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

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

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

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

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

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

We just aren’t demanding that basic level of accountability

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

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

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

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

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

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

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

Part 1 RACP and NACCHO Press Release

JOINT STATEMENT

HEALTH BODIES DECLARE ABORIGINAL YOUTH SUICIDE AN URGENT NATIONAL PRIORITY

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

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

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

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

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

We are calling on the Federal Government to:

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

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

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

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

 Kate Aubusson From the Brisbane Times 20 March 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Key messages from today’s discussion included:

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

Part 4 Minister Wyatt Press release

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

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

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

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

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

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

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

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

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

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

NACCHO Aboriginal Health and #SuicidePrevention : Minister @KenWyattMP @SenatorDodson and KAMS ACCHO respond to 42 recommendations of WA Coroner inquiry into the deaths of 13 Aboriginal children and young persons in the Kimberley region between 2012 and 2016


” Today, Western Australian State Coroner, Ros Fogliani, released her report of the investigation into the suicide deaths of 13 Indigenous young people that occurred between November 2012 and March 2016 in the Kimberley Region.

I cannot adequately express my sense of grief at the deaths of these young people. 

Nor can I ever comprehend the loss and devastation their families and their communities are feeling.

The families and communities who have experienced these tragedies have been deeply affected and the pain will never leave them.

The high rate of suicide among young First Australians is one of the nation’s most confronting challenges.

Minister Ken Wyatt Press Release see Part 1 Below

Download the 42 Recommendations 

13-Children-and-Young-Persons-in-the-Kimberley-Region-Finding

Key recommendations from the inquest:

  • Screen for foetal alcohol spectrum disorder during infant health assessments and when a child enters the child protection or justice systems for the first time
  • Restrict take away alcohol across the entire region, introduce a banned drinker register, resource police to enforce “sly grogging” regulations and provide more funding for patrols to take intoxicated people to a “safe place”
  • Extend an offer of a voluntary cashless debit card to the entire region
  • Build culturally-appropriate residential colleges for students who volunteer to be admitted with the consent of their parents and/or caregivers
  • Build a mental health facility in the East Kimberley that incorporates treatment for alcohol and drug abuse problems, and permanently base a mental health clinician in Halls Creek
  • Train child protection workers and teachers who have regular contact with Aboriginal children in suicide intervention and prevention
  • Expand the “Adopt-a-Cop” classroom program to improve the relationship between children and police, and expand a program where Aboriginal elders help conduct night patrols and speak with children on the streets
  • Introduce or continue to expand Aboriginal language classes in schools, and introduce re-engagement classrooms in primary schools to improve attendance rates
  • Consult more with Aboriginal people to “co-design” services and programs
  • Expand cultural programs including on-country trips, and develop or refurbish facilities for young people to meet and engage in activities.

“ The report handed down today must not join the 42 reports into Aboriginal well-being delivered over the last 15 years that simply sit and gather dust. This report must lead a paradigm shift that leads to community-led solutions that address the clear sense of suffering, hopelessness and disillusionment that is being felt.

We must continue to work towards building mabu ngarrungu, strong community, and mabu buru, strong country. Essential to this is mabu liyan – being well inside ourselves through strong connections to family, community and country. Government must understand us and our thinking around culture and well-being and not continue to simply impose its own views.

There is hope for a better way of doing things and to stop this sadness. It requires a resolve to work with First Nations peoples to establish new ways.”

Senator Patrick Dodson See full Press Release Part 2 Below

The issues are complex. It is not something that we can simply resolve by one program or one set of funding. It is something we need to tackle across the community with the help of the government,

A shift in the way major support services approach remote communities is needed to address the specific needs.

I think we’ve got a lot of mainstream services trying to impose a particular model on the needs of the community. What we really need is to work with the community to understand what are the needs; and design the services to respond to the needs.

“We can’t continue to impose things because an organisation simply says they’re the best organisation to deliver it.”

Rob McPhee, Deputy CEO of the Kimberley Aboriginal Medical Services, said it was going to take years to tackle the complex issues that arose in the report, but action was needed.

“I think it’s a real difference to the language I have heard previously. I thought there was recognition of all the issues that contribute to Indigenous suicide,

I think it’s not only good for the Kimberley, the outcomes, but it’s good for the whole country.”

To hear the recommendations about the social determinants, that holistic approaches are required,” 

Indigenous Health Professor Pat Dudgeon at the University of Western Australia said she felt the report showed recognition to the issues that have contributed to Indigenous suicide.

View further Interview HERE

The RACGP and National Aboriginal Community Controlled Health Organisation (NACCHO)’s National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people includes sections relevant to suicide intervention and prevention for Aboriginal and Torres Strait Islander youth:

  • Child health – FASD, prevention of child maltreatment, and supporting families to optimise child safety and wellbeing
  • The health of young people – social and emotional wellbeing and drug use
  • Mental health – prevention of depression and suicide
  • Lifestyle – including alcohol
  • Family abuse and violence

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

Part 1

Our national Aboriginal and Torres Strait Islander suicide death rate is more than double the rate of the rest of Australian society. And among 15 to 34 year olds, it’s three times as high.

The inquest has found common elements and factors contributing to the suicide deaths of the 13 young people.

These include alcohol abuse, domestic violence, poor living conditions and poor school attendance. Tragically, these young people were never able to reach out for help from support services.

There are 42 recommendations in Ms Fogliani’s report. These recommendations have been made to help target the causes of the issues.

A number of recommendations highlighted the need for suicide programs to be culturally sensitive, and that genuine and empowered relationships with First Nations communities are critical for the success of any program.

The report also highlights the need for better coordination between government agencies responsible for suicide prevention, and has recommended a Commissioner for Aboriginal Children and Young People be established.

The Australian Government has taken prompt action to address youth suicide in Aboriginal and Torres Strait Islander communities.

On 25 January 2019, I hosted an urgent meeting in Perth with experts and members from the communities to discuss how best to respond to these recent tragedies.

As a result, an additional almost $5 million has been provided for a range of initiatives, including:

  • fast tracking the rollout of the Be You school-based support in the Kimberley and Pilbara
  • delivering of a targeted social media campaign
  • expanding of the Young Ambassadors for Mental Health project to include a special focus in Aboriginal and Torres Strait Islander youth
  • supporting to families dealing with grief with a focus on suicide prevention.
  • commitment to working with my WA state colleagues.

The Australian Government also provides $4 million to each of the 12 National Suicide Prevention Trial sites, including two sites for Aboriginal and Torres Strait Islander communities in the Kimberley and Darwin.

The report provides a unique opportunity to rethink how we do things with local communities.

I will be reviewing the coroner’s report as a matter of urgency.

The Australian Government will carefully consider the WA Coroner’s report and recommendations. These will inform the Government’s approach towards the issue of Indigenous suicide in the Kimberley region going forward.

Part  2

Today is a difficult day for the Kimberley and the families of those who passed away.

Today, after nearly three years, State Coroner Ros Fogliani has delivered her findings in a significant inquiry into the deaths of 13 Aboriginal children and young persons in the Kimberley region between 2012 and 2016.

The Coroner’s findings were handed down in Perth, and live-streamed to the Regional Courts of Broome, Kununurra, Fitzroy Crossing and Halls Creek. I sat in the Broome Court and it was crowded with a good cross-section of the community.

This inquiry confirms what we already know – we have a crisis in the Kimberley. The rate of suicide in the Kimberley by Indigenous people, in particular young Indigenous people, is amongst the highest in the world. The Coroner reinforced the well-known social determinants of well-being which First Nations peoples live in.

Ten years have passed since the last major inquiry into the deaths of young Indigenous people – the Hope Inquest. Today confirms yet again, we have made little or no progress.

Clearly, the policies and service delivery that address suicide in our communities are failing and our people are losing hope. Too much seems to be reliant on being delivered from the outside and not from within our community or the Kimberley.

Today, on this day of sorrow and reflection, we must re-think the way we address Indigenous youth suicide.

There needs to be a new form of engagement with Indigenous communities and young people need to have a voice and role in future initiatives if we are to fix the issues and deliver the opportunities for change in the future.

The Coroner, in her final key recommendation, emphasised the principles of self-determination and empowerment in initiatives, policies and programs relating to First Nations peoples. She has relied on the expressed aspirations of the Western Australian Government. The Western Australian Government must now honour this with First Nations people.

Any new approach must be informed by a rigorous analysis of the values driving the delivery of services. It must be holistic and therapeutic – addressing the complex needs of entrenched socio-economic disadvantage, unresolved trauma, cultural disruption, and systemic social exclusion and disempowerment. We need to prioritise programs that value cultural imperatives and programs controlled by Indigenous people.

There is no magical solution to be handed down by government. But government must work in collaboration with communities to achieve a new social order

NACCHO Aboriginal #MentalHealth and #JunkFood : Increasing how much exercise we get and switching to a healthy diet can also play an important role in treating – and even preventing – depression

” The review found that across 41 studies, people who stuck to a healthy diet had a 24-35% lower risk of depressive symptoms than those who ate more unhealthy foods.

These findings suggest improving your diet could be a cost-effective complementary treatment for depression and could reduce your risk of developing a mental illness.

From the Conversation / Megan Lee

 ” NACCHO Campaign 2013 : Our ‘Aboriginal communities should take health advice from the fast food industry’ a campaign that eventually went global, reaching more than  20 million Twitter followers.”

See over 60 NACCHO Healthy Foods Articles HERE

See over 200 NACCHO Mental Health articles HERE 

Worldwide, more than 300 million people live with depression. Without effective treatment, the condition can make it difficult to work and maintain relationships with family and friends.

Depression can cause sleep problems, difficulty concentrating, and a lack of interest in activities that are usually pleasurable. At its most extreme, it can lead to suicide.

Depression has long been treated with medication and talking therapies – and they’re not going anywhere just yet. But we’re beginning to understand that increasing how much exercise we get and switching to a healthy diet can also play an important role in treating – and even preventing – depression.

So what should you eat more of, and avoid, for the sake of your mood?

Ditch junk food

Research suggests that while healthy diets can reduce the risk or severity of depression, unhealthy diets may increase the risk.

Of course, we all indulge from time to time but unhealthy diets are those that contain lots of foods that are high in energy (kilojoules) and low on nutrition. This means too much of the foods we should limit:

  • processed and takeaway foods
  • processed meats
  • fried food
  • butter
  • salt
  • potatoes
  • refined grains, such as those in white bread, pasta, cakes and pastries
  • sugary drinks and snacks.

The average Australian consumes 19 serves of junk food a week, and far fewer serves of fibre-rich fresh food and wholegrains than recommended. This leaves us overfed, undernourished and mentally worse off.

Here’s what to eat instead

Mix it up. Anna Pelzer

Having a healthy diet means consuming a wide variety of nutritious foods every day, including:

  • fruit (two serves per day)
  • vegetables (five serves)
  • wholegrains
  • nuts
  • legumes
  • oily fish
  • dairy products
  • small quantities of meat
  • small quantities of olive oil
  • water.

This way of eating is common in Mediterranean countries, where people have been identified as having lower rates of cognitive decline, depression and dementia.

In Japan, a diet low in processed foods and high in fresh fruit, vegetables, green tea and soy products is recognised for its protective role in mental health.

How does healthy food help?

A healthy diet is naturally high in five food types that boost our mental health in different ways:

Complex carbohydrates found in fruits, vegetables and wholegrains help fuel our brain cells. Complex carbohydrates release glucose slowly into our system, unlike simple carbohydrates (found in sugary snacks and drinks), which create energy highs and lows throughout the day. These peaks and troughs decrease feelings of happiness and negatively affect our psychological well-being.

Antioxidants in brightly coloured fruit and vegetables scavenge free radicals, eliminate oxidative stress and decrease inflammation in the brain. This in turn increases the feelgood chemicals in the brain that elevate our mood.

Omega 3 found in oily fish and B vitamins found in some vegetables increase the production of the brain’s happiness chemicals and have been known to protect against both dementia and depression.

Salmon is an excellent source of omega 3. Caroline Attwood

Pro and prebiotics found in yoghurt, cheese and fermented products boost the millions of bacteria living in our gut. These bacteria produce chemical messengers from the gut to the brain that influence our emotions and reactions to stressful situations.

Research suggests pro- and prebiotics could work on the same neurological pathways that antidepressants do, thereby decreasing depressed and anxious states and elevating happy emotions.

What happens when you switch to a healthy diet?

An Australian research team recently undertook the first randomised control trial studying 56 individuals with depression.

Over a 12-week period, 31 participants were given nutritional consulting sessions and asked to change from their unhealthy diets to a healthy diet. The other 25 attended social support sessions and continued their usual eating patterns.

The participants continued their existing antidepressant and talking therapies during the trial.

At the end of the trial, the depressive symptoms of the group that maintained a healthier diet significantly improved. Some 32% of participants had scores so low they no longer met the criteria for depression, compared with 8% of the control group.

The trial was replicated by another research team, which found similar results, and supported by a recent review of all studies on dietary patterns and depression. The review found that across 41 studies, people who stuck to a healthy diet had a 24-35% lower risk of depressive symptoms than those who ate more unhealthy foods.

These findings suggest improving your diet could be a cost-effective complementary treatment for depression and could reduce your risk of developing a mental illness.

 

NACCHO Aboriginal #MentalHealth and #SuicidePrevention : @ozprodcom issues paper on #MentalHealth in Australia is now available. It asks a range of questions which they seek information and feedback on. Submissions or comments are due by Friday 5 April.

 ” Many Australians experience difficulties with their mental health. Mental illness is the single largest contributor to years lived in ill-health and is the third largest contributor (after cancer and cardiovascular conditions) to a reduction in the total years of healthy life for Australians (AIHW 2016).

Almost half of all Australian adults have met the diagnostic criteria for an anxiety, mood or substance use disorder at some point in their lives, and around 20% will meet the criteria in a given year (ABS 2008). This is similar to the average experience of developed countries (OECD 2012, 2014).”

Download the PC issues paper HERE mental-health-issues

See Productivity Commission Website for More info 

“Clearly Australia’s mental health system is failing Aboriginal people, with Aboriginal communities devastated by high rates of suicide and poorer mental health outcomes. Poor mental health in Aboriginal communities often stems from historic dispossession, racism and a poor sense of connection to self and community. 

It is compounded by people’s lack of access to meaningful and ongoing education and employment. Drug and alcohol related conditions are also commonly identified in persons with poor mental health.

NACCHO Chairperson, Matthew Cooke 2015 Read in full Here 

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

Despite a plethora of past reviews and inquiries into mental health in Australia, and positive reforms in services and their delivery, many people are still not getting the support they need to maintain good mental health or recover from episodes of mental ill‑health. Mental health in Australia is characterised by:

  • more than 3 100 deaths from suicide in 2017, an average of almost 9 deaths per day, and a suicide rate for Indigenous Australians that is much higher than for other Australians (ABS 2018)
  • for those living with a mental illness, lower average life expectancy than the general population with significant comorbidity issues — most early deaths of psychiatric patients are due to physical health conditions
  • gaps in services and supports for particular demographic groups, such as youth, elderly people in aged care facilities, Indigenous Australians, individuals from culturally diverse backgrounds, and carers of people with a mental illness
  • a lack of continuity in care across services and for those with episodic conditions who may need services and supports on an irregular or non-continuous basis
  • a variety of programs and supports that have been successfully trialled or undertaken for small populations but have been discontinued or proved difficult to scale up for broader benefits
  • significant stigma and discrimination around mental ill-health, particularly compared with physical illness.

The Productivity Commission has been asked to undertake an inquiry into the role of mental health in supporting social and economic participation, and enhancing productivity and economic growth (these terms are defined, for the purpose of this inquiry, in box 1).

By examining mental health from a participation and contribution perspective, this inquiry will essentially be asking how people can be enabled to reach their potential in life, have purpose and meaning, and contribute to the lives of others. That is good for individuals and for the whole community.

Background

In 2014-15, four million Australians reported having experienced a common mental disorder.

Mental health is a key driver of economic participation and productivity in Australia, and hence has the potential to impact incomes and living standards and social engagement and connectedness. Improved population mental health could also help to reduce costs to the economy over the long term.

Australian governments devote significant resources to promoting the best possible mental health and wellbeing outcomes. This includes the delivery of acute, recovery and rehabilitation health services, trauma informed care, preventative and early intervention programs, funding non-government organisations and privately delivered services, and providing income support, education, employment, housing and justice. It is important that policy settings are sustainable, efficient and effective in achieving their goals.

Employers, not-for-profit organisations and carers also play key roles in the mental health of Australians. Many businesses are developing initiatives to support and maintain positive mental health outcomes for their employees as well as helping employees with mental illhealth continue to participate in, or return to, work.

Scope of the inquiry

The Commission should consider the role of mental health in supporting economic participation, enhancing productivity and economic growth. It should make recommendations, as necessary, to improve population mental health, so as to realise economic and social participation and productivity benefits over the long term.

Without limiting related matters on which the Commission may report, the Commission should:

  • examine the effect of supporting mental health on economic and social participation, productivity and the Australian economy;
  • examine how sectors beyond health, including education, employment, social services, housing and justice, can contribute to improving mental health and economic participation and productivity;
  • examine the effectiveness of current programs and Initiatives across all jurisdictions to improve mental health, suicide prevention and participation, including by governments, employers and professional groups;
  • assess whether the current investment in mental health is delivering value for money and the best outcomes for individuals, their families, society and the economy;
  • draw on domestic and international policies and experience, where appropriate; and
  • develop a framework to measure and report the outcomes of mental health policies and investment on participation, productivity and economic growth over the long term.

The Commission should have regard to recent and current reviews, including the 2014 Review of National Mental Health Programmes and Services undertaken by the National Mental Health Commission and the Commission’s reviews into disability services and the National Disability Insurance Scheme.

The Issues Paper
The Commission has released this issues paper to assist individuals and organisations to participate in the inquiry. It contains and outlines:

  • the scope of the inquiry
  • matters about which we are seeking comment and information
  • how to share your views on the terms of reference and the matters raised.

Participants should not feel that they are restricted to comment only on matters raised in the issues paper. We want to receive information and comment on any issues that participants consider relevant to the inquiry’s terms of reference.

Key inquiry dates

Receipt of terms of reference 23 November 2018
Initial consultations November 2018 to April 2019
Initial submissions due 5 April 2019
Release of draft report Timing to be advised
Post draft report public hearings Timing to be advised
Submissions on the draft report due Timing to be advised
Consultations on the draft report November 2019 to February 2020
Final report to Government 23 May 2020

Submissions and brief comments can be lodged

Online (preferred): https://www.pc.gov.au/inquiries/current/mental-health/submissions
By post: Mental Health Inquiry
Productivity Commission
GPO Box 1428, Canberra City, ACT 2601

Contacts

Inquiry matters: Tracey Horsfall Ph: 02 6240 3261
Freecall number: Ph: 1800 020 083
Website: http://www.pc.gov.au/mental-health

Subscribe for inquiry updates

To receive emails updating you on the inquiry consultations and releases, subscribe to the inquiry at: http://www.pc.gov.au/inquiries/current/mentalhealth/subscribe

 

 Definition of key terms
Mental health is a state of wellbeing in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.

Mental illness or mental disorder is a health problem that significantly affects how a person feels, thinks, behaves and interacts with other people. It is diagnosed according to standardised criteria.

Mental health problem refers to some combination of diminished cognitive, emotional, behavioural and social abilities, but not to the extent of meeting the criteria for a mental illness/disorder.

Mental ill-health refers to diminished mental health from either a mental illness/disorder or a mental health problem.

Social and economic participation refers to a range of ways in which people contribute to and have the resources, opportunities and capability to learn, work, engage with and have a voice in the community. Social participation can include social engagement, participation in decision making, volunteering, and working with community organisations. Economic participation can include paid employment (including self-employment), training and education.

Productivity measures how much people produce from a given amount of effort and resources. The greater their productivity, the higher their incomes and living standards will tend to be.

Economic growth is an increase in the total value of goods and services produced in an economy. This can be achieved, for example, by raising workforce participation and/or productivity.

Sources: AIHW (2018b); DOHA (2013); Gordon et al. (2015); PC (2013, 2016, 2017c); SCRGSP (2018); WHO (2001).

An improvement in an individual’s mental health can provide flow-on benefits in terms of increased social and economic participation, engagement and connectedness, and productivity in employment (figure 1).

This can in turn enhance the wellbeing of the wider community, including through more rewarding relationships for family and friends; a lower burden on informal carers; a greater contribution to society through volunteering and working in community groups; increased output for the community from a more productive workforce; and an associated expansion in national income and living standards. These raise the capacity of the community to invest in interventions to improve mental health, thereby completing a positive reinforcing loop.

The inquiry’s terms of reference (provided at the front of this paper) were developed by the Australian Government in consultation with State and Territory Governments. The terms of reference ask the Commission to make recommendations to improve population mental health so as to realise higher social and economic participation and contribution benefits over the long term.

Assessing the consequences of mental ill-health

The costs of mental ill-health for both individuals and the wider community will be assessed, as well as how these costs could be reduced through changes to the way governments and others deliver programs and supports to facilitate good mental health.

The Commission will consider the types of costs summarised in figure 4. These will be assessed through a combination of qualitative and quantitative analysis, drawing on available data and cost estimates, and consultations with inquiry participants and topic experts. We welcome the views of inquiry participants on other costs that we should take into account.

 

NACCHO Aboriginal Health and #SuicidePrevention Crisis : Five Indigenous teenage girls between the ages of 12 and 15 years of age have taken their own lives in the past few days. Comments from @TracyWesterman @joewilliams_tew @cultureislife @GerryGeorgatos

 

” Five indigenous teenage girls between the ages of 12 and 15 years of age have taken their own lives in the past nine days.

The most recent loss was of a 12-year-old Adelaide girl who died last Friday.

Three of the other cases occurred in Western Australia and one was in Queensland.

The spate of deaths, first reported by The Australian, is believed to have began on January 3, when a 15-year-old girl from Western Australia died in Townsville Hospital from injuries caused by self-harm. She had been visiting relatives in the beachside town.

A 12-year-old girl took her own life in South Headland, a mining town in WA, the next day.

On January 6, a 14-year-old also took her own life in Warnum, an Aboriginal community in the Kimberley.

Another 15-year-old indigenous girl is believed to have taken her own life in Perth’s south last Thursday, according to The Australian.

A 12-year-old boy is also on life support after what is believed to have been a suicide attempt. He remains in Brisbane Hospital where he was flown for treatment from Roma on Monday.

From news.com.au see Part 1 Below

Graphic above NITV see Part 3 article below

– Readers seeking support and information about suicide prevention contact: Lifeline on 13 11 14, the Suicide Call Back Service on 1300 659 467 or NACCHO find an Aboriginal Medical Service here.

There are resources for young people at Headspace Yarn Safe.

Read over 128 Aboriginal Health and Suicide Prevention articles published by NACCHO over past 7 years 

We have enormous amounts of funding injected into this critical area; yet, suicides continue to escalate. Our Indigenous youth are dying by suicide at EIGHT times the rate of non-Indigenous children and it is only right that we ask why this level of funding has had little to no impact.

There are actually two tragedies here; the continued loss of the beautiful young lives through suicide, and secondly, that all efforts to fund an adequate response capable of applying the science of what prevents suicide have failed.

I am as concerned that the primary focus is on encouraging people to simply ‘talk’ about suicide without the clinical and cultural best practice programs and therapies available to respond to this awareness raising, particularly in our remote areas.

Wasted opportunities for prevention are like an endless cycle in which money is thrown at band aid, crisis driven, reactive and ill-informed responses that disappear as fast as the latest headlines.

It is time to start demanding evidence of what works when we look at funded programs. Until we can get these answers, rates will continue to escalate.” 

Dr Tracy Westerman is a proud Njamal woman from the Pilbara region of Western Australia. She holds a Post Graduate Diploma in Psychology, a Master’s Degree in Clinical Psychology and Doctor of Philosophy (Clinical Psychology).

WEBSITE 

She is a recognised world leader in Aboriginal mental health, cultural competency and suicide prevention achieving national and international recognition for her work. This is despite coming from a background of disadvantage and one in which she had to undertake most of her tertiary entrance subjects by Distance Education. 2018 Western Australian of the Year

See Part 2 Below

” When a Suicide occurs; we are constantly telling people to ‘speak up’ when they aren’t well – it’s very easy to say that to people, but when you are hurting mentally, you can’t speak up, you don’t tell people yr not well and you pretend everything is ok whilst slowly dying inside!!

What’s stopping you from reaching in to help??

Don’t wait for people to speak up; start paying more attention to others; watch their behaviours, listen to how they respond.

If every person in the world pays attention to those close; family, kids, relatives, friends, work colleagues, team mates – then every person will be able to notice when someone isn’t well.

If we are not noticing, then I’m sorry, but we are not paying enough attention.

We are losing too many lives, every statistic is a person – don’t wait for others to reach out; reach in and help them when they feel silenced and it’s too hard for them to talk!!!

It starts with us – are we paying enough attention?

Joe Williams : Although forging a successful professional sporting career, Joe battled the majority of his life with suicidal ideation and Bi Polar Disorder. After a suicide attempt in 2012, Joe felt his purpose was to help people who struggle with mental illness. Joe is also an author having contributed to the book Transformation; Turning Tragedy Into Triumph & his very own autobiography titled Defying The Enemy Within – available in the shop section of this site.

Website 

In 2017 Joe was named as finalist in the National Indigenous Human Rights Awards for his work with suicide prevention and fighting for equality for Australia’s First Nations people and in 2018 Joe was conferred the highest honour of Australia’s most eminent Suicide Prevention organisation, Suicide Prevention Australia’s LiFE Award for his outstanding work in communities across Australia.

 “How can a child of 10 feel such ­despair that she would end her life? What must she have seen, heard and felt in such a short life to ­destroy all hope? What had she lived? How do her parents, her siblings, their communities live with the pain? How can they possibly endure the all-consuming grief of losing their child?

Now imagine if this were your child, your family, your close-knit community. Wouldn’t there be outrage, a wailing from the heart of overwhelming grief?

This is what is happening to ­indigenous children and young people in our country.”

See Part 4 Below : Love and hope can save young Aborigines in despair 

Published The Australian 17 January 

Download Press Release : culture is life press release 17 jan

Part 1 : Five indigenous girls take their own lives in nine-day period

“Suicides are predominantly borne of poverty and disparities,” said Gerry Georgatos, who heads up the federal government’s indigenous critical response team.

Writing in The Guardian, he described rural communities as being disparate from the rest of Australian society, where high incarceration rates infect communities, few complete schooling, employment is scant and “all hope is extinguished”.

He also said sexual abuse and self harm played a role in the suicides, with the recent spate taking the lives of young girls being “notable”.

The West Australian Government has advised that co-ordinators have been installed in every region of the state, alongside Aboriginal mental health programs.

These programs were introduced after a 2007 inquiry into 22 suicides across the Kimberley. The inquiry found the suicide rate was not due to mental illness such as “bipolar or schizophrenia” and that Aboriginal suicide was not for the most part attributable to individual mental illness.

It noted that the suicide rate, which had “doubled in five years”, was attributable to a governmental failure to respond to many reports.

Part 2 : It is time to start demanding evidence of what works when we look at funded programs. Until we can get these answers, rates will continue to escalate.

The Minister for Indigenous Affairs has recently shared that the Commonwealth Government has allocated $134M of funding into Indigenous suicide prevention. If you look at the current suicide statistics this crudely translates to $248,000 per suicide death annually – without adding State funding into the mix.

We have enormous amounts of funding injected into this critical area; yet, suicides continue to escalate. Our Indigenous youth are dying by suicide at EIGHT times the rate of non-Indigenous children and it is only right that we ask why this level of funding has had little to no impact.

I am not privy to how funding decisions are made and I have ZERO funding for my services, research or programs but the gaps are sadly too clear and have been for decades.

As a country facing this growing tragedy, we still have no nationally accepted evidence-based programs across the spectrum of early intervention and prevention activities. This needs to be our first priority.

Currently, and staggeringly, funding does not require that programs demonstrate a measurable reduction in suicide and mental health risk factors in the communities in which they are delivered. This needs to be our second priority.

What this means is that we are not accumulating data or research evidence of ‘what works’. If we don’t evaluate programs and accumulate evidence, we have no hope of informing future practice to halt the intergenerational transmission of suicide risk. This needs to be a third priority.

Additionally, we are the only Indigenous culture in the world that has a virtual absence of mental health prevalence data. Until we have a widely accepted methodology for the screening of early stages of mental ill health and suicide risk, early intervention will remain elusive; evidence based programs cannot be determined and treatment efficacy not able to be monitored. This needs to be our fourth priority.

There are actually two tragedies here; the continued loss of the beautiful young lives through suicide, and secondly, that all efforts to fund an adequate response capable of applying the science of what prevents suicide have failed.

When suicide becomes entrenched, approaches need to be long term and sustainable. Report after report has pointed to the need for ‘evidence-based approaches’ but has anyone questioned why this continues to remain elusive?

When you have spent your life’s work working in Indigenous suicide prevention and self funding evidence based research, as I have, I can also tell you that despite extensive training the complex and devastating issue of suicide prevention challenges you at every level.

It challenges your core values about the right of people to choose death over life; it stretches you therapeutically despite your training in best practice; and it terrifies you that you have missed something long after you have left your at-risk client.

The nature of suicide risk is that it changes. Being able to predict and monitor suicide risk takes years and years of clinical and cultural expertise and well-honed clinical insight and judgement. Throw culture into the mix and this becomes a rare set of skills held by few in this country. Indeed, a senate inquiry in December found that not only are services lacking in remote and rural areas of Australia, but culturally appropriate services were often not accessible.

Funding decisions that are unsupported by clinical and cultural expertise in suicide prevention must be challenged and redirected in the best way possible. Toward the evidence.

Instead we have inquiry after inquiry, consultation after consultation, statistics and mortality data quoted by media purely to satisfy the latest ‘click bait’ 24-hour news cycle headline. On top of that, there are continued calls from those who receive large amounts of funding that they need “more funding”.

I am as concerned that the primary focus is on encouraging people to simply ‘talk’ about suicide without the clinical and cultural best practice programs and therapies available to respond to this awareness raising, particularly in our remote areas.

Wasted opportunities for prevention are like an endless cycle in which money is thrown at band aid, crisis driven, reactive and ill-informed responses that disappear as fast as the latest headlines.

It is time to start demanding evidence of what works when we look at funded programs. Until we can get these answers, rates will continue to escalate.

The time is now to make these changes and ask these questions. I am up for the challenge and have spent my life building and self-funding evidence of what can work to halt these tragic rates in Aboriginal communities and amongst our people. Will the decision makers join me in finding evidence-based ways to address this or continue to throw money at approaches and programs that are simply not working?

Aboriginal people deserve better, our future generations deserve better

Part 3 NITV  Indigenous youth suicide at crisis point

Originally published HERE 

Communities and families are mourning the loss of five young Aboriginal girls who took their own lives in separate incidents in Western Australia, Townsville and Adelaide this year.

In early January, a 15-year old girl from Western Australia died two-days after self-harming on a visit to Townsville.

Last Sunday, a 12-year old girl died in the Pilbara mining town of Port Hedland, followed by a 14-year old girl in the East Kimberley community of Warmun last Monday.

Another was a 15-year-old Noongar girl from Perth who died last Thursday and a fifth was a 12-year-old girl from a town near Adelaide who died last Friday.

Another 12-year-old boy is reportedly on life support at a hospital in Brisbane after what is suspected to be an attempted suicide. He was flown from Roma to Brisbane yesterday, The Australian reports.

The Director of Suicide Prevention Australia, Vanessa Lee, is calling on the federal government to support an Aboriginal and Torres Strait Islander suicide prevention strategy tailored specifically to meet the needs of Indigenous people.

“When are we going to see change… when are we going to see a national Indigenous suicide prevention strategy supported by the COAG, delivering for Aboriginal and Torres Strait Islander people by Aboriginal and Torres Strait Islander people,” Ms Lee said.

“We need to remember that Indigenous people know the solutions. We know the answers. We didn’t write the Redfern Statement  for a joke… funding needs to be put into Indigenous organisations, into Indigenous hands.”

Aboriginal people know the answers

“We need to remember that Indigenous people know the solutions, we know the answers” – Vanessa Lee

National coordinator for the National Child Sexual Abuse Trauma Recovery Project, Gerry Georgatos, told NITV News the recently reported suicides have weighed heavily on the affected families and communities.

“These incidences… have impacted –psycho-socially– the family. Hurt them to the bone. There are no words for anyone’s loss,” he said.

“To lose a child impacts ways that no other loss does, and to lose a child is a haunting experience straight from the beginning and doesn’t go away.”

South-western Noongar woman, Grace Cockie, lost her 16-year old daughter to suicide last March in their home in Perth.

“It was a devastating experience, I don’t ever want to go through that again and I don’t want no one else to go through that,” Ms Cockie told NITV News.

“She went to school every day. She loved going to school, hanging out with her friends, playing football with her Aunties.

“Part of us is gone… No one is going to replace her,” she said.

Ms Cockie wants other parents to encourage their children to speak-out if they feel unwell and said there needs to be more mental health initiatives which offer culturally supportive help for Aboriginal youth.

“Keep an eye on them and talk to them all the time,” she said.

“There’s a lot of avenues for whitefella kids, you know, and with our Aboriginal kids they’re probably too scared… they probably think they (mental health workers) won’t help them,” she said.

The Kimberley region faces alarming suicide rates

The deaths come as WA waits on a final report from an inquest into 13 Indigenous youth suicides in the Kimberley region from 2012 to 2016.

The Kimberley region has the highest Indigenous suicide rates in Australia – not just for Aboriginal youth, but for the entire Aboriginal and Torres Strait Islander population.

The inquest by state coroner Ros Fogliani is expected to table findings early this year.

The Australian Bureau of Statistics found last month that Indigenous children aged between five and 17 died from suicide-related deaths at five times the rate of non-Indigenous children.

This rate was 10.1 deaths by suicide per 100,000 between 2013 and 2017, compared with 2 deaths by suicide per 100,000 for non-Indigenous children.

One in four people who took their own life before turning 18 were Aboriginal children.

Mr Georgatos said nine out of 10 suicides in the Kimberley region have involved Aboriginal and Torres Strait Islander people.

A senate inquiry in December found that not only are services lacking in remote and rural areas of Australia, but culturally appropriate services were often not accessible.

The inquiry found that the lack of culturally supportive services is leaving Aboriginal and Torres Strait Islander people accessing mental health services at a far lower rate than non-Indigenous people.

Mr Georgatos said that services aren’t accessible to the majority of people living in the Kimberley, saying that suicide prevention has come down to community support as opposed to accessible mental health professionals.

“Many of these communities [in the Kimberley region] have no services… It is forever community buy-in to support, to have a watchful eye …, but people become exhausted,” he said.

Mr Georgatos said he believes investing in local workforces that possess local cultural knowledge and training these workers to understand intense psychosocial support for young adults is the way forward.

Poverty the ‘driver’ towards suicide

Poverty and sexual abuse in the Kimberley region may be a leading factor for youth suicide, according to Mr Georgatos.

“Nearly 100 per cent of First Nations suicides… are of people living below the poverty line,” he said.

“Crushing poverty [in Kimberley and Pilbara] is the major driver of suicidal ideation, of distorted thinking, of unhappiness, of watching the world pass one by right from the beginning of life.

“One-eighth of First Nations people living in the Kimberley live in some form of homelessness… sixty per cent live below the poverty line.”

A Medical Journal of Australia report in 2016 showed seven per cent of all people living in the Kimberley were homeless.

Last year, forty per cent of youth suicides in Australia were Aboriginal and Torres Strait Islanders.

“It is a humanitarian crisis… one-third of those suicides is identified as children of sexual abuse, and we don’t have the early intervention to disable the trauma of child sexual abuse,” Mr Georgatos said.

“We don’t have the early intervention and the trauma recovery for them, we don’t have the outreaches for them but what we also don’t have is the talking up and calling out of sexual predation in communities.”

Mr Georgatos said he believes if we have education in communities about what young children should do if they were to ever be predated upon, it would reduce the child internalising their trauma which may lead to suicidal ramifications.

“What we need to do is we need to outreach more personal on the ground to outreach into these communities to support them into pathways where they can access education,” Mr Georgatos said.

“We need more psychosocial support, people just to spread the love… to keep people on a journey to a positive and strong pathway and to ordered thinking, not disordered thinking.”

“We need more psychosocial support, people just to spread the love” – Gerry Georgatos.

Government supported resources

Australian youth mental health organization, headspace, last week received a $47 million funding boost from the federal government.

Chief Executive Officer, Jason Trethowan, told SBS World News the organisation will be working closely with Indigenous communities thanks to the new funding.

“We know there are challenges around rural remoteness and often headspace hasn’t been there for them… that’s why we have a trial going on in the Pilbara region of Western Australia where there are actually headspace services without a headspace centre,” he said.

Indigenous health minister, Ken Wyatt, told NITV News the federal government will continue to invest $3.9 billion over the next three years (from 2018-22) in Primary Health Networks (PHNs) to commission regionally and culturally appropriate mental health and suicide prevention services, particularly in the Kimberley and the Pilbara regions.

Currently the key active programs in these regions include the government’s $4 million Kimberley Suicide Prevention Trial and the $2.2 million Pilbara headspace trial, which opened in April last year.

The Pilbara headspace trial was co-designed with local communities, including young people, service providers, community members and local Elders.

The Pilbara headspace team has staff located in Newman, Port Hedland and Karratha, with employees spending their time in schools, youth centres, Aboriginal Medical Services, community centres and other locations.

This allowing them to reach out to youth who may not typically engage with school or youth services, said Samara Clark, manager of headspace, Pilbara.

“It’s all about engagement first, building trust, building visibility,” she said.

“What we’re hoping for is positive help-seeking behaviour, where they feel safe and comfortable enough to come up to us,” she said.

Ms Clark encourages anyone who sees a headspace worker, who may be identified by their green t-shirts, to reach out to them for support.

“If a young person sees one of the team members around, even if a community member sees them, just go up and have a yarn … the team will talk to you then and there.”

– Readers seeking support and information about suicide prevention can contact: Lifeline on 13 11 14, the Suicide Call Back Service on 1300 659 467 or find an Aboriginal Medical Service here.

There are resources for young people at Headspace Yarn Safe.

Part 4 Love and hope can save young Aborigines in despair 

Published The Australian 17 January 

How can a child of 10 feel such ­despair that she would end her life? What must she have seen, heard and felt in such a short life to ­destroy all hope? What had she lived? How do her parents, her siblings, their communities live with the pain? How can they possibly endure the all-consuming grief of losing their child?

Now imagine if this were your child, your family, your close-knit community. Wouldn’t there be outrage, a wailing from the heart of overwhelming grief?

This is what is happening to ­indigenous children and young people in our country. And to parents and communities as our young people are dragged into a vortex of suicide by despair.

In a week, five Aboriginal girls have taken their own lives — prompting a warning from one ­researcher that indigenous children and young people could soon comprise half of all youth suicides. Researcher Gerry Georgatos says poverty is a major issue in suicide among young indigenous Australians, but also that sexual predation is a factor in a third of cases. My heart breaks for these girls and their families and their unimaginable pain.

The organisation that I lead, Culture is Life, wants our country to treat this as the national emergency it is. We want every Australian to think about the devastating toll of indigenous youth suicide and to help us to stop it. Urgently.

Instead of expecting youth suicide, we must take a stand of ­defiance against it. Unfortunately, across Australia, suicide and self-harm are on the increase. This is being driven by a deep sense of hopelessness and despair, by a lack of belonging and connection, and in some cases by the abuse young people have experienced.

Indigenous young people today are living with the consequences of acts committed by other human beings in charge of policies and laws through more than two centuries of trauma and dispossession. This history haunts us. It lives within us. It’s there in our families’ experiences of stolen land, children and wages, of killings and cruelty and abuses of power. They see this history in their grandparents’ eyes, if they are still alive. They discover it in their family stories of exclusion and unfairness.

And when they, too, feel the slap and sting of racism and ignorance when it comes at them as abuse in the schoolyard, or they sense the awkwardness of others in understanding their Aboriginality, or someone’s eyes won’t meet theirs, this history becomes the present. It eats away at them — at their confidence, their self-belief and their self-love — every time they are the target of racism and discrimination or at the end of ignorance and apathy, and when they are directly affected by abuse.

The task of repair and healing requires a powerful counterforce to all that.

We can tackle this together. We can begin to repair these wounds through daily acts of love and hope in communities, schools, universities and workplaces. Daily acts that send a message to our young people that there is belonging, strength and pride in indigenous peoples and cultures.

We are asking all Australians to show our young people that there is cause for love and hope. Show them that you share a deep sense of pride in who they are, in our inspiring cultures and in our strength. Tell them they matter, by showing your pride in Aboriginal and Torres Strait Islander cultures. Share it with #loveandhope and #cultureislife.

Because when our children have love and hope in their lives, it combats helplessness and reduces the risk of self-harm. It gives them the support and courage required to take the steps they need and want to take. And when the broader community shows our kids that they care, it deepens our connections as Australians. One of the things I love most about my people is our willingness to invite ­others to connect with us and to experience our culture. And the only reciprocal ask is to take up the invitation to connect. Once you take up the invitation, you will be an ally in rectifying some of the most haunting statistics for our country.

We know from the research, and from psychologists who work with young indigenous people, that such small gestures of affirmation can make a powerful difference to their safety. Tanja Hirvonen, an Aboriginal psychologist, says many people don’t know the power of “warm interactions and warm gestures” at just the right moment to avert disaster.

She hears time and again from young people that “there was someone there for them at a particularly tricky time in their life … a coach or a teacher or an aunt or a grandmother … someone has said something pivotal to them at a particular time. Those warm ­interactions matter.”

Culture and connection are powerful protective factors against indigenous youth suicide. That’s why the work of Aboriginal leaders across the country in ­cultural pride, revitalisation and renewal programs is so crucial. People such as Yuin elder Uncle Max Harrison, who is teaching young men the ways of the old people, their lore, their duties, their responsibilities. And, as he does so, he is building their pride, strength and resilience.

So that they walk taller, knowing who they are, that they are cared for and supported and connected to this land. It’s a model for us all to feel more connected as Australians.

We cannot fail to act when we are able to save children and young people from the agony and hopelessness and torment that leads to suicide. We can affirm them in who they are, and in so doing, we can save lives.

Belinda Duarte, a Wotjobaluk woman, is chief executive of Culture is Life.
For help: Lifeline 13 11 14, Beyondblue 1300 22 4636.

NACCHO Aboriginal Health and #SuicidePrevention : #ATSISPC18 #refreshtheCTGRefresh Pat Turner CEO NACCHO Setting the scene panel : Health led solutions through Aboriginal Community Controlled Health #Leadership

” It is well established that Aboriginal led solutions deliver better outcomes.

Aboriginal community-controlled health services should be funded based on need and so that they can develop comprehensive suicide prevention initiatives with the communities they service. 

The Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project identifies successful Indigenous community led health led responses including providing positive health messages and mental health support underpinned by a cultural framework and tackling harmful drug and alcohol use.

These initiatives can be delivered by properly funded and supported Aboriginal Community Controlled Health Organisations.

I also believe in regular full health checks for at risk people so that critical issues that can impact on a persons wellbeing, like poor hearing, can be picked up and addressed early. 

We also know that mainstream mental health service provision for Aboriginal and Torres Strait Islander people across the country is inadequate and inappropriate.

Many people feel unsafe accessing the care they need.

Aboriginal Community Controlled Health Organisations should be priortised for funding to support our own people.” 

Pat Turner AM CEO NACCHO who is working with Aboriginal and Torres Strait Islander peak bodies across Australia to ask COAG for a seat at the table on the Closing the Gap Refresh: so that we get that policy right : Part 1 Below

Picture above @CroakeyNews : Prof Pat Dudgeon kicks off the keynote panel session: “Setting the scene”. #ATSISPC18. Prof Tom Calma, Prof Helen Milroy, and our CEO Pat Turner

See the #RefreshtheCTGRefresh Campaign post HERE

Read over 120 NACCHO Aboriginal Health and #SuicidePrevention articles published over last 6 years 

Suicide among Aboriginal and Torres Strait Islander communities is regularly in the media and public conversations. Often the focus is on an individual completed or attempted suicide or the negative statistics.

The second National Aboriginal and Torres Strait Islander Suicide Prevention Conference, to be held in Perth on November 20-21, will shift the focus to solutions identified by Indigenous people themselves. The program consists of only Indigenous people from Australia and internationally.

Our voices are important because it is our mob who understand what is going on in our communities best. We live and breathe it, with many of us either having considered taking our own lives, making an attempt or having had family members who have.

This is why the program includes a focus on community-based solutions. “

Summer May Finlay writes Part 2 below for Croakey 

Part 1 : Why an urgent need for action

  • Our people are more than twice as likely to commit suicide than other Australians.
  • Young Aboriginal and Torres Strait Islander men are the most at risk of suicide in Australia.
  • Those in remote area are more disproportionately affected
  • Suicide and self-inflicted injuries was the greatest burden of disease for our young people in 2011.
  • If, Western Australia’s Kimberley region was a country, it would have the worst suicide rate in the world, according to World Health Organisation statistics.
  • Rate of suicide for Aboriginal people in the Kimberley is seven times the rest of Australia.
  • This is not news to us: but it is unacceptable and it is why we are here today.

Aboriginal control

  • At the heart of suicide is a sense of hopelessness and powerlessness.
  • Our people feel this powerlessness at multiple levels, across multiple domains of our lives.
  • It is why we have the Uluru Statement from the Heart: a cry from Aboriginal and Torres Strait Islander peoples across the nation to have a say over matters that impact on us.
  • At the national level, it means a Voice to the Commonwealth Parliament and a full partnership between Indigenous people and governments on the Closing the Gap Refresh with COAG.
  • At the regional level, it is about the formation of partnerships – like in the Kimberley one on suicide prevention – working together and advocating as a region.
  • At the local level, it is about Aboriginal people being in control of the design and delivery of programs to their own people.
  • The importance of Aboriginal control or Indigenous led is highlighted consistently as a way to achieve better outcomes for our people.
  • This is also reinforced at the Kimberley Roundtable and in the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project.
  • Community-led actions are the most effective suicide prevention measure for our people. This fundamental point cannot be ignored if the situation is to change.

Healing

  • Aboriginal suicide rates have been accelerating since 1980.
  • Aboriginal people did not have a word for “suicide” before colonisation.
  • To go forward, we must go back and identify and draw on those aspects of our culture that gives us strength and identity.
  • We also must heal by acknowledging and addressing the effects of intergenerational trauma.
  • Part of healing must include challenging the continuing impacts of colonisation on Indigenous peoples’ contemporary lives.
  • Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project identifies the success of Elder-driven, on-country healing for youth which has the dual effect of strengthening intergenerational ties as well as increasing cultural connection.
  • Red Dust Healing is another example of cultural reconnection achieving positive outcomes with people at risk.
  • The Healing Foundation also achieves similar outcomes with the same principles of empowerment and connection to culture.

A public policy crisis

  • Almost all Aboriginal people who commit suicide are living below the poverty line.
  • Other common factors are:
    • Aboriginal people who have been incarcerated and come out of prison with little to no hope on the horizon.
    • Aboriginal people who are homeless.
    • Aboriginal people who have been recently evicted from their public housing rentals.
    • Aboriginal people who are exposed to violence and alcohol misuse and suffer domestic abuse.
    • Aboriginal people who have multiple underlying health and metal health issues.
    • Aboriginal people who are young; males; and those who live in remote areas.
  • This tells us that we need a comprehensive public policy response to address suicide rates in our people – that suicide in our people is linked to our status and situation more broadly in Australia.
  • It is therefore unacceptable that the National Partnership Agreement on Remote Indigenous Housing has been allowed to lapse and no further investment has been agreed.
  • We must overturn and replace the Community Development Program that is leaving our young people completely disengaged.
  • We must also tackle the issues that lead to the greater incarceration of our peoples, with greater investment in ear health programs, employment and education.
  • It is why we must join the call for Newstart to be raised, so that our people who cannot find work, are not living in poverty.
  • And it is why myself and NACCHO are working with Aboriginal and Torres Strait Islander peak bodies across Australia to ask COAG for a seat at the table on the Closing the Gap Refresh: so that we get that policy right.
  • Whilst these matters can be overlooked in our efforts to respond to suicide in our people, and because it is difficult for governments, but they are fundamental drivers.

 .

Part 2 Follow #ATSISPC18 for news from National Aboriginal and Torres Strait Islander Suicide Prevention Conference : From Croakey 

The second National Aboriginal and Torres Strait Islander Suicide Prevention Conference will take place in Perth this week.

Summer May Finlay, who will cover the discussions for the Croakey Conference News Servicetogether with Marie McInerney, writes below that the focus will be on community-based solutions, as well as listening to young people and LGBTIQ+ sistergirls and brotherboys.

For news from the conference on Twitter, follow #ATSISPC18@SummerMayFinlay@mariemcinerney and @CroakeyNews.


 

Healing and support crew on hand should the be needed 

Summer May Finlay writes:

Suicide among Aboriginal and Torres Strait Islander communities is regularly in the media and public conversations. Often the focus is on an individual completed or attempted suicide or the negative statistics.

The second National Aboriginal and Torres Strait Islander Suicide Prevention Conference, to be held in Perth on November 20-21, will shift the focus to solutions identified by Indigenous people themselves. The program consists of only Indigenous people from Australia and internationally.

Our voices are important because it is our mob who understand what is going on in our communities best. We live and breathe it, with many of us either having considered taking our own lives, making an attempt or having had family members who have. This is why the program includes a focus on community-based solutions.

While the term “Aboriginal and Torres Strait Islander” is used as a collective term for the Indigenous nations in Australia, each community within each nation is unique – culturally, socially and historically. This means that solutions need to be tailored to each community. Again, this focus is reflected in the conference program.

That’s not to say everyone in each community has the same needs and concerns. Within communities there are sub-groups who also have distinct needs, such as young people and LGBTQI+ sister girls and brother boys.

Representation matters

Our young people and community of LGBTIQ+ sistergirls and brotherboys experience disproportionate rates of suicide. Their voices on how to address the situation are important to hear, which is why these groups are well represented at the conference, with sessions where people will share their stories of ways forward.

Dion Tatow, a conference presenter, says the focus needs to be on ways forward because being “LGBTIQ+ sistergirls and brotherboys isn’t the cause of suicide, it is the discrimination and exclusion that are the cause”.

He says: “The shame [and] secrecy. You have to hide it, so it’s not good for your own health and wellbeing.”

Tatow is an Iman and Wadja man from Central Queensland and South Sea Islander (Ambrym Island, Vanuatu) and chairperson of gar’ban’djee’lum, a Brisbane-based, independent, social and support network for Aboriginal & Torres Strait Islander people with diverse genders, bodies, sexualities and relationships.

He believes that Aboriginal and Torres Strait Islander people and organisations like Aboriginal Community Controlled Health Organisations (ACCHOs) and cisgender people and mainstream organisations have a role to play in improving the health and wellbeing of LGBTIQ+ sistergirls and brotherboys.

However, many health services “staff aren’t trained to deal with some LGBTIQ+ sistergirls and brotherboys’ health concerns such as gender reassignment.” This can mean LGBTIQ+ sistergirls and brotherboys can feel uncomfortable accessing a service.

Safe spaces needed

Tatow believes that ACCHOs need to step up and become “safe spaces” for LGBTIQ+ sister girls and brother boys. He says that there is a perception among LGBTIQ+ sistergirls and brotherboys that ACCHOs may be unsafe, with concerns particularly around confidentiality.

According to Tatow, the program Safe and Deadly Spaces run by Aboriginal and Torres Strait Islander Community Health Service in Brisbane (ATSICHS) is a great example of what ACCHOs can do to offer appropriate services to LGBTIQ+ sister girls and brother boys.

ATSICHS is “committed to being inclusive of all sexual orientations, gender identities and intersex variations to ensure every member our community feels safe, accepted and valued when they access our services and programs”.

Young Aboriginal and Torres Strait islander people also have a strong presence at the conference.

Culture is Life, led by the Chief Executive Officer Belinda Duarte, has taken charge of the youth program. Culture is Life backs Aboriginal-led solutions that deepen connection and belonging to culture and country, and supports young Aboriginal and Torres Strait Islander people to thrive. This includes allowing young Aboriginal and Torres Strait Islander people to take on leadership roles.

Will Austin, 22, a Gunditjmara man, from South West Victoria who is the Community Relations manager for Culture is Life, was charged with leading development of the youth program. He believes that young people being part of the program was important because “Aboriginal leadership and expertise needs to be shared in a really inclusive way with young people through listening and reciprocity across the generations.”

Culture is key

Culture is Life, as the name implies, places culture at the centre of the work they do, and Austin sees culture as key to health and wellbeing for our young people, connecting to cultural practice in traditional and modern ways. He says:

Modern culture is marching down the street and finding the balances in different ways such as art, dance and contemporary dance, poems, song writing, music.

Our culture has been around for thousands of years and shared through our Elders. It will evolve. There is no better feeling than going out on country, dancing on country, feeling your feet on the earth your ancestors have walked on. Connecting to the ancient knowledge and using modern ways to communicate it.”

Katie Symes, Culture is Life General Manager – Marketing and Communications, also believes Culture is a key “protective factor” for Aboriginal and Torres Strait Islander young people.

Will Austin and Katie Symes encourage young people at the conference to have their voices heard.

Austin said: “Don’t be shame. Make sure you step up. Make sure you contribute to the conversations…young Indigenous people are the heartbeat of the nation.”

Symes said: “It’s important for young people to be supported to cut their teeth in a really safe space.”

And the conference is designed to be just that, a safe space.

Listening with heart

Culture is Life is promoting the importance of “Listening with our hearts to the lived experiences of First Nations young people, their friends, families and communities” through its LOVE and HOPE campaign, which aims to aims to raise awareness through communicating the evidence, lived experiences and Aboriginal-led solutions. This aim is echoed through the conference.

You can watch the two campaign videos featuring young Aboriginal and Torres Strait Islander people and Professor Pat Dudgeon, chair of the conference organising committee, here and here. Also follow the campaign on social media using the hashtags #loveandhope  #culturesquad  #cultureislife.

The conference showcases evidence from research and lived experience from Aboriginal and Torres Strait Islander people and Indigenous brother and sisters from other countries. The uniqueness of the program will lend itself to a unique experience for attendees.

This conference follows the first conference held in Alice Springs in 2016 as part of the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project funded by the Commonwealth Government (see this Croakey report compiling coverage of the conference).

• If you or someone you know needs help or support, call Lifeline on 13 11 14 (24 hours-a-day), contact your local Aboriginal Community-Controlled Organisation, call Beyondblue on 1300 22 4636 or call Q Life: 1800 184 527.

• Further reading: On World Suicide Prevention Day, calls for the Federal Government to invest in Indigenous suicide prevention.

• The feature image above is detail from an artwork on the conference website: Moortang Yoowarl Dandjoo Yaanginy: Families (Cultures) Coming Together for a Common Purpose (Sharing) Shifting SandsThe website says: “This artwork represents our people doing business on country that is recovering from colonisation; our lands taken over, our cultures decimated, and our families separated, causing hardship, despair, and loss of hope

NACCHO Aboriginal Health and #SuicidePrevention News Alerts : National suicide data released by @ABSStats shows a 9.1% increase as Government invests more than $36 million in #suicideprevention

 

 

” The Federal Government will invest more than $36 million in national suicide prevention projects to raise awareness of the impact of suicide and to support Australians who may be at risk.

The funding, through the National Suicide Prevention Leadership and Support Program, will help to deliver important awareness and stigma reduction activities, research, and leadership through variety of projects. These initiatives aim to reduce deaths by suicide across Australia.”.

Download Minister Greg Hunt Press Release with all Project Funding Part 1 Below

$36 million for national suicide prevention projects

The data released today indicates that men are still more than three times more likely to die by suicide than women, with the national suicide rates highest among men in the 30s, 40s and 50s. And while suicide rates increased across many age groups, the largest rise was among men 45-55 years in 2017.

While young people under 20 years have the lowest rate overall, suicide remains a leading cause of death for young people and the suicide rate among Aboriginal and Torres Strait Islander people remains unacceptably high at more than double the national suicide rate, based on the data available.

Everymind’s Director Jaelea Skehan says it is critical governments, services and the broader community come together to ensure an inclusive and proactive response to suicide. Part 2 Below

Suicide in Australia is increasing at the same time as deaths from most physical
illnesses are decreasing. We must set a target to focus Governments’ funding and the community on suicide reduction.

We should say as a nation that we want zero suicides and we are starting with a target
to reduce suicide in Australia by 25% in the next 5 years. 3,128 people died last year from a mostly preventable illness this is an outrage and it is no longer acceptable.”

Lifeline Chairman, John Brogden, today called on the Federal Government to set a
national target to achieve 25% suicide reduction over 5 years.

 ” The National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conference Committee invite and welcome you to Perth for the second National Aboriginal and Torres Strait Islander Suicide Prevention Conference, and the second World Indigenous Suicide Prevention Conference.

Our Indigenous communities, both nationally and internationally, share common histories and are confronted with similar issues stemming from colonisation. Strengthening our communities so that we can address high rates of suicide is one of these shared issues. The Conferences will provide more opportunities to network and collaborate between Indigenous people and communities, policy makers, and researchers. The Conferences are unique opportunities to share what we have learned and to collaborate on solutions that work in suicide prevention.

This also enables us to highlight our shared priorities with political leaders in our respective countries and communities.

Conference Website 

” 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  

 NACCHO BACKGROUND

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

Read over 140 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

Pat Dudgeon explains why suicide rates among young Aboriginals are so high and what can be done to stem the tide.

Young Aboriginal Australians are four times more likely to commit suicide than non-indigenous Australians and in one remote community in the country’s Kimberley region, the Aboriginal suicide rate is estimated to be seven times the national average.

Experts and Aboriginal elders believe this can be attributed in part to a feeling of disconnection from the land and traditional culture and that the solution rests in restoring that, rather than solely in combatting drug and alcohol abuse. 

See Part 3 Below 

Part 1 Minister Greg Hunt Press Release 

Fifteen highly respected organisations will receive funding including Suicide Prevention Australia who will receive $1.2 million to continue its national leadership role for the suicide prevention sector.

Suicide is a national tragedy and close to 3,000 Australians take their lives each year.

One life lost to suicide is one too many.

The support I have announced today will be vitally important in helping to reduce the number of people we lose to suicide each year.

Male suicide rates are three times greater than females and the rate among Aboriginal and Torres Strait Islander people is around twice that of non-Indigenous people.

Awareness, prevention and intervention programs for occupations where larger numbers of men typically work will be delivered by the OzHelp Foundation and MATES in Construction to give men the confidence and support to open up and seek help for themselves, and their mates, when in need.

Funding will allow the University of Western Australia to continue critical research to ensure the best support and services are being provided to Aboriginal and Torres Strait Island people in our community.

A number of organisations, including R U OK?, Everymind, and Reach Out Australia, will receive funding for communication projects such as media and online campaigns to reduce stigma, encourage conversations and provide vital support and resources to individuals and communities at risk.

Mental Health First Aid Australia and Roses in the Ocean will receive funding to provide training, education and support for medical professionals and individuals with a lived experience of suicide.

A leadership role will be provided by Suicide Prevention Australia to build partnerships across the mental health sector and the community to change behaviour and attitudes to suicide behaviour.

The National Suicide Prevention Leadership and Support Program was launched in 2017. This funding boost today brings the total funding for the program to $79.9 million.

The Morrison Government is committed to investing in mental health services for all Australians. It is a key pillar of our Long Term Health Plan.

In the 2018–19 Budget, mental health funding increased by $338.1 million to boost support for suicide prevention, research and programs for older Australians.

Part 2 Everymind Press Release

The Australian Bureau of Statistics (ABS) released the Causes of Death data for 2017, reiterating the need to renew our collective commitment to suicide prevention in Australia – as individuals, services, communities and governments.

Following a modest decrease in 2016, the latest data shows that in 2017 3,128 people died by suicide nationally, the second time that number has surpassed 3,000 in the past three years. This equates to more than eight Australians every day.

The Everymind team, through Mindframe, has worked quickly today to interpret the data and summarise it for national stakeholders, but we understand that behind every number is a person and the family and community who are grieving their loss.

The data released today indicates that men are still more than three times more likely to die by suicide than women, with the national suicide rates highest among men in the 30s, 40s and 50s. And while suicide rates increased across many age groups, the largest rise was among men 45-55 years in 2017.

While young people under 20 years have the lowest rate overall, suicide remains a leading cause of death for young people and the suicide rate among Aboriginal and Torres Strait Islander people remains unacceptably high at more than double the national suicide rate, based on the data available.

Everymind’s Director Jaelea Skehan says it is critical governments, services and the broader community come together to ensure an inclusive and proactive response to suicide.

“No government, service or individual should think that the lives lost to suicide in this country are acceptable. As someone who works nationally in suicide prevention and as someone that has lost family and friends to suicide, I don’t think they’re acceptable.

“It would be easy to point a finger at one thing that needs to change or improve, but this is a big issue that requires a big response.

“One life lost, one family impacted, one community grieving is one too many.”

Jaelea Skehan, Everymind Director

While rates are still lower than our last national peak in 1997, there has been an increase in suicide rates and the number of deaths over the past five years. In 2017 the national suicide rate was 12.7 per 100,000, compared to 11.8 per 100,000 in 2016.

Of the states and territories, QLD, the ACT and NSW recorded some of the largest increases in 2017, while the number of suicide deaths decreased in TAS, VIC and SA.

“We need to really look at addressing the social determinants that contribute to distress. We need to empower and build capacity across our community, ensure we have an accessible and responsive service system and better wrap-around supports for people who have been impacted,” Ms Skehan said.

For the first time the ABS has provided data relating to comorbidities, with 80% of suicides having comorbidities mentioned as contributing factors. Mood disorders (including depression) were reported in 43% of all suicides and drug and alcohol use disorders were mentioned in 29.5% of suicides.

“The data suggests that we need to connect our drug and alcohol strategy and service system to our national suicide prevention efforts,” Ms Skehan said.

“The Fifth National Mental Health and Suicide Prevention Plan for Australia includes most of the recommendations from the World Health Organisation, with the exception of alcohol reduction.”

Suicide Prevention Program Manager Marc Bryant says it’s important to remember that behind the data released today are people, families and communities who have all been impacted.

“Every life lost is a life that is valued and missed. Suicide is complex and the reasons people take their own life are complex. There is often no single reason why a person attempts or dies by suicide.”

Mr Bryant says it’s also essential we communicate about suicide safely and seek guidance when interpreting the data.

“Mindframe has been working to translate the data from the ABS quickly and accurately for several years now to provide national briefings for the mental health and suicide prevention sectors, as well as the media.

“Suicide and suicide prevention are both important issues of public concerns, but we need to make sure we talk about them in a way that is safe,” he said.

For a snapshot of the data and expert guidance on reporting on suicide please visit Mindframe.

To find out more about suicide prevention in Australia visit Life in Mind.

If you or someone you know needs support, contact Lifeline on 13 11 14 or the Suicide Call Back Service on 1300 659 467.

Part 3 Aboriginal youth suicide rates?

Pat Dudgeon explains why suicide rates among young Aboriginals are so high and what can be done to stem the tide.

Young Aboriginal Australians are four times more likely to commit suicide than non-indigenous Australians and in one remote community in the country’s Kimberley region, the Aboriginal suicide rate is estimated to be seven times the national average.

Experts and Aboriginal elders believe this can be attributed in part to a feeling of disconnection from the land and traditional culture and that the solution rests in restoring that, rather than solely in combatting drug and alcohol abuse.

Professor Pat Dudgeon, from the Bardi people of the Kimberley, was the first Aboriginal psychologist to graduate in Australia and is the woman behind Australia’s first national suicide prevention strategy that specifically targets Aboriginals.

She talks to Al Jazeera about the mental state of Australia’s indigenous youth and what can be done to battle the suicide rate.

Al Jazeera: You were the first Aboriginal psychologist to graduate in Australia. What inspired your career path?

Pat Dudgeon: Growing up as an Aboriginal person, I became increasingly aware of the social and historical disadvantage that my people had suffered. I became determined to help them.

WATCH

Australia’s Lost Generation: Battling Aboriginal Suicide

I wanted to help people with their mental health problems. Life at times can be very difficult – for some groups more than others. And I felt we needed to heal to become a happier, more positive and functional people.

Al Jazeera: Has anything changed since we spoke to you for our 2012 documentary “Australia’s Lost Generation”?

Dudgeon: Apparently, the national suicide averages have stabilised or even gone down. But for indigenous suicides, there’s been no change; it’s stayed the same and there’s still a lot of suicides happening.

However, I think there’s more awareness. There is a greater voice demanding more programmes, but that isn’t being provided as well as it could be. And also, it’s going to take a while. It’s taken us a long time to get to this point.

Canadian professor Michael Chandler used to say that high youth-suicide rates are, in a sense, the miner’s canary; it tells you that things aren’t good. It’s the sharp end of a very bad situation telling us that things aren’t good in a society. We need to work to turn it around. But for some communities, that might take a long time.

Al Jazeera: Are indigenous children at a greater risk of suffering from mental health issues than their non-indigenous peers?

Dudgeon: Indigenous Australians are twice more likely to commit suicide than other Australians. When you break it down by age groups, certainly our youth are more vulnerable to suicide.

We live in a society that is often very racist and doesn’t give them much opportunityBut there’s a whole range of different reasons why our youth are suffering from mental health issues and are taking their lives, among them an intergenerational trauma.

Youth suicide is not just an issue for Australian indigenous people but other indigenous people from Canada, the United States and New Zealand, as well. And the one thing that we have in common is the story of colonisation.

Al Jazeera: Do you believe that the high suicide rates are a result of this colonisation process?

Dudgeon: The difference between us and other Australian people is that we’ve gone through a process of colonisation. It was quite a brutal and horrible process that has disempowered indigenous people.

Often, there were genocides committed. People were forcibly removed from their countries, from their lands and put into reserves and missions.

Children were forcibly separated from families and put into institutions where they were trained to be menial workers, and so on. Aboriginal culture was looked down upon and discouraged. So, as well as colonising the lands, Aboriginal culture and people themselves were, in a sense, colonised psychologically.

That had a lasting impact. Certainly, if you’ve been removed from your family and culture, there’s a whole lot of trauma that goes with that. Sometimes, that trauma is carried down from one generation to the next, so that’s something we do need to heal from.

It’s only recently that Australia has accepted responsibility and we had the national apology given by the then-prime minister, Kevin Rudd. For us, that was a big healing moment, a very big healing moment.

But certainly I think that the “stolen generations”, as we call it when people were removed from their family, is a big issue that we need to grapple with and a lot more healing needs to happen.

Al Jazeera: What needs to be done to help people heal?

Dudgeon: We have a national healing foundation that supports and encourages people from all across the country to undertake healing programmes, enabling them to heal and to reinstate a strong, healthy culture.

We know from our own research that for a programme to be effective, the local Aboriginal community must be involved.

And there needs to be a range of different programmes: from clinical services, to back to country, to cultural programmes. And we need a whole range of different services.

We need to support our youth, listen to them, hear what their issues are. We need to make our cultures strong to ensure that the youth has opportunities – that they have people to speak to and show them a way to engage in our culture, as well.

I think we could see change in our generation if we put in place good systems that supported the Aboriginal community, gave them a whole range of different services – including encouraging and supporting local communities to be involved in any programmes. And to develop local healing and cultural programmes.

So it’s not insurmountable. But I think it requires the government to change the way it views Aboriginal communities and their right to self-governing.

Al Jazeera: Why is the local approach so important?

Dudgeon: For a lot of Aboriginal people, or any person really, one of the things I’ve seen as a mental health professional is the emergence of the consumer movement. People who are consumers of mental health services now have a voice.

To improve a service, those who will be using it need to be actively involved in deciding what it should be and how it should be delivered. So, if you empower people, the change will be much more effective than if they’re just receiving through some professional high up, an outsider who doesn’t really understand the issue.

This applies to either indigenous or non-indigenous people, but particularly for indigenous people because of their history of colonisation.

Al Jazeera: What’s being done to help communities and individuals tackle mental health issues?

Dudgeon: There are a lot of programmes, including Gatekeeper Training that helps people identify the signs or symptoms of possible suicide and suggest strategies on how to deal with that.

Usually, people from within the community are also asked to go and see someone if there are concerns.

I think in today’s society, both indigenous and non-indigenous, we’re much more comfortable talking about suicide, addressing it and helping each other.

It was a very taboo subject some years ago. But now it’s OK to say that you’ve got problems. It’s OK to talk about it and to go and seek help. I think it’s good that we’re moving in that direction.

Suicide isn’t just indigenous, it’s mainstream, as well. So, if we are all conscious about our mental health, acknowledge that different groups need different solutions and different approaches, and do our bit to ensure that everyone is healthy, that’s an important first step

Al Jazeera: Could you tell us more about different suicide prevention programmes that are needed?

Dudgeon: There needs to be a whole range of different projects. When we started the Aboriginal, Torres Strait Islander suicide evaluation project, we looked at the different types of services needed.

When people are very unhealthy they might need clinics that can provide urgent care, they might also need medication. So, you need programmes that can provide immediate relief.

You also need programmes that can help them build resilience and strengthen their culture.

The main message that came through at the round tables that we undertook across Australia was that people were saying, “We need to build up our resilience.” And the big thing that everyone was concerned about was self-determination. That Aboriginal people, or indigenous people themselves need to be in charge of any developments in the community.

According to some research done in Canada looking at First councils tribes, those with low suicide rates had a higher level of self-determination and cultural reclamation. So, those are important factors for indigenous suicide prevention. Feeling like you belong and you’ve got a future is important and empowering for any human being.

Al Jazeera: How do you empower communities and people?

Dudgeon: I was involved in a project called, “The National Empowerment Project”. It started in response to the suicides that were happening, so we developed a programme to help build a relationship with the communities we wanted to engage with us.

The communities chose people, we trained them as co-researchers, and then, they went and asked everyone in their community, what were the main issues and what were the solutions. And after, that we reported our findings to each of the communities.

We developed a programme from all those consultations called “the Cultural, Social and Emotional Wellbeing Project”. It’s basically from an indigenous point of view, so it’s very much about indigenous wellbeing, culture and self-awareness.

The funding is provided by the government, and it enables people to deal with mental health issues and come up with psychological strategies, as well as strategies to navigate normal challenges of life. It also stresses the importance of elders and culture in a community. So, it’s all about self-awareness and cultural strength.

Al Jazeera: Is there any specific case that has stuck with you throughout the years?

Dudgeon: Yes. When we organised a big suicide prevention conference in Alice Springs, we decided to have it in Central Australia. There was a community that had suffered a high number of suicides.

They were giving a bursary for a couple of them to go to Alice Springs and attend the conference. But instead, they used that bursary to hire a bus for 12-15 people to go from Leonora all the way to Alice Springs, and they stopped in other communities along the way to exchange stories with them.

That stuck with me and it illustrates that the community is concerned about the high suicide rate, they will take action, and they’re determined to try and address things themselves.

Al Jazeera: Do you believe that this increased awareness can reduce the suicide numbers?

Dudgeon: I do get concerned that perhaps not enough funding is being put into Aboriginal communities and that’s probably where the Centre for Best Practice in Aboriginal Torres Strait Islander Suicide Prevention comes in.

I’m the director of the centre, and we’re setting up a clearinghouse with all the best practice programmes and services for indigenous suicide prevention. There will also be a lot of advice for communities. So, if they want to develop a programme and have it evaluated, they’ll be able to come to our website for that.

We can provide good strategies and when communities do get funded, they’ll be able to look at what’s happening on our website and connect with other programmes that they might think will be useful for themselves – in their own time, in their own way.

Australia's Lost Generation: Battling Aboriginal Suicide

REWIND

Australia’s Lost Generation: Battling Aboriginal Suicide

NACCHO Aboriginal #Mentalhealth #SuicidePrevention and #RUOKday : If you ask #RUOK ? What do you do if someone says ‘no’? Plus Sponsorships for 10 #Indigenous young people to take participate #chatsafe campaign

R U OK Day today encouraging all of us to check in with others to see if they’re OK.

But what if someone says “no”? What should you say or do? Should you tell someone else?

What resources can you point to, and what help is available?

Read NACCHO Aboriginal Health articles over the past 6 Years

Mental Health 189 posts 

Suicide Prevention 124 Posts

Here is a guide 

Stop and listen, with curiosity and compassion

We underestimate the power of simply listening to someone else when they’re going through a rough time. You don’t need to be an expert with ten years of study in psychology to be a good listener. Here are some tips:

Listen actively. Pay attention, be present and allow the person time to speak.

Be curious. Ask about the person’s experience using open questions such as

what’s been going on lately?

you don’t seem your usual self, how are you doing/feeling?

Validate their concerns. See the situation from the person’s perspective and try not to dismiss their problems or feelings as unimportant or stupid. You can say things like

I can see you’re going through a tough time

it’s understandable to feel that way given everything you’ve been going through.

There are more examples of good phrases to use here.

Don’t try to fix the problem right now

Often our first instinct is wanting to fix the person’s problems. It hurts to see others in pain, and we can feel awkward or helpless not knowing how to help. But you don’t have to have all of the answers.

Instead of jumping into “fix it” mode right away, accept the conversation may be uncomfortable and allow the person to speak about their difficulties and experiences.

Sometimes it’s not the actual suggestion or practical help that’s most useful but giving the person a chance to talk openly about their struggles. Also, the more we understand the person’s experience, the more likely we are to be able to offer the right type of help.

Encourage them to seek help.

Ask:

how can I help?

is there something I can do for you right now?

Sometimes it’s about keeping them company (making plans to do a pleasant activity together), providing practical support (help minding their kids to give them time out), or linking them in with other health professionals.

Check whether they need urgent help

It’s possible this person is suffering more than you realise: they may be contemplating suicide or self-harm. Asking about suicidal thoughts does not worsen those thoughts, but instead can help ease distress.

It’s OK to ask them if they’re thinking about suicide, but try not to be judgemental (“you’re not thinking of doing anything stupid, are you?”). Listen to their responses without judgement, and let them know you care and you’d like to help.

Read more: How to ask someone you’re worried about if they’re thinking of suicide

There are resources and programs to help you learn how to support suicidal loved ones, and crisis support lines to call:

  • Contact the Social and Emotional team at your nearest ACCHO
  • Lifeline (24-hour crisis telephone counselling) 13 11 14
  • Suicide Callback Service 1300 659 467
  • Mental health crisis lines

If it is an emergency, or the person is at immediate risk of harm to themselves or others, call 000.

Encourage them to seek professional help

We’re fortunate to be living in Australia, with access to high quality mental health care, resources and support services. But it can be overwhelming to know what and where to seek help. You can help by pointing the person in the right direction.

The first place to seek help is the general practitioner (GP). The GP can discuss treatment options (psychological support and/or medication), provide referrals to a mental health professional or arrange access to local support groups. You can help by encouraging your friend to make an appointment with their GP.

There are great evidence-based online courses and self-help programseducational resources and free self-help workbooks that can be accessed at any time.

There are also online tools to check emotional health. These tools help indicate if a person’s stress, anxiety and depression levels are healthy or elevated.

What if they don’t want help?

People with mental health difficulties sometimes take years between first noticing the problem and seeking professional help. Research shows approximately one in three people experiencing mental health problems accesses treatment.

So even if they don’t want help now, your conversation may have started them thinking about getting help. You can try understanding what’s stopping them from seeking help and see if there’s anything you can do to help connect them to a professional. You don’t need to push this, but simply inviting the person to keep the options in mind and offering your ongoing support can be useful in the long run.

Follow up. If appropriate, organise a time to check in with the person again to see how they’re doing after your conversation. You can also let the person know you’re around and they are always welcome to have a chat with you. Knowing someone is there for you can itself be a great source of emotional support.

Read more: Five types of food to increase your psychological well-being

The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences bursary

Orygen, The National Centre of Excellence is seeking expressions of interest (EOI) from all Aboriginal and Torres Strait Islander young people who would like to share their expertise, advice, and ideas and contribute to the development of a suicide prevention social media campaign!

About the #chatsafe campaign

We would like to partner with Aboriginal and Torres Strait Islander young people to co-design a suicide prevention social media campaign specifically for the Aboriginal community. The campaign will focus on educating and empowering young people to support themselves and other young people within their online social networks. Rather than speaking on behalf of Aboriginal communities, we wish to draw on the expertise, cultural identities, and strengths of the community to inform campaign materials.

The co-design workshop will involve a yarning circle, where young people will be given the opportunity to share their experiences and express their needs. The yarning circle will be facilitated by an Aboriginal and Torres Strait Islander person. The workshop will also involve working together, in groups, to generate ideas for a social media campaign (e.g., digital storytelling, drawing, etc.).

The workshop will be hosted in Perth, as a part of the The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences. The workshop will be conducted in the morning and breakfast will be provided. Young people will be reimbursed $30.00 per hour for their time.

Opportunity for financial support

Oyrgen would like to sponsor 10 Aboriginal and Torres Strait Islander young people to take part in our co-design workshop and The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences, hosted from 20 to 23 November, in Perth, by providing a bursary.

SEE CONFERENCE WEBSITE

Eligibility

To be eligible for Orygen’s bursary funding, the applicant must be an Aboriginal and Torres Islander young person, aged between 18 and 25 years. We encourage young people from all geographic regions, across Australia, to apply.

Submitting your application

If you would like to be a part of the co-design workshop, please email your application to Jo at

The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences bursary

Orygen, The National Centre of Excellence is seeking expressions of interest (EOI) from all Aboriginal and Torres Strait Islander young people who would like to share their expertise, advice, and ideas and contribute to the development of a suicide prevention social media campaign!

About the #chatsafe campaign

We would like to partner with Aboriginal and Torres Strait Islander young people to co-design a suicide prevention social media campaign specifically for the Aboriginal community. The campaign will focus on educating and empowering young people to support themselves and other young people within their online social networks. Rather than speaking on behalf of Aboriginal communities, we wish to draw on the expertise, cultural identities, and strengths of the community to inform campaign materials.

The co-design workshop will involve a yarning circle, where young people will be given the opportunity to share their experiences and express their needs. The yarning circle will be facilitated by an Aboriginal and Torres Strait Islander person. The workshop will also involve working together, in groups, to generate ideas for a social media campaign (e.g., digital storytelling, drawing, etc.). The workshop will be hosted in Perth, as a part of the The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences. The workshop will be conducted in the morning and breakfast will be provided. Young people will be reimbursed $30.00 per hour for their time.

Opportunity for financial support

Oyrgen would like to sponsor 10 Aboriginal and Torres Strait Islander young people to take part in our co-design workshop and The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences, hosted from 20 to 23 November, in Perth, by providing a bursary.

Eligibility

To be eligible for Orygen’s bursary funding, the applicant must be an Aboriginal and Torres Islander young person, aged between 18 and 25 years. We encourage young people from all geographic regions, across Australia, to apply.

Submitting your application

If you would like to be a part of the co-design workshop, please email your application to Jo at jo.robinson@orygen.org.au. Submissions can be made on, or before Sunday, 30 September, 2018.

Selection process

In the first week of October, a panel consisting of Oyrgen staff, a Culture is Life representative, Professor Pat Dudgeon from the conference organising committee, Summer May Finlay (a Yorta Yorta woman), and young people will review all written applications and select 10 successful applicants. The selection panel will endeavour to select a diverse range of young people. The 10 successful applicants will be notified by email by mid-October. The success applicants will have until 31 October, 2018 to accept the bursary offered.

Requirements

The successful recipients of the bursaries are required to attend a half-day co-design workshop. Recipients will also be asked to complete and submit a ‘Wellness Plan’, ‘Bank Details Form’, and ‘Consent Form’ prior to participation in the w

. Submissions can be made on, or before Sunday, 30 September, 2018.

Selection process

In the first week of October, a panel consisting of Oyrgen staff, a Culture is Life representative, Professor Pat Dudgeon from the conference organising committee, Summer May Finlay (a Yorta Yorta woman), and young people will review all written applications and select 10 successful applicants. The selection panel will endeavour to select a diverse range of young people. The 10 successful applicants will be notified by email by mid-October. The success applicants will have until 31 October, 2018 to accept the bursary offered.

Requirements

The successful recipients of the bursaries are required to attend a half-day co-design workshop. Recipients will also be asked to complete and submit a ‘Wellness Plan’, ‘Bank Details Form’, and ‘Consent Form’ prior to participation in the w

Anyone seeking support and information about mental health can contact beyondblue on 1300 22 46 36. For information about suicide and crisis support, contact Lifeline on 13 11 14 or the Suicide Callback Service on 1300 659 467

 

NACCHO Aboriginal Health NEWS : @AIHW report : The consumption of #alcohol, #tobacco and other #drugs is a major cause of preventable disease and illness in our communities

The consumption of alcohol, tobacco and other drugs is a major cause of preventable disease and illness in our comminities

There are a wide range of data sources available that contribute to our understanding of alcohol, tobacco and other drug use.

This web report from AIHW is intended to be a general reference for contemporary data on alcohol, tobacco and other drugs in Australia.

SEE Full Report 

This report consolidates the most recently available information regarding the use of tobacco, alcohol, cannabis, meth/amphetamines and other stimulants, the non-medical use of pharmaceutical drugs, illicit opioids (heroin) and new (and emerging) psychoactive substances (NPS).

Key trends in the availability, consumption, harms and treatment are identified and detailed data are presented for vulnerable populations.

These population groups include Aboriginal and Torres Strait Islander people, homeless people, older people, people from culturally and linguistically diverse backgrounds, people identifying as lesbian, gay, bisexual, transgender, intersex or queer (LGBTIQ), people in contact with the criminal justice system, people with mental health conditions, young people and people who inject drugs

Key findings Aboriginal and Torres Strait Islander people 

  • There has been significant declines in the proportion of Aboriginal and Torres Strait Islander people smoking and consume alcohol that exceeds lifetime risk guidelines (consuming more than two standard drinks per day on average).
  • The prevalence of smoking by Indigenous people has declined from 55% in 1994 to 45% in 2014–15.
  • The proportion of Indigenous people that consume alcohol as levels that exceed lifetime risk guidelines has reduced from 19% in 2008 to 15% in 2014–15.
  • In 2011, tobacco use accounted for 12% of the burden of disease for Indigenous Australians. This accounts for 23.3% of the health gap between Indigenous and non-Indigenous Australians.
  • In 2016, more than 1 in 4 (27%) Indigenous Australians used an illicit drug in the last 12 months. This was 1.8 times higher than for non-Indigenous Australians (15.3%).
  • The most commonly used illicit drug by Indigenous Australians is cannabis (16.7%), followed by the non-medical use of pharmaceutical drugs (11.0%).
  • Of clients of alcohol and other drug, treatment services, 15% were Indigenous Australians aged 10 and over, which is an overrepresentation relative to their population size.

Currently there are almost 800,000 Aboriginal or Torres Strait Islander people (see Box ATSI1) living in Australia, accounting for 2.8% of the Australian population [1]. There are substantial differences in measures of health and welfare between Aboriginal or Torres Strait Islander people and non-Indigenous Australians.

Box ATSI1: Aboriginal and Torres Strait Islander people

The terms ‘Aboriginal and Torres Strait Islander people’ is preferred in Australian Institute of Health and Welfare (AIHW) publications when referring to the separate Indigenous peoples of Australia. However, the term ‘Indigenous’ Australians is used interchangeably with ‘Aboriginal and Torres Strait Islander’ in order to assist readability.

The Australian Burden of Disease Study identified that Aboriginal or Torres Strait Islander people experience a burden of disease that is 2.3 times the rate of non-Indigenous Australians [2]. The gap in the disease burden is due to a range of factors including disconnection to culture, traditions and country, social exclusion, discrimination and isolation, trauma, poverty, and lack of adequate access to services [3]. Tobacco, alcohol, and other drugs are key risk factors contributing to the health gap between Indigenous and non-Indigenous Australians [2].

Box ATSI2. Data sources examining tobacco, alcohol and other drug use by Aboriginal and Torres Strait Islander people

There are a number of data sources that provide information about tobacco, alcohol and other drug use by Aboriginal and Torres Strait Islander people.

The National Aboriginal and Torres Strait Islander Social Survey (NATSISS) [4] and the Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) [5] collected by the ABS are designed to obtain a representative sample of Indigenous Australians. In relation specifically to tobacco smoking, the ABS has consolidated data from six large, national, multistage random household surveys to identify trends between 1994 and 2014–15 [6].

The AIHW’s National Drug Strategy Household Survey (NDSHS) uses a self-completion questionnaire to capture information about drug and alcohol use among the general Australian population; however it is not specifically designed to obtain reliable national estimates for Indigenous people. In 2016, 2.4% of the NDSHS (unweighted) sample aged 12 and over (or 568 respondents) identified as being of Aboriginal or Torres Strait Islander origin. The estimates produced by the NDSHS should be interpreted with caution due to the low sample size [7].

There are also other data sources that provide information relevant to Aboriginal and Torres Strait Islander people.

  • Australia’s Burden of Disease study analyses the impact of nearly 200 diseases and injuries in terms of living with illness (non-fatal burden) and premature death (fatal burden). In 2015, a report was released that provides estimates of burden of disease between Indigenous and non-Indigenous Australians [8].
  • The National Perinatal Data Collection covers each birth in Australia and includes information on Indigenous mothers and their babies [6].
  • The Alcohol and Other Drug Treatment Services National Minimum Dataset (AODTS-NMDS) contains information on treatment provided to clients by publicly funded alcohol and other drug services including Indigenous clients [9].
  • The Online Services Report (OSR) contains information on the majority of Australian Government-funded Aboriginal and Torres Strait Islander substance use services [6].

Tobacco smoking

While tobacco smoking is declining in Australia, it remains disproportionately high among Indigenous Australians. Data from the Australian Bureau of Statistics (ABS) has shown:

  • In 1994, the Indigenous Australian survey data showed that 55% of Indigenous Australians aged 18 and over were smokers; 20 years later, in 2014–15, this had declined to 45% (Table S3.4).
  • Over a similar 20-year period, the National Health Survey (NHS) the proportion of non-Indigenous smokers aged 18 and over declined, from 24% in 1995 to 16% in 2014–15 (Table S3.5).
  • There appears to have been no change to the gap in smoking prevalence between the Indigenous Australian adult population and the non-Indigenous Australian adult population from 1994 to 2014–15. Even though the Indigenous Australian smoking rates are declining, the non-Indigenous rate is declining at a similar rate, therefore the gap remained constant [6] (Figure ATSI1).

Most of the decline in smoking occurred in non-remote areas. Over the 20-year period, the proportion of Indigenous Australians aged 18 and over in non-remote areas who were smokers declined from 55% to 42%, while the proportion in remote areas remained relatively stable at between 54% and 56% (Table S3.4).

In 2014–15, Indigenous males were more likely than Indigenous females to be smokers (47% compared with 42%) [1].

Geographic trends

The 2014–15 NATSISS provides estimates of tobacco smoking for Indigenous Australians by jurisdiction. According to the 2014–15 NATSISS, 39% of Indigenous Australians aged 15 and over smoked daily. Those from the Northern Territory (45%) and Western Australia (42%) surpassed this national average, while Indigenous Australians from South Australia (35%) were the least likely to be a current daily smoker [4] (Table S3.3).

Tobacco smoking in pregnancy

Indigenous Australians are at an elevated risk of smoking during pregnancy compared with non-Indigenous Australians. The National Perinatal Data Collection showed that:

  • Indigenous mothers accounted for 19% of mothers who smoked tobacco at any time during pregnancy in 2015, despite accounting for only around 4% of mothers.
  • The age-standardised rate of Indigenous mothers smoking during pregnancy has decreased from 50% in 2009 to 45% in 2015.
  • Almost 1 in 2 (45%) Indigenous mothers reported smoking during pregnancy—compared with 12% of non-Indigenous mothers (age-standardised).
  • The age-standardised rate of Indigenous mothers quitting smoking during pregnancy (14%) is about half that of non-Indigenous mothers (25%) (based on mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy) [10].

Alcohol consumption

Abstinence (non-drinkers)

  • The 2016 NDSHS found that Indigenous Australians aged 14 and over were more likely to abstain from drinking alcohol than non-Indigenous Australians (31% compared with 23%, respectively) and abstinence among Indigenous Australians has been increasing since 2010 when it was 25% [7] (Table S3.1).
  • This pattern is consistent with data from the 2012–13 AATSIHS, where 28% of Indigenous Australians reported abstaining from drinking compared with 18% of non-Indigenous Australians [5].

Lifetime risk

  • The 2014–15 NATSISS found that the proportion of Indigenous Australians aged 15 years and over who exceeded the NHMRC lifetime risk guidelines for alcohol consumption (consuming more than 2 standard drinks per day on average) decreased between 2008 and 2014–15 (19% compared with 15%; non age-standardised proportions). The overall change is largely due to a decline in non-remote areas (19% in 2008 to 14% in 2014–15) [4] (Table S3.6).
  • Comparisons between Indigenous and non-Indigenous Australians are only available using age-standardised data from the 2012–13 AATSIHS and is not comparable to the 2014–15 NATSISS. The findings showed that lifetime risky drinking of Indigenous Australians aged 15 and over was similar to that of non-Indigenous Australians (9.8% compared with 9.7%; age-standardised) [5] (Table S3.7).

Single occasion risk

  • According to the 2014–15 NATSISS, 30% of Indigenous Australians aged 15 and over exceeded the single occasion risk guidelines for alcohol consumption (non age-standardised proportions), which is a decline since 2002 (35%).
  • Comparisons between Indigenous and non-Indigenous Australians are only available using age-standardised data from the 2012–13 AATSIHS and is not comparable to the 2014–15 NATSISS. The 2012–13 AATSIHS reported that 1 in 2 (50%) Indigenous Australians exceed the single occasion risky drinking guidelines (more than 4 standard drinks on a single occasion in past year). This was 1.1 times the rate that non-Indigenous Australians (44%) that exceeded these guidelines [5] (Table S3.7).

Risky alcohol consumption

  • According to the 2016 NDSHS, almost 1 in 5 Indigenous Australians (18.8%) consumed 11 or more standard drinks at least once a month. This was 2.8 times the rate that non-Indigenous Australians (6.8%) consumed this amount of alcohol [7] (Table S3.1).

Geographic trends

Between 2002 and 2014–15 there was a decline in the proportion of Indigenous Australians that resided in New South Wales Victoria, Queensland, South Australia, Western Australia and the Australian Capital Territory that exceeded the lifetime and single occasion risk guidelines (Figure ATSI2). Indigenous Australians residing in Tasmania (36%), the Australian Capital Territory (ACT) (35%), Queensland (33%) and Western Australia (33%) had higher rates of exceeding the single occasion drinking guidelines than the national average [4] (Table S3.8).

Indigenous Australians residing in Western Australia (16%), New South Wales (16%) and Queensland (15%) surpassed the national average for exceeding lifetime risk guidelines [4] (Table S3.9).

Illicit drug use

In the 2014–15 NATSISS, Aboriginal and Torres Strait Islander people aged 15 and over were asked whether they had used illicit substances in the last 12 months, and the types of illicit substances they had used during that period [4]. The data showed that:

  • Almost one-third (30%) of Indigenous Australians aged 15 and over reported having used illicit substances in the last 12 months, up from 22% in 2008.
  • Males were significantly more likely than females to have used illicit substances (34% compared with 27%), as were people in non-remote areas compared with those in remote areas (33% compared with 21%).
  • Cannabis was the most commonly reported illicit drug used by Aboriginal and Torres Strait Islander people in the last 12 months at 19% (25% of males compared with 14% of females).
  • The non-medical use of analgesics and sedatives (such as painkillers, sleeping pills and tranquilisers) was also relatively common (13%), with females (15%) being more likely than males (11%) to have used analgesics and sedatives.
  • One in twenty (5%) Indigenous Australians aged 15 and over reported having used amphetamines or speed in the last 12 months (6% of males compared with 3% of females) [4] (Figure ATSI3).

The 2016 NDSHS data showed that (other than ecstasy and cocaine), Indigenous Australians aged 14 and over recent used of illicit drugs was at a higher rate than non-Indigenous Australians (Table S3.1). Rates of illicit drug use in 2016 for Indigenous Australians aged 14 and older were:

  • Over one in four (27%) used any illicit drug in the last 12 months—1.8 times higher than non-Indigenous Australians (15.3%)
  • One in five (19.4%) used cannabis in the last 12 months—1.9 times higher than non-Indigenous Australians (10.2%)
  • Around one in 10 (10.6%) used a pharmaceutical for non-medical use—2.3 times higher than non-Indigenous Australians (4.6%) [7] (Table S3.1)
  • 3.1% used meth/amphetamines in the last 12 months—2.2 times higher than non-Indigenous Australians (1.4%).

The differences between Indigenous and non-Indigenous Australians were still apparent even after adjusting for differences in age structure (Figure ATSI4). There were no significant changes in illicit use of drugs among Indigenous Australians between 2013 and 2016, however due to the small sample sizes for Indigenous Australians, the estimates of the NDSHS should be interpreted with caution.

Geographic trends

Indigenous Australians aged 15 and over residing in the Northern Territory (22%) were the least likely to report substance use, while those from the Australian Capital Territory (41%) and Victoria (40%) were the most likely to report using substances.

Indigenous Australians from the Northern Territory (22%) and Queensland (29%) were the only jurisdictions below the national average (30%) [4] (Table S3.3).

Health and harms

The health status of Aboriginal and Torres Strait Islander people are considerably lower than for non-Indigenous Australians. For instance:

  • 35.1% of Aboriginal or Torres Strait Islander people compared with 58.3% of non-Indigenous Australia self-assessed their health as ‘excellent’ or ‘very good’ (age-standardised per cent).
  • 32.5% of Indigenous Australians compared with 12.3% of non-Indigenous Australians reported high/very high psychological distress (age-standardised per cent).
  • 71.0% of Aboriginal or Torres Strait Islander people reported having a long-term health condition compared with 55.3% of non-Indigenous Australians (age-standardised per cent) [4] (Table S3.6).

Almost 1 in 2 Indigenous Australians with a mental health condition were a daily smoker (46%) and about 2 in 5 (39%) to have used substances in the last 12 months. This was higher than for Indigenous  Australians with other long-term health conditions (33% and 24%, respectively) or those with no long term health condition (39% and 29% respectively) [4] (Table S3.11).

The Australian Burden of Disease Study provides an indication of the risk factors that contribute to the health gap between Indigenous and non-Indigenous Australians. In 2011, tobacco use accounted for 23.3% of the gap, and alcohol and drug use contributed to 8.1% and 4.1% of the gap, respectively [8] (Table S3.12).

Treatment

Indigenous Australians are also overrepresented in drug and alcohol treatment services. In 2016–17, the Alcohol and Other Drug Treatment Services National Minimum Dataset (AODTS-NMDS) showed that 15% of clients were Indigenous Australians aged 10 and over (Table S3.13). Indigenous Australians (3,313 per 100,000 population) were 7 times more likely to receive AOD treatment services than non-Indigenous Australians (430 per 100,000 population) were. Specifically where:

  • Amphetamines was the principal drug of concern, Indigenous Australians (1,204 per 100,000 population) were 8 times more likely than non-Indigenous Australians (155 per 100,000 population).
  • Heroin was the principal drug of concern Indigenous Australians (911 per 100,000 population) were 7 times more likely than non-Indigenous Australians (123 per 100,000 population) were.
  • Cannabis was the principal drug of concern Indigenous Australians (867 per 100,000 population) were 7 times more likely than non-Indigenous Australians (126 per 100,000 population) were.
  • Alcohol was the principal drug of concern Indigenous Australians (136 per 100,000 population) were 7 times more likely than non-Indigenous Australians (26 per 100,000 population) [9] (Table S3.14).

Dependence on opioid drugs (including codeine, heroin and oxycodone) can be treated with pharmacotherapy therapy using substitute drugs such as methadone or buprenorphine. The National Opioid Pharmacotherapy Statistics Annual Data collection (NOPSAD) provides information on clients receiving opioid pharmacotherapy treatment on a snapshot day each year. For jurisdictions where data was provided, in 2017:

  • Around 1 in 10 clients (9%) were Indigenous, an overrepresentation relative to their population size.
  • Indigenous Australians were almost 3 times as likely (70 clients per 10,000 population) to receive pharmacotherapy treatment as non-Indigenous Australians (26 clients per 10,000 population) [11] (Table S3.15).

Data from the OSR shows that 2015–16, there were 80 organisations around Australia that provided alcohol and other drug treatment services to around 32,700 Aboriginal and Torres Strait Islander clients [6]. The OSR data also shows that:

  • All 80 organisations reported that alcohol was one of the top five common substance-use issue, followed by cannabis (94%) and amphetamines (70%)
  • Treatment episodes were more likely to be to occur in non-residential settings (87%)
  • One third of all treatment episodes were in Very remote areas (32%) and the highest proportion of clients were located in Major cities (35%).

Policy context

The Aboriginal and Torres Strait Islander Health Performance Framework 2017

The Aboriginal and Torres Strait Islander Health Performance Framework 2017 includes a suite of products that give the latest information on how Aboriginal and Torres Strait Islander people in Australia are faring according to a range of 68 performance measures across 3 tiers: Tier 1—health status and outcomes, Tier 2—determinants of health, and Tier 3—health system performance. The measures are based on the Aboriginal and Torres Strait Islander Health Performance Framework and cover data that has been collected on the entire health system, including Indigenous-specific services and programs, and mainstream services [12].

National Aboriginal Torres Strait Islander Peoples Drug Strategy 2014–2019

The National Aboriginal and Torres Strait Islander Peoples’ Drug Strategy 2014–2019 was a sub-strategy of the National Drug Strategy 2010–2015 and remains a sub-strategy under the National Drug Strategy 2017–2025. The overarching goal of this sub-strategy is to improve the health and wellbeing of Aboriginal and Torres Strait Islander people by preventing and reducing the harmful effects of alcohol and other drugs (AOD) on individuals, families and their communities [13].

Minister @KenWyattMP launches NACCHO @RACGP National guide for healthcare professionals to improve health of #Aboriginal and Torres Strait Islander patients

 

All of our 6000 staff in 145 member services in 305 health settings across Australia will have access to this new and update edition of the National Guide. It’s a comprehensive edition for our clinicians and support staff that updates them all with current medical practice.

“NACCHO is committed to quality healthcare for Aboriginal and Torres Strait Islander patients, and will work with all levels of government to ensure accessibility for all.”

NACCHO Chair John Singer said the updated National Guide would help governments improve health policy and lead initiatives that support Aboriginal and Torres Strait Islander people.

You can Download the Guide via this LINK

A/Prof Peter O’Mara, NACCHO Chair John Singer Minister Ken Wyatt & RACGP President Dr Bastian Seidel launch the National guide at Parliament house this morning

“Prevention is always better than cure. Already one of the most widely used clinical guidelines in Australia, this new edition includes critical information on lung cancer, Foetal Alcohol Spectrum Disorder and preventing child and family abuse and violence.

The National Guide maximises the opportunities at every clinic visit to prevent disease and to find it early.It will help increase vigilance over previously undiagnosed conditions, by promoting early intervention and by supporting broader social change to help individuals and families improve their wellbeing.”

Minister Ken Wyatt highlights what is new to the 3rd Edition of the National Guide-including FASD, lung cancer, young people lifecycle, family abuse & violence and supporting families to optimise child safety & wellbeing : Pic Lisa Whop SEE Full Press Release Part 2 Below

The Royal Australian College of General Practitioners (RACGP) and the National Aboriginal Community Controlled Health Organisation (NACCHO) have joined forces to produce a guide that aims to improve the level of healthcare currently being delivered to Aboriginal and Torres Strait Islander patients and close the gap.

Chair of RACGP Aboriginal and Torres Strait Islander Health Associate Professor Peter O’Mara said the third edition of the National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (the National Guide) is an important resource for all health professionals to deliver best practice healthcare to Aboriginal and Torres Strait Islander patients.

“The National Guide will support all healthcare providers, not just GPs, across Australia to improve prevention and early detection of disease and illness,” A/Prof O’Mara said.

“The prevention and early detection of disease and illness can improve people’s lives and increase their lifespans.

“The National Guide will support healthcare providers to feel more confident that they are looking for health issues in the right way.”

RACGP President Dr Bastian Seidel said the RACGP is committed to tackling the health disparities between Indigenous and non-Indigenous Australians.

“The National Guide plays a vital role in closing the gap in Aboriginal and Torres Strait Islander health disparity,” Dr Seidel said.

“Aboriginal and Torres Strait Islander people should have equal access to quality healthcare across Australia and the National guide is an essential part of ensuring these services are provided.

“GPs and other healthcare providers who implement the recommendations within the National Guide will play an integral role in reducing health disparity between Indigenous and non-Indigenous Australians, and ensuring culturally responsive and appropriate healthcare is always available.”

The updated third edition of the National Guide can be found on the RACGP website and the NACCHO website.

 

Free to download on the RACGP website and the NACCHO website:

http://www.racgp.org.au/national-guide/

and NACCHO

Part 2 Prevention and Early Diagnosis Focus for a Healthier Future

The critical role of preventive care and tackling the precursors of chronic disease is being boosted in the latest guide for health professionals working to close the gap in health equality for Indigenous Australians

The critical role of preventive care and tackling the precursors of chronic disease is being boosted in the latest guide for health professionals working to close the gap in health equality for Indigenous Australians.

Minister for Indigenous Health, Ken Wyatt AM, today launched the updated third edition of the National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people.

“Prevention is always better than cure,” said Minister Wyatt. “Already one of the most widely used clinical guidelines in Australia, this new edition includes critical information on lung cancer, Foetal Alcohol Spectrum Disorder and preventing child and family abuse and violence.

“The National Guide maximises the opportunities at every clinic visit to prevent disease and to find it early.

“It will help increase vigilance over previously undiagnosed conditions, by promoting early intervention and by supporting broader social change to help individuals and families improve their wellbeing.”

The guide, which was first published in 2005, is a joint project between the National Aboriginal Community Controlled Health Organisation (NACCHO) and the Royal Australian College of General Practitioners RACGP).

“To give you some idea of the high regard in which it is held, the last edition was downloaded 645,000 times since its release in 2012,” said Minister Wyatt.

“The latest edition highlights the importance of individual, patient-centred care and has been developed to reflect local and regional needs.

“Integrating resources like the national guide across the whole health system plays a pivotal role in helping us meet our Closing the Gap targets.

“The Turnbull Government is committed to accelerating positive change and is investing in targeted activities that have delivered significant reductions in the burden of disease.

“Rates of heart disease, smoking and binge drinking are down. We are on track to achieve the child mortality target for 2018 and deaths associated with kidney and respiratory diseases have also reduced.”

The National Guide is funded under the Indigenous Australian’s Health Programme as part of a record $3.6 billion investment across four financial years.

The RACGP received $429,000 to review, update, publish and distribute the third edition, in hard copy and electronic formats.

The National Guide is available on the RACGP website or by contacting RACGP Aboriginal and Torres Strait Islander Health on 1800 000 251 or aboriginalhealth@racgp.org.au.