Wingara Aboriginal Health Series: Seminar 3

Transcript of Taking a 'best of both worlds' approach to Aboriginal wellbeing.

Nathan Moran, CEO, Sydney Metropolitan Local Aboriginal Land Council: As the Land Council looks after this area, we in fact point out we border up with La Perouse in the east along the Eastern Distributor and the airport on the south side. We meet up with Gandangara at Stacey Street down at Georges River and we extend all the way beyond the Hawkesbury River so we in fact cover the traditional area of the Eora people those Gail groups but we extend right up to one a Wonnarua country and out to a Wiradjuri country.

For those who aren't aware we're the first Land Council of Australia established voluntarily in 1972 and if you get a chance, have a look at our website, you'll see what we call the 'Boot of Italy', our backyard, the area that we're prescribed to look after, charged with under the Land Rights Act of New South Wales to protect, preserve and promote the culture and heritage within that boundary. And to show you that diversity, from Cessnock Local Government Area to Bankstown in the southwest, right into the city of Sydney including North Sydney, Metro Land Council looks after that vast area. But also to point out our membership.

The history is we are the community who founded the first legal services, the first housing services, the first children's services, the first housing services again but to say to you that the history of land rights, the history of our movement, really comes back to the resistance shown by people like Mosquito and certainly on the other side, people like Colbee and Cora Gooseberry and their campaigning for dignity and rights. But then certainly culminating in 1925 where the first Coloured Association on earth was established in Surry Hills. Following that we had the Day of Mourning in 1938 where people converged from all over the Great Island of Australia to call for equality and equity, at that time being citizenship. Wearing placards calling for citizenship on the very day that Australia celebrates its colonisation known as Australia Day. A very proud moment in 1938 and that's the badge I'm wearing here today to show our old people without their exemption certificates that was required by law to stand on a street in them days. They stood proudly dressed in appropriate attire to call for equity, to call for rights and certainly our Land Council acknowledges from 1938 onwards, Redfern become the centerpiece for our Aboriginal rights movement. And it culminated in them services being established in the 70s and ourselves coming up in 1983 with the New South Wales Land Rights Act.

But to say to you all that the greatest and you know alignment of what you do in health and our community land and business plan as it's known today is the fact that health and wellbeing is our number one goal. To try and attribute the need for health and wellbeing of our members our community. Without health and wellbeing we know that our communities can't succeed, let alone stop surviving and start thriving. So it's very critical for us to see the right work you do, the role you perform and for us to work with you and support you in addressing appropriate health needs for our people.

And more importantly continuing the work that you do and getting a different understanding of health, that it's a holistic thing. It's not just about your health status as your heart rate improves or your blood pressure, but actually looking at your living conditions, your employment standards, your income levels, your longer term and your more broader health outcomes and I commend like the North Sydney Health District for the work it does, the Wingara Health Seminars for how they promote the need to address it because it's surely something we need to do.

If we're to overcome being the most disadvantaged human species on earth, it's the only way to do it is to get our health and wellbeing first then the wealth, the reciprocity and then hopefully the ability to thrive and not survive will come soon. So again thanks for having us here today. Apologies for Anne not being able to be here today. Apologies for boring you as an admin worker who usually heads up people to get here for you, but I hope you have a deadly day together and I look forward to seeing your work continuing and us getting the benefits in the future from that deadly work. Again thanks Leonie. Thanks to everyone here thank you.

Leona McGrath, Centre for Aboriginal Health: Thank you very much Nathan. So my name is Leona McGrath, he calls me Leonie. I have known Nathan for about twenty years and that's he's always called me Leonie so I've given up I think.

So I'm from the Centre for Aboriginal Health and we are proud to bring you the 3rd Wingara Aboriginal Health Summit, and we would like to welcome Professor Pat Dudgeon. Professor Dudgeon is from the Bardi people in the Kimberley region in Western Australia. She's a psychologist and fellow of the Australian Society. Pat is a Professor and Poche research fellow at the School of Indigenous Studies at the University of Western Sydney in Perth. Her area of research includes Indigenous social and emotional wellbeing and suicide prevention.

Among her many commitments, Pat is a former Commissioner of the Australian National Mental Health Commission completed a five-year term in July 2017, Deputy Chair of the Australian Indigenous Psychologists Association, chair of the National Aboriginal and Torres Strait Islander leaders mental health and co-chair of the ministerial Aboriginal and Torres Strait Islander mental health and suicide prevention advisory group and also a member of the NH and MRC Mental Health Research Committee.

Pat's current role is the Executive Director of the National Empowerment Project - an Indigenous suicide prevention project working with 11 sites in Aboriginal communities across the country. The Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project and the Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention.

Please welcome Professor Pat Dudgeon.

[Applause]

Professor Pat Dudgeon: Thank You Leona. Before I start I'd like to acknowledge the wonderful welcome to country. I was thinking he could go on and talk more so I'd like to acknowledge the Cameraygal people and Nathan who did the welcome to country on behalf of the Land Council and as I've been introduced I actually live and work in beautiful Nyoongar country in Perth but my mob from the Kimberley but I was born and grew up in Darwin and there's someone who grew up in the same street as me in the audience. Where are they? Yeah there. So it's a small world guys.

So I'd like to thank the New South Wales Centre for Aboriginal Health for having me here it's a real privilege to be here I'm on a number of different projects and I'm happy to share my learnings and journeys with everyone so today I'm going to speak about I've got I'm going to try and keep it short because I can rave on for a good half day he let me to all the entertain myself there but but what I'm gonna do is to I would like to speak for a little while then to get some discussion going because I might not be able to answer everything but I'm sure others can as well but as Leona said earlier my interest is social emotional well-being and policy change of accepts what's needed.

I was one of the first indigenous psychologists to graduate. Lucky I didn't know it when I was studying or also I probably would have freaked out and frozen. But there's a lot of change that needed to be done and things have moved, so I mean this is back in the old days. The reason I went left down to study psych and went to Perth was because there wasn't a university in Darwin at the time, so we talkin back in the ice ages there guys. But in any case things have changed a lot you know when I was studying everything was so very mainstream and very rigid and very Western and to listen to Nathan talked about the unsung history now that's starting to come out and our heroes mainly Aboriginal but non-Aboriginal people too, so there's a whole history.

I used to think Australian history was boring but it isn't, it's just that we never got to hear their the stories or our own histories and particularly us as Aboriginal people. So without further ado and enough rabbiting on now. I'm during my presentation. I want to talk a little bit about the social emotional well-being strategic framework now that represents a lot to us Indigenous people in the mental health and social emotional well-being area, so I'll talk a little bit about that then I'm going to share with you the story of the wonderful Aboriginal Torres Strait Islander Suicide Prevention Evaluation Project, which has changed things considerably. And how Indigenous suicide, which is not good folks, is being viewed, at least where we've gathered evidence and consulted with the community across Australia to present information and that's actually part of the government policy. So as with the Gayaa Dhuwi declaration - which we were I'm no longer chair of the National Aboriginal Torres Strait Islander Leaders in Mental Health, Tom Brideson of New South Wales is now the chair of that - but an important piece of work we did was the Gayaa Dhuwi Declaration, which I'll be giving Leona and she'll stick it up in the Centre for Aboriginal Health, so do read it. That's part of the fifth mental health plan so we're really pleased about that the Gayaa Dhuwi.

So policy change is needed and we make no apologies for that. I was going to share about the Aboriginal Torres Strait Islander Suicide Prevention Evaluation Project, then talk a little bit about the Center for Best Practice, which I'm now working in and to tell you all about our really fabulous forthcoming indigenous suicide prevention conferences that are happening in Perth in November. Come you guys, make sure you all come. It's gonna be fabulous.

So I'll rabbit on about it a bit more but I do want to also have a bit of interaction going so you get your specific questions asked maybe not answered but certainly asked so I'll just move on a lot of our the work I do certainly. And the work that's important for indigenous people started with the ways forward report and what. I was actually there. I was a part of that. So I gave evidence at the verdict on inquiry which was a big inquiry about mental health in general in Australia, but they had a deadly chapter on indigenous mental health. But the ways forward report was another led by Pat Swan and Beverley Raphael and that's sort of our Bible and that was translated into the the first national strategic framework for Aboriginal peoples' mental health and social emotional well-being. That framework was renewed last year and launched last year, so it's survived and it's again very important for us.

So what I'd like to do is just go through some of the guiding principles in it. It's basically, it was intended to respond to the high incidence of social emotional well-being problems and mental ill-health by providing a framework for national action. The main thing though is the framework recognizes the strengths, resilience and diversity of Aboriginal Torres Strait Islander communities, acknowledges that Aboriginal Torres Strait Islander peoples have different cultures and histories, and in varying instances different needs as well. And they must be acknowledged and they need to be addressed by locally-developed, specific strategies. Because it's easy for us say you know it's Aboriginal it should apply to everyone - some universal things do - but when you're working with Aboriginal communities, and that goes for me too, are speaking to to the group earlier and just some Aboriginal doesn't mean I get an automatic magic person you know not to work properly with the communities. And if we are going to change all those terrible stats around, we do have to try different things and I don't think I've actually put them in this presentation but you can go to the overcoming indigenous disadvantage reports and it shows that pretty well on every health indicator and social indicator, Indigenous Australians do very badly. But this is where my focus is.

So basically, the guiding principles say that Aboriginal Torres Strait Islander health has to be viewed in a holistic context that encompasses mental health and physical health, cultural and spiritual health. and in it land is central to well-being. Crucially, it must be understood that if the harmony of all these interrelations is disrupted, well our ill health and mental health will persist. Self-determination. I was excited when I went into the Centre for Aboriginal Health that they'd had an Indigenous Health Summit recently, and in it some of the very artistic, I thought, outcomes of the summit had been written up and self-determination was one of the headlines. So self-determination. We're not the only ones who are saying it, we won't be the first and won't be the last, and the international research shows that.

So you know we've based a lot of our work and suicide prevention on the work of Professor Michael Chandler from Canada and they went and talked they went and did this big research into First Nation communities, or tribes they call them, and they found that that when they desegregated all the stats on suicide, they were up there. They were pretty bad when they desegregated all the statistics. What happened is they did it by tribe by tribe, some tribes had no or little suicide, but some tribes went right off the graph, so it was a sawtooth effect that was showing. So I would have personally gone into the communities that had higher suicide rates and yes it would have just you know panicked me but and I would have tried to help but they actually were intelligent and so they went to the communities had that had no little suicide and try to find out what was happening in those communities that made the rates turn out the way they were. And they came up with this theory, and they probably did a lot of statistical you know who hocus pocus things and you know multiple analysis and intervals and whatever, but anyway they came up with that a theory of cultural continuity. And basically, broken down, there were all eight different markers, but broken down it meant that if a community had a lot of instances of good strong self-determination and they were doing cultural reclamation, they were the things that counted. So all those things are positive, are correlated positively to arm low suicide. And when we read that, we were like, yeah, hey, we knew it. We've been saying that, but without their evidence for years. And so we've actually brought Professor Chandler over to Australia, on a number of occasions and got him to speak to the government. Because sometimes when you view the problems of an indigenous group that aren't your own, in your own backyard, it's easier to think about it. So, so that was good but we do have the evidence for that and there's many others to which I'll point you in the same direction.

So again, the message is self-determination is central to the provision of Aboriginal Torres Strait Islander health and mental health services. Culturally valid understandings must shape the provision of services, guide the assessment, care and management of Aboriginal Torres Strait Islander peoples health problems generally, but in particular mental health problems. And it must be acknowledged or recognised that the experience of trauma loss presents and European invasions are a direct outcome to the disruption of well-being and trauma and loss of that magnitude. Because to anticipate some questions, I've had a lot of conversations with Indigenous psychiatrists, there are some out there and they say that a lot of the indigenous clients get misdiagnosed because they're in, they've got post-traumatic stress and and conditions like that, when it's being seen as a mental ill-health they're being diagnosed differently. So we are, as a group, in recovery of colonisation. And it's not just this airy ferry thing, that sort of, you know, they were quite powerful actions that took place. The stolen gen being one of them in recent times, removal of people from their countries.Just now, Nathan talking to us about a history of this area here that until recently that wasn't told. So all those things do impact on the the health and mental health of a group of people and they are intergenerational.

The other principle is that the human rights of Aboriginal Torres Strait Islander peoples must be recognised and respected. Failure to respect these human rights can constitute a continuous disruption to mental health. And human rights relevant to mental illness must be specifically addressed, rightly so too. When I was with the Mental Health Commission, the consumer movement came about and, well, it was probably there all the time, but I didn't see it clearly before. But I think that's an amazing and good thing that's happening in our society. That it is time for people who are the clients or the end user of any service to have a say on what's happening and how it should be done. But one thing that the consumers said was that they, their motto was nothing about us without us. And I thought, they've stolen our saying. But the saying, you know, you don't, go and engage with the group and we don't know though when we're planning the next national and international suicide prevention conference and we've got youth leading the youth stream, Indigenous LGBTIQ leading the LGBTIQ stream, lived experience experts leading the lived experience stream and it's hard. It'd be nice if I just sat them there and came up with it, all but we know it is important for if it's about that group of people, and even in our own indigenous group, you need to break it down and make sure that the right people are represented and they have the say on what's happening.

So another guiding principle is racism. Stigma, environmental adversity and social disadvantage constitute ongoing stresses and have negative impacts on Aboriginal Torres Strait Islander and mental health and well-being. The seventh principle is that the centrality of Aboriginal Torres Strait Islander family and kinship must be recognised. As well as the broader concepts of families, the bonds of reciprocal affection, responsibility and sharing. And I think that came home to us, particularly when we had done a research project with a local community group. It was a mainstream organisation, but they were really trying to and successfully to be culturally competent and we were you know doing a lot of interviews with them looking at what they could do as an organisation. And we interviewed some of the staff about their engagement of with Aboriginal clients and they said for them the two big things that stood out was that firstly, family - the strength of family. Sometimes a client would like to see the council alone, but sometimes or usually they'd bring their entire family in and any solution needed to consider the family. Not your nuclear family, we're talking about extended family. So that needs to be recognised. I'm going off too much you're gonna have to be my timekeeper.

The eighth principle is that there's no single Aboriginal Torres Strait Islander cultural group but numerous groupings, languages, kinships, tribes, as well as different ways of living. Some people might live in urban, remote or rural settings in an urbanised or traditional or moving between these. So Aboriginality is a very diverse thing.

The ninth and last principle is that it must be recognised that Aboriginal Torres Strait Islander peoples have great strengths creativity, endurance and a deep understanding of the relationships between human beings and their environment. Torres Strait Islander people have different cultures in history and in some instances will have different needs. Nevertheless, both groups are affected by the programs that face them as Indigenous peoples of Australia and the differences must be acknowledged.

So most of you probably are aware of the renewed SU framework, as we call it. And sure it is on the internet, I'll be leaving these two copies here. It was launched last year and why we're particularly in heart and bite is that when they when it went through renewal, a big consultancy happened. So it went all across the country and all the communities were invited to to talk about what social emotional well-being was, to have input into this document. And the nine guiding principles didn't change. They all want that to stay as is so. It is there, do read it, the latest strategy. It's very informative and I think it gives a good insight and it has been properly consulted.

The indigenous, as the Australian Indigenous Psychologists Association took information from the strategy and we came up with what we model of indigenous selfhood. So self to us, and this was part of the national consultation that went out and we were happy for the government to take our model out, but what we wanted was the feedback from those consultations, and we adjusted our, our model accordingly. But a lot of Western psychological models or theories of person, you know, who an individual is and usually it is individual, doesn't include the things that are important for in an Aboriginal person. So for us and we had pull this out of the social emotional well-being framework, a person is, these are the other dimensions of themselves that are important to and that is that we all have a connection to body, we all live in physical bodies that need looking after and so on. We all have a connection to our mind and emotions, and that's where mental health would be situated but for Aboriginal people. The connection to families and kinship is also very important thing. The connect, and then there's a connection to community, to culture, to country, to spiritual ancestors.

And that all that doesn't stand in isolation. That's all been impacted on by history of colonisation and social determinants. You know, interestingly, I heard Nathan refer to you know health isn't just about physical. It's about a whole lot of things and what would we call social determinants, so they play a part in it as well. And we say there's also political determinants and historical determinants. I will leave where you can get, we've written this brilliant chapter may I say, about social emotional well-being and how that figures and the SU framework also addresses how those different dimensions are activated and they're not like these separate little pizza slices. As we've you know happily put it up there guys, it's actually that all criss cross over so and different dimensions might be important for people at different times of their life and their development. So we're still unpacking the model, but most of the people who had consulted about the SU framework thought it was pretty good, so we feel confident that that we're trying to capture our culturally appropriate thinking and paradigm about what indigenous self hood and other self hood would be like. One of the indigenous psyches actually does workshops using that model with non-indigenous people because he says that we've all got those connections to our lesser or greater extent so so it belongs to all of us.

Okay leading on, when I met the person who who knew me when I was growing up in Darwin and she remembered myself and my brother and then we talked about, apparently there is a page with people who have taken their lives on it. For us Indigenous people, there's not many of us, because don't forget our families aren't just nuclear, they're extended as well. I'd say right now that there's not one family who hasn't experienced suicide, so that's a reality for many of us. Not us on our own either. I talk to married people from New Zealand, Canadians from Canada and I'm sure I haven't talked to many, but Native American people from the USA. So far we're starting to do a bit of research looking at that something's happening for indigenous people, particularly in settler countries, where there's been that history of a dominant culture. So our suicide rates are twice that of that other population and I think, I don't know, we're still getting the stats on the other global countries, but it is very similar.

For me, I probably really avoided suicide prevention and other more challenging parts of psychology until it came to my front door. so that's when I got stuck into it then, because I was angry that had happened and this wasn't the first one, a lot of the other people in my extended family had taken their own lives. It never happened in my childhood, this is recent, this is very recent, this high level of indigenous suicide and children you know 10 years old taking their lives. And we've got to find out what's going on and start stopping it, guys.

So we were commissioned by the PMC, the Commonwealth Government, to investigate and find out you know which programs would be good to fund or which are the best practice programs for Indigenous suicide prevention. And we did this huge project that went for for a couple of years in actual fact because we insisted on doing a community consultation, even though we were apprehensive, because you know one of the other things Aboriginal people say is we get researched and consulted to death, and then nothing ever changes, and which is fair enough. So we were thinking, oh we've got to go out there and talk to people and which we did end up having these big round tables across the country. And we did it very apologetically and also with the understanding that we would do our darndest to change things then. Because people do, Aboriginal people always being consulted and nothing ever changes, it is true. So with that in mind, we have, I hope, things have changed, anyway but we did it our the main organisation that was involved in the project was the University of Western Australia but also the Telethon Kids Institute and the Healing Foundation. So we had a number of different parties.

But just to a quick thumbnail sketch of it all. We know that over the last 30 years Aboriginal suicide has increased dramatically and it's the leading cause of death and for some of our age groups and I think you know they say a picture tells a a picture's better than a thousand words or whatever they say tells a story better than a thousand words and I think that graph is good for that when you can see that the bottom line is the non-indigenous right across different ages and the red top line is the indigenous suicide rate. So I think that's telling and it hasn't changed in over time neither and people well because we were doing a lot of media when we were doing our project and and the big question was why, why, why, are Aboriginal people taking their own lives? I mean I don't know, I think that every life is important and different whether they're an Aboriginal and non-Aboriginal, so I think sometimes we get caught up in the whole stats and what not when you know, if people choose not to be there for some reason, that's important in its own right. And one of my angers when that was happening for my family, was that my people were turned into statistics, so I think we should never forget that these are human beings who are losing. And maybe we should be changing society so we can make it better, so people choose not to leave.

But in any case, for Aboriginal people it's a whole, I think, it's complex for any human being. It's complex but particularly for Aboriginal Torres Strait Islander people because we do have that, dare I say, history of colonisation. And I've said that publicly and people say, oh my god, stop trying the red, black and yellow but folks that's just how it is. We have a history of colonisation that contributes towards it. There's ongoing exposure to socio-economic disadvantage and multiple psychological stressors. And we've got all. it's all written down. The people who are listening in feeds. these are all on the internet. so I'll leave all the websites, but I will leave a couple of reports here. Please come and go out and lend them and download your own copy off the internet.

But there's grief from premature deaths of family, community members and friends and and that includes from suicide. As well, a common thing that said out there is that people say we don't get a chance. In the old days, you know, you'd have a loss and you'd have time to grieve that in the community, to come together. Sometimes there's no recovery time. You know, just a lot of deaths are happening, not only from suicide but early and and you know unexpected or, or deaths. And peers and communities do not have a chance to recover. There's violence and interpersonal conflict that contributes to our suicide rates, intergenerational trauma, grief and loss, the effects of forced removal of children and mistreatment. We know the stolen gens, if you look at their statistics, they're particularly vulnerable to a whole range of things including suicide. So whether we like it or not, that intergenerational trauma and and the effects of being removed as children, still is coming out into our into our societies and families.

Pervasive racism and discrimination at individual, institutionalised, institutional and system levels. There's a loss of sense and purpose and meaning in life. Poor health, including a number of comorbidities and severely compromised mental health and social and emotional well-being and importantly an access gap to mental health services. So 35% of Aboriginal people who reported very high or high rates of psychological distress also experienced problems accessing health services. So there's also problems with accessing health services early. There's actually a summit happening soon and I think it is in Sydney about people in emergency departments with mental health issues, so we're ensuring there's some Aboriginal mental health professionals going there because we know that our people turn up mainly in the emergency department with mental health issues, but they're not going and seeing counsellors and whatnot earlier on. And there's quite a marked difference, so maybe we need to have more community counseling services and what not available.

In any case our outcomes of the Aboriginal Torres Strait Islander Suicide Prevention Evaluation Project, our key outcomes was a tool to assist funders to assess applications regarding indigenous suicide prevention programs. A culturally appropriate tool for communities themselves to assess suicide prevention programs suit their needs and evaluation framework to evaluate indigenous suicide prevention activity. We did 12 national roundtables - six of these were regional and then six were on topical issues. And like we did a big LGBTIQ workshop, Indigenous LGBTIQ, where LGBTIQ people ran the workshop and were the participants, I know it sounds weird guys, but I actually went to an Aboriginal youth forum and there were no Aboriginal youth there, so when we had an Aboriginal youth round table, it was the Aboriginal youth. So I'm again, you know, we don't want experts speaking on behalf, we need to get the people there themselves.

We had a number of discussion papers, we had a number of fact sheets, our website still there, so please have a squiz. We had a final report with 17 recommendations and that has become part of policy and picked up very strongly by the PHN's and what not. And we had the first ever, I was shocked, the first ever national Aboriginal Torres Strait Islander suicide prevention conference. I was shocked to find out that was the first one in 2016. and it was great it was fantastic so we did it in a way because I used to preach at the Australian psyche society and Suicide Prevention Australia saying You know, the way you guys do your conferences it's like you know it excludes a lot of Aboriginal people in it. You have to get your abstract in really early and then you pay a lot of money to come to your conference and you alienated. So why would the community want to come you know I barely can drag myself there in workplace before, but anyway. So I used to preach at them a lot and then when we had the conference I thought I better start walking my talk now so we did we spent all our money on community bursaries we ensured that Aboriginal people and speakers led all the discussions. It wasn't exclusive, we had mixed groups of presenters, but we had you know I think 12 indigenous counselors available at at all times and they were psychologists and mental health professionals. We had art therapy workshops all going, we had the Ngangkere healers, who are the traditional healers and we were lucky because we were in Alice Springs so they were out in the lobby and if anyone wanted to come and get a bit of cultural healing the Ngangkere's would take them off. So it was really fabulous. It was very strength-based. It was all our entertainers - Aboriginal - we had Stephen Oliver there from Blak Comedy, he's going to be coming to Perth for our conference as well so it was absolutely fabulous. And just having all the you know I felt very humbled because I know that some of the people who came and we were we are offered bursaries particularly to people who had lived experience, who had lost people to suicide and I know some of the community mob who came that might have been the first time that they had actually come to a gathering like this, stayed in a hotel with like-minded people, and it was safe for them to be then grieved together. So for me that was I know that the people who came to the conference for us that was like a very unique experience. Yeah, I'm thinking I don't know if we can repeat that, but we'll certainly try and have it as culturally appropriate as possible but we're doing two days national and then two days international, so the first day of the international will be a whole lot of cultural ceremonies with Nyoongar elders welcoming in other elders and then you know there are other indigenous people from other countries. So it's going to be yeah, very exciting.

The overall messages from the project were that community control empowerment was community control empowerment. So projects really need to be grounded in the community, owned by the community, based on community needs and accountable to the community. And it doesn't matter where it is whether it's it's a universal suicide prevention project or whether it's actually in I don't know mental health services. So there's room for community ownership and and engagement. That holistic, it should be based on Aboriginal Torres Strait Islander definitions of health that is sustainable. So it should be strength-based, capacity building and they should be funded. Enough of this one-off one-off, we never get a chance for our communities to establish programs and start to get the runs on the board and then get the evidence. You know, the money gets hosed on and then it gets hosed off because some Minister wants to fund another project or government department, I don't know.

So I think what we need to do is to allow projects to to have a bit of a long lifespan so they can start getting the evidence together. Partnerships that, projects need to work in genuine partnerships with local Aboriginal and Torres Strait Islander stakeholders and other providers to support and enhance existing local measures, not duplicate or compete with them. I get to hear this all the time and when Aboriginal community go to me to discuss projects they call, oh okay I'll stop my see, i got sidetracked. I'm getting signals and I did want a discussion anyway.

We have to work and that includes us. I can't just style up into the community and you know and not do a proper consultation process and we do so we yeah we just wouldn't be successful if we didn't do the right thing okay from the from the Aboriginal Torres Strait Islander Suicide Prevention Evaluation Project because I thought all we're going to provide this report and it might get shelved and gather dust like a lot of our good other good indigenous reports but it has been taken up by the government. It's part of the fifth mental health plan and so on, but we all say we're funded by the Department of Health, is one of the leadership suicide prevention programs with a whole lot of other players and our main job is to service the PHN's but we consider we do that plus more. So our part we've got a consortium again and it's us who are leading it but Telethon Kids Institute, the Healing Foundation, Health Infomap because we're putting up clearing houses and Menzies School of Health Research and basically in a nutshell I'm going to speed this on and see if there's any I'm not going to go through our principles, I'm gonna leave my powerpoint here and you guys can look at it but basically what we're doing is setting up a big clearing house where we'll be seeking the best practice programs and services. So if there's any and New South Wales that you guys know of please come and see us, we've actually got a template that people have to go through because not all of the world might be best practice for various reasons, but we also will be doing a clearinghouse on best practice research so all the interesting research so people can go there are communities PHN's chance or government departments can go to a central place knowing it's been vetted by Indigenous eyes as well.

So we do have absolutely fabulous expert reference groups for each of these functions and we'll probably have a clearinghouse of best practice Indigenous governance, because with the Black Dog Institute we've developed a big indigenous governance framework and we'll be doing eight national workshops and that's all about how to work with communities how to work with co design and so on so. I know it'll be cut a long time coming but I think there is a, I sense there's a willingness for change and trying different innovative ways and we just have to start giving people the means of doing that and good examples that it can work so I think that's important to it and for us it's a challenge you know we as I said we have to do exactly the same thing there is no exemption you know if we go into a community we have to go through a lot of protocols and sure community ownership and so on and it is a challenge and it's hard but we all have to do it if we are to change things around and I do it for you know it goes for any group to the consumer our movement motto, nothing about us without us. So that breaks down to subgroups as well.

Just quickly some of our principles that are informing our work is that we're very concerned with so from that Aboriginal Torres Strait Islander Suicide Prevention Evaluation Project work we did we are - our Center is concerned with self-determination and community governance reconnection and community life restoration and community resilience, so we take a certain critical perspective on suicide prevention and that's where we come from. We will also include clinical factors, we'll have a clinical factors clearinghouse as well, but it needs to be based from those philosophical understandings. These are more from the Aboriginal Torres Strait Islander Suicide Prevention Evaluation Project and the research we've done to date but there's some good resources around if you want to. There's a good overall resource I'm working together, a book and that goes through everything mental health and we've got all the big stars in there Aboriginal and non-Aboriginal, such as Steve Zooreckon and all the rest how on. Helen Milroy is a co-editor. She's our first indigenous psychiatrists so that's a pretty good book and that's been very useful. It was sponsored by the government, so it's free everyone. So it's a gift from the government to all of you to the Commonwealth government to all of you. So I think Telethon we're the ones who've got some so we're happy to send a box to you guys if you want some and I was gonna bring some but they're heavy as they're really thick.

Just a bit of work what we've been doing in our state was is working with the AMS's to start looking at social emotional well-being services that are offered and we're doing a bit of work with AMS's and aqua our state ims affiliate to to look at what's out there and what's existing, where are the gaps and what we might need to do to fill that. So this is from the working together book but it's good to see some of these things are not just theories, they're realities that we're trying, attempting to meet together with Aboriginal community and the brilliant starting to come to our close the conference, which I spoke about is you can see there's some very handsome and good-looking people presenting their, being Helen Milroy, Tom Calmar, Stephen Oliver. So do consider coming if you know I think our community bursaries close next week, so if you know community mob who want to come tell them to get a bursary in. But so if we don't get many from New South Wales or Victoria, we get a lot of WA because we tell them and Queensland as strangely and nothing better from Northern Territory, so spread the word folks and come yourselves so um it's gonna be pretty good. I'm sure it'll be as exciting as Alice Springs, different but exciting.

I think that's it then. Oh there we are be here for the Gayaa Dhuwi, which we're very proud of. It's part of the fifth mental health plan, so part of the government will require people to implement this so that's going to be good. And some of the 8th national workshops that we do is not only the Indigenous governance framework but it'll be the Gayaa Dhuwi declaration as well, so it's part of the fifth mental health plan and happily or you'll be happy to know everyone that will be required to implement it but there'll be good people like Tom Brideson and NATSIMAL and the Center for Best Practice that will help PHN's and government departments do that. But if you want to have a look at it there's been papers written with, written papers about it in refereed journals but it will be posted up in the Centre for Aboriginal Health if you want to have a look. You can Google it as well. Basically it's about taking and that's the topic of my seminar was taking the best of both worlds and and creating our service that's culturally appropriate and good for Indigenous people and probably non-Indigenous people as well. And I better close there and if we've got time for a question to be good, but if we haven't, maybe I'll come back another day.

[Applause]

Current as at: Monday 30 September 2019
Contact page owner: Centre for Aboriginal Health