NACCHO Aboriginal #AMS #MentalHealth Funding 2016-19 @KenWyattMP announces $9.1 Million funding for Aboriginal Health Services

“The nine Aboriginal Medical Services in the North Coast region of NSW , such as Bulgarr Ngaru, Jullums and Bullinah are doing some outstanding work to support their patients.

This includes ensuring that community members with chronic disease get to see the health practitioners they need to, are provided with specialised medical aids where necessary and are assisted with transport to attend medical appointments.

The tremendous work being done by the Aboriginal Community Controlled organisations such as Durri and Rekindling The Spirit, and the other organisations who have received funding, will go a long way to improving health and wellbeing,”

The Federal Minister for Indigenous Health, Mr Ken Wyatt AM, has announced that the Commonwealth has invested more than $9.1 m in a range of health services specifically for Aboriginal communities across the North Coast.

See full list below or Download

20171107-Commissioning-Summary-Aboriginal-Health

North Coast NSW – comprising Northern NSW and the Mid North Coast – has an average Aboriginal population of 4.5%, nearly double that of other areas of Australia (2.5%).

Funding distributed through North Coast Primary Health Network (NCPHN) enables 14 different service providers to deliver a range of services and programs from Tweed Heads down to the Clarence Valley. These services help fill identified health service gaps and provide specialised training for both health professionals and community members.

In the Needs Assessment conducted by NCPHN last year, health service providers said that mental health and drug and alcohol counselling were the two health services that Aboriginal and Torres Strait Islander people found most difficult to access.

Mr Wyatt said he was delighted that a significant amount of the funding had been distributed to deliver such services and programs to meet the needs of the Aboriginal population.

He also praised the work being done by Aboriginal Medical Services.

See Quotes above

North Coast Primary Health Network Chief Executive Dr Vahid Saberi said it is pleasing that NCPHN had been successful in commissioning such a range of health services specifically for Aboriginal people.

“Our commissioning process has resulted in selecting excellent providers to deliver these services. There is some exciting work happening and I look forward to seeing what is achieved, recognising that more work needs to be done.”

The funding is also providing much needed training in suicide prevention for both community members and health professionals, as well as specialist support for clinicians working with people with drug and/or alcohol issues.

Key North Coast PHN Indigenous investments:

  • Integrated Team Care: $5.029 million (2016-18) to improve access to coordinated care for chronic conditions and culturally appropriate care.
  • Drug and Alcohol Treatment Services for Aboriginal and Torres Strait Islanders: $2.095 million (2016-19) to increase capacity of the drug and alcohol treatment sector though improved regional coordination and by commissioning additional drug and alcohol treatment services for Aboriginal and Torres Strait Islander people.
  • Indigenous Mental Health Flexible Funding: $2.006 million (2016-18) to improve access to integrated, culturally appropriate and safe mental health services that holistically meet the needs of Aboriginal and Torres Strait Islander people.

Source: Ice dependence, chronic disease among targets of North Coast health blitz

Click here to download a summary of current NCPHN commissioned services.


EXAMPLES OF CURRENT ABORIGINAL HEALTH PROJECTS LISTED BELOW:

INTEGRATED TEAM CARE & OUTREACH PROGRAM

Providers: Jullums Aboriginal Medical Service (AMS) Lismore, Bullinah AMS, Ballina, Bulgarr Ngaru Aboriginal Medical Corporation; Durri Aboriginal Medical Corporation; Werin Aboriginal Corporation Medical Clinic; Bawrunga Coffs Harbour GP Super Clinic Ltd.

This program is run through Aboriginal Medical Services and supports Aboriginal patients with chronic disease in purchasing specialised medical aids and with transport and support to attend GP and specialist medical appointments. Delivered across the entire region.


DRUG AND ALCOHOL SERVICE REDESIGN PROJECT

Provider: Jullums AMS and Rekindling The Spirit

The project aim is to align the Alcohol and Other Drug (AOD) service delivered by Jullums to national guidelines for managing people with co-occurring alcohol and drug issues and mental health conditions in community settings. The guidelines will be amended to ensure that the service is culturally appropriate and is tailored to meet the needs of each patient.


ADDICTION SPECIALIST CLINICAL SUPPORT SERVICE

Provider: Bulgarr Ngaru Aboriginal Medical Corporation

Addiction specialist support to the clinicians working in Bulgarr Ngaru medical clinics, located in Grafton, Casino and Tweed Heads.


CLINICIAN SUPPORT FOR MANAGEMENT AND TREATMENT OF DRUG/ALCOHOL ISSUES

Provider: Bulgarr Ngaru Aboriginal Medical Corporation

Clinician support for management and treatment of drug/alcohol issues – Grafton and surrounds.


HEALTHY LIFESTYLE PROGRAM

Provider: Bulgarr Ngaru Aboriginal Medical Corporation

A holistic and culturally appropriate cardiac health prevention and management program – Clarence Valley


KIDNEY HEALTH PROJECT

Provider: Bulgarr Ngaru Aboriginal Medical Corporation

The Kidney Health Project aims to improve early identification and interventions to achieve better kidney health, thus preventing the onset of chronic kidney disease. Run in collaboration with Northern NSW Local Health District. To be run across Northern NSW.


CLINICIAN SUPPORT FOR MANAGEMENT AND TREATMENT OF DRUG/ALCOHOL ISSUES

Provider: Jullums Aboriginal Medical Service

Clinician support for management and treatment of drug/alcohol issues. Delivered in Lismore and surrounds.


HEALTHY LIFESTYLE PROGRAM

Provider: Werin Aboriginal Corporation Medical Clinic

A holistic and culturally appropriate cardiac health prevention and management program. Delivered in the Port Macquarie LGA.


BOWRAVILLE FAMILY THERAPY

Provider: Durri Aboriginal Medical Corporation

Assisting families with a range of health related matters, identifying ways to improve health outcomes. Delivered in the Nambucca region.


MENTAL HEALTH IMPROVEMENT PROJECT

Provider: Galambila Aboriginal Health Service Corporation

Working with Mid North Coast LHD staff to improve mental health and wellbeing. Mid North Coast region.


MAAYU MALI (GROW STRONG PROGRAM)

Provider: Galambila Aboriginal Health Service Corporation

Maayu Mali means to “make better”. It offers a 3-month residential rehabilitation program followed by after-care services, delivered in a culturally sensitive context to people experiencing drug and alcohol addiction. Hastings-Macleay region.


EXTENSION OF NAMATJIRA HAVEN “GULGIHWEN” RESIDENTIAL POGRAM & WITHDRAWAL MANAGEMENT SERVICE

Provider: Namatjira Haven

This is a program for Aboriginal men with both alcohol and/or other drug issues and mental health problems. It works to re-connect Indigenous men to their history, culture and community. Delivered for residents in Ballina, Lismore, Byron Bay, Casino and Kyogle.


MENTAL HEALTH FIRST AID TRAINING

Provider: Namatjira Haven

Mental Health First Aid courses teach mental health first aid strategies to community members. The first aid is given until appropriate professional help is received or the crisis resolves. Delivered in Alstonville.


ALCOHOL AND DRUG TREATMENT INTEGRATION PROJECT

Provider: The Buttery

Aboriginal workforce development, capacity building, information and education for health professionals to improve the coordination and integration of drug and alcohol treatment services. Delivered across Northern NSW.


GARIMALEH WERLA NA (TAKING CARE OF YOURSELF PROGRAM)

Provider: University Centre for Rural Health, Lismore

Enhances social and emotional wellbeing, particularly with complex health needs in relation to disconnection, trauma and substance misuse. Delivered in Lismore, Alstonville and Ballina.


THE LIFE TREE MENTAL HEALTH & SUICIDE PREVENTION TRAINING FOR ABORIGINAL COMMUNITY MEMBERS

Provider: CRANES

The Life Tree Mental Health & Suicide Prevention Training Program for Aboriginal community members. Delivered across North Coast.


THE LIFE TREE MENTAL HEALTH & SUICIDE PREVENTION TRAINING FOR CLINICIANS WORKING IN ABORIGINAL HEALTH

Provider: CRANES

The Life Tree Mental Health & Suicide Prevention Training Program for clinicians working in Aboriginal Health. Delivered across North Coast.


ART ON BUNDJALUNG COUNTRY

Provider: North Coast Primary Health Network

A creative arts project to nurture local Indigenous artists and to prepare work for a special exhibition at the new Lismore Regional Gallery late in the year. It’s well known that engagement in the arts can enhance health and wellbeing. Delivered in the Northern Rivers region.


HEALTHY MINDS

Provider: North Coast Primary Health Network

A free, referral-based psychological service for those needing access to mental health services who are financially disadvantaged, including members of the Aboriginal community. Delivered across North Coast.


MENTAL HEALTH NURSING SERVICES

Provider: North Coast Primary Health Network

For people with a mental illness impacting severely on their lives, including members of the Aboriginal community. Delivered across North Coast.


“WE YARN” ABORIGINAL SUICIDE AWARENESS & PREVENTION WORKSHOPS

Provider: Centre for Rural and Remote Mental Health, University of Newcastle

For Aboriginal community members interested in suicide prevention. Delivered across the region

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

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

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

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

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

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

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

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

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

See full press release from Minister Part 3 below

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

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

READ MORE ON THIS TOPIC HERE

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

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

READ MORE ON THIS TOPIC HERE  

Part 1 NACCHO BACKGROUND

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

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

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

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

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

Download the final #ATSISPEP report here

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

Part 2 Mental Health Australia campaign

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

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

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

Mental Health Australia CEO Mr Frank Quinlan

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

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

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

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

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

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

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

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

‘What will your #MentalHealthPromise be?

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

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

Australia’s new digital mental health gateway now live

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

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

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

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

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

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

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

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

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

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

 

NACCHO Aboriginal Health #suicideprevention and solutions : Download @MindframeMedia Aboriginal Suicide Data 2012-2016

 

” The report released today by the Australian Bureau of Statistics (ABS) shows that 2,866 Australians died by suicide in 2016. This is a decrease of 161 deaths from the previously reported 2015 figure of 3,027.

While we are seeing the first decrease in some years, suicide remains the leading cause of death for Australians aged 15-44.

Aboriginal and Torres Strait Islander peoples are approximately twice as likely to die by suicide than non-Indigenous Australians, with 162 Aboriginal and Torres Strait Islanders dying by suicide in 2016.”

Download  2016 Aboriginal and Torres Strait Islander Summary

  • 162 (119 male, 43 female) Aboriginal and Torres Strait Islander people died by suicide, which is slightly higher than the 152 recorded in 2015.
  • Suicide was the 5th leading cause of death for Aboriginal and Torres Strait Islander peoples across NSW, QLD, SA, WA and NT, compared to the 15th leading cause of death for non-Indigenous people in these states.
  • In these states, the standardised death rate for Aboriginal and Torres Strait Islander peoples (23.8 per 100,000) was more than twice the non-Indigenous rate (11.4 per 100,000).

Background NACCHO Aboriginal Health Alert :

Launch #ATSISPEP Community-led solutions for Indigenous suicide prevention

Read over 110 Suicide Prevention articles published by NACCHO over 5 years

Solutions that Work: What the Evidence and Our People Tell Us.

Download

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

atsispep

 

The report sets out a new blueprint to improve suicide-prevention services and programmes for Aboriginal and Torres Strait Islander people based on the principle of prioritising community led, culturally-appropriate services.

Peak body reports a national decrease in deaths by suicide

Download 2016 National Summary

Suicide Prevention Australia (SPA) Chief Executive Sue Murray calls for those working in suicide prevention to hold their focus: “Suicide is a complex public health issue that requires sustained investment in prevention efforts to support more Australians to live. We are encouraged by the reported decrease, increased funding, support across Parliament and focus on regionally driven suicide prevention over the past year.

“Many organisations and communities are working hard to implement locally driven prevention plans focusing on priority issues such as primary care and care following discharge from our hospitals, as well as trialling innovative whole of community solutions. We will continue to encourage all working in suicide prevention to hold their focus on making the deep systemic and social changes needed.”

SPA Director Matthew Tukaki says of the release: “Above all else, on behalf of Suicide Prevention Australia, I acknowledge each of these lives lost to suicide and the pain suicide brings to individuals, families and whole communities.

“As well as taking a whole-of-community-approach to prevention we must look to how individuals and organisations support priority populations that are continually overrepresented in deaths by suicide.”

The ABS is to be congratulated for improving the timeliness of this data.

Headline data published includes:

  • There were 2,866 deaths due to suicide in 2016 with an age-specific rate of 11.8 per 100,000.
  • There were an average of 7.9 deaths by suicide in Australia each day.
  • There were 2,151 male deaths at a age-specific rate of 17.9 per 100,000.
  • There were 715 female deaths at an age-specific rate of 5.9 per 100,000.

For a full summary of ABS Causes of Death data relating to suicide, please visit the Mindframe website at http://www.mindframe-media.info/ and the Australian Bureau of Statistics (ABS) website for full data sets.

Talking about suicide in the media: A reminder of the Mindframe Media guidelines – http://www.mindframe-media.info/ and http://ww.conversationsmatter.com.au for tips on how to talk safely and constructively about suicide.

24/7 crisis support information

Lifeline 13 11 14 www.lifeline.org.au/gethelp
Suicide Call Back Service 1300 659 467 http://www.suicidecallbackservice.org.au 
Kids Helpline 1800 55 1800 www.kidshelp.com.au
MensLine 1300 78 99 78 www.mensline.org.au
beyondblue 1300 22 4636 www.beyondblue.org.au
Qlife 1800 184 527  http://www.qlife.org.au /

For additional services and support visit www.suicidepreventionaust.org and click on the Get Help button.

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

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

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

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

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

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

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

Prime Minister Malcolm Turnbull addressing the RUOK Breakfast 12 September

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

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

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

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

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

There is always time to start a conversation.

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

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

Opposition Leader  Bill Shorten addressing the RUOK Breakfast 12 September

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

Part 1 The cause bringing Turnbull and Shorten together

From SBS Report

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

He stopped at about seven.

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

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

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

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

“These are preventable deaths.”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Thank you very much.

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

Good morning everybody.

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

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

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

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

It really was a good set of words.

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

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

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

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

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

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

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

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

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

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

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

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

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

Is there something you could have done differently?

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

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

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

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

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

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

And you do think about what you could have done.

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

Seven Australians – every day.

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

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

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

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

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

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

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

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

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

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

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

Completely alienated and unsure of where they fit in.

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

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

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

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

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

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

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

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

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

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

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

It’s about digging a bit deeper.

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

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

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

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

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

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

There is always time to

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

There is always time to start a conversation.

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

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

NACCHO Aboriginal Health and #WSPD17 World #Suicide Prevention Day “Take a Minute, Change a Life”

 ” Yesterday ( 10 September ) was World Suicide Prevention Day and this year’s theme, “Take a Minute, Change a Life”, captures the idea that each of us has a role to play in suicide prevention.

The same concept lies behind R U OK? Day, which will be marked next Thursday 14 September

Just a simple, sincere question can show a distressed friend, colleague, family member or even a stranger that they are not alone and that help is available.”

Health Minister Greg Hunt : Marking World Suicide Prevention Day ( see Part 2 Below)  

 ” For me, suicidal ideation is a daily battle. It might be intense for a little bit, then I use my coping mechanisms and strategies I have learnt and they pass. Lately however, the ideations have been crippling – to the point where I can’t get out of bed, I can’t talk to people and at times before one of my education sessions, I felt I couldn’t go on stage. I was behind the curtain sobbing like a baby – petrified to talk to anyone.

The past few months I have been in a real struggle, the biggest and most constant fight I have ever been in.”

Joe Williams ( Pictured above ) will be a guest speaker at NACCHO #OchreDay2017 in Darwin Oct 4-5 : See full text Part 3 Below from the Enemy Within  .

 “The worst response to suicide within Aboriginal and Torres Strait Islander communities is to ignore social disadvantage and instead attribute the loss of life to individual failure or weakness.

“Addressing the social disadvantage plaguing our communities is critical to solving many of the challenges facing our peoples, including suicide.

Our nation must face up to the devastation that has been wrought upon our peoples and which overwhelms us today,”

The Aboriginal and Torres Strait Islander Social Justice Commissioner, June Oscar

Read her full speech Suicide Prevention Speech HERE

 ” The suicide rate of Aboriginal and Torres Strait Islanders is a catastrophic humanitarian crisis. According to the Australian Bureau of Statistics, one in 18 Aboriginal and Torres Strait Islander deaths is a suicide. However, because of under-reporting issues and circumstances where there is an inability to gather adequate evidence to satisfy the coroner of a suicide, I estimate that rather one in 10 Aboriginal and Torres Strait Islander deaths is a suicide.’

Read full article Here : We should weep, but more importantly we should act to stop Indigenous suicides

NACCHO Aboriginal Health Alert : Launch #ATSISPEP Community-led solutions for Indigenous suicide prevention

Read over 110 Suicide Prevention articles published by NACCHO over 5 years

Solutions that Work: What the Evidence and Our People Tell Us.

Download

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

atsispep

 

The report sets out a new blueprint to improve suicide-prevention services and programmes for Aboriginal and Torres Strait Islander people based on the principle of prioritising community led, culturally-appropriate services.

“This is where the rubber hits the road, working very closely at the community level, involving young people, families and elders,

We now have a strong operational plan based around the communities, to bring promising and proven strategies together in liaison with local people, to make a difference on the ground.”

Indigenous Health Minister Ken Wyatt AM will co-chair a new steering committee working directly with local Aboriginal communities, as the Kimberley Suicide Prevention Trial begins detailed planning and delivery of potentially lifesaving initiatives across the region.

Part 1 Increased youth focus as Minister co-chairs suicide prevention committee

Indigenous Health Minister Ken Wyatt AM will co-chair a new steering committee working directly with local Aboriginal communities, as the Kimberley Suicide Prevention Trial begins detailed planning and delivery of potentially lifesaving initiatives across the region.

“This is where the rubber hits the road, working very closely at the community level, involving young people, families and elders,” the Minister said.

“We now have a strong operational plan based around the communities, to bring promising and proven strategies together in liaison with local people, to make a difference on the ground.”

Minister Wyatt said the recent  suicide prevention roundtable in Broome was important in establishing a strong working partnership between local Aboriginal communities and the Commonwealth, especially through younger people.

He praised a presentation by Kimberley Aboriginal Youth Suicide Prevention Forum members Jacob Corpus (20) from Broome and Montana Ahwon (19) from Kununurra, and said young people must be supported to play key roles in reducing suicide.

“Both Montana and Jacob are incredible and inspiring young leaders who have helped identify key factors that impact on Kimberley youth, which the steering committee will now consider,” he said.

“I will also encourage relevant Commonwealth and State organisations to ensure they include young Aboriginal people on advisory groups, to help empower them to take up future leadership roles.”

Youth forum recommendations included:

– Support for emerging young leaders, positive role models and mentoring

– The teaching in school of local culture and country traditions, the dangers of drugs and alcohol, and the importance of resilience

– Strong youth engagement and networking through sports, arts and local cultural activities

The roundtable also heard of the need for community-run “safe houses” for young people and the potential positive effects of having pairs of youth coordinators employed by Aboriginal community groups in towns across the Kimberley.

The steering committee will be co-chaired by Kimberley Aboriginal Medical Service Deputy CEO Rob McPhee and will report to the Kimberley Suicide Prevention Working Group.

Minister Wyatt commended everyone involved in the development of this work and is looking forward to returning to the Kimberley in November.

Part 2 Health Minister Greg Hunt Marking World Suicide Prevention Day

Marking World Suicide Prevention Day

 

Today is World Suicide Prevention Day and this year’s theme, “Take a Minute, Change a Life”, captures the idea that each of us has a role to play in suicide prevention.

The same concept lies behind R U OK? Day, which will be marked next Thursday.

Just a simple, sincere question can show a distressed friend, colleague, family member or even a stranger that they are not alone and that help is available.

More than 3000 Australians take their own lives each year and sadly, the rate is increasing. This means that many of us have been touched by this tragedy, directly or indirectly.

But not everyone understands that they can help to reduce this number.

Results of a recent survey by Colmar Brunton show that almost one in five Australians believe that talking about suicide will make a depressed person more likely to take their own life.

More than one in three others surveyed were unsure whether talking about suicide was a good or bad thing to do.

In fact, at the personal level, asking someone who is depressed and suicidal, about their thoughts can be the most effective way to allow them to get perspective, find support and reach a solution.

The Turnbull Government is committed to improving our national suicide prevention effort through new regional approaches, innovative programs and research.

We are spending $34 million over three years on 12 national suicide prevention trials which will gather evidence on better suicide prevention in regional areas of Australia, and particularly, in high risk populations.

Specific areas of focus for the trials include Indigenous communities in the Kimberley and Darwin regions and the former Defence Force members in in Townsville.

Regions of Queensland, NSW, Victoria and SA have also been selected to trial strategies that better target people at risk of suicide and ensure a more integrated, regionally-based approach to suicide prevention.

To support the National Suicide Prevention Trials, we’re also providing $3 million to the Black Dog Institute.

This funding is enabling the Black Dog Institute to provide assistance with the development of local strategies and to share best practice.

We are providing $43 million in funding for national suicide prevention leadership and support activity to organisations across Australia, such as R U OK?, Mates in Construction Australia, Suicide Prevention Australia, United Synergies, Mindframe and Orygen.

Suicide Prevention Australia has also been selected to establish and manage our new $12 million suicide prevention research fund that will tell us what works and how to deliver effective support – to individuals, families and communities.

And to help care for those that care for us, we are providing $1 million to specifically support mental health and reduce suicide in the health workforce.

On 4 August 2017, the Commonwealth and State and Territory Health Ministers endorsed the Fifth National Mental Health and Suicide Prevention Plan and Implementation Plan.

The Turnbull Government will continue working together with the States and Territories to develop a national approach to address suicide prevention and to support health agencies to interact with other portfolios to drive action in this vital area.

The loss of a loved one to suicide is an immense tragedy and this is why the Turnbull Government is delivering on its commitment to provide a range programs and services that support local needs so we avoid this unnecessary loss of life now and into the future.

 

 

Part 3 My Daily fight I won’t give up

Have you ever heard the song  by Kate Miller-Heidke called ‘Last Day on Earth’? I’ll get to why it’s important shortly.

I have been in a real internal fight with myself recently. It has been for a few different reasons, triggers that set them off, but for the most part I believe it’s because I have been taking lower doses of my medication. I am doing this under the care of my psychiatrist so that I can go onto another medication.

For me, suicidal ideation is a daily battle. It might be intense for a little bit, then I use my coping mechanisms and strategies I have learnt and they pass. Lately however, the ideations have been crippling – to the point where I can’t get out of bed, I can’t talk to people and at times before one of my education sessions, I felt I couldn’t go on stage. I was behind the curtain sobbing like a baby – petrified to talk to anyone.

The past few months I have been in a real struggle, the biggest and most constant fight I have ever been in. That song I mentioned has been playing through my head, literally every morning as soon as I wake up. The chatter and noise starts in my mind and I have genuinely believed this will be my last day on earth. I have to fight the mental pain that wants to take me away.

With the effects of CTE and concussions over the years, there is every chance this illness I go through, these tough times, may get worse. But I am not ready to go out yet. I’m not ready for my life to be over. So I promise I will fight tooth and nail to make sure I am here; especially for my kids and my loved ones. I will stay in this fight!!

Each day that I have this internal battle, it’s tough. I want it to go away and sometimes I get to the point where I’ve had enough. But it’s this battle that makes me who I am. That makes me resilient and a fighter.

I have to thank my friends who have been quite persistent in checking in and making sure I am ok lately, as I know I isolate and try do it alone.

During the tough times I know it’s beneficial to talk. I know it’s beneficial to get the mess out of my body and my mind – even writing it down helps; but it’s just so hard.

I can’t do it alone. I need my doctor, my friends and my loved ones to stay close – even though I push everyone away, I need them to stay close!! If it were up to me, I would push everyone away – but I know that’s not the right thing to do for me to stay well, I know that verbalising the pain helps.

Minute by minute, moment by moment, one day at a time – I promise to stay in this fight.

It may battle me; but it won’t beat me

 https://youtu.be/KhQ5seprs6s

Last Day On Earth – Kate Miller

 

Aboriginal Health and the @AusLawReform inquiry into the incarceration rate of Aboriginal peoples

 

” The Terms of Reference for this Inquiry ask the ALRC to consider laws and legal frameworks that contribute to the incarceration rate of Aboriginal and Torres Strait Islander peoples and inform decisions to hold or keep Aboriginal and Torres Strait Islander people in custody.

ALRC Home page

Download this 236 page discussion paper

discussion_paper_84_compressed_no_cover

Full Terms of reference part B below

The ALRC was asked to consider a number of factors that decision makers take into account when deciding on a criminal justice response, including community safety, the availability of alternatives to incarceration, the degree of discretion available, and incarceration as a deterrent and as a punishment

The Terms of Reference also direct the ALRC to consider laws that may contribute to the rate of Aboriginal and Torres Strait Islander peoples offending and the rate of incarceration of Aboriginal and Torres Strait Islander women.

Submissions close on 4 September 2017.

Make a submission

Part A Proposals and Questions

1. Structure of the Discussion Paper

1.40     The Discussion Paper is structured in parts. Following the introduction, Part 2 addresses criminal justice pathways. The ALRC has identified three key areas that influence incarceration rates: bail laws and processes, and remand; sentencing laws and legal frameworks including mandatory sentencing, short sentences and Gladue-style reports; and transition pathways from prison, parole and throughcare. These were the focus of stakeholder comments and observations in preliminary consultations.

1.41     Part 3 considers non-violent offending and alcohol regulation. It provides an overview of the detrimental effects of fine debt on Aboriginal and Torres Strait Islander peoples, including the likelihood of imprisonment in some jurisdictions. Fine debt can be tied to driver licence offending, and the ALRC asks how best to minimise licence suspension caused by fine default. Part 3 also looks at ways laws and legal frameworks can operate to decrease alcohol supply so as to minimise alcohol-related offending in Aboriginal and Torres Strait Islander communities.

1.42     Part 4 discusses the incarceration of Aboriginal and Torres Strait Islander women. It contextualises Aboriginal and Torres Strait Islander female offending within experiences of trauma, including isolation; family and sexual violence; and child removal. It outlines how proposals in other chapters may address the incarceration rates of Aboriginal and Torres Strait Islander women, and asks what more can be done.

1.43     Part 5 considers access to justice, and examines ways that state and territory governments and criminal justice systems can better engage with Aboriginal and Torres Strait Islander peoples to prevent offending and to provide better criminal justice responses when offending occurs. The ALRC places collaboration with Aboriginal and Torres Strait Islander organisations at the centre of proposals made in this Part, and suggests accountability measures for state and territory government justice agencies and police. The remoteness of communities, the availability of and access to legal assistance and Aboriginal and Torres Strait Islander interpreters are also discussed. Alternative approaches to crime prevention and criminal justice responses, such as those operating under the banner of ‘justice reinvestment’, are also canvassed.

2. Bail and the Remand Population

Proposal 2–1        The Bail Act 1977 (Vic) has a standalone provision that requires bail authorities to consider any ‘issues that arise due to the person’s Aboriginality’, including cultural background, ties to family and place, and cultural obligations. This consideration is in addition to any other requirements of the Bail Act.

Other state and territory bail legislation should adopt similar provisions.

As with all other bail considerations, the requirement to consider issues that arise due to the person’s Aboriginality would not supersede considerations of community safety.

Proposal 2–2        State and territory governments should work with peak Aboriginal and Torres Strait Islander organisations to identify service gaps and develop the infrastructure required to provide culturally appropriate bail support and diversion options where needed.

3. Sentencing and Aboriginality

Question 3–1        Noting the decision in Bugmy v The Queen [2013] HCA 38, should state and territory governments legislate to expressly require courts to consider the unique systemic and background factors affecting Aboriginal and Torres Strait Islander peoples when sentencing Aboriginal and Torres Strait Islander offenders?

If so, should this be done as a sentencing principle, a sentencing factor, or in some other way?

Question 3–2        Where not currently legislated, should state and territory governments provide for reparation or restoration as a sentencing principle? In what ways, if any, would this make the criminal justice system more responsive to Aboriginal and Torres Strait Islander offenders?

Question 3–3        Do courts sentencing Aboriginal and Torres Strait Islander offenders have sufficient information available about the offender’s background, including cultural and historical factors that relate to the offender and their community?

Question 3–4        In what ways might specialist sentencing reports assist in providing relevant information to the court that would otherwise be unlikely to be submitted?

Question 3–5        How could the preparation of these reports be facilitated? For example, who should prepare them, and how should they be funded?

4. Sentencing Options

Question 4–1        Noting the incarceration rates of Aboriginal and Torres Strait Islander people:

(a)     should Commonwealth, state and territory governments review provisions that impose mandatory or presumptive sentences; and

(b)     which provisions should be prioritised for review?

Question 4–2        Should short sentences of imprisonment be abolished as a sentencing option? Are there any unintended consequences that could result?

Question 4–3        If short sentences of imprisonment were to be abolished, what should be the threshold (eg, three months; six months)?

Question 4–4        Should there be any pre-conditions for such amendments, for example: that non-custodial alternatives to prison be uniformly available throughout states and territories, including in regional and remote areas?

Proposal 4–1        State and territory governments should work with peak Aboriginal and Torres Strait Islander organisations to ensure that community-based sentences are more readily available, particularly in regional and remote areas.

Question 4–5        Beyond increasing availability of existing community-based sentencing options, is legislative reform required to allow judicial officers greater flexibility to tailor sentences?

5. Prison Programs, Parole and Unsupervised Release

Proposal 5–1        Prison programs should be developed and made available to accused people held on remand and people serving short sentences.

Question 5–1        What are the best practice elements of programs that could respond to Aboriginal and Torres Strait Islander peoples held on remand or serving short sentences of imprisonment?

Proposal 5–2        There are few prison programs for female prisoners and these may not address the needs of Aboriginal and Torres Strait Islander female prisoners. State and territory corrective services should develop culturally appropriate programs that are readily available to Aboriginal and Torres Strait Islander female prisoners.

Question 5–2        What are the best practice elements of programs for Aboriginal and Torres Strait Islander female prisoners to address offending behaviour?

Proposal 5–3        A statutory regime of automatic court ordered parole should apply in all states and territories.

Question 5–3        A statutory regime of automatic court ordered parole applies in NSW, Queensland and SA. What are the best practice elements of such schemes?

Proposal 5–4        Parole revocation schemes should be amended to abolish requirements for the time spent on parole to be served again in prison if parole is revoked.

6. Fines and Driver Licences

Proposal 6–1        Fine default should not result in the imprisonment of the defaulter. State and territory governments should abolish provisions in fine enforcement statutes that provide for imprisonment in lieu of unpaid fines.

Question 6–1        Should lower level penalties be introduced, such as suspended infringement notices or written cautions?

Question 6–2        Should monetary penalties received under infringement notices be reduced or limited to a certain amount? If so, how?

Question 6–3        Should the number of infringement notices able to be issued in one transaction be limited?

Question 6–4        Should offensive language remain a criminal offence? If so, in what circumstances?

Question 6–5        Should offensive language provisions be removed from criminal infringement notice schemes, meaning that they must instead be dealt with by the court?

Question 6–6        Should state and territory governments provide alternative penalties to court ordered fines? This could include, for example, suspended fines, day fines, and/or work and development orders.

Proposal 6–2        Work and Development Orders were introduced in NSW in 2009. They enable a person who cannot pay fines due to hardship, illness, addiction, or homelessness to discharge their debt through:

  • work;
  • program attendance;
  • medical treatment;
  • counselling; or
  • education, including driving lessons.

State and territory governments should introduce work and development orders based on this model.

Question 6–7        Should fine default statutory regimes be amended to remove the enforcement measure of driver licence suspension?

Question 6–8        What mechanisms could be introduced to enable people reliant upon driver licences to be protected from suspension caused by fine default? For example, should:

(a)     recovery agencies be given discretion to skip the licence suspension step where the person in default is vulnerable, as in NSW; or

(b)     courts be given discretion regarding the disqualification, and disqualification period, of driver licences where a person was initially suspended due to fine default?

Question 6–9        Is there a need for regional driver permit schemes? If so, how should they operate?

Question 6–10      How could the delivery of driver licence programs to regional and remote Aboriginal and Torres Strait Islander communities be improved?

7. Justice Procedure Offences—Breach of Community-based Sentences

Proposal 7–1        To reduce breaches of community-based sentences by Aboriginal and Torres Strait Islander peoples, state and territory governments should engage with peak Aboriginal and Torres Strait Islander organisations to identify gaps and build the infrastructure required for culturally appropriate community-based sentencing options and support services.

8. Alcohol

Question 8–1        Noting the link between alcohol abuse and offending, how might state and territory governments facilitate Aboriginal and Torres Strait Islander communities, that wish to do so, to:

(a)     develop and implement local liquor accords with liquor retailers and other stakeholders that specifically seek to minimise harm to Aboriginal and Torres Strait Islander communities, for example through such things as minimum pricing, trading hours and range restriction;

(b)     develop plans to prevent the sale of full strength alcohol within their communities, such as the plan implemented within the Fitzroy Crossing community?

Question 8–2        In what ways do banned drinkers registers or alcohol mandatory treatment programs affect alcohol-related offending within Aboriginal and Torres Strait Islander communities? What negative impacts, if any, flow from such programs?

9. Female Offenders

Question 9–1        What reforms to laws and legal frameworks are required to strengthen diversionary options and improve criminal justice processes for Aboriginal and Torres Strait Islander female defendants and offenders?

10. Aboriginal Justice Agreements

Proposal 10–1       Where not currently operating, state and territory governments should work with peak Aboriginal and Torres Strait Islander organisations to renew or develop Aboriginal Justice Agreements.

Question 10–1      Should the Commonwealth Government develop justice targets as part of the review of the Closing the Gap policy? If so, what should these targets encompass?

11. Access to Justice Issues

Proposal 11–1       Where needed, state and territory governments should work with peak Aboriginal and Torres Strait Islander organisations to establish interpreter services within the criminal justice system.

Question 11–1      What reforms to laws and legal frameworks are required to strengthen diversionary options and specialist sentencing courts for Aboriginal and Torres Strait Islander peoples?

Proposal 11–2       Where not already in place, state and territory governments should provide for limiting terms through special hearing processes in place of indefinite detention when a person is found unfit to stand trial.

Question 11–2      In what ways can availability and access to Aboriginal and Torres Strait Islander legal services be increased?

Proposal 11–3       State and territory governments should introduce a statutory custody notification service that places a duty on police to contact the Aboriginal Legal Service, or equivalent service, immediately on detaining an Aboriginal and Torres Strait Islander person.

12. Police Accountability

Question 12–1      How can police work better with Aboriginal and Torres Strait Islander communities to reduce family violence?

Question 12–2      How can police officers entering into a particular Aboriginal or Torres Strait Islander community gain a full understanding of, and be better equipped to respond to, the needs of that community?

Question 12–3      Is there value in police publicly reporting annually on their engagement strategies, programs and outcomes with Aboriginal and Torres Strait Islander communities that are designed to prevent offending behaviours?

Question 12–4      Should police that are undertaking programs aimed at reducing offending behaviours in Aboriginal and Torres Strait Islander communities be required to: document programs; undertake systems and outcomes evaluations; and put succession planning in place to ensure continuity of the programs?

Question 12–5      Should police be encouraged to enter into Reconciliation Action Plans with Reconciliation Australia, where they have not already done so?

Question 12–6      Should police be required to resource and support Aboriginal and Torres Strait Islander employment strategies, where not already in place?

13. Justice Reinvestment

Question 13–1      What laws or legal frameworks, if any, are required to facilitate justice reinvestment initiatives for Aboriginal and Torres Strait Islander peoples?

Part B The Term of reference

ALRC inquiry into the incarceration rate of Aboriginal and Torres Strait Islander peoples

I, Senator the Hon George Brandis QC, Attorney-General of Australia, refer to the Australian Law Reform Commission, an inquiry into the over-representation of Aboriginal and Torres Strait Islander peoples in our prisons.

It is acknowledged that while laws and legal frameworks are an important factor contributing to over‑representation, there are many other social, economic, and historic factors that also contribute. It is also acknowledged that while the rate of imprisonment of Aboriginal and Torres Strait Islander peoples, and their contact with the criminal justice system – both as offenders and as victims – significantly exceeds that of non‑Indigenous Australians, the majority of Aboriginal and Torres Strait Islander people never commit criminal offences.

Scope of the reference

  1. In developing its law reform recommendations, the Australian Law Reform Commission (ALRC) should have regard to:
    1. Laws and legal frameworks including legal institutions and law enforcement (police, courts, legal assistance services and prisons), that contribute to the incarceration rate of Aboriginal and Torres Strait Islander peoples and inform decisions to hold or keep Aboriginal and Torres Strait Islander peoples in custody, specifically in relation to:
      1. the nature of offences resulting in incarceration,
      2. cautioning,
      3. protective custody,
      4. arrest,
      5. remand and bail,
      6. diversion,
      7. sentencing, including mandatory sentencing, and
      8. parole, parole conditions and community reintegration.
    2. Factors that decision-makers take into account when considering (1)(a)(i-viii), including:
      1. community safety,
      2. availability of alternatives to incarceration,
      3. the degree of discretion available to decision-makers,
      4. incarceration as a last resort, and
      5. incarceration as a deterrent and as a punishment.
    3. Laws that may contribute to the rate of Aboriginal and Torres Strait Islander peoples offending and including, for example, laws that regulate the availability of alcohol, driving offences and unpaid fines.
    4. Aboriginal and Torres Strait Islander women and their rate of incarceration.
    5. Differences in the application of laws across states and territories.
    6. Other access to justice issues including the remoteness of communities, the availability of and access to legal assistance and Aboriginal and Torres Strait Islander language and sign interpreters.
  2.  In conducting its Inquiry, the ALRC should have regard to existing data and research[1] in relation to:
    1. best practice laws, legal frameworks that reduce the rate of Aboriginal and Torres Strait Islander incarceration,
    2. pathways of Aboriginal and Torres Strait Islander peoples through the criminal justice system, including most frequent offences, relative rates of bail and diversion and progression from juvenile to adult offending,
    3. alternatives to custody in reducing Aboriginal and Torres Strait Islander incarceration and/or offending, including rehabilitation, therapeutic alternatives and culturally appropriate community led solutions,
    4. the impacts of incarceration on Aboriginal and Torres Strait Islander peoples, including in relation to employment, housing, health, education and families, and
    5. the broader contextual factors contributing to Aboriginal and Torres Strait Islander incarceration including:
      1. the characteristics of the Aboriginal and Torres Strait Islander prison population,
      2. the relationships between Aboriginal and Torres Strait Islander offending and incarceration and inter‑generational trauma, loss of culture, poverty, discrimination, alcohol and drug use, experience of violence, including family violence, child abuse and neglect, contact with child protection and welfare systems, educational access and performance, cognitive and psychological factors, housing circumstances and employment, and
      3. the availability and effectiveness of culturally appropriate programs that intend to reduce Aboriginal; and Torres Strait Islander offending and incarceration.
  3. In undertaking this Inquiry, the ALRC should identify and consider other reports, inquiries and action plans including but not limited to:
    1. the Royal Commission into Aboriginal Deaths in Custody,
    2. the Royal Commission into the Protection and Detention of Children in the Northern Territory (due to report 1 August 2017),
    3. Senate Standing Committee on Finance and Public Administration’s Inquiry into Aboriginal and Torres Strait Islander Experience of Law Enforcement and Justice Services,
    4. Senate Standing Committee on Community Affairs’ inquiry into Indefinite Detention of People with Cognitive and Psychiatric impairment in Australia,
    5. Senate Standing Committee on Indigenous Affairs inquiry into Harmful Use of Alcohol in Aboriginal and Torres Strait Islander Communities,
    6. reports of the Aboriginal and Torres Strait Islander Social Justice Commissioner,
    7. the ALRC’s inquiries into Family violence and Family violence and Commonwealth laws, and​
    8. the National Plan to Reduce Violence against Women and their Children 2010-2022.

The ALRC should also consider the gaps in available data on Aboriginal and Torres Strait Islander incarceration and consider recommendations that might improve data collection.

  1. In conducting its inquiry the ALRC should also have regard to relevant international human rights standards and instruments.

Consultation

  1. In undertaking this inquiry, the ALRC should identify and consult with relevant stakeholders including Aboriginal and Torres Strait Islander peoples and their organisations, state and territory governments, relevant policy and research organisations, law enforcement agencies, legal assistance service providers and the broader legal profession, community service providers and the Australian Human Rights Commission.

Timeframe

  1. The ALRC should provide its report to the Attorney-General by 22 December 2017.

 

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

 

  Included in this NACCHO Aboriginal Health News Alert

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

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

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

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

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

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

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

Read over 50 NACCHO NATSIHP Articles published over past 50 years

INTRODUCTION

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

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

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

Major items discussed by Health Ministers today included:

2.Andrew Forrest and the Eliminate Cancer Initiative

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

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

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

3.Family violence and primary care

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

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

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

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

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

4.Fifth National Mental Health and Suicide Prevention Plan

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

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

1. Achieving integrated regional planning and service delivery

2. Effective suicide prevention

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

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

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

6. Reducing stigma and discrimination

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

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

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

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

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

5.The National Psychosocial Supports Program

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

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

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

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

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

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

7.Amendment to mandatory reporting provisions for treating health practitioner

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

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

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

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

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

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

Download Strategy and work plan here  

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

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

Expanding the public reporting of patient safety and quality measures

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

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

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

 

9.National human biomonitoring program

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

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

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

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

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

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

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

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

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

11.Vaccination

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

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

Health Ministers approve Australia’s National Digital Health Strategy

Digital information is the bedrock of high quality healthcare.

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

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

Download Strategy and work plan here  

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Greg Hunt Press Conference

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

NACCHO Aboriginal Health and #NSPC17 #SuicidePrevention : Full Transcript June Oscar Conference Speech

 

” Addressing the social disadvantage plaguing our communities is critical to solving many of the challenges facing our peoples, including suicide. It is critical to realizing the human rights of Aboriginal and Torres Strait Islander peoples. Our nation must face up to the devastation that has been wrought upon our peoples and which overwhelms us today.

I have said before, that I will work to make sure that human rights are more than just words on a page for our people, but a part of our lived reality. I know that we have much work to do in order to be closer to that day.”

Aboriginal and Torres Strait Islander Social Justice Commissioner, June Oscar. SEE FULL speech part 2

The worst response to suicide within Aboriginal and Torres Strait Islander communities is to ignore social disadvantage and instead attribute the loss of life to individual failure or weakness.

“Addressing the social disadvantage plaguing our communities is critical to solving many of the challenges facing our peoples, including suicide.

“Our nation must face up to the devastation that has been wrought upon our peoples and which overwhelms us today,” according to the Aboriginal and Torres Strait Islander Social Justice Commissioner, June Oscar.

“The colonisation of our country has come at a great cost for our peoples. We see it everyday in the health and wellbeing of our peoples, in the lack of jobs and in the trauma and disadvantage that surrounds us.

“We see the cost in the eyes of our children who have come to expect this life of pain, of interaction with the care and justice systems, drugs, alcohol and little hope that things will change.

“We must work to challenge the view that somehow our position in society is simply because of our failure or weakness as individuals.

“It is essential that we find ways to ensure that suicide is the rarest of tragedies in our communities. At a time when our peoples are faced by so many challenges, when our life expectancy is already significantly shorter than the non-Indigenous population, we cannot afford to have it shortened even further by suicide.”

Addressing the National Suicide Prevention Conference on 27 July 2017, Commissioner Oscar said the words of colleague Richard Weston are helpful in this context.

“Richard said earlier this year that it’s not about trying to have a debate in this country about blame or guilt for non-Aboriginal people, it’s really just trying to understand how we got to where we are.

“If we understand how we got to where we are, we can create solutions that can change the situation.”

Commissioner Oscar said suicide prevention strategies should acknowledge and build on relationships, culture, resilience and respect.

“These are key to our existence as Aboriginal and Torres Strait Islander people. Our culture is both an ancient and continuing source of resilience. And it is a necessary part of the solutions that we are forging in our communities right across this country.

“Research tells us that strong cultural connections are a necessary ingredient for good health and wellbeing. Of course we already know this but we need to build the evidence base around what works.

“Our culture is the inspiration behind the therapeutic economies giving hope to our women in the Kimberley.

“Similar initiatives exist across the country and we are finding new and innovative ways to broach this difficult subject. I want to acknowledge the work of Walpiri elders for trying to find a way to reach and reconnect with their young people through the development of the Kurdiji App. I look forward to seeing what other creative solutions our people come up with to tackle this important issue. This is the cultural medicine that our people need.

“We also know that bringing about change means moving away from discussions that are based in the ‘deficit’ and channelling our efforts into the strengths-based programs and services such as those that I have already mentioned.

“The language of strength, not deficit is what will keep our cultures and our communities alive.

“We need to shift how Aboriginal and Torres Strait Islander peoples are able to participate in Australian society.

“We need structures, schools, safe spaces where we see ourselves reflected back to us, where we are respected, where we have the same opportunities as others, but also where our voices are heard. I don’t mean having a separate society for our peoples but one where we clearly see a place for ourselves and our children in what exists around us. This is what cultural security looks like.”

Part 2 : Conference Strengthens Indigenous Suicide Prevention : Ken Wyatt

Leading Aboriginal and Torres Strait Islander people involved in tackling suicide have received Australian Government scholarships to enable them to attend this week’s National Suicide Prevention Conference.

Minister for Indigenous Health, Ken Wyatt AM, said their participation would provide important perspectives and contribute to the knowledge shared at the event, to be hosted in Brisbane by Suicide Prevention Australia (SPA) from 26-29 July.

“Sharing ideas, experiences and bringing together people involved in suicide prevention and those with lived experience is crucial to finding the best ways forward,” Minister Wyatt said.

“The Turnbull Government is pleased to sponsor both the conference and the indigenous participants.

“We are committed to suicide prevention around Australia but we need a special focus on indigenous suicide, to help reduce the unnecessary loss of life that contributes to the difference in indigenous and non-indigenous life expectancy.”

Approximately 400 people, including 11 scholarship recipients, are expected at the conference, which has the theme “Relationships, resilience and respect: Responding to vulnerability in life”.

The conference aims to increase the profile of indigenous suicide prevention, with a focus on learning from programs featured in the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project.

“The conference will complement the Turnbull Government’s $34 million commitment to 12 national suicide prevention trials, which will gather evidence on better suicide prevention in regional areas of Australia, particularly in high-risk populations” Minister Wyatt said.

Specific areas of focus for the trials include Indigenous communities in the Kimberley and Darwin regions and former Defence Force members in Townsville.

 
Part 3 : Cultural strength is key to suicide prevention : Full Speech

[Introduction in Bunuba]

Yaningi warangira ngindaji yuwa muwayi ingirranggu, Jagara and Turrbal yani u.   Balangarri wadjirragali jarra ningi – gamali ngindaji yau muwayi nyirrami ngarri thangani. Yaningi miya ngindaji Muwayi ingga winyira ngarragi thangani.  Yathawarra, wilalawarra jalangurru ngarri guda.

I stand here today on the lands of the Jagara and Turrbal People. There are many of us that have come from afar, we come speaking different languages, and we are strangers to these lands. The ear of this land is hearing our different languages and we reassure that we gather and talk together with good feeling.

I would like to begin by acknowledging the Traditional Owners of the land upon which we meet, the Jagara and Turrbal peoples.

I am a proud Bunuba woman from Fitzroy Crossing in Western Australia, and it gives me great pleasure to be here with you all to discuss this critical issue that impacts far too many Australians, and far too many of our peoples.

I am all too familiar with the devastation that suicide wreaks on our communities. And it is a sad fact that, like many of you, I speak with firsthand experience of its terrible impacts on my own community.

It is devastating that the Kimberley is going through its second inquest in as many years on this issue. I gave evidence in 2007 and I sincerely hope that this current process can lead to substantive changes that are so desperately needed. But I know that this is an issue that affects so many of our peoples across this nation, not just in my homelands.

I address you today as the first Aboriginal woman appointed to the role of the Aboriginal and Torres Strait Islander Social Justice Commissioner at the Australian Human Rights Commission in 30 years. I look forward to bringing my experiences from living in community to this role and to elevating the voices of our people, throughout my term to address the various challenges facing our communities.

I am proud to follow in the footsteps of my predecessors such as Mick Gooda and Tom Calma who have both been strong advocates on this issue and many others affecting our peoples for many years.

People like Tom Calma and my fellow Western Australian, Professor Pat Dudgeon, have been fighting long and hard to make Governments sit up and take action on this national tragedy – particularly how it effects Australia’s First Peoples.

I will reference their work in the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project –in my remarks today.

I am grateful for their leadership and point to their work to tackle the underlying issues of suicide for our people. But I am also grateful for the work of everyone in this room for what you are doing everyday to improve the lives of our people. We have all been touched by suicide in some way or another and together, I know that we have the best chance of bringing hope and change to our communities.

But we know that we know that this is not an issue that we can tackle alone, that the causes are complex and demand responses that address the quality of life of our peoples.

Over the next 30 minutes or so, I want to discuss the historical and societal conditions that lead to suicide and self-harm in Aboriginal and Torres Strait Islander communities. And then, drawing on my own experience in my community in Western Australia, look at the things we know can and must be done to reverse those conditions.

Rights based approach

It is appropriate to highlight the need for a ‘Rights’ based approach in discussing suicide in Australia.

We need to be clear about how a Rights-based framework is critical to understanding how to tackle the causes of suicide.

The Universal Declaration of Human Rights, the bedrock of Rights internationally for the last 70 years says that: Everyone has the right to a standard of living adequate for the health and well-being…(1)

The United Nations Declaration on the Rights of Indigenous Peoples also speaks to the rights of Indigenous peoples, like all other peoples to enjoy the same rights to life, liberty and security. It highlights the particular need for the rights of Indigenous elders, women, children and people with disability to be protected.(2)

These human rights frameworks are a critical starting point for all peoples. But for Aboriginal and Torres Strait Islander peoples, we know that the reality of our existence falls far, far short of these standards. We know that particularly in the remoter parts of the country that our peoples are living on top of each other and sometimes without the benefit of running water. We know the reality of some town camps where, cut off from basic services our people sleep outside, go hungry and struggle to keep warm.

I saw similar conditions during my drive from my home in Fitzroy Crossing to take up my new role the city of Sydney. I travelled through many places across the country and saw our old people living in tin shacks far from essential services. These conditions are a breeding ground for suicide, self-harm and ill health to prosper.

This reality jars against the image of Australia as a prosperous nation. Our country ranks as one of the richest OECD countries on earth and yet Aboriginal and Torres Strait Islander peoples do not sit at this table of wealth.

We know that our nation’s prosperity and our people’s place amongst the most socially and economically disadvantaged are no coincidence. These events are inextricably linked.

The colonization of our country has come at a great cost for our peoples. We see it everyday in the health and wellbeing of our peoples, in the lack of jobs and in the trauma and disadvantage that surrounds us.

We see the cost in the eyes of our children who have come to expect this life of pain, of interaction with the care and justice systems, drugs, alcohol and little hope that things will change.  The normalization of this despair is killing our people.  We must all work harder to change the narrative of low expectations, that is set upon us by others and which we inherit, but we must also demand more from government.

Our very survival in this country, is testament to our strength as a peoples and to our ability to adapt to our conditions. It is evidence of the strength of our culture which we know must be the bedrock of any solutions to many of the challenges that we face.

We know that suicide speaks to our experience as Aboriginal and Torres Strait Islander peoples, as a peoples who are still grappling with our existence in a world that is very different from that of our ancestors.

We must work to challenge the view that somehow our position in society is simply because of our failure or weakness as individuals. We know that much of our experience as First Peoples is a product of the past.

Addressing the social disadvantage plaguing our communities is critical to solving many of the challenges facing our peoples, including suicide. It is critical to realizing the human rights of Aboriginal and Torres Strait Islander peoples. Our nation must face up to the devastation that has been wrought upon our peoples and which overwhelms us today.

I have said before, that I will work to make sure that human rights are more than just words on a page for our people, but a part of our lived reality. I know that we have much work to do in order to be closer to that day.

It would be easy to focus solely on the heartbreak that is suicide in our communities. We must give place to mourning and acknowledgement of those we have lost.

But it is essential that we find ways to ensure that suicide is the rarest of tragedies in our communities. At a time when our peoples are faced by so many challenges, when our life expectancy is already significantly shorter than the non-Indigenous population, we cannot afford to have it shortened even further by suicide.

The power of culture

The power of our culture in healing and the necessity of community designed and led solutions are key antidotes for change.

I am encouraged by the theme of this conference – with the focus on Relationships, Resilience and Respect.

These are key to our existence as Aboriginal and Torres Strait Islander people. Our culture is both an ancient and continuing source of resilience. And it is a necessary part of the solutions that we are forging in our communities right across this country.

We know the healing power and protective role that culture plays in our communities. Our culture kept us safe and healthy long before the British arrived on our shores and long before we even had words to describe the devastation of suicide. It has been a reservoir of strength that has sustained us throughout time.

Research tells us that strong cultural connections is a necessary ingredient for good health and wellbeing. Of course we already know this but we need to build the evidence base around what works.

Our culture is the inspiration behind the therapeutic economies giving hope to our women in the Kimberley – who are creating new lives for themselves away from violence and drug dependence through making wearable art.

Similar initiatives exist across the country and we are finding new and innovative ways to broach this difficult subject. I want to acknowledge the work of Walpiri elders for trying to find a way to reach and reconnect with their young people through the development of the Kurdiji App. I look forward to seeing what other creative solutions our people come up with to tackle this important issue. This is the cultural medicine that our people need.

We know that culture is a critical ingredient of any approach for addressing suicide in our communities and is a lifeline to all of us but especially our most vulnerable.

We also know that bringing about change means moving away from discussions that are based in the ‘deficit’ and channelling our efforts into the strengths-based programs and services such as those that I have already mentioned.

The language of strength, not deficit is what will keep our cultures and our communities alive.

I know that there will be plenty of facts provided at this conference about the size and nature of suicide, so I will just quickly run through a few details regarding suicide in our communities.

In my home state of Western Australia, suicide rates for Aboriginal people in remote areas of the state are some of the worst in the world. It is well documented that self-harm rates are at least 10 times higher than non-Indigenous people.(3)

Across the country, suicide accounts for up to 30 per cent of the premature deaths of our young people under the ages of 18 years.(4)

Aboriginal and Torres Strait Islander young people between the age of 15 and 24 years are over five times more likely to die of suicide than their non-Indigenous peers.(5)

Trauma

It is still not well understood enough in the wider Australian community, why suicide and self-harm are so prolific among Aboriginal and Torres Strait Islander peoples. But for us we know this phenomenon is intimately linked to trauma.

To borrow the term from Professor Colin Tatz, I think non-Indigenous people can sometimes suffer ‘wilful amnesia’ about the history of the First Peoples of this country and this means we are all left poorer for it.

The impact of 200 plus years of colonisation, government policies resulting in dispossession, stolen generations and brutal assimilation have caused a level of trauma that passes from one generation to the next.

Our children and grandchildren continue to suffer the terrible impact of the sufferings of their parents, grandparents and elders.

The words of Richard Weston, are helpful in this context, he said earlier this year that: it’s not about trying to have a debate in this country about blame or guilt for non-Aboriginal people, it’s really just trying to understand how we got to where we are.

So if we understand how we got to where we are, we can create solutions that can change the situation.(6)

A cycle of despair and the toll of intergenerational trauma are the conditions too many Aboriginal and Torres Strait Islander people live with.

We know that a society that boldly acknowledges the wrongs of the past, and is determined to address those wrongs in the present will succeed in creating a stronger and safer place for Aboriginal and Torres Strait Islander people to prosper.

20 years ago, the Bringing them Home report told Australians and the world the truth of the Stolen Generations. It also told us something that we know all too well which is that – “trauma compounds trauma”.

That Report further stated that: Trauma experienced in childhood becomes embedded in the personality and physical development of the child. Its effects, while diverse, may properly be described as ‘chronic’. These children are more likely to ‘choose’ trauma-prone living situations in adulthood and are particularly vulnerable to the ill-effects of later stressors.

The cycle must be broken in order to stem the flow of suicide in our families and communities. We need to ensure that the conditions are right for healing.  We know that the best way to achieve this is by addressing the social disadvantage I spoke of earlier, but also supporting Aboriginal and Torres Strait Islander families to create strong communities as the basis for healing.

The best support structures begin with mentally and spiritually strong families, clans and communities.

Sadly, we know that even the best, most connected, well serviced communities still have a huge challenge in addressing the needs of generational trauma.

The reality is many Aboriginal and Torres Strait Islander communities are dealing with trauma in conditions that are unacceptable for non-Indigenous Australia.

FASD and Suicide

We know that with all the energy in being strong, that some of us succumb to the trauma around us. Far too many of our people and particularly our young people look to drugs and alcohol to numb their pain.

This is an issue that is very close to my heart.

One of the big challenges in our communities, with clear links to suicide and self-harm is the prevalence of Fetal Alcohol Spectrum Disorder or FASD.

There are many symptoms and outcomes of intergenerational trauma but this is one of the most acute issues that I have experienced in community.

After a series of tragic suicides in 2006 a coronial inquest examined why so many Kimberley Aboriginal people were taking their own lives.

Not surprisingly it found that alcohol abuse was the primary reason for the suicide epidemic of Kimberley Aboriginal people.

I have said before, that my own impossible dream was to bring about better life opportunities for the children in my community and town of Fitzroy Crossing. I know that like me, many of us see the pain that our people, carry around and we want to take that away. But sometimes wounds are so deep for cultural medicine alone to fix.

After 50 deaths and attending too many funerals, I found it unacceptable that people I knew were dying in such high numbers from alcohol related preventable deaths. I knew that if we did not act, we would continue to see our families suffering and caught in a rut of grief and loss for years to come.

This was painfully disturbing to see and incredibly difficult to live within this environment of deep sadness, in a country as rich and blessed as Australia in the twenty first century.(7)

In February 2008, the State Coroner described the living conditions for Aboriginal people in Fitzroy Crossing as a “national disaster with no disaster response.”(8)

Remember, trauma compounds trauma.

Along with several other key leaders, we took an unprecedented step. With the support of our elders we lobbied the Director of Liquor Licensing seeking an initial 12 month moratorium on the sale of full strength take-away liquor across the Fitzroy valley.

We were met with fierce resistance, especially from some members of our own community who were addicted to a destructive lifestyle, but we were unrelenting in what we knew was a necessity to break a circuit of chaos and grief.

The restrictions have now been in place for nearly 10 years due to ongoing community support. Many who opposed our efforts are now thankful of the positive impacts that have become entrenched since the restrictions were put in place.

Independent evaluations have shown some great results due to the restrictions; large reductions in alcohol related police interventions, large reductions in alcohol related presentations to hospital and an increase in school attendance.

As a community, we started to change the conditions that incubate suicide and self-harm- but alcohol management is just one plank in the program of solutions that are needed.

Let me be clear, while we have seen some amazing results in my home community in Fitzroy Crossing, alcohol restrictions have never been intended as a panacea.

Alcohol management is just one part of an ongoing strategy for my community. We know that the support services that are desperately needed are often lacking in our communities if they exist at all.

While there has been some good progress in Fitzroy Crossing, we still lose too many people, particularly our young people, to suicide.

I am disheartened to hear that a decade on we are back again before another Coronial Inquiry.

I despair, as I am sure many of you do, knowing that inquiries aren’t a substitute for action but remain hopeful that the findings might translate into meaningful change for our communities.

Hard as it is, I know that we must continue to thrust the suicide epidemic that we are facing across the country into the spotlight.

I thank the work of people like Professors Pat Dudgeon and Tom Calma for doing just this through the work of the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation.

We know from that report, as with all other issues affecting our communities, that approaches to suicide prevention must be community owned and led if they are to be successful.

The Report recognises our holistic approach to health and articulates the connection between culture, healing, social determinants such as housing and education, and the generational impact of trauma.

One of the keys to preventing suicide is to remove the siloed approach to all these issues and instead, consider them all together. Our community controlled services are at the forefront of providing holistic, wrap-around services that look at the entirety of need.

Such approaches are a core part of the ongoing criticisms of how governments tend to organise their programs and services. When it comes to suicide prevention, we cannot afford to live with the chaos of disconnected programs and services.

The Close the Gap Campaign, of which I am a member, has been calling on the Federal government to fund an Implementation Plan for the National Aboriginal and Torres Strait Islander Suicide Prevention Strategy.

This Strategy has a holistic view of our mental, physical, cultural and spiritual health. It has an early intervention focus that works to build strong communities through more community-focused and integrated approaches to suicide prevention.

A considered Implementation Plan with Government support is needed to genuinely engage with our communities, organisations and representative bodies to develop local, culturally appropriate strategies to identify and respond to those most at risk within our communities.

A future Implementation Plan should begin with the recommendations of the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project Report from last year.

Conclusion

But there is a final point that I wish to make about this important issue and that is about the issue of place.

Too many Aboriginal and Torres Strait Islander peoples do not feel at home in the place we call our own. We feel at unease at the ever increasing role of governments and other agents in our lives. Daily experiences of racism and disadvantage are the norm and eat away at our health and wellbeing. It is sad that we live in a world so desensitised to our trauma that 10 year olds committing suicide are met with expectation and not surprise.

This is an indictment on our country. This is the story of Australia.

Brick by brick, structures have been built on our ancestral homes, leaving little room for our cultural way of life.

The challenge for us in the modern world is how do we continue to be sustained by the world’s oldest living culture in a society that seems to give it so little value. Walking in two worlds of what it means to be an Indigenous person in this country is not an easy path. Sadly, it is too easy to get swept up in the pain when you are surrounded by little else.

We need to shift how Aboriginal and Torres Strait Islander peoples are able to participate in Australian society.

We need structures, schools, safe spaces where we see ourselves reflected back to us, where we are respected, where we have the same opportunities as others, but also where our voices are heard. I don’t mean having a separate society for our peoples but one where we clearly see a place for ourselves and our children in what exists around us. This is what cultural security looks like.

I want to finish up by using a quote from Yolngu leader, Gularrwuy Yunupingu, which I believe speaks to so many things. He said:

What Aboriginal people ask is that the modern world now makes the sacrifices necessary to give us a real future. To relax its grip on us. To let us breathe, to let us be free of the determined control exerted on us to make us like you. And you should take that a step further and recognise us for who we are, and not who you want us to be. Let us be who we are – Aboriginal people in a modern world – and be proud of us. Acknowledge that we have survived the worst that the past had thrown at us, and we are here with our songs, our ceremonies, our land, our language and our people – our full identity. What a gift this is that we can give you, if you choose to accept us in a meaningful way’(9)

It is my hope that one day we won’t need conferences like these, and that our people will find a place in our country where they feel strong and supported and exist on equal footing with their fellow Australians.

That day is yet to come but being in the presence of you all gives me great hope for the future.

Thank you

Help

Lifeline 13 11 14

Suicide Call Back Service 1300 659 467

BeyondBlue 1300 224 636 or

Mensline 1300 789 978

KidsHelpline 1800 551 800

 

 

 

NACCHO Aboriginal Health News : Indigenous Health Minister @KenWyattMP visits , promotes and engages with our ACCHO’s during #NAIDOC2017 week

 

 “ This week, celebrating and acknowledging the power of our languages, the importance of language, but even where we’ve think we’ve lost languages I’m often surprised with the older people within our communities who can still speak the language.

And in my own country there are people teaching Noongar language and reviving the veracity of the language. Now language often is an identifier of who we are and what country we’re associated with.

NAIDOC Week is about celebrating, enjoying ourselves within our community, having fun, but also reflecting. 

Alice Springs : Ken Wyatt being interviewed by Kyle Dowling from CAAMA radio about Congress ACCHO Alice Springs and  the 11 organisations partnering in the new Central Australia Academic Health Science Centre SEE PART 3 Below

Aboriginal Health #NAIDOC2017 : New Aboriginal-led collaboration has world-class focus on boosting remote Aboriginal health

Victoria / VACCHO / VAHS

APY LANDS

Kowanyama /Cairns QLD  :

“I am closely involved with the Darwin and Kimberley suicide prevention trials, part of the Federal Government’s $192 million commitment to addressing regional mental health issues,

“What we learn from those sites, which have acute suicide rates, will be made available as appropriate for North Queensland, in close collaboration with local communities.”

Mr Wyatt, in was Cairns  speaking at the myPHN Conference (see Part 3 for PHN Press Release ) said close engagement with the community and respecting locally endorsed solutions to guard against suicide was the way forward

Part 1  : Minister rolls out mental health action plan for Kowanyama

FINDINGS from suicide prevention trials being carried out in Western Australia will be implemented in the Far North to help lower the rising suicide rate in indigenous communities.

From The Cairns Post

Indigenous Health Minister Ken Wyatt says he is “very concerned” about reports of the suicide rates in the region’s remote indigenous population growing to become one of the highest in the world.

The Weekend Post has reported concerns by community leaders at Kowanyama that the mental health crisis was sparked by the tragedy in the community in October, when a vehicle rammed into a house full of mourners, resulting in one death and 25 people being serious injured.

There had been more than 20 suicides or attempts at Kowanyama, which has a population of about 1200, since the ­October tragedy.

Mr Wyatt, was Cairns  speaking at the myPHN Conference, said close engagement with the community and respecting locally endorsed solutions to guard against suicide was the way forward.

“I am closely involved with the Darwin and Kimberley suicide prevention trials, part of the Federal Government’s $192 million commitment to addressing regional mental health issues,” he said.

“What we learn from those sites, which have acute suicide rates, will be made available as appropriate for North Queensland, in close collaboration with local communities.”

An experienced social work has been flown into Kowanyama to join a mental health clinical nurse consultant who travels to the remote Cape York community for four-day visits.

Mr Wyatt said further emergency action was underway with the federally-funded Northern Queensland Primary Health Network working with the Royal Flying Doctor Service to expand mental health services at Kowanyama.

“This additional commitment has already ensured an extra clinician for the community, to provide support and targeted suicide prevention activities with this full-time position starting on Tuesday, July 11,” he said.

If you or someone you know needs assistance please call Lifeline Australia on 13 11 14.

Cairns Apunipima

 Part 2  : Working with communities to deliver better health is our primary aim
The nation’s Primary Health Networks (PHNs) are being encouraged to work closely with communities to tackle health challenges and improve the wellbeing of all Australians.
Aged Care Minister and Indigenous Health Minister Ken Wyatt said he hoped opening the 2nd annual myPHN Conference in Cairns today would help guide a new era in effective and efficient care.
 
This year’s conference theme of ‘Transforming Healthcare Together’ challenges current beliefs on the best ways to improve patient outcomes,” said Minister Wyatt.
“PHNs are leading the charge in this space. After undertaking detailed analysis of their regions’ specific health needs, they are now commissioning services to fill these gaps.
 
“These range from building the capacity of General Practitioners (GPs) and tackling mental health, chronic conditions and obesity, to engaging with consumers in disease prevention.
The Minister said the first stage of the national trial of Health Care Homes was another example of the fresh approach to the care of people with complex conditions.
“Participating GPs and Aboriginal Community Controlled Health Services will work closely with patients and specialists, pharmacists and allied health care to empower patients to take an active role in health improvements,” he said.
 
Minister Wyatt said primary health providers had a vital role in helping improve Indigenous health and that of older Australians.
“Despite the progress we’ve made to date, Indigenous people still have a shorter life expectancy and are more likely to develop chronic conditions such as diabetes  kidney and cardiovascular diseases than non-Indigenous Australians,” Minister Wyatt said.
 
We have to do better, and primary health professionals are well placed to develop innovative new programs that can make a real difference.”
A good example is the Northern Queensland PHN workforce investment, including funding more than 100 Aboriginal and Torres Strait Islander people to become qualified indigenous health workers. 
 
The conference also focuses on how social and cultural influences can effect  health outcomes, promising new hope for closing the life expectancy gap for Indigenous Peoples.
 
Innovation and new thinking will help deliver a stronger health and aged care system,” said Minister Wyatt.
 
“Learning from the experiences of other communities and nations will also keep older Australians healthier for longer, and give them more flexibility on when and how they access care as they age.
“Better health is a partnership between governments, the health sector, and the consumer. Greater collaboration and new models of care promise positive outcomes.”

Part 3 Transcript of Interview on CAAMA Radio with Kyle Dowling on 5 July 2017

Ken Wyatt:What I like about the centre is that it is an alliance of organisations that have been heavily involved in research around many of the health issues impacting on our people. But what’s more important significant is that Congress is the lead agency or the lead player in all of this and having that Aboriginal leadership working so closely with the expertise and knowledge and skills and capability of research is fantastic.

Kyle Dowling: Ken Wyatt, the Federal Minister for Indigenous Health and Aged Care, recently congratulated the 11 organisations partnering in the new Central Australia Academic Health Science Centre.

Ken Wyatt: Any of us have the capability and capacity to take leading voices. It’s whether we have the confidence and courage to do it at times. And I think Congress has really set a framework for showing that they are leaders. That they are prepared to go and fight for the things they believe in, but equally they work very closely with people who’ve got a like-minded thinking who want to make a difference.

I think the other part that is important in this is their voices are also about translating research into real change on the ground in the community with families. And that’s an important translation of research into practice. And they’ve been around a long time so their knowledge of the health of people within the area, but not only the area, but nationally has been well-based on being involved with the community, listening to community, but treating community for the range of illnesses that they’ve seen over the years. So I want to complement them on their vision, but also being a leader to demonstrate that our voices do count. That they are important.

Kyle Dowling: : So Ken, can you just talk to us about the actual role of the Central Australia Academic Health Centre and the importance of the collaboration between Aboriginal community-controlled health services and leading medical researchers.

Ken Wyatt:What’s important about the centre is that it’s now recognised as a centre of excellence for research. That means it gives them access to Commonwealth funding out of the Futures Research Fund, but also NHMRC funding as well. They’re also recognised as being of a national standing in the quality of what they are capable of doing, but the team they have within that alliance. So you’re really saying that you- you’ve brought together this incredible group of skills, resources and thinking that will be used to tackle some of those complex issues on the ground.

Yesterday, Alan Cass talked about renal disease and the work that affected him into making the decision to look at the whole issue of progression to dialysis and what we still need to do. And he talked about some of the alarming figures here that- when you think about the number of Aboriginal people within the Territory- those figures are extremely high. So we’ve got to do something about it and that’s what he’s talking about when he is involved in this collaborative centre.

Kyle Dowling: Why Central Australia? Why was this area the right place for the centre?

Ken Wyatt: Look, I think it’s just natural to expect it to be here because you’ve got an incredible organisation like Congress. You have Aboriginal leadership here whose thinking and whose passion for making a difference for people here and across Australia. But you’ve also got these incredible alliances with Flinders Uni, Baker IDI, and there’s other collaborative members of that group who are also deliverers of services. And if we think of the history of the Territory, there have been some outstanding individuals that have been involved. So you only have to look at the Menzies Research Centre, the work that they have done. It’s a natural fix and it’s a good mix of bringing some incredible people together to work on these issues.

Kyle Dowling: Now the partners in the CAAHSC have identified research priorities. Can you touch on a little bit of those?

Ken Wyatt: The five areas that they have identified are good, but the one that excites me is the whole issue of workforce and development of capacity. But developing of capacity for Aboriginal research- there was a young woman I met yesterday who has become a researcher and her passion for that work now is growing. It’s- and she becomes an example for others that research is an important area and that I can do it, so can you. And that workforce capacity also means that they will be looking at, not only what’s needed today, but the type of skills we’ll need for tomorrow and the future. And aged care is in that mix.

I had a good meeting with Congress this morning about older people who live in this area that I need to have a look at the issues around their needs, but equally be made aware of the number of older people now living in community and what we have to do for them.

Kyle Dowling: Now, Central Research has been dubbed a hub of hope for Indigenous health. How would you describe Central Research as in fact being a hub of help for Indigenous hope.

Ken Wyatt: That whole hub of hope I see in an optimistic sense. I see it as a group of people believing what they do, but then wanting to turn that into having access to further work they have to do to find and identify reasons. And I use the term causes of the cause.

So what are the causes that cause an illness or what are the causes that cause renal failure. And then to look at how do we go upstream and prevent that from happening. So if it’s skin diseases, if it’s other factors that result in kidney failure, then how do we address and tackle those. But equally what they’ll be looking at is what treatment can we provide and what treatment can we also think about providing at the local community level because the problem with dialysis is that you really need to live with the chairs are that provide you with that life-saving support. But ultimately if we can find a cure for kidney failure then that makes it far more expecting of pushing out life, but also preventing kidney failure and giving people in any individual hope for a future, hope for a longer life because the point I want to make is that every person we lose out of our community is a history book.

We never write our histories, we never write our stories on paper. We only learn in transmission in conversation, art, the stories we tell dance. Now when we take one of those people out, that’s the end of that story. We can never go back and re-read it, and that’s why that the work that this centre does is critical in keeping people alive longer because young people like you will need the knowledge of the stories, but also the history and every aspect that gives us what is important spiritually, culturally, but as an identity as an individual within our community.

Kyle Dowling: Before I do let you go, I did just want to get a quick message from you. It is NAIDOC Week. Your message to everyone across the country on NAIDOC weekend, what NAIDOC means to you as an Aboriginal person?

Ken Wyatt: This week, celebrating and acknowledging the power of our languages, the importance of language, but even where we’ve think we’ve lost languages I’m often surprised with the older people within our communities who can still speak the language. And in my own country there are people teaching Noongar language and reviving the veracity of the language. Now language often is an identifier of who we are and what country we’re associated with.

NAIDOC Week is about celebrating, enjoying ourselves within our community, having fun, but also reflecting.

Kyle Dowling: Yes, well on that note, Ken thank you for taking out your time to have a chat with us here on CAAMA Radio and thank you for tuning in.

That’s going to be it for Strong Voices today. Thank you for tuning in. I hope you enjoyed the program. Make sure you check out our CAAMA webpage. It’s caama.com.au. Make sure you check out our social media as well -our Facebook and Twitter. And we’ll be back the same time tomorrow.

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

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

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

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

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

Photo above

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

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

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

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

Lynne Henderson, former RFDS Central Operations mental health clinician.

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

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

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

RFDS CEO Martin Laverty see story Part 2 below

Mental health in remote and rural communities

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

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

Download the report HERE

RN031_Mental_Health_D5

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

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

 

Part 1  Indigenous mental health and suicide

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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

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

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

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

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

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

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

Source ABC

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The suicide rate is even greater in very remote communities.

If you or anyone you know needs help:

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

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

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

Mental health counselling has given her a valuable outlet.

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

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

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

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

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

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

The leading causes for evacuation flights due to mental disorder are

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

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

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

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

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

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

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

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

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