NACCHO #HaveYourSayCTG about #closingthegap on Aboriginal and Torres Strait Islander youth health : #NACCHOYouth19 Registrations Close Oct 20 @RACGP Doctor :Routine health assessments co-created with young Aboriginal and Torres Strait Islander people may soon be adopted by general practice.

Part 1 : Research project ‘Developing, implementing, and testing a co-created health assessment for Aboriginal and Torres Strait Islander young people in primary care’

Part 2 : Registrations close 20 October for the NACCHO Youth Conference Darwin 4 November 

Part 3 : If you cannot get to Darwin  you can still have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander youth

‘General practice needs to think more carefully about the issues facing young people as a distinct group. Better understanding has to start with asking Aboriginal and Torres Strait Islander people about important health priorities, and then listening carefully to the responses.

Once we have listened to community voices on health priorities and co-created the young person’s health assessment, we intend to conduct a pilot randomised trial of the new health assessment looking at outcomes including social and emotional wellbeing, detection of psychological distress and appropriate management and referrals.” 

Dr Geoffrey Spurling first had the idea for his research project ‘Developing, implementing, and testing a co-created health assessment for Aboriginal and Torres Strait Islander young people in primary care’ during a moving experience not so long ago, when he attended the funeral of a young Aboriginal woman who had committed suicide. See Part 1

The project was originally published in the RACGP News GP

Read all NACCHO Youth Articles HERE 

Part 1 ‘Developing, implementing, and testing a co-created health assessment for Aboriginal and Torres Strait Islander young people in primary care’. Continued from intro above

‘It was a profoundly sad experience,’ Dr Spurling told newsGP.

‘At the same time, community members were telling me that social and emotional wellbeing, especially for young people, was a health priority.

‘I wanted to do what I could with my medical and research skills to understand and help address the social and emotional wellbeing issues facing the community.’

It was here that his research project began to take shape.

Dr Spurling, a GP at Inala Indigenous Health Service and senior lecturer at the University of Queensland, was recently granted funds from the National Health and Medical Research Council (NHMRC) to develop his project, ‘Developing, implementing, and testing a co-created health assessment for Aboriginal and Torres Strait Islander young people in primary care’.

Through collaboration with Aboriginal and Torres Strait Islander community members, this research aims to develop and implement a health check especially tailored for young people in these communities.

Current Aboriginal and Torres Strait Islander Medicare health assessments involving adolescents are constructed for 5–14-year-olds and 15–54-year-olds. Dr Spurling believes more focus is needed on the health of young people within the second age group, and a specific health assessment should be implemented.

Following development of the tailored health assessments, Dr Spurling and his team intend to conduct a trial comparing the new health check with the current one available in clinical software, aiming to show better detection and management of social and emotional wellbeing concerns.

‘By creating a youth health assessment together with both young people and clinicians, I hope we can have more relevant conversations about health in general practice within both the specific context of the newly developed young person’s Aboriginal and Torres Strait Islander health assessment, and more broadly in general practice.’

The National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people recommends the Social Emotional Wellbeing (SEW) and HEEADSSS screening tools as part of health assessments for young people.

Investigator Grants is the NHMRC’s largest funding scheme, with a 40% allocation from the Medical Research Endowment Account. The scheme’s objective is to support the research of outstanding investigators at all career stages, providing five-year funding security for high-performing researchers through its salary and research support packages. The 2019 Investigator Grants funding totals $365.8 million.

Part 2 NACCHO Youth Conference Darwin 4 November 

 ” Culturally-appropriate care and safety has a vast role to play in improving the health and wellbeing of our people.

In this respect, I want to make special mention of the proven record of the Aboriginal Community Health Organisations in increasing the health and wellbeing of First Peoples by delivering culturally competent care.

I’m pleased to be here at this conference, which aims to make a difference with a simple but sentinel theme of investing in what works, surely a guiding principle for all that we do

Providing strong pointers for this is a new youth report from the Australian Institute of Health and Welfare.

Equipped with this information, we can connect the dots – what is working well and where we need to focus our energies, invest our expertise, so our young people can reap the benefits of better health and wellbeing “

Minister Ken Wyatt launching AIHW Aboriginal and Torres Strait Islander Adolescent and Youth Health and Wellbeing 2018 report at NACCHO Conference 31 October attended by over 500 ACCHO delegates including 75 ACCHO Youth delegates Pictured above 

Read Download Report HERE

The central focus of the NACCHO Youth Conference Healthy youth, healthy future is on building resilience. For thousands of years our Ancestors have shown great resolve thriving on this vast continent.

Young Aboriginal and Torres Strait Islander people, who make up 54% of our population, now look to the example set by generations past and present to navigate ever-changing and complex social and health issues.

Healthy youth, healthy future provides us with opportunities to explore and discuss issues of importance to us, our families and communities, and to take further steps toward becoming tomorrow’s leaders.

We hope to see you there!

Registrations CLOSE 20 October 

Registrations are now open for the 2019 NACCHO Youth Conference, which will be held November 4th in Darwin at the Darwin Convention Centre

REGISTER HERE

Part 3 Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander youth #HaveYourSay about #closingthegapCTG

Aboriginal and Torres Strait Islander people know what works best for us.

We need to make sure Aboriginal and Torres Strait Islander youth voices are reflected and expertise is recognised in every way at every step on efforts to close the gap in life outcomes between Aboriginal and Torres Strait Islander people and other Australians.’

‘The Coalition of Peaks is leading the face to face discussions, not governments.

The Peaks are asking Aboriginal and Torres Strait Islander youth to tell us what should be included in a new Closing the Gap agreement and we will take this to the negotiating table.’

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

NACCHO Aboriginal Health @AIDAAustralia News : The @AMAPresident Dr Tony Bartone speech opening #AIDAConf2019 : We must use collective wisdom and advocacy to ensure that #ClosingtheGap is not just words, but a meaningful and deliverable target. #HaveYourSayCTG

 

 “ The basic principles of successful Indigenous healthcare models should be better promoted as exemplars and replicated across the country.

This will support Aboriginal and Torres Strait Islander people to translate their knowledge into innovative practices that will help solve intractable health problems in their communities.

Governments at all levels must ensure that policy frameworks move towards harmonisation with norms recognising the autonomy of Aboriginal and Torres Strait Islander people.

Governments must ensure that these frameworks are bolstered with adequate funding and workforce strategies to enable Indigenous communities to succeed in their pursuit of the right to health and wellbeing.

With the right support, Aboriginal and Torres Strait Islander people stand to address health inequities by transforming services under their purview, as well as health services provided to Indigenous people by the mainstream.

As President of the AMA, I will continue to ensure that Aboriginal and Torres Strait Islander health is a key priority.”

President of the AMA Dr Tony Bartone opening speech

Photo above : Opening of #AIDAConf2019 a Welcome to Country from Larrakia Dr Jessica King. MC Jeff McMullen, keynotes  AIDA President Dr Kris Rallah-Baker, NLC CEO Marion Scrymgour, Danila Dilba ACCHO Olga Havnen, Dr Tony Bartone

I would like to begin by acknowledging the traditional owners and custodians of the land on which we meet today, and I pay my respects to their elders, past and present.

Thank you to the Australian Indigenous Doctors’ Association (AIDA) for inviting me to speak at your annual conference. This is my third year attending, and I feel very privileged to be here.

The theme for this year’s Conference is ‘Disruptive Innovations in Health Care’.

As a General Practitioner who has been practising medicine for over 30 years, I well and truly understand that innovative health care is needed to achieve improved outcomes for patients.

Indeed, innovation will be crucial as we deal with a health system that is so under strain.

This is especially true for Indigenous health, given the much higher burden of disease and mortality rates among Aboriginal and Torres Strait Islander people, and the need for care to be delivered in a manner that is culturally safe.

We all know that Indigenous health statistics paint a bleak picture.

And we all know that Aboriginal and Torres Strait Islander people have poorer health than other Australians.

Medical science is constantly evolving and we have, only in recent times, recognised the innovations and practices of Indigenous people here and overseas.

There are some parallels and similarities in the way Australia and Canada – both former British colonies – are trying to improve health care for First Nations peoples.

In both countries, we are trying to address a legacy of harm from the imposition of policies that resulted in poor health today.

Sadly, investments in Indigenous health are often inadequate, and they are implemented without proper engagement with, and direction by, Aboriginal and Torres Strait Islander people.

We all know that this approach does not work.

However, I know that there are many innovative health services that are delivering high quality health care for their communities, driven by local leadership.

There are models of health care that are delivering proved health outcomes for Aboriginal and Torres Strait Islander people, and these should be supported in terms of funding and workforce.

I was fortunate to visit one such model last year and see first-hand just one example of quality health services and witness the important work that they do.

There are others all underpinned by community oversight and direction. This sense of community leadership is a key feature.

I am sure you will hear of many more positive and innovative healthcare models throughout this Conference.

The problem with such models is that they are not being sufficiently resourced and funded to continue and further their development.

The basic principles of successful Indigenous healthcare models should be better promoted as exemplars and replicated across the country.

This will support Aboriginal and Torres Strait Islander people to translate their knowledge into innovative practices that will help solve intractable health problems in their communities.

Governments at all levels must ensure that policy frameworks move towards harmonisation with norms recognising the autonomy of Aboriginal and Torres Strait Islander people.

Governments must ensure that these frameworks are bolstered with adequate funding and workforce strategies to enable Indigenous communities to succeed in their pursuit of the right to health and wellbeing.

With the right support, Aboriginal and Torres Strait Islander people stand to address health inequities by transforming services under their purview, as well as health services provided to Indigenous people by the mainstream.

As President of the AMA, I will continue to ensure that Aboriginal and Torres Strait Islander health is a key priority.

I am very proud to lead an organisation that champions Aboriginal and Torres Strait health care.

This is demonstrated through:

  • the AMA’s Taskforce on Indigenous Health, which I am honoured to Chair;
  • having AIDA represented on the AMA’s Federal Council;
  • producing an annual Report Card on Indigenous Health;
  • supporting more Aboriginal and Torres Strait Islander people to become doctors through our Indigenous Medical Scholarship initiative;
  • participation in the Close the Gap Steering Committee; and
  • participation in the END Rheumatic Heart Disease Coalition, among many other things.

 See all NACCHO and AMA Articles HERE 

The AMA also supports the Uluru Statement from the Heart, and is encouraging the Australian Parliament to make this a national priority.

I firmly believe that giving Aboriginal and Torres Strait Islander people a say in the decisions that affect their lives will allow for healing through recognition of past and current injustices.

The AMA believes respecting the decisions and directions of Aboriginal and Torres Strait Islander people should underpin all Government endeavours to close the health and life expectancy gap.

The AMA is pleased to see the agreement between the Council of Australian Governments and a Coalition of Peak Aboriginal and Torres Strait Islander organisations – an historic partnership to oversee the refresh of the Closing the Gap strategy.

See Coalition of Peaks Press Release this week

But this is not enough.

We must use this collective wisdom and advocacy to ensure that Closing the Gap is not just words, but a meaningful and deliverable target.

This is certainly an innovative approach to improving health and life outcomes for Indigenous Australians.

Since the beginning of the Closing the Gap strategy, progress has been mixed, limited, and, overall, disappointing.

This must change. It has to change.

It is simply unacceptable that year in, year out, we see the same gaps and the same shortfalls in funding and resources.

I hope that the partnership between COAG and the Coalition of Peaks will result in some real, meaningful change. It must.

Governments cannot keep promising to improve health and other services and not deliver on their commitments.

The AMA welcomed the stated intent of the Minister for Indigenous Australians, Ken Wyatt, to hold a referendum on Constitutional recognition for Indigenous peoples.

And I was disappointed by his recent announcement that an Indigenous voice to Parliament enshrined in the Constitution would not be included as part of this process.

Ken Wyatt has achieved a tremendous amount in his time as Minister, and I hope that Constitutional recognition is part of his legacy.

Let me conclude by saying that it is our responsibility as doctors to ensure that Aboriginal and Torres Strait Islander people can enjoy the same level of good health as their non-Indigenous peers – that they are able to live their lives to the fullest.

The AMA recognises that Indigenous doctors are critical to making real change in Indigenous health, as they have the unique ability to align their clinical and cultural expertise to improve access to services and provide culturally safe care.

The Indigenous medical workforce is steadily growing, but we need more Indigenous doctors. And dentists, nurses, social workers, and all other allied health specialists.

The AMA remains committed to working in partnership with Aboriginal and Torres Strait Islander people to advocate for better Government investment and cohesive, coordinated strategies to improve health outcomes.

Thank you, and I wish you the very best for your Conference.

 Part 2  Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander people #HaveYourSay about #closingthegap

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

NACCHO Aboriginal Women’s Health  : October is #BreastCancerAwarenessMonth Our Feature Story @VACCHO_org BreastScreen Victoria’s hot pink breast screening vans Plus Download Resources from @CancerAustralia

 ” October, Australia’s Breast Cancer Awareness Month, provides an opportunity for us all to focus on breast cancer and its impact on those affected by the disease in our community.

Breast cancer remains the most common cancer among Australian women (excluding non-melanoma skin cancer). Survival rates continue to improve in Australia with 89 out of every 100 women diagnosed with invasive breast cancer now surviving five or more years beyond diagnosis.

Take the time this month to find out what you need to know about breast awareness and share this important information with your family, friends and colleagues.

Breast cancer is the most common cancer experienced by Aboriginal and Torres Strait Islander women and is the second leading cause of cancer death after lung cancer. Research shows that survival is lower in Aboriginal and Torres Strait Islander women diagnosed with breast cancer than in the general population.

Cancer Australia is committed to working with Aboriginal and Torres Strait Islander communities to provide women with important information about breast cancer awareness, early detection as well as breast cancer treatment and care.

Looking after your breasts – Find breast cancer early and survive see Part 2 Below

See BCNA story Part 4 Below

BreastScreen Victoria and the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) are saying goodbye to the days of sterile, cold mammograms under fluorescent flickering lights and saying hello to mammograms in hot pink vans, with beautifully created cultural shawls and lots of love and giggles.

October is Breast Cancer Awareness Month and the organisations have introduced a program which enables Aboriginal women living in regional and remote areas of Victoria to access safe, free and comforting breast screening facilities.

 “ The idea for the program was born from conversations between BreastScreen Victoria CEO, Vicki Pridmore and VACCHO Manager of Public Health and Research, Susan Forrester.

Ms Forrester said that most women shy away from breast screening due to the safety aspect.

“Why we use the word safe is because there are lots of layers around health and some of the themes that were emerging were that women may have felt a bit uncomfortable being screened for multiple reasons and at times, the staff they had contact with across the health system, although [they] may have been very well meaning, lacked cultural awareness.”

See full story Part 3 below

Picture opening graphic  : Almost all the DWECH BreastScreen Team. Rose Hollis DWECH Community Worker, Allira Maes DWECH Aboriginal Health Worker, Joanne Ronald BSV Radiographer, Lisa Joyce BSV Health Promotion Officer

Part 1 Cancer Australia is committed to working with Aboriginal and Torres Strait Islander communities to reduce the impact of cancer on Indigenous Australians

About 3 Aboriginal and Torres Strait Islander Australians are diagnosed with cancer every day. Indigenous Australians have a slightly lower rate of cancer diagnosis but are almost 30 per cent more likely to die from cancer than non-Indigenous Australians1.

Cancer Australia is committed to working with Aboriginal and Torres Strait Islander communities to reduce the impact of cancer on Indigenous Australians.

Our work includes:

  • raising awareness of risk factors and promoting awareness and early detection for the community
  • developing evidence-based information and resources for Aboriginal and Torres Strait Islander people affected by cancer and health professionals
  • providing evidence-based cancer information and training resources to Aboriginal and Torres Strait Islander Health Workers
  • increasing understanding of best-practice health care and support, and
  • supporting research.

We have a range of resources which provide information to support you and the work you do:

Breast Cancer: a handbook for Aboriginal and Torres Strait Islander Health Workers

This handbook has been written to help health professionals support Aboriginal and Torres Strait Islander people with breast cancer. Increasing the understanding of breast cancer may help to encourage earlier investigation of symptoms, and contribute to the quality of life of people living with breast cancer.

This handbook has been written for Aboriginal and Torres Strait Islander Health Workers, Health Practitioners and Aboriginal Liaison Officers involved in the care of Aboriginal and Torres Strait Islander people with breast cancer in community and clinical settings.

Download HERE

Part 2 BE BREAST AWARE

Finding breast cancer early provides the best chance of surviving the disease. Remember you don’t need to be an expert or use a special technique to check your breasts.

Changes to look for include:

  • new lump or lumpiness, especially if it’s only in one breast
  • change in the size or shape of your breast
  • change to the nipple, such as crustingulcerredness or inversion
  • nipple discharge that occurs without squeezing
  • change in the skin of your breast such as redness or dimpling
  • an unusual pain that doesn’t go away.

Most changes aren’t due to breast cancer but it’s important to see your doctor without delay if you notice any of these changes.

My breast cancer journey: a guide for Aboriginal and Torres Strait Islander women and their families

Cancer Australia has developed a new resource My breast cancer journey: a guide for Aboriginal and Torres Strait Islander women and their families which outlines the clinical management of the early breast cancer journey to support Aboriginal and Torres Strait Islander women with breast cancer and their families.

DOWNLOAD HERE

Part 3 BreastScreen Victoria and the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) are saying goodbye to the days of sterile, cold mammograms under fluorescent flickering lights

Read full story from NIT 

The program was trialled, a screen-friendly shawl was designed using artwork by Lyn Briggs, and the shawls were gifted to each woman who was screened.

The trial was a result of a team of around 15 women who screened 14 First Nations women. The feedback received was exactly what BreastScreen Victoria’s Senior Health Promotion’s Officer, Lisa Joyce had hoped for.

“The feedback included things like, I feel safe, protected by culture, cultural safety blanket, made me proud of who I am and visible, the shawl was a screen from feeling shame and it was beautiful, easy to wear and makes you feel comfortable and safe,” Ms Joyce said.

BreastScreen Victoria and VACCHO have partnered with eight Aboriginal Community Controlled Health Organisations (ACCHOs) who will receive visits from Nina and Marjorie – BreastScreen Victoria’s hot pink breast screening vans.

The vans will work with ACCHOs to provide Aboriginal women with free mammograms, which assist in the identification of breast cancer in its early stages. The program is aimed particularly at women between 50 and 74, who are at higher risk of breast cancer.

Picture above :Rose Hollis who is a DWECH Community Worker had her breast screen and then spent the rest of her day driving Community members to their screenings.

The program will also gift a shawl to 50 women from each centre – which will be printed with a design of their country.

Amber Neilley, VACCHO’s State-wide Health Services Program Officer said artworks have been created by artists both established and emerging.

“Each shawl has been designed by a local artist, we are taking the shawls with the designs back to country,” Ms Neilley said.

Ms Joyce said that bringing the vans onto ACCHO sites offers leadership to those centres.

“We are playing into self-determination in that way as the organisation is in control of who screens and what happens in their community in that time,” Ms Joyce said.

“Many of the sites we are going to … have permanent breast screening facilities in the town but we know that Aboriginal women aren’t attending those clinics so we are trying to increase that by bringing it to a familiar place.”

“Taking the van and using the shawls is the first step in improving Aboriginal women’s experiences when they come to breast screens. I think unfamiliarity, lack of trust and potential fear is why we don’t have that contact with many women.”

Research shows that once a woman has screened for breast cancer, she is more likely to regularly screen – a hope the team have for the women in these communities.

“We hope that when the project leaves town the shawl will be in the permanent screening space and people will become involved,” Ms Forrester said.

“We want to be able to say here is a strength-based, culturally-led model that can go national, and international. The CEO of BreastScreen has just been at the World Indigenous Cancer Conference in Canada and presented this on our behalf and she has had a world of interest.”

Dates and locations for BreastScreen Victoria’s screening vans include:

  • 30/9 – 4/10 at Dhauwurd-Wurrung Elderly and Community Health Service (DWECH)
  • 7/10 – 10/10 at Winda-Mara Aboriginal Corporation
  • 14/10 – 18/10 at Gunditjmara Aboriginal Cooperative
  • 21/10 – 24/10 at Kirrae Health Service
  • 28/10 – 1/11 at Wathaurong Aboriginal Cooperative
  • 11/11 – 15/11 at Rumbalara Aboriginal Cooperative
  • 18/11 to 22/11 at Ramahyuck District Aboriginal Corporation.

For more information, visit: https://www.breastscreen.org.au/.

Part 4 Aboriginal and Torres Strait Islander women share their breast cancer experience in new BCNA video

Aboriginal and Torres Strait Islander women have come together to share their stories and experiences as breast cancer survivors as part of a  video produced by BCNA.

See Website 

The video shares the experiences of Aboriginal and Torres strait Islander women affected by breast cancer and aims to encourage other Aboriginal and Torres Strait Islander women to connect, seek support and information on breast cancer.

A number of women in the video, including Aunty Josie Hansen, highlight the importance of early detection.

‘Early detection is really important; not just for women, but for men too,’ Aunty Josie said.

‘Being diagnosed with breast cancer isn’t a death sentence, there’s always hope … as long as you have breath there’s hope,’ she said.

Aunty Thelma reflected that breast cancer is ‘just a terrible disease’.

‘I think it’s so important that women go and have their breast screens done,’ she said.

The video was filmed at the Aboriginal and Torres Strait Islander Think Tank at BCNA’s National Summit in March. The Think Tank was facilitated by BCNA board member Professor Jacinta Elston.  Jacinta said that Aboriginal and Torres Strait Islander women’s outcomes are poorer both in survival and at diagnosis.

The Think Tank brought together 48 Aboriginal and Torres Strait Islander women from around Australia to share issues around treatment and survivorship of breast cancer in their communities. The key outcome of the Think Tank was the development of a three-year Action Plan that outlines BCNA’s key future work, in partnership with national peak Aboriginal health organisations.

The group worked to develop and prioritise future action to improve support and care for Aboriginal and Torres Strait Islander women diagnosed with breast cancer.

This included identifying locally based cultural healing projects, to allow breast cancer survivors to connect and support each other in culturally safe spaces. A weaving project in Queensland and a possum skin cloak project in Victoria is being undertaken and used to support the training of health professionals in local culture and knowledge. The Culture is Healing projects are supported by Cancer Australia.

This video was produced as part of BCNA’s ongoing commitment to better support Aboriginal and Torres Strait Islander women diagnosed with breast cancer.

You can watch the video below:

Aboriginal #MentalHealth and #Wellbeing #SuicidePrevention : NATSIMHL and @cbpatsisp #GayaaDhuwi (Proud Spirit) Declaration and Indigenous Governance workshop : Keynote Speech from John Paterson CEO @AMSANTaus

“ AMSANT understands that social determinants of health are critical to improving health outcomes for Aboriginal Communities and recognises the role that these determinants play in the development of mental health and harmful substance use issues within communities.

AMSANT therefore recognises that a crucial component of providing support to the delivery of AOD and Mental Health programs and services through the Community Controlled Sector is to continue to advocate and lobby for the improvement of the social determinants of health and mental health for Aboriginal people.

We understand that these determinants extend beyond issues relating to, for example, housing, education, and employment, to more fundamental issues relating to the importance of control, culture and country and the legacy of a history of trauma and loss.

Strong and empowered community governance is the backbone to community resilience and Self-Determination and leads to better health outcomes

We have great challenges and great opportunities here in the Territory and with your commitment to self-determination, Aboriginal Governance, policies and practices that do not re-traumatise, we can achieve strong outcomes together

But first we need to recognise and acknowledge the past to inform our future journey and the sometimes difficult paths we will need to take. 

We as Aboriginal people understand the inter-connectivity of all things;

Our call to action is what part will you play, where are you positioned within this connectivity to ensure health and wellbeing is strong for Gayaa Dhuwi our Proud Spirit. “

John Paterson CEO AMSANT ( Pictured above with Kerry Arabena ) Keynote speech see Part 2 Below

Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander people see part 3 below #HaveYourSay about #closingthegap   

Part 1 Help close the Aboriginal and Torres Strait Islander mental health gap by pledging support for the Gayaa Dhuwi (Proud Spirit) Declaration.

The mental health of Aboriginal and Torres Strait Islander peoples is significantly worse than that of other Australians across many indicators. In particular, the suicide rates are twice as high.

The reasons for the gap are many but include the lack of culturally competent and safe services within the mental health system, that balance clinical responses with culturally-informed responses including access to cultural healing.

To rectify this, Aboriginal and Torres Strait Islander leadership is needed in those parts of the mental health system that work with Aboriginal and Torres Strait Islander populations.

Pledging your organisation’s or personal support for the Gayaa Dhuwi (Proud Spirit) Declaration is a first step in supporting Aboriginal and Torres Strait Islander leadership in appropriate parts of the mental health system to improve our mental health and reduce suicide.”

More info sign HERE

Or Download the 6 Page Brochure HERE

Gayaa-Dhuwi-Declaration_Proud-Spirit

Part 2

The Aboriginal Medical Services of the NT is the peak body for the community controlled Aboriginal primary health care (PHC) sector in the Northern Territory (NT). We have 25 members providing Aboriginal comprehensive primary health care (CPHC) right across the NT from Darwin to the most remote regions.

AMSANT has been established for 25 years and just recently celebrated our 25 year anniversary in Alice Springs.   AMSANT has a major policy and advocacy role at the NT and national levels, including as a partner with the Commonwealth and NT governments in the Northern Territory Aboriginal Health Forum (NTAHF).

The ACCHSs sector in the NT is comparatively more significant than in other jurisdictions, being the largest provider of primary health care services to Aboriginal people in the NT. Over half of all the episodes of care approximately 60% and contacts 65% in the Aboriginal PHC sector in the Northern Territory are provided by ACCHSs. Moreover, ACCHS deliver comprehensive primary health care that incorporates social and emotional wellbeing, mental health and AOD services, family support services and early childhood services, delivered by multidisciplinary teams within a holistic service model.

Aboriginal people experience a disproportionate morbidity and mortality burden from mental health and alcohol and other drug (AOD) problems. Nationally, mental health conditions are estimated to account for 12% of the life expectancy gap between Indigenous and non-Indigenous Australians, with suicide contributing another 6% and alcohol another 4% (Vos et al. 2007). Tragically, from 2011-15, the Indigenous suicide rate was twice that of the non-Indigenous population (AHMAC 2017).

At AMSANT, we have come to believe that encouraging an understanding of trauma and its impact and facilitating trauma informed perspectives and ways of working – for all staff throughout our health services – can enhance service delivery and outcomes for the communities in which these services are based.

Some of the most challenging, complex and life threatening issues faced within our health services can be better understood in the context of historical and ongoing experiences of trauma. But as we understand these difficulties in relation to the stories of trauma that communities have lived through since colonisation, it is vital that we also see and understand the strengths and resilience of Aboriginal and Torres Strait Islander peoples and communities – and that we recognise the central role of connection to culture, cultural identity and cultural continuity in maintaining these strengths and keeping people well.

Many Aboriginal people in the NT are happy, engaged with their families and culture, and prepared to make a positive contribution to their communities. The physical and mental health of Aboriginal people have been maintained through beliefs, practices and ways of life that supported their social and emotional wellbeing across generations and thousands of years.

However, factors unique to the Aboriginal experience—including the historical and ongoing process of colonisation that has seen loss of land, suppression of language and culture, forcible removal of children from families, and experiences of racism—have all contributed to profound feelings of loss and grief and exposure to unresolved trauma, which continues disadvantage, poor health and poor social outcomes for far too many Aboriginal people.

This process has directly involved the disruption and severing of the many connections that are protective in maintaining strong mental health and wellbeing – Our connections to a strong spirit

Identifying the extent and impacts of poor mental health among Aboriginal people must be founded on an understanding of this context and the reality that Aboriginal understandings and experiences of mental health and wellbeing are in many ways very different to that of mainstream society.

Also in relation to health and mental health, there is an acknowledgement of the significance of the social determinants of health.  There is an understanding of how ongoing marginalisation, disempowerment, discrimination and stress contribute to poor health and mental health outcomes.

AMSANT understands that social determinants of health are critical to improving health outcomes for Aboriginal Communities and recognises the role that these determinants play in the development of mental health and harmful substance use issues within communities.

AMSANT therefore recognises that a crucial component of providing support to the delivery of AOD and Mental Health programs and services through the Community Controlled Sector is to continue to advocate and lobby for the improvement of the social determinants of health and mental health for Aboriginal people.

We understand that these determinants extend beyond issues relating to, for example, housing, education, and employment, to more fundamental issues relating to the importance of control, culture and country and the legacy of a history of trauma and loss.

Strong and empowered community governance is the backbone to community resilience and Self-Determination and leads to better health outcomes.  For this reason APONT’s Partnership Principles have been developed to improve collaboration and coordination between service providers with the aim of strengthening and rebuilding an Aboriginal controlled development and service sector in the NT.

It is widely understood that mental illness carries a certain amount of social stigma. The impact of this is magnified however for Aboriginal people, who are often subject to systemic racism and discrimination in their everyday lives.  This is demonstrated in the overrepresentation of Aboriginal young people in justice and child protection systems

Census data from June 2017 revealed that among the 964 young people in detention on an average night in Australia, 53% were Aboriginal or Torres Strait Islander and 64% had not been sentenced. In the Northern Territory, these rates were as high as 95% for Aboriginal or Torres Strait Islander children, with 70% not sentenced.

It is now well known that unresolved traumatic experience impacts the developing brain, causing an over-developed fear response leading to increased stress sensitivity and related symptoms can include isolation, aggression, lack of empathy and impulsive behaviour.

Often children in the youth justice system may appear to be violent, aggressive, oppositional, unreachable or disturbed, however, underlying these behaviours is the grief of a child who has had to live through experiences that no human being should ever experience especially a child who does not have the agency to repair, respond and heal, resulting in feelings of powerlessness, anxiousness, and depression.

For these reasons, having a youth justice system that incorporates punishment as a form of behavioural management will only perpetuate the child’s belief that their world is unsafe, and further compound and escalate complex and violent behaviours. If the emotional and psychological wounds do not get appropriately addressed then there is risk of a lifelong pattern of anger, aggression, self-destructive behaviours, academic and employment failures, and rejection, conflict, and isolation in every key relationship. This cycle of trauma and violence can continue across generations.

AMSANT believes that a youth justice system that is trauma informed and sits within a social emotional wellbeing (SEWB) framework would be a positive way forward in redirecting youth away from the justice system, supporting social and emotional health and aiding in community re-entry.

It is also necessary to understand and confront the cumulative impacts of institutional racialism and discriminative policies. For example, the Intervention in the Northern Territory involved the imposition of a series of punitive measures against 73 Aboriginal communities and denied opportunities for community leaders to govern their own communities. The effects of the Intervention on Indigenous people throughout the NT and the fundamental disempowerment that it represented, can hardly be overstated and is demonstrated in our continuing unacceptable disparity in health outcomes.

However Aboriginal Territorian are working together and in collaboration to overcome these disparities.  For example, here in the Territory we have the Aboriginal Health Forum which provides high-level guidance and decision-making. The Forum enables joint planning and information sharing, where partners work together in a spirit of partnership and collaboration.

Nationally AMSANT is involved through the Coalition of Peaks in developing agreed policy positions to negotiate a new National Agreement on Closing the Gap with the Council of Australian Governments or COAG.  For a long time, Aboriginal and Torres Strait Islander peoples have been calling to have a much greater say in how programs and services are delivered to our peoples.

See Part 3 below to have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander people #HaveYourSay about #closingthegap

As a result of the work of the Coalition of Peaks, we are now formally represented on the Joint Council on Closing the Gap – which is the first time an external non-government partner has been included within a COAG structure.

Finally we are seeing a change in the policy conversation on Closing the Gap, with our mob at the decision-making table.

And regionally, leadership exists throughout all of our communities.   Even without the resources and empowerment that would allow for leadership and governance to thrive, it is intrinsically there, understood and followed by the protocols of community life and our kinship systems.

Our ACCHS in the Northern Territory recognise social emotional wellbeing as holistic and interconnected which includes our cultural knowledge and practices as well as mental health and the social determinants of health.

Having control and governance over our service delivery has paved the way for innovation and best practice within our SEWB programs.

We have great challenges and great opportunities here in the Territory and with your commitment to self-determination, Aboriginal Governance, policies and practices that do not re-traumatise, we can achieve strong outcomes together

But first we need to recognise and acknowledge the past to inform our future journey and the sometimes difficult paths we will need to take.

We as Aboriginal people understand the inter-connectivity of all things;

Our call to action is what part will you play, where are you positioned within this connectivity to ensure health and wellbeing is strong for Gayaa Dhuwi our Proud Spirit.

Part 3 Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander people #HaveYourSay about #closingthegap

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

 

NACCHO Aboriginal and Torres Strait Islander Health Workforce : Donnella Mills @NACCHOChair Keynote Address at #CATSINaM19 Building a workforce and embedding #CulturalSafety : Connecting care through culture

” I’m keen to hear your ideas on how we can cooperate across the sector to develop a better workforce with cultural safety embedded throughout the hundreds of clinics and hospitals across the country.

I was impressed by the theme you chose for your conference: ‘connecting care through culture’. That simple phrase captures so much of what we do in our sector each and every day.

Cultural safety, I believe, is what makes us unique and what represents our greatest strength.

In the Aboriginal community-controlled health organisations – the ACCHOs – you have this reinforced through the operating model.

Community control’ is not just a term – it is a 48-year-old model – forged at Redern in 1971 – and now exercised in 144 local Aboriginal and Torres Strait Islander communities across the country.” 

Donnella Mills Acting Chair, NACCHO Keynote address at the CATSINaM National Professional Development Conference Sydney 26 September 

I would like to acknowledge that this conference is being held on Aboriginal land. I recognise the strength, resilience and capacity of the Gadigal people of the Eora Nation who are the traditional custodians of this place we now call Sydney. I pay my respects to their elders.

For those of you who don’t know me, I am a Torres Strait Islander woman with ancestral and family links to Masig and Nagir. I am the Acting Chair of NACCHO, which stands for the National Aboriginal Community Controlled Health Organisation.

I thank the CATSINaM Board for inviting me to deliver this address. It is a privilege to be talking with you today and a special pleasure to be among so many hard-working and dedicated healthcare professionals.

Without you, the Health gap would be so much wider than it is now. Without you, there would be little cultural safety in our hospitals and medical services. I have seen how important your work is on the ground at Wuchopperen and in the other services I have visited. You are the backbone of Aboriginal health.

I plan to speak for about 25 minutes. That will leave us about 20 minutes for yarning at the end. I’m keen to hear your ideas on how we can cooperate across the sector to develop a better workforce with cultural safety embedded throughout the hundreds of clinics and hospitals across the country.

Community control

Our people trust us with their health. We build ongoing relationships to give continuity of care so that chronic conditions are managed and preventative health care is effectively targeted.

Studies have shown that Aboriginal controlled health services are 23% better at attracting and retaining Aboriginal clients than mainstream providers.

Through local engagement and a proven service delivery model, our clients ‘stick’. The cultural safety in which we provide our services is a key factor of our success. In this way, ACCHOs are already ‘leading the way’.

We also build partnerships that make things work. Leadership is not all about the strength to stand up on your own, it is about being smart enough to stand shoulder-to-shoulder with one another. It is about galvanising support on the ground. It is about forging alliances in the sector and building strategic partnerships at the national level.

Employment

Another strength – one that we tend to overlook – is the sheer size of our sector. Let’s have a look at the ACCHO part of it alone. It is not widely known, but the 144 ACCHOs, collectively, are the single largest employer of Aboriginal and Torres Strait Islander people in Australia. That means that one in every 44 Indigenous jobs in Australia is at one of our health services.

If we add the Aboriginal health workers in the mainstream and the rest of the sector, these numbers become all the more impressive.

Our sector is doing more to close the employment gap than any of the employment measures dreamed up by Government agencies.

If the Government really wants to get people off welfare, don’t punish vulnerable people with cashless welfare cards, robo-debts or by sending them off to meaningless Work for the Dole activities.

Work with our sector and grow the Aboriginal workforce together. We have real jobs located in real communities. That is where the investment needs to go.

We should remind our politicians of this when they visit us.

They may see a small clinic somewhere with a few staff, but if they understood that we are part of a huge national network of Aboriginal professionals, they might take more notice of us and realise what we have to offer.

Comprehensive primary health care

Another challenge for us is continuing the development of a comprehensive primary health care model. I think we have been hearing this since the release of the National Aboriginal Health Strategy way back in 1989.

Twenty-one years later, a study concluded that ACCHOs are one of a very few settings where ‘comprehensive primary health care’ is delivered. If we keep offering a comprehensive approach for primary health care across the nation, our people will be much less likely to fall between the cracks.

We can do this through colocation of services or forming partnerships at the local level. This can include clinical care, immunisation and environmental health programs, on-site pharmaceutical dispensing and partnerships with family violence, child protection counselling and legal services.

We can also develop links with sports programs, homelessness services, dental services, aged care and disability support. None of these elements can fully succeed when they stand alone. The voluminous literature on the social determinants of health tell us that. But more importantly, it is what we all know from our own personal experiences.

You don’t need an academic to tell you that comprehensive primary health care is the best approach. We all know this intuitively and from our experiences on the ground.

I am not saying that we should all diversify or ‘dilute’ what we are doing. What I am saying is that while we focus on our core activities, we should also be taking every opportunity we can to link up with other Aboriginal and Torres Strait Islander services and programs in complementary areas.

From my own experience ….

When you think about it, it should not be hard to promote ourselves; to sell ourselves to a new Government. After all, we provide value for money. ACCHOs result in greater health benefits per dollar spent; measured at a value of $1.19 for every $1 spent.

Studies have also shown that the lifetime health impact of interventions delivered by ACCHOs is 50% greater than if these same interventions were delivered by mainstream health services. This is primarily due to improved Aboriginal access and outcomes.

I don’t need to tell you that we also have some pretty significant challenges ahead of us. And I’d like to address these now, one by one.

Remuneration

If we are serious about workforce development, then we cannot ignore the issue of wages. Correct me if I am wrong, but from what I have heard, remuneration is a big issue for nurses and midwives. The ALP, as part of its election platform in May of this year had much to say about improving wages and conditions in the childcare sector, and justifiably so. Childcare is another industry in which women dominate, but are underpaid.

We need the Commonwealth and State Governments to take a similar approach to nurses and midwives. As you all know, women make up almost 90% of all employed nurses and midwives. Representative bodies like NACCHO and CATSINaM need to work together to drive this message home to Governments across the country. Remuneration is an important aspect in attracting and retaining staff.

Vocational development

I think we need to keep improving the career development opportunities and skills acquisition not just for nurses and midwives, but for all Aboriginal health workers. Currently, there is an imbalance in the medical services in which we see more Aboriginal people on the lower levels and amongst the non-clinical staff.

The graph in my presentation shows the situation for ACCHOs. We need more Aboriginal non-clinical staff but we need even more Aboriginal clinical staff.

Recruitment

I see that CATSINaM has a proud record in increasing its membership in recent years. I think you had a record number in your 2018 Annual Report – 1,366 members – representing a jump of 35%. Clearly, you are doing something right to have recruited so many new members.

You must have won the trust of your members to have such a healthy and expanding membership base. With almost half of the Aboriginal and Torres Strait Islander nurses and midwifes in Australia as your members, CATSINaM is the key organisation in addressing many of the workforce development issues in our sector.

Certainly, much more needs to be done to develop career pathways to secure more Aboriginal and Torres Strait Islander nurses and midwifes as well as more doctors and allied health professionals.

Across Australia in 2015 the AIHW reported that there were only about 180 medical practitioners, 750 allied health professionals, and 3,200 nurses (including 230 midwives) who identified as Aboriginal or Torres Strait Islander people. For nurses, this represents just over 1% of all employed nurses and midwives Australia-wide.

The Northern Territory (2.4%) and Tasmania (2.2%) had the highest proportion of Aboriginal nurses and midwives, while Victoria had the lowest (0.5%). Compare these figures to our proportion of working-age Australians – close to 3.%. We should have 3% of all nurses and midwives, not 1%.

As I have already said, our sector is the largest employer of Aboriginal and Torres Strait Islander people across the country.

Now, if the ACCHOs as a group employ about 6,000 staff, of which 56 per cent are Aboriginal or Torres Strait Islanders, then we still have another 2,500 jobs in our own sector which could be filled by Aboriginal and Torres Strait Islander people.

We have a significant opportunity here. Think of what we could do for our people if we filled such a large number of jobs.

Retention

A big challenge that we confront every day – particularly in the bush – is retention. Stress and burnout is a real problem as Fran Baum’s research has shown. Turnover of staff is high and vacancies remain unfilled for longer than we would like.

With so many vacancies, particularly in remote clinics, a concerted effort could also have a significant positive impact on the size and health of our workforce. It is troubling to hear of the high reported vacancy rate of 6% (i.e. about 380 vacancies at any point in time).

Nevertheless, ACCHOs are doing pretty well in comparison with mainstream and non-Aboriginal organisations. The proportion of health vacancies was 6% compared with 9% for other organisations. My guess is that it is cultural safety that explains the advantage here.

So, if we have a good model and we have sector already working hard for Aboriginal health, then how are we going?

Life expectancy target not met

If we look at just one of the ‘Closing the Gap’ targets – life expectancy – you can see how stark the differences are. According to ABS data, which probably overestimate Aboriginal life expectancy, non-Aboriginal Australians can expect to live to about the age of 82. Aboriginal and Torres Strait Islander people are lucky to make it to 72. T

hat’s a ten-year difference. We would be better off living in other countries where the life expectancy is higher. Countries – believe it or not – like Bangladesh or Azerbaijan. Life expectancy is longer in some Third World countries than it is for our people.

Funding for Aboriginal health has fallen

Despite all the words we have heard from Commonwealth and State Governments over the years about ‘Closing the Gap’, instead of increasing expenditure, Governments have actually decreased expenditure on Aboriginal health over the past decade.

Governments need to spend two to three times more on Aboriginal health if we are to have a level of funding commensurate with the actual cost of the burden of disease. This is a huge sum – about $1.4 billion per year – on one estimate.

In real terms health expenditure (excluding hospital expenditure) for Aboriginal people fell 2% from $3,840 per person in 2008 to $3,780 per person in 2016. Over the same period, expenditure on non-Aboriginal people rose by 10%. How can you expect to close the gap when you are reducing funding for our people and increasing it for the non-Aboriginal population?

If we act as one, we can turn things around.

Look at the way that the Aboriginal peaks, like NACCHO and CATSINaM, stood together to force the nine Australian governments to restart the Closing the Gap process. Before we came together and complained to them, the consultation process was expensive lip service.

Before we stood together with one voice, our separate voices were ignored. Now they are listening. Now things are back on track.

Funds are tighter than ever to procure, but, over the years, we have built a world class model of health care and there is too much at stake for us now to start drifting backwards now.

The timing is critical, especially now that we have a re-elected Government and the new arrangements in the administration of Aboriginal programs. It is great to see Ken Wyatt as the first Aboriginal Cabinet member as the Minister for Indigenous Australians.

But we need to engage as closely as we can with him and with Minister Hunt. We also need to keep the dialogue open with Senator Dodson, Senator McCarthy and the Member for Barton in NSW, Linda Burney.

There are also plenty of good Aboriginal leaders in the State and Territory Governments and I urge you to keep talking to them. It is important to have our voice heard.

Especially when we face a mainstream system that continues to overlook us; especially when we have a mainstream system that continues to patronise us. If we don’t act now and keep the pressure up, we will lose some of our recent hard-won gains.

The future

Despite the appalling funding neglect for programs and the low wages paid to our health workers, you have shone in adversity. You are resilient. You survive despite whatever circumstances you find yourselves in.

It’s self-determination and the need to control our own health programs that led to the ACCHO model of care in the first place. It is a lesson for our sector.

If the system was working now, we would have zero preventable hospital admissions. The evidence is not just here, it is overseas as well.

In Canada it has been shown that First Nations communities that transitioned from government-control to community-control of health services experienced a 30% reduction in hospitalisation rates compared with communities where government control was maintained.

In a perfect world our model of primary care through community control would also be complete. We would have full coverage across the land.

We would also have an Aboriginal NDIS workforce in fully-funded models for disability services rolled out, Australia-wide.

And of course, all this hinges on a more accountable public health system and an uncapped needs-based funding model. Who knows, if we had all these things, we may even seriously imagine a future in which we have actually closed the health gap.

With Aboriginal health in Aboriginal hands I know that we can get there eventually.

NACCHO and CATSINaM can continue to work together and to set the way forward for Aboriginal health.

But we can also show the non-Aboriginal population what is possible. It is this future that I imagine for my daughter and my own family.

I am sure that it is a vision that we all share.

Leading the way for all of Australia through cultural safety and respect.

Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander people #HaveYourSay about #closingthegap

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

 

NACCHO Aboriginal Health #IYIL2019 and Early Childhood Development #ClosingTheGap : @theALNF shines on the world stage for its innovative use of technology to help solve the literacy challenges facing our Indigenous communities

 

“Language gives us a sense of identity and, for many Indigenous peoples globally, storytelling is the way our culture and history is shared through the generations. With the loss of language therefore comes the loss of identity.

The importance of First Language, particularly to early childhood development, has been recognised by the United Nations and it’s especially exciting for us to win this award during the International Year of Indigenous Languages ‘

Professor Tom Calma AO, Co-Chair of ALNF and Reconciliation Australia 

“ Language is more than a mere tool for communicating with other people. People simply don’t speak words. We connect, teach and exchange ideals. Indigenous languages allows each of us to express our unique perspective on the world we live in and with the people in which we share it with.

Unique words and expressions within language, even absence of, or taboos on certain words, provide invaluable insight to the culture and values each of us speaks.

Our Language empowers us.

It is a fundamental right to speak your own language, and to use it to express your identity, your culture and your history. For Indigenous people it lets us communicate our philosophies and our rights as they are within us, our choices and have been for our people for milleniums “

Minister Ken Wyatt sharing Australia’s story on preserving and revitalising #IndigenousLanguages at @UNHumanRights Council

Read full speech Here 

Australian technology innovation shone on the world stage today when the Australian Literacy and Numeracy Foundation (ALNF) won the MIT Solve Challenge for ‘Early Childhood Development’ in New York.

The Australian charity was selected out of 1400 entrants, and was one of 61 finalists for the global accolade which recognises innovative technology solutions for global challenges.

ALNF was awarded for its ground-breaking ‘Living First Language Platform’ (LFLP), a highly accessible, cross- platform multi-media app that preserves and revitalises Indigenous First Languages, empowering speakers with best-practice literacy tools to learn to read, write and teach in their mother tongue

The award recognises ALNF’s innovative use of technology to help solve the literacy challenges facing Indigenous communities and will see MIT Solve deploy its global community of private, public, and non-profit leaders to help ALNF build the partnerships needed to scale their work nationally and internationally.

ALNF seeks to address the lack of linguistically inclusive early education, which is recognised by communities and leaders as a major factor in low levels of attainment and engagement of Indigenous children and families in early education.

In remote areas of Australia, around two-thirds of Indigenous children speak some words of an Indigenous language, and in some communities, almost 100% of children encounter English for  the first time when they enter school. Globally, around 221 million children do not have access to education in their First Language.

See a demonstration of the ‘Living First Language Platform’ in action here

Importantly, the platform also aims to stem the rapid and ever-increasing loss of Indigenous languages. There are more than 4,000 Indigenous languages in the world and devastatingly, one is lost approximately every 14 days.

The support from the MIT Solve network will help us to continue to develop and grow the platform’s capability, ensuring a robust Early Childhood Development resource. Additional funding received from investors and donors will go directly to ALNF to enable us to work with more communities in Australia to record our own Indigenous languages and improve literacy levels.”

ALNF is currently working with five Australian Indigenous language groups on the platform, in some instances recording ancient languages for the first time.

One of these languages, Erub Mer from the Torres Strait, has only a few fluent speakers remaining. Thanks to the Living First Language Platform, more than 2000 Erub Mer words have been added to ALNF’s teaching tool by an enthusiastic community, passionate about passing their language on to the next generation.

Photos from Erub Mer workshop Kenny Bedford 

The six global challenges in the MIT Solve Challenge were determined via consultation with more than 500 leaders and experts and workshops with communities around the world. ALNF was among 61 global finalists invited to New York city to pitch their technology solution to the MIT Solve Challenge Leadership Group — a judging panel of cross-sector leaders and MIT faculty —during U.N. General Assembly Week.

In addition to today’s MIT Solve win, the ‘Living First Language Platform also won in its category of ‘Innovation in Connecting People’ at the South by Southwest (SXSW) Innovation Awards in Austin, Texas earlier this year.

For more information or to donate go to alnf.org/program/firstlanguages/.

Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander people #HaveYourSay about #closingthegap

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

NACCHO Aboriginal #MentalHealth Download @NMHC National Report 2019 Released today : The Australian Government encourages PHNs to position Aboriginal Community Controlled Health Services as preferred providers for mental health and suicide prevention services for our mob

” Working to improve the health of Aboriginal and Torres Strait Islander people is a priority area for PHNs.

The PHN Advisory Panel Report recommended that PHN funds for mental health and suicide prevention for Aboriginal and Torres Strait Islander people should be provided directly to Aboriginal Community Controlled Health Services (ACCHS) as a priority, unless a better arrangement can be demonstrated.

The Senate Inquiry into the accessibility and quality of mental health services in rural and remote Australia also made a similar recommendation.

PHNs should continue to work on formalising partnerships with ACCHS.

The NMHC supports the recommendations made by both these reports and recommends that the Australian Government encourages PHNs to position ACCHS as preferred providers for mental health and suicide prevention services for Aboriginal and Torres Strait Islander people “

Extract from Page 14 

Recommendation 16: The Australian Government encourages PHNs to position Aboriginal Community Controlled Health Services as preferred providers for mental health and suicide prevention services for Aboriginal and Torres Strait Islander people.

The National Mental Health Commission today released its National Report 2019 on Australia’s mental health and suicide prevention system, including recommendations to improve outcomes.

Download the full 97 Page Report HERE 

National_Report_2019

or 9 Page Summary HERE 

National Report 2019 Summary – Accessible PDF

The Commission continues to recommend a whole-of-government approach to mental health and suicide prevention.

This broad approach ensures factors which impact individuals’ mental health and wellbeing such as housing, employment, education and social justice are addressed alongside the delivery of mental health care.

National Mental Health Commission Advisory Board Chair, Lucy Brogden, said we are living in a time when we’re seeing unprecedented investment and interest in making substantial improvements to our mental health system.

“Current national reforms are key, but complex, interrelated and broad in scope, and will take time before their implementation leads to tangible change for consumers and carers,” Mrs Brogden said.

“The National Report indicates while there are significant reforms underway at national, state and local levels, it’s crucial that we maintain momentum and implement these recommendations to ensure sustained change for consumers and carers.”

National Mental Health Commission CEO Christine Morgan said the National Report findings align with what Australians are sharing as part of the Connections Project, which has provided opportunities for the Commission to hear directly from consumers, carers and families, as well as service providers, about their experience of the current mental health system.

“What’s clear is we must remain focused on long term health objectives. Implementation of these targeted recommendations will support this focus,” Ms Morgan said.

The NMHC recommendations require collaboration across the sector.  As part of its ongoing monitoring and report role, the NMHC will work with stakeholders to identify how progress of the recommendations can be measured.

For your nearest ACCHO contact for HELP 

NACCHO Aboriginal #Environmental Health ClosingtheGap #HaveYourSay : Our CEO Pat Turner’s speech to the National Aboriginal and Torres Strait Islander Environmental Health Conference in Perth this week

” In mainstream settings, there is no battle for recognition or resources for environmental health from finance departments. There is nothing more to prove and a fully resourced framework is in place. 

But Aboriginal environmental health is something else again.

Aboriginal environmental health combines deep cultural knowledge of how things work in Aboriginal communities with these hard scientific facts about disease.

Aboriginal environmental health must forge high-trust partnerships with community. 

Aboriginal environmental health is a community asset.

And Aboriginal environmental health is needed now more than ever.   Why is this so?

Public housing and public utilities have largely been taken out of Aboriginal control. In some locations, funding for the Aboriginal Environmental Health workforce has evaporated.\

Sometimes, the power to make the simplest decision on the ground has been ripped away from local communities. 

Instead, this power is with someone far away who doesn’t even know us.

This is nowhere more manifest than in Aboriginal housing. 

Effective Aboriginal environmental health programs must be in Aboriginal hands. 

Community controlled organisations must drive the necessary knowledge exchange between those who hold technical expertise and those who have been denied it.

The very nature of this work means that Aboriginal communities must retain the reins – and retain the knowledge

Selected extracts NACCHO CEO Pat Turner addressing the National Aboriginal and Torres Strait Islander Environmental Health Conference in Perth this week

As an Aboriginal woman of Gudanji-Arrernte heritage, I wish to acknowledge the Whadjuk people of the Noongar nation as traditional owners of the land where we meet today.

I also acknowledge our continuing and vibrant First Nations cultures.  I am grateful for the contributions of our past, present and emerging leaders.

Our cultures, our leaders and our country give us collective strength and resilience as Aboriginal and Torres Strait Islander peoples.

Just a note for about language conventions in Western Australia. I tend to use the term Aboriginal in recognition that Aboriginal people are the original inhabitants here. This is not out of any disrespect to Torres Strait Islander colleagues and communities.

I have discovered that the first NATSIEH conference was held in 1998. Every second year or so since, the aim of these national conferences is to increase the understanding and awareness of environmental health issues in our communities.

This year, your theme is ONE GOAL: MANY PATHS.  There must be a huge diversity of backgrounds, professions and experiences in the room.   I am delighted to be here.  I hope I have something for everyone in my address to you today.

I will begin with recent CHANGES in the way governments must now work with Aboriginal and Torres Strait Islander people.

Then I’ll cover some CHALLENGES that we can no longer ignore.

And finally, I’ll explain how Aboriginal LEADERSHIP will show the right path that we must take together.

How has our political landscape changed?

Please cast your minds back to 2008 when the original Closing the Gap policy was agreed by the Council of Australian Governments – known as COAG.

There was never full ownership of Closing the Gap from Aboriginal and Torres Strait Islander peoples. CLOSING the Gap was always considered to be an initiative of Governments.  Frankly, it was governments talking to other governments ABOUT us.  WITHOUT us.

Many Aboriginal and Torres Strait Islander Peak bodies supported Closing the Gap in good faith, particularly with new funding given to specific issues including housing, health and education.

But was Closing the Gap ever going to work with its genesis in the bureaucratic backrooms of Canberra?

Our people were always going to be configured as ‘the problem’.  Not as allies, not as experts, not as partners, not as equals.  It was not surprising to Aboriginal people to see that progress was patchy.

As Prof Marcia Langton, a leading Aboriginal academic of Yiman and Bidjara heritage, said in February this year at the Australian and New Zealand School of Government Indigenous conference:

“You can’t have administration of very complex matters from the Canberra bubble. It’s not working and lives are being lost. 

… We must push for policies that give formal powers to the Indigenous sector and remove incompetent, bureaucratic bungling.”

Marcia made a specific request of those who were listening:

“Please do not feel personally offended by what I have to say to you” she said.

I also ask this of you today.  And as Marcia continued to say:

‘… we must all take responsibility and be courageous enough to take action, to put an end to the policies and programs that disempower Aboriginal and Torres Strait Islander people, not just causing a decline in their living standards, but accelerating them into permanent poverty.

Especially the vulnerable. The children and youth are victims of a failed view of the Indigenous world and Indigenous people. This is a dystopian nightmare. We must imagine a future in which Indigenous people thrive and we must do whatever it takes to reach that future. This is urgent.”

It is not surprising then, that after 10 years, not much progress against the Closing the Gap targets had been made.

As the Closing the Gap targets were expiring, COAG announced a “Refresh” of Closing the Gap.  This “refresh” kicked in during 2017.  As various conversations took place however, it became clear that governments were still not listening properly or engaging in a genuine way, and they only wanted to talk about new targets.

Many Aboriginal Peak bodies wanted more time to test the options being put before us in these conversations. Most importantly, Peak bodies needed to be sure that THEIR voices were truly being heard. There was a real concern – AGAIN – that governments had already decided what they wanted to do. That governments were now negotiating behind closed doors to decide new priorities and targets without our input.

As Aboriginal peak bodies, we had to call this out before the country made another momentous mistake. We were very insistent.  We formed a Coalition.  The Prime Minister and his COAG colleagues had to adopt a better way of working.  Without a radical change in approach, the next ten years would be more of the same lack luster approach.

To his credit, Prime Minister Morrison listened.

He opened the door to a new way of working, giving his personal authority to change.

An historic Partnership Agreement on Closing the Gap was signed this year in March between COAG and the Coalition of Peaks.  This means that now, for the first time, Aboriginal and Torres Strait Islander people, through their peak body representatives, will share decision making with governments on Closing the Gap.

How is this to be done?

This Partnership Agreement has created a high-level COAG Joint Council.  This Joint Council is made up of 22 members.  That means a Minister from the Commonwealth Government, a Minister from each State and Territory Governments, and a representative for local government. This makes up ten members.

But significant success was realized when the Coalition of Aboriginal Peak Bodies ensured TWELVE Aboriginal or Torres Strait Islander representatives were on the Joint Council.  Chosen by us, in the majority, working for our mobs.

The Joint Council is co-chaired by the current Commonwealth Minister for Indigenous Australians and a representative of the Coalition of Peaks chosen by the Peaks. Currently, that representative is me.

The Partnership Agreement embodies the belief of all signatories that:

  • When Aboriginal and Torres Strait Islander peoples are included and have a real say in the design and delivery of services that impact on them, the outcomes are far better;
  • Aboriginal and Torres Strait Islander peoples need to be at the centre of Closing the Gap policy: the gap won’t close without our full involvement; and
  • COAG cannot expect us to take responsibility and work constructively with them to improve outcomes if we are excluded from the decision making.

So to those public servants in the audience, whether you work in Commonwealth, state, territory or local government institutions, I say this.

If the Director-General, Secretary or CEO of your department or agency is not enabling you to do your work differently and act in accordance with the Partnership Agreement, Principles, then you need to join the movement and shake the tree.

I encourage you to:

  • Initiate co-design that looks entirely different to the way your department worked two years ago.
  • Give power of veto to communities on priorities. Listen to what THEY say.
  • Double the number of Indigenous people on your committees.
  • Forget ‘one size fits all’ … because it doesn’t.
  • Immerse yourself in this unprecedented opportunity for true equity in our country.

Trust me, your change of practice will be noticed, commended and supported.

Within the Joint Council, we will continue to lead the structural reform that will make your change of practice easier.  At our recent meeting in Adelaide, the Joint Council significantly agreed to develop a new National Agreement on Closing the Gap centred on three reform priorities.

The reform priorities seek to change the way Australian Governments work with Aboriginal and Torres Strait Islander peoples and organisations, and accelerate life outcomes for Aboriginal and Torres Strait Islander peoples, these are:

  1. Establishing shared formal decision making between Australian governments and Aboriginal and Torres Strait Islander people at the State/Territory, regional and local level to embed ownership, responsibility and expertise on Closing the Gap.
  2. Building and strengthening Aboriginal and Torres Strait Islander community-controlled organisations to deliver services and programs in priority areas.
  3. Ensuring all mainstream government agencies and institutions undertake systemic and structural transformation to contribute to Closing the Gap.

The Joint Council also agreed to the Coalition of Peaks leading engagements with Aboriginal and Torres Strait Islander people over the next two months to ensure others can have a say on the new National Agreement on Closing the Gap.

The Coalition of Peaks want to hear views from across the country on what is needed to make the reform priorities a success.

 

I encourage you all to contribute and have your say.

You can find out more on the NACCHO website. Step up and join in!

I know these priorities, especially the first two, are critical to our success as Aboriginal  people. And I know this from a lifetime of advocacy and service for my people, including my current role as CEO of NACCHO.

NACCHO is the living embodiment of the aspirations of Aboriginal and Torres Strait Islander communities and our struggle for self-determination.  NACCHO is the national peak body representing 143 Aboriginal Community Controlled Health Services or “ACCHOs” across the country.   NACCHO has a history stretching back to a meeting in Albury in 1974 in country New South Wales.

For those who don’t know, an “ACCHO” is a primary health care service initiated and operated by the local Aboriginal community to deliver holistic, comprehensive, and culturally appropriate health care to the community which controls it, through a locally elected Board of Management.

As a sector, we are especially proud that ACCHOs are the largest employer of Aboriginal and Torres Strait Islanders in the country.  Not even the mining sector compares. We also have evidence that ACCHOs are demonstrably better than mainstream in providing culturally responsive, clinically effective primary health care.

At this year’s AMSANT conference, Donna Ah Chee, a Bundgalung woman from NSW and CEO of Central Australian Aboriginal Congress, said precisely what community control means in this context.

Read full speech HERE

It means:

  • The right to set the agenda and determine what the issues are
  • The right to determine which programs or approaches are best suited to tackle the problems in the community
  • The right to determine how a program is run, its size and resources
  • The right to determine when a program operates, its pace and timing
  • The right to say where a program will operate, its geographic coverage and its target groups
  • The right to determine who will deliver the program its staff and advisers.

This commitment to equal partnership through COAG has brought us to the table.  There’s no going back.

I’d now like to cover some CHALLENGES in environmental health. 

Environmental health is a science-based, technical practice.  Environmental health takes scientific knowledge to people. It focuses on disease risk and finds the way to limit disease in modern society. Environmental Health Practitioners draw the connection between environmental factors and health outcomes.

Environmental health practitioners take this science and fix environmental hazards to prevent risk. They nip outbreaks in the bud.

They influence and draft legislation, and monitor compliance with public health laws and the regulations to protect people’s health.

Of course, in mainstream Australia, hardly anyone recognizes the role that environmental health plays.  For the majority of the population, environmental health is silently present. Water, sanitation, rubbish, housing standards, food safety, everything … it is all taken for granted.

In mainstream settings, there is no battle for recognition or resources for environmental health from finance departments. There is nothing more to prove and a fully resourced framework is in place.

But ABORIGINAL environmental health is something else again.

Aboriginal environmental health combines deep cultural knowledge of how things work in Aboriginal communities with these hard scientific facts about disease. Aboriginal environmental health must forge high-trust partnerships with community.

Aboriginal environmental health is a community asset.

And Aboriginal environmental health is needed now more than ever.   Why is this so?

Public housing and public utilities have largely been taken out of Aboriginal control. In some locations, funding for the Aboriginal Environmental Health workforce has evaporated. Sometimes, the power to make the simplest decision on the ground has been ripped away from local communities.  Instead, this power is with someone far away who doesn’t even know us.

This is nowhere more manifest than in Aboriginal housing.

First, the evidence.  A recent systematic review of the scientific literature has summarized the known causal links between the home environment and health.  Here are some examples:

  • Skin-related diseases are associated with crowding
  • Viral conditions such as influenza are also associated with crowding.
  • Ear infections are associated with crowding, lack of functioning facilities for washing people, bedding and sewerage outflow.
  • Gastro infections are associated with poorly maintained housing and the state of food preparation and storage.

These are not hypothetical claims yet to be proved.  These have academic weight and the verdict is in.

In mainstream Australia, these causal links between the housing and health have been actioned.  In mainstream Australia, sustained progress in the social and environmental determinants of health has permanently reduced the rates of preventable infectious diseases.  One look at the disease burden tells us that.

BUT … because of the state of OUR environmental conditions, Aboriginal people are denied the health outcomes that non-Indigenous people now enjoy.

The challenge is huge.

  • Let’s consider clinic presentations for Aboriginal children for their first year of life. Did you know that research has found that the median number of clinic presentations per child in the first year of life was 21.  Twenty-one! Per child!   Children in this NT study would typically have six clinic presentations for diarrhea in any one year!  SIX! An infectious ear disease known as Otitis Media and skin infections were also high on the list of most frequent reasons for Aboriginal children coming to the clinic in their first year of life. These infectious diseases are NOT caused by bad parents.  They are caused by poor living conditions, overcrowding and poverty imposed on our people.
  • In the Fitzroy Valley in the Kimberley here in Western Australia, 70% of Aboriginal children have been admitted to hospital at least once before they turn seven years of age. A closer look at the reasons why is shocking.  The researchers concluded that most of these admissions would not have happened at all if household disadvantage, poor quality housing and access to primary health care had been addressed.
  • Another example comes from the Western Desert region here in Western Australia. This looked at clinic presentations of all children aged 0 to 5 years of age.  These children had on average more than 30 clinic visits each per year to their clinic. ………  Think about what that means to the morale of the parents, the attitudes of the clinicians, the health budget bottom line. Infectious diseases explained half of these presentations:
    • Ear infections were 15%
    • Upper respiratory tract infections, 13%
    • Skin sores were 12% of the total.
    • And 25% needed treatment for scabies.
  • These statistics aren’t just confined to remote communities. Aboriginal children in Western Sydney in homes with 3 or more housing problems were two and a half times more likely than others to have recurrent gastro-enteritis. For every additional housing problem, the odds of infectious disease significantly increased.

But is this all NEWS?  What about the year of your first NATSIEH conference in 1998?

1998 was the year a study was published showing that admissions to hospital for skin disease of Aboriginal children under five years of age was ten times higher than that of their non-Indigenous counterparts.

It was also the year that deaths among Aboriginal men from infectious diseases were calculated to be some 15 times higher than deaths among non-Indigenous men.

1998 was also the year a study measured the precise “wear and tear” on washing machines installed in seven remote communities.

1998 was a year AFTER a study had already been published showing that over one-third of Aboriginal remote communities had water supply or sanitation problems. Seventy percent had housing problems.  In the words of the researchers, overcrowding and substandard housing were “commonplace”.

So there we have it.   Even this brief snapshot shows we have a disconnect between data and decisions.

From your first conference in 1998 to this one in 2019 …

….  Aboriginal people, their children and now their children’s children have NOT been afforded their DUE HUMAN RIGHTS in response to these “repeat plays” of research data.

Should we have mobilised a more strategic response at the time these research studies were published?

Perhaps data sovereignty is another challenge we need to face.

I regret thinking of the number of children growing up since 1998 who should have been safe from preventable infections IF THERE HAD BEEN ACTION.  I think of how many children need not have gone to hospital.  Who should NOT have ended up with permanent damage for life from rheumatic heart disease or deafness …

… and would NOT have ended up with these conditions if their houses had been safe, healthy and affordable.

I have been told even mental health problems – including suicide – get worse in overcrowded houses not fit for social purpose.

And please don’t tell me we can’t find the money.  My colleagues in the Kimberley estimate that one third of the entire cost of hospital admissions of Aboriginal children is DIRECTLY due to the environmental conditions in which these children live.  Let me repeat that. One third of the entire cost.

In one year alone, $16.9 million is the estimated cost for hospitalisations of Aboriginal people directly due to the environment. And that was just the Kimberley.

Maybe all those departments of housing really don’t have the money BUT their colleagues in health departments are spending it hand over fist.

The Australian Indigenous Governance Institute affirms that Aboriginal people have the right to:

  • Exercise control of the data “ecosystem” including creation, development, stewardship, analysis, dissemination and infrastructure.

We also have the right to:

  • Data structures that are accountable to Aboriginal and Torres Strait Islander peoples and their governance structures.

And the right to

  • Data that is protective and respects our individual and collective interests.

AND

  • Data that is relevant and empowers sustainable self-determination and effective self-governance.

In my view, Aboriginal people must more clearly set the agenda for the health data story.

As Aboriginal people, WE are vested in the outcomes.  WE are accountable to each other, our families and communities.  These research studies represent OUR families, OUR loved ones, OUR LOST ones.

I believe the character and foresight of Aboriginal leadership will show the right path. 

Should you need convincing, I can think of no better example in environmental health than Yami Lester and the Nganampa Health Council in the APY lands.

Decades ago, these leaders knew that health improvement required medical services AND a healthy living environment.  In 1986, they initiated a collaborative project between local Anangu people and technical experts to ‘stop people getting sick’. Some of you may recognise this as the UKP project.

These Aboriginal leaders engaged Paul Pholeros and Dr Paul Torzillo to work together to develop a codified schedule for home assessments and repairs.  When assessments were finished, simple repairs to health hardware that could be fixed, WERE fixed.  Immediately, over 75% of these assessment and repair teams were local Aboriginal and Torres Strait Islander people trained and assisted by skilled managers and team leaders.

Any requirements for major repairs that were the responsibility of the landlord were submitted, logged and monitored. As this program expanded, data from different locations showed that the reasons for poor housing conditions were shoddy building materials in the first place (22%); inadequate maintenance schedules by the landlord (70%) and less than 8% was due to damage by occupants.

As relevant today, Yami Lester and his Council knew the importance of sharing with their people knowledge about disease transmission and supporting households to adopt new habits to sustain health in circumstances none of us would find easy.

And they succeeded.

Their legacy is the framework of nine Healthy Living Practices about washing, clothes, wastewater, nutrition, crowding, animals, dust, temperature and safety against injury.

Today, housing audits and home hardware assessments conceived by Aboriginal leaders in this UKP project MUST be permanently funded everywhere and combined with culturally responsive support directed by communities to re-build THEIR knowledge about disease transmission.

Every home is different.  Every environmental risk assessment is unique.  In one, there might be an issue with food-borne diseases. In another, passive smoking that affects the children’s ears, lungs and eyes.  In another, it could be …

– a blocked toilet,

– a shower dislodged from a poorly laid wet floor, or

– a washing machine that has collapsed under the pressure from multiple loads and hard water every single day.

Resources enable Aboriginal environmental health workers and families to work together over time to build the household’s confidence and knowledge.  The shared goal is self-management in healthy habits ….. AND an assertiveness as tenants to report poor quality building materials, housing problems and urgent repairs to the respective housing landlord.

Effective Aboriginal environmental health programs must be in Aboriginal hands.  Community controlled organisations must drive the necessary knowledge exchange between those who hold technical expertise and those who have been denied it. The very nature of this work means that Aboriginal communities must retain the reins – and retain the knowledge.

What Yami Lester envisaged is our unrealized obligation.

Housing programmes will have limited impact UNLESS they are controlled in their design and delivery by Aboriginal organisations with sustained visibility, authority and relationships in the community.  Communities have ideas on how to manage overcrowding, maintain housing stock and build new housing through local entrepreneurship. It is time once again for Aboriginal leaders to be heard.

You may know about extensive consultations conducted across the country in 2017 known as “My Life My Lead”.

The purpose of these consultations was to provide an opportunity to shape the next update of the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan released originally in 2013.

At these consultations, Aboriginal people spoke up about the fundamental significance of social, economic and environmental determinants affecting their health and wellbeing.

Environmental health was identified as one of seven top priorities for the next Implementation Plan.

I quote:

Addressing the underlying environmental health conditions that contribute to poor health outcomes in many Aboriginal and Torres Strait islander communities will lead to long-term improved health, education and employment outcomes. 

This is why I hope my message to you today is clear. We will get better health by improving housing and environmental health programs. Regaining control over decisions about housing will also lead to better health.  Returning authority for decision-making to communities about resources and program design reinvigorates empowerment, autonomy and more equitable power arrangements.  Self-determination promotes health.

With a decent investment in Aboriginal housing alongside genuine shifts in who makes decisions about resource allocation, I am prepared to guarantee to you today that the impact on Aboriginal health outcomes will be large, positive and permanent.

If those estimates of the costs from hospital admissions hold true nationally, I am also prepared to guarantee a significant reduction in healthcare budgets.

Our Prime Minister is inclined to miracles … so I think this would be the next miracle he’d very much like to see!

If we believe in public health and preventing the preventable …

If we believe in equity and social justice …

If we believe in community control …

… then we have everything we need to turn this around.

To governments I say let Aboriginal leaders sit down with you and – together in partnership – analyse the current state of environmental health and housing in your jurisdictions.

Let’s establish the level of investment that will reduce the cost of hospitalisations of Aboriginal children, adults and elders due to poor housing and living conditions.

Let’s develop national standards for a safe house. Let’s agree to strict criteria for urgent and priority housing repairs.  Let’s audit repair performance.  Let’s publish the data.

Let’s get more accountability from public housing for proactive home maintenance schedules and repairs.

Let’s invest in environmental and building programs that will cut the demand in primary health care clinics by a quarter and let these busy staff focus on other priorities.

Let’s grow knowledge in our communities as experts in healthy living.

Let’s train, credential and employ young Aboriginal people as environmental health workers, plumbers, electricians and carpenters to keep houses safe, healthy and ready for climate change ahead.

Let’s ensure a sustainable on-the-ground workforce for effective environmental health employed by Aboriginal organisations.

Here at this conference, let’s create the cross-sectoral approach involving communities, environmental health, primary health care and governments IN PARTNERSHIP to get this moving.

In closing, I’d like to quote Senator Patrick Dodson, a Yawuru man from Broome who, in February this year, asked a very important question:

“Who actually closes the gap?”

He answered this by saying:

“It’s the people working at the grassroots, led by First Nations peoples, with a deep understanding and lived experience of the needs of their communities.”

It is in that spirit that I thank each and every Aboriginal Environmental Health Practitioner at this conference whether it is your 1st or your 12th.

I know you work hard. I know you care deeply about your communities.  I know you lead by example.

I respect your hard-earned skills and your expertise to provide a huge scope of professional services ranging from dog control to vector management.

I admire your precise and up-to-date knowledge of disease transmission routes, hazardous chemicals, sanitation and practical engineering.

I am sincerely impressed by the care you take to work with families whose circumstances are complex … and that you find THEIR strengths and work with their capacities.

You respect cultural protocols.  You deliver with few resources, a lot of ingenuity and teamwork.

It is enabling YOU to do an even better job for YOUR communities that motivates me to do mine.  And I will keep on working just as hard as you do.

It’s been a pleasure sharing my reflections with you all.

Thank you for this opportunity to kick off the second day of your 12th NATSIEH conference here in Perth.

 

NACCHO Aboriginal Mental Health #RUOKDay @ruokday ? Download #RUOKSTRONGERTOGETHER resources a targeted #MentalHealth #SuicidePrevention campaign to encourage conversation within our communities. Contributions inc Dr Vanessa Lee @joewilliams_tew @ShannanJDodson

Regardless of where we live, or who our mob is, we can all go through tough times, times when we don’t feel great about our lives or ourselves. That’s why it’s important to always be looking out for each other.

If someone you know – a family member, someone from your community, a friend, neighbour or workmate – is doing it tough, they won’t always tell you.
Sometimes it’s up to us to trust our gut instinct and ask someone who may be struggling with life “Are you OK?”.

By asking and listening, we can help those we care about feel more supported and connected, which can help stop them from feeling worse over time.

That’s why this campaign has a simple message: Let’s talk. We are stronger together

“Nationally, Indigenous people die from suicide at twice the rate of non-Indigenous people. This campaign comes at a critical time.

As a community we are Stronger Together. Knowledge is culture, and emotional wellbeing can be learned from family members such as mothers and grandmothers.

These new resources from R U OK? will empower family members, and the wider community, with the tools to look out for each other as well as providing guidance on what to do if someone answers “No, I’m not OK”.”

Dr Vanessa Lee BTD, MPH, PhD Chair R U OK’s Aboriginal and Torres Strait Islander Advisory Group whose counsel has been integral in the development of the campaign

Read over 130 + NACCHO Aboriginal Health and Suicide Prevention articles

Click here to access the STRONGER TOGETHER resources on the RUOK? website

The Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP)

https://www.atsispep.sis.uwa.edu.au/

 I have struggled with depression and anxiety for as long as I can remember. I’m 32 years old and only this year did I have the first psychologist ever ask me about my family history and acknowledge the intergenerational trauma that runs through Indigenous families.

Like many others, I have thought about taking my own life. There were a myriad of factors that led to that point, and a myriad of factors that led to me not following through. But one of the factors was the immense weight of intergenerational trauma that I believe is embedded into my heart, mind and soul and at times feels too heavy a burden to carry.

We can break this cycle of trauma. We need culturally safe Indigenous-designed suicide prevention programs and to destigmatise conversations around mental health. My hope is that, by sharing my own experiences of dealing with this complex subject, other people will be able to see that intergenerational trauma affects all of our mob.

The more we identify and acknowledge it, we’ll be stronger together “

Shannan Dodson is a Yawuru woman and on the RUOK? Indigenous Advisory committee that has launched the Stronger Together campaign targeted at help-givers – those in our communities who can offer help to those who are struggling ;

See full story Part 2 Below or HERE

R U OK? has launched STRONGER TOGETHER, a targeted suicide prevention campaign to encourage conversation within Aboriginal and Torres Strait Islander communities.

Developed with the guidance and oversight of an Aboriginal and Torres Strait Islander Advisory Group and 33 Creative, an Aboriginal owned and managed agency, the campaign encourages individuals to engage and offer support to their family and friends who are struggling with life. Positive and culturally appropriate resources have been developed to help individuals feel more confident in starting conversations by asking R U OK?

The STRONGER TOGETHER campaign message comes at a time when reducing rates of  suicide looms as one of the biggest and most important challenges of our generation.

Suicide is one of the most common causes of death among Aboriginal and Torres Strait

Islander people. A 2016 report noted that on average, over 100 Aboriginal and Torres Strait Islander people end their lives through suicide each year, with the rate of suicide twice as high as that recorded for other Australians [1]. These are not just numbers. They represent lives and loved ones; relatives, friends, elders and extended community members affected by such tragic deaths.

STRONGER TOGETHER includes the release of four community announcement video

The video series showcases real conversations in action between Aboriginal and Torres Strait Islander advocates and role models.

The focus is on individuals talking about their experiences and the positive impact that sharing them had while they were going through a tough time.

“That weekend, I had the most deep and meaningful and beautiful conversations with my Dad that I never had.

My Dad was always a staunch dude and I was always trying to put up a front to, I guess, make my Dad proud. But we sat there, and we cried to each other.

I started to find myself and that’s when I came to the point of realising that, you know, I’m lucky to be alive and I had a second chance to help other people.”

When we talk, we are sharing, and our people have always shared, for thousands of years we’ve shared experiences, shared love. The only way we get out of those tough times is by sharing and talking and I hope this series helps to spread that message.”

Former NRL player and welterweight boxer Joe Williams has lent his voice to the series.

Born in Cowra, Joe is a proud Wiradjuri man. Although forging a successful professional sporting career, Joe has battled with suicidal ideation and bipolar disorder. After a suicide attempt in 2012, a phone call to a friend and then his family’s support encouraged him to seek professional psychiatric help.

Australian sports pioneer Marcia Ella-Duncan OAM has also lent her voice to the series. Marcia Ella-Duncan is an Aboriginal woman from La Perouse, Sydney, with traditional connection to the Walbunga people on the NSW Far South Coast, and kinship connection to the Bidigal, the traditional owners of the Botany Bay area.

“Sometimes, all we can do is listen, all we can do is be there with you. And sometimes that might be all you need. Or sometimes it’s just the first step towards a much longer journey,” said Marcia.

Click here to access the STRONGER TOGETHER resources on the RUOK? website.

If you or someone you know needs support, go to:  ruok.org.au/findhelp

Part 2

Shannan Dodson is a Yawuru woman and on the RUOK? Indigenous Advisory committee that has launched the Stronger Together campaign targeted at help-givers – those in our communities who can offer help to those who are struggling ;

Originally Published the Guardian and IndigenousX

It is unacceptable and a national disgrace that there have been at least 35 suicides of Indigenous people this year – in just 12 weeks – and three were children only 12 years old.

The Kimberley region – where my mob are from – has the highest rate of suicide in the country. If the Kimberley was a country it would have the worst suicide rate in the world.

A recent inquest investigated 13 deaths which occurred in the Kimberley region in less than four years, including five children aged between 10 and 13.

Western Australia’s coroner said the deaths had been shaped by “the crushing effects of intergenerational trauma”.

When we’re talking about Indigenous suicide, we have to talk about intergenerational trauma; the transfer of the impacts of historical trauma and grief to successive generations.

These multiple layers of trauma can have a “cumulative effect and increase the risk of destructive behaviours including suicide”. Many of our communities are, in essence, “not just going about the day, but operating in crisis mode on a daily basis.”

I have struggled with depression and anxiety for as long as I can remember. I’m 32 years old and only this year did I have the first psychologist ever ask me about my family history and acknowledge the intergenerational trauma that runs through Indigenous families.

Like many others, I have thought about taking my own life. There were a myriad of factors that led to that point, and a myriad of factors that led to me not following through. But one of the factors was the immense weight of intergenerational trauma that I believe is embedded into my heart, mind and soul and at times feels too heavy a burden to carry.

Indigenous suicide is different. Suicide is a complex issue, there is not one cause, reason, trigger or risk – it can be a web of many indicators. But with Aboriginal and Torres Strait Islander people intergenerational trauma and the flow-on effects of colonisation, dispossession, genocide, cultural destruction and the stolen generations are paramount to understanding high Indigenous suicide rates.

When you think about the fact that most Indigenous families have been affected, in one or more generations, by the forcible removal of one or more children, that speaks volumes. The institutionalisation of our mob has had dire consequences on our sense of being, mental health, connection to family and culture.

Just think about that for a moment. If every Indigenous family has been affected by this, of course trauma is transmitted down through generations and manifests into impacts on children resulting from weakened attachment relationships with caregivers, challenged parenting skills and family functioning, parental physical and mental illness, and disconnection and alienation from the extended family, culture and society.

The high rates of poor physical health, mental health problems, addiction, incarceration, domestic violence, self-harm and suicide in Indigenous communities are directly linked to experiences of trauma. These issues are both results of historical trauma and causes of new instances of trauma which together can lead to a vicious cycle in Indigenous communities.

Our families have been stripped of the coping mechanisms that all people need to thrive and survive. And while Aboriginal and Torres Strait Islander people are resilient, we are also human.

Our history does shape us. Let’s start from colonisation. My mob the Yawuru people from Rubibi (Broome) were often brutally dislocated from our lands, and stripped of our livelihood. Our culture was desecrated and we were used for slave labour.

My great-grandmother was taken from her father when she was very young and placed in a mission in Western Australia. My grandmother and aunties then all finished up in the same mission. And two of those aunties spent a considerable time in an orphanage in Broome, although they were not orphans.

In 1907, a telegram from Broome station was sent to Henry Prinsep, the “Chief Protector of Aborigines for Western Australia” in Perth. It reads: “Send cask arsenic exterminate aborigines letter will follow.” This gives a glimpse of the thinking of the time and that of course played out in traumatic and dehumanising ways.

In the late 1940s a magistrate in the court of Broome refused my great-grandmother’s application for a certificate of citizenship under the Native Citizen Rights Act of Western Australia. Part of his reasons for refusing her application was that she had not adopted the manner and habits of civilised life.

My anglo grandfather was imprisoned for breaching the Native Administration Act of Western Australia, in that he was cohabiting with my grandmother. He was jailed for loving my jamuny (grandmother/father’s mother).

My dad lost his parents when he was 10 years old. My grandfather died in tragic circumstances – and then my grandmother, again in tragic circumstances, soon after.

My dad was collected by family in Katherine and taken to Darwin. There was a fear that he would be taken away – Indigenous families knew well the ways of the Native Welfare authorities, and I suspect they were protecting my dad from that fate. Unlike many Indigenous families, he was permitted to stay with them and became a state child in the care of our family.

My family has suffered from ongoing systematic racism and research has shown that racism impacts Aboriginal people in the same way as a traumatic event.

My family and community have suffered premature deaths from suicide, preventable health issues, grief and inextricable trauma.

We can break this cycle of trauma. We need culturally safe Indigenous-designed suicide prevention programs and to destigmatise conversations around mental health. My hope is that, by sharing my own experiences of dealing with this complex subject, other people will be able to see that intergenerational trauma affects all of our mob. The more we identify and acknowledge it, we’ll be stronger together.

NACCHO Aboriginal #MentalHealth and #SuicidePrevention : Read and Watch @beyondblue Chair The Hon Julia Gillard AC speech @UniofAdelaide Truth-telling and reconciliation will enhance the social and emotional wellbeing of Indigenous Australians.

” Suicide in our Indigenous communities is one of the greatest challenges of our times and its causes are complex.

Beyond Blue cannot claim or seek to be a specialist or comprehensive provider of social and emotional wellbeing or suicide prevention services for Aboriginal and Torres Strait Islander people.

That is a role which is more appropriately the domain of Aboriginal-led and community-controlled organisations.

But we can apply what we have learnt so far through our Reconciliation Action Plan, our growing cultural competencies, and strong relationships with Aboriginal and Torres Strait Islander peoples, leaders and organisations.

We can complement the work of the Aboriginal organisations and others by ensuring our major interventions are suitable for, and accessible to, Aboriginal and Torres Strait Islander people wherever possible, and use our well-known brand and strength in communications to fight racism and discrimination.

We will recognise those inherent protective factors of Indigenous cultures and communities – those powerful forces of resilience, humour, spirituality and connectedness – that can and should be utilised as sources of strength and healing.

We are ready to work alongside Indigenous people and communities in co-designing solutions to provide better outcomes for health and wellbeing.

We intend to be the best ally we can be, lend our voice when required and listen to learn.

We need to educate ourselves and ask questions when we need to; to commit, to support, to ally.

We pledge to be a positive force for change as the nation addresses the issue of constitutional recognition of Aboriginal and Torres Strait Islander peoples.

Aboriginal and Torres Strait Islander peoples have always resisted actions designed to destroy their culture, disperse their families and sever their connections to Country.

The day will come when we look with pride upon that determination, and indeed celebrate it as a complete history.

The Hon Julia Gillard AC University of Adelaide public lecture 2019 3 September 2019

Yellaka Dance Group 

Read over 230 Aboriginal Mental Health articles published by NACCHO in past 7 years

Read over 150 Aboriginal Suicide Prevention articles published by NACCHO in Past 7 years

I acknowledge the traditional owners of the land on which we meet and in the spirit of reconciliation, pay my respects to Elders past and present. Yellaka, thank you for your warm Greeting to Country.

Introduction

The is the second time I have had the privilege of being so welcomed by Yellaka. The first time was at the recent South Australian State dinner to celebrate 125 years of women’s suffrage in our State – a milestone to be inspired by.

In fact, that dinner was very important for me in preparing for this lecture.

It caused to me to reflect on the complexity of history; on our achievements and failings. In that speech I spoke about the need to erect a permanent monument to celebrate the fight for women’s suffrage and all that was gained here in South Australia in 1894.

But in doing so, I said care must be taken to tell the whole story, not part of it.

Despite Aboriginal men and, as a result of women’s suffrage, Aboriginal women having the right to vote, it was common for them neither be told about it nor supported to enrol. Sometimes this oppressive neglect morphed into a more active discouragement from participating.

This pernicious repudiation of a human right was compounded by a direct legal bar, when in the 1902 Commonwealth Franchise Act, Aboriginal and Torres Strait Islander people were excluded from voting in federal elections. It was not until 1962 that Indigenous Australians could have a say in who governed our nation.

We cannot tell the history of how our democracy developed without looking squarely at how equality was denied for so long.

This is just one example of the need to tell the deeper truths that lie beyond the surface.

To quote the words of Labor Prime Minister Paul Keating in his famed Redfern Speech, we need:

Recognition that it was we who did the dispossessing.

We took the traditional lands and smashed the traditional way of life. We brought the diseases. The alcohol.

We committed the murders.

We took the children from their mothers.

We practised discrimination and exclusion.

It was our ignorance and our prejudice.

And our failure to imagine these things being done to us.

With some noble exceptions, we failed to make the most basic human response and enter into their hearts and minds.

We failed to ask – how would I feel if this were done to me?

Friends, this question is as profoundly challenging today as it was when Paul spoke those words almost thirty years ago. Trying to answer it requires honesty, empathy, intellectual understanding, spiritual depth.

Today, I am asking you to bring those characteristics with you as we discuss the tragic topic of suicide and Indigenous Australians.

Honesty

First, with honesty, let’s confront the facts.

Since 2012, suicide has been the leading cause of death among young Aboriginal and Torres Strait Islander people aged 15 to 34.

The suicide rate for Aboriginal and Torres Strait Islander teenagers aged 15 to 19 of both genders is around four times that of their non-Indigenous peers.

Despite Aboriginal and Torres Strait Islander people comprising around three per cent of the Australian population, they account for thirty per cent of the suicide deaths among those under 18 years of age.

There are significant suicide or self-harming clusters that can occur within a single community or locale over a period of weeks or months.

For example, In February, Western Australia’s State Coroner handed down her report on a cluster of 13 deaths that occurred in less than four years in the Kimberley region and included five children aged 10 to 13.

The Coroner spoke of the deaths as profoundly tragic, individually and collectively, of dysfunction, alcohol, domestic violence and grief.

But she added:

to focus only upon the individual events that occurred shortly before their deaths would not adequately address the circumstances attending the deaths. These tragic individual events were shaped by the crushing effects of inter-generational trauma and poverty upon entire communities. That community-wide trauma, generated multiple and prolonged exposures to individual traumatic events for these children and young persons.

Watch video 

Please note : Julia Gillard starts her talk at about 27 minutes into the 1hr 10 min event, and talks for just under 30 minutes. It finishes with a Q&A session (of about 20 minutes).

Empathy

The Coroner here is calling to our ability to show empathy. To walk alongside our First Peoples and try to understand how history and lived reality come together and can create circumstances of despair.

Great damage has been done to our Aboriginal and Torres Strait Islander communities through two centuries of discrimination, dislocation and cultural disruption.

Culture is a word that is often tangled up with nationality, but it entails much more.

Our culture determines so much of our identity; our values, the way we view the world, the way we interact with others, our sense of belonging.

And if the foundations of culture are systemically disrupted – connection to land, traditional places and practices, languages, spirituality, family and kinship ties – it causes devastation across generations.

But honesty also requires us to recognise that there is both deep lingering pain from our history, and new pain that arises in the present.

Imagine not getting the job you’re qualified for because of the colour of your skin; to know you are being followed by a store detective just for being you; to feel the stranger sitting beside you slip sideways to create greater distance.

These are everyday situations – the constant but subtle cues of difference – and where being racially different is nearly always positioned as a liability.

Put simply, racism, including these kinds of behaviours, is not only bad for mental health and wellbeing – it both causes and perpetuates high levels of social and emotional distress for Aboriginal and Torres Strait Islanders. In addition, there is a ‘dose’ effect for psychological distress caused by racism: the more a person is exposed to it, the greater the impact.

That was why Beyond Blue launched its Stop, Think, Respect invisible discriminator campaign in 2014 with a repeat run in 2016.

The campaign – the most viewed and shared in Beyond Blue’s history – highlights the routine everyday impact of subtle racism on the social and emotional wellbeing of Aboriginal and Torres Strait Islander people.

The campaign aimed to change behaviour by encouraging non-Indigenous Australians to think about their often, unconscious behaviours and to think again before they act.

  • To think before they laughed along – even uncomfortably – at a racist joke in the pub.
  • To challenge why they may not sit beside an Aboriginal person on a crowded bus.

But it was the reaction from Indigenous people that was most revealing.

They told us they loved the campaign because finally somebody had noticed that, for them, every day could be a little tougher than it should be.

Over half of Aboriginal and Torres Strait Islander people who experience racial discrimination report feelings of psychological distress, meaning they are at elevated risk of anxiety and depression, substance use and contemplating or attempting suicide.

Empathy requires us to recognise that the threads of the past and the attitudes shown in the present day are woven together. For non-Indigenous Australians, our collective failure to face up to all of the brutal truth of our history and its ongoing effects holds us back from full understanding today.

For Indigenous Australians, the interconnected issues of cultural dislocation, personal trauma and the ongoing stresses of disadvantage, racism and exclusion are absolutely contributing to the heightened risk of mental health problems, substance misuse and suicide.

All this was acknowledged by the Royal Commission Into Aboriginal Deaths In Custody. That report was tabled in 1991.

Intellectual understanding

Driven by empathy, we also need to engage intellectually on the best ways to provide culturally appropriate services and supports to prevent Indigenous suicide.

Nothing less than profound systemic reform is needed to improve social and emotion wellbeing.

Such major change must be culturally informed and co-designed. As many Aboriginal and Torres Strait Islander people continue to remind us, Indigenous policies and responses must be led by Indigenous people, which might mean solutions that look different to anything that has been implemented before.

Innovation and new efforts are needed nationally and locally.

In 2009 the Rudd Government launched the ‘Closing the Gap’ response as a measurable account of Indigenous disadvantage that would be reported to parliament annually on progress.

In the 10 years since launch most of the indicators of disadvantaged have remained stubbornly unmoved. Aboriginal and Torres Strait Islander people can expect to live 10 to 17 years less than other Australians.

While there have been some improvements against some performance indicators, these have been small and incremental.

And babies born to Indigenous mothers still die at more than twice the rate of other Australian babies.

Aboriginal and Torres Strait Islander people experience higher rates of preventable illness such as heart disease, kidney disease and diabetes.

And a major contributing factor to the life expectancy gap is suicide.

There are no mental health or suicide prevention targets in Australia’s Closing the Gap strategy despite the alarming statistics on Indigenous suicide and psychological distress, but as a member of the steering committee, Beyond Blue is adding our voice to rectifying this.

At the same time, we are calling for this act of national leadership, as an organisation we are trying to be a good partner in locally led change models.

In November 2018, Beyond Blue launched Be You: a Commonwealth-funded national initiative that aims to strengthen the mental health literacy, resilience, self-care and help-seeking of every member of Australia’s school communities and early childhood settings.

In January, Minister Wyatt announced $2.3 million over two years to pilot and evaluate a culturally appropriate, place-based adaptation of Be You for schools in the Kimberley and Pilbara regions of WA, in partnership with Aboriginal communities.

That work is now underway. And we are taking a very different approach to this work than what we would normally.

Local stakeholder engagement has confirmed that we must be guided by local communities to genuinely co-design the project; to employ people with community relationships and credibility; and to engage Aboriginal community-controlled organisations to support implementation and delivery of the program.

It’s still very early days, but we are gaining much from partnering with Indigenous communities.

Spiritual depth – Uluru Statement from the Heart

Honesty, empathy, intellectual understanding, all are necessary in the cause of tackling the rate of Indigenous suicide.

But so is spiritual depth, the ability to transcend a divided past, address the dispiriting inequalities of the present and embrace a united future.

Just over two years ago, 250 Aboriginal and Torres Strait Islander leaders endorsed by standing ovation the Uluru Statement from the Heart.

In burning prose it describes that the sovereignty of this nation’s First peoples is ‘a spiritual notion: the ancestral tie between the land, or ‘mother nature’, and the Aboriginal and Torres Strait Islander peoples who were born therefrom, remain attached thereto, and must one day return thither to be united with our ancestors. This link is the basis of the ownership of the soil, or better, of sovereignty.’

It goes on to say:

Proportionally, we are the most incarcerated people on the planet. We are not an innately criminal people. Our children are aliened from their families at unprecedented rates. This cannot be because we have no love for them. And our youth languish in detention in obscene numbers. They should be our hope for the future.

These dimensions of our crisis tell plainly the structural nature of our problem. This is the torment of our powerlessness.

We seek constitutional reforms to empower our people and take a rightful place in our own country. When we have power over our destiny our children will flourish. They will walk in two worlds and their culture will be a gift to their country.

We call for the establishment of a First Nations Voice enshrined in the Constitution.’

As we all know, changing our constitution is difficult in every sense. Conducting and carrying a referendum by a special majority is hard to do. Our history books are littered with the stories of failed referendums. Nineteen referendums proposing 44 changes to the Constitution have been held since Federation but the Australian people have agreed to only eight changes with the last ‘yes’ vote occurring in 1977.

Of course, the Indigenous leaders who gave us the Uluru statement from the heart know this history. They neither underestimate how hard it is to have voters accept change, nor the joy that can come when they do. Many of them were alive when more than 90 percent of Australians voted in the 1967 referendum to allow First Nations people to be included in the census and for the Federal Parliament to have the power to legislate for an improved future.

In the Uluru statement, Indigenous leaders are specifically calling for a comparable act of national unity. There is some reason to believe that voting Australians in their millions are prepared to answer that call.

The Australian Reconciliation Barometer is a national research study conducted every two years to measure and compare attitudes and perceptions towards reconciliation.

In 2018 the Barometer found:

  • 90 per cent of Australians believe the relationship between Aboriginal and Torres Strait Islander people is important;
  • 95 per cent believe that it is important for our First Peoples to have a say in matters that affect them;
  • and 80 per cent support a formal truth telling process.

That there is a public mood for change is further confirmed by the Australian Constitutional Values Survey of 2017 released by the Centre for Governance and Public Policy at Griffith University.

It found 61 per cent of respondents would vote “yes” in a referendum to add an Indigenous voice to Parliament.

So, we increasingly desire a richer understanding of our shared history and some form of national reconciliation, but change can be hard to achieve, even when the majority is willing.

Successive Prime Ministers and governments, Indigenous leaders and organisations have tried to advance this cause.

The government I led set out to bring a referendum on constitutional recognition to the people by the 2013 election. I appointed an Expert Panel on Constitutional Recognition of Indigenous Australians to advise on the wording.

On that panel were some of our most persuasive and respected Indigenous leaders, including The Hon. Ken Wyatt AM, the first Indigenous Australian to serve in the House of Representatives.

The panel’s recommendations were sensible and smart.

But before we could proceed, we needed to diagnose the prospects of success at a referendum. The very worst thing we could do would be to put a referendum proposal forward only to have it fail.

The consensus was we did not have time to build momentum for change ahead of a 2013 election.

That need for certainty remains a critical issue for today’s leaders as they move towards a proposal to put to the people.

But much has changed since 2013 and we can all be heartened by that.  I am especially heartened that we have, for the first time, extremely talented and respected Aboriginal people from both sides of politics leading Indigenous policy and discussion on this issue.

With bi-partisan support, shared commitment and collaboration, change is achievable.

We know wellbeing is intrinsically linked to a strong sense of self, connections to community, and recognition of culture.

That is why I and my Beyond Blue Board colleagues recently approved a comprehensive Aboriginal and Torres Strait Islander Strategy to guide our contribution for the next five years. Through the Strategy, we have resolved to continue to advocate on national issues of importance to Aboriginal and Torres Strait Islander people.

We are particularly determined to raise our voice in support of an openhearted and respectful response to the Uluru Statement from the Heart.

Beyond Blue acknowledges that there are still community and political discussions occurring about constitutional change and recognition. As that conversation continues, Beyond Blue advocacy will be aimed at our nation adopting the kind of far-sighted change that can bring a new era of healing and unity.

This isn’t a mental health organisation dabbling in politics. We do it because structural discrimination has a profound and proven negative impact on individual and community wellbeing and mental health.

This is absolutely about ‘sticking to our knitting’.

This is about the Board of Beyond Blue supporting action on the basis there will be significant benefit to a population group at higher risk of mental health conditions and suicide, and who experience discrimination and disadvantage.

The Board of Beyond Blue also accepts the invitation issued in the Uluru Statement from the Heart to walk with you in ‘a movement of the Australian people for a better future’.

To our federal parliamentarians who are working through how best to respond to the Uluru statement my personal message is this; I know what it is like to be beset with doubts about the best way to respond to a call to address trauma and despair. To worry about making the wrong decision, one that risks more damage.

I went through every painful permutation of that in my head when I worked through whether to call a Royal Commission into Child Sexual Abuse in Institutional Settings. I am not ashamed to say here that in the face of such a major decision, I was afraid.

Specifically, I was afraid that holding a Royal Commission would retraumatise, rather than heal.

As history records, I worked through those fears and called the Commission. I know now from my own observations of the impact of the Royal Commission that great healing can come from heeding the call, truth-telling and acknowledgement of past trauma.

I ask our current leaders on all sides of the parliamentary chamber to work through their fears and concerns. I ask our current leaders to heed the call of the Uluru Statement from the Heart.

Conclusion

Suicide in our Indigenous communities is one of the greatest challenges of our times and its causes are complex.

Beyond Blue cannot claim or seek to be a specialist or comprehensive provider of social and emotional wellbeing or suicide prevention services for Aboriginal and Torres Strait Islander people.

That is a role which is more appropriately the domain of Aboriginal-led and community-controlled organisations.

But we can apply what we have learnt so far through our Reconciliation Action Plan, our growing cultural competencies, and strong relationships with Aboriginal and Torres Strait Islander peoples, leaders and organisations.

We can complement the work of the Aboriginal organisations and others by ensuring our major interventions are suitable for, and accessible to, Aboriginal and Torres Strait Islander people wherever possible, and use our well-known brand and strength in communications to fight racism and discrimination.

We will recognise those inherent protective factors of Indigenous cultures and communities – those powerful forces of resilience, humour, spirituality and connectedness – that can and should be utilised as sources of strength and healing.

We are ready to work alongside Indigenous people and communities in co-designing solutions to provide better outcomes for health and wellbeing.

We intend to be the best ally we can be, lend our voice when required and listen to learn.

We need to educate ourselves and ask questions when we need to; to commit, to support, to ally.

We pledge to be a positive force for change as the nation addresses the issue of constitutional recognition of Aboriginal and Torres Strait Islander peoples.

Aboriginal and Torres Strait Islander peoples have always resisted actions designed to destroy their culture, disperse their families and sever their connections to Country.

The day will come when we look with pride upon that determination, and indeed celebrate it as a complete history.

I look forward with hope to that day and I thank you.