NACCHO Aboriginal Health news:Today is World Suicide Prevention Day.

Close The gap

Today is World Suicide Prevention Day.

“Aboriginal and Torres Strait Islander people experience suicide at around twice the rate of the rest of the population. Aboriginal teenage men and women are up to 5.9 times more likely to take their own lives than non-Aboriginal people,”

Mr Mohamed said in a recent NACCHO press release (below)

Let’s talk about what can be done by neighbourhoods and workplaces to identify and support people at risk. Let’s see if we can agree about what is best done by families, what by mental health professionals, what by government agencies.

It’s a big ask but let us all think for some moments this week about what we personally can do, and whether there is someone in our personal network who would benefit from a chat about mental stress, or loneliness, or alienation.

Doing nothing won’t help. Doing something may

SUICIDE PREVENTION AUSTRALIA

NACCHO press release

READ previous NACCHO articles on suicide prevention here

Former Federal Mental Health Minister Mark Butler recently released the National Aboriginal and Torres Strait Islander Suicide Prevention Strategy which aims to address Aboriginal suicide rates – which are as high as one a month is some remote Aboriginal communities.

NACCHO Chair Justin Mohamed said the Federal Government’s focus on the issue, particularly the emphasis on local solutions and capacity building, is welcomed, however he said the detail of the plan still needs careful examination.

“Aboriginal and Torres Strait Islander people experience suicide at around twice the rate of the rest of the population. Aboriginal teenage men and women are up to 5.9 times more likely to take their own lives than non-Aboriginal people,” Mr Mohamed said.

“This is a crisis affecting our young people. It’s critical real action is taken to urgently to address the issue and it’s heartening to see the Federal Government taking steps to do that.”

However Mr Mohamed said that for any strategy to be effective, local, community-led healthcare needed to be at its core.

“Historically, Aboriginal people have not had great experiences with the mental health system, so breaking down the barriers and building trust is going to be key and having Aboriginal people involved in the delivery of services is critical.

“Aboriginal Community Controlled Health Organisations are already having the biggest impacts on holistic improvements in Aboriginal health, including mental health. We are already a trusted source of primary health care within our communities, so its important those centres play a pivotal role in any strategy.

“The Aboriginal Community Controlled Health Sector has always recommended that services be funded to offer an integrated social and emotional wellbeing program with Aboriginal family support workers, alcohol and substance abuse workers, social workers and psychologists available.

“Up to 15 per cent of the 10-year life expectancy gap between Aboriginal and non-Aboriginal Australians has been put down to mental health conditions. We look forward to working with the government to map out the best possible approach to addressing this crisis in our community.

Media contact: Colin Cowell 0401 331 251, 

NACCHO political alert: Don’t ignore Aboriginal male health new Government urged

Mark

The Mad Bastards

Sharing Jack Bulman’s outrage about the funding back-down is leading Aboriginal doctor and men’s health campaigner, Dr Mark Wenitong, (a consultant to NACCHO) who described the Mad Bastards program as, “one of the few really resonant resources that speak intimately to Aboriginal and Torres Strait Islander males in a way they can relate to.”

“We know this program works and works well, and our communities know it works well,” said Dr Wenitong. “But once again Aboriginal and Torres Strait Islander men’s health has been sacrificed.”

Jack

Press release

A national Indigenous men’s health charity said the withdrawal of a federal funding offer for a unique national program is further evidence of government neglect of Aboriginal men’s health.

Jack

Mibbinbah CEO Jack Bulman said his organisation had been offered funding to deliver the Mad Bastards program for a year by Indigenous Health Minister, Warren Snowdon, only to have it snatched away again as the Government moved into caretaker mode.

The Mad Bastards Guide: Be The Best You Can Be is an award winning outreach program that builds on the success of ‘Mad Bastards’ – the movie.

Developed over the past two years by a volunteer working group of Aboriginal men’s health experts, doctors and academics the successful outreach program has been delivered in seven communities and within the Western Australian corrections system and has been praised for its ability to inspire cultural strengthening and cultural exchange across generations.

The program has been developed and delivered with not one cent of government money.

“Those of us working in Aboriginal men’s health are used to being largely ignored and having to fight for funding,” said Mr Bulman. “But to be offered a relatively small amount of money (less than $400,000) to deliver a vital service to Aboriginal men and then have the offer withdrawn by the Minister’s office is both cruel and unacceptable.”

Mr Bulman said that there was compelling evidence that Aboriginal and Torres Strait Islander men’s health was regularly given a low priority by Australian governments.

“Here we have a program which came from the Aboriginal community itself; was developed and delivered to communities and prisons across the country by volunteers using no tax-payers money and which has received universal support from both Aboriginal men and women as a powerful and effective tool for health and healing and the minister’s office treats us with contempt.

“This has caused our efforts enormous damage and has dismayed the lots of communities who see this program as something that can help our men back to their rightful place in society, and in doing help women, children and whole of communities,” said Mr Bulman.

Sharing Jack Bulman’s outrage about the funding back-down is leading Aboriginal doctor and men’s health campaigner, Dr Mark Wenitong, who described the Mad Bastards program as, “one of the few really resonant resources that speak intimately to Aboriginal and Torres Strait Islander males in a way they can relate to.”

“We know this program works and works well, and our communities know it works well,” said Dr Wenitong. “But once again Aboriginal and Torres Strait Islander men’s health has been sacrificed.”

“How are we going to close the gap without our men? How can we turn around the terrible fact that more Aboriginal men are in prison than complete year 12? How are we going to create safe, nurturing families and communities for our kids to grow up in and meet their full potential if our men aren’t healed and don’t have purpose?” asked Mr Bulman. “We want Governments, to get fair dinkum about our health and well-being; the Howard Government didn’t prioritise Aboriginal and Torres Strait Islander males’ health and well-being; the Rudd and Gillard governments have continued this paying lip service to our health.

“The Rudd/Gillard government spent $13m on the failed Grocery Watch and $18.4 million was spent by the Howard Government on maintaining two permanent residences Kirribilli House and the Lodge but apparently we can’t find less than half a million to provide real opportunities for healing Aboriginal men.

“We urge the incoming government, whoever wins on Saturday, to take our health needs seriously and start by funding a tried and true effective program which assists our men to health themselves and take responsibility for their own actions.

“It’s time to act, Mr Rudd and Mr Abbott,” Jack Bulman said.

For more information and interviews:

Mibbinbah CEO Jack Bulman 0416 173 975

Dr Mark Wenitong 0417 648 767

http://mibbinbah.org/

http://www.madbastards.com.au/

NACCHO political news: How will our NACCHO members survive a change of government?

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“Both major parties say they are committed to Aboriginal health care – the NGO’s major activity – but until the dollar numbers are made public, there’s a question mark over the size of their commitment.

There are something like 15 health providers. This is ridiculous. We need to be working in partnership. I don’t give a hoot who gets the kudos out of that, as long as the outcomes for our clients is better.” Des Rogers

Des Rogers pictured above left with Dr Mark Wenitong and Kevin from Jimmy Little Foundation making recommendations at a recent Male health summit.

The wish list of the Central Australian Aboriginal Congress, for whomever will gain power in Canberra, contains not what it wants to get, but what it doesn’t want taken away.

From Erwin Chlanda SUBSCRIBE HERE  Alice Springs News

In a swirl of rumored spending cuts, where will the money come from to drive the NGO’s newly chosen direction?

It is 40 years old, has a budget of $38m a year, for both town and “auspiced” services. More than 70% comes from the Feds. Congress has 300 employees, half of them Aboriginal. It has a new chairman (William Tilmouth), a new CEO (Donna Ah Chee) and a new Deputy CEO

The NGO has emerged from the bunker where the previous regime resided, until it got its marching orders after a string of scandals and a Federal review.

Both major parties say they are committed to Aboriginal health care – the NGO’s major activity – but until the dollar numbers are made public, there’s a question mark over the size of their commitment.

Congress now wants to go further, earning back a place in town it occupied decades ago, not only as the voice of Aboriginal people, but engaging with the broad community and economy.

On the health scene, care for children from conception to age four is a key part of the main mission, in tandem with an attack on domestic violence where the facts are horrendous, mostly “Aboriginal male violence on Aboriginal women,” says Mr Rogers.

“You only need to go to the hospital emergency department, or sit in the mall, and you’ll see young and old Aboriginal women who are bruised, battered and in some cases disabled because of violence.

“Because of customs, kinship and cultural law, particularly Aboriginal women on a community attract violence. They either end up dead or they walk into the desert and end up dead. We’ve got to do something about that.

“There are plenty of Aboriginal men who would love to stand up for Aboriginal women but they don’t get the opportunity.”

Mr Rogers quotes some figures from the Justice Department: mothers of NT children are 48 times more likely to be admitted to hospital for reasons of assault than all Australian women.

In 2009/10, more than 840 Aboriginal women had assault-related admissions to hospital in the NT, compared with 27 “other” women. In the year ending June 2012, the rate of “assault offences” recorded in Alice Springs was nearly six per 100 people (almost double the NT average). 68% of domestic violence is alcohol related. The rate of domestic violence assaults is 98% greater than the NT average.

Aboriginal women in the NT are 80 times more likely than other Australian women to be hospitalised as a result of assault.

But the news is not all bad, says Mr Rogers: “In the NT, in terms of Aboriginal health improvement, there has been a 30% decline in the all-cause mortality rate over the last decade or so, and we want to build on what is working, and not throw the baby out with the bathwater.”

Congress has a major clinic, open seven days a week; a male health unit, family partnership program, birthing centre and other programs. It has spread beyond the town limits, “auspicing” five bush clinics at Amoonguna, Santa Theresa, Areyonga, Hermannsburg and Mutitjulu.

Congress is seeking Aboriginal Benefits Account money for a truck carrying three small offices on the back for doctors, paramedics or social workers, which will do the rounds of communities, spending several weeks in each one, as long as it takes, finding out from the locals what their issues and concerns are.

“It could be alcohol, suicide, violence,” says Mr Rogers. “We’ll let the community come to us, encourage them through activities, kids, women, fellas.

“Then we would encourage other agencies which have the expertise to come out and talk to the community. It’s grassroots stuff. You might say it’s an Aboriginal problem. In fact it affects all of us, the town, the economy.”

Mr Rogers, currently on three months’ probation but willing to serve Congress for five years, says he has never been on the dole, has run a produce business for 13 years, “trained, employed and mentored more than 200 Aboriginal people” most of whom “went on to bigger and better things”.

He says some of his employees left because they didn’t like the hours – 4am starts: “On the Mondays, during footy season, I employed backpackers,” he says. “You needed to be flexible as an employer.”

He was briefly a town council alderman, and the Labor Party candidate last year in the NT seat of Namatjira. He’s had a hand in several other businesses, including hospitality and security services.

Mr Rogers spoke with Alice Springs News Online editor ERWIN CHLANDA.

NEWS: What about self-help to end the blight of welfare dependency? Drinking, not taking children to school, not feeding them properly – isn’t all of this up to the individual, or the community?

ROGERS: Yes and no. The main problem with Aboriginal children is neglect. It’s not deliberate neglect. It’s partly because young mothers and families don’t know how to look after young people, it is partly due to addictions and other mental health conditions and it is partly due to the often very adverse social environment that parents are trying to raise their children in. It is also a lack of knowledge caused by low levels of education.

A couple of my daughters are foster carers. Young babies, one or two years old, they certainly know what a straw is but you try to bottle feed them and they have never been bottle fed.

NEWS: How can that be changed?

ROGERS: It’s about education. We can blame us mob for everything – we drink and we fight and we argue, we smell and we’re untidy, we don’t want to be part of society. My view has been for a long time that it’s the system that has created that.

If you sit under that tree over there, regardless of what colour you are, and all the service providers come to you – as hard as it is to comprehend – you accept that as normal behaviour. And the media perpetuate that.

I’ve had a fortunate life, in a sense. I was sent to school down south, to Gawler, north of Adelaide. They were establishing Elizabeth at that time, for “ten pound Poms”. You go back there today, and you see four generations of welfare recipients.  And I would strongly suggest that if you went to any major city in this country, you would find suburbs with welfare recipients.

The media is quite quick to point the finger of blame at the blackfellas, look how lazy they are, ripping off the welfare system. But the system has created that, nationally.

NEWS: Isn’t this the litany we’ve heard for decades? Should the dole be withdrawn for people not reasonably accepting employment offered?

ROGERS: It’s hard when your mum and dad have never worked, your grandparents have never worked. As a welfare recipient – going back to Elizabeth, you learn to manipulate the system.

But the days of sitting on your bum and having all the services come to you are over. We’re not going to come and wake you up in the morning. But we can demonstrate we are a good employer, we have a good process in place, you show potential and we’ll mentor you into senior positions. I think that’s a great outcome.

NEWS: Could that be exported to other companies?

ROGERS: Yes, it can.

NEWS: Is such a process under way? Are you in touch with the Chamber of Commerce, for example?

ROGERS: I must say, no.

NEWS: This is the number one question today: How do you put an end to passive welfare, the issue often spoken of by Noel Pearson?

ROGERS: Sitting under that tree – if you start to withdraw some of those services, for example, the doctor and nurses, then I’ll have to get off my bum and go and see them.

What that does is instil a bit of responsibility. And I think that’s what we have to do, change the system, change the mentality. The Toyota dreaming – whitefellas coming in and out every day, yet making very little difference.

NEWS: How do you translate that into reality?

ROGERS: In this organisation, through the cross-cultural awareness program for staff.

NEWS: But these are people who have a job. What about the recipients of Congress services, how can they be motivated to help themselves?

ROGERS: Pre-birth to four, these are the formative years in terms of the development of responsibility and initiative, no matter what colour you are. We’ve got a number of generations out there who, to be honest, are a bit of a lost cause. And I’m not saying we should forget about them.

Congress does a whole bunch of stuff but we can drill it down to basically three things: we look after the elderly, we try to help the sick, and the other thing we do is preventative care. And it’s that which in the next couple of generations will make the difference. Give people a healthy upbringing then they can make choices.

NEWS: How grave is your fear that funding cuts will affect Congress work?

ROGERS: Taxation revenue is now less than 22% of GDP which is almost the lowest in the OECD and both sides want to reduce taxes further although the Coalition is planning bigger cuts than the ALP in this regard. Where is the money going to come from?

NEWS: Can the funding be streamlined?

ROGERS: There are something like 15 health providers. This is ridiculous. We need to be working in partnership. I don’t give a hoot who gets the kudos out of that, as long as the outcomes for our clients is better.

We are adopting the “collective impact” model, promoted here by Desert Knowledge here but in use world-wide now. It is about everyone working together. Here in Alice Springs, perhaps because of the funding models, we’ve had everyone working in parallel, especially Aboriginal organisations, diving into the same bucket, trying to get hold of the same money, being possessive about that as well, but serving the same clients.

That’s changing. For example, the Department of Families, Housing, Community Services and Indigenous Affairs is changing their funding model from something like 100 different funding contracts down to six. That alone is fantastic. Congress is currently dealing with some 160 projects with a string of agencies, this will cut down on a mountain of paperwork.

NEWS: Are there too many NGOs?

ROGERS: It’s up to the government. It’s a question of compliance. Are NGOs actually spending the money they get appropriately and effectively?

NEWS: How do they decide what’s working and what’s not?

ROGERS: We have an open book policy with our funding providers, and I think that needs to occur. If we get money for a specific program and we see it’s not working, we want to have the ability to say to the funding agency, we think you need to change the parameters, because we can get better results by doing it this way.

Congress is very good at presenting evidence data, we can back our outcomes or outputs with evidence. There are problems when funding agencies allow their money to be spent willy nilly. The Office for Aboriginal and Torres Strait Islander Health, which is part of the Commonwealth Department of Health and Ageing, have been very good with us. We have built a very good, honest, open relationship with them.

NEWS: What are the job opportunities right now? There used to be a cattle industry on what is now Aboriginal land, there are wild horses, camels, lots of land, idle labour and enough water. Road trains are going empty one way and could provide cheap transport of produce to markets. Should Congress develop some of these opportunities? Congress is picking up where people are already damaged. Is there not a case for that damage to be prevented?

ROGERS: Primary production has been tried here in the past but it has failed because it is a foreign industry, so to speak. We are hunters and gatherers. Where do you start? Is it housing, is it education? I’ve had a long time to think about this, and I think it starts from a health perspective. If you are a healthy child, regardless of your race, the other things will come.

NEWS: Could primary health care not include having a purpose in life, a job?

ROGERS: We are the largest primary health care provider in the NT but we’re not going to be able to fix all the problems.

NEWS: What changes is Congress making to its structure?

ROGERS: We now require people with tertiary qualifications to be in the top positions, not appointing Aboriginal people into management positions, irrespective of qualification, as a report 20 years ago recommended.

Unfortunately, that set some Aboriginal people up to fail. We are mentoring Aboriginal people into management roles. This is big business, and needs to be treated like big business.

IMAGES from the Congress annual report 2010-11, as published on the World Wide Web.

NACCHO political alert: NACCHO calls on both parties for greater control of Aboriginal health

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Transcript from World News Australia Radio

Aboriginal community-controlled health organisations have entered the election fray, releasing a major plan they want political parties to commit to.

At a national summit in Adelaide, the organisations challenged both sides of politics to promise to give Aboriginal communities greater control over health programs.

Karen Ashford reports.

Trust us – that’s the message from the leaders of some 150 Aboriginal controlled health agencies, who contend a community-driven approach to Indigenous health can deliver results the mainstream can’t.

Ngiare Brown (pictured above) is research manager for the National Aboriginal Controlled Community Health Organisation, or NACCHO.

She says governments have to be prepared to try something different if Australia’s to make any headway on addressing indigenous health disadvantage.

“I think it was Albert Einstein wasn’t it that said insanity isn’t that when you do the same things over and over and expect a different result?”

NACCHO thinks it would be smarter for Australia to embrace its 40 years of community health provision that it says delivers results – and they’ve produced a ten point plan to take it further.

The plan focuses Indigenous leadership, to drive health reforms and find innovative ways of closing the gaps on Indigenous health between now and 2030.

Ngiare Brown says it’s a much-needed departure from the traditional mainstream model.

“There is an ever changing line up of politicians and bureaucracies and in systems, so we’re having the same sorts of conversations over and over again. So if we’re able to demonstrate and articulate those principals and provide the kind of evidence and structural approach to that change, it should be independent of any change of government, any change in politics, any reform of the system that’s outside of that, because we in fact are one of the most consistent leadership processes and a demonstration of community control that this country has. In fact whilst there’s the revolving door of politics, Aboriginal community control is one of our strongest and most consistent national vehicles for positive change. ”

The NACCHO plan, presented to more than 300 delegates at its inaugural Primary Health Care Summit in Adelaide comes hot on the tail of the Australian Institute of Health and Welfare report card which has given Aboriginal-controlled health organisations a big tick.

The report credited those organisations with making significant improvements in areas like diabetes management, increase child birth weights and better maternal health.

NACCHO chairman Justin Mohamed says the only thing missing is political attention, with indigenous health hardly mentioned so far in the federal election campaign.

“I think to be honest both parties at different times do talk about Aboriginal community control, do talk about Aboriginal health, but I think what we’re seeing in the election process at the moment is that I would like to see more of the parties to let us know what their platform is or what their thoughts are around Aboriginal health, not just health in general.”

Mr Mohamed argues that Aboriginal community-controlled health bodies have proven their expertise and efficiency, and whoever wins government on September 7 must show greater faith in the sector.

“I think that this is a time that things are changing. Our stakeholders and other groups that are working in health are actually saying to government that Aboriginal community controlled health works, you need to give them the keys to the vehicle and let them drive it, and results will show with that. And we’ve seen the results in recent reports that Aboriginal community control delivers results in health.”

A big slice of the conference was devoted to governance.

“You certainly need to be aware of potential risks to your operations” (fade under)

Much of the program was devoted to discussing how community health bodies could make sure they’re accountable.

Ngiare Brown says the sector is tired of paternalism and keen to prove they can be trusted with the purse strings.

“I think we’ve become far more sophisticated. So in the past it has been very much the attitude for example of politicians and departments that they’re doing us a favour by providing us with funds and resources, but we’ll still maintain that control – we are actually able to demonstrate that we’re focused on governance, we’re focused on our internal capacity to be able to lead, to understand business models, to be able to be responsible for funding and other resources, and we demonstrate that at more than 150 services across the country as well as at a national level. ”

Meanwhile, Justin Mohamed won’t say whether he believes Labor or the Coalition is leading in promises on Indigenous health, instead committing to work with whoever wins.

“We need to see results. We aren’t worried about being a political football and thrown around and showcased, or rolled out when it suits – we want to see results, and we just can’t afford to take sides, it’s about we want results and we need to have whoever is in power to give us those results and work with us.”

NACCHO Male Health event alert:NACCHO OCHRE DAY Canberra 8 August registrations close 26 July

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REGISTER HERE

NACCHO Ochre Day to be held in Canberra on 8th August 2013

NACCHO Ochre Day Breakfast: Male only

NACCHO Ochre Day will commence with a Male only breakfast to be held in the Members Dining Room at Old Parliament House. (Registration for this event is essential)

This event will begin at 8-30am and will include a celebration of current Aboriginal Male Health programs at four  Aboriginal Community Controlled Health Services via 10 minute presentations.

The breakfast shall also include an introduction facilitated by Dr Mark Wenitong to NACCHO’s “Blueprint for Aboriginal Male Health”.

Dr Mark

Dr Mark Wenitong (left) pictured here with Cleveland Fagan Apunipima Cape York Health Council.

The breakfast will conclude at 10-30am. Numbers for the breakfast are limited; however priority will be given to delegates from NACCHO Members Services.

YOU MUST REGISTER FOR THIS EVENT .

NACCHO Ochre Day Federation Mall:

Following the breakfast, NACCHO Ochre Day will continue at Federation Mall from 11am with a celebration of achievements in Aboriginal Male health with presentations to be delivered by invited speakers.

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Importantly, as the focal point for the NACCHO Ochre Day the NACCHO Blueprint for Aboriginal Male Health will be launched here.

The event will conclude with a “NACCHO Ochre Day Dedication Ceremony” which will include one of the largest gatherings of Aboriginal Male’s to play their didgeridoo’s in the one place at the same time.

If you are bringing a Didgeridoo please advise us with your registration

For additional information and ways that you could support the NACCHO Ochre Day please contact;

Mark Saunders, Aboriginal Male Health, NACCHO.

Ph; 02-6246 9300 Mob; 040 995 9191

mark@naccho.org.au

REGISTER HERE ONLINE

NACCHO social policy news:Indigenous Australians a quarter of Australia’s prisoner population. It’s a social policy disaster.But could there be solution!

Prison

Firstly though, politicians and the public alike need to understand and admit that the current policy ethos, and its reliance of incarceration, is a failure, both socially and economically.

Australia spends $2.6 billion a year incarcerating adults

But could there  be  solution!

We invite our members to make comment see below

Reproduced from the DRUM : Paul Simpson and Michael Doyle

The continual rise in incarceration rates of Indigenous Australians represents nothing short of social policy disaster.

jail

If reducing the numbers of those in prison is to be achieved, then we need to end the reliance on incarceration and invest more into new thinking and rigorous research on non-incarceration alternatives.

Marking 20 years of monitoring since the Royal Commission into Aboriginal Deaths in Custody, the Australian Institute of Criminology finally released its ‘deaths in custody‘ report last Friday and the figures reaffirm the increasing over-representation of Indigenous persons in custody.

In 20 years rates have gone from one Indigenous person in seven incarcerated to one in four.

Indigenous persons make up 26 per cent of the prisoner population yet only constitute 2.5 per cent of the Australian population.

The over-representation of Indigenous persons in Western Australian prisons is the highest of any Indigenous group in the OECD.

Addressing Indigenous over-representation in custody requires new thinking and tested approaches to the offender population.

Firstly though, politicians and the public alike need to understand and admit that the current policy ethos, and its reliance of incarceration, is a failure, both socially and economically.

Australia spends $2.6 billion a year incarcerating adults. Punitive penal policies cost Australia big time.

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While happy to scrutinise the effectiveness and efficiencies of all other sectors and services, political authorities seem quite content to overlook the billions poured into the prison system.

The return on this ‘investment’ amounts to very little. It simply does not prevent re-offending.

Longitudinal studies show that two-in-five people are re-imprisoned within two-to-five years of release.

Those who advocate for new thinking beyond the current social policy failures have hailed Justice Reinvestment (JR) as one new approach.

Justice Reinvestment was introduced to the US in 2003 by the Open Society Institute and has subsequently been adopted in eleven US states.

It involves identifying geographic areas from where significant numbers of the incarcerated population emanate and investing in services in these areas.

Importantly, at the policy level JR aims to divert funds that would be spent on criminal justice matters (primarily incarceration) back into local communities to fund services that are said to address the underlying causes of crime, thus preventing people from engaging with the criminal justice system.

Detention under this model is seen as a last resort – for only the most dangerous and serious offenders.

The goal is to shift the culture away from imprisonment and to restoration within the community through restorative health, social welfare services, education-employment programs and programs to prevent offending.

The effectiveness of JR was reported on at the First National Summit on JR in Washington in 2010, where lawmakers from several American states discussed how they had enacted policies to avert projected prison growth, saving several hundred million dollars, while decreasing prisoner numbers and recidivism rates.

Australian scholars have reservations about the type of JR model adopted in some US states, specifically querying who controls and receives the funding. Is it the community-sector or another state agency?

Former Aboriginal and Torres Strait Islander Social Justice Commissioner Dr Tom Calma commended JR as a possible solution to Indigenous over-representation in Australia’s criminal justice system. Several other Australian commentators have followed suit.

Despite the increasing popularity of JR, Australia so far lacks evidence to support it beyond its appealing rhetoric and, some might argue, simplistic notion as a viable policy alternative.

Members of the Indigenous Offender Health Research Capacity Building Group (IOHR-CBG) and the Australian Justice Reinvestment Project based at the University of NSW have begun research efforts to address this paucity of information, .

Following two national Justice Reinvestment forums convened by IOHR-CBG member Dr Jill Guthrie, a three-year JR research project has begun at National Centre for Indigenous Studies.

Using a case study approach, the research explores the conditions, governance and cultural appropriateness of reinvesting resources otherwise spent on incarceration, into services to enhance juvenile offenders’ ability to remain in their community.

The Australian Justice Reinvestment Project is currently is examining JR models from overseas in order to provide a sound theoretical and practical foundation for the future development of JR strategies in Australia.\

There is also a Citizens’ Jury research project being run this year by IOHR-CBG researchers aimed at eliciting the values and priorities of a critically informed Australian community with respect to JR.

Citizens’ Juries have been used in various policy fields internationally, including in health in Australia. They involve bringing together group of randomly selected citizens, giving them a variety of evidence-based information on the issues to hand and asking them, as representatives of the community, about their preferences for certain policy options or priorities for resource allocation.

The project also assesses how the results of the Citizens’ Juries might influence the decision making of government policy makers.

Research of this nature is critical in order to imagine and test new and viable alternatives to incarceration. Unfortunately, the current amount invested in such research is minute.

As the recently-emerged adage says, a ‘tough on crime’ approach needs to be replaced by a ‘smart on crime’ approach. A new policy platform to justice is well overdue.

This platform must be informed by evidence and not the tired political populism that exploits the fears of the electorate if we are to ever make inroads in reducing the hugely disproportionate Indigenous incarceration rate in Australia.

Paul Simpson and Michael Doyle are research fellows with the Justice Health Research Program at the Kirby Institute, University of NSW, and are also members of the Indigenous Offender Health Research Capacity Building Group.

NACCHO health awards:Unique trial of a smoking intervention for pregnant Aboriginal women is the winner National Prize for Excellence

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Dr Mark Wenitong, Senior Medical Officer at the Apunipima Cape York Health Council and Part time PHMO at NACCHO pictured bottom left one of the team

A UNIQUE trial of a smoking intervention for pregnant Aboriginal and Torres Strait Islander women is the winner of the 2013 MJA, MDA National Prize for Excellence in Medical Research, for the best research paper published in the Medical Journal of Australia in the previous calendar year.

Entitled “An intensive smoking intervention for pregnant Aboriginal and Torres Strait Islander women: a randomised controlled trial”, the winning paper was authored by Sandra Eades, head of the Indigenous Maternal and Child Health Research Program at the Baker IDI Heart and Diabetes Institute in Melbourne; Rob Sanson-Fisher, Laureate Professor of Health Behaviour at the University of Newcastle; Mark Wenitong, Senior Medical Officer at the Apunipima Cape York Health Council in Cairns; Katie Panaretto, Population Health Medical Officer at the Queensland Aboriginal and Islander Health Council in Brisbane; Catherine D’Este, Professor of Biostatistics at the University of Newcastle; Conor Gilligan, lecturer at the University of Newcastle; and Jessica Stewart, a PhD student at the University of Newcastle.

Smoking rates for Aboriginal and Torres Strait Islander women are high and a particular problem is the prevalence of smoking during pregnancy, which is thought to be about 50%.

In this trial — the first of its kind — 263 women attending their first antenatal visit at one of three Aboriginal community-controlled health services were randomly allocated to two pathways.

The intervention group was invited to participate in a program of tailored advice and ongoing support to quit smoking, delivered by a general practitioner and other health care workers.

The “usual care” group received standard advice and support from the GP at scheduled antenatal visits.

There was a high uptake of the intervention by the women to whom it was offered but this was a “negative study” in the sense that smoking rates remained high at 36 weeks of pregnancy — 89% in the intervention group and 95% in the usual care group — a difference that was not statistically significant.

This was in some ways a disappointing outcome, especially as it came on the back of extensive background research and a unique collaboration by this group of researchers from the Baker IDI Heart and Diabetes Institute in Melbourne, the University of Newcastle, the Apunipima Cape York Health Council and the Queensland Aboriginal and Islander Health Council.

However, the judges from the MJA’s Content Review Committee recognised that this research, conducted with robust and transparent methodology in a difficult real-world setting, contributes to the very important endeavour of improving the health of Aboriginal and Torres Strait Islander women and their children.

Sponsored by MDA National, this prize awards the authors a cash prize of $10 000.

NACCHO dental health news:NACCHO wants fluoride added to the water supplies of all Aboriginal communities.

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NACCHO- the National Authority for comprehensive Aboriginal Primary Health  wants fluoride added to the water supplies of all Aboriginal communities.

 The National Aboriginal Community Controlled Health Organisation (NACCHO) CEO Lisa Briggs  gave evidence to a House of Representatives inquiry hearing into adult dental services today.
 

Download the NACCHO submission

In its submission NACCHO called on the federal government to provide money to Aboriginal-controlled health organisations so they could provide dental services.

Aboriginal people were more likely than non-indigenous Australians to have lost all their teeth, it said.

The organisation urged state and territory government to fluoridate all town, city and Aboriginal community water supplies.

As well more work was needed to attract dental workers to remote Aboriginal communities.

“There are concerns among dental health professionals that positions in Aboriginal communities are not seen as part of the usual career ladder,” NACCHO said.

Exposure to Aboriginal controlled health organisations during training would help attract more young dentists.

Proper funding would allow organisations to offer competitive remuneration packages that would encourage dentists to remote and rural areas

RECOMMENDATIONS

NACCHO recommends that the NPA for adult public dental services:

1. Provide culturally appropriate oral health services to all Aboriginal and Torres Strait Islander people;

2. Increase the oral health workforce available to improve the oral health of Aboriginal and Torres Strait Islander people;

3. Increase oral health promotion activity with the aim of improving health outcomes for Aboriginal and Torres Strait Islander people;

4. Improve the collection, quality and dissemination of oral health information about Aboriginal and Torres Strait Islander people; and

5. Foster the integration of oral health within health systems and services, particularly with respect to primary health care and Aboriginal and Torres Strait Islander people.

In addition, NACCHO asserts that:

 1) Oral Health is a priority health issue for Aboriginal peoples.

2) Oral health is a core part of the holistic health that Aboriginal Community Controlled Health Services aim to provide.

3) Aboriginal Community Controlled Health Services should provide primary oral health care services including emergency and preventative oral health care and oral health promotion.

4) Australia’s National Partnership Agreement to come into effect June 2014 should be fully funded and implemented, in particular in relation to measures for Aboriginal and Torres Strait Islander Peoples in particular.

5) The Patient-assisted Transport Scheme (PATS) must be extended to dental patients.

6) Dental services should be subsidised to all needy Aboriginal and Torres Strait Islander patients to reduce or eliminate cost as a barrier to accessing services..

7) Aboriginal and Torres Strait Islanders in correctional facilities should have access to culturally appropriate oral health programs.

8) All oral health workers must receive cultural awareness training either as part of their initial training or through on-going professional development. This will increase the level of culturally accessible oral health services.

9) There should be support for more Aboriginal and Torres Strait Islander individuals to be trained in all the oral health profession: dentists, dental hygienists, dental therapists, etc.

10) The Australian Dental Council (ADC) should include performance indicators for training schools for recruitment and retention of Aboriginal and Torres Strait Islander trainees and have a target of 2.4% of each profession being Aboriginal and/or Torres Strait Islander individuals.

11) Oral health should be included in the core training of all health workers including Aboriginal Health Workers.

12) Fluoridation of drinking water supplies is an effective strategy to reduce oral health problems.

13) Culturally appropriate Oral Health promotion materials need to be developed, tested for impact, and widely disseminated if effective.

14) Improved and regular collection of data on Aboriginal oral health status and use of services is needed to allow monitoring of the impact of interventions and assessment of achievement of oral health goals and targets.

NACCHO will:

15) Work with all Australian governments to develop oral health service provision at all its member health services.

16) Work with stakeholders to develop cultural awareness training for all oral health workers.

17) Campaign in support of fluoridation of city, town and community water supplies.

18) Improve the level of useful Aboriginal oral health data initially by influencing the capacity for the sector to collect national data collection in those Aboriginal Community Controlled Services with an existing oral health service – e.g periodontal and dental caries status, oral hygiene knowledge and periodontal disease links with Diabetes etc.

19) Support research to collect information on the areas of individual oral health behaviours, knowledge and barriers in regards to oral health including the availability and affordability of oral hygiene items.

 NACCHO calls upon the Federal Government, in collaboration with state and territory governments and NACCHO, to:

20) Fully fund and implement the 2014 National Partnership Agreement

21) Set and monitor goals and time specific targets in relation to meeting a range of oral health outcomes such as caries rates, periodontal disease rates and tooth extraction rates.

22) Formally recognise oral health as a key part of Aboriginal holistic health care to be provided by ACCHSs.

23) Allocate resources specifically for oral health services for Aboriginal peoples.

24) Increase oral health promotion activities in ACCHSs. This would require both increased financing for the development and testing of suitable materials, service provision and training of the AHW workforce.

25) Provide subsidised tooth brushes, tooth paste and floss to all remote communities in the first place and extend this as necessary to other communities where data collection indicates there is an access issue for these items.

NACCHO calls upon state and territory governments to:

26) Fluoridate all town, city and Aboriginal community water supplies that do not naturally contain a level of fluoride sufficient to prevent dental caries and immediately fluoridisation where this has ceased.

We welcome feedback on this recommendations

NACCHO good news:New National Health Careers Program for Aboriginal and Torres Strait Islander

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Our future Aboriginal doctors and health workers pictured above arriving in Canberra

30 Aboriginal and Torres Strait Islander senior high school students from around the country have been selected to be part of the inaugural National Aboriginal and Torres Strait Islander Health Careers Development Program: Murra Mullangari – Pathways Alive and Well.

 The Australian Indigenous Doctors’ Association President, Dr Tammy Kimpton said “it is extremely important for Aboriginal and Torres Strait Islander children to know the wide range of rewarding careers in health that are open to them, from a very early age”

 “Murra Mullangari is just one way of empowering our young people to achieve their goals.”

 Murra Mullangari is an initiative of the Australian Indigenous Doctors’ Association, designed and delivered in partnership with the following Aboriginal and Torres Strait Islander peak health organisations:

 o National Aboriginal Community Controlled Health Organisation

o Indigenous Allied Health Australia

o Indigenous Dentists Association Australia

o National Aboriginal and Torres Strait Islander Health Worker Association

o Congress of Aboriginal and Torres Strait Islander Nurses; and

o Australian Indigenous Psychologists Association

 17 year old Ms Annie Ingui, a Torres Strait Islander student from Queensland said “I am interested in pursuing a health career because I have always wanted to make a difference in Indigenous communities.

 I think it is important to make other Indigenous mothers comfortable while they are having their baby and Indigenous women are most likely going to want an Indigenous midwife”.

 “Murra Mullangari will be an important experience for me because it’s going to help me go further in being a midwife”. Murra Mullangari comprises of a 5 day residential program and follow-up mentoring component. Illustrating the high demand for such a program, around 200 application were received for the 30 places.

 AIDA CEO, Mr Romlie Mokak said “The high demand reflects the fact that Murra Mullangari is a program run by Aboriginal and Torres Strait Islander health organisations for Aboriginal and Torres Strait Islander young people.

 The participants will be immersed in a culturally, educationally and professionally empowering space”.

 The Program will encourage Indigenous students to pursue a career in health and support transitions from secondary school toward careers in health. The program aims to increase awareness of pathways into the health workforce, identify common educational barriers and build strong networks.

For further information visit www.aida.org.au/murramullangari

NACCHO SUPPORT: In a time of need, the Lowitja Institute is asking for your support to Close the Gap

“Just over four years have elapsed in the Closing the Gap program that represents the commitment by all Australian governments to improve the lives of Aboriginal and Torres Strait Islander Australians.”

The Chair of NACCHO Justin Mohamed is calling for SUPPORT register HERE

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From Patricia Anderson former Chair of NACCHO and now Chair of the Lowitja Institute

Read full report  CROAKEY Melissa Sweet

Tangible progress is being made and there are positive signs in some health indicators.

For example, the reduction of mortality rates for Aboriginal and Torres Strait Islander children under five.

SEE NACCHO chair Justin Mohamed Press Release 1 March 2013

However, this program stretches out to 2031 and much work remains to be done. Now is not the time to pull back on either funding or effort.

Within the space of a week in February this year Prime Minister Julia Gillard made two key parliamentary addresses focused on her Government’s commitment to Aboriginal and Torres Strait Islander people: the fifth annual Closing the Gap Statement, and her debate speech introducing the Act of Recognition into the House of Representatives.

Both speeches were notable for the bipartisan support they attracted from across the political divide, reflecting the building groundswell of national support for improving the lives of Australia’s First Peoples and achieving lasting reconciliation.

Given this, it seems anomalous that the Lowitja Institute – Australia’s only Aboriginal and Torres Strait Islander organisation with a pure focus on facilitating research into Aboriginal and Torres Strait Islander health – should find itself under threat of closure.

How could this be?

First, a brief history: the Institute traces its origins back to the foundation of the Cooperative Research Centre (CRC) for Aboriginal and Tropical Health in 1997, which was followed by the CRC for Aboriginal Health in 2003 and then the CRC for Aboriginal and Torres Strait Islander Health (CRCATSIH) in 2010.

The Institute was established in 2009 initially as the host organisation for the CRCATSIH but with the ultimate aim of becoming a permanent facilitator of research into Aboriginal and Torres Strait Islander health when CRC funding expires in June 2014.

And herein lies the dilemma. Under the rules governing the Commonwealth’s CRC program, no CRC can be funded for more than three terms – and so there is no possibility of further allocations to the Lowitja Institute’s hosted CRC.

Knowing this, the Institute also put in place a clear strategy to seek funding for a permanent institute beyond 2014 from the private and philanthropic sectors. However, in 2009 not many foresaw the severity or extent of the international financial calamity of 2008 and the implications this would have for budget bottom lines, and thus for fund-raising.

Despite this, our representations to government to secure ongoing funding continue in earnest and we are confident we will ultimately succeed in establishing a permanent and independent future for the Lowitja Institute.

Our achievements

Over the past 16 years we have provided vital financial and in-kind support to more than 200 research projects focused in areas such as chronic conditions, the social determinants of health and primary health care.

To cite just a few examples, this research effort has led to new ways of treating scabies (a prime causative factor in rheumatic heart disease), new approaches to the provision of mental health care in remote communities and the establishment of a network of more than 200 health centres across Australia using innovative continuous quality improvement tools and techniques.

Our work has contributed to the setting of Closing the Gap health goals, especially in the area of chronic conditions and tobacco consumption. For instance, a Showcase we helped organise at Parliament House in Canberra in 2008 influenced the Federal Government’s subsequent decision to invest $100.6 million in its Tackling Indigenous Smoking strategy.

Most recently, our support has contributed to the establishment of a National Indigenous Cancer Network (NICaN) and a Centre for Research Excellence in Aboriginal and Torres Strait Islander Cancer, and our funded research continues to inform the Closing the Gap program.

The Lowitja Institute is currently funding a range of projects across three program areas, including the clinical trial of a Streptococcus vaccine, a study of Aboriginal child mortality in Victoria, a national appraisal of CQI initiatives in Indigenous primary health care and a review of government efforts to improve funding and governance arrangements for providers of primary health care in Aboriginal and Torres Strait Islander settings.

Just as importantly, our early work on how best to undertake Aboriginal and Torres Strait Islander health research has contributed to improvements in the way research is conducted outside the Lowitja Institute.

Our emphasis on community involvement in the development and approval of research proposals has ensured that our funding is focused on community priorities, and this approach is now used widely. We believe we have, in partnership with the community controlled sector and other partners, changed the way in which Aboriginal and Torres Strait Islander health research is undertaken in Australia.

We also have a strong commitment to ensuring research findings are translated into practice through knowledge exchange, principally through collaborations with our 14 research partners but also through workshops, roundtables and headline events such as the biennial Congress Lowitja.

Our most recent Congress Lowitja was held at the Melbourne Cricket Ground (MCG) in November last year and was in fact focused on the twin themes of Knowledge Exchange and Translation into Practice. The conference brought together some 250 leading health researchers, practitioners, policy makers, community health representatives and others with an interest in Aboriginal and Torres Strait Islander health to share ideas and research findings. It also provided a forum for a discussion about the future of Aboriginal and Torres Strait Islander health research, and the funding shortfall confronting the Lowitja Institute.

As a result of this discussion, Congress delegates drew up a short statement outlining the key role the Lowitja Institute and its predecessors had played in the Aboriginal and Torres Strait Islander health sector. This ‘MCG Statement’ calls on the Australian Government and all political parties to commit to the ongoing funding of the Institute, noting that just 1 per cent of the National Health and Medical Research Council’s $800 million recurrent budget ‘would double the current funding to the Lowitja Institute’.

‘The Lowitja Institute since its inception has been able to bridge the gap that previously existed between researchers and Aboriginal communities,’ the MCG statement says. ‘It has been a leader in the incorporation of an evidence-based approach to Aboriginal health both in terms of services and programs and policy, [and] its research agenda has helped shape Aboriginal health policy and practice throughout the nation.’

‘Now more than ever we need to build on this success and strengthen, not weaken, the use of research and incorporation of evidence in to practice in Aboriginal health so that the gains that have been made continue.’

We feel confident that our efforts to secure government funding will be honoured, and we can continue our vital work. Our proud history as an Aboriginal and Torres Strait Islander-led health research organisation is too important to forego, and we trust that with the support of our health sector peers we will be able to continue to making a significant contribution to the health and wellbeing of our people.

To read the MCG Statement in full, to see how others view our role in the health sector and to register your support, please click here.

• Patricia Anderson is Chair of the Lowitja Institute