NACCHO #coagvawsummit Aboriginal Health and violence against women : ACCHO’s join #AMA and #Fare calling for policy interventions

coagvawsummit

 “A coalition of alcohol experts including doctors and researchers have accused federal, state and territory governments of failing to properly acknowledge the role of alcohol in family violence.

The Council of Australian Governments two-day summit on family violence will begin on today in Brisbane, prompting the Foundation for Alcohol Research and Education to issue a statement of concern.”

Among the 21 signatories are family violence experts, emergency department doctors and alcohol researchers and the Chief Executive Officer of the Central Australian Aboriginal Congress Aboriginal Corporation and former NACCHO CEO Donna Ah Chee.

Download Fare Statement of Concern

or read full statement below

statement-of-concern-coag-national-summit-oct-2016

 ” But it is clear that the overwhelming majority of people who experience such violence are women.

“The most prevalent effect is on mental health, including post-traumatic stress disorder, depression, anxiety, suicidal ideation, and substance abuse.

“There are also serious physical health effects including injury, somatic disorders, chronic disorders and chronic pain, gastro-intestinal disorders, gynaecological problems, and increased risk of sexually transmitted infections.

As a community, we must stamp out violence against Australian women, and bring an end to all forms of family and domestic violence, whoever the victim.

“This will involve commitment and coordination from governments; support services; the related professions, especially medical, health, and legal; neighbourhoods; and families – backed by adequate funding.”

AMA President, Dr Michael Gannon see full press release below

These policy interventions have the full support by frontline services and health professionals who have long been advocating for preventive action.

We know what works, and armed with that evidence we now need the political will to introduce evidence-based measures that look beyond headlines and election cycles and will be effective in saving lives and reducing the damage wrought by alcohol behind closed doors,”

General Practitioner and public health medical officer at the Central Australian Aboriginal Health Congress Dr John Boffa

“We fear that the forum today and the future discussions will continue to ignore alcohol’s role in family violence and fail to embrace strategies to address the issue,” the statement said.

Fare Statement of Concern

“We know from our research that the role of alcohol in family violence cannot be ignored. Alcohol contributes to between 23 to 65% of domestic incidents reported to police and between 15 to 47% of child abuse cases reported in Australia.

“More than a third of intimate-partner homicides involve alcohol consumption by the perpetrator.”

The foundation’s chief executive, Michael Thorn, said he expected New South Wales Bureau of Crime Statistics and Research to be released in a few weeks’ time to show a significant and immediate drop in family violence as a direct result of the state’s lockout and last-drinks laws and tightened bottle-shop closing hours.

“There don’t seem to be any alcohol or mental health experts attending this domestic violence summit, even though we know from research their significant contribution to family violence,” Thorn said.

“We suspect the third national family violence plan will be launched at this summit and there has being very little engagement with alcohol experts about that plan. So we fear that there is unlikely to be anything of anything substance in that plan in relation to alcohol that can be done to address family violence.”

This included reforming the way alcohol is taxed, restricting the sale of alcohol to reduce its availability, and tackling the sexualisation of alcohol through advertising, he said.

Among the signatories to the statement were professor of social work at the University of Melbourne and domestic violence researcher, Cathy Humphreys, and the chief executive officer of the Central Australian Aboriginal Congress Aboriginal Corporation, Donna Ah Chee.

The chief executive officer of Domestic Violence Victoria, Fiona McCormack, who was not a signatory to the statement, said she would be surprised if governments weren’t taking the role of alcohol in family violence seriously. “My experience of the federal government and in fact all governments is that they’re working from the current evidence,” McCormack said.

“It’s really important to consider the issue of alcohol and the impact it has and, in particular, the way it can exacerbate the impact of the violence. However, I’d be concerned if this was about closing down the argument to only focus on alcohol, because we need a plurality of expertise and strategies to address family violence.”

But a signatory to the statement, Assoc Prof David Caldicott, an emergency consultant at Calvary hospital in Canberra,said governments were not taking the role of alcohol “an an agent in harm” seriously.

“I completely understand the perspective of those who are concerned that focusing on alcohol takes away from the role of the responsibility of the perpetrator,” he said.

“Intoxication is never an excuse for violence. But I don’t think focusing on alcohol dilutes anything. You can debate whether alcohol is associated with or causes family violence, but there is no dispute that it is heavily associated with it.”

NACCHO HEALTH NEWS:Alcohol enquiry good opportunity to examine policy for combating alcohol abuse in Aboriginal communities says NACCHO chair

ABORIGINAL INTERVENTION LEGISLATION DARWIN

You need to look at the community. You need to engage the community in the initiatives and the things that can work have to be owned and obviously embraced and I think once you achieve that, the more successful things that I’ve seen, heard about and read about have been ones where there’s been some real leadership from within the community and from the leaders and organisations that are obviously providing services and looking after their community interests

I believe the inquiry is a good opportunity to examine what policy approaches have worked or haven’t worked at combating alcohol abuse in Indigenous communities

Justin Mohamed NACCHO chair speaking on  World News Radio

Indigenous organisations have called for effective community consultation as the federal government launches a new inquiry into alcohol consumption in Indigenous communities.

The parliamentary inquiry was initially intended to look at alcohol-related violence across the country but has now been narrowed to deal specifically with Indigenous communities.

Some Indigenous health groups are hopeful the inquiry could lead to more effective strategies to tackle alcohol abuse, providing Indigenous communities are properly engaged as part of the process.

Michael Kenny reports.

(Click on audio tab to listen to this item)

The inquiry is to be conducted by the House of Representatives Standing Committee on Indigenous Affairs, chaired by Liberal MP Sharman Stone.

FULL DETAIL OF ENQUIRY HERE

It will look at the patterns of supply and demand for alcohol in Indigenous communities and the incidence of alcohol-fuelled violence.

The inquiry will also examine how alcohol impacts upon unborn and newborn babies and what approaches have worked in other countries to combat alcohol abuse.

The Federal Indigenous Affairs Minister, Senator Nigel Scullion, has told NITV the government is not trying to single out Indigenous Australians as the only group that has problems with alcohol.

“This is about poverty, not ethnicity. But I acknowledge that there have always been and we have never really seen a break, particularly in reports of domestic violence, defence injuries, alcohol, deaths through alcohol…. through cars….and violence.”

Senator Scullion says the inquiry will also look at how socio-economic background could be linked to alcohol abuse.

The opposition Labor Party in the Northern Territory is critical of the inquiry, saying it’s “insulting” towards Indigenous Australians.

However, some Indigenous organisations believe it could be a step in the right direction towards tackling alcohol abuse.

Dr John Boffa is the medical officer with the Central Australian Aboriginal Congress and has worked in the Indigenous health field for over 20 years.

He has told NITV he believes an investigation into Indigenous alcohol abuse is long overdue.

“This is a useful inquiry. Alcohol problems are obviously very prevalent in Aboriginal communities. But I think if the inquiry is done well, it’s got the potential to provide some solutions that will address alcohol misuse, not just amidst Aboriginal people but amongst the broader population as well.”

That’s a view shared by the chairman of the National Aboriginal Community Controlled Health Organisation Justin Mohamed.

Mr Mohamed believes the inquiry is a good opportunity to examine what policy approaches have worked or haven’t worked at combating alcohol abuse in Indigenous communities.

Alcohol restrictions have been in place in remote Indigenous communities in the Northern Territory, parts of the Kimberley region in Western Australia and in Cape York in Queensland for a number of years.

However Mr Mohamed believes it is critical to ensure that any scrutiny around these policies is underpinned by consultation and engagement with the Indigenous communities themselves.

“You need to look at the community. You need to engage the community in the initiatives and the things that can work have to be owned and obviously embraced and I think once you achieve that, the more successful things that I’ve seen, heard about and read about have been ones where there’s been some real leadership from within the community and from the leaders and organisations that are obviously providing services and looking after their community interests.”

Mr Mohamed says while previous government inquiries have looked at social problems like domestic violence in Indigenous communities, it is the first time an inquiry has focused specifically on alcohol abuse.

He says it is pleasing to see that the inquiry will look at what strategies have worked in Indigenous communities in other countries, saying Australia could learn a lot from that.

“Like Canada and New Zealand- obviously there would be things happening around alcohol and how they can manage that and make sure that the community is not affected at levels that are unacceptable. You would have to look internationally as well to make sure that you get a really good idea on what is out there and what does work and how that has worked over the years.”

The inquiry has called for public submissions to be made by April 17.

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NACCHO Aboriginal health debate : Chronic drinking problem in the NT costs about $642 million annually

Alice

One new policy that does appear effective is stationing police officers outside bottleshops. Regrettably this has also stirred up racial tension. The officers check drinkers’ IDs to see if they live in a proscribed area, and confiscate their purchases if they do. John Boffa (Congress Aboriginal Health ) a spokesman for the People’s Alcohol Action Coalition, estimates reductions in domestic violence of up to 50 per cent in Alice Springs when police cover all 11 liquor outlets at once.

Priscilla Collins, chief executive of the North Australian Aboriginal Justice Agency, thinks both AMT and APOs unfairly target the most disadvantaged, who are often also the most visible. “They will probably end up going back to the long grass,”

IF the Northern Territory were a country, it would rank alongside vodka-soaked ex-Soviet republics in terms of per capita alcohol consumption; not long ago it would have been second in the world.

 Refer NACCHO NT AMSANT grog summit news:

Four major outcomes on alcohol policy and its impact on Aboriginal people and communities

PICTURE :Police on duty outside a Northern Territory bottleshop. ‘The (alcohol) industry is now being propped up by the Alice Springs police force,’ says head of the police union Vince Kelly. Picture: Amos Aikman Source: News Limited

Alcohol abuse costs the NT about $642 million annually in police time, corrections, judicial support, medical treatment and lost productivity – equivalent to roughly $4000 per person or 4 1/2times the national average – according to research quoted by the government last year. The latest figures show per capita alcohol consumption is again on the rise, ending a six-year decline.

Territory drivers are 20 times more likely than the national average to be caught over the limit; booze is a factor in many road deaths. A majority of Territory assaults involve alcohol and the Territory’s assault victimisation rate is more than 50 per cent above the rest of the nation’s.

In 2011-12, indigenous women were 18 times more likely to be bashed than non-indigenous women, and four times more likely than the Territory average.

Last financial year saw almost 40 per cent more alcohol-related assaults and almost 60 per cent more domestic violence related assaults than the equivalent period five years ago.

Since the Country Liberals took office 18 months ago, Aboriginal groups and legal and health policy experts have accused the Territory government of criminalising drunkenness, ignoring evidence and favouring the interests of the alcohol industry.

The government insists its policies are both appropriate and working, though many cracks have emerged. The CLP campaigned on a pledge to cut crime by 10 per cent annually – which by a slip of the tongue quickly became 10 per cent in a four-year term once it took office. CLP backbencher Gary Higgins recently acknowledged MPs are receiving a “barrage of complaints” about alcohol abuse from the community. His comments drew a quick rebuke from Chief Minister Adam Giles, who said: “We know that there are issues with alcohol in our society, but anyone who has a good look at the statistics will see that things are getting better.”

After repeatedly dodging questions about the saga unfolding on his doorstep, federal Indigenous Affairs Minister and NT senator Nigel Scullion proposed a sweeping national inquiry into drinking habits. The following day he appeared to have been overruled by his colleagues in favour of a tighter probe into Aboriginal drinking that will scrutinise the CLP policies more closely. Giles has already suggested any inquiry would be “navel gazing”. Nevertheless, the process offers his government an opportunity to gracefully adjust its course.

The CLP’s first act in office was to abolish Labor’s Banned Drinker Register, a point-of-sale supply restriction designed to curb heavy drinking. For almost a year, while the new government convulsed with internal ructions, nothing replaced the BDR. Then less than a month after Giles took power in a coup in March, his government unveiled a forced alcohol rehabilitation program called Alcohol Mandatory Treatment. The scheme, which has been running for seven months, involves locking up habitual drinkers in treatment centres with fences and guards.

Associated legislation was passed in the face of vocal opposition. At about $43,000 per drinker treated, AMT is more expensive than many private rehabilitation clinics. Experts think 5 per cent success would be good going. More than 150 people have completed the program; the government has established 120 beds. Alcohol Rehabilitation Minister Robyn Lambley says some patients have had their lives changed, but others are known to have relapsed.

Before Christmas a system of on-the-spot alcohol bans, Alcohol Protection Orders, was also legislated, again despite opposition. These affect people charged with, but not necessarily convicted of, offences in which alcohol was deemed a factor.

The government argues these policies transfer responsibility from society to drinkers, but important figures, such as head of the NT police union Vince Kelly, argue that is a furphy. “If you’re an alcoholic you haven’t got (personal responsibility) in the first place, and if you’re an intergenerational alcoholic you probably don’t know what the concept means.”

Not long ago a doctor who played a key role in establishing AMT, Lee Nixon, walked out in disgust. “A large number of (AMT patients) had little understanding of the process, and at the end of the time when they were there, were still asking, ‘Why am I here?’,” Nixon told ABC’s Lateline. “At the outset it was clear that we were introducing a program with no evidential base for effectiveness.” One drinker had her treatment order overturned by a court on the grounds she received it without proper legal representation. Justice groups say few drinkers appear before the AMT Tribunal with a lawyer.

Priscilla Collins, chief executive of the North Australian Aboriginal Justice Agency, thinks both AMT and APOs unfairly target the most disadvantaged, who are often also the most visible. “They will probably end up going back to the long grass,” she says.

Shortly after taking up his post, Alcohol Policy Minister Dave Tollner openly acknowledged one of AMT’s goals was to push drinkers to “go and hide out in the scrub”. AMT is now being reviewed.

The CLP has trenchantly refused to contemplate imposing any new supply restrictions. Giles told a gathering of hoteliers drinking was a “core social value”, while Tollner said Labor had treated publicans “akin to heroin traffickers”. The latest round of annual political returns to the Australian Electoral Commission reveal the alcohol industry’s main lobby, the Australian Hotels Association, has emerged as the Territory’s largest political donor. The organisation contributed $300,000, split between the major parties in the lead up to the August 2012 Territory election. According to an analysis of declared donations, the lobby donated almost 14 times as much per head of population in the Territory while the BDR was in place than it has in any other jurisdiction in the past decade.

At the time it was abolished there was little evidence clearly supporting the BDR. However it has since become clearer that although policy did not turn around increases in alcohol-related harm and violence as promised, it may have blunted them. Some quite senior CLP figures talk privately about bringing the BDR back.

One new policy that does appear effective is stationing police officers outside bottleshops. Regrettably this has also stirred up racial tension. The officers check drinkers’ IDs to see if they live in a proscribed area, and confiscate their purchases if they do. John Boffa, a spokesman for the People’s Alcohol Action Coalition, estimates reductions in domestic violence of up to 50 per cent in Alice Springs when police cover all 11 liquor outlets at once.

However the approach is a de facto supply restriction, with responsibility for enforcement transferred from the liquor retailer to the public service, as Kelly points out: “The (alcohol) industry is now being propped up by the Alice Springs police force.”

Combined with AMT’s high price tag, the government’s measures do not look at all cost effective. Assuming the number of people taking up drinking is proportional to population growth overall, the government would need at least five times the present number of AMT beds just to keep the number of alcoholics stable. The cost of that would exceed $1 billion by the end of the decade, or roughly 20 per cent of last year’s Territory budget.

Higgins called for a bipartisan inquiry with measures his government officially opposes – an alcohol floor price, shorter opening hours and BDR-like supply controls – put back on the table. “While they do inconvenience a lot of people, all of them should be considered,” he said. Kelly thinks there is a “gaping hole” in public policy around alcohol supply issues. “Neither the Labor government or the CLP government has covered itself in glory when it comes to that type of thing because they’re simply too close to the industry,” he says.

“There has got to be some serious question about whether (an inquiry) is warranted.”

A serious investigation would need to consider not just the efficacy of a range of policies, but the circumstances in which they are applied. Alcohol bans in remote communities push drinkers into towns, where their drinking often worsens. Proscribed urban areas leave residents who can legally buy takeaway alcohol unable to legally drink it. Stationing police outside bottleshops increases familial pressure on those living in non-proscribed areas to become involved in the alcohol supply trade; anecdotal evidence suggests the black market is thriving.

Some federally administered draft alcohol management plans are stuck in limbo, in part because it is unclear what the basic requirements are for Aboriginal communities to responsibly manage alcohol themselves. Community leaders often blame disenfranchisement for their giving up on the task. Many people familiar with these issues say the solutions lie not in textbooks or boardroom chats, but in the lives of Aboriginal people; another desktop study will not help.

It is also worth considering whether alcohol-related harm can be reduced to acceptable levels soon, or just mitigated and hidden. Not even the last of those has been accomplished so far. NT Attorney General John Elferink argues for stricter controls on welfare to break the link between welfare dependency and drinking: “We can build massive institutions to deal with alcoholism, but while the federal government pours free money into our jurisdiction, spending millions of dollars every fortnight, we as a government are going to be spending millions of dollars every fortnight cleaning up the mess.” Without action on several of these fronts, the NT’s alcohol abuse crisis looks likely to get worse.

NACCHO Aboriginal health debate:Was Gillard wrong? Can bans stop those ‘rivers of grog ?

“Aboriginal communities have the governance and the capacity to make their own decisions

The days of grand pronouncements from the ivory towers of Canberra must end.”

alcoholbottles

The article below is not NACCHO policy but provided to inform and generate debate

We encourage our members to respond in the COMMENTS section below

NACCHO thanks Chris Graham for permission to republish

He is the former and founding editor of the National Indigenous Times, and Tracker magazine. He’s a freelance writer based in Sydney

Gillard is wrong, bans won’t stop those ‘rivers of grog’

There’s no question grog kills a lot of Aboriginal people and destroys a lot of Aboriginal lives. But for all the damage grog can do to an Aboriginal community, it’s nothing compared to the damage wrought by politics.

Earlier this week, Prime Minister Julia Gillard delivered her “closing the gap speech on indigenous disadvantage.

After the declaring that the gap was closing (it isn’t), she lined up conservative governments in Queensland and the Northern Territory over their moves against alcohol bans: “I have a real fear that the rivers of grog that wreaked such havoc among indigenous communities are starting to flow once again.”

I’m not sure where Gillard has been spending her time recently, but I do recall her visiting Alice Springs last year. So what did she see?

The rivers of grog in the Territory have never dried up. At best, you could say they’ve changed course slightly. In the first six months of 2010, the Substance Abuse Intelligence Desk (an initiative of the Northern Territory intervention) reported seizing 404 litres of alcohol from Aboriginal communities.

By July 2011 that figure increased 1233 litres, climbing to 1445 by the end of the year. This is four years AFTER government intervention and grog bans. At the same time, alcohol infractions went through the roof.

The bi-annual intervention monitoring report concedes that in 2007, there were 1784 “alcohol related incidents”; by 2011 it was 4101. Alcohol-related domestic violence incidents also rose, from 387 in 2007 to 1109 in 2011.

The federal government likes to claim the increase in crime statistics is a result of more police. So, more coppers, more reporting. Yet while assault rates have more than doubled since 2007, the number of lodgements (charges that flow from an incident) is virtually the same in 2011 as in 2008 (548 in 2011 versus 537 in 2008).

The federal government also likes to claim the policies of the Northern Territory intervention need time to bite. After all, it’s only been five years.

Fortuitously, we have more than a decade of grog bans in Cape York on which to judge (the statistics I’ve used are assault rates, because proponents of grog bans routinely use them to justify banning alcohol). During 2000/01, the assault rate in Cape York communities was almost three times the state average (at a rate of 1419 assaults per 100,000 people). In 2001/02, the rate dropped to 1382. The following year, it dropped to 1216.

Enter the Beattie government, and a new policy of alcohol management plans, or AMPs. Over the next two years, the drop in assault rates slowed dramatically, then plateaued. Within two years, it jumped substantially, and then slowly climbed its way back down.

The net result was that after a decade of grog bans, assault rates in Cape York reduced by 15% — the same drop that occurred in the two years prior to grog bans. Why? Beyond the fact that grog bans don’t work, no one really knows. But know assault rates in Cape York — while certainly much higher than the state average — mirrored almost precisely the rise and falls of assault rates across Queensland. And you could hardly suggest that’s a dry community.

Government-imposed grog bans don’t work. Indeed, they’ve never worked. Not for Aboriginal people, not for non-Aboriginal people. All grog bans do is frame a behaviour that should be treated as a health problem as a law and order issue. Which of course helps fill our jails.

In Cape York in 2000/01, prior to the grog bans, “liquor offence rates” — which include illegal possession of alcohol — were at 142 per 100,000 people. By 2009/10 they’d increased more than seven fold to 1087, and “good order” offences also increased markedly over the same period.

“Aboriginal communities have the governance and the capacity to make their own decisions … The days of grand pronouncements from the ivory towers of Canberra must end.”

So grog bans had no real impact on assault rates on Cape York, but they were a raging success in the criminalisation of Aboriginal drinkers.

So there’s the facts, now back to the politics. The CLP’s motivation to drop the grog bans in the NT is one part “they don’t work” and nine parts “voters in Alice Springs — home to four CLP seats — are sick and tired of Aboriginal drinkers pouring into town to escape grog bans on their communities”.

Whatever their motivation, the CLP’s opposition to broad-brush grog bans across whole swathes of the Territory is the right policy. With one caveat. The CLP has abolished the banned drinkers register, drawing the ire of the Prime Minister. ”Since it was pulled down by the Country Liberal Party… we’re hearing worrying reports about the rise in admissions in the emergency department at Alice Springs Hospital due to alcohol-related accidents and abuse,” she said.

I don’t consider “we’re hearing worrying reports” to be an evidence-based discussion. If our Prime Minister is going to defend a policy, she should work in some hard stats. Even so, there is strong support for the banned drinkers register in Alice Springs.

Unlike blanket grog bans across communities, the BDR is a small, manageable policy. It targets individuals who are repeat offenders and have significant drinking problems, as opposed to targeting a whole race of people based on the colour of their skin.

Dr John Boffa, an Alice Springs doctor who has worked in Aboriginal health for 20 years, defends the BDR: “This is one strategy that’s working. And we’ve got the highest alcohol-related harm in Australia. It’s not acceptable to not implement all possible measures that we know are having an effect.”

Which brings me back to the politics. If all politics are local, then why is all policy created in Canberra? The solution to these problems lie in the communities where the drinking occurs. Many communities later targeted by the intervention were already dry, courtesy of local decision-making.

With support, Aboriginal communities have the governance and the capacity to make their own decisions. In Queensland, that’s where the Newman government is heading, to their enormous credit. And it’s what Gillard rails against. What Campbell Newman has apparently realised is that control of Aboriginal lives needs to be put into the hands of Aboriginal people. The days of grand pronouncements from the ivory towers of Canberra must end.

Gillard said: “The government will take action in response to any irresponsible policy changes that threaten to forfeit our hard-won gains.” Great news. And does the same government have the courage to take action in response to its own irresponsible policies which have been shown time and again to fail?

*Chris Graham is the former and founding editor of the National Indigenous Times, and Tracker magazine. He’s a freelance writer based in Sydney