NACCHO Aboriginal #MentalHealth #HOSW8 : Health Minister @GregHuntMP releases  terms of reference for the Productivity Commission’s inquiry into mental health but no specific reference to the needs of young people, Aboriginal and  CALD and LGBTIQ communities

The Coalition Government has this week released the terms of reference for the Productivity Commission’s inquiry into mental health and announced the appointment of an Associate Commissioner for the inquiry.

The Federal Government will establish a Productivity Commission Inquiry into the role of mental health in the Australian economy and the best ways to support and improve national mental wellbeing.

Mental health challenges not only have a devastating personal impact, but significantly affect individuals’ employment and productivity. This has an effect on incomes, living standards, physical wellbeing, and social connectedness.

Mental health also affects businesses, the hospital system, and social services, and therefore has a large effect on Australia’s economy.”

See Part 1 below for Terms of Reference

Productivity Commission’s inquiry into mental health website

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” The Minister for Health promised the Inquiry would begin in October but delayed the release of the Terms of Reference until today.

Labor wrote to Minister Hunt and Treasurer Frydenberg seeking input into the Terms of Reference of this important Inquiry.

We are pleased the Inquiry will have regard to previous work by the National Mental Health Commission and the Productivity Commission but are disappointed emphasis on prevention, early intervention and the need for data has not been explicitly mentioned.Labor also hoped to see specific reference to the needs of young people, Aboriginal and Torres Strait Islanders , Culturally and Linguistically Diverse (CALD ) and Lesbian, Gay, Bisexual, Transgender, Intersex, Queer/Questioning and Allied ( LGBTIQ)  communities in the Terms of Reference.

We are disappointed that the needs of these communities have not been explicitly addressed in the Terms of Reference despite the fact that, sadly, mental ill health and suicide continues to disproportionately impact these groups ” 

Federal Opposition Press Release see Part 2

The Commission will consult with Indigenous leaders including the National Mental Health Commission’s Professor Helen Milroy and Professor Ngiare Brown on their expertise.

Four million Australians deal with some form of chronic or episodic mental health condition. As well as the individuals affected and people close to them, poor mental health also affects businesses, the hospital system, emergency services and social services.”

Minister for Health, Greg Hunt said he has consulted with state and territory health and mental health ministers as well as the National Mental Health Commission to seek their views on the scope and terms of reference of the inquiry.

Part 1 The terms of reference will include:

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

To assist the Commission in undertaking this inquiry, Professor Harvey Whiteford has been appointed as an Associate Commissioner.

Professor Whiteford is a member of the National Mental Health Commission’s Advisory Board, Professor of Population Mental Health at the University of Queensland, and Professor of Global Health at the Institute of Health Metrics and Evaluation, University of Washington.

He brings extensive experience to the role, having worked on mental health policy with the World Health Organisation, World Bank, OECD and governments in Europe, Africa and Asia. Authorised by Greg Hunt MP, Liberal Party of Australia, Somerville, Victoria.

The two Commissioners overseeing the inquiry are Dr Stephen King and Julie Abramson.

Treasurer Josh Frydenberg said: “The inquiry will be able to make recommendations as to how the Government can better support Australians living with mental illness, to enable them to lead fulfilling and contributing lives.”

The Commission will take submissions and will hold public consultations, including in regional areas.

All interested parties, including carers and patients, are encouraged to participate.

The inquiry will begin immediately and is due to report to Government within 18 months.

Part 2 Federal Opposition press release

While Labor welcomes the release of the Terms of Reference for the Productivity Commission Inquiry into Mental Health, we reiterate the Abbott-Turnbull-Morrison Government should not use this Inquiry to delay action in progressing reform that is needed.

The Productivity Commission inquiry will be important to understanding the social and economic costs in relation to mental health. But sadly there have already been delays to getting the Inquiry underway. Questions remain about why this Inquiry is being initiated now, 18 months after former National Mental Health Commission chairman Professor Allan Fels called for it.

The Minister for Health promised the Inquiry would begin in October but delayed the release of the Terms of Reference until today.

Labor wrote to Minister Hunt and Treasurer Frydenberg seeking input into the Terms of Reference of this important Inquiry. We are pleased the Inquiry will have regard to previous work by the National Mental Health Commission and the Productivity Commission but are disappointed emphasis on prevention, early intervention and the need for data has not been explicitly mentioned.

Labor also hoped to see specific reference to the needs of young people, ATSI, CALD and LGBTIQ communities in the Terms of Reference. We are disappointed that the needs of these communities have not been explicitly addressed in the Terms of Reference despite the fact that, sadly, mental ill health and suicide continues to disproportionately impact these groups.

Too often the Abbott-Turnbull-Morrison Government has played catch-up in this vital area of policy, approaching mental health reform from a piecemeal perspective. Australians living with mental ill health cannot afford more delays. The Productivity Commission Inquiry represents a real opportunity for reform and should not be squandered by this government.

The Morrison Government should be leading the states and territories with reform to ensure the 4 million Australians living with mental ill health get the vital support and services they need. Labor will be closely monitoring the progress of this important Inquiry.

Part 3 Background

Productivity Commission’s inquiry into mental health website

This comprehensive inquiry will reveal the true impact of mental illness on the economy, and provide recommendations on how the Government can most effectively improve population mental health, and social and economic participation.

The Federal Government will spend an estimated $4.7 billion this year on mental health. Once state and territory government funding is added to this, the investment in mental health rises to around $9 billion per year – that is equivalent to $1 million per hour – every hour of every day.

Treasurer Josh Frydenberg said: “It is crucial that we know that this funding is delivering the best possible outcomes for individuals and their families, and that is one of the issues the inquiry will investigate.”

Minister for Health, Greg Hunt, said he has worked closely with the Prime Minister and Treasurer to finalise the terms of reference and establish the inquiry.

“Every year around four million Australians deal with some form of chronic or episodic mental health condition. Sadly, one in five Australians affected by mental illness do not seek help because of stigma,” Minister Hunt said.

“I have consulted with state and territory health and mental health ministers to seek their views on the scope and terms of reference of the inquiry and have welcomed their support.

“As we enter Mental Health Week it is important that we continue to shine a light on mental health and work hard to ensure we are providing the best possible support to Australians living with mental illness.”

The Productivity Commission will undertake broad consultation, including holding hearings in regional Australia and inviting public submissions. It will then make recommendations on measures to improve population mental health to help people lead full and productive lives.

The inquiry is due to begin later this month and the final report should be provided to the Government within 18 months.

The Morrison Government is committed to making a difference and has made mental health a key pillar in our Long Term Health Plan.

Our commitment is also reflected in our extra $338.1 million investment in suicide prevention, research, and programs for older Australians in this year’s Budget.

Update

Representatives from more than 60 mental health organisations will meet with politicians at Parliament House today, Tuesday 27 November, to ask three key questions ahead of the 2019 Federal Election and Productivity Commission Inquiry.

The Mental Health Australia Parliamentary Advocacy Day will see key Ministers, Senators and MPs including Minister for Families and Social Services, The Hon Paul Fletcher MP Minister for Health The Hon Greg Hunt MP, and Shadow Minister for Ageing and Mental Health The Hon Julie Collins MP, meet with over 100 sector delegates to discuss mental health reform.

Advocacy efforts will focus on ensuring policy makers recognise the value of investment in mental health, asking parties to articulate their policies ahead of the election, address gaps in the NDIS, and keep funding programs that work while the Productivity Commission Inquiry is underway.

Mental Health Australia CEO Frank Quinlan says the timing is right for the sector as a whole to ask politicians to commit to expanding and reorienting mental health reform.

“Firstly, we will be asking the major parties to prepare standalone mental health policies as part of their 2019 election platforms and we will assess these policies ahead of the election,” said Mr Quinlan.

“We are looking for major parties to articulate their plans for systematically increasing investment in mental health services and programs over the coming decade, along with plans to address the social determinants of mental health.”

“Secondly, we will be asking for urgent commitments to address the major gaps that are opening up in psychosocial support and community based mental health as the NDIS is rolled out, and as related programs are being wound back.

“As we know, nearly 800,000 Australians report experiencing serious mental illness each year. Estimates suggest some 300,000 would benefit from individualised supports. However, only 64,000 will receive supports through the NDIS.”

“The current investments in ‘continuity of support’, new psychosocial support measures, and state-based community mental health, are inadequate to meet this demand. This issue continues to require urgent attention from policy- makers.”

“Thirdly, rather than waiting for the Productivity Commission’s report in 18 months’ time, we will be asking for continued investment in programs and services that are supported by evidence.”

“The KPMG and Mental Health Australia Report ‘Investing to Save’ provides an excellent starting point for this investment, with well documented initiatives – supported by the very best international evidence – with enormous potential to provide substantial return on investment to governments and the community.”

https://mhaustralia.org/sites/default/files/images…

The 2018 Mental Health Australia Parliamentary Advocacy Day and Members Policy Forum will be held at Parliament House, Canberra TODAY Tuesday 27 November from 9:30am.

NACCHO Aboriginal #MentalHealth #Suicide : #DefyingTheEnemyWithin Powerful new book extract from @joewilliams_tew out 22 January – a promising career derailed by booze, drugs and mental health problems.

That afternoon, a guy I’d never seen before, who was partying with the group, approached me and asked if I needed anything to help me stay awake. That was the day I had my very first ecstasy tablet. Boom. I was instantaneously hooked.

Now I had a drinking and drug problem. But I didn’t for one second think I might have a mental-health problem.

I thought that someone who was mentally unwell was “weird” or not stable in society. I even believed that mentally ill people were criminals.

How wrong I turned out to be. “

This is an edited extract from Defying The Enemy Within by Joe Williams, published by ABC Books, in stores Monday

See 3 Pages from book below Part 2

Win a copy of the book by sending an email to media@naccho.org.au

Telling Joe in 50 words or less why you would like to read his book : Entries Close Wednesday 24 January : Winner Announced Thursday 25 January NACCHO Deadly Good News Post

‘Joe Williams has been into the darkest forest and brought back a story to shine a light for us all. He’s a leader for today and tomorrow.’Stan Grant

‘In telling his powerful story, Joe Williams is helping to dismantle the stigma associated with mental illness. His courage and resilience have inspired many, and this book will only add to the great work he’s doing.’Dr Timothy Sharp, The Happiness Institute

‘It is through his struggles that Joe Williams has found direction and purpose. Now Joe gives himself to others who walk the path he has.‘ – Linda Burney MP

Former NRL player, world boxing title holder and proud Wiradjuri First Nations man Joe Williams was always plagued by negative dialogue in his head, and the pressures of elite sport took their toll.

Joe eventually turned to drugs and alcohol to silence the dialogue, before attempting to take his own life in 2012. In the aftermath, determined to rebuild , Joe took up professional boxing and got clean.

Defying the Enemy Within is both Joe’s story and the steps he took to get well. Williams tells of his struggles with mental illness, later diagnosed as Bipolar Disorder, and the constant dialogue in his head telling him he worthless and should die. In addition to sharing his experiences, Joe shares his wellness plan – the ordinary steps that helped him achieve the extraordinary.

Joe Williams was guest speaker at NACCHO Conference Canberra : See full text from the Enemy Within  .

 

View Joe Williams Presentation from NACCHO Conference 2018

Read over 169 NACCHO Mental Health Articles published over past 6 years

Read over 119 NACCHO Suicide Prevention articles published over past 6 years

MOVING to Sydney to chase my dream in the NRL was a fantastic opportunity; spending my first two years in the big city under Arthur Beetson’s roof gave me a lifetime of memories and an experience I am truly grateful for.

But those years also provided me with some of the biggest and toughest life lessons I’ve learned.

During the 2002 pre-season, I got my first taste of mixing with the squad as a full-time player. I was expected to train with the team either on the field or in the weights room two or three times a day, five days a week.

It was essential to get to training on time but one day I was running late for a mid-morning session because I’d had to stay at Marcellin (College) a bit later than usual for school photos.

I raced to training, knowing I’d get in trouble from coach Ricky Stuart for being late. Sure enough, being the tough coach he was, Ricky started ripping into me.

When I told him I was late because I had my school photos, he and all the players burst out laughing. For the next few weeks, it became the running joke as an excuse for being late.

I learned so much during that off-season and impressed the coaching staff enough to be chosen in the top squad for the trial period.

Having just turned 18, it was amazing to play in two trial first grade NRL games at halfback inside Brad “Freddy” Fittler, one of the greatest five-eighths of all.

I didn’t make my NRL debut that year because the coaching staff wanted me to gain more experience playing in the Roosters’ under-20s Jersey Flegg side.

Looking back, although I felt like I was ready, I definitely needed the time and experience under my belt to become a more complete player and the sort of on-field leader a halfback needs to be

At the time, though, it was disappointing to go from playing with the first grade team one week to training with guys who were pretty much hoping to get a spot so they’d be contracted.

It was after I was put back to the under-20s that I first noticed the negative voices in my mind rearing their ugly head, telling me I didn’t deserve to be in Sydney given I wasn’t playing first grade and that I should just pack up and head back to the bush (Wagga) because I was worthless.

Back then, there wasn’t as much emphasis on the psychology of professional athletes and the pressures that came with playing elite sport.

There were days when training staff were almost like army drill sergeants. Sometimes they screamed at players and humiliated and even degraded players in front of other members of the team.

Occasionally, they would even bring the racial identity of a player into the abuse. It may be that they believed this was the way to make the players mentally stronger and that, if you weren’t mentally strong, you should just give up playing rugby league.

For me and many others, that approach of ridicule, embarrassment and tough love didn’t work.

In fact, it had the opposite impact of sending my self-esteem lower and lower.

But the negative thoughts were a different story altogether. They’d often spiral out of control, to the point where I felt like I was witnessing an argument taking place between two separate people; the negative Joe and positive Joe.

The head noise and voices affected my mental well-being so severely that it started to affect me physically.

Things grew worse, as the voices wreaked havoc on my ability to think. I started second-guessing every decision I made both on and off the field. The voices became so vivid and loud in my head, it was like I was hearing actual voices.

After a while, I became so anxious and down that I’d get to the point where I’d convinced myself I was worthless, a failure.

Even on the days I didn’t put a foot wrong on the footy field or won player of the match, I’d convince myself I would be dropped from the squad because of the negatives in my game.

I would be scared to go to training because I dreaded the coach saying I wouldn’t be in the team the following week.

The only way I knew how to combat these constant thoughts, turn down the voices and deaden the pain I felt, was to drink as much alcohol as I could.

Despite the negative voices and drinking, I managed to stay on track with my footy, even captaining the under-20s Roosters team. They were a great bunch of guys and good players and we ended up having a fantastic season and making it through to the Grand Final.

On the day of the Grand Final I kicked three goals, had two try assists and kicked the winning field goal. After our first grade team also won their grand final, we had one hell of a party that went on for a few days.

During the 2003 season, I was really battling emotionally, suffering from homesickness and looking for comfort at the bottom of a bottle. Instead of concentrating on playing well, I was busy worrying about what drinking and late-night partying the crew had planned after the game.

It all began to take its toll physically and mentally. At the same time, I found I was clashing with some of the coaching staff. I became desperate for a change. As a result, I decided to move to South Sydney Rabbitohs.

When I called my mother to tell her I’d signed with the Rabbitohs, she burst into tears of joy. Mum had been an avid Souths fan since she was a young girl and had dreamed that one day she’d get to see me run out in the famous red-and-green South Sydney colours.

I’d signed with Souths to show I was still keen to be an NRL player but the money wasn’t great so the pre-season was tough. As a result, I had to make a living like many league players did, working long hours labouring on a construction site. Afterwards, I’d go to football training then get some sleep and do it all over again.

To make matters worse, I broke my thumb in the opening trial game and had to have surgery on it, causing me to miss the first six weeks of the season.

I was no longer drinking so much or partying hard as I didn’t have much money. After a few weeks of putting a huge effort into training and committing myself both physically and mentally, I was picked in the reserve grade team. I began to play myself into form, stringing a few good games together and it was noticed by the coaching staff.

It wasn’t long before I was picked in the first grade team to make my NRL debut. Finally, the time had come to live out my childhood dream.

I didn’t sleep a wink the night before my first grade debut. On the way to Shark Park, I seemed to take every wrong turn and was late for the warm-up. To my surprise and happiness, though, the coach had organised for my dad to present me with my playing jersey.

I’d dreamed of this moment for most of my life and the fact I was playing for the mighty South Sydney Rabbitohs made things even sweeter.

People sometimes ask me what it was like playing my first NRL game. The funny thing is, I copped a knock to the head that gave me a mild concussion for the rest of the match.

I do remember that we lost but one thing that stood out for me was that my idol, close friend and mentor Dave Peachey was playing in his 200th NRL game. After the siren and when we were shaking hands, “The Peach” said to me: “Young brother, as my career is nearing its end, yours is just starting. Good luck”.

Joe Williams tells his story.

I had spent my entire life chasing the dream of becoming an NRL player. I now had the monkey off my back and it was time to get to work and live up to my potential.

Unfortunately, wins were few and far between for Souths in 2004.

My alcohol abuse was becoming rampant again, now I was earning more, and playing first grade had sent my ego to an all-time high, especially after I was named Rookie of the Year in 2004.

Things got even worse when I discovered party drugs during the 2004-2005 off-season. I enjoyed being the life of the party, laughing and joking, the centre of attention.

On Mad Monday, I celebrated by drinking so much alcohol I couldn’t stand up. That afternoon, a guy I’d never seen before, who was partying with the group, approached me and asked if I needed anything to help me stay awake. That was the day I had my very first ecstasy tablet. Boom. I was instantaneously hooked.

Now I had a drinking and drug problem. But I didn’t for one second think I might have a mental-health problem.

I thought that someone who was mentally unwell was “weird” or not stable in society. I even believed that mentally ill people were criminals.

How wrong I turned out to be.

NEED Help ? Contact your nearest ACCHO and see a Doctor or Mental Health Professional OR

 

NACCHO Aboriginal Health News: Better aim needed to hit bullseye in mental health

help  ” Young Aboriginal and Torres Strait Islander people take their own lives at a rate five times that of other Australians,”

“This is devastating Aboriginal communities and we must do everything in our power to try to save these young lives.

If we can train up young people and others in our communities to recognise and react to the warning signs in their peers, there is a good chance we can support those who are suffering before they reach the point of no return.

This is a good initiative which empowers communities to be part of the solution.’

Matthew Cooke NACCHO Chair Press Release May 2016

Understanding how many people in each community need hospital treatment for mental health conditions, helps to identify local areas that may require more ACCHO services and support.”

NACCHO Mental Health Articles 117 in total

NACCHO Suicide Prevention articles 87 in total

“Are people living in rural and remote Australia more likely to be hospitalised for mental health conditions than their city counterparts?

The report, Healthy Communities: Hospitalisations for mental health conditions and intentional self-harm in 2013-2014, recently released by the Australian Institute of Health and Welfare gives some insight into this issue.

The report looks at hospitalisations for five mental health conditions: schizophrenia and delusional disorders, anxiety and stress disorders, depressive episodes, bipolar and mood disorders and dementia as well as drug and alcohol use and intentional self-harm.”

The National Rural Health Alliance is Australia’s peak non-government organisation for rural and remote health. Its vision is good health and wellbeing in rural and remote Australia

The report, Healthy Communities: Hospitalisations for mental health conditions and intentional self-harm in 2013–14, looks at local-level variation in populations across Australia’s 31 Primary Health Network (PHN) areas and 330 smaller local areas.

Download the report aihw_hc_report_mental_health_september_2016

‘Overnight hospitalisations for mental health conditions varied across PHN areas, from 627 per 100,000 people in the ACT to 1,267 per 100,000 in North Coast NSW. Overall, regional PHN areas had higher rates of hospitalisations than city-based PHNs,’ said AIHW spokesperson Michael Frost.

The disparity between regional and metropolitan PHN areas was more pronounced for hospitalisations related to intentional self-harm.

‘Across all PHN areas, rates ranged from 83 per 100,000 people in Eastern Melbourne PHN area to 240 per 100,000 in Central Queensland, Wide Bay and Sunshine Coast – a three-fold variation,’ Mr Frost said.

The report also looks at hospitalisations for six sub-categories of mental health: drug and alcohol use, schizophrenia and delusional disorders, anxiety and stress disorders, depressive episodes, bipolar and mood disorders, and dementia. Hospitalisations for these sub-categories varied across PHN areas.

For the 330 smaller local areas, the report examined variation in overnight mental health hospitalisations within and across socioeconomic and remoteness areas. It found significant disparities – up to four-fold variation – when comparing similar local areas.

The report will be also available on the MyHealthyCommunities website (http://www.myhealthycommunities.gov.au).

The website is now managed by the AIHW, following the transfer of functions from the former National Health Performance Authority in June.

Updated information is also available on the website for a range of Medicare Benefits Schedule statistics in 2014–15, and life expectancy and potentially avoidable deaths’

This report focuses on the mental health of populations in small areas across Australia. It aims to assist Primary Health Networks and others in making informed decisions about resources required in providing effective primary mental health care.

The report finds:

  • In 2013–14 across the 31 Primary Health Network (PHN) areas that cover Australia, the age-standardised rate of mental health overnight hospitalisations was twice as high in some PHN areas compared to others. Across more than 300 smaller local areas called SA3s, the rates were almost six times higher in some local areas compared to others. Rates of hospitalisation include admissions to both public and private hospitals
  • The most common group of mental health conditions requiring hospitalisation was from drug and alcohol use (38,636 hospitalisations). These overnight admissions accounted for 299,829 bed days nationally. In 2013–14 the age-standardised rate of hospitalisations varied more than three-fold, from 87 admissions per 100,000 people (in North Western Melbourne PHN area) to 275 per 100,000 people (in Western Queensland PHN area)
  • The second most common group of mental health conditions requiring hospitalisation was schizophrenia and delusional disorders (36,562 hospitalisations). These overnight admissions accounted for 813,514 bed days nationally – the most bed days for any of the groups of conditions in the report. The age-standardised rate of hospitalisations varied more than two-fold, from 102 admissions per 100,000 people (in Australian Capital Territory PHN area) to 234 per 100,000 people (in North Coast NSW PHN area)
  • In 2013–14, there were 33,956 hospital admissions (including overnight and same-day) for intentional self-harm, which accounted for 184,332 bed days nationally. The age-standardised rate of hospitalisations for intentional self-harm varied from 83 per 100,000 people (in Eastern Melbourne PHN area) to 240 per 100,000 people (in Central Queensland, Wide Bay and Sunshine Coast PHN area).

Better aim needed to hit bullseye in mental health

Overall, overnight hospitalisation rates were 13 per cent higher in rural and remote areas (971 hospitalisations per 100 000 population) as compared to metropolitan areas (857 per 100 000 population).

While data indicates significant difference in the rates of hospitalisation in rural and remote Australia compared with major centres, it also reveals significant variation within regions – the rates of hospitalisation in some towns can be almost 8 times higher than for other towns of the same remoteness.

The NSW north coast had the lowest overall rate of overnight hospitalisations for health conditions. For drug and alcohol hospitalisations, western Queensland had the highest rates. Country South Australia had the highest hospitalisation rate for depressive episodes. Central Queensland/Sunshine Coast had the highest hospitalisation rate for intentional self-harm.

The very large variations in mental illness hospitalisation within cities, within rural Australia and within remote communities underlies the importance of targeting programs to specific towns and communities, rather than our current approach of treating all rural areas and all remote areas as if they have the same needs.

The variation in rates could be due to a number of factors including differences in the prevalence in mental illness, variable access to mental health services and programs or even differences in hospital admissions processes in rural and remote hospitals.

The National Rural Health Alliance is Australia’s peak non-government organisation for rural and remote health. Its vision is good health and wellbeing in rural and remote Australia.

The data will be invaluable to funders and health services in identifying and targeting areas of poor health to ensure that efforts and resources are targeted to the areas of greatest need.

The National Rural Health Alliance looks forward to working with the Rural Health Commissioner, when they are appointed, to address such poor health outcomes within rural and remote Australian communities.

If you or anyone you know needs help,

you can call Lifeline on 13 11 14.

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NACCHO Press Release: Mabo day highlights need for full constitutional recognition: peak Aboriginal health body

 

14-maboday

Constitutional recognition is so important because it is about recognition of Aboriginal heritage, our connection to country and our rights as Australia’s First Peoples.

“Racism, discrimination and a lack of respect and recognition have terrible and lasting impacts on Aboriginal and Torres Strait Islander people’s mental health and social wellbeing.”

National Aboriginal Community Controlled Health Organisation (NACCHO) Chair, Matthew Cooke

The peak Aboriginal health organisation today reaffirmed its support for the full and proper recognition of Aboriginal and Torres Strait Islander people in Australia’s Constitution as Mabo Day is celebrated across the country.

Mabo Day commemorates a landmark High Court decision that removed the idea of ‘terra nullius’ from Australian law, after a decade long campaign for a native title claim by a group of Torres Strait Islander people, led by Eddie Koiki Mabo.

Photo /painting :Eddie Koiki Mabo (c. 29 June 1936 – 23 January 1992) from the Torres Strait Islands known for his role in campaigning for Indigenous land rights and for his role in a landmark decision of the High Court of Australia which overturned the legal doctrine of terra nullius (“land belonging to nobody”) which characterised Australian law with regard to land and title

National Aboriginal Community Controlled Health Organisation (NACCHO) Chair, Matthew Cooke, said Mabo Day celebrates a big step towards reconciliation for Aboriginal people but also highlights how far we have to go and the need to remove all discrimination from the Australian Constitution.

“Twenty three years has passed since that historical decision which finally recognised that Aboriginal and Torres Strait Islanders had occupied this land for tens of thousands of years before white colonisation.

“We now need nothing less than full and proper recognition of Aboriginal and Torres Strait Islander people in Australia’s constitution and the removal of all traces of discrimination,” said Mr Cooke.

“Constitutional recognition is so important because it is about recognition of Aboriginal heritage, our connection to country and our rights as Australia’s First Peoples.

“Racism, discrimination and a lack of respect and recognition have terrible and lasting impacts on Aboriginal and Torres Strait Islander people’s mental health and social wellbeing.

“Constitutional recognition, like the Mabo decision and the national apology, would be another step in the right direction towards not just reconciliation but also in closing the gap in the health of Aboriginal and Torres Strait Islander people.

“However, efforts to achieve recognition need time and proper planning, including an extensive education and awareness campaign to ensure all Australians fully understand why recognition is so important.

“It is also critical that constitutional recognition does not prevent or make void any efforts by Aboriginal and Torres Strait Islander people to assert their rights as sovereign peoples or to pursue a treaty.

“The bipartisan support for recognition offers us a real opportunity for us to get this right and ensure the full and proper recognition of Aboriginal people in the Australian Constitution.”

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NACCHO Aboriginal Health: Estimated 400 suicides in our communities in last three years

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

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

For any strategy to be effective, local, community-led healthcare needs to be at its core.

But so far we have not heard from this Government on the future of The Aboriginal and Torres Strait Islander Mental Health and Suicide Prevention Advisory Group and the $17.8 million over four years in funding to reduce the incidence of suicidal and self-harming behaviour among Indigenous people.”

Justin Mohamed Chair NACCHO commenting on the crisis 

During the last three years of Aboriginal and Torres Strait Islander suicides are at nearly 400, no less than 380.

Research by Gerry Georgatos

Last year, I aggregated Australian Bureau of Statistics (ABS) hospital collated data on reported suicides of Aboriginal and Torres Strait Islander peoples – 996 suicides from 2001 to 2010. That is 1 in 24 of all deaths of Aboriginal and Torres Strait Islander people – by suicide.

READ previous NACCHO articles on suicide prevention here

NACCHO community support : Raising funds for Elders report into Preventing Self-harm & Indigenous suicide.

Update we reached out goal of $9,500

There is no ABS data available at time to determine whether the crisis has abated or got worse, but I have been record keeping reported suicides – whether through the media, community organisations or via other sources – for my own academic research on premature and unnatural deaths. I have found that from the beginning of 2011 to end 2013 there have been nearly 400 suicides – child, youth and adult – of Aboriginal and Torres Strait Islander peoples.

My own research estimates that the 996 suicides recorded between 2001 to 2010 are an under reporting of the actual numbers, and instead of 1 in 24 deaths by suicide, I have estimated that the rate of suicide was between 1 in 12 to 1 in 16. The 2001 to 2010 suicides average to 99.96 suicides per year. In reflection it was 99 custodial deaths alone over a ten year period in the 1980s that led to the Royal Commission into Aboriginal Deaths in Custody. How many suicides will it take before this nation’s most horrific tragedy is met head on with a Royal Commission?

My research compilations during the last three years of Aboriginal and Torres Strait Islander suicides are at nearly 400, no less than 380. Where there had been an average 99 deaths by suicide from 2001 to 2010, according to my research the annual average for 2011 to 2013 has tragically increased to approximately 130 suicides per annum.

Last year, on October 23, the Chair of the Prime Minister’s Indigenous Advisory Council (IAC), Warren Mundine read my journalism and some of the research published predominately in The National Indigenous Times and by The National Indigenous Radio Service and in The Stringer and Mr Mundine responded with a never-before-seen commitment by a high profile Government official to urgently do something about the out-of-control crisis

He added the crisis to the IAC’s mandate – and he time-limited it to six months so that the crisis would not languish. But three months have passed and we have not heard anything from the Council despite several requests to them for information on any potential progress.

At the time, Mr Mundine expressed his shock at the extent of the crisis.

“The figures sit before your eyes and the scale of it you sort of go ‘oh my god, what the hell is going on?’ I admit that I was probably one of the problems, because we seem to handle mental illness and suicide and shunt it away, we never dealt with it as a society, but we have to deal with it, confront it, because we are losing too many of our people, too many of our young ones… It is about us understanding this and challenging ourselves, and as I said I am just as bad as anyone else out there who put this away and did not want to deal with mental health and the suicide rates, so we have to get over that,” said Mr Mundine.

“We are looking at putting (the suicide crisis) on the table for our first meeting, and looking at over the next three and six months at what’s the advice we will be looking at giving to the Government and the Prime Minister to deal with this issue.”

“My personal opinion, and there is no science in this, this is just my observation, is our self-esteem and culture, I think, plays a major part in these areas.”

“It is a problem and I congratulate The National Indigenous Times for putting it on the front page. We need to really start focusing on this a lot better and I’m not talking about the people who are in there already doing it because they’re the champions. I’m talking about myself and the rest of Australia, we need to get our act together.”

Since October 23 there have been two score suicides.

Dumbartung Aboriginal Corporation CEO Robert Eggington said that in the last two weeks another spate of suicides has blighted both the south west and the north west of Western Australia.

“There have been suicides among our youth in recent weeks, another tragic spate. We met with the Premier last year and we are waiting for his promises to be kept to fund safe spaces and strategies for us to coordinate the helping of our people, but to date we have been kept waiting,” said Mr Eggington.

Chair of the Narrunga People, Tauto Sansbury said that he has been trying to arrange a meeting with Mr Mundine but despite three months of effort this has not occurred – Mr Mundine had promised to organise a meeting with Mr Sansbury following articles about the high rate of suicides among South Australia’s Aboriginal people.

“We have become used to broken promises by our State Government for a 24/7 crisis centre for our people and we hoped that Warren (Mundine) would represent the needs of our people, stand up for our most vulnerable, the at-risk, but to date he is yet to meet us let alone represent us,” said Mr Sansbury.

“Our young people and adults continue to fall victim to suicide.”

To the Northern Territory, where Aboriginal child suicides have increased by 500 per cent since the launching of the infamous “Intervention”, Arrente man and Bond University criminology student, Dennis Braun has reported the dark plight of one of the Territory’s communities – 33 deaths in five months. The community’s Elders have requested that the community is not publicly identified.

“The majority of the deceased were under 44 years of age. The youngest was a 13 year old who committed suicide a couple of days just before Christmas.”

“There should be an inquiry, but there is not despite 33 deaths. If this happened in an urban community like Sydney there’d be an outcry even after three or four deaths, with (residents and the wider community) wanting to know why it is happening and where to go for help.”

This publication has prioritised the suicide crisis for quite some time, sustaining the coverage, and the stories of loss, the grieving families, and we have effectively campaigned to Government to rise to the occasion. We do not apologise for this. On October 23, Mr Mundine and the Indigenous Advisory made a commitment that they must keep.

Links:

Warren Mundine including the suicide crisis to the IAC mandate

Government to address Aboriginal suicides

30 suicides in the last three months as we wait for promises to be kept

996 Aboriginal deaths by suicide – another shameful Australian record

Australia’s Aboriginal children – the world’s highest suicide rate

Whose child will be the next to die?

Suicide gap widening, says researcher

NACCHO Aboriginal Health reports:Sport and recreation programs help health in Aboriginal communities

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A paper released last week on the Closing the Gap Clearinghouse website examines the beneficial effects of participation in sports and recreation for supporting healthy Aboriginal and Torres Strait Islander communities.

The paper, Supporting healthy communities through sports and recreation programs, reviews over 30 studies, covering all geographic areas from inner city to remote regions, and age groups ranging from primary school to young adult.

DOWNLOAD THE REPORT HERE

It shows that there are many benefits to Aboriginal and Torres Strait Islander communities from participation in sport and recreational programs, including some improvements in school retention, attitudes towards learning, social and cognitive skills, physical and mental health and wellbeing; increased social inclusion and cohesion; increased validation of and connection to culture; and some evidence of crime reduction.

MAKE A DONATION TO THE NACCHO SPORTS HEALTHY FUTURES PROGRAM

OR VIA THE NACCHO APP

APPLY FOR FUNDING FROM THE NACCHO SPORTS HEALTHY FUTURES PROGRAM HERE

The paper shows that although the effects of sports and recreation programs can be powerful and transformative, these effects tend to be indirect and therefore hard to measure.

For example, programs to reduce juvenile antisocial behaviour largely work through diversion—these can provide alternative and safer opportunities for risk-taking, for maintenance of social status, and in building healthy relationships with elders.

Because of the lack of direct measures on the impact of sports and recreation programs on various outcomes for Indigenous Australians, this resource sheet focussed on some of the principles that can help ensure that the program is successful. These include:

  • Linking sports and recreation programs with other services and opportunities;
  • Promoting a program rather than a desired outcome;
  • Engaging the community in the planning and implementation of programs, as this will ensure that the program is culturally appropriate, and potentially sustainable.

What we know

• There is some evidence, in the form of critical descriptions of programs and systematic reviews, on the benefits to Aboriginal and Torres Strait Islander communities from participation in sport and recreational programs. These include some improvements in school retention, attitudes towards learning, social and cognitive skills, physical and mental health and wellbeing; increased social inclusion and cohesion; increased validation of and connection to culture; and crime reduction.

• Although the effects of sports and recreation programs can be powerful and transformative, these effects tend to be indirect. For example, using these programs to reduce juvenile antisocial behaviour largely work through diversion, providing alternative safe opportunities to risk taking, maintenance of social status, as well as opportunities to build healthy relationships with Elders and links with culture.

• Although Indigenous Australians have lower rates of participation in sport than non-Indigenous people, surveys suggest that around one-third of Indigenous people participate in some sporting activity (ABS 2010). That makes sports a potentially powerful vehicle for encouraging Indigenous communities to look at challenging personal and community issues.

• Within Indigenous communities, a strong component of sport and recreation is the link with traditional culture. Cultural activities such as hunting are generally more accepted as a form of sport and recreation than traditional dance. Therefore sport and recreation are integral in understanding ‘culture’ within Indigenous communities, as well as highlighting the culture within which sport and recreation operate.

What works

There are a range of benefits pertaining to participation in sports and recreation activities. In the absence of evaluation evidence, below is a list of principles of ‘what works’ and ‘what doesn’t work’ to assist with sport and recreation program implementation.

• Providing a quality program experience heightens engagement in the sports or recreational activity.

• Where no activity has been previously made available, offering some type of sport or recreation program to fill that void should be given priority over making selective decisions about which program to carry out.

• Linking sports and recreation programs with other services and opportunities (for example, health services or counselling; jobs or more relevant educational programs) improves the uptake of these allied services. This assists in developing links to other important programs for improving health and wellbeing outcomes, or behavioural change.

• For sporting programs, providing long-term sustained, regular contact between experienced sportspeople and participants allows time to consolidate new skills and benefits that flow from involvement in the program.

• Promoting a program rather than a desired outcome improves the uptake of activities—for example, a physical fitness program is more likely to be well used if promoted as games or sports rather than a get-fit campaign.

• Involving the community in the planning and implementation of programs promotes cultural appropriateness, engagement and sustainability.

• Keeping participants’ costs to a minimum ensures broad access to programs.

• Scheduling activities at appropriate times enhances engagement—for example, for young people, after school, weekends and during school holidays, when they are most likely to have large amounts of unsupervised free time.

• Facilitating successful and positive risk taking provides an alternative to inappropriate risks.

• Creating a safe place through sports or recreation activities, where trust has been built, allows for community members to work through challenges and potential community and personal change without fear of retribution or being stigmatised.

• Ensuring stable funding and staffing is crucial to developing sustainable programs.

NACCHO press release:NACCHO launches new Aboriginal Health in Aboriginal Hands App

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The chair of National Aboriginal Community Controlled health organisation (NACCHO) this week joined with the AFL Indigenous All Stars at its International rules training session in Melbourne to launch Australia’s first Aboriginal Health APP.

Pictured above: MICK O’Loughlin coach of the Indigenous All Stars and Sydney Swan legend promoting the NACCHO APP

Mr Mohamed said it was quite appropriate to publicly launch the NACCHO Aboriginal Health App in front of 25 of the fittest Aboriginal males in Australia, because the new APP compliments NACCHO’s  Investing in Healthy Futures for Generational Change plan 20130-2030 and  sports activity is a key element to Close the Gap.

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“Our APP promotes the sports healthy futures program that will give Aboriginal youth the opportunity to improve their overall health and wellbeing through active participation in sports.

Research shows that if a young person is happy and healthy they will be able to get the most out of their education, build their confidence and their self-belief and hopefully one day become a well-educated “Indigenous All-star” in the sport or employment of their choosing.” Mr. Mohamed said.

Mr. Mohamed said he is encouraging all  150 NACCHO members and stakeholders to promote the APP to their 5,000 staff and over 100,000 clients so that our community members can really have Aboriginal health in Aboriginal Hands. All ready in first few days over 1,000 Apps have been downloaded from the APP Store and Google Android store.

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Here are the URL links to the App – alternatively you can type NACCHO into both stores and they come up!

iPhone/iPad

ios.giveeasy.org/naccho

Android

android.giveeasy.org/naccho

“The NACCHO App contains a geo locator, which will help you find the nearest Aboriginal Community Controlled Health Organisation in your area and  provides heath information online and telephone on a wide range of topics and where you can go to get more information or assistance should you need urgent help “ Mr Mohamed said.

Location

Health help includes:

Ambulance, Alcohol, Babies Breast Cancer, Cancer, Children,  Depression, Diabetes, Domestic Violence, Drugs, eHealth, Eye Health, Gambling, Healthy Eating, Hearing, Male health, Medicare, Mental Health, Prostate cancer, Smoking , Suicide, Teenagers, Women’s Health.

The NACCHO App allows users  to share, connect or contact NACCHO through our social media platforms such as Twitter, Facebook, daily news alerts and the NACCHO website.

The App also allows people to donate to the NACCHO Sport Health Futures program. Through the NACCO App you can make secure credit card donations, have receipts delivered straight to your device and find out how your donation is making a difference to the lives of young and old Aboriginal Australians.

The Sport Health Futures program aims to distribute up to 1,000 AFL/NRL footballs, netballs, soccer balls, basketballs and other sports equipment to Aboriginal community organisations, sporting clubs and schools throughout Australia.

Mr Mohamed said he would encourage any NACCHO member, Aboriginal community, sports or school to complete this  online  application.

For the donated sports equipment the applicant must partner with a NACCHO member and organise for  team members to have a health checks at an Aboriginal Community Controlled Health Service or other medical service if applicable –

APPLY HERE

For media contact and further information contact Colin Cowell Mobile 0401 331 251 or Email

APP DETAILS

This App provides a quick and easy way

1. Find an Aboriginal Health Service

Aboriginal patients can now locate their nearest Aboriginal Community Controlled Health service throughout Australia.

2. Health Help online and Telephone

Need health help or information online or a telephone hotline number for;

Ambulance, Alcohol, Babies Breast Cancer, Cancer, Children,  Depression, Diabetes, Domestic Violence, Drugs, Ehealth, Eye Health, Gambling, Healthy Eating, Hearing, Male health, Medicare, Mental Health, Prostate cancer, Smoking , Suicide, Teenagers, Women’s Health.

3. NACCHO AFL Indigenous players

Our NACCHO Investing in Healthy Futures For Generational Change Plan 2013-2030 has just been released and by partnering in 2013 with the AFL we can promote and achieve our Close the Gap targets for our future generations.

NACCHO is a proud partner of the Indigenous All-Stars Team and all the current listed AFL indigenous players are listed on this APP.

4. Learn/Inform

How our NACCHO members are making a difference

5. Share, Connect or contact

With NACCHO through our social media platforms such as Twitter, FACEBOOK and Daily News Alerts and website

6. Invest/donate to healthy futures.

We are inviting all sport followers to help NACCHO “invest in healthy futures for generational change” by donating to our sports star future fund that aims to supply over 1000 footballs, netballs, soccer balls and basketballs to Aboriginal community clubs over the next 12 months.

NACCHO World Mental Health Day news :Abbott Government Commitment to Mental Health

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The Minister for Health, the Hon Peter Dutton, MP announced today the first Australian Government actions to progress mental health as a key priority area.

Marking World Mental Health Day, Mr Dutton said there was clearly a need for a comprehensive review of mental health services to ensure that they are delivered to those people most in need, and that funding is provided to those programmes that have proven to be most effective on the frontline.

SEE ALL NACCHO previous mental health stories here

SEE ALL NACCHO Social and emotional stories here

SEE ALL NACCHO suicide prevention stories here

“People with mental illness deserve the same standards of access and treatment as those with a physical illness and I have asked the National Mental Health Commission to do a thorough review of all existing services, state and federal and non-government, to assess how well and efficiently they are helping their clients,” Mr Dutton said.

“The Review aims to ensure services are being properly targeted, that services are not being duplicated and that programmes are not being unnecessarily burdened by red tape.

“As part of this process, we will seek to identify gaps in both mental health research and workforce development and training. We will also consider the particular challenges of providing services in rural, regional and remote Australia.”

Other areas of committed funding are:

  • Establishment of a National Centre for Excellence in Youth Mental Health.  At a cost of $18 million over four years, the new National Centre will be established by the Orygen Youth Health Research Centre in Victoria which will conduct  clinical trials on cutting edge treatments for young people and train a new generation of mental health workers.
  • Development of a comprehensive e-mental health platform. With funding of $5 million over three years  the Young and Well Cooperative Research Centre will develop a new, comprehensive e-mental health platform to make it easier for young people to access advice and support 24 hours a day.
  • headspace: Building on the investment in headspace youth mental health centres, the government will expand the number of sites around Australia to 100.
  • Dementia Research: The government confirms that it will provide a further $200 million over five years to Australian scientists and researchers working on ways to prevent or cure dementia, a brain disease that is expected to affect nearly one million Australians  by 2050,

Mr Dutton said in Australia there is a lot of evidence that people are not getting the mental health help they need, especially young people.

“More research is urgently needed to develop better ways of preventing and treating mental illness and the services provided must be guided by evidence of what works and what doesn’t.

“The Review by the Mental Health Commission is the first step in establishing how we should be funding mental health programmes into the future so that people can have better access to the treatments and services they need as they struggle with mental illness,” Mr Dutton said.

Media contact:  Kay McNiece, Minister Dutton’s Office, 0412 132585

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Are you interested in working in Aboriginal health?

NACCHO as the national authority in comprenhesive Aboriginal primary health care currently has a wide range of job opportunities in the pipeline.

Register your current or future interest with our HR TEAM HERE

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

Close The gap

Today is World Suicide Prevention Day.

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

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

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

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

Doing nothing won’t help. Doing something may

SUICIDE PREVENTION AUSTRALIA

NACCHO press release

READ previous NACCHO articles on suicide prevention here

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

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

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

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

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

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

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

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

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

Media contact: Colin Cowell 0401 331 251, 

NACCHO health alert – Gambling causing harm to Aboriginal children’s health-Menzies research

New Microsoft Publisher Document

Image above from Aboriginal Problem Gambling

A study by the Menzies School of Health Research has confirmed that gambling problems in remote Indigenous communities are associated with poorer health outcomes for children.

The study by Dr Matthew Stevens is the first of its kind to look at the association between reported gambling problems and Indigenous child health.

The study entitled, Gambling, housing conditions, community contexts and child health in remote Indigenous communities in Australia, analysed data from 10 Northern Territory communities collected as part of a larger housing and child health study.

 A range of information was collected from the primary care provider of children aged under seven years and from the ‘head’ of the house. This included data on housing conditions, community contexts, characteristics of the carer and the head of the house, household and carer reported gambling problems, and child health.

 Dr Stevens said the study revealed a direct correlation between levels of gambling in communities and carer report of illness experienced by Indigenous children in those same communities.

 “We found that where gambling problems were reported in households, there was a 50 per cent increase in carer report of ear infection, and for scabies, rates of reporting were nearly doubled in these houses,” he said.

“Across the 10 communities involved in the study the prevalence of reported gambling problems in houses ranged from 10 per cent to 75 per cent.

 Dr Stevens said the relationship between gambling problems and infectious disease could be a result of children being exposed to other gamblers who may be carriers.

 “If the house is a regular card gambling venue there would be a steady flow of visitors through the house who would be using household facilities such as the toilet, linen and towels, and if contagious, greatly increase the chances of transmission to children in the house,” he said.

 “This is very concerning because the immediate health problems identified in this research are in addition to the other impacts of gambling in communities, including a lack of money, child neglect when parents are gambling for long periods of time, and kids failing to attend school due to a lack of sleep resulting from noise associated with card games.”

 The study also investigated a range of community variables such as location and access to services, to see what made a difference to community rates of reported gambling problems.

 “I found that gambling problems were higher in communities where there were poorer housing conditions and where environmental health was poor, such as sewerage leaks and litter around the community,” Dr Stevens said.

“There is an identified need to develop and implement public health programs and initiatives to minimisethe harm associated with gambling in remote Indigenous communities. These approaches also need to link closely with other measures to improve community safety.

 “Interestingly, carer reported gambling problems were lower in communities where they had a permanent doctor and community facilities such as an aged care and women’s centre, dropping from 52 per cent to 25 per cent.”

 Future research is planned that hopes to shed light on the relationship between gambling problems and community services, and how these services could play a role in reducing harms associated with excessive gambling.

 Dr Stevens was conferred a Doctorate of Philosophy at Charles Darwin University’s recent mid-year graduation ceremony.

Dr Steven’s study is available here :