older Aboriginal man looking directly at camera with Aboriginal male youth in background - image from Diabetes Australia website

NACCHO Aboriginal Health News: First Nations People should not pay price for Australia’s economic recovery

First Nations people should not pay price for economic recovery

The Edmund Rice Centre today expressed serious concern at the disregard for the needs of First Nations Peoples and Refugees in the 2020–21 Federal Budget. “It has been said that the Federal Budget is statement on the nation’s priorities. Clearly if that is the case, judging by this Budget, First Nations Peoples, refugees and people seeking asylum – some of the most vulnerable people to the pandemic – are very low priorities for this Government”, Phil Glendenning, Director of the Edmund Rice Centre and President of the Refugee Council of Australia said. Two months ago the Prime Minister signed a new Closing the Gap Agreement committing Federal and State Governments to a long-term program to finally reduce the huge disparities in life expectancy, health, incarceration, education and employment between First Nations peoples and other Australians. “Prime Minister Morrison’s signing of the new Closing the Gap Agreement just two months ago was a welcome step, but in last night’s Budget the Government provided no resources to make it happen”, Mr Glendenning said. 

To view the Edmund Rice Centre media release click here.

Victorian Aboriginal Community Controlled Health Organisation (VACCHO) CEO, Jill Gallagher agreed, saying a lack of Federal Government support towards Closing the Gap targets was a major omission in a Budget that would provide some hip pocket relief and new jobs for young people but delivered “nothing of substance” for Victorian Aboriginal and Torres Strait Islander communities.

Ms Gallagher said Treasurer Josh Frydenberg mentioned Aboriginal and Torres Strait Islanders just once in his speech. She described the lack of money for new Closing the Gap measures as “dispiriting”. “There are a number of targets which all levels of Government have committed too but where is the investment?”, she asked.

To view the article about the VACCHO comments click here.

Funding to improve health of First Nations families

A program that is already showing unprecedented success in improving the health and employment outcomes of First Nations families has been awarded $2.5 million in funding through the National Health and Medical Research Council. Led by the team at Charles Darwin University’s Molly Wardaguga Research Centre at the College of Nursing and Midwifery, the project is focused on providing the Best Start to Life for First Nations women, babies and families and has been awarded a Centres of Research Excellence (CRE) grant. Co-director of the Molly Wardaguga Research Centre Associate Professor Yvette Roe said the funding would allow the centre to expand and build on a current program that had resulted in a 50% reduction in preterm birth and 600% increase in First Nations employment.

To read the full article click here.

Women and researchers during the Caring for Mum on Country project, Galiwinku, Northern Territory. (L-R)-Yvette Roe, Dhurruurawuy, wurrpa Maypilama, Sarah Ireland, Wagarr and Sue Kildea

Women and researchers during the Caring for Mum on Country project, Galiwinku, Northern Territory. (L-R)-Yvette Roe, Dhurruurawuy, wurrpa Maypilama, Sarah Ireland, Wagarr and Sue Kildea. Image source: Katherine Times.

Palawa man heads mainstream health peak body

The Australian Physiotherapy Association (APA) has announced the appointment of Palawa man Scott Willis as its 22nd national president, the first Indigenous president of a mainstream health peak body in Australia. Scott, who commences his two year term on 1 January 2021, said “Aboriginal and Torres Strait Islander peoples’ health remains a priority area for our profession. We’re going to ensure not only that we are a culturally safe, engaged profession by listening to, learning from and working with First Nations peoples, but we’re going to make physio a known, viable and aspirational professional choice for young Aboriginals coming through the education system. I want them to know they can and should aspire to strong and respected leadership roles in the community.”

To view the APA media release click here.

portrait photo of APA President Scott Willis

APA president-elect Scott Willis. Image source: Australian Physiotherapy Association.

Cashless Debit Card expansion opposed

The Aboriginal Peak Organisation of the Northern Territory (APO NT) have called on all members of parliament to strongly oppose the legislation that would make the Cashless Debit Card (CDC) permanent in the current trial sites and expand it to the NT and Cape York, despite there being no proof that compulsory income management works. APO NT spokesperson John Paterson said, “Support for the bill would directly contradict the recent National Agreement on Closing the Gap that was supported by all levels of government including the Commonwealth. It is not in keeping with the spirit of the agreement and its emphasis on Aboriginal and Torres Strait Islander self-determination.” Mr Paterson added, ”We did not ask for the card, yet 22,000 of us will be affected if the card is imposed on NT income recipients.”

To view the APO NT’s media release click here.

Aboriginal man under tree holding Cashless Debit Card to camera

Image source: Gove Online.

Restricting high-sugar food promotion helps diet

Restricting the promotion and merchandising of unhealthy foods and beverages leads to a reduction in their sales, presenting an opportunity to improve people’s diets, according to a randomised controlled trial of 20 stores in remote regions of Australia. Julie Brimblecombe, of Monash University, Australia, co-joint first author of the study, said: “Price promotions and marketing tactics, such as where products are placed on shelves, are frequently used to stimulate sales. Our novel study is the first to show that limiting these activities can also have an effect on sales, in particular, of unhealthy food and drinks. This strategy has important health implications and is an opportunity to improve diets and reduce associated non-communicable diseases. It also offers a way for supermarkets to position themselves as responsible retailers, which could potentially strengthen customers loyalty without damaging business performance.” 

To read the full article published in The Lancet click here.

hands of Aboriginal person pushing trolley or health foods in outback store

Image source: Adult Learning Australia website.

New research supports self-care

Federal Health Minister Greg Hunt is set to launch a new policy blueprint that calls for policy reform to improve population health and reduce health service demand through effective self-care. Released by the Mitchell Institute, the document notes a range of environmental, economic and social factors drive self-care capability. It says governments can play a major role in creating environments that either inhibit or enable self-care. The importance of self-care to good health has also been highlighted by COVID-19, according to the Mitchell Institute’s Professor of Health Policy, Rosemary Calder. “Now is the time for a systematic approach, led by a national agenda to enable shared responsibility between government organisations and health care professionals to tackle health inequity and support self-care for all Australians,” she says.

To view the full article click here.

man's hand holding baby's hand both cradled in woman's hand against blurred grass background

Image source: Emerging Minds, Australia website.

Funding for healthy ageing research

Professor Dawn Bessarab from the University of WA’s Centre for Aboriginal Medical and Dental Health and her team will lead the Centre for Research Excellence on the Good Spirit Good Life: Better health and wellbeing for older Aboriginal and Torres Strait Islander Australians. The first Centre for Research Excellence in Australia to explore Indigenous ageing, Professor Bessarab and her team were awarded $2.5 million in NHMRC funding. They will develop their research with and from the perspective of Aboriginal people, to better understand healthy ageing in older Aboriginal people and inform culturally secure and effective service provision.

To view the full article click here.

elderly Aboriginal woman in hospital bed looking up to nurse

Indigenous elder Mildred Numamurdirdi. Image source: The Guardian.

Cost of hygienic products linked to high disease rates

A Senate committee investigating the over-pricing of items in remote Aboriginal communities has heard from Melbourne University Indigenous Eye Health Institute’s senior engagement officer Karl Hampton, who said the price-gouging of items like soap and towels is a key factor to Indigenous youth holding “the heavy burden” of serious trachoma infections.

To view the full Global Citizen article click here.

supermarket shelves showing high cost of soap

Image source: The Guardian Australian edition.

Keeping our sector strong discussion

Indigenous Business Australia (IBA) is hosting a virtual forum from 12.00–1.00 pm (AEDT) Monday 12 October 2020 with the Minister for Indigenous Australians, The Hon Ken Wyatt, AM, MP, to discuss the changes made by Indigenous businesses adapting to survive and thrive in the current climate.

To find out more and register your attendance click here.

Spaces are limited for this opportunity so be sure to register today!

Learning from each other webinar series

The Sydney Institute for Psychoanalysis invites you to join them as they bring together First Nations’ thinkers with psychoanalysts and psychotherapists in a series of six webinars in the spirit of Two Way – working together and learning from each other.

All profits will go to CASSE’s Shields for Living, Tools for Life, a dual cultural and therapeutic program, based in the Alice Springs region for ‘at-risk’ youth, providing an alternative to detention and reducing the likelihood of offending or reoffending.

The Two-Way: Learning from each other webinar series will stream 8.00–9.30 pm AEST each Tuesday from 13 October to 17 November 2020.

Click here for the webinar program and registration.

Queenie McKenzie Dreaming Place - Gija country 1995

Queenie McKenzie, Dreaming Place – Gija Country, 1995.
Image source: Australian Psychoanalytical Society,

Range of health scholarships available

The following scholarship programs, aimed at increasing Aboriginal and Torres Strait lslander participation in the health workforce and improving access to culturally appropriate health services, are seeking applications.

Indigenous Health Scholarships – Australian Rotary Health administer these scholarships on behalf of the Department of Health, providing a one off grant of $5,000 to assist students with their day to day expenses and provide mentoring support while they undertake a course in a wide range of health related professions. For further information click here.

Nursing Scholarships – the Australian College of Nursing are currently offering nursing scholarship opportunities for study in 2021 with undergraduate and postgraduate scholarships of up to $15,000 per year of full time study being available for eligible courses. Further information is available here. Applications close from 25 October 2020.

Puggy Hunter Memorial Scholarship Scheme – provides financial assistance to Aboriginal and Torres Strait Islander undergraduate students for entry level studies that lead or are a direct pathway to registration or practice as a health professional.  Further information is available here. Applications close on 8 November 2020 for studies in 2021.

portrait of Indigenous Health Scholarship 2020 recipient Marlee Paterson, UNSW, Doctor of Medicine.

Indigenous Health Scholarship 2020 recipient Marlee Paterson, UNSW, Doctor of Medicine. Image source: Australian Rotary Health website.

NSW – Taree – Biripi Aboriginal Corporation Medical Centre

Aboriginal Health Worker – Drug & Alcohol/Sexual Health – Identified x 2 (male and female)

Human Resources Officer x 1

Maintenance Officer x 1

Biripi Aboriginal Corporation Medical Centre (Biripi ACMC), a community controlled health service providing a wide range of culturally appropriate health and well-being services covering communities across the Mid-Northern NSW Region, is looking to fill a number of vacant positions.

To view the job descriptions for each position click on the name of the position above.

Applications for all positions close 5.00 pm Sunday 18 October 2020.Biripi Aboriginal Corporation Medical Centre logo silhouette of two black hand overlapping inside yellow circle inside border top half black, bottom half red with words Our Health In Our Hands

VIC – Shepparton – Rumbalara Aboriginal Co-operative Ltd.

PT Case Manager (Re-advertised)

FT Cradle to Kinder Worker

FT Family Preservation Worker 

Kinship Care Case Management

FT Practice Manager

Rumbalara Aboriginal Co-operative Ltd. has a number of vacancies within its Health & Wellbeing, Engagement & Family and Positive Ageing & Disability services areas.

Applications for the Case Manager position close 4.00 pm Tuesday 13 October 2020.

Applications for the Cradle to Kinder Worker, Family Preservation Worker and Kinship Care Case Manager positions close 4.00 pm Wednesday 14 October 2020.

Applications for the Practice Manager position close 4.00 pm Friday 23 October 2020.

NSW – Sydney – The George Institute for Global Health

FT Research Associate (project Manager)

The George Institute for Global Health has a very exciting opportunity for a Research Associate (project Manager) to join its ‘Safe Pathways’ team that will work in partnership with families to focus on developing a discharge planning and delivery model of care that will: address institutionalised racism; facilitate access to ongoing specialist burn care; and enhance communication, coordination and care integration between families, local primary health services and the burns service at Westmead. 

The George Institute’s Aboriginal and Torres Strait Islander Health Program cuts across content areas and is conducted within Aboriginal and Torres Strait Islander ways of knowing, being and doing, with a focus on social determinants of health, health systems and healthcare delivery, and maintains an Aboriginal and Torres Strait Islander paradigm of health and healing (physical, emotional, social, cultural and spiritual) and a commitment to making impact through translation that influences policy.

For further details about the position click here. Applications close on 30 October 2020 or sooner if a suitable candidate is found.The George Institute for Global Health banner, words and purple tick with dot in shape of flame

World Evidence-Based Healthcare Day

World Evidence-Based Healthcare Day is a global initiative that raises awareness of the need for better evidence to inform healthcare policy, practice and decision making in order to improve health outcomes globally. It is an opportunity to participate in a debate about global trends and challenges, but also to celebrate the impact of individuals and organisations worldwide, recognising the work of dedicated researchers, policymakers and health professionals in improving health outcomes. World Evidence-Based Health Day is on Tuesday 20 October 2020 and has the 2020 theme is ‘Evidence to Impact’. For further information click here.logo with words World Evidinece-Based Healthcare Day 2020 ebhc 20 October 2020 light blue & navy

White Ribbon Day

Together, we really can end men’s violence against women in our communities and in our workplaces. But it starts with us turning awareness into sustained, collaborative action and it needs to start now. This year White Ribbon Day is on Friday 20 November. White Ribbon Australia are asking you to hold an event – online or as a group (following local COVID-safe guidelines) – to bring your community together as a catalyst for ongoing action. Download a Community Action Kit here to access ideas and resources to bring your community together on White Ribbon Day, get involved on social media, and to kick-start a Community Action Group that will continue to create impact long after the event is over.White Ribbon Australia banner - black bacground words White Ribbon Australia & white ribbon icon

NACCHO Aboriginal Health News: First Nations peoples’ COVID-19 response among the best in the world

feature tile First First Nations peoples' response among best in the world & image of Aboriginal man wearing face mask with Aboriginal flag

First Nations Peoples’ COVID-19 response among best

In a recent interview, Australia’s most respected paediatric epidemiologist, Professor Fiona Stanley, said that although Aboriginal and Torres Strait Islander people are the highest-risk people in our community, they have done exceptionally well in response to the COVID-19 pandemic. According to Professor Stanley this is because “Indigenous people took control. They lobbied the government to close remote communities, get personal protective equipment and get tested. They took their vulnerable, old Indigenous people off the streets and put them in good housing. They’re doing better than almost any population worldwide.”

To read a transcript of the full interview click here.

image of Aboriginal man wearing face mask with Aboriginal flag

Image source: NITV website.

First permanent LOV eye clinic in Kimberley

$4.7 million has been allocated towards the first permanent Lions Outback Vision (LOV) eye clinic in the Kimberley. This clinic, to be located in Broome, with outreach services to Derby, Fitzroy Crossing, Halls Creek, Kununurra, Wyndham and Warmun, will enable residents across the Kimberley to receive treatment and prevention services for serious eye diseases on country and close to home.

To read the related media release click here.

Lions Outback Image bus with door open & health professional checking someone's eyes

Image source: National Rural Health Alliance.

Aquarobics classes get results

row of Aboriginal women in a pool holding on to the side

Image source: Great Lakes Advocate.

Six month extension for COVID-19 health measures

Millions of Australians will continue to receive medical care and support in their own homes with the Commonwealth Government investing more than $2 billion to extend a range of COVID-19 health measures for a further six months, to 31 March 2021. Medicare-subsidised telehealth and pathology services, GP-led respiratory clinics, home medicines delivery, public and private hospital services will all be extended, as well as further investments in PPE. These health initiatives play a major role in detecting, preventing and treating COVID-19.

To view the media release regarding this funding click here.

health worker in mask, covid cell image superimposed

Image source: Hospital Management.

COVID-19 double standard for the Barkly

Anyinginyi Health Service has expressed concern and frustration at the granting of an exemption from compulsory supervised quarantine for workers from Melbourne brought to Tennant Creek to work outside the town. Anyinginyi General Manager, Barb Shaw, said “This breaches the NT Government’s own policy to not allow exemptions from compulsory quarantine for people coming from a hot spot” and “the government must urgently explain its decision and immediately work with the Aboriginal community, including Anyinginyi Health Service, to ensure the safety of our community”.

To view the Anyinginyi Health Service’s media release click here and click here to view a supporting media release from the Aboriginal Medical Services Alliance NT.text quote from Pat Turner 'I can't be any blunter...if COVID-19 gets into our communities, we are gone

WA grants for projects with COVID-19 focus

The first program to be funded under WA’s Future Health Research and Innovation (FHRI) Fund is now open and calling for projects with a COVID-19 focus. The FHRI Focus Grants: COVID-19 Program will initially provide up to $4 million for research and innovation that helps promote the health and wellbeing of Western Australians. The program is designed to fund research and innovation that addresses health and wellbeing challenges relevant to the COVID emergency. This could include projects related to infection prevention and control, surveillance, diagnostics and therapeutics as well as the direct or indirect impact of COVID-19 across a range of health conditions. Grants will be made available across three streams of funding – research, innovation and infrastructure.

To view the related media release click here.

COVID-109 virus cell

Image source: Medical Xpress.

Gynaecological cancer award nominations open

The rate of gynaecological cancers among Aboriginal and Torres Strait Islander women is shocking. In the case of cervical cancer for example Aboriginal and Torres Strait Islander women are 2.5 times more likely to be diagnosed with, and 3.8 times more likely to die than non-Indigenous women.

Do you know someone who has made an exceptional contribution to improving the outcomes for women affected by gynaecological cancers?

You have only one week left to make a nomination for the 2021 Jeannie Ferris Cancer Australia Recognition Award.

Applications close at 5.00 pm (AEST) Wednesday 30 September 2020.

To view further details about the award and how to nominate someone click here.

Waminda senior regional manager Krissy Falzon at desk looking at her computer

Krissy Falzon, South Coast Womens Health & Welfare Aboriginal Corporation. Image source: South Coast Register.

Simon Says Ear Health Volume 2

Volume two of AHCWA’s Simon Says series has been released. The latest resources allow you to read along with Simon and his friends to learn about the flu and how you can keep yourself and your community safe. Physical copies are  available and you are welcome to print copies as you need them.

To view volume two of the Simon Says series click here.

cartoon of Aboriginal man with family standing behind him punching giant green flu virus

Image source: AHCWA Simon Says Volume 2.

Mental health wellbeing trial using horses

A group of Broome-based Indigenous health workers are helping develop a mental wellbeing trial that uses horses to help people to express themselves openly. Known as Yawardani Jan-ga — or horses helping — the trial capitalises on the ties between Aboriginal people and horses and rodeo culture in the Kimberley to enhance the social and emotional wellbeing of youngsters while building leadership skills. It is an adapted form of the global Equine Assisted Learning model, which uses horses to build emotional skills and personal development, and will be rolled out in the region.

To read The West Australian article about the trial click here.

young Aboriginal girl on horse & Aboriginal man trainer

Image source: ABC News.

medical professional with PPE - head covering, mask & rubber gloves

NACCHO Aboriginal News Alert: Healthcare worker PPE too little too late

Healthcare worker PPE too little too late

The AMA has demanded revised guidelines on personal protective equipment (PPE) for healthcare workers, following revelations that more than 2,500 Victorian healthcare workers have contracted COVID-19. More than two-thirds of the second wave infections of healthcare workers in Victoria have been confirmed to have happened in the workplace.

To view the AMA’s media release click here.

Updated RACS Indigenous Health position paper

The Royal Australasian College of Surgeons’ (RACS) has released an updated Indigenous Health position paper outlining its commitment to addressing health inequities of Indigenous communities in Australia and NZ.

To review the position paper click here.

two medical staff in scrubs in theatre

Image source: Newcastle Herald.

Framework to guide health professional practice

Working effectively with Aboriginal and Torres Strait Islander people is important in maximising the effectiveness of health care interaction between Aboriginal and Torres Strait Islander patients and health professionals. BioMed Central (BMC) Health Services Research has published a paper outlining a framework to guide health professional practice in Aboriginal and Torres Strait Islander health.

To view the research article click here.

Image of ophthalmologist with Aboriginal patient lying on medical bed under eye equipment

Image source: Fred Hollows Foundation website.

Self-harm spike across Kimberley

Researchers and medical services in the Kimberley say they are “concerned but not surprised” at the findings of a new University of WA report A profile of suicide and self-harm in the Kimberley, outlining the still disproportionately high suicide and self-harm rates in the region compared to the rest of WA and Australia. The report recommends a thorough redesign of health services in the Kimberley and the need to ensure adequate resourcing to ensure better care is provided.

To view the full ABC News article click here.

image of multiple white crosses marking graves in red dusty country

Image source: ABC News.

Indigenous LGBQTI+SB suicide prevention introduction

Indigenous LGBQTI+SB people deal with additional societal challenges, ones that can regularly intersect, contributing to the heightened development of depression, anxiety, alcohol and drug problems, and risk of suicide and suicidal behaviour. To coincide with World Suicide Prevention Day activities globally on Thursday 10 September 2020, Dameyon Bonson, an Indigenous gay male, recognised as an Indigenous suicide prevention subject matter expert, specifically in Indigenous LGBQTI+SB suicide, will be presenting an on-line introduction to Aboriginal and Torres Strait Islander LGBQTI+SB suicide prevention.

To register for this event click here.Dameyon Bonson banner for on-line Indigenous LGBTIQ+SB suicide prevention course & photo of Dameyon Bonson

SNAICC COVID-19 resources for children

The Secretariat of National Aboriginal and Islander Child Care (SNAICC) has developed a number of resources to help Aboriginal and Torres Strait Islander people develop a better understanding of COVID-19 and help children, carers and families get through this difficult time.

For details of the SNAICC COVID-19 resources click here.

young Aboriginal boy

Image source: Health Times.

2020 smoking in pregnancy roudtable summary

An alarming 46% of Indigenous women smoke during pregnancy, 3.6 times the non-Indigenous rate. Serious effects from smoking in pregnancy include obstetric and per-natal complications, heart disease, obesity, diabetes, and behavioural and learning problems in children. Maternal tobacco smoking is the most important preventable risk factor for chronic lung disease in offspring. Babies born to smokers are twice as likely to have low birth weight compared to those born to non-smoking mothers, but if the mother quits smoking early in pregnancy the low birth weight risk decreases to non-smoking levels.

The Australian Government Department of Health convened a Smoking and Pregnancy Roundtable discussion in February 2020, chaired by Professor Tom Calma AO. The summary report of the roundtable presentations and discussions, including videos of the presentations, can be found here.

belly of pregnant Aboriginal women breaking a cigarette in half

Image source: Coffs Coast Advocate.

Canberra – ACT

ACT Ministerial Advisory Council on Women – Council Member

The ACT Ministerial Advisory Council on Women (MACW) has opened up nominations for the next MACW term, 2021–22.

Members of the Council meet bi-monthly and raise and debate issues which matter most to women and girls in Canberra, as well as advocate for the advancement of women and the opportunities available to them, with the Council then providing strategic advice to the ACT Government as an independent voice.

The ACT MACW are hoping for a diverse range of women to be on the Council and would welcome applications from Aboriginal and Torres Strait Islander women.

For further information click here.

silhouette of 10 women holding hands at sunset

Image source: ANU website.

National Stroke Week – 31 August – 6 September 2020

National Stroke Week Become a F.A.S.T. Hero poster - image of man standing against a wooden fence, hand on hip, looking skywards like a hero

Image source: Stroke Foundation website.

World Suicide Prevention Day Thursday 10 September 2020World Suicide Prevention Day & orange & yellow ribbon cross over point hands

NACCHO Aboriginal Health Resources Alert : NACCHO and @RACGP are pleased to launch the Aboriginal and Torres Strait Islander #715health assessment templates.

With support from the Department of Health, NACCHO and RACGP established a working group in 2019 to review and update Aboriginal and Torres Strait Islander annual health check templates.

Throughout 2020 we will be testing these templates for operability in a range of services.

We are keen to hear your feedback and will be conducting a survey later in the year.

A key recommendation was to update elements to better reflect age-appropriate health needs. This resulted in five new templates that span the life course:

  1. Infants and preschool (birth-5 years)  PDF  RTF
  2. Primary school age (5-12 years) PDF  RTF
  3. Adolescents and young people (12-24 years) PDF  RTF
  4. Adults (25-49 years) PDF  RTF
  5. Older people (50+ years) PDF  RTF

These are example health check templates that include recommended core elements.

The criteria for inclusion can be accessed in our template development information pack.

Adaptation of these templates to local needs and priorities is encouraged, with reference to current Australian preventive health guidelines that are culturally and clinically suitable to Aboriginal and Torres Strait Islander needs.

These templates are not intended to promote a tick box approach to healthcare, but rather to prompt clinicians to consider patient priorities, opportunities for preventive healthcare and common health needs.

As the Partnership Project continues, we are exploring opportunities for integration of health check activities into clinical software.

We are also interested to hear about your experiences of providing health checks via telehealth.

Contact aboriginalhealth@racgp.org.au to understand more or contribute your ideas and experiences.

Understand the purpose of the health check is to:

  • support initial and ongoing engagement in comprehensive primary healthcare in a culturally safe way
  • provide evidence-based health information, risk assessment and other services for primary and secondary disease prevention
  • identify health needs, including patient health goals and priorities
  • support participation in population health programs (eg immunisation, cancer screening), chronic disease management and other primary care services (eg oral health )

Know that a high-quality health check is:

  • a positive experience for the patient that is respectful and culturally safe
  • provided with a patient, not to a patient
  • useful to the patient and includes patient priorities and goals in health assessment and planning
  • supports patient agency
  • provided by the usual healthcare provider in the context of established relationship and trust
  • provided by a multidisciplinary team that includes Aboriginal and/or Torres Strait Islander clinicians
  • evidence-based as per current Australian preventive health guidelines that are generally accepted in primary care practice (eg National Aboriginal Community Controlled Health Organisation [NACCHO]–Royal Australian College of General Practitioners [RACGP] National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people, Central Australian Rural Practitioner’s Association [CARPA] Standard Treatment Manual, etc)
  • provided with enough time (usually 30–60 minutes, with a minimum of 15 minutes with the GP) and often completed over several consultations
  • followed up with care of identified health needs (ie continuity of care).

Make sure your practice is providing health checks that are acceptable and valuable to patients by:

  • identifying Aboriginal and Torres Strait Islander patients in a welcoming, hospitable manner
  • explaining the purpose and process of the health check and obtaining consent
  • enquiring about patient priorities and goals
  • adapting the health check content to what is relevant and appropriate to the patient
  • asking questions in ways that acknowledge strengths, that are sensitive to individual circumstances and that avoid cultural stereotyping
  • completing the health check and identifying health needs
  • making a plan for follow-up of identified health needs in partnership with the patient
  • making follow-up appointments at the time of the health check, where possible
  • considering checking in with the patient about their experience of the health check, in order to support patient engagement and quality

Potential pitfalls of health checks:

  • A poor health check can lead to non- or dis-engagement in healthcare and has the potential to do harm – establish engagement and trust
  • Health checks can have highly variable content and quality
  • use endorsed high-quality templates
  • Increasing the number of health checks without a focus on quality may undermine benefit for patients – avoid quantity over quality
  • Health checks are not proxy for all preventive healthcare – they are one activity in the range of health promotion and disease-prevention activities in primary care
  • No follow-up will have no or minimal impact on improving health outcomes – follow up identified health needs
  • Cultural stereotyping – acknowledge the health impacts of racism and build a culturally safe practice

 

NACCHO Aboriginal Health Research Alert : @HealthInfoNet releases Summary of Aboriginal and Torres Strait Islander health status 2019 social and cultural determinants, chronic conditions, health behaviours, environmental health , alcohol and other drugs

The Australian Indigenous HealthInfoNet has released the Summary of Aboriginal and Torres Strait Islander health status 2019

This new plain language publication provides information for a wider (non-academic) audience and incorporates many visual elements.

The Summary is useful for health workers and those studying in the field as a quick source of general information. It provides key information regarding the health status of Aboriginal and Torres Strait Islander people across the following topics:

  • social and cultural determinants
  • chronic conditions
  • health behaviours
  • environmental health
  • alcohol and other drugs.

The Summary is based on HealthInfoNet‘s comprehensive publication Overview of Aboriginal and Torres Strait Islander health status 2019. It presents statistical information from the Overview in a visual format that is quick and easy for users to digest.

The Summary is available online and in hardcopy format. Please contact HealthInfoNet by email if you wish to order a hardcopy of this Summary. Other reviews and plain language summaries are available here.

Here are the key facts

Please note in an earlier version sent out 7.00 am June 15 a computer error dropped off the last word in many sentences : these are new fixed 

Key facts

Population

  • In 2019, the estimated Australian Aboriginal and Torres Strait Islander population was 847,190.
  • In 2019, NSW had the highest number of Aboriginal and Torres Strait Islander people (the estimated population was 281,107 people, 33% of the total Aboriginal and Torres Strait Islander population).
  • In 2019, NT had the highest proportion of Aboriginal and Torres Strait Islander people in its population, with 32% of the NT population identifying as Aboriginal and/or Torres Strait Islanders
  • In 2016, around 37% of Aboriginal and Torres Strait Islander people lived in major cities
  • The Aboriginal and Torres Strait Islander population is much younger than the non-Indigenous population.

Births and pregnancy outcomes

  • In 2018, there were 21,928 births registered in Australia with one or both parents identified as Aboriginal and/or Torres Strait Islander (7% of all births registered).
  • In 2018, the median age for Aboriginal and Torres Strait Islander mothers was 26.0 years.
  • In 2018, total fertility rates were 2,371 births per 1,000 for Aboriginal and Torres Strait Islander women.
  • In 2017, the average birthweight of babies born to Aboriginal and Torres Strait Islander mothers was 3,202 grams
  • The proportion of low birthweight babies born to Aboriginal and Torres Strait Islander mothers between 2007 and 2017 remained steady at around 13%.

Mortality

  • For 2018, the age-standardised death rate for Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT was 1 per 1,000.
  • Between 1998 and 2015, there was a 15% reduction in the death rates for Aboriginal and Torres Strait Islander people in NSW, Qld, WA, SA and the NT.
  • For Aboriginal and Torres Strait Islander people born 2015-2017, life expectancy was estimated to be 6 years for males and 75.6 years for females, around 8-9 years less than the estimates for non-Indigenous males and females.
  • In 2018, the median age at death for Aboriginal and Torres Strait Islander people in NSW, Qld, WA, SA and the NT was 2 years; this was an increase from 55.8 years in 2008.
  • Between 1998 and 2015, the Aboriginal and Torres Strait Islander infant mortality rate has more than halved (from 5 to 6.3 per 1,000).
  • In 2018, the leading causes of death among Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT were ischaemic heart disease (IHD), diabetes, chronic lower respiratory diseases and lung and related cancers.
  • For 2012-2017 the maternal mortality ratio for Aboriginal and Torres Strait Islander women was 27 deaths per 100,000 women who gave birth.
  • For 1998-2015, in NSW, Qld, WA, SA and the NT there was a 32% decline in the death rate from avoidable causes for Aboriginal and Torres Strait Islander people aged 0-74 years

Hospitalisation

  • In 2017-18, 9% of all hospital separations were for Aboriginal and Torres Strait Islander people.
  • In 2017-18, the age-adjusted separation rate for Aboriginal and Torres Strait Islander people was 2.6 times higher than for non-Indigenous people.
  • In 2017-18, the main cause of hospitalisation for Aboriginal and Torres Strait Islander people was for ‘factors influencing health status and contact with health services’ (mostly for care involving dialysis), responsible for 49% of all Aboriginal and Torres Strait Islander seperations.
  • In 2017-18, the age-standardised rate of overall potentially preventable hospitalisations for Aboriginal and Torres Strait Islander people was 80 per 1,000 (38 per 1,000 for chronic conditions and 13 per 1,000 for vaccine-preventable conditions).

Selected health conditions

Cardiovascular health

  • In 2018-19, around 15% of Aboriginal and Torres Strait Islander people reported having cardiovascular disease (CVD).
  • In 2018-19, nearly one quarter (23%) of Aboriginal and Torres Strait Islander adults were found to have high blood pressure.
  • For 2013-2017, in Qld, WA, SA and the NT combined, there were 1,043 new rheumatic heart disease diagnoses among Aboriginal and Torres Strait Islander people, a crude rate of 50 per 100,000.
  • In 2017-18, there 14,945 hospital separations for CVD among Aboriginal and Torres Strait Islander people, representing 5.4% of all Aboriginal and Torres Strait Islander hospital separations (excluding dialysis).
  • In 2018, ischaemic heart disease (IHD) was the leading specific cause of death of Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT

Cancer

  • In 2018-19, 1% of Aboriginal and Torres Strait Islander people reported having cancer (males 1.2%, females 1.1%).
  • For 2010-2014, the most common cancers diagnosed among Aboriginal and Torres Strait Islander people living in NSW, Vic, Qld, WA and the NT were lung cancer and breast (females) cancer.
  • Survival rates indicate that of the Aboriginal and Torres Strait Islander people living in NSW, Vic, Qld, WA, and the NT who were diagnosed with cancer between 2007 and 2014, 50% had a chance of surviving five years after diagnosis
  • In 2016-17, there 8,447 hospital separations for neoplasms2 among Aboriginal and Torres Strait Islander people
  • For 2013-2017, the age-standardised mortality rate due to cancer of any type was 238 per 100,000, an increase of 5% when compared with a rate of 227 per 100,000 in 2010-2014.

Diabetes

  • In 2018-19, 8% of Aboriginal people and 7.9% of Torres Strait Islander people reported having diabetes.
  • In 2015-16, there were around 2,300 hospitalisations with a principal diagnosis of type 2 diabetes among Aboriginal and Torres Strait Islander people
  • In 2018, diabetes was the second leading cause of death for Aboriginal and Torres Strait Islander people.
  • The death rate for diabetes decreased by 0% between 2009-2013 and 2014-2018.
  • Some data sources use term ‘neoplasm’ to describe conditions associated with abnormal growth of new tissue, commonly referred to as a Neoplasms can be benign (not cancerous) or malignant (cancerous) [1].

Social and emotional wellbeing

  • In 2018-19, 31% of Aboriginal and 23% of Torres Strait Islander respondents aged 18 years and over reported high or very high levels of psychological distress
  • In 2014-15, 68% of Aboriginal and Torres Strait Islander people aged 15 years and over and 67% of children aged 4-14 years experienced at least one significant stressor in the previous 12 months
  • In 2012-13, 91% of Aboriginal and Torres Strait Islander people reported on feelings of calmness and peacefulness, happiness, fullness of life and energy either some, most, or all of the time.
  • In 2014-15, more than half of Aboriginal and Torres Strait Islander people aged 15 years and over reported an overall life satisfaction rating of at least 8 out of 10.
  • In 2018-19, 25% of Aboriginal and 17% of Torres Strait Islander people, aged two years and over, reported having a mental and/or behavioural conditions
  • In 2018-19, anxiety was the most common mental or behavioural condition reported (17%), followed by depression (13%).
  • In 2017-18, there were 21,940 hospital separations with a principal diagnosis of International Classification of Diseases (ICD) ‘mental and behavioural disorders’ identified as Aboriginal and/or Torres Strait Islander
  • In 2018, 169 (129 males and 40 females) Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA, and the NT died from intentional self-harm (suicide).
  • Between 2009-2013 and 2014-2018, the NT was the only jurisdiction to record a decrease in intentional self-harm (suicide) death rates.

Kidney health

  • In 2018-19, 8% of Aboriginal and Torres Strait Islander people (Aboriginal people 1.9%; Torres Strait Islander people 0.4%) reported kidney disease as a long-term health condition.
  • For 2014-2018, after age-adjustment, the notification rate of end-stage renal disease was 3 times higher for Aboriginal and Torres Strait Islander people than for non-Indigenous people.
  • In 2017-18, ‘care involving dialysis’ was the most common reason for hospitalisation among Aboriginal and Torres Strait Islander people.
  • In 2018, 310 Aboriginal and Torres Strait Islander people commenced dialysis and 49 were the recipients of new kidneys.
  • For 2013-2017, the age-adjusted death rate from kidney disease was 21 per 100,000 (NT: 47 per 100,000; WA: 38 per 100,000) for Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and NT
  • In 2018, the most common causes of death among the 217 Aboriginal and Torres Strait Islander people who were receiving dialysis was CVD (64 deaths) and withdrawal from treatment (51 deaths).

Injury, including family violence

  • In 2012-13, 5% of Aboriginal and Torres Strait Islander people reported having a long-term condition caused by injury.
  • In 2018-19, 16% of Aboriginal and Torres Strait Islander people aged 15 years and over had experienced physical harm or threatened physical harm at least once in the last 12 months.
  • In 2016-17, the rate of Aboriginal and Torres Strait Islander hospitalised injury was higher for males (44 per 1,000) than females (39 per 1,000).
  • In 2017-18, 20% of injury-related hospitalisations among Aboriginal and Torres Strait Islander people were for assault.
  • In 2018, intentional self-harm was the leading specific cause of injury deaths for NSW, Qld, SA, WA, and NT (5.3% of all Aboriginal and Torres Strait Islander deaths).

Respiratory health

  • In 2018-19, 29% of Aboriginal and Torres Strait Islander people reported having a long-term respiratory condition .
  • In 2018-19, 16% of Aboriginal and Torres Strait Islander people reported having asthma.
  • In 2014-15, crude hospitalisation rates were highest for Aboriginal and Torres Strait Islander people presenting with influenza and pneumonia (7.4 per 1,000), followed by COPD (5.3 per 1,000), acute upper respiratory infections (3.8 per 1,000) and asthma (2.9 per 1,000).
  • In 2018, chronic lower respiratory disease was the third highest cause of death overall for Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT

Eye health

  • In 2018-19, eye and sight problems were reported by 38% of Aboriginal people and 40% of Torres Strait Islander people.
  • In 2018-19, eye and sight problems were reported by 32% of Aboriginal and Torres Strait Islander males and by 43% of females.
  • In 2018-19, the most common eye conditions reported by Aboriginal and Torres Strait Islanders were hyperopia (long sightedness: 22%), myopia (short sightedness: 16%), other diseases of the eye and adnexa (8.7%), cataract (1.4%), blindness (0.9%) and glaucoma (0.5%).
  • In 2014-15, 13% of Aboriginal and Torres Strait Islander children, aged 4-14 years, were reported to have eye or sight problems.
  • In 2018, 144 cases of trachoma were detected among Aboriginal and Torres Strait Islander children living in at-risk communities in Qld, WA, SA and the NT
  • For 2015-17, 62% of hospitalisations for diseases of the eye (8,274) among Aboriginal and Torres Strait Islander people were for disorders of the lens (5,092) (mainly cataracts).

Ear health and hearing

  • In 2018-19, 14% of Aboriginal and Torres Strait Islander people reported having a long-term ear and/or hearing problem
  • In 2018-19, among Aboriginal and Torres Strait Islander children aged 0-14 years, the prevalence of otitis media (OM) was 6% and of partial or complete deafness was 3.8%.
  • In 2017-18, the age-adjusted hospitalisation rate for ear conditions for Aboriginal and Torres Strait Islander people was 1 per 1,000 population.

Oral health

  • In 2014-15, the proportion of Aboriginal and Torres Strait Islander children aged 4-14 years with reported tooth or gum problems was 34%, a decrease from 39% in 2008.
  • In 2012-2014, 61% of Aboriginal and Torres Strait Islander children aged 5-10 years had experienced tooth decay in their baby teeth, and 36% of Aboriginal and Torres Strait Islander children aged 6-14 years had experienced tooth decay in their permanent teeth.
  • In 2016-17, there were 3,418 potentially preventable hospitalisations for dental conditions for Aboriginal and Torres Strait Islander The age-standardised rate of hospitalisation was 4.6 per 1,000.

Disability

  • In 2018-19, 27% of Aboriginal and 24% of Torres Strait Islander people reported having a disability or restrictive long-term health
  • In 2018-19, 2% of Aboriginal and 8.3% of Torres Strait Islander people reported a profound or severe core activity limitation.
  • In 2016, 7% of Aboriginal and Torres Strait Islander people with a profound or severe disability reported a need for assistance.
  • In 2017-18, 9% of disability service users were Aboriginal and Torres Strait Islander people, with most aged under 50 years (82%).
  • In 2017-18, the primary disability groups accessing services were Aboriginal and Torres Strait Islander people with a psychiatric condition (24%), intellectual disability (23%) and physical disability (20%).
  • In 2017-18, 2,524 Aboriginal and Torres Strait Islander National Disability Agreement service users transitioned to the National Disability Insurance Scheme.

Communicable diseases

  • In 2017, there were 7,015 notifications for chlamydia for Aboriginal and Torres Strait Islander people, accounting for 7% of the notifications in Australia
  • During 2013-2017, there was a 9% and 9.8% decline in chlamydia notification rates among males and females (respectively).
  • In 2017, there were 4,119 gonorrhoea notifications for Aboriginal and Torres Strait Islander people, accounting for 15% of the notifications in Australia.
  • In 2017, there were 779 syphilis notifications for Aboriginal and Torres Strait Islander people accounting for 18% of the notifications in Australia.
  • In 2017, Qld (45%) and the NT (35%) accounted for 80% of the syphilis notifications from all jurisdictions.
  • In 2018, there were 34 cases of newly diagnosed human immunodeficiency virus (HIV) infection among Aboriginal and Torres Strait Islander people in Australia .
  • In 2017, there were 1,201 Aboriginal and Torres Strait Islander people diagnosed with hepatitis C (HCV) in Australia
  • In 2017, there were 151 Aboriginal and Torres Strait Islander people diagnosed with hepatitis B (HBV) in Australia
  • For 2013-2017 there was a 37% decline in the HBV notification rates for Aboriginal and Torres Strait Islander people.
  • For 2011-2015, 1,152 (14%) of the 8,316 cases of invasive pneumococcal disease (IPD) were identified as Aboriginal and Torres Strait people .
  • For 2011-2015, there were 26 deaths attributed to IPD with 11 of the 26 deaths (42%) in the 50 years and over age-group.
  • For 2011-2015, 101 (10%) of the 966 notified cases of meningococcal disease were identified as Aboriginal and Torres Strait Islander people
  • For 2006-2015, the incidence rate of meningococcal serogroup B was 8 per 100,000, with the age- specific rate highest in infants less than 12 months of age (33 per 100,000).
  • In 2015, of the 1,255 notifications of TB in Australia, 27 (2.2%) were identified as Aboriginal and seven (0.6%) as Torres Strait Islander people
  • For 2011-2015, there were 16 Aboriginal and Torres Strait Islander people diagnosed with invasive Haemophilus influenzae type b (Hib) in Australia
  • Between 2007-2010 and 2011-2015 notification rates for Hib decreased by around 67%.
  • In 2018-19, the proportion of Aboriginal and Torres Strait Islander people reporting a disease of the skin and subcutaneous tissue was 2% (males 2.4% and females 4.0%).

NACCHO Aboriginal Women and Children Health #MothersDay #IndigenousMums Aboriginal mothers are living with the fear their children could be taken. @HealingOurWay @DjirraVIC @JustinCCYP

“The fear these mothers, sisters, grandmothers and aunties have is justified and stems from lived experience and real situations.

There are real accounts of children being removed and often never being able to reconnect again. There is an acceptance this is not right. We need to see Aboriginal children reunified with their families.

As a white family you won’t have this feeling, as you parent, that a department could come and be involved in raising or even removing your children.

Institutional racism was part of the reason why so many Aboriginal children were still removed from their parents in Australia.

The view and past policies of Aboriginal people in Australia has been through the lens of white Australia, who see Aboriginal people as dysfunctional.

So the policies developed are saying we need to protect Aboriginal people from themselves.

Institutional racism has to be addressed to change a racist process of class and value … or lack of value.”

The Victorian Commissioner for Aboriginal Children and Young People, Justin Mohamed ( and former NACCHO Chair ) , said the over-representation of Aboriginal children in out-of-home care was an Australia-wide situation.

Originally published HERE

Link to community healing 

Key points:

  • Indigenous children are 10 times more likely to be removed from their families than other children
  • Victorian Commissioner for Aboriginal Children and Young People says institutional racism is part of the problem
  • A support service for Aboriginal families says women have a justified fear of the system

The Victorian Government announced a $10 million redress scheme for Stolen Generations survivors recently.

But many in the Australian Indigenous community say children are still being taken.

“I’d just given birth, my daughter was two hours old and we were in hospital when I received a call,” Gunditjmara and Yuin Nation mother Yaraan Bundle said.

“It’s extremely traumatic, at such a sacred time where you should be protected and nurtured, to experience the department coming and trying to remove your family.”

The department referred to is the Victorian Department of Health and Human Services (DHHS). It acknowledges that Aboriginal children are over-represented in out-of-home care.

National research shows Indigenous children are 10 times more likely to be removed from their families than other Australian children, and they make up 36 per cent of children living away from their parents in Australia.

Ms Bundle’s daughter remains with her, but so does the fear, anger, and frustration.

“I feel an intense fire deep within me, like a lioness protecting her babies. I always thought hospitals were the safest place for us to give birth, but now I understand they are not.”

Many women, same concerns

Indigenous mother Carla (not her real name) is eight months pregnant.

“Absolutely they’ll try and take my baby from me,” she said.

Carla has had children removed from her care with her children separated in different out-of-home care situations.

“I’ve got my own housing, I’ve done parenting courses, I’ve done everything they’ve said, as well as try and cope without my children, which is a struggle every day,” she said.

“This has put a big hole in my life. You can never heal that pain, and this has been happening to our people for generations.”

A Facebook post by an anonymous source complaining about a baby being taken from hospital.(Facebook)

Aunty Hazel volunteers her time supporting mothers as part of the organisation she began in 2014, called Grandmothers Against Removal.

Aunty Hazel said she remembered hiding as a child when the department came to take children from the mission she lived on.

Fighting for her family’s reunification is what inspired her to help other mothers.

“When you reflect back on these conversations you’re having with women, you’ll realise the essence of what they’re saying is like you’re talking to one person, not many,” Aunty Hazel said.

“By the time the children can get back they don’t know where they came from. It can be an 18-year sentence.”

‘Institutional racism’ part of the problem: commissioner

The Victorian Commissioner for Aboriginal Children and Young People, Justin Mohamed, said the over-representation of Aboriginal children in out-of-home care was an Australia-wide situation.

“Institutional racism has to be addressed to change a racist process of class and value … or lack of value.”

DHHS said, in a statement, self-determination for Aboriginal families was part of the solution.

“We’re working hard to address the unacceptable over-representation of Aboriginal children in out-of-home care and improving outcomes for Aboriginal children involved with child protection,” the statement said.

Antoinette Braybrook (far right) as a child with her brothers Shaun and Ryan in 1974.(Supplied: Antoinette Braybrook)

Connection to culture key to strengthening families

Antoinette Braybrook is the CEO of Djirra, a legal, cultural and support service for Aboriginal families.

She said she remembered DHHS coming to her door if she and her siblings missed any school, even though she had a happy and safe childhood.

“With my work with Djirra we see this happening all of the time with Aboriginal women, a justified fear of the system,” she said.

“It’s an approach that’s not about supporting. It’s about punishing.”

Waka Waka woman Naomi Murphy was taken from her parents when she was a child.

Ms Murphy’s mother is part of Australia’s Stolen Generations.

“My sister and I were taken two states away. My first suicide attempt was when I was 11 because I missed my parents like crazy,” she said.

“DHHS never stepped in because we were with white men. When I finally got home to my parents I was broken.”

Ms Murphy is now a mother herself, and said she has lived with threats her children could be taken.

“Healing started when I connected to my culture. It gives you purpose and identity,” she said.

“I had to learn how to be a mum because my mum was Stolen Generations and she didn’t know how to be a mum.”

NACCHO Aboriginal Women’s Health and #Smoking #IDM2020 #Midwives2020 News Alert : Dr @michelle_bovill : What ngidhi yinaaru nhal yayi (this woman told me) about smoking during pregnancy changes the conversation about this national priority.

 ” Let me make it clear right from the start. Aboriginal and Torres Strait Islander women are quitting smoking during pregnancy and care deeply about the health and wellbeing of their babies.

While there has been an acknowledgement that the proportion of Aboriginal and Torres Strait Islander women smoking during pregnancy has declined, reports more frequently measure and monitor smoking rates during pregnancy and compare these to non‐Aboriginal pregnant women.

For example, 43% of Aboriginal and Torres Strait Islander mothers reported smoking during pregnancy compared with 12% of non‐Aboriginal Australians.

I have been privileged to hear Aboriginal and Torres Strait Islander women from Worimi, Awabakal, Biripi, Goomeroi/Kamilaroi/Gamilaraay and Boandik communities share their stories with me about smoking and becoming pregnant.

I acknowledge my responsibility to pass on these stories to inform the conversations about smoking during pregnancy among Aboriginal and Torres Strait Islander women.

What ngidhi yinaaru nhal yayi (this woman told me) about smoking during pregnancy changes the conversation about this national priority.

What is now owed to these women is more action. Action by health professionals to advise Aboriginal and Torres Strait Islander women to quit smoking during pregnancy, and action to find meaningful support strategies to achieve abstinence. “

Selected extracts from

Michelle Bovill as published in MJA Journal

Download the publication HERE

mja250523

However, two things happen when we measure and monitor in this way. First, this approach assumes that Aboriginal and Torres Strait Islander communities are homogenous.

We are not; we are extremely diverse in cultures, customs and experiences. Second, it creates the impression that smoking during pregnancy is the issue and that Aboriginal and Torres Strait Islander women present a deficit.

This is detrimental because our lived experiences are not the same, nor have they been for generations. Colonisation, dispossession onto missions and reserves, the removal of children, unpaid labour, and refusal of the equal right to education, employment and health care over generations has led to a gap in social and cultural determinants of health.

This gap is founded on racist policies that positioned Aboriginal and Torres Strait Islander people as inferior to other Australians. The gap and deficit mentality follow us today and can be found in countless government reports on Aboriginal and Torres Strait Islander disadvantage.

When we don’t contextualise in terms of colonisation and the resulting social and cultural determinants of health, and fail to privilege Indigenous knowledges, we cannot truthfully address any area of health inequity.

While it has been identified that Aboriginal and Torres Strait Islander women experience multiple barriers to quitting smoking during pregnancy, little work has been conducted to ask Aboriginal and Torres Strait Islander mothers about their experiences of quitting and what they believe could support them to become smoke‐free during pregnancy.

Quit attempts are being made “A lot of people are more wanting to give up smoking but not having the information”

Across New South Wales, Queensland and South Australia, Aboriginal and Torres Strait Islander women often shared a desire to quit smoking and reported making several quit attempts during pregnancy. Aboriginal and Torres Strait Islander people in general are more likely than other Australians to make a quit attempt but are less likely to succeed, which raises the question, “what is happening when Aboriginal and Torres Strait Islander people make a quit attempt?”.

Stories of quit attempts lasting at least 24 hours but often less than a full week were often shared. If we listen to Aboriginal and Torres Strait Islander women, we can hear that motivation to quit is high.

The problem with reduction “I think doctors need to stop telling people to cut down”

Aboriginal and Torres Strait Islander women across communities yarra (say) reduction in cigarette consumption was suggested by health providers.

This tendency to advise reduction in tobacco consumption rather than recommending to women that they quit completely has been previously reported.

 Advising women to cut down cigarette consumption during pregnancy when they are unable to quit smoking is still being promoted across the country in clinical practice guidelines.

 If we only ever report quit rates, yet Aboriginal and Torres Strait Islander women are only being advised to reduce, how will we ever achieve the lower smoking rates of the non‐Aboriginal population?

“I was doing 10 to 15 cigarettes down to 1 to 2 cigarettes a day. I think that is a big, a big reduce”

Aboriginal and Torres Strait Islander women are proud of their success in reducing cigarette consumption. Why shouldn’t they be? Women are successfully following the advice of their health providers.

The only randomised controlled trial conducted with Aboriginal and Torres Strait Islander women during pregnancy reported that 70% of women who were advised to quit smoking by their health provider made a quit attempt.

A recent survey of Aboriginal women who smoke revealed positive attitudes to advice and support from doctors (61%) and midwives (62%). However, health provider support for planned smoking cessation is reported to be weak.

Pregnancy is a life stage during which there are multiple opportunities to offer cessation support to mothers.

Each opportunity should repeat the unambiguous message that the best thing for mothers’ and babies’ health is to quit smoking completely, explain that they are not alone, and offer cessation support.

We therefore hit a dilemma: what cessation support should even be offered? Systematic reviews on Aboriginal tobacco control have concluded that there is limited evidence of effective programs for Aboriginal and Torres Strait Islander people in general as well as during pregnancy.

Community led initiatives are key to successful outcomes

“Everybody looks up to their Elders and stuff, as you know, maybe just a yarn or a get‐together to discuss smoking could help”

Aboriginal women in NSW yarra (speak) of their desire to receive support from their community and Elders. Elders understand community dynamics and the context of women’s lives in a way that (non‐Aboriginal) health providers cannot

. But what would this look like in a health care setting? How can we ensure that consistent messages are offered throughout community to support being smoke‐free?

“I was just thinking that these products, I wouldn’t use them. I’d think about the side effects”

Aboriginal and Torres Strait Islander pregnant women yarra (speak) of their desire to use non‐pharmacological and stress management approaches for smoking cessation. The use of alternative approaches (such as yoga and mindfulness) has been reported in white populations with high socio‐economic status; however, the effectiveness of some of these approaches is as yet uncertain.,

Aboriginal and Torres Strait Islander health does not focus on the individual, but rather the social, emotional and cultural wellbeing of the whole community in which each individual is able to achieve their full potential.

It is therefore important that any support program to address health inequities also focuses on community engagement and empowerment. Aboriginal and Torres Strait Islander women want control and ownership of the quitting process and should be empowered to quit smoking.

If we truly want to support Aboriginal and Torres Strait Islander women to quit smoking during pregnancy, we need to privilege their voices in the process of developing effective and meaningful supports.

I have been privileged to hear Aboriginal and Torres Strait Islander women from Worimi, Awabakal, Biripi, Goomeroi/Kamilaroi/Gamilaraay and Boandik communities share their stories with me about smoking and becoming pregnant.

I acknowledge my responsibility to pass on these stories to inform the conversations about smoking during pregnancy among Aboriginal and Torres Strait Islander women.

What ngidhi yinaaru nhal yayi (this woman told me) about smoking during pregnancy changes the conversation about this national priority.

What is now owed to these women is more action. Action by health professionals to advise Aboriginal and Torres Strait Islander women to quit smoking during pregnancy, and action to find meaningful support strategies to achieve abstinence.

Developing appropriate support strategies for Aboriginal and Torres Strait Islander people should draw on traditional and contemporary knowledges, values and practices.

Over the next 4 years, with the support of a National Health and Medical Research Council Early Career Fellowship and a National Heart Foundation Australian Aboriginal and Torres Strait Islander Award, I will commence this exploratory work in partnership with NSW Aboriginal communities through the Which Way? project.

This project will partner with four communities to explore what Aboriginal and Torres Strait Islander women desire to support smoking cessation and develop an Indigenous led evidence base on smoking cessation.

This work will build on the request for non‐pharmacological support and align with a holistic definition of health and wellbeing. It is my belief that by developing, implementing and evaluating a support strategy that Aboriginal and Torres Strait Islander women desire, our communities can achieve smoking abstinence.

Aboriginal Women’s Health #CoronaVirus News Alert No 44 : April 22 #KeepOurMobSafe : #OurJobProtectOurMob : The Australian Government needs to step up and better support Aboriginal women and children at-risk of violence amid COVID-19

 “The Australian government has promised a $1.1 billion health and domestic violence package to help protect vulnerable Australians during the COVID-19 crisis. But one of the most vulnerable groups of all, Aboriginal women and their children, may see little benefit at all.

Recent cuts to critical Aboriginal family violence services mean support for Aboriginal women and children vulnerable to domestic violence was already going backwards before the government’s latest promises.

New restrictions and social distancing also pose a unique challenge to the Aboriginal community-controlled sector, community health, social and family services that are relied on by Aboriginal women for family violence support.

Aboriginal women and children are significantly over-represented in all domestic and family violence statistics. Aboriginal women are 32 times as likely to be hospitalised due to family violence as non-Aboriginal women. Aboriginal children are seven times as likely to be the subject of substantiated child protection notifications, often due to family violence.

Shawana Andrews Associate Director, Melbourne Poche Centre for Indigenous Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne : Originally Published HERE

” The National Family Violence Prevention Legal Services Forum was formally established in May 2012. It is comprised of thirteen member organisations across Australia who are service providers under the Family Violence Prevention Legal Services (FVPLSs) Program.

FVPLSs provide specialist, culturally safe legal services and supports to Aboriginal and Torres Strait Islander victim/survivors of family violence across Australia.”

For FVPLS help CLICK HERE

Domestic violence, isolation and COVID-19

These higher risks are exacerbated during times of crisis and high stress, like now.

Even without COVID19 Aboriginal families face additional stressors like overcrowded housing, inequitable health care access, trauma and racism.

With so many intersecting issues, the psychological impact of quarantine and lockdown measures will be significant.

The National Aboriginal Community Controlled Health Organisation mobilised early to protect Aboriginal communities from COVID-19 and has worked hard to establish with the government an emergency response management plan to ensure an adequate response to the virus itself and its broader health impacts.

But recent advice from the Australian Indigenous Doctors Association (AIDA) suggests that Aboriginal people continue to face racism in the health system when seeking COVID-19 testing and treatment.

The child, family and social services sector has been less co-ordinated and there has been little to no specific response from the COAG Women’s Safety Council regarding Aboriginal women’s and children’s safety during this time.

The burden has once again fallen to the Aboriginal community-controlled sector which is responding within its limited available resources, mobilising its community structures and relying on social media to reach out to Aboriginal women.

With such a distracted health system and the ‘usual’ barriers still impacting upon access to care for Aboriginal people, Aboriginal women’s voices and needs risk once again being unheard.

A community acting against family violence

As remote Aboriginal communities close their borders and urban communities cope with lockdowns and move into crisis response mode, critical supports for Aboriginal women experiencing violence risk being either cut-off or significantly reduced due to inadequate resourcing.

Aboriginal women experiencing violence also rely heavily on their protective kinship relationships with other Aboriginal women. With social interaction currently limited to two people, COVID-19 measures will heavily impact upon both the formal and informal collective gatherings that Aboriginal women use for support.

Governments must therefore be proactive and provide specific financial and bespoke workforce support to leading Aboriginal health, social and family violence services to develop revolutionary, culturally-framed and safe mechanisms for Aboriginal women to seek the support they require.

Social media and technology is offering women some of the support they need and holds great potential in times such as these. This is one avenue of support for Aboriginal women if set up to support safety. Safe housing, appropriate legislation changes and community-based systems of reaching women and children whilst they are in lockdown are also critical.

The onus is on government to ensure the needs of at-risk Aboriginal women and children aren’t forgotten amid the COVID-19 crisis. Rohan Thomson/Getty Images

Listening to those working on the front line and across the sector is critical, as is listening to the voices of many Aboriginal women who are currently in desperate need of a government that responds to their needs.

The COVID-19 pandemic shouldn’t be remembered as the time during which governments failed to act and unprecedented numbers of Aboriginal women suffered at the hands of their violent partners or that the rates of Aboriginal children in out-of-home care soared even higher than the current alarming rate.

Time is running out for mobilising support for one of Australia’s most vulnerable groups.

Aboriginal women who live with violence show great resilience and agency day in, day out. In their mothering role, they work tirelessly to protect their children which includes mitigating the risk from both a violent partner and a violent child welfare system that often seeks to remove their children.

Aboriginal mothers need, now more than ever, opportunities to connect with trusted friends and family, help with safety plans, support for their children and ways to communicate safely.

In this context Aboriginal women generally have few supports, and the critical supports they do have are now at risk of being inaccessible or over-burdened.

Now is the time for governments to step up.

NACCHO Aboriginal Health #Stroke #Heart #ClosetheGap Research : @ANUmedia New recommendations for cardiovascular disease risk assessment and management in Aboriginal and Torres Strait Islander adults aged under 35 years

This is a great step in reducing the burden of cardiovascular disease in Aboriginal and Torres Strait Islander people.”

Our people have greater rates of heart disease and screening from a younger age will contribute to longer healthier lives. NACCHO encourages all Aboriginal Community Controlled Health Organisations to implement these new guidelines in their practices.

The Chair of the National Aboriginal Community Controlled Health Organisation, Donnell Mills

The updated recommendations are for Aboriginal and Torres Strait Islander individuals to receive:

  • Combined early screening for diabetes, chronic kidney disease and other cardiovascular (CVD) risk factors from the age of 18 years at latest;
  • Assessment of absolute CVD risk using an Australian CVD risk calculator from the age of 30 years at the latest.

New recommendations for CVD risk assessment and management were published today in the Medical Journal of Australia.

See all Close the gap articles in the MJA Journal HERE

The recommendations were endorsed by the National Aboriginal Community Controlled Health Organisation, Royal Australian College of General Practitioners, Central Australian Rural Practitioners Association and the Australian Chronic Disease Prevention Alliance, led by the Heart Foundation.

The approach to early screening was developed in partnership with the Australian National University’s Aboriginal Reference Group (Thiitu Tharrmay) and other Aboriginal and Torres Strait Islander leaders in CVD prevention.

Take home messages

  1. Most heart attacks and strokes can be prevented, and in the last 20 years, the rate of deaths from CVD in Aboriginal and Torres Strait Islanders peoples has almost halved.
  2. High risk of cardiovascular disease begins early among Aboriginal and Torres Strait Islander peoples and is mainly due to diabetes and renal diseaseIt is recommended that there should be:
    1. Combined early screening for diabetes, chronic kidney disease and cardiovascular disease risk factors from the age of 18 years. This should include assessment of blood glucose level or glycated haemoglobin, estimated glomerular filtration rate, serum lipids, urine albumin to creatinine ratio, and other risk factors such as blood pressure, history of familial hypercholesterolaemia, and smoking status.
    2. Assessment of absolute CVD risk using an Australian CVD risk calculator from the age of 30 years. Outside of Communicare, the best CVD risk calculator to use is auscvdrisk.com.au/risk-calculator/
  3. What you can do: Assessment of CVD risk as part of a health check. The most important part of this check-up is working with your doctor to manage your risk factors to improve your heart health and help you live a healthier, longer life.

” Around 80% of heart attacks and strokes can be prevented with optimal care. Cardiovascular disease (CVD) remains a leading contributor to Aboriginal and Torres Strait Islander mortality despite a 40% decrease in deaths in the past two decades and significant decreases in smoking prevalence.

High risk of CVD begins early among Aboriginal and Torres Strait Islander peoples, mainly in people with diabetes and/or renal disease.

Our program of work, funded by the Australian Government Department of Health, is focused on improving prevention of cardiovascular disease for Aboriginal and Torres Strait Islander peoples through:

  • Revision and alignment of clinical practice guidelines ( see part 2 below )
  • Revision and enhanced Medicare Benefits Schedule items for prevention of chronic disease
  • Workforce education and engagement

See ANU program website

Read over 80 Aboriginal Heart health articles published by NACCHO over past 8 Years 

Read over 100 Aboriginal and Stroke articles published by NACCHO over past 8 years 

To combat high risk of heart attack and strokes, Aboriginal and Torres Strait Islander people should have had their heart checked by a GP by age 18 at the latest, according to new national recommendations.

As part of a regular health check with a GP, the recommendations launched today have moved the age Indigenous people should get screened for Cardiovascular Disease (CVD) down from 35 to 18.

Based on research from The Australian National University (ANU), a host of health professionals and Aboriginal and Torres Strait Islander CVD experts have agreed on the latest efforts to continue closing the gap on early heart attacks among Indigenous Australians.

“We have seen great improvements in CVD prevention and this was highlighted in this year’s Closing the Gap speech,” said ANU lead researcher, Dr Jason Agostino.

“However, it remains a leading cause of preventable death in Aboriginal and Torres Strait Islander peoples. We need to be doing all we can to prevent it.

“Just about every Aboriginal person I know has a family member or a community member who’s died young from a heart attack or stroke. We need to change that.

“We can improve things by picking up conditions like diabetes and kidney disease early and starting conversations about treatment.”

In the last 20 years, the rate of deaths from heart attacks and strokes among Aboriginal and Torres Strait Islanders peoples have almost halved.

However, three out of four Aboriginal and Torres Strait Islander adults under 35 have at least one CVD risk factor.

Rheumatic Heart Disease Australia’s Senior Cultural Advisor, Vicki Wade, is a 62-year-old cardiac nurse who has heart disease. She said it is important to remind community and health workers about the risks of CVD.

“Although rates have improved, the statistics are frightening. We have generations of Aboriginal people who are not seeing their grandchildren growing up because of heart attack and stroke,” Mrs Wade said.

“This is a chance for local solutions, community engagement and health workers to be educated.”

Fellow author, Heart Foundation Chief Medical Adviser, cardiologist Professor Garry Jennings, said: “Evidence shows that Indigenous Australians have CVD risk factors like diabetes, high blood pressure and high cholesterol at a young age. We need to prevent, identify and treat these.”

Aboriginal and Torres Strait Islanders should now undergo CVD risk factor screening from 18 years, at the latest, and use Australian CVD risk calculators from age 30.

“It’s easy to do. The assessment involves the normal parts of a health check with a blood and urine test. It is quick and can be done by your local GP,” said Dr Agostino.

“For the vast majority it will be bulk-billed and free.”

The move is backed by the Royal Australian College of General Practitioners, the National Aboriginal Community Controlled Health Organisation, The Australian Chronic Disease Prevention Alliance, and the Editorial Committee for Remote Primary Health Care Manuals.

“This is about getting consistency everywhere. This is what Aboriginal and Torres Strait Islander leaders and the evidence is telling us we should do,” Dr Agostino said.

“Many GPs are already screening as early as 15 but some GPs and nurses don’t know about the need to test early.

“This is about doing what we can to pick up risk factors early and close the gap on early heart attacks and strokes.”

RACGP Aboriginal and Torres Strait Islander Health Chair, Associate Professor Peter O’Mara welcomed the new recommendations, saying they could make a real difference in improving health outcomes for Aboriginal and Torres Strait Islander peoples.

“We cannot hope to close the gap without making evidence-based changes – these new recommendations are a positive step to improving early detection and treatment of CVD.

“The RACGP has over 40,000 members, including 10,000 members in the faculty of Aboriginal and Torres Strait Islander health. While many GPs know about early screening not all do. These new recommendations will help spread awareness among GPs, improving access to early screening and quality care.”

Under the new recommendations, young adults with type 2 diabetes and microalbuminuria, kidney disease, and very high blood pressure or high cholesterol will be identified as high- risk of CVD.

Want more information and resources?

A team at ANU is developing a toolkit on risk communication in CVD: Healing Heart Communities. Designed as a resource for all clinical staff in primary care, it aims to support conversations about CVD risk.

During development, the team has consulted the Australian National University’s Aboriginal Reference Group (Thiitu Tharrmay) and partnered with We are Saltwater People, an Indigenous-owned graphic design company based in QLD to create original artwork, design and layout.

You can find these initial resources here: [

NACCHO Aboriginal Mental Health News : Download @MenziesResearch and @orygen_aus A practice guide for ‘Improving the Social and Emotional Wellbeing of Young Aboriginal and Torres Strait Islander people

 ” Menzies Research and Orygen Australia have developed & just published a practice guide for ‘Improving the Social and Emotional Wellbeing of Young Aboriginal and Torres Strait Islander people’.

Little is known about how best to practically meet the social and emotional wellbeing (SEWB) needs of young Aboriginal and Torres Strait Islander people, particularly those with severe and complex mental health needs.

Yet, there is an urgent need for health programs and services to be more responsive to the mental health needs of this population.

Based on recent statistics, 67 per cent of Aboriginal and Torres Strait Islander young people aged 4-14 years have experienced one or more of the following stressors:

  • death of family/friend;
  • being scared or upset by an argument or someone’s behaviour; and
  • keeping up with school work. “

Download the Report HERE ( See PDF for all research references )

orygen-Practice-Guide-to-improve-the-social-and-emotional-wellbeing-of-young-Aboriginal-and-Torres-Strait-Islander-people

Read over 250 Aboriginal Mental Health articles published by NACCHO over past 8 Years

It is well documented that there are:

  • high rates of psychological distress, mental health conditions, and suicide noted among Aboriginal and Torres Strait Islander young people when compared to non-Aboriginal young people;
  • a lack of evidence-based and culturally informed resources to educate and assist health professionals to work with this population; and
  • notable gaps between knowledge and practice, which limits opportunities to improve the SEWB of young Aboriginal and Torres Strait Islander people.

This promising practice guide draws on an emerging, yet disparate, evidence-base about promising practices aimed at improving the SEWB of Aboriginal and Torres Strait Islander young people. It aims to support service providers, commissioners, and policy-makers to adopt strengths-based, equitable and culturally responsive approaches that better meet the SEWB needs of this high-risk population.

Rationale

The Australian Government appointed Orygen to provide Australia’s 31 Primary Health Networks (PHNs) with expert leadership and support in commissioning youth mental health initiatives.

Orygen has subsequently commissioned Menzies School of Health Research to identify and document promising practice service approaches in improving SEWB among young Aboriginal and Torres Strait Islander people with severe and complex mental health needs. This promising practice guide is an output of that work.

What do we know about the social and emotional wellbeing of Aboriginal and Torres Strait Islander young people?

It is recognised that Aboriginal and Torres Strait Islander societies provided the optimal condition for their community members’ mental health and social and emotional wellbeing before European settlement.

However, the Australian Psychological Society has acknowledged that these optimal conditions have been continuously eroded through colonisation in parallel with an increase in mental health concerns.2

There is clear evidence about the disproportionate burden of SEWB and mental health concerns experienced among Aboriginal and Torres Strait Islander people. The key contributors to the disease burden among Aboriginal and Torres Strait Islander young people aged 10-24 years are:1 suicide and self-inflicted injuries (13 per cent), anxiety disorder (eight per cent) and alcohol use disorders (seven per cent).3

Based on recent statistics, 67 per cent of Aboriginal and Torres Strait Islander young people aged 4-14 years have experienced one or more of the following stressors:

  • death of family/friend;
  • being scared or upset by an argument or someone’s behaviour; and
  • keeping up with school work.4

The stressors have a cumulative impact as these children transition into adolescence and early adulthood. Another study has shown that Aboriginal and Torres Strait Islander young people are at higher risk of emotional and behavioural difficulties.5

This is linked to major life stress events such as family dysfunction; being in the care of a sole parent or other carers; having lived in a lot of different homes; being subjected to racism; physical ill-health of young people and/or carers; carer access to mental health services; and substance use disorders. These factors are all closely intertwined.

Relevant national frameworks and action plans

The Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023 (2015) was developed by the Australian Government Department of Health in close consultation with the National Health Leadership Forum. It has a strong emphasis on a whole-of-government approach to addressing the key priorities identified throughout the plan.

The overarching vision is to ensure that the strategies and actions of the plan respond to the health and wellbeing needs of Aboriginal and Torres Strait Islander people across their life course. This includes a focus on young people.6

The National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017-2023 provides more specific direction by highlighting the importance of preventive actions that focus on children and young people.7 This includes:

  • strengthening the foundation;
  • promoting wellness;
  • building capacity and resilience in people and groups at risk;
  • provide care for people who are mildly or moderately ill; and
  • care for people living with severe mental illness.

In addition, the National Action Plan for the Health of Children and Young People 2020-2030 identifies building health equity, including principles of proportionate universalism, as a key action area and identifies Aboriginal and Torres Strait Islander children and young people as a priority population.8

Social and emotional wellbeing frameworks relating to Aboriginal and Torres Strait Islander people

 

Over the past decades, multiple frameworks have been developed to support the SEWB of Aboriginal and Torres Strait Islander people in Australia.4-8 These have identified some common elements, domains, principles, action areas and methods.7, 9-12

One of the most comprehensive frameworks is the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017-2023, which has a foundation of development over many years.13

It has nine guiding principles:

  1. Health as a holistic concept: Aboriginal and Torres Strait Islander health is viewed in a holistic context that encompasses mental health and physical, cultural and spiritual health. Land is central to wellbeing. Crucially, it must be understood that while the harmony of these interrelations is disrupted, Aboriginal and Torres Strait Islander ill-health will persist.
  2. The right to self-determination: Self-determination is central to the provision of Aboriginal and Torres Strait Islander health services and considered a fundamental human right.
  3. The need for cultural understanding: Culturally valid understandings must shape the provision of services and must guide assessment, care and management of Aboriginal and Torres Strait Islander peoples’ health problems generally and mental health concerns more specifically. This necessitates a culturally safe and responsive approach through health program and service delivery.
  4. The impact of history in trauma and loss: It must be recognised that the experiences of trauma and loss, a direct result of colonialism, are an outcome of the disruption to cultural wellbeing. Trauma and loss of this magnitude continue to have intergenerational impacts.
  5. Recognition of human rights: The human rights of Aboriginal and Torres Strait Islander peoples must be recognised and respected. Failure to respect these human rights constitutes continuous disruption to mental health (in contrast to mental illness/ill health). Human rights specifically relevant to mental illness must be addressed.
  6. The impact of racism and stigma: Racism, stigma, environmental adversity and social disadvantage constitute ongoing stressors and have negative impacts on Aboriginal and Torres Strait Islander peoples’ mental health and wellbeing.
  7. Recognition of the centrality of kinship: The centrality of Aboriginal and Torres Strait Islander family and kinship must be recognised as well as the broader concepts of family and the bonds of reciprocal affection, responsibility and sharing.
  8. Recognition of cultural diversity: There is no single Aboriginal or Torres Strait Islander culture or group, but numerous groupings, languages, kinship systems and tribes. Furthermore, Aboriginal and Torres Strait Islander people live in a range of urban, rural or remote settings where expressions of culture and identity may differ.
  9. Recognition of Aboriginal strengths: Aboriginal and Torres Strait Islander people have great strengths, creativity and endurance and a deep understanding of the relationships between human beings and their environment.13

While the principles outlined above are not specific to young Aboriginal and Torres Strait Islander people, they are considered to be appropriate within the context of adopting a holistic life-course approach.

What’s happening in practice?

This promising practice guide attempts to collate disparate strands of evidence that relate to enhancing youth mental health; improving Aboriginal and Torres Strait Islander SEWB; and strategies for addressing severe and complex mental health needs.

It has been well documented that there are significant limitations in the evaluation of Aboriginal and Torres Strait Islander health programs and services across Australia.22-24 The Australian Governments’ Productivity Commission Inquiry into

Mental Health and the Lowitja Institute are, at the time of producing this document, looking at ways to strengthen work in this space.24, 25

In the absence of high-quality evaluation reports, the term ‘promising practice’ is used throughout this guide.

This is consistent with the terminology used by the Australian Psychological Society through its project about SEWB and mental health services in Australia (http://www.sewbmh.org.au/).

It adopts a strengths-based approach26 which acknowledges and celebrates efforts made to advance work in this space in the absence of strong practice-based evidence.

This is achieved through the presentation of five active case studies.

These reflect organizational, systems and practice focused service model examples. The principles included in the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017-2023 have been mapped against each case study to illustrate how these privilege Aboriginal and Torres Strait Islander ways of knowing, doing and being.

Each case study includes generic background information to provide important contextual information; key messages or lessons learned, and reflections from staff involved in the project.

They have been developed in consultation with both the commissioning PHN and the service/organisation funded to develop and/or deliver the framework, program and service. Where possible, Aboriginal and Torres Strait Islander stakeholders were consulted during the development of the case studies.

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