 15 years and over said they experienced disability, including 7.7% who needed assistance with core activities some or all of the time (Table 12).

Around one in five (19.0%) Aboriginal and Torres Strait Islander people aged 15 years and over were living in a household in which someone smoked inside (24.7% in remote areas compared with 17.4% in non-remote areas) (Table 16).

About three in 10 (30.4%) Aboriginal and Torres Strait Islander people aged 15 years and over reported having used illicit substances in the last 12 months (34.0% of males compared with 27.1% of females) (Table 12).

Safety, law and justice

Just over one in five (22.3%) Aboriginal and Torres Strait Islander people aged 15 years and over had experienced physical or threatened physical violence in the last 12 months (Table 15).

Around one in eight (13.3%) Aboriginal and Torres Strait Islander people aged 15 years and over had experienced physical violence in the last 12 months, including 8.1% who had experienced physical violence on more than one occasion (Table 15).

Half (50.2%) of Aboriginal and Torres Strait Islander people aged 15 years and over who had experienced physical violence in the last 12 months said that a family member (including a current or previous partner) was the perpetrator of the most recent incident (63.3% of females who had experienced physical violence compared with 34.6% of males) (Text table 8.2).

Around one in seven (14.5%) Aboriginal and Torres Strait Islander people aged 15 years and over said they had been arrested in the last five years (20.4% of males compared with 9.2% of females (Table 15).

Almost one in 10 (8.8%) Aboriginal and Torres Strait Islander people aged 15 years and over had been incarcerated in their lifetime (13.6% in remote areas compared with 7.4% in non-remote areas). Males were almost four times as likely as females to have been incarcerated (14.6% compared with 3.5%) (Table 15).

Housing

Just over two-thirds (67.3%) of Aboriginal and Torres Strait Islander people aged 15 years and over were living in a rented property, 19.4% in a dwelling which was owned with a mortgage and 9.3% in a dwelling which was owned without a mortgage (Table 16).

Around one in seven (14.9%) Aboriginal and Torres Strait Islander people aged 15 years and over were living in a dwelling in which there were facilities that were not available or did not work (27.7% in remote areas and 11.2% in non-remote areas) (Table 16).

Around three in 10 (29.1%) Aboriginal and Torres Strait Islander people aged 15 years and over had experienced homelessness during their lifetime (32.1% in non-remote areas compared with 18.4% in remote areas) (Table 14).

Indigenous health: Aboriginal and Torres Strait Islander smoking rate drops below 40 % From Helen Davidson

For the first time the rate of smoking among Aboriginal and Torres Strait Islander people has dropped below 40% and a third of those who have previously smoked have now successfully quit, new data shows.

However, the rate remains much higher than non-Indigenous Australians and it is unlikely the gap will close any time soon.

The data comes from the Australian Bureau of Statistics, which has released its six-yearly National Aboriginal and Torres Strait Islander Social Survey on Thursday. The survey also revealed incarceration rates have not improved and rates of racial discrimination and physical violence are high.

In 2014-15, 39% of Indigenous people aged 15 and over smoked daily, a decrease of 10 percentage points since 2002. The proportion of young Indigenous people who smoked dropped from 39% to 31% for those aged 15-24 and from 53% to 45% for 25-34-year-olds.

“This suggests that fewer young people are starting to smoke than was previously the case,” the report said.

Associate prof David Thomas, the head of the tobacco control program at the Menzies Health research centre, said: “Aboriginal adults today can expect that their kids are less likely to smoke than they were and less likely to suffer health harms their generation will.”

Tobacco smoking is estimated to be the leading cause of the burden of disease on Indigenous people.

While the decrease has been across the board, most of the decline was seen in non-remote areas, where there had been a small but “encouraging” drop of about 3%.

Thomas said the fact more than one third of Indigenous people who have ever smoked had successfully quit was significant and showed it was “not an impossible task”.

“Aboriginal and Torres Strait Islander people are successfully becoming ex-smokers and in so doing are dramatically improving their health outcomes,” he said. “This is something Aboriginal people have achieved.”

The overall rate, however, remains much higher than the 14% of non-Indigenous people who smoke. Closing the Gap targets on smoking were unlikely to be met but Thomas said they had been “extraordinarily ambitious”.

“The figures don’t suggest the gap is closing but they do show clear signs of improvement, which is all saying smoking prevalence and the harm it causes to Aboriginal people, families and communities are reducing,” Thomas said.

Multiple factors were behind the decline in smoking rates, he said, and continued investment in tobacco control was of enormous proven benefit. He said evidence showed the effectiveness of plain packaging, mainstream awareness campaigns, Indigenous-specific programs and price increases.

Cigarette price hikes have been a contentious issue in Australia, with critics labelling it an unfair hit on people from lower socioeconomic backgrounds.

“Increasing the price of cigarettes is one of the most efficient ways of reducing smoking prevalence and is even more effective amongst poorer and more disadvantaged members of any country, and more effective in poorer countries than rich countries,” Thomas said.

The ABS Indigenous Social Survey has been conducted every six years since it was launched as a recommendation of the royal commission into Aboriginal deaths in custody 20 years ago.

Thursday’s release also revealed the health of children under 14 had improved and there was an “upward trend” in rates of year 12 completion and non-school qualifications, said Dr Paul Jelfs, the ABS senior reconciliation champion.

“Overall life satisfaction is high,” he said. “More than half of those surveyed rated their lives as eight out of 10 or better. A third of people in remote areas felt their community was a better place to live, compared to the previous 12 months, but 16% felt it was getting worse.”

Rates of physical violence did not see a significant change, with 22% of Indigenous people aged 15 years and over experiencing physical or threatened physical violence in the year to 2014-15.

One in three people reported racial discrimination.

One in seven reported being arrested in the last five years and 9% had been incarcerated. This was twice as likely in remote areas than non-remote areas and males were four times more likely to be jailed than females.

Tom Calma, the former Aboriginal and Torres Strait Islander social justice commissioner, said the survey was not just about Indigenous people but all Australians.

“We need this information to make sure that we are getting things right – we need to feel confident that our issues are accurately reflected in government policies, programs and services,” he said.

NACCHO #healthelection16 : Vulnerable Aboriginal communities must lead their own recovery

Tom 2

“In fact, to those calling for another stolen generation – well, we already have one. Thousands of our children are today involved in child protection services; at a rate eight times higher than non-Indigenous children.

And despite the care and commitment of services and those involved in fostering, there are risks for all children, black or white, involved. This includes “broken placements” and institutionalisation, and increased rates of mental health issues, contact with the criminal justice system, substance use and abuse, and homelessness later in life.

For our children in particular, risks associated with compromising strong Aboriginal identity-formation and the breaking of cultural transmission are well-documented.”

Dr Tom Calma AO and Professor Pat Dudgeon

As originally published in the NACCHO Aboriginal Health Newspaper April

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The recent terrible news that a 10-year-old Aboriginal girl had taken her own life shook many Australians. Yet there would be few Aboriginal families who have not already been affected by the suicide or attempted suicide of their young people. This includes our own extended families and kin.

Our families have suffered the losses of a loved 14-year-old girl and two equally loved young men who were employed and content. All tragic and unexplained losses that have left those grieving feeling hollow and bewildered.

The deaths by suicide of our young people then are not isolated events. The latest statistics show that our 15- 24 year olds are dying by suicide at four times the non-Indigenous rate; and our 1 – 14 year olds at nine times the non-Indigenous rate.

Colonisation still impacts upon us. Our young people and children are not immune from the “deep and persistent disadvantage”, or poverty and social exclusion, that the Productivity Commission reports still characterises about one in 10 Indigenous Australians.

What this means is stressful life events impact on our mental health – be they violence, racism, long term unemployment or poor health. High levels of psychological distress are reported in over one in four of us three times higher than the non-Indigenous rate. Another contributing factor is the use and abuse of drugs and alcohol. Ice is just the latest community and family-destroying scourge.

Trauma, including intergenerational trauma, is also a major issue particularly (but not only) for stolen generations survivors and their descendants. This group report higher rates of mental illness and alcohol and other drug problems than Aboriginal people who weren’t removed from their families, communities and cultures.

This belies the knee jerk response of removing children from families in crisis, rather than working with their families. While removal is necessary in extreme cases, it should always be seen as a last resort. We need to break the intergenerational cycles of despair and dysfunction, not accelerate them.

And removing a child can also exacerbate existing factors, or itself be a suicide risk, and as was reported in the case of the girl who died last week.

What we have then is a concentration of suicide risk factors in many of our communities, with our children and young people in the front line. Yet for some, the response is to close these communities down: put them in the “too hard” basket. But this is lazy policy that will cause as much harm as it might prevent.

So we are all asking: what can be done?

More forced social engineering is not the answer

Aboriginal people have already experienced the trauma of communities being closed down. Historically, peoples with different cultures and languages were forced to live together under the control of missionaries and governments. This is one of the roots of the crises in many communities today.

And where will the people from the closed down communities go? Is it better that they end up homeless in towns that shun them, and live in camps where violence, sexual abuse and alcohol and drug use are just as problematic?

More forced social engineering is the last thing the members of these communities need. People advocating community closures need to ask themselves: what will be the effects be of removing them from sustaining and well being-supporting contact with kin, culture and country? Yes, there are challenges in many communities, but let’s also acknowledge that there are cultural and other strengths that can be built on, and that could be lost in closures.

Stop seeing Indigenous communities as a drain on the public purse

And instead of responding after the event to crisis after crisis, let’s be proactive and preventative in our focus. Let’s think about investing in these communities, rather than seeing them as a drain on the public purse.

In particular, where are the services, including mental health and drug and alcohol services, to meet the needs of these communities? As the National Mental Health Commission reported in its 2015 review, despite much good work in recent decades, on a needs basis there are still significant mental health and other service gaps. This includes services to support our families and communities in crisis situations, and to support them before they get into such situations.

The National Mental Health Commission recommended to Government that there was a Closing the Gap target for improved Indigenous mental health, and a national target to reduce suicide by 50% in a decade – including a 50% reduction in suicide among Indigenous Australians. Further, that an Indigenous mental health action plan be developed. However, there has been no take-up at this time.

Vulnerable communities must lead their own recovery

There are alternative ways to respond to child suicide in our communities without removing children from families or closing communities down, but it requires resources and placing communities in the driver’s seat.

Most broadly, “upstream” activity to mitigate the impact of disadvantage and the associated suicide risk factors is required. Here vulnerable communities must take the lead in identifying their needs and priorities, be it addressing community safety, unemployment or alcohol and drug use. And yes, it might include whole-of-community responses to preventing child sexual abuse.

Developmental factors and culturally-informed norms are crucial

It might also include building on protective culturally-informed norms (including familial norms) and other cultural reclamation work that has been shown to be protective against youth suicide in indigenous Canadian communities, and that we believe has an important role to play here.

In particular, addressing the developmental factors that can pre-dispose our children and young people to suicide is critical. Protecting them from sexual abuse is important, but sexual abuse is not the only cause of suicide among our children and young people. Among some, impulsiveness and overwrought responses to the end of a relationship have been reported as being enough to lead to suicide.

In fact, a comprehensive response might include addressing healthy cognitive development from conception onwards, providing age and culturally appropriate school programs about relationship issues and how to handle break-ups, and promoting cannabis and other drug use reduction. It should involve strategies to reduce the contact of our young people with the criminal justice system including by addressing boredom and increasing employment opportunities.

Communities themselves are also best placed to develop situational analyses to support more focused universal suicide prevention activity, including by identifying specifically suicidal behaviours and suicide risk factors among their members – and appropriate responses.

Access to the same support as all Australians at risk

Our communities must also have access to the same high quality clinical standards, treatments and support available to all Australians at risk of suicide. Critical in this is access to culturally safe mental health service environments, and culturally competent staff (who are able to work effectively, cross-culturally with us).

We should also have access to cultural healers as needed. Effective transitions from community-based primary mental health settings to specialist treatment and then back again to community primary mental health care settings are also important.

After a suicide, postvention is critical

Because many of our communities are small and close knit, a death by suicide can have a significant destabilising impact and may influence other community members to attempt suicide or self harm. As such, when culturally appropriate and with social support as required, postvention is an important suicide prevention measure in our communities. Programs that respond to suicide, such as the one currently piloted in WA by the Australian Government, are a welcome example of this.

And with many responsibilities for suicide prevention being devolved to the primary health networks, it is critical that these bodies partner with our communities in suicide prevention activity. This is particularly so in relation to the implementation of the National Aboriginal and Torres Strait Islander Suicide Prevention Strategy against which $17.8m has been pledged by the Australian government, and that has been entrusted to them.

Sustainable outcomes in the longer term require empowering and meaningfully engaging with Indigenous families and communities including those in crisis situations.

But this is best done long before they reach the terrible point of losing yet another child to suicide.

If you need help call Lifeline on 131114

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