'Still Riding for Freedom' – An Aboriginal and Torres Strait Islander Human Rights Agenda for the Twenty First Century

Keynote Address - Mr Tom Calma, Aboriginal and Torres Strait Islander Social Justice Commissioner, Australian Human Rights Commission. Other Speakers - Dr Michael Spence, Vice-Chancellor and Principal, University of Sydney; Mr Neville Perkins OAM, Master of Ceremonies; Mr Charles Madden, Welcome to country.; Ms Janet Mooney, Director, Koori Centre; Paul Gray, Naomi May Cook and Alana Moffett, Prize winners, Dr Charles Perkins AO Annual Memorial Prizes

Effective strategies to strengthen the mental health and wellbeing of Aboriginal and Torres Strait Islander people

Introduction: The purpose of this paper is to draw on Aboriginal and Torres Strait Islander (Indigenous) perspectives, theoretical understandings, and available evidence to answer questions about what is required to effectively address Indigenous people’s mental health and social and emotional wellbeing. Social and emotional wellbeing is a multifaceted concept. Although the term is often used to describe issues of ‘mental health’ and ‘mental illness’, it has a broader scope in that Indigenous culture takes a holistic view of health. It recognises the importance of connection to land, culture, spirituality, ancestry, family and community, how these connections have been shaped across generations, and the processes by which they affect individual wellbeing. It is a whole-of-life view, and it includes the interdependent relationships between families, communities, land, sea and spirit and the cyclical concept of life–death–life. Importantly, these concepts and understandings of maintaining and restoring health and social and emotional wellbeing differ markedly to those in many non-Indigenous-specific (or mainstream) programs that tend to emphasise an individual’s behavioural and emotional strengths and ability to adapt and cope with the challenges of life. This paper explores the central question of ‘what are culturally appropriate mental health and social and emotional wellbeing programs and services for Indigenous people, and how are these best delivered?’. It identifies Indigenous perspectives of what is required for service provision and program delivery that align with Indigenous beliefs, values, needs and priorities. It explores the evidence and consensus around the principles of best practice in Indigenous mental health programs and services. It discusses these principles of best practice with examples of programs and research that show how these values and perspectives can be achieved in program design and delivery. This paper seeks to provide an evidence-based, theoretically coherent discussion of the factors that influence the effective development, implementation and outcomes of initiatives to address Indigenous mental health and wellbeing issues. It seeks to assess whether the current investment in Indigenous people’s mental health is aligned with available evidence on what works. To this end, the paper reviews Australian literature and government health, mental health and social and emotional wellbeing policies and programs. The scope of programs and their criteria for inclusion in this paper are informed by the Key Result Area 4, Social and Emotional Wellbeing objectives, within the National Strategic Framework for Aboriginal and Torres Strait Islander Health 2003–13: Australian Government Implementation Plan 2007–2013. This paper acknowledges the holistic nature of health, mental health and wellbeing, and the effects of Australia’s colonial history and legacy on the contemporary state of Indigenous social and emotional wellbeing. It recognises that there is a complex relationship between social and emotional wellbeing, harmful substance misuse, suicide, and a range of social and economic factors. Although this paper encompasses the broad priorities identified within the key Indigenous mental health policies and frameworks, it does not provide a detailed discussion of programs and resources that, although relevant here, are covered in a number of existing Closing the Gap Clearinghouse resource sheets and issues papers (see Appendix 1). These interweavings and overlaps are not surprising given the complexity and interconnectedness of the issues and determinants that are being addressed to strengthen Indigenous mental health and wellbeing

The context and causes of the suicide of Indigenous people in Australia

When comparing suicide in the Aboriginal and Torres Strait Islander (Indigenous) population to that in the non-Indigenous populations of Australia, there are significant differences in the rates of suicide and the age groups at risk of suicide. The etiology of these differences includes a history of colonisation and its aftermath including a burden of intergenerational trauma in the Indigenous population. It also includes contemporary disadvantage and discrimination. These not only impact on Indigenous family and community life but also on potential sources of social and emotional wellbeing and resilience that help protect Indigenous individuals against suicide. They also result in the greater exposure of Indigenous families and individuals to trauma, and other risk factors associated with suicide. Further, they underpin those families and individual’s lower access to culturally appropriate mental health and suicide prevention services and programs. Although there is a degree of commonality between the specific causes associated with the suicide of Indigenous and non-Indigenous individuals, the burden and the accumulation of underlying trauma, risk factors and specific causes in the case of Indigenous individuals results in higher rates of suicide. The increasing Indigenous suicide rate suggests that the overall current approach to Indigenous suicide prevention is not working. Innovative Indigenous community-led, strengths based approaches should be supported in the context of a different national approach. This includes, in addition to targeted responses to Indigenous individuals and population groups at risk of suicide, empowering communities to address their challenges, including those associated with suicide. It includes empowering communities to heal intergenerational trauma at the individual, family, community-level. It includes strengthening culture and sources of resilience to protect against suicide at the community level

Deadly news: the downward trend continues in Aboriginal and Torres Strait Islander smoking 2004-2019

Smoking is the leading contributor to the burden of disease among Aboriginal and Torres Strait Islander Australians, and one of the largest causes of preventable morbidity and mortality. Reducing exposure to tobacco provides substantial opportunity for improving the health outcomes of Aboriginal and Torres Strait Islander peoples and is reflected in the Framework Convention on Tobacco Control (FCTC). The FCTC acknowledges concern "about the high levels of smoking and other forms of tobacco consumption by indigenous peoples"(FCTC, Preamble). It is important to continue the focus on reducing tobacco use and promoting smoke-]free environments, consequently improving Aboriginal and Torres Strait Islander health outcomes

Building a sustainable national Indigenous representative body - issues for consideration

Issues of Indigenous disadvantage and dysfunction are before our eyes more frequently and more prominently than ever before. Barely a day goes by without another chilling and heartbreaking story of abuse, violence or neglect; or of demonstrations of the impact of entrenched poverty and despair among our communities. Without proper engagement with Aboriginal and Torres Strait Islander peoples, (Indigenous peoples) governments will struggle in their efforts to make lasting progress in improving the conditions of Indigenous people and in our communities. A National Indigenous Representative Body is a fundamental component of any future action if we are to achieve positive change. At present, there is not a transparent, rigorous process for engaging with Indigenous peoples in determining the policy settings and to hold governments accountable for their performance

Social justice and human rights: using Indigenous socioeconomic data in policy development

"The perspective that I intend to bring to this discussion is a human rights one. I want to reflect on the importance and utility of Indigenous socioeconomic data in contributing to improved enjoyment of human rights by Indigenous peoples in Australia."ANU Centre for Aboriginal Economic Policy Researc

Multiculturalism

This paper seeks not only to reiterate the support that HREOC has given to multiculturalism over the past two decades but also to reinvigorate multiculturalism as an important foundation for the growing cultural, linguistic and religious diversity of Australian society

Sustainable options for Australia's new national Indigenous representative body

This paper argues that a national Indigenous representative body has to be a fundamental component of the Indigenous policy landscape if we are to make lasting progress in improving the conditions of Indigenous people and our communities